“C-section at OR 3,” said the clerk at the neonatal ICU (NICU). We then sped to the prep area to enter the OR as soon as we could.
Once geared up, we entered the OR and waited for the new addition to the NICU family. Mom had no prenatal care, but we knew she had used multiple illicit drugs throughout the pregnancy, she was young, had a history of psychiatric disease, and had no family support. We also knew that there was IUGR (intrauterine growth restriction), which means we expected a smaller than normal for gestational age baby. There was the team, patiently waiting for the 27-week-old baby.
Expecting the best, but prepared for the worst. I saw when the baby came out and was quickly transported to the newborn table to be examined and cared for by the NICU team. Previously being present in other deliveries, I knew that no crying was not a good sign. It was then when I saw one of the many beautiful things in medicine, the combination of competence, compassion, and teamwork all in one event. The nurses were stellar; my attending was calm and composed giving instructions and working to make this fragile 500-gram baby breath.
In all honesty, I felt useless at that time, but now, I realize that it was an excellent opportunity for me that I may not have again. Being purely a spectator, I got to see all the action medically, but also all their facial expressions of concern but strength and determination to get this baby stabilized. The baby required intubation and surfactant administration (lung development is not complete at 27 weeks) and was then transferred to the unit to provide mechanical ventilation, warmth, and monitor other parameters such as glucose levels. I was astounded by the amazing work that health professionals in this field do, it is truly and immediately life saving.
There, I stood by that baby until she was stabilized, I just couldn’t leave until I knew she was going to be OK. This time the nurses were kind enough to give me a job to do, compress the cotton ball where the peripheral line was attempted to prevent bleeding. I felt incredibly incompetent, but at the same time very moved, and motivated by their skills and compassion towards this delicate baby. This was the last day of my rotation, which was sad for me because I really wanted to be there to see that baby grow and get better.
There are many things to talk about with this case, including the social components and what will happen with this baby when they leave the hospital, but all that just seems more manageable when faced with a situation like this, truly life or death situation. It still brings tears to my eyes and makes my heart shake to think we could have just lost that innocent 27-week-old baby. I hope that this experience stays very present in my mind; so that I never forget the difference we can really make being not only doctors, but doctors with compassion, competence, love, and care for our patients even after long hours of work and many years of practice.
Esther Quintero is a medical student.
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