A few years ago we received a request from a family, whose baby had been a patient in our NICU, to speak with the neonatologist who had cared for their child. I remembered the name vaguely, but was unclear about the circumstances of the encounter, so I had to go way back into the database to find the record.
Turns out that the patient was a little boy who had been born extremely premature, and a patient for less than 24 hours before he died. As I recall, those had been some very long hours. He had been born at one hospital, where I was on call, and then transferred to a higher level hospital, where I just happened to be on call the following night. Mom was terribly sick, and too unstable to transfer along with her baby, although the father and some other family members were able to follow the baby to the new location.
It was one of those sad cases in which a life can be both too short and too long simultaneously. What I mean by that is that while he was here for such a short time, tremendous efforts were made to save his life, requiring highly sophisticated monitoring and ventilator technology, a rapid-fire laboratory and radiology service, and especially highly skilled nursing and respiratory care support. The baby’s response to even the most aggressive maneuvers was limited, and although we are acutely sensitive to making sure that pain is addressed and controlled, you cannot help feeling after some time that you are literally “beating up” this poor child, and hope begins to fade. Then, over a very short period of time, specific signs and symptoms arose that made our worst fears a reality: A quick diagnostic study confirmed that the little boy had suffered a massive bleed into the brain. We had a conference with the father in which we broke the sad news, the decision was then made to remove the child from support, and the family was allowed to hold him in his final moments. It was over very quickly.
A life both too short and too long.
Notes were written, a death certificate signed, organ donor services notified, and all the paperwork put in order. Our hearts break with the family, and I have witnessed our staff, especially the nurses, shed many tears over those kids. But then the world must go on turning. There were many other very sick babies that had to be attended to that day and every day thereafter.
Two years later I sat in my office with a thick chart on my desk to reference for any questions they might have. Right on time, Mom and Dad came in. Much to my delight she was carrying a car seat in which a gorgeous baby girl lay with a little ribbon in her hair, sleeping soundly. Obviously they had given birth to another in the time since I had last seen them, and they had warm smiles and hugs for me before sitting down in the chairs set out for them earlier.
The events of that terrible night had faded somewhat, and they simply wanted to discuss what had happened, the timeline of care, the decisions that were made, and so on. Mom spoke very limited English, so Dad did all of the talking, although I did my best to address my answers to the both of them. Over the next 30 minutes or so, I reviewed all the relevant historical information, and tried to give them some comfort and reassurance, especially with regard to the baby’s pain management throughout his time in the NICU.
The baby girl in the car seat squirmed a few times, a few grunts and (adorable) sighs, but remained sleeping throughout, like the perfect little angel that she is. Mom remained silent for the entire encounter, until the end of my narrative.
And then she began to weep.
And she wept.
And she wept.
She openly wept for a full 10 minutes as her husband attempted to console her. Ten minutes is a long time. It was terribly uncomfortable, I must admit. The father apologized as they left. He then confided to me in his broken English that he really didn’t understand how after a full two years this was still so heavy on her heart. Especially since the baby had been only alive for less than 24 hours. Now with a little girl and a supportive extended family, they needed to move on from there. I nodded, asked him to try and be compassionate and to love her, and assured him that I would pray for all of them.
In the silence of the next hour I reviewed what I had seen, what had been said, the responses that had come as a result of those words, and so on. Then what should have been obvious the entire time became suddenly crystal clear. There was a reason that her grief has been so ongoing, and why it would not, and will never, go away. It will always be just underneath the surface. Why was she this way?
Because she KNEW him, that’s why.
She had received a glimpse of him in the delivery room, never to see him alive again. She would not see him until the mortuary. But the true source of her pain went far deeper than even that sad reality.
It wasn’t just 24 hours that he had been here. In the months leading up to his birth she and he had bonded at the most intimate level. She was aware of her blessed part in being the carrier of new life. She had felt him many times kicking after a meal, and he had awoken her with the same on several nights. She would laugh excitedly in private about his birthday parties, and the times they would spend with her family and his cousins. Christmas mornings. Some days when the house was empty or in her car she would sing to him and he would hear her voice, which to him was the most exquisite sound that could ever be. She would wonder about what sort of a man he would be. Who would he marry? She would bring him up to be a great man like her father was, and her grandfather was. She was planning the arrangement of his bedroom.
She KNEW him.
God has blessed woman with the ability to give birth. To experience and be a part of a Christ-like love that wants only to give, never to receive. I have said many times (and mean it) that the most beautiful thing in this world is seeing a brand new mother with her newborn. We witness a love far beyond our understanding, and which is not of this world, but rather is but an echo of the One in whose spiritual image we all are made.
And this is why the grief will never quite go away. In her heart will always remain that little corner. A corner in which there sits an empty bassinette bearing the name of one very precious little boy. A little one whom she knew and whose presence she will always sense. And some day, some beautiful day that she knows deep in her soul will come, he will be waiting there for her and all will be as it was meant to be.
(Photo: Dr. Tackman’s fingertip under a premature infant’s hand/Courtesy of Dr. Tackman)
Anthony Tackman, M.D. is a neonatologist in practice in Coastal Carolina.