A NICU is a terrible place for a social animal. How are you? Eye contact. A quick look- how is their baby? Going home is a good day. Bad days are unthinkable. In between is a terrible negotiation- your bad day may be their hesitant dream. Or vice versa. Someone will feel guilty. How are you?
They say this place is a really good hospital. Surely not because of their definition of “parent.” A parent can be biomom, biodad, or biomom’s husband; biomom’s unweddable female partner doesn’t exist. No, this is a “really good hospital” because a manager gives the admission worker a clear instruction to ignore that definition. We go upstairs with matching parent badges.
I haven’t been writing entries here. We had a baby. He aspirated poop. He’s beautiful- every baby is. Now he has tubes in his nose.
My only title here is mom. Believe me, its enough. This ward, like all American health care, runs on nurses- nurse practitioners manage the care plans and nurses manage the patients. Medical students, notoriously, labor under the misapprehension that they manage the nurses, and I’m not here to antagonize anyone. My close-to-college address has provoked the question only once; I demurly identify as a grad student.
For all the machines, this is a human space, and language and names have power. I worry that my easy familiarity with the jargon will expose me. “The monitor’s saying he desatted, but the probe has no waveform and his respers are good; no flaring.” I use metric measurements and reflexively throw the diaper on the scale. Then I overhear other parents and we all talk the same way. We are refugees in a strange country; we learn the language to survive.
The first night we meet a first-year resident. She is very upset that we skipped the erythromycin drops in his eye. We explain that we know mom’s GC/herpes status is negative. “You need to understand” she says. We do understand- she has to report to someone else. She promises to return with a form for us to sign. A minute later we overhear the NP telling her there is no form “but you can document you talked to them if it makes you feel better.” We never see her again.
We understand ourselves too. Refusing erythromycin is harmless, and a powerful gesture to remind ourselves: this is our kid, even here.
In the parent area a large family sits with a doctor and an NP. They are talking about Down’s syndrome. “Do you have any children?” I ask the cleaning lady. Her one son is 26. Her other son died. There is no escape.
This is a progressive facility. The staff believe in sun lamps, room-air CPAP, breast feeding- my god do they believe in breast feeding. It must be hard not to breast-feed here. There are porta-pumps, pump rooms, lactation consultants everywhere. By day three he is no longer receiving any other medication.
They also believe in “kangarooing”, which you could also call “Harlowing” or just “holding your baby.” “Sessions start at one hour” reads the color promotional poster on the bathroom wall, “and may be increased to three hours.” Three hours is the interval between weighings and diaper changes. There’s (almost) no other reason to put him down, so we don’t.
The poster is brilliant by the way. The photo models are a smiling black mother in an isolation gown and a tough-looking white guy with a bad shave. You aren’t too hard for this, it implies, and your baby is not too sick.
We have one nurse who is uncomfortable with all the holding. She would prefer it if we call her for help when we transfer him back and forth. We wouldn’t want him to pull out his IV line again, or his OG tube. She is very young. We think she means “dear god in heaven, let me never put in an IV or an OG tube wrong”
“dead god in heaven, maybe if I don’t have to put in any IVs or OG tubes at all”
The most important things are small things and can’t be put into words. How to double-secure an IV. How to secure a CPAP mask using only the straps. How to do it with your thumb. Under the bili light, the nurse tucks an extra blanket under the foot of his U-roll and he goes from squalling to sleeping instantaneously. I repeat this myself later, and a new nurse calls me “the baby whisperer.” This is my real medical education.
Every family is different. In one bed a grandma holds her granddaughter around the clock. Another family shows up in matching “its a girl!” shirts. One mom is in a wheelchair, clearly a recent change in her life. We worry about the baby next to us, then the parents finally show up. He is wearing the torn jeans and cement-flecked workboots of a day laborer. In poor English he apologizes for their transportation problems. She says nothing at all. On TV, Mitt Romney is complaining about Americans too poor to pay income tax, calling them dependents who “think they’re victims.” There is no escape.
The nurses can’t understand why we have a pack of diapers on our parent shelf. Does he need special diapers? No, we just have what we were carrying when the ambulance came. My sister-in-law brings us clean underwear and a nail clipper.
The lonely babies get a mobile and a NICU-issued electronic music box with a bizarre playlist. Frere Jacques shares duties with the Battle Hymn of the Republic and Dvorak’s New World Symphony. Its like being in an amateur ring-tone factory, especially when more than one box is playing at a time. A nurse reports hearing a father hum Frere Jacques in the hallway.
The above was transcribed from my notes. We are home now.
