So recently, I have been working the NICU more than I have been working with adults. It isn’t my favorite place to work, but I like it. Just so you know, my favorite will always be adult critical care because it is so…familiar. I have spent the brunt of my career (to date) taking care of the sickest of our adults. The NICU is interesting because it is a challenge. The critically ill newborn is not just a small version of a critically ill adult. There are new intricacies, new puzzles to solve. New. My inner geek loves the challenge–the part of me at my core that isn’t happy unless there is something interesting to do, a new challenge to tackle. Some of us went into the field because we wanted to cuddle little babies. I’ll be honest here: that just isn’t me. I like babies, but I like my own. I like kids if they are my own. I can look at your kid and think they are adorable, but I am just too no-nonsense for the goo-goo, gah-gah stuff. But I am a NICU respiratory therapist. Because someone told me I should be. Because I am good at my job.
So I have a whole new and different set of challenges, and oddly enough, several of these have nothing to do with the functioning of a neonate. I have personal challenges. Issues that reverberate to my very soul. And suddenly hardcore, no-nonsense Andi isn’t so tough. So here is my little list. My confessions.
1. That moment when I am called. There is a 30-weeker being delivered by crash c-section and I am needed in the OR, Stat. My heart still skips a beat and I still wonder if I am good enough. Will I know enough? Will I be able to help? What am I walking into?
2. That moment? You know the one, right? Where a new mom is born. And the room quiets except for one little cry. And my emotions are fricken traitors and my eyes get moist. Because to cry is to be healthy. And isn’t that what the parents wanted? And there is a new person in the room. It is absolutely awesome, whether that new person entered via guts and determination of the mother, or whether there was a surgical incision involved. It’s still the same to me. It should be to all of us. And I have just taught myself a lesson: to let go of the issues I have with the way my boys came into the world. They came into the world. That’s all I need.
3. If you name your child something stupid, I will make fun of you behind your back. Sorry, but you kind of deserve it. If we tell you your chosen name for your baby is “interesting”, that means we think it is the most ridiculous thing we have ever heard.
4. I got attached this past spring. I was there for 4 days straight. I was called to the OR for the delivery of a mom who almost died from blood loss. And she could’t see her baby for days. I resuscitated the baby. I kept him alive. I worked my ass off for four days straight. When he was crying because he was hungry, but he couldn’t eat. When he just wanted to be held, but any disruption made his heart rate plummet too low and his oxygen saturation bottom out. And his mommy was too sick to be there. So I leaned over him, with my hand on his little diapered butt and the other hand on the top of his head. Gentle pressure so he felt like he was being held without being held. So he could have some comfort without coding on me. And I was off for awhile. When I returned, I worked with adults. He was gone. He went home. He and mom both recovered. I had done a good job. And it affected me so profoundly that I cannot put it into words. And I still wonder what happened to them. So now I am distant. Forgive me for that. I have to be.
5. Last night, I resuscitated a 33 weeker. Zach’s gestational age. I wanted to tell the scared parents that it would be ok. That before they know it, there will be a robust toddler destroying their home. But I can’t do it. Because every baby is different. And just because it was all ok for us doesn’t mean it will be for them. Their baby came out not breathing. About half of Zach’s size. A heartrate low enough that we had to perform chest compressions. And then I start to wonder. Why us? Why them? And I see Zach’s face and I fight, fight, fight. I become over-invested. Because, while our efforts worked last night, there will be times when they do not. Last night could’ve been one of those times, and I know that my soul would’ve been crushed.
6. There are ugly babies. I’m sorry, but there really are. All that matters is the parents think they are amazingly beautiful. I just don’t tell them the truth.
7. We judge you parents. If you are pieces of shit, we know it. When you go out for “fresh air” and come back to your sick baby, covered in the residue of smoke. When you come back positive for drugs. When baby looks nothing like Baby Daddy but mysteriously like Neighbor, who is Baby Daddy’s BFF. When you are overbearing and, though you mean well, you try too hard and impede the necessary medical treatment of your very sick kid. Secretly, I want to take the baby home with me. I want to tell you that you are a piece of shit. But I cannot. We don’t leave the door to the room open so we can “hear alarms”. Those alarms sound throughout the whole unit. We leave the door open to supervise your ass.