Monday, July 03, 2006

Keep Me In Your Heart

Dear baby F,

I'm so sorry. I want to start out that way. I know that what happened wasn't my fault, and I hope that wherever you are now, you're beyond blaming anyone, but...I'm sorry. I'm sorry I didn't push harder for a DHHS referral. I'm sorry we sent you home again.

We didn't know what was wrong with you. We didn't know why your mother kept bringing you in to the hospital, and saying that you were choking. When we looked at you, you were a gorgeous baby girl. We did every study we could find, and didn't even find any reflux. We found nothing. We called it reflux anyway and treated you, figuring that at least we were doing something.

You never had a choking spell at the hospital. You never turned gray, or even blue. You never dropped your oxygen saturations on the monitors. You smiled at us, and you loved when we fed you, and held you, and walked around the unit holding you, swaying from side to side and humming softly under our breath.

Everything you owned was pink, and when she brought you in she always brought a bag full of your clothes, before she turned and fled down the hall. The nurses chased her down the hall, shouting questions at a quickly retreating back and thin shoulders. "What does she eat? How much? How often? Do you thicken her formula? Hello?" Then she was gone, and we had to guess.

We stopped having to write new admission notes on you. We called up your last file from medical records and copied the last one, which was only a few days old, and merely added another hospital admission to the list. "Admitted 3 times since 3/06." "4th admission since birth." "Fifth..." "Sixth..."

Finally we started to ask hard questions. We had the abuse specialist see you. We x-rayed your bones and scanned your head. There was nothing pathologic there. We knew the visiting nurses were coming to see you, and we thought it was enough. We thought she cared, and we taught her CPR. Just in case, we said to ourselves. We thought we had done enough. We thought you had time enough.

The seventh admission was the last one. You hadn't been home long, and--it was the morning again--she called the ambulance again. You weren't breathing, she said. She found you like that, she said. She tried CPR, she said.

I don't know how or why, but we brought you back. But we didn't bring you back--not the you that you were. We brought back your brainstem, and your heart beat for us, but that was all. You didn't breathe on your own. You didn't look at us anymore. You were a tiny corpse, kept alive by our persistence, by our unbelief, by our sheer conviction that babies should live, that babies can live, that babies can survive miraculously. You were kept alive by our love.

We didn't believe the first EEG, which lacked the mountainous pulsations or brain activity. We didn't believe the examinations that showed that all of your baby body was limp and lifeless. We barely believed the second EEG, still flat and serene, but the third one visited reality on us. You really were gone.

There were so many of us who knew you. All the nurses loved you, even if they hadn't taken care of you. Most of the residents knew you--most of the residents had admitted you. Your pediatrician had seen you so many times in your short life, and the loss of you broke him. He was kicking things in the ICU, trash cans, cart racks, anything in his way, so angry, so lost.

We were all of us powerless to change the fate that awaited you, rustling in the wings, behind the heavy velvet curtain that hid the things we cannot see. We could not see into her heart, into her fears, into her intent toward you. We could not understand the message she tried to give us. She in turn could not understand we would have taken you. We would have kept you. If she couldn't take care of you, we would have. There were so many of us who loved you, and so many families desperate for a sweet, well-behaved, healthy baby. If she had only known...If we had only said...

We don't know what happened to you. The autopsy showed nothing, and she said nothing. Anything could have happened. Just anything.

There is so little we can do for you, little girl. We can imagine you as a bigger girl...wearing a pink bathing suit, playing in a sprinkler...smiling, your front teeth missing, on your first day of school...blowing out the candles on a birthday cake...lying down to sleep on pink and purple sheets. You sleep somewhere else now, somewhere cold and dark, and our memories and imaginations cannot reach you there.

But we can promise you this. We will remember you. We will carry you with us. We will keep you in our heart. That's all we can do for you now.

And little baby, I am so, so, so sorry.


The Purloined Letter said...

This is so heartbreaking!

Susan said...

Thank you for taking care of her and for caring for her now in your words.

Anonymous said...

You poor soul; that's a heavy weight to put on yourself.
How sad life can be.

Anonymous said...

"We will remember you. We will carry you with us. We will keep you in our heart. That's all we can do for you now."

What a tragic story and how beautifully you told it and let us know about that precious little one.

There are always a few patients who stay with us always, mostly because we learned something very profound from them and that knowledge helps us be the better healthcare professional.