We Can Let Babies Die: 6 Realities Of Neonatal Nursing
The birth of a child is supposed to be one of the happiest moments in a person's life ... but sometimes, things don't go as planned. If a child is born prematurely or disabled, then instead of the loving arms of its mom and dad, it goes straight to the hospital's neonatal intensive care unit (NICU), a.k.a. the saddest place on Earth. We decided to learn more about these anti-Disneylands, so we reached out to a registered NICU nurse. She wanted to remain anonymous, for reasons which will become obvious as soon as you learn that ...
A Hospital Can Let A Baby Die Without The Parents' Consent
Many places around the U.S. actually make it legal to stop treating a dying infant, despite the parent's wishes. It only happens when a child is in such bad shape that no further medical treatment will be able to help them. However, we always give parents the option to transfer their hopeless cases to another hospital that doesn't believe in letting a patient die with dignity. Well ... almost always.
"But in the meantime, feel free to get your hopes up so this can be super devastating later."
There was a baby boy who had been in a vegetative state since birth. He couldn't breathe without a machine, and had no brain stem reflexes. So we sent him out to have feeding and breathing tubes implanted, but the surgical team refused to do it. It'd be like giving mouth-to-mouth to a steak. Here's the thing, though: No one informed the mother that the surgery was being postponed for ethical reasons. Instead, the head doctor simply said that they needed to do more tests.
A week later, the ethics committee met -- without ever contacting the mom -- and decided that we should let the kid die. It's been months now, and the woman still doesn't know what's going on with her son. Don't get me wrong; I think that ceasing treatment is the right decision. But the hospital went about it in a terrible way, and there's shockingly little I can do about it besides file complaints.
Babies Are Dying Because There's No Money In Saving Them
A few years back, we discovered that giving premature infants injections of vitamin A three times a week helps prevent chronic lung disease. Around the same time, the manufacturer put the vitamin on back order because of high production costs. Of course, as soon as they realized that their product could save lives, they immediately put it back on the marke--BUAHAHA! Sorry, sorry, what I meant to say was that the vitamin stayed on back order for three whole years, because there just wasn't any money in helping all those infants breathe.
Though if you're already on the hook for $1,000,000, what's another few grand between friends?
Calcium glubionate and zinc are also good examples. Calcium glubionate prevents seizures and abnormal heart rhythms in kids without causing intestinal issues. It's pretty awesome like that, and yet the hospital I used to work at couldn't get it no matter what they did. Zinc lowers the risk of respiratory and intestinal illnesses, mental and developmental delays, and poor growth. It too was put on back order, and stayed there so long that some hospitals would give kids expired or unapproved zinc from Europe. It was still technically good (minerals don't really "expire"), and they would always get the parents' consent before administering any of it.
Dying Babies Kill Marriages
In my experience, dads love fixing things, and consequently have difficulty coping with that helpless feeling you get when your child is potentially dying and there's nothing you can do about it. (That's one of many reasons Corvettes are better than children.) Men are also given less time off from work when they have a child than the mother, and don't get me started on how idiotic that is. All of these things add up to the mom staying alone at the NICU among all the dying babies while watching her own child struggle in pain.
The fact that the closest they can get is like hugging someone inside a clothes dryer doesn't help.
It doesn't take long for NICU parents to start resenting each other -- especially if one of them is more ready to say "That's enough, please let the baby go" than the other. I think both options have merit. Sometimes, it is less cruel to let a child die. But ...
Every Live Birth Is A Motherfucking Miracle
From the moment of conception, literally a million different things can go wrong with us. We all start as two cells, and even the smallest mistake in the process of us becoming a person can have devastating results. At one point in embryonic development, your heart is above what will become your head, and it doesn't always scooch over to where it's supposed to be. Your guts sometimes develop inside the umbilical cord, or right where your lungs ought to be. In short: Cronenberg doesn't have shit on the stuff we see in the NICU.
Sorry folks, no pictures of that because of course fucking not.
You also have to worry about things you can't see. If there's a problem with your chromosomes, you can expect a host of issues, including learning disabilities, increased risks of cancer, and early-onset Alzheimer's disease. There's also a gene that codes for, and I'm being totally serious here, the Sonic Hedgehog protein, which is vital in some very important processes, like telling your brain how to develop. A defect in it can result in a child being born with only one eye, and is frequently fatal.
We've Only Recently Discovered How Not To Kill Infants
Here's a disturbing fact delivered via horrible pun: Neonatology, the branch of pediatrics dedicated to keeping newborns alive, is basically still in its infancy. It's only become a specialty that doctors could train in around the 1970s. Before then, the best that hospitals could do for premature or sick babies was pray and blame their inevitable deaths on the mother not having gone to church enough.
"If you'd like, I can also walk away, shaking my head and muttering that we wrote off eugenics too soon."
In 1960 alone, about one in 40 newborns born in the U.S. would not leave the hospital alive, and many of those who did were not presented to the parents in factory condition. The most common problem with premature babies is their lungs not working well, so for the longest time, hospitals pumped oxygen into their incubators to help them breathe.
Unfortunately, we then discovered that too much oxygen made premature babies blind, as it caused their retinas to detach. (Sorry, Stevie Wonder!) But when we did the next logical thing and kept the oxygen lower to protect the babies' eyes, we screwed up and accidentally went a little too low, resulting in a bunch of kids coming down with mental disabilities. Oops.
In the end, we discovered that preemies like to start their days the same way as everyone else: with beautiful, life giving caffeine.
Doctors finally started getting their shit together around 1963, after they failed to save JFK's son. His name was Patrick and he was born about a month too early. These days, it is nearly unheard of for such a baby to die, but back then, the hospital couldn't even keep the freaking President's child alive for two days. Things got better after that, but it was a slow, bumpy process.
The Job Is Both Heaven And Hell
We have to handle babies who are so premature that their skin comes off at the slightest touch, whose eyelids are fused, or whose lungs are like those of an 80-year-old smoker. Do that more than once, and you'll be ready to drink yourself into oblivion ...
"Code Red. I need 50 ccs, stat."
But then the next day, I might come home all happy and jazzed-up on adrenaline because I got to save a newborn's life by sticking a giant needle into its chest while imagining I'm John Travolta in Pulp Fiction, or because I got to watch an AWESOME fetal surgery on the hospital TV while eating popcorn. (Word of advice: If a nurse ever asks if you want to see something "awesome," you should probably say "no" and start running in the opposite direction.)
Just don't run screaming; there are kids trying to sleep around here.
Jane Doe is a nurse, ex-NICU parent, and the most depressing person to have at dinner parties when you ask her what she does for a living. Cezary Jan Strusiewicz is a Cracked columnist, interviewer, and editor. Contact him at firstname.lastname@example.org
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