Did you know that September is NICU awareness month?
Sometimes I forget because there’s a lot of awareness. March, for example, is IUGR (Intrauterine growth restriction) awareness month. That one sticks with me because Charlie, my first born was IUGR and we had NO idea until after she was born. Additionally, she came home from the NICU on IUGR DAY. So double extra reason to remember.
But September is important to.
10% of all babies are born prematurely. A premature baby is a baby that was born BEFORE 37 weeks of gestation. They aren’t “early babies” that come before their due dates, they’re premature, meaning that they were born before their bodies were ready to function on the outside.
Both of my daughters were born premature and spent time in the NICU (neonatal intensive care unit).
My first was born at 28 weeks 5 days and spent 67 days in the NICU. My second was born at 36 weeks and spend 72 hours in the NICU.
But it’s not only premature babies that end up in the NICU. Term babies can end up needing NICU time also.
No matter what the reason for NICU time, it’s an incredibly difficult time for parents, babies and family members. The month of September is meant to acknowledge this time and those who experience it.
In honor of NICU awareness month I wrote a short story. It’s a work of fiction that is meant to honor those who have fought the NICU fight and bring awareness.
I hope you enjoy it.
Machine-Baby
Jill N Davies
Day one
“I need to pump!”
It was the first thing Emily said in the recovery room after the obvious series of questions.
What happened?
Did he make it?
Is he okay?
Her son was alone on a different floor. Instead of a womb and an umbilical cord, he was on life support. Pumping was all she had left to do for him now. Use a machine to extract milk from her breasts so that he could have it. She reached over and let her fingers run across the slick surface of the ultrasound picture. Her baby’s cheeks looked so plump, his lips were full and pouty. He looked like the perfect little baby.
But Emily knew that’s not what he would look like on the outside. She’d googled premature babies. At 26 weeks and 1 day her little man wouldn’t look like the chubby bunny she’d expected. He would look stringy, pink and wrinkled, more alien than human.
The ultrasound technician handed her the printout just after midnight during the first of what should have been four scans that day. But in the middle of the scan the tech stepped out to grab the doctor. There was no more fluid. While the doctor explained the situation, Emily’s baby’s heart rate dropped down so low that people started to panic.
By the time it bounced back up the room was full of people—doctors and nurses in the process of whisking her away for an emergency extraction. But even though the immediate danger had passed the doctor was steadfast. It was time to deliver.
For what it was the delivery went pretty well. Baby boy (Mr. No-name, as she thought of him since she’d only just discovered she was having a boy and didn’t even have a short-list yet) was born at 1 pound and 15 ounces—a great weight for a 26-week micropreemie. He even gave a little, mouse-like squeak before the NICU team whisked him away.
Then Emily had started to bleed. Things got very blurry after that.
She managed to pump once in the recovery room. Five minutes before she got light-headed and nauseous. In that five minutes she hadn’t managed to get anything.
She remembered the bitter tears when the doctor had explains the state of her boy—not breathing on his own, sedated in the NICU. He had given her some statistics on his likelihood of survival, of brain bleeds and the chances of severe health complications…
“How are you feeling?”
Emily’s head jerked up at the sound of the nurse’s voice. It took her a disoriented second to find the nurse’s face. It was a kind face, with dark, searching eyes.
Had she been sleeping?
Emily blinked. “I’m, um…”
The nurse came to her bedside and placed a reassuring hand on her shoulder. “I know. It’s been a rough few hours.”
Emily nodded at that, gripping the ultrasound printout until it crinkled in her hand. She choked back a sob. “What time is it?”
“It’s a little after eleven. My name is Jade. I’m going to do your vitals really quick.” Jade wrapped the blood pressure cuff around her arm and stuck a thermometer in her mouth.
Eleven. What time had she gone back for surgery? One, maybe two? The day was nearly half gone and she hadn’t even met her Mr. No Name…
“I can’t believe I fell asleep,” She mumbled.
“Oh honey, I can! After that hemorrhage? You’re lucky you didn’t end up in the ICU!” Jade said, pressing a button.
The blood pressure cuff buzzed as it inflated around her arm. Emily lost herself to her own thoughts again. Thoughts about how she had failed her baby. She couldn’t bring him to term and now she wasn’t able to produce any milk for him. She hadn’t even been able to name him.
Her numb, swollen and stitched up stomach was empty. No more kicks or squirms. She couldn’t place her hand there and no that her baby’s flicker of a heartbeat was galloping on beneath it. The knowledge of it consumed her.
“82/56. If you’re feeling up to it I can take you down to your baby,” Jade offered.
“Take me down to see him?” she repeated, as if the words made no sense strung together.
“I’ve got a wheelchair parked right outside your room in case you wanted.”
Of course, she wanted.
Didn’t she?
Emily thought about what waited for her in the NICU. A tiny baby with no name, fighting for his life.
What could she offer him?
Not life, not sustenance… What could she do for him other than be his mother? And what did it mean to be a mother if it wasn’t those things?
There were so many questions.
What if she didn’t recognize him? What if he didn’t recognize her? Would she be flooded with maternal love for him?
“I’d like to go see him,” Emily said, fighting back the fear and doubt.
Jade smiled. “I thought you’d say that.”
She disappeared behind the curtain, returning with a squat, double-wide wheelchair.
Emily took one last look at the ultrasound picture before setting it on the table next to a jug of water. Ready or not it was time to meet the real deal. Black and white come to life.
The elevator ride to the basement was much like her pregnancy, both agonizingly slow and done too soon. The door opened to the hollow halls of the artificially lit NICU floor with a hollow ding. They turned a corner to face a door. Emily’s mouth went dry. Her heart fluttering in her chest like a caged bird. Panic rose, but she swallowed it down. The nurse swiped her key card in front of the sensor and the doors opened.
Emily was greeted with half a dozen alarms signaling along with the electronic beeps and buzzes of too much equipment. Nurses moved stoically through the maze of plastic isolettes. Quiet conversations wafted from drawn curtains.
“He’s in the corner over there,” Jade pointed to the far side of the room.
Emily took it in as the wheelchair proceeded. She did not see any sign of a baby. A petite woman in dark blue scrubs sat in front of a glowing computer screen tapping away. Next to that was a large monitor with three rows of information. A green pulse and a green number, 143. A blue sine wave and a blue number, 92, then a pink trace. In front of all that was a large machine that looked like something out of the dark ages. It wasn’t until they were right up on her baby’s little corner that she was able to see his isolette.
He’s in there. Mr. No-Name.
It sat amidst everything like a sentinel—too large for too tiny baby, yet she knew he was contained within its plastic walls. An animal-print blanket was draped over the top of the isolette so that she couldn’t see him. She ached with a longing that was somehow bigger than her fears.
The woman in the dark blue scrubs popped up out of her chair at their approach. Her eyes found Emily’s immediately, crinkling into a kind squint.
“You must be mom,” she said so matter-of-factly that Emily actually felt like a parent for the first time.
Emily nodded, offering the plastic medical bracelet that she was told she’d need to be identified to the woman for confirmation.
The woman checked it. “I’m Evie and I’m his nurse for this shift. I just did his care and he’s resting now.”
“His care?” Emily asked. Everything felt so strange. She was five feet from her baby but still hadn’t even caught a glimpse of him.
“That’s right. I changed his diaper, checked his vent settings, cleaned his airways…” Evie explained.
Emily shook her head. “What are vent settings?” she asked.
Evie gestured to the big machine next to the isolette. “This is a ventilator. It’s breathing for your son. It’s providing the pressure and oxygen he needs in order to keep him alive.”
Emily thought of the old iron lungs in her history book that used to breath for polio victims. Lungs breathing for the sick.
She remembered what the doctor said to her when he explained her son’s state. “He’s very sick right now…”
“Can I see him? I need to see him,” she said, pushed by a growing urgency that once again managed to overpower her fear.
“We like to keep such fragile preterm babies as peaceful as possible in between their cares, but you can take a little peak,” Evie said.
Jade pushed her chair forward, following Evie to the crowded space next to the covered isolette. Evie dimmed the lights before lifting the corner of the animal-print blanket draped over the plastic womb containing her boy.
Emily’s breath caught in the back of her throat. There he was, nestled in a bed of wires and wraps with a tube sticking out of his mouth. He was tiny and pink, with a fine down covering the small bits of his exposed shoulders. She glanced at the clock on the wall. At 11:48 am Emily caught her first glimpse of her son.
There was almost nothing to see. He was so small and so covered. If it weren’t for the tube in his mouth his thin little lips would practically disappear. His head was covered by the world’s smallest knit cap, and the rest of him was either covered or had a monitor attached. She blinked back at the tears threatening to spill over. She lifted a heavy hand and placed it on the plastic wall of the container, still inches away from his tiny body.
He didn’t look sick. Just small.
“Hey you…” she whispered, stopping herself from calling him Mr. No-Name. She’d have to fix that fast, she decided.
As she gazed upon the tiny baby, Emily became overwhelmed with grief and fear and a bit of anger. But somewhere in that chemical mix of emotion, there was love.
“I want to hold him,” She told Evie without looking away. The thought of his tiny body in her arms was horrifying, but something inside of her knew she needed to more than she needed to do anything else. More than carrying him, more than pumping for him she needed to hold him—to love him and believe in him.
That was what she could do for him as his mother.
“I’m not sure if he’s stable enough. You’ll have to wait for the doctor to know if that’s possible,” Evie said.
“Then I’ll wait,” Emily said, resolved to do what her heart told her was necessary.
“Okay,” Evie said, eager to seal the isolette up again, “I can call you and let you know what he says.”
“I’ll wait for him here so that I can ask,” Emily corrected, suddenly and steadfastly resolved in her role as a mother.
“You don’t have to do that, I can call,” Evie protested.
“I want to be here. I can pump here. I’ll rest, but I need to be next to him,” Emily insisted
Evie relented wordlessly, moving back to the computer to finish her charting. Jade leaned over the wheelchair.
“I’ll tell the nurse you’re down here. She’ll come grab you at shift change to give you your medicine. I won’t let anyone tell you that you have to move. You’ve found your job.”
Emily let out a relieved breath. “Thank you,” she said, overcome with the support of her nurse.
Jade squeezed her arm. “Anything else I can get you, momma?”
Momma. It sounded right.
“Could you find me a pump?” Emily asked.
Jade smiled. “I’ll be right back.”
Emily sat alone in the dim light, looking at her baby. She studied the pieces of him she could see until every single detail was etched into her memory. His cheeks looked the same as they did in the ultrasound. She decided that she recognized him after all.
Jade came back pushing the pump. She handed Emily a fresh bag of pump parts before taking her leave. Emily dutifully put the plastic pieces together and connected them to the pump. She fumbled with the buttons on the machine while holding the cups in her other hand. It was only the third time she’d managed to pump since delivery. She knew it wasn’t enough, but there was nothing she could do about that now except try again.
Finally, after what felt like too long, she had everything set. She held the funnels against her breasts and prayed for it to work. Instead of staring at the nothing that her breasts produced, she returned her gaze to her son.
“Mr. No-Name isn’t going to do. What do you like?” She asked, keeping her voice low so that the conversation stayed between the two of them.
He didn’t respond. He didn’t even move. She let the tears flow. Next to her the ventilator beeped it’s signs of life. She listened to the rhythm of the breast pump as it mingled with the beeps and dings of the NICU.
The ventilator machine was breathing for her baby. If it weren’t there, then neither would he be. In that moment it was as though the two of them were one. Ventilator and baby.
“You’re just as much machine as you are baby right now, aren’t you?” she whispered again.
The vent beeped. It made her smile.
“My very own medical marvel,” she mused. It gave her an idea.
She didn’t want to think of her baby as medically fragile. She hated the statistics and percentages the doctors gave her. She didn’t care about the chances of mortality, likelihood of complications and long-term health outlooks. Those numbers were based on other babies, she decided, not her machine-baby.
Beep, the ventilator agreed.
And who cared that Evie didn’t think she’d be able to hold him? She was basing that on other babies, not him. Her son wanted to be held. He wanted her there, looking in on him.
Beep.
The pump shut off. Emily looked down at the empty cups, wishing she could do better for him.
As she pulled the funnels away from her breasts she noticed some moisture, and there was a collection of colostrum stuck in the duckbills. Emily’s heart swelled. It wasn’t much, but it was there—little golden drops of promise.
She clung to that promise as she collected the colostrum in a small orange syringe. One third of a milliliter. She held on to that number as the hours passed and she waited for the doctor what would tell her she could hold her son. While she waited, she whispered to her son—too quiet for him to hear and be disturbed from his peaceful slumber. But each time the vent would speak for him. A beep in agreement. A beep of consent. A beep to let her know that he was still with her.
She pumped again and captured 1.2 milliliters. The vent beeped approval. The nurse came to take her up for her vitals and medicine. Emily counted the seconds away from the giant plastic container that held her boy. Back in the NICU she returned to the pump, counting the drops of golden promise once more; 3.5 milliliters. Beep.
It was nearly 10 pm when the doctor finally made his rounds.
“I hear you have a question for me,” he said as he pulled a fresh pair of blue gloves over his hands.
“I want to hold him,” Emily said, certain of what the outcome should be.
“A lot of the time babies at this age aren’t up for it, but I’ll take a look and see how he’s done today,” He said, pulling up the chart.
“He’s ready for it, doctor,” Emily said, willing it to be so.
Beep.
She held her breath as he read over the chart. She held it for so long that her heart started to pound. She let it out slowly as the doctor turned his attention to the isolette, lifting the blanket and opening the side. While the doctor examined the little boy hidden amidst wires and tubes, Emily thought about how naturally breathing came to her. Would it ever be that effortless for him?
Beep, the machine promised.
The doctor closed the side of the isolette. “I think we can give it a try,” He said.
Emily’s heart sang. “I knew it. He’s stronger than he looks.”
“Does he have a name yet?” He asked.
“Austin,” She said. “My six-million-dollar machine baby.”
Beep, said the vent.
Someday, Emily knew, Austin would respond for himself. Until then the vent was there, making sure he was heard.
The End
I hope you enjoyed this short story.
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