Lilah was about eight months old and essentially abandoned to the neonatal intensive care unit of the hospital where she was born, and where I trained. She had been born extremely prematurely to a mother lost to addiction and never heard from again. She had just about every complication of prematurity. Her face was round and shiny with wide open eyes that didn’t see, so she made blind, uncoordinated swipes at the faces of whoever had time to hold her. She was fairly tethered to her crib and her machines; she breathed through a tracheostomy tube attached to a ventilator and fed through a gastric tube, so lifting her and rocking her was not a simple matter. But people came to hold her and rock her: experienced volunteers, nurses on break, and, occasionally, rarely, residents like me, late in the night shift.
That’s not her name. But I thought of her for the first time in a long time this weekend, the image of her triggered by a conversation with friends. I realized it has been almost fifteen years since I met Lilah. I didn’t know much about her then- who had named her? What was her legal status, how likely was it that she would ever know a home? And I know even less now- what happened to her? Does anyone else remember her?
Residency training was the hardest thing I have ever completed. I will not even for one second pretend that it was hard because I was doing noble work, studying and caring about people, blah blah. I had been a fresh and idealistic gunner medical student, and I wandered blithely into this war zone of a situation called residency. It was “student” to “provider” overnight. Illness and crisis and logistical urban nightmare, and suddenly I was supposed to know what I was doing, and I didn’t, and people suffered. My temperament and constitution did not hold up well under the four years of relentless physical demand, impossible intellectual tasks and emotional stress. It was a brutal regime to be just survived. I survived quite poorly, fueled by grit and alcohol. We took “liver rounds” to a higher level. I fled the place as often as I could. I don’t think I opened a medical journal for the whole damn time.
I made very few connections during those years. I know I was as miserable to be around as I felt. But one rotation, I worked with an intern, another young woman who, like me, was feeling overwhelmed. We were working at a small-town hospital, in the adult intensive care unit. One night, we were witness to a horrible death in the emergency room. We had been part of the “code team” working on the patient, a young woman who died unnecessarily, of postoperative complications. The death was awful enough, but the explosive response of her family upon hearing the news was worse. Violence broke. Chairs were thrown, people screamed, a security guard told us to leave the area.
We fled up a stairwell and instinctively, just kept walking past the ICU. I think she said something like, I just can’t go back in there yet. And I said, Me neither. One of us had the idea, and so, we kept walking, right up to labor and delivery, to the nursery.
There were a couple of nurses in there, with a small batch of fresh babies. We stood at the glass. I tapped, smiling: Please, we just wanted to see the babies, if we can? and she added, It’s been a rough, rough night in the emergency room, Us both smiling sweetly, thinking, Please, let us see something good, let us be a part of something good.
The nurses were a bit startled, but nice: We heard the code called down there. I think they asked us if we’d like to hold a baby, and we said no, better from this side of the glass, all those horrible germs in the ICU and ER. And so they showed us each baby, lifting them to the glass, cuddled burrito-style, with a small blurb about each one, like, Jessie’s parents barely made it here! One push in triage and here he is! and we cooed and aaahed and chatted until we were paged from the ICU more than a few times.
That was so many years ago, and it can all come back, the sting of almost-tears when I asked, begged, Please, we just wanted to see the babies… my voice cracked just slightly as I realized I was close to breaking down and desperate not to.
Heat rises in my face at the remembered injustices of training. Not being taught and then expected to know. Left to sink or swim, and the patients along with us. Not anyone’s fault, really; but rather the antiquated system. Our teachers were floundering too. And, I know I was personally ill-equipped to handle the whole thing.
I survived, and now, I am so, so grateful to have these little babies to see at the end of a long workday.