Thursday, July 17, 2008

Leftover baby weight

I've been wanting to try meditation lately but I'm scared to see what will happen if I stop moving for just a minute. Instead, I run, even though it's 90 degrees by noon here. Sometimes I can get good and zen in a heat-stroked quiet mind.

Today though, I just replayed yesterday at work over and over in my mind as I jogged through the woods. I was baby-nurse for an emergency c-section. There was thick meconium and a very non-reassuring fetal heart beat: lots of late decelerations. I wasn't really following the case, I had my own patients but was able to assist with this case once I transfered one to postpartum.

I set up the warmer, ensured the code pink team was on the way, and assisted the delivery nurse as much as I could. I made sure that the clock was working but thought it wasn't. Time is so strange on adrenalin. Waiting for a single second to click by seemed so long that I assumed the clock was broken. Ran back to my patient's room for a quick assessment and then unfolded the sterile baby-catching drape over my arms. The first assistant deep-suctioned a few times and the surgeon screamed "Go! GO! GO!" They passed off the kid and I ran to the treatment center. For the first time I knew that the surgeon wasn't screaming at me because he doubted me, but that he doubted this baby.

I could still feel the weight of this baby in my arms as I ran through the woods. A full-term baby who is barely alive is so heavy. Normally I'd support the baby in one arm and vigorously rub his back in the other to stimulate crying, but in this case I did nothing but run. Didn't want him to aspirate his meconium. He was heavy and inert and I told my feet to GOGOGO.

On the warmer the fellow immediately attempted an intubation. I'd tested the laryngoscope in preparation of every single patient I had, but had never seen one used. Suddenly I was charting the resuscitation, q 30 seconds. I'd left a clipboard nearby and I was prepared but trembling. They upped the level of the code, we needed the full team.

The charge nurse came to help me. I was doing okay. I could still feel the weight of this big baby in my arms. I cannot get it out of my mind, cannot quiet my mind. Usually when I replay things from work, I am trying to figure out what I could have done better or differently, what I missed, what I want to learn from the day. The repeated memory of this baby was none of those. He was sent to the NICU and will probably be okay. My arms are still heavy and I cannot quiet my mind. I run over roots on a narrow woodsy path and I wish I could feel more sure-footed running across smooth OR tiles. I pump my arms and they are heavy with this leftover baby-weight memory.

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