My day in the Neonatal ICU
So, Laura, where the hell have you been?! Well, I have been studying ALL weekend. Barely time to check in on my blog, email, etc. In case I haven't bitched enough about it, my exam is Tuesday morning. Learning 4 chapters in a weekend is ... interesting. Tiring. But my pre-med education this weekend hasn't been just reading chemistry notes and solving problem sets...
I spent yesterday morning in the neonatal/newborn ICU of a local hospital going on rounds with a neonatalist. It was one of the most intense experiences of my life.
The neonatal ICU is for babies born prematurely, many due to high-risk pregnancies. When I first arrived, the doctor and I chatted for a few minutes. We discussed my goals as a physician, what I've done so far, and where I was looking to go to med school. He told me about his son, who is a little bit younger than me and just quit working to enter Columbia University's post-bacc pre-med program. So, he was really familiar with my long-term goals. He then explained what happens in the neonatal ICU, and what I was about to see. Then he took me on his rounds. Honestly, I knew I was going to see sick babies, but I never imagined how tiny they would be. Sure, I’ve seen pictures, but seeing them in real life, inches away…
We went from baby to baby checking everything: all the vitals, how they are healing from their surgery (a high number of premies are born with hernias, and have surgery very shortly after birth to repair it), their O₂ levels, if they need a diaper change, etc. The first baby I saw was the sickest. And he literally took my breath away: he was just under 2 pounds. He had the tiniest tubes in his nose feeding him O₂. Leads from a heart monitor were taped to his little chest, and he was wearing a tiny, tiny little diaper, which was still baggy on him. The most striking thing: his hands. His entire hand was no bigger than my thumbnail, his fingers barely distinguishable.
He was born at 25 weeks -- that's about 11 weeks too early -- and he is probably going to be there a few months. But he was doing great! He was born on Friday night -- when I saw him he was about 12 hours old. There were about 11 babies total in the ICU, some sicker than others. As we went to each and every one of them, the doctor explained everything to me: what was wrong with the baby, how premature he/she was, and the course of medical treatment they were giving. We then met with the residents and PA. I sat in on their discussion for the day's plan, mesmerized by how much they new: They talked a lot of numbers, mostly about meds, how they reacted with other meds, what might have caused a certain baby to lose 25 grams overnight, how to correct it. Once the day’s plan was set, we finished his rounds. And no sooner did he finish, he was paged to the newborn nursery where there was a baby just born. The mother wasn't sure how long she was pregnant, and he was tiny and needed to be evaluated. Seeing newborn infants, and I mean minutes old, was mind-boggling. I've never had a child, so I have never been exposed to a baby younger than a few days old. And never a premature one. This baby was fine. Very, very cute. And very healthy. Just little.
The docs, residents, PAs and nurses were the absolute most amazing people. They explained *everything* to me.
Does this experience make me want to focus on neonatalogy? I don't think so, but I can’t say for sure. My fear with specialties such as this is that I think it can be unbearably heartbreaking.
Not all of those babies in the ICU will make it. Yet some of them defy the most astounding odds.
The day definitely gave me renewed vigor to come home and crack the books. If doing this will get me there, then it’s worth the pain and suffering of five weeks of hell. Besides, compared to a 1lb, 10 oz. premature baby, I don’t know what suffering is.