Just then the baby kicked a couple of times so I listened to the heart again with my stethoscope. It was still beating pretty strongly. I decided that weighing the kid might help decide whether he was viable or not, so I asked the nurse to get a scale. And just then, as my panic was reaching its peak, Larry came walking in. Thank fucking God! I think I had been out of the labor room for maybe a minute by that point, but it had definitely been the worst minute of my life.
I told Larry everything that had happened. He took one look at the baby and said, “Forget it. This kid’s not viable. Don’t do anything.” I was pretty relieved. I still felt bad because I didn’t even have a clue about what I was supposed to do, but at least I realized I hadn’t done anything that was harmful.
Then the nurse came back with this rickety old scale; it looked like something out of the nineteenth century. We put the baby on it and it read twelve hundred grams. No way that baby weighed twelve hundred grams! She said, “Well, this is the scale we use to weigh all the babies.” Larry said, “Well, it’s wrong.”
We wrapped the baby up in a towel and brought him back into the labor room. Larry explained to the mother that the baby was too small to survive but since he still had a heart rate, we were going to have to take him down to the NICU. The midwife started throwing a shit fit. She said, “You can’t take the baby downstairs! This baby belongs with his mother! You have no right to take the baby out of this room!” Larry told her that he wished he could leave the baby, but it was hospital policy that any infant with a heartbeat had to be brought to the NICU.
Then Larry and the midwife started fighting about where the baby should be kept while we waited for him to die. I stayed out of it; I agreed with the midwife, but I wasn’t going to argue with the resident who had just rescued me. Finally Larry called the hospital administrator. She showed up, heard the story, and agreed with Larry. The midwife argued with her for a while but finally she backed down and we took the baby downstairs.
When we got down to the NICU, we reweighed him; he really weighed only 460 grams. We put him in an isolette [also called an incubator—a Plexiglas box with a mattress and a heating element, used to house sick newborns] to keep him warm. I checked his heart rate about every ten minutes. Finally, after an hour, the heart stopped and I declared him dead. Then I went upstairs and told the mother that the baby had died. We brought him back up and gave him to her to hold for a while. She was exceedingly sad.
Then I went downstairs and started doing more scut. At about seven o’clock all the new nurses came on, and they started yelling at me. They wanted to know why I hadn’t filled out the death certificate and gotten permission for an autopsy. They were being really hostile. I was exhausted and I’d had a horrible night; all I wanted to do was be left alone. I didn’t even know I was supposed to fill out the damned death certificate and get consent for the autopsy. Nobody told me I had to do those things.
Finally, one of the nurses came up to me, and she was really nice. She knew I hadn’t done any of this stuff before so she showed me exactly what had to be done. She gave me the death certificate and the autopsy form and the form for burial. She told me that I should go up and talk to the mother and tell her that if she wanted a private funeral, it’d cost $600, and if she didn’t have the money, the city would bury the baby free.
So I went back upstairs and talked to the mom, told her how sorry I was. I didn’t know what to say; I don’t have a lot of experience with this. I asked her if she wanted us to do an autopsy and she said no. She was really broken up.
So I was up all night working pretty hard. Then today we rounded nonstop until one-thirty and then I had to go to my outpatient clinic. I signed out all my work. I saw five patients in clinic and that went pretty well. I got done by four o’clock or so and then I sat around and talked with my clinic preceptor, Ann Covington, for a while. I like Ann a lot. It’s nice to have someone calming like her to talk to.
I went back to the NICU after clinic to finish my work. I got out at about eight and had to go to the bank and to the supermarket. The A&P closes at eight, so I missed it and now I can’t go shopping again for another three days. I’m totally out of food. I have to bring stuff home from the deli down the street if I want to eat dinner. It’s either that or going out every night. Fuck!
Karen called last night; I guess it was after I had gone to sleep. I don’t even remember what we talked about. I don’t remember a word I said. We talked for quite a while, I think. It’s ridiculous. I hope she’s home tonight so I can find out what’s happening.