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Chapter 11

Spoilers: NICU


 The NICU is a whole different world from the ER

Jake is like my little patient. From the day that I first started my NICU rotation, he has been here. It is so hard to see someone so small fighting for their life.

I looked up and saw that Carter was with Jake and the mom, and I walked up to them.

"I'm here to check on Jacob. He looks great," Carter said, trying to explain why he was here.


"His suck is still weak, but Abby tells me to keep on trying," the mom said.

"He'll get there."

That is the only thing I can tell them. Just to just keep on trying. There is nothing more you can tell the parents.

I looked at Carter, who was starting to make faces at Jake. He is so great with kids; he is going to be a great father. It is still so hard to think that he is going to be a father, but I am happy for him.

The mom then asked a question about Jake's health, and Carter said that it was for a question for cardiology, but since I have been here for I realized that the parents are so scared for their child that just want to know everything that could happen.

I replied. "The area where the aorta was repaired gets blocked with scarring but usually they can take care of it in the CathLab and avoid another surgery."

The mom then thanked me, but it wasn't like I did much. I explained about the surgery, but I guess that is all they want to know sometimes.

I told her that I had to get back to work, but I would come back later. I walked into the drug lockup and Carter followed me in there. I didn't realize that he was still there. I thought after seeing Jake he would go back to the ER.

"Looks like you are doing well in here," Carter said.

"Right," I said. I wasn't sure if I was doing well in my rotation or not. It doesn't seem like the attending liked me very much.

After I finished helping the nurse, I turned around and saw Carter was still there; he waited to talk to me. Maybe we can be friends again.

"The parents love you, nurses wouldn't give you the time of day if they didn't think that you knew what you were doing," Carter replied.

I smiled.

I guess the parents do like me. Suddenly I started to think of Jake, and what that mom has been though so far.

"Yeah. Tell that to my attending, you should see me on rounds."

It was like old times when Carter and I used to talk to each other about anything and everything. But it wasn't like old times anymore. I'm in med school, and he is going to be a father.

He then started to talk about him and Kem looking at labor and delivery suites. I looked up at him and smiled. "You are gonna to be a dad."

"Yeah," Carter said.

"How's it feel?" As I was looking at him, I was trying to see if he was excited about it or scared, but I couldn't tell. I used to be able to read his looks, and everything, but not anymore. We're both so different now from the people we used to be.



"Scary. Especially in this room. You start to think about all the things that could go wrong. All the mistakes you can make," Carter replied.

"You are going to be a great father," I said. There was no doubt about that. I didn't even need to think about that. I know he is going to be a great father to his child.

"Hey Abby."

I turned around.

"You're going to be a great doctor."

I looked at him and smiled, then continued to get ready for the delivery. Having Carter say that to me means so much.


I am starting to believe that myself, that I am going to be a great doctor.


**
Right before I did the intubation, I looked at the parents. How hard this must be for them to see their son in this condition again. Right when they thought he was getting better. "I see the cord. Tube," I said. As the parents looked at me, I took my stethoscope and checked his heart rate. He was stable.


"I don't know if I can take another round of this," the mom said. She looked so exhausted.

"Take a seat," I said.

I didn't know what to say. There wasn't much I could say.

"We are trying our best to help your son."

"I know you are, Abby."

"I'll be back in a while." As I was walking away, I turned around and looked at the parents with Jake. I don't know how much longer they could take it.


**
Later that day,

"Are you finished for the day?" I asked Neela. Neela nodded. "Let's go," I said as we left the NICU.

"So how is Jake doing?" Neela asked as we got on the elevator.

"Not good."

"I'm sorry, Abby.  I know that you feel attached to him?"


"I wouldn't say I'm attached, but I guess he is my special patient," I said, as we got out of the elevator and headed out of the hospital.

"I'll see you tomorrow, "I said.



**

As Elizabeth and I were wheeling Jake to surgery, I saw his family burst out of the elevator. Thinking that this may be one of the last times they may get to see him, I asked her to wait for the family to come over. She didn't want to wait, since they needed to get him to surgery right now, but I thought that his big sister deserved to see her baby brother, and since I didn't know what was going to happen in surgery, I knew that if she didn't now, she might never really have a chance.

I knelt down beside the little girl. "Hey. Would you like to see your little brother up close?"

The little girl nodded.

"Abby. " Elizabeth said. I looked up at Elizabeth. "Kids aren't allowed in the NICU," I tried to explain. "Just five seconds."

She stayed silent.

"Here he is," I told the little girl.

"Can he hear me?"

"Yes he can." The little girl was going to touch him, but then she looked up at me. I could see that she was scared to touch her brother, like she was afraid she would break him.

"It's okay, you won't hurt him," I reassured her.

She was quiet for a while,  and then spoke to him.

"I'm Miranda, your big sister."

I remained kneeling next to her and I watched as her little fingers wrapped around his even littler ones. I was so glad that I had made Elizabeth stop, even if the outcome of this surgery was successful.

After the little girl had seen her brother, Elizabeth and I wheeled Jake to surgery. I just hope and pray that this was going to work out, and Jake is going to make it through the surgery okay.


**

Jake's gone.


When Elizabeth told me they couldn't repair the bowel, I couldn't believe it. I knew it could happen, but it was still really hard. When you are a doctor, you are supposed to be saving people, especially the little ones. I picked up Jake, wrapped him in a blanket, and walked with him into the waiting room where the family was waiting to spend their last minutes with Jake. I put Jake in the mom's arms and started to walk away, when I heard my name. I turned around.

"Thank you, Abby, for trying to help my son," the mom said in no more than a whisper.

I nodded and walked out of the room, leaving the family to say goodbye.


**
My last day in my NICU rotation…

Kerry had just given me a bottle of cider to celebrate.

I decided to go and look for Neela when suddenly I bumped into someone. "Sorry." I looked up and saw that it was Carter.

"I had a break so I thought I would come and see how Jake is doing." When Carter said Jake's name, I suddenly realized that Carter didn't know about Jake's death. I looked up at him, and said softly. "Why don't we go somewhere else"

I pressed the alarm to get us out of the room. "Let's sit down?" I said. We sat.

"John, Jake didn't make it. He went into surgery so they could repair the bowel, but they couldn't fix it."

Carter looked up at me with this shocked look on his face, but I think his reaction has more to do with his and Kem's baby than Jake.

"Oh. When I came to see Jake that time, he seemed like he was getting better, but I guess this what happens," Carter said quietly.

Then Carter suddenly went silent; I wondered what he was thinking about. Then I thought about what he told me when we talked in the drug lockup.

Scary. Especially in this room. You start to think about all the things that could go wrong. All the mistakes you can make.

He is so scared that something could go wrong with his baby, and here I am telling him that something did go wrong with a baby. But that doesn't mean that is going to happen with his child.

"John, I know what you are thinking, that if something like this could happen to Jake, it could just as easily happen to your baby. But that's not going to be the case. Yes sometime things go really wrong, but something things go just right. Look at Kerry's baby, Henry. He was in the NICU for a couple of days, but now he is going home with Sandy and Kerry," I said. I hoped I helped him understand a little better that things were probably going to go alright with his baby.

 Carter looked at me. " Thank you, Abby."

I noticed that Carter was eying the bottle that was in my hand. "It's cider. I haven't had a drink for months," I told Carter.

"You don't have to tell me, it is none of my business."

"I know I don't, but I want to."

Suddenly Carter's pager went off. Carter stood up. "I should get back downstairs to the ER, thanks for telling me about Jake. So are you finished with your NICU rotation?"

I nodded.

"I'll see you back in the ER tomorrow."

I smiled. "Yeah, I'll see you then."


**
Up at the roof,

"We are finally finished with our NICU rotation, and we can go back to ER. I kind of miss it down there," Neela laughed.

"Same here."

"Are you going to try one of the cigars?" Neela asked me.

"No, they are disgusting. Are you?"

"Sure, I don't see why not." Neela said. She took a puff of the cigar and coughed.

"This is disgusting!"

"I told you."

"Why are cigars associated with babies? This stinky thing really has no place in a nursery."

"It's Froudian. Something about men wanting to have sex with your mother." I said laughing.

"Thank you," Neela said. I laughed again.

Neela asked why we were drinking cider instead of champagne, and I told her that Kerry knew that I don't drink. I asked if she was still thinking about going in neo natology, but she said no. Neela said she thought that I should go into neo natology, but I could never do it. I got attached to Jake and look at what happened. I could get attached to all the babies there… and watch them all die.

A little while later,

"I guess it is time for us to go," Neela said.

"Yeah, I'll see you tomorrow," I said, as Neela walked away. I sat down on the chair that was there, and thought about my whole experience in the NICU, it's something that has changed me forever.