Our unit has been running a high census for months. If that sounds like “running a fever”, it is in fact rather similar: a high rate of activity and stress. The babies keep coming and going. Sometimes we say “they’re falling from the sky!” Or “it’s raining babies!” Or “this unit just has a revolving door!”
After having rounded daily for more than a week straight, I catch myself taking the fastest way out of the unit. I’m exhausted from participating in the long litanies of vital signs, growth velocities, fluid volumes in and out, ventilator settings, lab results, problems, and plans. Much as I hate to admit it, their stories are blurring together.
I realize I’m hiding from my patients’ parents. And I’m ashamed.
I fear entering a room, greeting parents, and then not being able to answer questions about the details of their precious baby’s care. I fear that if they notice the weariness in my eyes, they will suspect the fog in my sleep-deprived brain, the ache in my long-clenched jaw, the knot in my fearful, overly responsible gut. And I fear there is a callus forming tight and thick around my endlessly-breaking heart.
I feel as though I’m making a mockery of the “hospitality” part of “hospitalization.”
On my way to the stairs, I pass one darkened room where I know what is going on. The parents are sitting and their baby is is sleeping. His ventilator is rhythmically puffing tiny spurts of breath into his lungs and pausing to let the air back out. His monitor tracks heart rate, oxygen level, and ventilator breaths. He’s not breathing much without the ventilator.
Well, yes, I know what’s going on — I just don’t know why this particular baby needs this particular degree of critical care. We’ve ruled out infection, malformations, and obvious metabolic problems. But yet every time we try to back off a little on the support, he shows us he needs it.
We’ve consulted various subspecialists, none of whom have immediate answers either. We’ve sent more tests that could take weeks to result. And, of course, we’ve recited his particular litany on rounds, as a group, daily.
His parents receive it there, daily. And the rest of the time, they sit quietly at his bedside and watch and wait. The nurses help them with diaper changes, with feedings (by tube), and with careful cuddling sessions (with tubes and monitors attached).
I feel like I have nothing to add to his care. As the attending, I think, I should have the answers, the plan, the authority.
But without any of these things — I don’t feel qualified to enter the room.
Well, I tell myself, at least I can offer my presence. That might be comforting, if not exactly healing.
I take a deep breath, knock on the door, slide it quietly, part the curtain behind it, and poke my head in. They don’t seem angry to see me — they might even be pleased.
“How are you doing?” I ask as I sit down.
They speak of nothing but gratitude for our team, perspective on the wait, love for their son.
In return I haltingly voice my frustrations with the limitations of our service. I apologize for not having answers this far into the NICU stay. And then I realize that I have been impatient, presumptuous and, yes, pompous in seeing myself, us, the NICU, as “the problem” just because their baby is still here. And I thank them for their time and their patience.
The stunning gratitude and generosity of this couple, in their caring for me, reminds me: caring is not the same as fixing, or solving— or, for sure, eliminating—all problems.
That day I learned, again, that we in the hospital may offer hospitality— but we also receive it. I’ve learned this every time a baby’s family member demonstrates that they see us as human beings, not just “care providers” (a term that, if you look at it for too long, is reminiscent of Rosie the robot maid from The Jetsons, or Baymax in Big Hero 6).
I’m learning that hospitality comes from making space for attending. As Henri Nouwen put it “There is a powerful connection between our emptiness and our ability to welcome. When we give up what sets us apart from others—not just property but also opinions, prejudices, judgments, and mental preoccupations—then we have room within to welcome friends as well as enemies.” (You Are the Beloved, p. 270)
(Note: account of patient encounter is fictionalized and is not intended to describe any individual/family.)