ATTENDING: beyond the long white coat

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B: babies, beginnings, and belonging

Why are so many of us fascinated by babies? 


“Where’s the window where we can go look at the babies?” is a question I’ve grown used to hearing from hospital visitors, even though no such window exists. And our stabilization team is never surprised to see passersby stop and crane their necks, trying to get a view of our passenger, as we roll the transport incubator down the corridors from the delivery room to the NICU. For that matter, in the not too distant past, crowds flocked to see “incubator baby exhibits” at world’s fairs, expositions, and even a permanent installation at Coney Island!


Do babies draw our attention because they’re so new that we’d all like to see them as our own — or even, somehow, as ourselves? Do we want to help tell their stories?

 



Most of the words we use at work aren’t originally English in derivation! But “baby” has been an English word all along.  According to the OED,  it originated with the Middle English “babe” (and the parallel “bab”) and is thought to be imitative of babies’ early vocalization of simple syllables with consonants , i.e. “ba-ba-ba”.  Both “babe” and “baby” have their first documented written use in the late 14th century.  


Some of us, though, prefer to refer to our patients as “infants”. “Infant” feels like a more formal word, perhaps more fitting for the distance between physician and patient.  And its etymological roots, although almost as old as “baby”‘s, could be fairly described as diametrically opposed. It derives, via Old French enfant, from Latin “unable to speak” or, literally, “without speaking” (fāns being the present participle of fārī “to speak”).


How do we see/hear/attend to babies? When we use the word “baby” — with its rootedness in early expressive language — are we recognizing an individual who is beginning to communicate, even if preverbally? Or do we view the speechless “infant” as a blank slate upon which adults are responsible to begin a narrative? 

The relatively new discipline of narrative medicine gives medical professionals the chance to work toward better understanding patients (the people under our care) by closely attending to their stories.  The implication here is that the patient is the narrator of the story to which the care team must attend.

But to whom, exactly, does a baby’s narrative belong?  T. Berry Brazelton, an attending pediatrician who (I now realize) deeply influenced me, says in his memoir, Learning to Listen: “In my work I’ve learned that everyone who cares deeply about a baby is in competition for that baby: parents with each other, grandparents who feel ‘if only they'd do it my way,’ caregiver and parent, parent and teacher, coach and parent. It's an inevitable reaction and part of attachment.”  

And of course it is true that our NICU patients are preverbal. So any approach to narrative medicine in our world necessarily involves work to understand each patient’s parents and to help them develop their infants’ narratives, voices, and, sometimes, medical decisions. 

Yet it is also true that babies are individual human beings: Tara Westover illustrates this masterfully in Educated , her account of learning to separate her own narrative from her parents’. Her conclusion includes the assertion that “we are all of us more complicated than the roles we are assigned in the stories other people tell.”    

And, finally, it is certainly true that perceived conflict between parents’ narratives and babies’ wellbeing can be a significant source of moral distress for a NICU team. In most cases, this distress can be lessened by listening: sharing perspectives can spread the distress more thinly for families as well as for providers. 


But the fact remains that babies’ stories are being told, and heard, by more than one person.   And, coming back to our human fascination with babies, and the possibility that we identify with them to some degree — isn’t the complex nature of narrative true throughout life? Isn’t each person’s own narrative more complicated and multifaceted than we as individuals imagine? 


I would say yes. Babies need us to help shape their stories, and we need each other to help shape our own  — but none of us is the ultimate Author.  We can look at this narrative-shaping as a conversation (what Charles Taylor terms the “fundamentally dialogical character” of human life) because we are all designed to function in community. As Curt Thompson puts it in Anatomy of the Soul, “the concept of a single functioning neuron or a single functioning brain simply does not exist in nature.” (p.112)

(True confession: the Taylor quote “showed up'“, in a timely fashion, on p57 of The Rise and Triumph of the Modern Self by Carl R Trueman the day after I’d written this.)

Babies are individuals, but they are dependent upon their mothers (or, less optimally, upon NICU technology) throughout gestation and even after birth, during the “fourth trimester” and beyond.  Children are individuals, but they are dependent upon adults.  And Jesus warns us adults that “(u)nless you turn and become like children, you will never enter the kingdom of God.”  


We can all help to shape one another’s narratives in the light of His eternal, overarching story.  Every one of us belongs to Him — and, in Him, to one another. Once we can acknowledge this truth, we are free to live out our identity as heirs of His Kingdom, members of His Body: dependent upon one another, and held together by His love. 


We are not alone.

1937 image from the New York Public Library via History.com