Nursing Voices

Monday, January 15, 2007

When Words Are Not Enough

Sometimes all it takes is one sentence to trigger a flood of memory. Kim's moving recollection about a very sick AIDS patient sent me flying into the past with this sentence: "A family desperately clinging to denial is a painful thing to witness."


She was 22 weeks along, and absolutely convinced that she was out of the danger zone, that there must be something we could do, either to stop her from delivering or to save her baby. If she prayed hard enough, had enough faith... surely everything would be fine.

"I felt him kick again. He's still alive!" she exclaimed brightly. Smiling at her husband, she said, "See honey? He's right here. I can feel him kicking."

Over and over she murmured to herself, "It's going to be okay, you're going to make it. Just keep praying..."


"Do a C-section. Save my baby!" she demanded, once she realized that delivery was unavoidable and the baby's heart rate was slowing. Now, she was scared and angry.

We gently explained that the baby was too early and did not have any hope of survival, whether or not we delivered him quickly. She refused to accept these facts. The tension and terror were palpable in the room, a wall of silence between us.

"It's going to be fine... he's going to make it."

Her denial persisted as we moved her to a delivery room, where the inevitable birth would take place. She insisted that we call the neonatal team to be present, so that they could resuscitate the baby, make him LIVE, as she knew in her heart he could, if only she prayed hard enough. She asked for a chaplain and "anyone that believes in God" to come and pray with her.


And then it came.

The moment of realization, like an invisible bubble bursting. She saw him.

"Oh," she whispered, as he was whisked into the waiting arms of the neonatologist... "He's too small." And she looked into my eyes, and then, she knew.


He was too small. Only 370 grams, 13 ounces.

There is no ET tube small enough... no prayer big enough. I wanted to take her in my arms, shield her from the pain.

But at last, she was able to let go. Now she could see that it was not meant to be. Now she could hold her son, and grieve for him, and love him, as he was.


Denial can be so cruel. So, too, can the onset of reality... and with it, the loss of hope.


oncRN said...

this leaves me chilled and heartbroken. it must be surreal to have birth and death collide right in front of you. i cannot imagine.

Kim said...

This post was so well-written, so vivid, and so heartbreaking. How utterly, desperately sad.

Nurse Practitioners Save Lives said...

What a heartbreaking post. My last pregnancy was very high risk and I had to have a cerclage. I was on bedrest my entire term. I was able to bring him to fullterm and was very blessed. Others unfortunately are not able. It's so sad.