Small Great Things(22)

What am I supposed to do?

What am I not supposed to do?

Any moment now, Corinne or Marie might walk into the nursery. They’d see me interfering with this infant, and then what?

Sweat runs down my spine as I hastily wrap the baby up in his swaddling blanket again. I stare at his tiny body. My pulse throbs in my eardrums, a metronome of failure.

I’m not sure if three minutes have passed, or only thirty seconds, when I hear Marie’s voice behind me. “Ruth,” she says, “what are you doing?”

“Nothing,” I respond, paralyzed. “I’m doing nothing.”

She looks over my shoulder, sees the blue skin of the baby’s cheek, and for a hot beat meets my gaze. “Get me an Ambu bag,” Marie orders. She unwraps the baby, taps his little feet, turns him over.

Does exactly what I did.

Marie fits the pediatric face mask over Davis’s nose and mouth and starts to squeeze the bag, inflating his lungs. “Call the code…”

I follow her order; dial 1500 into the nursery phone. “Code blue in the neonatal nursery,” I say, and I imagine the team being pulled from their regular jobs in the hospital—an anesthesiologist, an intensive care nurse, a recording nurse, a nursing assistant from a different floor. And Dr. Atkins, the pediatrician who saw this baby only minutes ago.

“Start compressions,” Marie tells me.

This time I don’t waver. With two fingers, I push down on the baby’s chest, two hundred compressions per minute. As the crash cart is jostled into the nursery, I reach with my spare hand for the leads and affix the electrodes to the baby so that we can see the results of my efforts on the cardiac monitor. Suddenly the tiny nursery is jammed with people, all jockeying for a spot in front of a patient who is only nineteen inches long. “I’m trying to intubate here,” the anesthesiologist yells at an ICU nurse who’s attempting to find a scalp vein.

“Well, I can’t get an antecubital line,” she argues.

“I’m in,” the anesthesiologist says, and he falls back to let the nurse have better access. She prods, and I push harder with my fingers, hoping to make a vein—any vein—stand out in stark relief.

The anesthesiologist stares at the monitor. “Stop compressions,” he calls, and I raise my hands like I’ve been caught in the middle of a crime.

We all look at the screen, but the baby’s rhythm is 80.

“Compressions aren’t effective,” he says, so I press down harder on the rib cage. It’s such a fine line. There are no abdominal muscles protecting the organs beneath that little pouch of belly; bear down a bit too much or a tad off center and I might rupture the infant’s liver.

“The baby isn’t pinking,” Marie says. “Is the oxygen even on?”

“Can someone get blood gases?” the anesthesiologist asks, his question tangling with hers over the baby’s body.

The ICU nurse reaches into baby’s groin for a pulse, trying to stick the femoral artery for a blood sample to see if the baby’s acidotic. A runner—another member of the code team—rushes the vial off to the lab. But by the time we get the results in a half hour, it won’t matter. By then, this baby will be breathing again.

Or he won’t.

“Dammit, why don’t we have a line yet?”

“You want to try?” the ICU nurse says. “Be my guest.”

“Stop compressions,” the anesthesiologist orders, and I do. The heart rate on the monitor reads 90.

“Get me some atropine.” A syringe is handed to the doctor, who pulls off the tip, removes the Ambu bag, and squirts the drug down the tube into the baby’s lungs. Then he continues to bag, pushing oxygen and atropine through the bronchi, the mucous membranes.

In the middle of a crisis, time is viscous. You swim through it so slowly you cannot tell if you’re living or reliving each awful moment. You can see your hands doing the work, ministering, as if they do not belong to you. You hear voices climbing a ladder of panic, and it all becomes one deafening, discordant note.

“What about cannulating the umbilicus?” the ICU nurse asks.

“It’s been too long since birth,” Marie replies.

This is going downhill fast. Instinctively, I press harder.

“You’re being too aggressive,” the anesthesiologist tells me. “Lighten up.”

But what breaks my rhythm is the scream. Brittany Bauer has entered the room and is wailing. She’s being held back by the recording nurse as she fights to get closer to the baby. Her husband—immobile, stunned—stares at my fingers pushing against his son’s chest.

“What’s happening to him?” Brittany cries.

I don’t know who let them in here. But then again, there was nobody available to keep them out. Labor & Delivery has been overworked and understaffed since last night. Corinne is still in the OR with her stat C-section, and Marie is here with me. The Bauers would have heard the emergency calls. They would have seen medical personnel rushing toward the nursery, where their newborn was supposed to be sleeping off the anesthesia from a routine procedure.

I would have run there, too.

The door flies open, and Dr. Atkins, the pediatrician, immediately shoves her way to the head of the bassinet. “What’s going on?”

There is no answer, and I realize I am the one who is supposed to reply.