When you spend enough time with babies at the hospital, you would soon learn that contrary to popular belief, not all babies are cute and cuddly. As we were having our rounds at the Sick Neonates Ward that November morning, a particular set of 10-day old twins has proven to me that some of them can be pretty ugly.
It’s not that they were not at all cute or cuddly. It’s just that they looked so exaggeratedly unhealthy: their skin and lips bluish, their bodies small, their heads disproportionately large. When I saw them, I secretly thanked my luck that I was my group’s head nurse for that day. I didn’t have to directly handle those twins. I just have to supervise the staff nurse who did.
Not even ten minutes after the morning rounds, one of my staff nurses came running to me to say that one of the ugly twins had a heart rate of a horrifying 30 beats per minute. The heart of a neonate usually beats at an average of 120-160 every minute – a 30 on a 10-day old baby was just unheard of.
We immediately called our clinical instructor and went to the baby. Compared to her already sick-looking twin, the baby bradying down looked so much worse. We checked her heart rate again, and found that it was even slowing down. We exposed the baby’s chest and stomach to check her breathing, but we didn’t see any chest movement at all. In the short minute that we observed her, the baby only gasped for a breath once, and then grew still. She was falling into apnea.
When the nurse on duty came by, her eyes grew wide when she saw that the baby was already cyanotic. She told us to get the baby to the treatment room quickly, while she went outside the ward to call a doctor from her phone. The mother immediately picked up her sick twin and went with us to the treatment room. The father remained with the better twin in the ward.
We placed the baby under a high rate of oxygenation once we got her on the treatment table. The nurse was pacing outside the room, clearly rattled as she yelled at her phone and told the doctor how bad the baby’s condition was.
I was worried that the mother would also be as frantic as the nurse outside. You can see the worry on her face, feel it on the way she looked at her baby. She was trying hard to hold on to composure, but you can tell that she was already brimming with hysterics as she stood there helplessly by her child.
I went to the mother, and took the baby from her arms, smiling at her as I did. I took the oxygen mask and put it over the baby’s face. But even with the oxygen mask covering her entire face, the baby was still not breathing. All the oxygen had no use. Her chest and stomach were still motionless, her skin was getting darker, her limbs were growing more limp by the minute.
I quickly reviewed my lessons in my head: How do you treat apnea? How do you wake up a purposively asleep baby? How do you stimulate someone else’s brain to tell their lungs to start pumping air into the body again?
It was probably not mentioned in class, or maybe I was not paying enough attention when we discussed conditions like this. But nothing came to mind about rescuing a baby from apnea. The only thing my mind could grasp was Sudden Infant Death Syndrome, and that had no cure at all. It was what it was – death swooping down, sudden and imminent.
I looked at the baby, only 10 days old, her eyes closed, her mouth open from her last gasp, her skin, lips and fingernails tinged with a type of blue you would never want to see on anyone, and I told myself that Sudden Death couldn’t claim her. Not yet.
In class, we were taught that right after birth, it is advisable to lightly slap an unconscious neonate’s feet in order to bring them into wakefulness. With that in mind, I exposed the baby’s feet and massaged them, hoping that the same mechanism would work on her, hoping that she would be stimulated into consciousness too. I didn’t even know what I was doing then. I was just rubbing her feet, when all of a sudden, the baby gasped and moved.
Surprised and relieved, I continued massaging the baby’s feet, and unexpectedly, miraculously, she continued breathing too. Her first breaths were hungry and deep, but after a while, she started breathing normally again.
My staff nurse who was watching the baby as intently as I was immediately exclaimed, “There it is! There it is! She’s breathing again!”
“Yeah,” I said, smiling behind my mask, thankful and happy that my thoughts about the baby’s imminent death were wrong.
In just a minute, the baby’s color started to return. Health started flowing into her blood vessels again. Her nail beds became pink. Her skin lost all its sickly blueness and returned to its usual brown.
She even began to cry. Crying is lung exercise, so her wails only meant that her lungs were trying to function well again.
I don’t think I’ve ever been that happy to see someone crying.
I looked at the mother and saw that even with the relieved smile on her face, she was crying too. I pulled off my mask to smile at her.
“Your baby was just kidding, ma’am,” I told her jokingly, in an attempt to comfort her.
She laughed, took the baby from me, and held her baby in her arms again.
Gracielle Deanne Tubera was a fellow for Creative Nonfiction at the 2012 Davao Writers Workshop. She is currently on her last year as a Nursing student in Ateneo de Davao University.