In this past year God allowed me to realize that Palliative Care was a calling for me. For those of you who may not know, Palliative Care specifically involves improving quality of life and providing comfort for those at the end of life. Nurturing anyone at the end of life is a challenge for the patient as well as the caregivers even when it is expected as a natural progression of age. However providing palliative care in the nursery or labor and delivery presents an entirely unique set of challenges…no matter how much information we have…nothing ever prepares a parent to say good-bye to a child and especially a baby. So although I consider this a calling, and although even as I write I am completing a course at Harvard for certification in Palliative Care, I am clear that when my brother died in July nothing in my grief training could have prepared me for it.
My brother was brutally murdered in his home on June 29th, 2010…he was thirty-five…tomorrow October 14th would have been his 36th birthday. It’s only been three months since he passed and it still doesn’t seem real. His killer has not been found…but my sadness, my regret at not being able to see him one last time hurts way more than my anger at an investigation that seems to be at a standstill. And even if the person was found today I am clear that it would not bring him back. And even if God himself told me why he had to die this way…somehow I don’t think I would have less sadness or less regret.
I think about all the parents I have prayed with, held hands with, cried with, hugged, been at witness at baptism, taken pictures of, and tried to comfort as they said good-bye to their precious babies who were destined to be angels. I was always aware that words could never be enough, but always prayerful that in time healing and peace would come. I think about all the babies over the past ten years that I have had to say good-bye too. And all the baby funerals I have attended…and standing in a baby cemetery looking at tombstones covered with dolls and trucks and trying to make sense of it all. Yet, somehow deeply understanding that sometimes we simply will not understand. We just have to accept and move on…find a way to live with our grief and to cherish the memory of our loved one’s in that grief. But no one really move’s on, because to move on means to move forward in the same direction. I think those of us in the grief process move forward but our destination is very different than the one it would have been without this experience of pain.
In my brother’s death I received a greater understanding of what loss means for these families…it’s not that I haven’t lost loved one’s before I have..and it never gets easy just the manner in which I lost him did leave me totally blind sided and wonder how did I ever console a parent? How did I ever a hold a baby and watch it take its last breath? It’s times like that…time’s like these that we know without a doubt there is a greater power…and I am grateful for daily peace in the midst of tears. I am grateful for the capacity to love and to remember.
I am so grateful for the opportunity I had to have experienced Frederick Demond Jackson for thirty five years. I miss your smile…your big eyes…your wicked laugh…your passion for life…your always knowing what was going on and always managing to be on the VIP list…your sense of style…your accountability to everyone in our family…your loyalty…and of course your insatiable love of ketchup. I miss you…but I know somewhere you are smiling…and getting ready to celebrate your birthday with banana pudding and ketchup..but hopefully not together…but knowing you I wouldn’t be surprised. Happy Birthday Fred…love your Big Sis.
Wednesday, October 13, 2010
Physician Heal Thyself
Although I have been taking care of babies and families for over ten years when it was time to take care of myself I didn’t have a clue as to where to begin. As a neonatologist I get the pleasure of attending deliveries usually every day…I get to witness the miracle of birth every day…and sometimes that miracle comes with a few complications. The delivery of my own first child was associated with such a complication as I required an episiotomy or incision at the birth canal to safely deliver my daughter. This kind of incision can lead to problems years later with having normal bowel habits. I would say more but I think you get the picture!!.
So flash forward 12 years and I find that in the prime of my medical career I have an unpleasant reminder of one of the most wonderful events of my life. On the one hand I have a beautiful daughter growing into a splendid young lady and on the other hand I am a forty two year old in diapers. Now for most people this kind of choice would be clear…daughter yes, diapers no but not for me the Great Physician or so I thought. I considered medical management…fiber yes, diapers unfortunately still yes. I tried avoiding eating, starvation yes, unfortunately diapers still yes.
Several people who knew way more about the condition than I recommended surgery, but the thought of surgery petrified me. The thought of being sick petrified me. And pain…please I had already committed to a variety of the newest brand of Depends underwear to avoid pain. A friend asked me quite simply did I think I was behaving like a rational person…I replied, “Why yes, of course, I thought I was.” The same friend asked me how could I be such a champion for babies, my family, and my friends and not for myself. When I shared that I would rather have a colostomy than have surgery…my friend said okay let me know how that works for you and your EGO.
What a blow…but how true. I thought how many times I have shared with parents how brave they are watching their one and two pound miracles fight for life. How many conversations have I had with their little miracle babies as I cheer them through each breath on the ventilator, each heel stick for a blood draw, each dropped heart rate, and each disruption of the day. And just how have I been able to do that? I am able to do that because I keep my eyes on the end result and move through the process. I clearly, quietly realize and acknowledge that God is always in control…and I am simply a vessel.
Finally I realized that yes, this was true for me also…He was in control…and if I focused on my end result and trusted him then I too could get through the process. So now six weeks later as hard as it has been to say good-bye to Depends and the fear of unexpected accidents, I am grateful that I had the opportunity to meet God in a new way on this journey…and to participate in the Healing of myself. And believe me grateful has taken on an entirely new meaning….and so has potty break! I hope it does for you too. Whether you have surgery or not…you have a preemie or not…you have been a patient or not…we have soo much to be grateful for ...let’s not take it for granted. I know I won’t!
So flash forward 12 years and I find that in the prime of my medical career I have an unpleasant reminder of one of the most wonderful events of my life. On the one hand I have a beautiful daughter growing into a splendid young lady and on the other hand I am a forty two year old in diapers. Now for most people this kind of choice would be clear…daughter yes, diapers no but not for me the Great Physician or so I thought. I considered medical management…fiber yes, diapers unfortunately still yes. I tried avoiding eating, starvation yes, unfortunately diapers still yes.
Several people who knew way more about the condition than I recommended surgery, but the thought of surgery petrified me. The thought of being sick petrified me. And pain…please I had already committed to a variety of the newest brand of Depends underwear to avoid pain. A friend asked me quite simply did I think I was behaving like a rational person…I replied, “Why yes, of course, I thought I was.” The same friend asked me how could I be such a champion for babies, my family, and my friends and not for myself. When I shared that I would rather have a colostomy than have surgery…my friend said okay let me know how that works for you and your EGO.
What a blow…but how true. I thought how many times I have shared with parents how brave they are watching their one and two pound miracles fight for life. How many conversations have I had with their little miracle babies as I cheer them through each breath on the ventilator, each heel stick for a blood draw, each dropped heart rate, and each disruption of the day. And just how have I been able to do that? I am able to do that because I keep my eyes on the end result and move through the process. I clearly, quietly realize and acknowledge that God is always in control…and I am simply a vessel.
Finally I realized that yes, this was true for me also…He was in control…and if I focused on my end result and trusted him then I too could get through the process. So now six weeks later as hard as it has been to say good-bye to Depends and the fear of unexpected accidents, I am grateful that I had the opportunity to meet God in a new way on this journey…and to participate in the Healing of myself. And believe me grateful has taken on an entirely new meaning….and so has potty break! I hope it does for you too. Whether you have surgery or not…you have a preemie or not…you have been a patient or not…we have soo much to be grateful for ...let’s not take it for granted. I know I won’t!
Monday, July 12, 2010
Happy Father's Day in the NICU
When I wrote the blog celebrating Mother's Day in the NICU, I had every intention of dedicating a similar blog to Dad's in the NICU on their special day as well. But here it is July 12th almost a month after Father's Day and I am just getting around to it. First let me apologize to Dad's everywhere....please know that you have a special place in my heart and I have carried this message in my head for the past three weeks.....I guess it's true that Dad's are often the last to get recognized. My husband always says.....there's way more attention given to Mom's on Mother's Day than Dad's on Father's Day and wives or girlfriends on Valentine's Day than husbands or boyfriends...I must admit it's sad but true...even Mom's get more attention on Valentine's day when Dad's may not. So let me go on record by saying that even though June 19th has come and gone..as far as I am concerned every day is Father's Day!!
Father's in the NICU are some of my favorite people...they constantly fulfill two roles...they want to be and have to be strong for the Mom's but at the same time they show incredible tenderness in the face of what for many is the most fragile of human lives. I recently attended a delivery and was reminded by a Dad what a gift it is for me to be there to see a new soul enter the world and not to ever take that for granted. I was standing in my usual spot in the delivery room, near the warmer in what seemed like the zillionth delivery of my life and listening to a mom push and finally deliver her baby. I heard the OB sharing what a beautfiul baby it was and coaxing this new and tentative Dad into his first official Daddy duty...cutting the umbilical cord which he did with impressively steady hands. Finally the nurse brought the baby to my team and we begin to dry her and encourage her already healthy cry and obviously well working lungs.
From the side I heard the slightest sniffle, then a whisper....." Hello Baby Girl.....I love you soo much....and I can't wait to change your first diaper....." I looked in to the face of a Dad, a Father......and I saw pure love, genuine tenderness, and shining adoration...and I smiled....yep another Daddy's girl in the making. NICU Dad's do cry in the delivery room....they also cry in the NICU....they pray in the NICU, they hold Mommy's hand, they hug Mommy's shoulders, they wheel her wheelchair back and forth from Mom's room to the NICU, they bring breast milk to the NICU from home....they get updates for Mom....they go to work and drive mom to the hospital every day while on maternity leave....they figure out how to use their large hands to lift a one pound bundle and change a diaper or take a temperature and every now and then they manage to get a nap while kangarooing the tiniest of humans on their chests...skin to skin, heart beat to heart beat...father to child...and for that and so much more we appreciate them.
But as I shared in the Mother's Day Blog....you don't have to be a NICU Dad to be celebrated on Father's Day. The same traits we see in NICU Dad's we see in all awesome Father's. They are protectors and providers, they know how to have fun, they are troop leaders and team captains, they are movie buddies and confidantes, they give the family security, they make time for their children, they make time for Mom, they love with sacrifice, and they are committed to creating a world that their child can thrive in...and their dreams can come true. So if you know a Dad like that....then thank them....they may be macho on the outside...but they want to know that they are appreciated too...that every now and then they got it right...so for now...we can tell them...and then later....the kids that make them Father's can tell them too..and I am sure that's the best Father's Day present of all!
Father's in the NICU are some of my favorite people...they constantly fulfill two roles...they want to be and have to be strong for the Mom's but at the same time they show incredible tenderness in the face of what for many is the most fragile of human lives. I recently attended a delivery and was reminded by a Dad what a gift it is for me to be there to see a new soul enter the world and not to ever take that for granted. I was standing in my usual spot in the delivery room, near the warmer in what seemed like the zillionth delivery of my life and listening to a mom push and finally deliver her baby. I heard the OB sharing what a beautfiul baby it was and coaxing this new and tentative Dad into his first official Daddy duty...cutting the umbilical cord which he did with impressively steady hands. Finally the nurse brought the baby to my team and we begin to dry her and encourage her already healthy cry and obviously well working lungs.
From the side I heard the slightest sniffle, then a whisper....." Hello Baby Girl.....I love you soo much....and I can't wait to change your first diaper....." I looked in to the face of a Dad, a Father......and I saw pure love, genuine tenderness, and shining adoration...and I smiled....yep another Daddy's girl in the making. NICU Dad's do cry in the delivery room....they also cry in the NICU....they pray in the NICU, they hold Mommy's hand, they hug Mommy's shoulders, they wheel her wheelchair back and forth from Mom's room to the NICU, they bring breast milk to the NICU from home....they get updates for Mom....they go to work and drive mom to the hospital every day while on maternity leave....they figure out how to use their large hands to lift a one pound bundle and change a diaper or take a temperature and every now and then they manage to get a nap while kangarooing the tiniest of humans on their chests...skin to skin, heart beat to heart beat...father to child...and for that and so much more we appreciate them.
But as I shared in the Mother's Day Blog....you don't have to be a NICU Dad to be celebrated on Father's Day. The same traits we see in NICU Dad's we see in all awesome Father's. They are protectors and providers, they know how to have fun, they are troop leaders and team captains, they are movie buddies and confidantes, they give the family security, they make time for their children, they make time for Mom, they love with sacrifice, and they are committed to creating a world that their child can thrive in...and their dreams can come true. So if you know a Dad like that....then thank them....they may be macho on the outside...but they want to know that they are appreciated too...that every now and then they got it right...so for now...we can tell them...and then later....the kids that make them Father's can tell them too..and I am sure that's the best Father's Day present of all!
Friday, May 7, 2010
Happy Mother's Day in the NICU
As I reflect on Mother’s Day weekend ….I think of all the things it meant to me before this year and what it means to me now. One week ago my husband and best friend for almost 17 years, suffered a major head and spinal cord injury and remains hospitalized. Although I was very worried about him, part of me couldn’t help but think ….this will be the first Mother’s Day that I won’t be pampered ……because he’s always spoiled me for Mother’s Day. Slowly and clearly I began to visualize Mother's Day 2010… I would spend Mother’s Day being a single parent. I would spend Mother’s Day driving back and forth to the hospital, being tired; sleep deprived….and most of all worried about my husband and the father of my children.
Part of his symptoms included severe nerve pain and intolerance to touch……several times he screamed please don’t touch me….don’t hug me…don’t kiss me….I am still dealing with the sadness of not being able to even touch the one you love….to know that your touch—no matter how gentle is causing pain…is not something I can say I had ever experienced...nor do I ever want to exprerience again. Human touch is such a basic need ... one I believe we all take for granted…..simple hugs….little kisses…a pat on the back…each healing in it’s on way…a basic connection that validates we are loved and that someone cares. So I began to pray….Lord just let me be able to touch him without causing pain. I cotinued to pray steadily for my husband and encouraged all of my family and friends to join me. During that same time period God had a good friend email me on my blog about the NICU experience for Mother’s Day.
I immediately was reminded that NICU mom’s spend mother’s day driving back and forth to the hospital. NICU Moms spend mother’s day worried. And too often…..NICU Mom’s spend mother’s day wishing they could touch and hold their babies….or even hear them cry. Over forty years ago my sister was born very premature at a time when families were not allowed frequent visits with their infants…and rarely allowed to touch. My parents visited my sister often on Sundays and looked at her through a window…waiting for the day they could take her home. It makes me grateful for the opportunity to give Mom’s the gift of touch in the NICU today.
Today we are able to offer mother’s the opportunity to participate in kangaroo care or skin to skin contact with their babies sometimes immediately after birth and if not…then as soon as possible. Kangaroo care has been shown to improve health outcomes for premature infants and enhance the parent child bond which is often strained in critical care settings. So I want to say to everyone providing care in the NICU or every family with a baby in the NICU……please take advantage of one of our most simple but special gifts...the gift of human touch.
So what does Mother's Day in the NICU mean?….it may not mean Sunday brunch…it may not mean cute handmade cards, flowers or chocolates…but it can mean….the opportunity to take time to treasure the life you have helped to create…the life that made you a mother. It can mean the opportunity to place one of your fingers in the palm of a tiny hand and watch each of those tiny little fingers curl around in it…in a life confirming grasp. It can mean watching a cute yawn, a startled expression, or stroking the faintest baby hair. It can mean counting ten fingers and toes….marveling at God’s perfect image. It can mean one more day to celebrate Life..Peace…and Your Family. And of course one more day to celebrate God’s grace and all the daily blessings we take for granted.
Of course….you don’t have to be a NICU mom to do this…..in fact…..I challenge all Mom’s to spend Mother's Day celebrating the little lives you helped to create…the lives that made you Mom’s……..in the place that you most feel like a Mother...which is usually right next to your little one's .....Happy Mother’s Day.
Part of his symptoms included severe nerve pain and intolerance to touch……several times he screamed please don’t touch me….don’t hug me…don’t kiss me….I am still dealing with the sadness of not being able to even touch the one you love….to know that your touch—no matter how gentle is causing pain…is not something I can say I had ever experienced...nor do I ever want to exprerience again. Human touch is such a basic need ... one I believe we all take for granted…..simple hugs….little kisses…a pat on the back…each healing in it’s on way…a basic connection that validates we are loved and that someone cares. So I began to pray….Lord just let me be able to touch him without causing pain. I cotinued to pray steadily for my husband and encouraged all of my family and friends to join me. During that same time period God had a good friend email me on my blog about the NICU experience for Mother’s Day.
I immediately was reminded that NICU mom’s spend mother’s day driving back and forth to the hospital. NICU Moms spend mother’s day worried. And too often…..NICU Mom’s spend mother’s day wishing they could touch and hold their babies….or even hear them cry. Over forty years ago my sister was born very premature at a time when families were not allowed frequent visits with their infants…and rarely allowed to touch. My parents visited my sister often on Sundays and looked at her through a window…waiting for the day they could take her home. It makes me grateful for the opportunity to give Mom’s the gift of touch in the NICU today.
Today we are able to offer mother’s the opportunity to participate in kangaroo care or skin to skin contact with their babies sometimes immediately after birth and if not…then as soon as possible. Kangaroo care has been shown to improve health outcomes for premature infants and enhance the parent child bond which is often strained in critical care settings. So I want to say to everyone providing care in the NICU or every family with a baby in the NICU……please take advantage of one of our most simple but special gifts...the gift of human touch.
So what does Mother's Day in the NICU mean?….it may not mean Sunday brunch…it may not mean cute handmade cards, flowers or chocolates…but it can mean….the opportunity to take time to treasure the life you have helped to create…the life that made you a mother. It can mean the opportunity to place one of your fingers in the palm of a tiny hand and watch each of those tiny little fingers curl around in it…in a life confirming grasp. It can mean watching a cute yawn, a startled expression, or stroking the faintest baby hair. It can mean counting ten fingers and toes….marveling at God’s perfect image. It can mean one more day to celebrate Life..Peace…and Your Family. And of course one more day to celebrate God’s grace and all the daily blessings we take for granted.
Of course….you don’t have to be a NICU mom to do this…..in fact…..I challenge all Mom’s to spend Mother's Day celebrating the little lives you helped to create…the lives that made you Mom’s……..in the place that you most feel like a Mother...which is usually right next to your little one's .....Happy Mother’s Day.
Monday, March 22, 2010
Special Families..... Special Babies
One of the hardest things about being in the NICU is dealing with the question of why....which of course you can't really deal with because no one ever really knows why.
We can explain medical conditions and it makes us feel better but do we really know why? We can talk about prenatal care....but what if you did get prenatal care? Then why? We can talk about risks for prematurity...but why does someone else have the same risk factor and end up with a baby that avoids the NICU? Why do term babies end up in the NICU? Why are there problems at birth that didn't show up on the sono? Why do some babies go home healthy and others go home with challenges? As you know the list goes on and on...and unfortunately it is infinitely longer than the answers.
I have been in practice 10 years and out of medical school 15 years. I have been to tons of lectures, done tons of research and spent tons of money on my education. I have taken care of thousands of babies and still it doesn't matter...because none of us really knows why. And that's the question parents seem to ask themselves the most in those first few days.,weeks... months and sometimes years later. And truthfully it's a question I have too.
At one of those many lectures I attended I had the opportunity to hear a mom speak about her child who was born with a serious chromosome defect and only lived until she was 9 months of age.... a miracle in itself because the doctors had said she wouldn't live past 24 hours. What she said was this............"God could have chosen anyone in the world to be this child's Mom and Dad...and he chose us...Why Me?........ Why Not Me?... we are forever grateful for the privilege of having held her, cared for her and to this day loving her."
Those words have stayed with me..........."Chosen".....I never really thought about it that way..............but it's true. And they provided me great comfort as I thought about my own son...who was full term and healthy but with significant learning disabilities............."God could have chosen anyone in the world to be his mom and dad ...but he chose us ....trusted us...Why Us? Why Not Us?"
So now whenever I meet a special new life in the NICU.....I think...... I was chosen to work today....to experience this life....experience this family....to treasure this moment.....I am grateful for the opportunity....and look forward to another chance to learn...to grow....to share.
Special Families..... Special Babies... Chosen Journeys...Appointed Moments...it's all in a day's work in the NICU and you know what.....out of the NICU too!
We can explain medical conditions and it makes us feel better but do we really know why? We can talk about prenatal care....but what if you did get prenatal care? Then why? We can talk about risks for prematurity...but why does someone else have the same risk factor and end up with a baby that avoids the NICU? Why do term babies end up in the NICU? Why are there problems at birth that didn't show up on the sono? Why do some babies go home healthy and others go home with challenges? As you know the list goes on and on...and unfortunately it is infinitely longer than the answers.
I have been in practice 10 years and out of medical school 15 years. I have been to tons of lectures, done tons of research and spent tons of money on my education. I have taken care of thousands of babies and still it doesn't matter...because none of us really knows why. And that's the question parents seem to ask themselves the most in those first few days.,weeks... months and sometimes years later. And truthfully it's a question I have too.
At one of those many lectures I attended I had the opportunity to hear a mom speak about her child who was born with a serious chromosome defect and only lived until she was 9 months of age.... a miracle in itself because the doctors had said she wouldn't live past 24 hours. What she said was this............"God could have chosen anyone in the world to be this child's Mom and Dad...and he chose us...Why Me?........ Why Not Me?... we are forever grateful for the privilege of having held her, cared for her and to this day loving her."
Those words have stayed with me..........."Chosen".....I never really thought about it that way..............but it's true. And they provided me great comfort as I thought about my own son...who was full term and healthy but with significant learning disabilities............."God could have chosen anyone in the world to be his mom and dad ...but he chose us ....trusted us...Why Us? Why Not Us?"
So now whenever I meet a special new life in the NICU.....I think...... I was chosen to work today....to experience this life....experience this family....to treasure this moment.....I am grateful for the opportunity....and look forward to another chance to learn...to grow....to share.
Special Families..... Special Babies... Chosen Journeys...Appointed Moments...it's all in a day's work in the NICU and you know what.....out of the NICU too!
Wednesday, March 10, 2010
Wednesday, March 3, 2010
Why Neonatology?
I've wanted to start a blog for years....to connect with those special people chosen for NICU journeys and to connect with those people trying to help those people chosen for NICU journeys. Although I have been a neonatologist for 10 years..........there's one question that always seems to make me pause........cause my voice to crack...and bring tears to my eyes. It's a simple enough question, "What do you do for a living?" We all answer this question over and over...again and again...and most of us know the answer. It's not that I don't know what I do...I do know...it's that most people understand what I do...what they really want to know is Why I do.
A neonatologist is a pediatrician that specializes in the care of premature infants and sick term infants. Usually when I say that...the next comment i s, "Why?? How sad....I couldn't do that." To that I say.....I was originally led to neonatology because my sister was a preemie and I was fascinated that she had spent the first three months of her life in a plastic box called an incubator. But the longer I live... the more I realize those seeds were planted by God.....this isn't just a job it's a ministry and for that I am grateful. Every time I am in the delivery room....and look into a precious baby's face....I remember we are created in His Image. I think I am looking at His Image. To feel a little chest moving, to see a little heart beating to watch a baby receive what truly is the breath of life... what a gift.
What's more...unfortunately and yes sadly, sometimes the gift is short....and then not only do I get to see His image but I get to see the faces of angels. I am reminded again how precious life is, how precious families are and how precious children are. What a privilege it is to care for them and their families....and I don't take it for granted. I recognize that we will not be able to save every baby...but we can save the human spirit...and that's what it's all about..............and that's why I do Neonatology!
A neonatologist is a pediatrician that specializes in the care of premature infants and sick term infants. Usually when I say that...the next comment i s, "Why?? How sad....I couldn't do that." To that I say.....I was originally led to neonatology because my sister was a preemie and I was fascinated that she had spent the first three months of her life in a plastic box called an incubator. But the longer I live... the more I realize those seeds were planted by God.....this isn't just a job it's a ministry and for that I am grateful. Every time I am in the delivery room....and look into a precious baby's face....I remember we are created in His Image. I think I am looking at His Image. To feel a little chest moving, to see a little heart beating to watch a baby receive what truly is the breath of life... what a gift.
What's more...unfortunately and yes sadly, sometimes the gift is short....and then not only do I get to see His image but I get to see the faces of angels. I am reminded again how precious life is, how precious families are and how precious children are. What a privilege it is to care for them and their families....and I don't take it for granted. I recognize that we will not be able to save every baby...but we can save the human spirit...and that's what it's all about..............and that's why I do Neonatology!
Thursday, February 25, 2010
Subscribe to:
Posts (Atom)