An Anticipatory Grief

Mortality is a subdued thought that is always scratching from the back of our minds- Casey

I got bored of helping my classmate putting the diaper on the baby that she just had suctioned of its secretions and bathe, so I decided to stroll around the nursery living her behind panicking. The room is not that big. Earlier, I was able to mop the place in less than 4 minutes.

Just like an eager enthusiast scrutinizing each specimen of his collection, I pored around from one bassinet to next and from one incubator to another gazing at the babies sound asleep. I somehow felt envious, it was already 5 in the morning and I haven’t slept yet.

I passed by the incubator that was placed in the farthest corner of the room. The baby inside was born 2 months less to maturity; he was being sustained by a mistent for his oxygen. Babies who are born after a complete nine months of pregnancy usually sleep with their arms and legs curled and folded with their tiny fist closed into balls reminding us of boxers ready to punch anytime; however, this particular baby laid his arms and legs straight on his side with the fists hanging open- the very evidence of his prematurity. I noticed that the child’s skin has streaks of yellow on his head and chest which gradually changes to dark red at the arms and legs to dark violet on the soles and palms. I know perfectly well that this means that there is an impairment in the child’s tissue oxygenation. I looked closely at his chest and watch if it rises or fall. I tried to observe for movement but it was clear that he’s not breathing. I reported the matter to my Clinical Instructor who was now helping my classmate. She notified the nurse afterward who immediately came.

The nurse instructed someone to call for the mother outside while she instructed me to replace the mistent with an ambubag. It wasn’t difficult to bring back the baby’s color, what is hard is how to maintain it. She irritated the baby and made it cry so that it can gasp for air. Everything is already fine when the mother entered the room

I was a bit surprised when I saw the mother. Well she is very young. I had many experience with teenage mom and I am never really fond of them. They are usually the irritating and very stubborn. They are the most difficult to handle inside the delivery room. When she came, she was immediately greeted by the nurse by saying, “Iha, baka hindi na magtagal yung anak mo. Mahina sya oh.’ (Miss, your son won’t make it. He’s weak). It wasn’t really the fact that the nurse, although we are not allowed, giving a “prognosis’ that shocked me… it was rather the nurse’s tactlessness. The girl momentarily stopped and tried to maintain her composure, she might have wanted to say something but she just left us and proceeded to the incubator. I, on the otherhand, resumed helping my classmate. But then the baby stopped breathing and changed its color again. The nurse did just as what she did earlier but the baby’s color did not return. I tickled the baby to cry but he didn’t. There is no pediatrician inside and nurses are not allowed to prescribe any medication. But the nurse willingly took a piece of prescription form and wrote epinephrine… she gave this to the mother and told her to buy. It turned out that there is a stock of epinephrine inside the nursery and she only made the prescription for the replacement, without any doctor’s order the nurse injected the ampoule through the baby’s IV line. In no time the baby was crying lustily. Then I resumed helping my classmate again.

A few minutes later, my CI instructed me to check the babies’ Heart and Respiratory Rates. I decided to record the baby in the incubator first. The girl watched her son inside the incubator; she had her hands on the transparent barrier that separates them. I came forward, but I was a bit taken aback when I heard the girl sobbing and saw tears swelling from her eyes. I couldn’t help but blame the nurse for her insensitivity. She moved sideway when she felt me coming, I wanted to say something therapeutic, but I am never good at this stuff. So I just asked her age, hell I couldn’t think of anything else to say, she said fourteen. I was more astounded.

The most important thing to do if a newborn dies is to let the mother hold the baby in her arms so that she could start with the normal grieving process. But what if the mother is experiencing an anticipated grief? The answer… I really do not know, but I really wanted to do something to make things easier for her. I understand that getting pregnant at the age of fourteen is tough, let alone learning that your son will soon to die. I cannot think of anything else to do so I just weakly smiled and gave her my stethoscope. I encouraged her to listen to her son’s heartbeat.

She took it and listened to her son’s heart. She glanced at me and I saw that more tears came pouring down to her face, and she said, “Tumitibok pa.” (Still beating.) I can sense a revived hope in her voice. According to Angelo my heart is as hard as a stone. He told me this because when we had our self awareness in the Mental Hospital, I was the only one in our group who did not cry. And I guess my heart indeed is cold and hard. But I think that time, whatever it is that made my heart froze, it was drenched away by all the tears that the girl cried. Just by the mere sound of her sobbing was enough to melt my heart. Although I did not cry, I was extremely bothered. I wanted to pat her on her back or say something really, really nice but I couldn’t find the proper words.

After our duty, instead of going straight home I decided to stay at the school to return a book. Since the library opens at 8, I made it a point to visit the church and to pray for the two of them.