Sam
Present
Philadelphia, Pennsylvania
Age 23
“HEY,” CASSIE SAYS, pulling me out of my haze. I’ve been in a fog all morning, unable to shake the cobwebs from my head. I haven’t slept in what seems like days. This time of year is especially difficult. My parents’ birthdays are this week, and it’s an unwelcome reminder that they aren’t here with me.
I shake my head and force a smile. “Sorry, it’s been a rough week.”
Cassie knows all too well how hard it is on me. She’s dried my tears on more than one occasion. “I’m so glad you have your aunt. She’s awesome and can help in any situation.” Her words of encouragement do anything but that. They only remind me of everything I have lost.
“Aunt Peggy’s the best,” I respond, thankful that I have her support.
Cassie pulls me against her firmly and squeezes. “You’re amazing, Sam. You know that?” I let her pull me tighter. “I say this all of the time, but I’m so proud of you. You went to college, got a nursing degree and now you’re here, in one of the best neonatal intensive care units in the state. You did this all yourself.” She hugs me tighter and then releases me to look into my eyes. “And you brought me along for the ride.”
“I’m not doing it alone,” I say humbly. “I’m still living in my Aunt’s house.” My aunt took me in right after my parents were killed. She has a large home in Villanova and I have my own space there.
Aunt Peggy’s a personal assistant and housekeeper to some guy who moved to the area when I was in nursing school. I think she said he’s a musician or something like that. He’s barely ever home, and she basically takes care of everything while he’s away. She’s been doing this type of work her entire life. The last family she worked for moved out to California when their daughter landed a role in a television sitcom. She worked for them for almost twenty years, and they were devastated when she told them she couldn’t move with them. We argued about it, actually. She insisted that she stay with me, and I feel tremendous guilt over this. I wish she was able to go out to California; it would force me to finally do things for myself and on my own.
I wish I wasn’t her obligation. Her burden. I absolutely hate it. Which is exactly why I’m saving every dime that I earn, so I can get my own place and let Aunt Peggy finally live her own life, instead of feeling the need to take care of me.
“Well, you’re doing a fantastic job. Someday you’ll get to do this for a husband and kids.” Today, we’re wearing our pink teddy bear scrubs. Our unit coordinates our scrubs each day of the week, and today is pink teddy bears.
“Right,” I say sarcastically. “And don’t forget the little detail of a husband. Or lack thereof.”
“There are dozens of men patiently waiting for you to wake up and dive into the dating pool.”
“Dozens?” I say, raising my eyebrow and giving her my best smirk possible. “Now that’s a bit of an exaggeration, don’t you think?”
“You don’t even know how stunning you are, do you?”
I laugh heartily. “Seriously, these teddy bear scrubs are super hot. Step aside and let me break all of the hearts of the countless men waiting for me outside.” I giggle, laughing harder than I have in a long time. Cassie is kind and my best friend, but she’s seriously delusional. I haven’t been out with a guy in ages. I honestly can’t remember when someone has even shown interest in me. My last boyfriend broke up with me almost two years ago, when it became apparent to him that my career was an important part of my life. He wanted me to himself, all of the time. I was working nights and weekends and barely had time to sleep. I was exhausted. He was exhausting.
“Just wait, Sam. He’s out there, waiting. Ready to sweep you off your feet and give you the life you deserve.”
“You’re drunk,” I say to her. “What guy is out there, ready to fall in love with a hot mess of a nurse? I’ve got too much baggage, Cassie. It’ll never happen for me.”
“I promise you that it will. You’re too special to not have that kind of love in your life. You’ve got a great head on your shoulders, and as much as you don’t want to admit it, you’re a beautiful person.” She grabs my hand, pulling me toward the door of the on-call room. “Break is over. Dr. Hagan will be doing her rounds in a few minutes.” My adrenaline kicks in, and I realize we have a long, trying day ahead of us.
This week has been exceptionally difficult here at work. The neonatal intensive care unit is at capacity. The last baby admitted to our unit is a baby boy, born eleven weeks premature. He’s barely three pounds and it’s been touch and go for the past several days.
I hop on alternating feet as I cover my Dansko clogs with blue sterile booties. We take turns scrubbing our hands in the sink in the outer room of the NICU and slip into sterile gowns. The change of shift is always hectic, and we ask that the families vacate the room while we discuss with the doctors and nurses their medical updates. I see the young mother of the eleven-week-old preemie, Olivia, looking pale and drawn. She’s curled up in a chair next to her son’s incubator, her hand pressed up against the clear casing.
I nod toward her and raise my eyebrow to Becky, the overnight nurse. “Rough night?” I ask softly, not wanting Olivia to hear us.
“She won’t leave him. And for once, I can’t force her to. His neuro scans came back a little while ago and he has two brain bleeds. One is a grade two, but the other is grade three. Dr. Hagan wants to run a new scan in a few hours, but she’s very concerned. To top it off, his bradycardia episodes are getting worse and they are going to intubate him again.” Seeing babies with breathing tubes is very scary, but so vital for their long-term prognosis. Every time he stops breathing or his heart rate slows, he could be doing more damage to his organs and brain.
My heart drops for this tiny little life. Olivia is only twenty years old, just married last year. Her husband is deployed and has been in Afghanistan for the past five months. She moved up to Pennsylvania to live with her mother so she wouldn’t have to be alone. The baby wasn’t due for several more months, and her husband would have been home for his birth. Now he’s here, way too early, and desperately struggling to live.
We see babies like this every day. Premature, not ready for this world. We do everything we can to make sure they get the care that they need so they can thrive and grow and go home.
“She named him today,” Becky whispers as her eyes glisten. “Benjamin.”
I suck in my breath and grab my chest. My father’s name. “Ben,” I say softly and hear my mother’s voice screaming his name. “What did you do to him? Ben? Can you hear me?”
“Are you okay?” Cassie asks, concern sweeping over her face.
“I’m—I’m okay,” I stammer and reach for the charts we’re about to review with Dr. Hagan.
“You sure? You don’t look so good,” she says and places her hand on my arm.
“Yup,” I force out my breath, regaining my composure.
“Are you ladies ready?” Dr. Hagan enters the room. The overnight nurses, Becky and Marcie follow close behind her, detailing the stats for the five babies in the NICU. Cassie and I listen intently, quietly cataloguing the precious details. I watch Olivia closely when we near baby Benjamin’s incubator. She stares at him with fear in her eyes. She’s too young to be dealing with the hardships in front of her and what may lie ahead with her son. A grade two bleed is bad, but a grade three bleed is worse. Ben could have permanent damage or worse.
Dr. Hagan makes arrangements for another scan for Ben and signs discharge papers for little Hope. Her family is going to be thrilled, and I’m happy that I get to tell them during my shift.
Becky and Marcie stop and say goodbye to Olivia, Marcie’s hand lingering on her shoulder. My heart grabs again as Ben’s monitors sound loudly. Marcie opens the incubator and softly presses his chest with her gloved hand. It takes a few moments, but his heart rhythm begins to normalize. Dr. Hagan nods toward the ventilator and Becky moves away to scrub her hands again. They’re going to put him back on the vent. “Mrs. Gibson, can you move out to the hallway for a few minutes? We’re going to examine Ben.” Dr. Hagan doesn’t tell her what we’re about to do, and I’m glad. Intubating an infant looks scary, but under her delicate hands, it will be effortless.
“Okay,” Olivia says feebly. She stands up, and her sterile gown practically slides off of her slight frame. Her dark, hollow eyes are sad and scared.
Once she leaves the room, Dr. Hagan gently places her stethoscope on Ben’s fragile chest. He’s so tiny; you can see his heart beating underneath his frail ribcage. Becky moves to her side, and soon he’s on the ventilator, the breathing tube safely inserted. My pulse races as I watch his chest move up and down mechanically. He’s sedated now but doesn’t look peaceful. My heart is breaking for this little guy.
“I’m going to get Hope ready to go.” I turn away and grab her chart. I don’t know why, but watching Ben struggle is excruciating. I’ve seen so much worse. Watched babies take their last breath and their families’ lives shattered. But Ben…
I attempt to smile at the little girl I’m washing up. Her tiny legs are kicking and her arms are flailing in the air. She moved into a bassinet last week and was able to drink from a bottle yesterday. She graduated from ‘feed and grow’ to ‘feed and thrive,’ and her parents were ecstatic. I hear Cassie on the phone with them right now, telling them to bring her car seat. Before they leave the NICU, they have to watch a video, explaining all that they need to look out for. Baby Hope is going home with a heart and lung monitor, so her parents have to meet with the vendor and get a tutorial on how to operate it and transmit the daily readings. She’s so tiny, only four pounds. But she’s eating on her own and has consistently gained weight every day this week. She’s the perfect NICU graduate.
“Yes, you are? Aren’t you?” I say through my smile. I rub lotion into her soft skin and say, “Our little graduate. You’re going to grow up to be a beautiful girl.” I hold her tiny feet in the palm of my hand, massaging the lotion gently. “These little feet are going to run along the beach and dance up a storm.” Her eyes search for me as her tongue peeks out of her mouth. I place a pink rubber pacifier against her lips, and she eagerly takes it, sucking on it like her life depends on it. Her eyes roll into her head and she falls asleep. All of this excitement tuckered her out. I swaddle her tight in her blanket and place my hand over the crown of her head. “I’m going to miss you, Hope. Grow big and grow strong.” I say this to all of our graduates—a private moment just for me and my patients.
I turn and look over at Ben. Olivia is back and curled up in her familiar position in the chair. Eyes glazed over, worry set in. She’s nodding her head as Dr. Hagan explains why Ben is back on the ventilator, and I wonder if she’s grasping the dire situation. He isn’t able to breathe on his own, and his heart rate has been dangerously erratic. With a significant brain bleed on top of this, I’m terrified that this is going to end very badly. This can’t end badly.
We can’t lose Ben.