BACK TO THE NURSERY

Introducing . . . After two weeks of the CMDA conference and a field trip to Naivasha's maternity and neonatal programs . . it was time to return "home" to the Special Care Nursery. Here are a few of the babies. Naomi is well on the way to becoming the SECOND gastroschisis survivor. Hannah Wangari went home at the end of last week, and Naomi has had a miraculously straightforward course, her protruding intestines quickly fit back into her tiny abdomen. Little Samuel has a spinal cord open-to-the-air defect on his back and no opening to his anus, not to mention a very very small head and un-find-able testicles. I find him cute in his own unique way. Can't seem to find a clear syndrome that combines all his problems, so maybe he really is unique. Amazingly Kijabe has some of the best surgeons in the world for these malformations. This baby's mother was infected with a virus called CMV, relatively benign for her but devastating for the baby. He has cataracts, and severe hearing loss, jaundice from a liver that doesn't work normally, and he needs oxygen to breathe. However he's much better over the course of the week with supportive care, and he'll get good audiologic follow-up from our neighbor and eye care from the nearby Kikuyu eye hospital. I had little hope when I was pitching in two weekends ago to help a visiting doctor cover that baby Paul would live. His mom died in the ICU that weekend, and I was second-guessing my decision to intubate Paul. But he's a champ, and it looks like he might make it, all three pounds of him. This baby, sadly, died this morning, after I had snapped this photo yesterday. He was born in an ambulance on his way here to a mother who had no prenatal care, at 27 weeks (out of 40) gestation and weighed 830 grams yesterday. That's small. He had a rough night, and when our team tried to help him all morning we just kept losing ground. Finally we gathered around him, holding his tearful mom's hand, and prayed. But God did not do the miracle we asked for. An hour later he died in his mother's arms. Satan always attacks the weakest. So sorry for Lucy, the mom. This little pumpkin is my vote for the cutest baby in the nursery. He's close to being big enough to go home. Lastly, our newest baby, NEONATALIE. She is a very realistic baby model made for teaching. After our excellent conference I was able to go through a "Helping Babies Breathe" curriculum with the staff, and have them practice ventilating and caring for little NeoNatalie. The instructor can make the baby breathe, cry, and have a pulse. Or not. So that the student has to really react and take action.

I loved sitting in class, absorbing. But it is also nice to be back in the real world with Paul and Naomi and Samuel and the others, fighting for life instead of just talking about it. Even though we don't always win.