Ilka St. Denis
I was on my break in the lunchroom when Lola rushed in and announced: “Ellie, the Octopus is here!” To anyone other than the nurses at St. Luke’s Hospital in Charlotte, North Carolina, this would make no sense. However, to us, to me, this meant the mother with eight fetuses had arrived.
This was probably the craziest case St. Luke’s had ever seen. After pleading with my boss, I was placed on it. Somewhere, somehow, Octomom found a doctor to implant 10 fertilized eggs into her uterus. Any sane doctor would have implanted at most three eggs due to the increased risk of health problems for mother and baby during multiple gestations. However, after struggling to conceive for years, she refused to terminate any of the eight fetuses that took. Eight months later, Octomom arrived via wheelchair to be put on bed rest until her scheduled C section next week.
That was, until Octomom’s urinalysis came back. The protein in her urine indicated preeclampsia. Even though I was fresh out of nursing school, I knew what this meant for her. The funny thing I learned about preeclampsia is that the best treatment is birth. If not treated immediately the outcome could be disastrous for both mother and child.
“Ma’am, you have a condition that requires an emergency C section,” said Dr. Santiago.
“They aren’t ready!” Octomom said. She sounded so scared. “Please leave them in a little longer! Just save my children please!”
“The doctor will do his best,” I replied, trying to comfort her. Trying to instill any hope I could, I held Octomom’s hand until we reached the swinging doors of the operation room.
In the meantime, I had other patients to care for. I picked up a new chart and walked into Room One. “Just take him away, say he didn’t make it,” cried my patient. She shoved her newborn child at me. “Please, before my husband comes back, just take him away,” she begged. Holding her son in my arms, I stood dumbfounded. They didn’t prepare me for this in nursing school. I rushed out of the room with the baby, looking for Jackie, my supervisor, unsure of what to do. I found her in the waiting room calming down an anxious father. I pulled Jackie away and blurted, “The mother in Room One doesn’t want her baby. She wanted me to say he didn’t make it.” With pursed lips and a furrowed brow, Jackie expressed disapproval but remained calm. “Follow me, Ellie,” she said soothingly. Jackie pulled me into an empty room.
“What did the mother look like?”
“Well, she looked pretty upset.”
“No no, what did she look like? What color was her skin?”
“About the same as you, a slight tan if that.”
“And the father?”
“I didn’t see him, she didn’t want him in the room.”
“And what color was the baby?”
That’s when it clicked. The baby was not her husband’s.
Two hours passed and eight beds in the neonatal unit were filled. Each of Octomom’s babies weighed less than two pounds. Each was on a ventilator with a breathing tube smaller than the circumference of my pinky. Each was outfitted with heart monitors and IV drips.
For me, this situation was all too familiar. My youngest step-sister was a neonatal baby, born at 26 weeks because my mom’s appendix had ruptured. At only nine years old, I stood next to her incubator for hours each day after school. At three months premature, her doctors were doubtful she would survive. She was 2 pounds 4 ounces at birth, and stayed in the hospital for a month. I remembered looking at her through the incubator, asking my mom when we could take her home. Since then, I’ve always had a soft spot for preemies, and I knew I wanted to spend the rest of my life helping families going through the same thing me and my family did.
I was checking on the oldest of the eight children when the smallest of the bunch suddenly went into cardiac arrest. I called a code blue, and immediately opened up the incubator. I started CPR, pressing down with only my index finger. My finger was like that of a giant on his small body; he was the smallest preemie I had ever worked on. Dr. Santiago rushed in and took over. Relieved, I stepped back, trying to hide my shaking hands. As Dr. Santiago pressed incessantly on the baby’s chest, I heard those sickening pops. The hairs on the back of my neck stood up as I tried to divert my glance from the baby. With a sound akin to a wishbone breaking at Thanksgiving dinner, his ribs were snapping. I could never get used to that sound.
Dr. Santiago called the time of death at 21:18.
The tenured nurses decided that I, after working as a nurse for only two weeks, only 24 years old, should break the news to Octomom and her family. My first death notice.
Holding back my tears, I wrapped the motionless, blue baby boy in a warm, white blanket. He almost got lost in the blanket, and to anybody else the blanket would feel empty. I carried him, holding him close as I headed back to Octomom’s room. I stood in the doorway, managing to get the words out before my throat tightened. “I am so sorry, but he didn’t make it.” I walked towards the mother and placed her dead son in her arms. We sobbed.
I wheeled Octomom into the neonatal intensive care unit to see her seven children. “Can I hold them?” she whispered.
“Not at the moment, I’m sorry,” I whispered back.
Octomom stared silently, and put her hand on the glass of the closest incubator.
As much as I wanted to stay, I had to leave her and check back in on Room One. Inside the room, my supervisor was holding adoption paperwork.
“Now, we cannot say that your son died, but you can give him up for adoption and then tell your husband whatever you want.”
“Yes, perfect! Give me the paperwork,” said the mother. She grabbed for the papers.
“Okay, fine, I need your signature here, here, and here; and initial here and sign the date.”
The mother scribbled her name where it had to be, then asked for her discharge papers. I tried to hold back a grimace by clenching my teeth, but the mother read my mind.
“I can’t take a black baby back to my white husband,” she said under her breath.
After the signing of the paperwork, I left the room with my supervisor.
“So what happens to him now?” I asked.
“Well, she has 30 days to change her mind, and then he is in the state’s system. But most of the time the mothers never come back,” she muttered.
I went back to Room One and the husband there.
“And when he came out he had the umbilical cord around his neck and he was all blue. The doctors said there was nothing they could do… I’m so sorry,” the mother explained tearfully.
She shot me a worried glance. Even if I wanted to say something, this is why there are patient confidentiality laws. HIPAA would have my ass if I said anything.
What I wanted to say was: “Don’t do this. My birth mother left me on the stairs of a church at two weeks old. I was lucky to find a nice family by age 10 and escape foster care. Please! Can’t you just give him a chance?”
What I actually said was: “Here are your discharge papers. Please let me know if you need any help.”
I hurried out of the room, trying not to let my anger get the best of me.
When I came back half an hour later, Room One was empty. I angrily ripped the sheets off of the bed to prepare for the next patient, and a scrap of paper fell to the floor.
Tell him I’m sorry, please take care of him.
Tears welled up in my eyes as I tore the note apart. It meant nothing. I remembered something my foster mother told me. The road to hell is paved with good intentions.