Rebuilding a Wall of Truths While Watching the Fog Roll In
I walked into the NICU terrified. The babies looked so very sick, attached to ventilators, feeding tubes, IVs, you name it. They were dwarfed by the machines surrounding them. For the most part they laid quietly in their isolettes, their parents hovering over them itching to hold them close.
It was 1979 and I started the job in an NICU (Neonatal Intensive Care Unit) right out of nursing school. I was only 21. I wanted to be in an exciting part of nursing. I wanted to have intense experiences. I wanted to feel important. So I chose NICU. Every day I took care of very very sick new little babies. Having not been a mother yet, I didn’t fully understand the intense emotions of the parents and I could keep a certain emotional distance from the babies themselves. It was a challenging job and I loved it! I learned more in the first six months at that job than I had learned in the entire four years of nursing school. I knew there was still a lot to learn, but I was feeling better every day about my new found nursing skills.
One day we heard that a 26 weeker was coming to our unit. We had never been able to save any baby under 28 weeks. We all asked why? Why were they sending this baby to our unit when we all knew he wouldn’t make it through the night?
Little Paul arrived along with his hopeful parents and we set to work to do everything we could. We were afraid we wouldn’t be able to keep him warm enough in the isolette so we covered him with foil to keep the heat in. We questioned every procedure that we did to weigh the benefits against the risks. We touched him as little as possible. Every time we opened the isolette to do anything we felt we were risking his life.
And we all questioned why. Why should we work so tirelessly trying to save a 26 weeker’s life, knowing full well he wasn’t going to make it? Why are we even giving these parents hope? Why are we putting this baby through all of these painful procedures knowing in the end he was going to die? Couldn’t we just put him in his mother’s arms and let him die peacefully? We were told that caring for him as if he would live would help us learn what to do with the next 26 weeker. Was that right? Was it right to put Paul and his parents through this so that we might learn something from it? Perhaps it was, if it gave the next 26 weeker a better chance. None of us knew the answer. Paul died 48 hours later.
I watched as babies died, babies whose parents came in every day to be with them. I watched babies whose parents had abandoned them live, only to be put in foster care. Sometimes we did everything we could for a baby - went way above and beyond to save his life, knowing full well that the life he would have would be one of severe and crippling disabilities. All of this left me questioning and confused.
Because we were a teaching hospital we allowed inexperienced residents to do spinals, IV’s, and central lines on babies so they could learn. Sometimes we had to play deaf to the babies’ cries as these procedures were performed because they were too little for us to give them anything for pain. I saw incompetent physicians make bad decisions which prolonged a baby’s stay and I saw egotistical physicians who would not admit when they made a mistake. I saw nurses who had turned off all emotions and lose their compassion for both the babies and their parents.
During that year I saw more and learned more about myself and my values and the world at large than any other time in my life. Coping with the stress and ethical issues of an NICU became a huge and what felt like insurmountable challenge.
I drank a lot that year . . . I remember one night when I had gone out for a night of heavy drinking after a particularly stressful day at work. A couple of hours after going to bed I woke up throwing up and cursing the babies. “Those damn babies” I was saying out loud between heaves to no one in particular, “Look what they are doing to me. Damn you babies!!” It was definitely a wake up call.
By the time I was in my twenties, I had many beliefs and values, most of them taught to me by my parents, my church, my teachers or what little life experience I had accumulated growing up overprotected in my white upper middle class neighborhood. I was raised with certain truths - life is good, bad things don’t happen to good people, babies don’t die, there is a God and he protects the weak, people will act responsibly and ethically when it comes to others’ lives. All of these beliefs that I had acquired during my childhood and young adulthood were held into question that year. Life wasn’t always good, bad things do happen to good people, babies do die and if there is a God he/she isn’t always around to protect the weak and there will always be people who disappoint you.
The ethical issues were overwhelming at times and left me questioning everything I ever believed about life and the world we live in.
Over the years I had built a brick wall where every brick represented a belief or a value that I had accumulated over the years. Building a brick wall such as this sounds like a straightforward job, but it can be deceptively complicated. Up until now those beliefs and values guided my behavior and shaped my character. But something was wrong. When I had an experience like I had in the NICU, it felt like someone had just driven right through my wall and toppled it. There are bricks everywhere and my first thought is “Oh my gosh, what do I do? How am I going to stack all of those bricks up again?” Then, I realize that some of those bricks are defective and I couldn’t keep them in my wall. So, I very carefully pick up each brick and I take a good long look at it and I have to decide if it should be tossed aside or put back into my wall of beliefs and values. And as I do this, I very slowly rebuild that wall discarding some of what I thought were truths. But now my wall is stronger because I have gotten rid of the faulty bricks, the ones that don’t hold up to my new belief system. I then believed more strongly in my wall because it’s a wall that I built based on MY experiences and MY beliefs, not my parents’ or my teachers’ or my church’s. It’s a more flexible wall that will be knocked down and rebuilt again and again as my life experiences accumulate and the strength of my character emerges and even though I make decisions based on my wall I also have come to realize that some things are not black and white but rather a shade of gray that comes and goes like the fog on the Bay.