The Birthday Party

Pulse: Voices from the Heart of Medicine April 2023

Forty years ago, I experienced a miracle—the first of many in my nursing career. I was about six months into my first nursing job, in the neonatal ICU at Children’s Memorial Hospital in Chicago. It was there that I met baby Jonathon, and it was his mother who made me a true believer.

Jonathon had come to us with severe kidney disease. He looked sickly: His skin was very pale—translucent even. He acted like a healthy infant, though, and as he got older, he actually smiled at us. But despite the doctors’ best efforts, his kidneys were barely functioning.

Back then, we kept all of our babies in one big room, with eight or so bassinets spaced about ten feet apart. Although we tried hard to give the parents and babies some privacy, it was very difficult; we could usually hear exactly what was going on at every bed.

Every day Jonathon’s mother, Sue, would come to visit him. A small woman in her thirties with shoulder-length brown hair, she walked quietly through the door, always with a smile on her face for Jonathon, who was her first child.

Cradling him in her arms, she would say in a singsong voice, “Jonathon, you are so special. You are the most beautiful baby in the world. We love you so much, Jonathon, and we know you’re going to get better and come home to us.”

Day after day, from nine in the morning until mid-afternoon, Sue repeated these four phrases. As much as the nurses and other parents tried to have compassion for her, we all found the constant repetition of these words, and their seeming futility, very wearing. Although she sometimes gave us a respite by arriving a bit later, she never missed a day—and we nurses would roll our eyes at one another when she walked through the door each morning to begin her litany.

This went on for several months. During that time, Jonathon continued to deteriorate, and the physicians were running out of ideas on how to help him. But Sue never lost hope; she continued to visit and carry out her daily ritual.

Some of the other parents were driven to distraction, and we nurses often talked among ourselves about how difficult it was going to be for Sue when Jonathon died, as seemed inevitable. We tried to prepare her for this eventuality, but she would have none of it.

The day finally came when the neonatologist and Jonathon’s primary nurse met with Sue to talk with her about Jonathon, then four months old.

“There is nothing more we can do for Jonathon,” they told Sue. “We’ve tried everything. The best thing would be for you to take Jonathon home to spend his final days there.”

She smiled.

“I’ll take him home, but not to die,” she answered. “Jonathon is strong, and our love is strong, and he’ll be fine.”

And with that, Jonathon was discharged. The nurses and other babies’ parents let out a collective sigh of relief as quiet settled over the unit once more.

In the weeks that followed, we often talked about Jonathon and his mom, expressing our hope that she would be able to find peace when he died; but as time passed, our attention turned to our new admissions and to the babies we knew we could help.

About eight months later, the unit received a small, simple invitation from Sue. Jonathon would soon turn one year old, and Sue was asking all of us to attend his birthday party.  A physician who’d stayed in touch with Sue told us of a surprising turn of events. Once Jonathon arrived at home, he’d started to thrive. His kidneys had kicked in, and his health had rebounded. At one year, he was only slightly behind developmentally; otherwise, he was the picture of health.

So, instead of mourning the loss of Jonathon, we attended his one-year birthday party and I never again questioned the power of persistence combined with a mother’s love, or the possibility of miracles.