Lily of a Day, страница 1
Lily of a Day
Copyright 2012 Joyce Burgess
This is a work of fiction. Any resemblance to
persons living or dead is coincidental
Table of Contents
It is not growing like a tree
In bulk doth make Man better be;
Or standing long an oak, three hundred year,
To fall a log at last, dry, bald, and sere:
A lily of a day
Is fairer far in May,
Although it fall and die that night-
It was the plant and flower of Light.
In small proportions we just beauties see;
And in short measures life may perfect be.
1573 - 1637
Brenna hurried into the nurses’ lounge, sliding her plastic coffee mug across the table. “Traffic was a nightmare.”
Molly looked up from the coffeemaker where she was brewing the first pot of the evening shift and smiled. “Late again, are we?” she teased, knowing full well it was usually she and not Brenna who came storming in at the last minute.
“Shut up, you,” Brenna replied, grabbing clean blue scrubs off the shelf and her shoes from her locker. She dressed quickly and pulled her auburn hair up in a ponytail, frizzy curls escaping here and there due to the humidity of the warm, rainy day. After gulping some coffee, she glanced at the clock, relieved to note she’d at least make it to the Neonatal Intensive Care in time for report. She locked up her purse and clothes, and followed Molly down the hall.
After they scrubbed their hands thoroughly, Molly swiped her name badge through the NICU lock and held the door for Brenna.
“About time, you guys. I want out of here! It’s been a zoo today.” Caren sat down with a thump and laid a chart on the rolling cart near an isolette holding a tiny baby. After running a hand through her short blonde hair, she pulled pens and alcohol swabs from the pockets of her rumpled uniform, laying them on the cart.
“How’s Jack doing today?”
“He’s feeling better; in other words, he’s been a little pill. I’ve had him and Lakeesha because that new one just got here from Astoria.”
“What’s up with her?”
“We don’t know yet. Initially, she looked septic to them, but her blood work’s okay and her chest x-ray looked normal. Her color’s crappy and her blood pressure's dropping so Dr. Lee’s thinking heart. They just finished doing an echo.”
Molly looked at Brenna. “You pick, you’ve had a worse morning than me.”
“Okay, I’ll take the new one. I had Jack last night and he was a bugger then, too.”
“You got it.” Molly started getting report from Caren while Brenna crossed the aisle to the radiant warmer surrounded by staff in uniforms and paper gowns.
“Hi, guys. Relief’s here.”
“Yeah, for Scott anyway,” smiled the respiratory therapist, carrying away a blood gas sample. Brenna picked up her new patient’s chart.
Scott gave her a weary smile. “Well, I got all the initial admitting stuff and the echo out of the way. Unfortunately, the echo showed she’s got left heart. Dr. Lee’s gone to talk to the parents.”
“Oh, that’s too bad. What a sweetie.” The baby girl lay still and limp in the warmer as a ventilator assisted her breathing in an attempt to keep oxygen circulating through her little body. But Scott and Brenna both knew what they had here was a pump problem. Just as in any operating thing, if the pump wasn’t able to keep things circulating, then the fluid it was circulating, in this case oxygenated blood, wasn’t of the benefit it should be. Since the left side of her heart had not developed, it was failing, unable to do its job.
“I gave her a dose of Indocin to keep the ductus open and she was happy with that. Her sat’s been more stable. But her only chance is surgery now.” Scott stared at his patient, her black hair curling on top as if it had been wound around a finger. Nurses often have a sixth sense of their patient's condition, and Scott’s face was grim. He sighed and started giving a more detailed report, running over her IV fluids and rates, medications, and ventilator settings.
When he finished, he clapped Brenna on the shoulder. “Okay," he said. "Have a good night, kiddo.”
Brenna smiled after him as he walked off. He had been with them for several years and was one of her favorite nurses. His large hands could handle the smallest preemie with infinite gentleness and his calm in a crisis was a definite asset.
She surveyed the child before her, assessing her visually without touching her so as not to stress her more than necessary. She was reading her history and chart when Dr. Lee, her small footsteps silent as usual, approached the warmer.
“Brenna, these are Ariel’s parents, Ben and Lisa. We’ve already discussed Ariel’s condition and what she’ll be facing.”
Brenna put her arm around Lisa and gently drew her toward the warmer. “You can touch her and talk to her, if you like. They always recognize their parents’ voices.”
Ben cleared his throat. “Dads too?”
“Oh, yes, anyone who’s been with Mom frequently through the pregnancy.”
“He...he talked to her every day,” Lisa said, her voice quavering. She bent over the warmer, tears falling from her cheeks onto the blanket on which her baby lay. “Hi, honey. Mommy and Daddy are here.” Ben put his arm around his wife, but his voice choked up when he tried to talk.
“Ariel’s been given a sedative so she won’t be upset by the ventilator tube. That’s why she appears to be sleeping.”
Lisa looked up. “So she’s not hurting, right?”
“Oh, no, she’s resting comfortably.”
Lisa drew in a ragged breath and moved over a little so Ben could get closer to the warmer. “Talk to her, honey, she needs to know we’re here.”
Ben leaned over his daughter. “Hi, peanut. You just sleep and rest up. You’ve got some work to do getting better. We love you, we won’t leave the hospital until you’re better. Grandma and Levi send hugs and kisses.”
He straightened and thanked Dr. Lee and Brenna for the care their baby was getting, then guided his wife to the exit doors. Lisa managed to make it through the door before Brenna saw her through the window, doubled over in grief. Ben put his arms around her and they walked away.
“Who’s Levi?” Brenna asked.
“Ariel’s big brother, he’s four.”
“They’re worse. And the repeat chest x-ray she got here showed some cardiomegaly. She’s in congestive heart failure and it’s just getting worse, but there are no hearts available for transplant. We don’t believe she’d make it through the Norwood procedure because her aorta’s in pretty bad shape too.”
“So we’re just in a holding pattern for now?”
“That’s about it. It doesn’t look good.”
Brenna quietly turned back to the warmer and gently wound the little black curl around her finger.
Over the next hour, Ariel worsened considerably. Her lungs were filling with fluid and her color was mottled and graying. Brenna knew she didn’t have long and was about to call Dr. Lee when she approached the warmer.
“I’m going to go talk to the parents. There’s nothing we can do for this little one.”
“I know,” Brenna said quietly. “I was just about to page you.”
The doctor passed through the exit door and Brenna saw her enter the family room through the large window that opened onto the NICU. She sat next to Ben and as she began to speak, Lisa buried her face in Ben’s sleeve, her shoulders shaking. Ben nodded and turned to his wife, hiding his grief in her dark curls, holding her tightly. Lisa’s mother sat next to them with Levi curled in her arms, and she rocked him gently as tears began to roll down her cheeks.
Dr. Lee returned to the NICU, walking more slowly as if she had taken on a great weight since leaving the room. And in a way, she had. The burden of any death sentence is great, but when it was a tiny baby who had not yet had a chance to live, it took a toll on everyone. She gave the order to discontinue life support and left the nursery silently.
When the doctor had gone, Brenna began turning off all the monitors. She checked Ariel’s diaper, but her kidney function had slowed and it was dry. After removing her IVs, she wrapped her in a warm blanket. Looking up to see Ariel's family leaving the visitors’ room, she pulled the ET tube from the baby’s airway and suctioned her mouth. As Lisa and Ben approached the warmer, Brenna picked Ariel up and led them to a private room. In Ben’s arms was the little boy with Ariel’s pale skin and dark hair, the grandmother following closely behind them.
They sat down in wooden rockers and Brenna put the baby in Lisa’s arms. Hooking up the heart monitor, the beep silenced, Brenna looked at the rhythm; the heart rate was becoming more rapid as the small heart tried desperately to do its job. Ariel’s breathing was also rapid, but her family noticed none of that as they zeroed in on their only daughter.
“Hi, my sweetie, Mommy’s here,” Lisa said softly.
“This is your baby sister, Levi. Isn’t she pretty?” Ben asked his son. Levi nodded, his fingers in his mouth. “She’s only going to be with us a few more minutes, she’s too sick to stay with us. But God sent her to us for a short while and she’s beautiful, isn’t she?” Levi nodded.
Lisa stroked her baby’s cool cheek. “I think she has your eyes, Ben. And my ears.” She pulled the blanket back slightly. “And my hands. You’re my pretty angel, Ariel.”
It was becoming obvious to them now that the end was close. Ben handed Levi back to his grandma, and they returned to the family room. Brenna stood by to provide Ben and Lisa with any support they needed.
Lisa swallowed and a few tears rolled down her cheeks. “It’s okay to go home, honey. We love you so much and I wish you could stay. But I guess God needs you back. He must be short on angels.” She wiped her own tears from her baby’s face as the monitor showed severe tachycardia. “It’s okay, honey; you don’t have to fight.”
Ben got on his knees and put his hand on his daughter. “It’s okay, honey. We love you,” he echoed his wife.
Lisa kissed her as the monitor showed asystole; the little heart had stopped. “It’s all right, honey. See you soon.”
Brenna reached over and turned off the monitor. “She’s gone, Lisa.”
Lisa froze and looked at her baby’s still face. “Oh, God.”
Brenna disconnected the monitor leads. “Do you want to spend some time alone with her?”
Lisa raised agonized eyes to Brenna’s. “Please.”
Brenna went out, closing the door behind her. As she returned to the warmer to clean up, she heard a cry that chilled her heart. Lisa had kept her composure until her daughter had died, but was now grieving aloud. Brenna quietly picked up all the garbage and linen, the last thing to do, other than to write in Ariel's chart, "2110 – Patient expired peacefully in mother's arms, father @ side."