The Best American Newspaper Narratives of 2012

Never Let Go

Never Let Go Tampa Bay Times December 9, 12, 16, 2012 By Kelley Benham When a baby is born at the edge of viability, which is the greater act of love: to save her, or to say goodbye? PART ONE Our baby came swirling into view in black and white, week after week, in the grainy wedge on the ultrasound monitor. First a dark featureless pool, then a tiny orb, then budding arms and legs and finally long fingers and a recognizable profile. Precisely on schedule, I felt her squirm and thump. After years of grueling and unnatural fertility treatments, the promise of her unfolded easily. We learned her gender in week 16, cataloged her anatomy in week 20. I scrubbed the baseboards in the spare bedroom and stopped buttoning my jeans. I tried to imagine her as a real child, in my hands and in my life. 38 TheBestAmericanNewspaperNarrativesof2012 I drew, in ballpoint pen, her cartoon outline on my skin—with big eyes, a sprout of hair, and an umbilical tether to my navel that made her look like a startled space walker. That was the extent to which I understood her: only in outline, the details waiting to be filled in. Suddenly there was blood. Blood on my hands. Blood on a thin cotton hospital gown. Blood in red rivulets and blood in dark clumps. Bright beads of blood on the doctor's blue latex gloves. Blood in such startling quantity we could only imagine there was no life, no baby, not anymore. My obstetrician looked stricken that day in March 2011 when he rushed into a triage room at Bayfront Medical Center. I clenched and vomited as he explained that our baby had no chance of surviving outside the womb —if she wasn't already gone. A tech tried for long minutes to summon a heartbeat on the monitor, searching every quadrant of my abdomen. I don't remember if we held our breath or gasped or spoke or sobbed. I remember only the frozen shock when a heartbeat flooded the room, a sound like a galloping horse. In just a few hours, our baby had been lost and then found. On the monitor, she bobbed and floated in a pixelated haze. But next to her loomed a mysterious shape that had not been there two days before: a clot of blood the size of a fist, created as the placenta had begun to tear loose from my body. A nurse pumped drugs into an IV to stall the labor, and gradually they took a tenuous hold. But it was clear to everyone that the reprieve was temporary. My baby and I were coming apart. A normal pregnancy lasts 40 weeks. I was only halfway there. If the doctors had not intervened, my baby would have been a miscarriage . But the odds for her had not improved by much. Early arrival kills more newborns than anything else, and complications from prematurity kill more babies in the first year than anything else. Some babies are born so early they are beyond rescue. If a baby is born at or before the 22nd week, it is usually considered a miscarriage or a Tampa Bay Times 39 stillbirth. Almost no doctor will intervene, because there is nothing he or she can do. Other babies ripen in the womb into the third trimester but arrive a little early. If a baby is born later than about 25 weeks, studies show that almost all doctors feel morally and legally obligated to try to save its life. Some preemies have serious medical problems, but most spend a few days or weeks in the hospital learning to breathe and eat and then they go home. In between those scenarios is a zone between life and death, between viability and futility. If a baby is born after the 22nd week of pregnancy but before the 25th, not even the smartest doctors in the world can say what will happen to it. New technologies can sometimes keep these micropreemies alive, but many end up disabled, some catastrophically so. Whether to provide care to these infants is one of the fundamental controversies in neonatology. Babies born at the edge of viability force us to debate the most difficult questions in medicine and in life. Who deserves to live, and at what cost? Who decides whether a life is worth saving, or worth living? When does...