warm fuzzies

Over the last few days I was taking care of a newborn baby who had been born to young parents. Like all of the babies I've seen this week, this was not a planned pregnancy. When I came into the room to interview the parents and do a head-to-toe exam on the newborn, mom was holding him in the bed and dad was sleeping nearby, his many blankets pulled tightly over his head. I interviewed mom and dad never even looked up.
"No, not planned, but yes, it's now welcome," she said tenuously.
"We work in retail; I finished high school and he's just finished community college."
"No not sure of a name yet"
"No, we don't have a pediatrician"
"Yes, I'm having trouble feeding, he's fussy all the time, but it hurts when he tries to suck and I don't think there's any milk coming out. He's been crying all night."

The story was not different from many of the babies born in our hospital. Except dad didn't even look up, and when I finially took the baby from mom so that she could go to the bathroom, and told the dad that he had a healthy and beautiful son, he mumbled biterly from under the blankets "Yeah, I can hear him."

That little attitude nearly earned them a social work consult. I put it down on my paperwork, and then told myself that I would check up on them later, giving dad the benefit of the doubt and deciding that he was probably still in shock.

Later that afternoon, the young parents were holding their son together, smiling and talking. I was relieved but still cautious. By the next day, I realized that unlike even some of the most devoted fathers on the floor, this boy never left his girlfriend's side. By the afternoon, he was ready with the carseat to take the baby home.

That morning, during my exam, I notice that the baby was a little more jaundiced than we usually like. I checked his bilirubin level and it was in the intermediate risk range. My resident and attending had told me to discharge the family, because this was common and he'd likely get better. If not, the doctor at his appointment tomorrow would be able to tell. I argued that at the pace that his bilirubin was rising, there was a chance that it would be dangerously high by the time the doctor got the lab results. We decided to keep him overnight under lights, which ended up being the righ decision since his bilirubin rose very quickly throughout the day.

Meanwhile, I talked to the parents and gave them our discharging babies home talk. It covers all those topics parents should absolutely know. I told them what to do if there was a fever, how to wash the baby, how often to feed. I told them that all babies are diffeerent, that some smile and laugh and sleep a lot and that others cry for the first two months, and that we didn't know how their baby was going to be but that it would be him, and it would be his special way of being and that even during the hardest days, they needed to love him for it. Then I told them that that meant that they needed to take care of each other, too. That they had to be in tune with each other an know when to ask for help or offer it. I warned mom about postpartum depression and told dad that if I injected into him all the chemicals and hormones flying around in mom right now, he'd be crying at cute commercials. And I told them that if things ever got really bad, and they were too exhausted, too frustrated, too tired to hold their screaming child, it was OK to put him down safely in his bed, leave the room, close the door and take care of themselves for a few hours.

The next morning, the baby was no longer yellow. I told the parents that they would likely go home later in the day, and went to class. I forgot to even say goodbye, since I had done all my discharge paperwork along with the talk the day before. But when I was walking back into the hospital, I passed the parents as they were leaving with the baby. I was just going to wave and keep, going, but mom stopped me, beaming happily and said "Thank you so much, you were wonderful. Everything was wonderful. Thank you for taking such good care of us and our baby. Thank you so much."

Yeah. That's enough warm fuzzies to last me through the winter.