‘I want you to go through the
charts and tell me when we started losing the baby.’ I nodded my head agreeing
to that. I was emotionally blunt, didn’t have any true scientific curiosity. It
was 9:30 am in the morning after a 24-hour shift in the cardiac infant ICU. A
baby, who was admitted with us for last 20 days, had expired. He was operated
for a complex congenital heart disease. The post-operative period was a gloomy
long journey down the hill, but with occasional rays of hope.
Any one who has worked in
neonatal or infant cardiac surgical ICUs will understand the feeling, which I
had, without much explanation. Babies come to the ICU from the operation
theater with labels: PFO present, Sternum open, Severe PAH etc. A quick look
into the case sheet and preoperative notes will give a light into what the
future looks like. But the surgeons face itself will give more information,
which is not mentioned in the operative notes.
I have been working in this ICU
for last two months. But the actual line, where we start losing the babies is
still unclear. It is not a line; it is rather a zone, a zone that extends from
state of recovery to state of deterioration. But one thing is for sure, Once
you realize that you have crossed that zone and the baby has started losing,
there is nothing much to do.