As neonatal nurses we deal with death on a regular basis. We don’t see it every day or even every week but it is something we are always aware of. Each and every time a baby dies our hushed voices, expressions of pain and words of sadness are completely real. We each deal with these deaths in our own way, taking some harder than others but being marked by them all the same.
I am someone who reacts to death with tears, unable to stop this very physical manifestation of grief from showing itself. At first glance it may seem as though this is a hugely unhelpful thing for me to be doing when parents need my support but I truly believe that my tears show them how much I care far more than any words ever could.
I know from my own experience that going into premature term labour is one of the most terrifying things that can happen. In the space of a few hours I went from being six months pregnant to having to face the very real possibility that Squidge might be born very sick and far too soon. As frightening as the whole experience was, had the doctors not been able to stop my labour the Northern One and I would have had some warning that things were likely to be bad and a little time to decide what we wanted to do. It wouldn’t have made things any easier for us but at least we would have had some time to try and prepare ourselves.
However, there are some babies whose parents have no warning, either because things go wrong at the very last minute or because they have already safely delivered their baby and tragedy strikes seemingly out of nowhere. The loss of each and every baby is a tragedy but it is the babies who die unexpectedly that, for me, cut the deepest.
The first time I ever cared for a baby on the last day of their far too short life came as a complete shock to me. I knew the little boy was very sick; so sick that he required my undivided attention for the entire shift but I didn’t realise that by the end of the day he would be gone. Just a few days ago he had been pink and healthy and full of life; feeding and growing and getting ready to go home with his parents to start their new life as a family.
Now he lay silent and still, tubes and wires snaking all over his little body, his skin grey and his eyes closed.
The only sounds came from the insistent beeps of the monitors and the click and hiss of the ventilator as it moved air in and out of his tiny lungs; breathing for him because he was too sick to be able to breathe for himself.
By early afternoon it became clear that no matter what we tried, nothing was working. Despite the tireless mechanical breaths of the ventilator we were unable to get enough oxygen into his bloodstream and the effects were beginning to show.
No longer was he just still, instead his little face had taken on an almost mask-like quality that was the truest sign that although we had fought hard, battling for his life with all the medications and technology available to us, we had still lost.
The parents had barely left his cot side, silently watching him as though they could fight the very thing that was taking him from them with sheer force of will alone. The spoke occasionally but otherwise they stayed quiet, as though they were afraid to ask any questions because deep down they knew what the answers would be.
But even the strongest will or the greatest love cannot hold death at bay and we have to tell the parents that there is nothing more we can do to save their little boy.
Mum bows her head and tries to choke back the sobs that threaten to engulf her.
Dad turns his back on us and marches out of the room, unable to stay and listen to us a moment longer. When he returns a few minutes later he is calmer and he and Mum ask to hold their baby for a little while. I tell them that they can hold him for as long as they need; that he is still their baby and that it is more important than ever that he knows they are there.
I sat beside the parents, camera in my hands, taking photograph after photograph of the little boy as they carefully hold him on a pillow. I am acutely, painfully aware that these are the last memories these parents will ever have of their son and that somehow I have been entrusted with making them.
The photographs that I take will be one of the few physical reminders that their little boy lived; photographs that will be stored in a box of precious keepsakes to be taken out when the grief becomes overwhelming and the images that they keep in their minds just aren’t enough.
In my mind I can see these broken, grieving parents opening their box of memories; taking out the items one by one and turning them over in their hands as they have done so many times before.
The little plastic name bands, inscribed with his name and date of birth, that circled his hands and feet. The biro letters are clear but the writing is slightly scribbled, as though someone wrote them in a hurry, not knowing how valuable those few words would become.
The stocking hat that was put on his head almost as soon as he was born that may yet still bear the faintest trace of his baby smell.
The knitted blanket that kept him warm during that last, bitter sweet cuddle.
I carry on taking photographs; of his little hands and feet, his face, zooming in so that he fills the camera frame. My hands shake so badly that I have to rest the camera on my knee so that I don’t blur these precious pictures of their last minutes together as a family.
The parents are adamant that they don’t want their baby to suffer and so they have already agreed with the consultant that she will remove the breathing tube when they tell her it’s time. Mum and Dad ask if I’ll stay with them until it’s over and I promise that I won’t leave their side for even a moment until they want me to go.
I put the camera down and help the consultant to gently remove the breathing tube, being so careful not to tug at the little boy’s skin or to distress him in any way. I talk to him softly, calling him sweetheart and telling him not to be scared; that his Mummy and Daddy are here with him and that they love him so very much.
The consultant waits quietly until Mum asks her if her baby has gone and she listens for his heartbeat with her stethoscope. His heart is still beating, slowly and faintly, waiting a few minutes more before quietly slipping away.
The tears that I’ve tried so hard to keep at bay start to run down my cheeks but they are silent and for this I am grateful. I try to discreetly wipe them away but they keep falling unbidden and there’s nothing I can do to stop them but at least I can keep the sobs inside until I am alone.
Somehow the end of the shift has arrived and as I step out of the room and into the corridor a noisy sob rises and escapes before I have time to choke it back. I quickly look around but no one else is there and so I manage to keep my emotions in check until I’m safely sat inside my car and I know no one can hear or see me as I cry.
After a few minutes my eyes are swollen and my head aches and I would have given almost anything to be home already. But I know it’s nothing compared to the pain those parents are feeling; whose arms are empty and whose baby boy now lives only in photographs.