Vigil

"She looks sick," said the doctor, turning her back and forth after examining her. The words echoed in my head, and my mind leapt to that old sleepover game, when all the girls put two fingers under a girl lying down in the middle, and each repeats "She looks sick" and then...

No! Don't think about that!

So she went back up to intensive care, after three days on the regular sick-baby ward. The IV went back in, the feeding tube went back in, antibiotics and infusions were started. And Saturday night, the nurse assured us that she looked okay. Her heart rate and blood oxygenation levels were very good. We should go home and get some sleep.

The phone rang at 9:15 am Sunday morning. We needed to get to the hospital immediately. There was something wrong with her abdomen. She needed to be transferred to another hospital, one with pediatric surgeons. When we arrived, our baby was naked in the isolette because, the nurse said, just the touch of the diaper around her tummy pained her too much. She laid on her right side, her legs drawn up. Her stomach was hard. She whimpered and sometimes cried in her sleep. She was too pale.

Within minutes of our arrival, her isolette was surrounded by doctors. It was clear they had no idea what the problem was. Infection, they said, but from an unknown source. Or a twist in the bowel. Or meningitis. Or, or, or. Her vitals remained steady, which each doctor reminded us of just after he or she mentioned one more horrifying possibility. And the monitors did chug steadily on, the only reassurance.

An enema seemed to relieve some of the pressure. Her tummy became soft again. But she was still in pain, still clenched in a ball, her little legs drawing up as far as they could go. The doctor decided to wait two hours and then re-evaluate. She remained stable. They took blood again. Her white blood cells were down, her hemoglobin declining. Both indicators of infection...somewhere.

They made us leave the room for the lumbar puncture. When they let us back in, she was lying so still, with a sheen of perspiration on her face. The sedative, they said. It would take several hours to wear off. At least she wasn't in any pain.

By this time, it was 2:30 pm. Time for the nurses' shift change. The kind nurse who had cared for Annika since the early morning hours peered into the isolette one more time before she went home. "Her color looks a little better," she said. "This morning, she looked gray. It's hard to describe, but her skin looked...yes, gray. Bad. Her color looks better now," she repeated. We took some comfort from this. Nurses can tell, right? They have seen many sick babies.

Through the long afternoon and evening, we waited and watched and reached our disinfected hands into the isolette to cup her head or hold her hand. Each time the doctor came back, we asked more questions. He admitted that he just didn't know. She didn't have enough of the right symptoms to add up to any one diagnosis. She got an X-ray and an ultrasound. We saw her intestines, liver, gall bladder, kidneys, brain. All clear. They would wait another few hours (again) and then re-evaluate (again).

Sitting there, watching her, I was seized by the urge to go home. To go home to my healthy, robust 6-year-old, where I could do something. Hug her, talk with her, put her to bed. Contribute to her well-being. Anything but watch and wait and cry and pray and think entirely too much.

Finally it seemed that she was going to remain stable, that perhaps the worst had been in the morning, that maybe, maybe, she was holding her own. We left the hospital at about dinnertime. We'd had only a snack or two all day. Grandma, who has been taking care of Katrina, made dinner. We ate together, trying to be cheerful for Katrina's sake. My husband went back to the hospital immediately. I stayed behind to read stories, sing songs, provide a bit of normalcy to Katrina before bed. When she was asleep, I went back, as well.

Annika was the same. Holding her own, vitals stable, but still very sick. Her anemia (low hemoglobin) had nearly reached the point where a blood transfusion would be needed. Last blood draw had showed hemoglobin of 8.3. If she went below 8, she would need a transfusion. One more blood draw, at about 9:30 pm. Results would be back in a few hours. I decided to stay for the results. My husband went home to get some sleep.

I sat in the darkened NICU beside the isolette, the only adult in a room with five sleeping babies. I must have dozed a bit, because the doctor was suddenly there, kneeling down to my level in the chair. "We got the results back and her hemoglobin was up slightly," she whispered. "There will be no transfusion tonight." I smiled wearily and thanked her, then patted my baby one more time and left for the night.

It was midnight. She had made it through the day. We would start again tomorrow.

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Since Sunday, Annika has improved. The doctors have not yet made a definitive diagnosis and are still testing for a variety of possible bacterial, viral, and fungal infections. The leading contender at the moment is some sort of virus. The doctor said to me yesterday, "Doctors treat, but nature cures."

After several days with no milk, just a glucose and vitamin infusion (plus three different antibiotics and immunoglobulin), they started her on just a few milliliters of sterile formula diluted with water every few hours. Today they went to undiluted formula, just 4 milliliters every three hours. Thanks to the infusion, she has continued to gain weight even through this crisis. She is still pale but pink, and is now lying comfortably on her back, stomach, or side with no apparent pain. She is still anemic, but not enough to require intervention. She managed to pull out her feeding tube yesterday and, in one doctor's words "killed" her IV today. So, mostly back to her active, kicking self.

But I don't think her father and I have recovered yet.


Before the crisis