Baby Blue Eyes

New Born Eyes Caves of Sight. Old Wisdom in New Bodies. Expressions and Gestures Familiar And For The The First Time. New Born Our First Breath Lasts a Lifetime. Harriette Hartigan

From New England J. of Medicine, December 3, 1982 More than anything, it's the eyes that haunt you. All at once full of wonder, bewildered, yet somehow accusing. You can see almost anything you want in them if you look long enough. Trust perhaps? Or is it resignation? A glimmer of understanding that seems to vanish in an instant. It's always the eyes you remember. They lie in a sea of high-powered technology, some rocking gently on the water mattresses meant to simulate the womb from which they were thrust too fast, too soon, unprepared, and ill-equipped. Small clenched fists not grasping rattles or brightly colored toys, but arterial lines and plastic tubing. Silent cries from babies whose first pacifier is an endotracheal tube. This is the world of an infant intensive care unit, a fluorescent, timeless place where children cry without sound and lullabies are barely audible above the gentle whoosh of the ventilators and the rhythmic beeping of the cardiac monitors. We make our daily rounds, glibly discussing the T-E fistula in three or the possible NEC in six, gently probing tiny abdomens, listening to the harsh crackles of immature lungs straining to expand, checking the rapid patter of hearts no larger than a silver dollar. We adjust infusion rates, calculate fluid balance, and estimate maintenance requirements for bodies whose entire blood volume would fit in a teacup. Across the room, two parents watch silently as their child gives a sleepy yawn, oblivious to the array of gauges and alarms that tell of the precarious balance in which this new life hangs. A furry stuffed toy nuzzles gently below a subclavian catheter line. An oversized baseball cap sits unabashedly atop a recent craniotomy. As I peer up from a clipboard chock full of "the numbers on each of my newborn charges, I find a pair of crystal blue eyes peering intently into my own. For a moment, I feel compelled to apologize, to justify, to explain why all this is necessary. I place my finger in the tiny palm to be reassured by the grasp reflex, which somehow doesn't seem quite so primitive right now. The eyes close in seeming silent understanding. From isolette to isolette, each time it's the same. Always the eyes. Placing my stethoscope on the chest of a sleeping 28-weeker, I'm met with another pair of questioning eyes. "Where am I ? they seem to ask. ICU, little one. A place that someday, when you're strong and healthy, you'll never remember. ICU, little one. Can you really see me?