Shift Change

by Robert Lanz LCSW

 

 

 

I thought the story about my bad experience in the pathology lab was the worst story I would ever tell. I should have known that even a good social worker is capable of repression under the right, or I guess, wrong circumstances- a normal response to the worst of anything. With effective repression, even your dreams are altered. Those nagging headaches and backaches and fatigue are there to remind you that you are in pain, temporary diversions to fool you into not paying close attention to what really is the source of the pain-like another dead infant. Another nightmare trip upstairs. Another charge nurse I’m friends with and have to make nice with no matter what the circumstances. A cumulative emotional thrashing in some far corner of the hospital, burning time I could have used to recover from the morass of bad patients, angry families, unnecessary death and the general cacophony of the ER. Upstairs is seldom, if ever, a relief. Even the cafeteria isn’t a good place to hide.

My trip up to neonatal ICU fills that category of no relief. NICU is a bad news zone on a good day and this was already shaping up to be a bad night because there’s only one reason to call the social worker up there after dark. The day shift worker gets to have a few in the win column on her shift, a baby finally turns back to normal baby color after a few days under the sun lamp, a baby is extubated and breathes on his own, that kind of stuff. No one calls down to the ER with that news and asks me up to celebrate life. Only bad news gets called down and the SW has to go up to take care of it.

The dead baby’s family was tearful as you would expect it to be after a lingering death following a difficult birth and an even more problematic pregnancy. After a night of passion with high hopes and big dreams, virtually everything that could go wrong did. Pre-eclamptic bleeding, a questionable ultrasound, premature birth.

Expectations may have some temperance with some families but hope is a powerful force and people will hold on to it until the end, or longer, and seem to be in a state of disbelief. This all leads up to great sadness with no one to blame but “circumstance”. It was catching. After hearing the endless dashing of hope since conception they certainly deserved some relief but other than an ability to listen and absorb the heartbreaking story I didn’t have much to offer.

When the family was finished and left I did my charting and the charge nurse did the same. I had unfinished patients waiting for me in the ER and they had been, what, cheated out of a timely intervention by the social worker when he had to go upstairs for another dead baby?

“Sorry I’m slow getting back to you. Had to go upstairs and I’m working alone tonight.”

Not much else to do or say.

A couple of hours later I got another call from upstairs. Another fetal demise mother, who was just a teenager, almost a child herself, wanting to hold her baby one more time and was now unwilling to let the nurse take it back to the morgue. The charge nurse didn’t know what else to do but call the social worker and invite him up for another torturous intervention where the only reward would be to have completed the gruesome task.

Another bullet I couldn’t dodge-babies having babies like they were cuddly stuffed pandas or something. Girls barely old enough to have sex having babies and now the mom holding the baby in a death grip you might say, oblivious to how much work and sacrifice it would have been to actually mother that baby. I remember thinking at the time, “Who signed me up for this anyway?”

The situation started going south the day her boyfriend convinced her they were in love and then convinced her that most people in love don’t use condoms or some such variant of that same old testosterone story. And in the end, just call the social worker to make it better.

Somehow I did. Active listening I guess. The mom reminded me of some of the girls I worked with in juvenile hall when I was younger and frequently asked, after a lengthy listening session, “What do you think is the best thing to do now?”

It worked well enough for her to voluntarily hand the baby to me, still wrapped in the baby blankets, I cradled the baby like it was still alive and went to the nurses station and wrote a brief note for the daytime social worker to follow up. I looked down at the silent package and it looked just like a sleeping infant to me, then I pulled the blanket over its face.

“Bob” the charge nurse said. “We’re short up here tonight. Can you put the baby in the morgue on your way back to the ER? I’ll have security meet you there and let you in. I already did the toe tag.”

Why not? Yeah. Why the hell not? Just another dead baby that looks alive going into the icebox. Why would that bother me? Ouch!

Dead babies in the morgue have their own special drawer and you never know how many of them will be in there, wrapped in towels or blankets or even heavy butcher paper sometimes. I never asked why. They just looked like pork chops or tri tip at the corner store and it hurts to even think about it.

The security staff opened the door and left. The baby already had the toe tag so all I had to do was slip it into the drawer and leave. I pulled on the handle, expecting to see the little packages that were always there. What I got was the fetal demise from neo-natal ICU, unwrapped, pleading eyes wide open staring right at me.

The emotional energy flung me back into the wall, tears streaming down my face as my knees buckled and I went down hard, defenseless. I almost dropped the baby as I hit the floor, a dead baby staring me in the face and another one clutched to my chest.

I don’t know who put that baby in the drawer that way and I was ready to hurt someone but for a moment I couldn’t even get up off that ugly cement floor, just the sobbing alone withered me. Finally I put the baby I was carrying in the drawer, removing one of the blankets and wrapping the other staring baby head to toe. I held its eyes closed until they stayed that way on their own. It was a little late for me but I didn’t want anyone else, ever, to feel what I just had.

I went back to the ER and found no patients waiting for me, the shift had changed and I left for home. I don’t remember much after that. That wasn’t repression. That was on purpose. This is a terrible story and I’ve never told it before. You’ve got it. Please never ask again what the worst thing that ever happened to me in the ER is.

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About robertjlanz

Author and health care professional.
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One Response to Shift Change

  1. Abe says:

    Thank you for sharing, and for all you do.

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