Baby medicine (medicine for babies, not carried out by babies)
Nine months of planning and hoping and dreaming, maybe longer, maybe even years of it. Babies are the embodiment of pure potential; each one a blank little person with endless possibilities. Hospitals and parents go to extraordinary lengths to ensure that this potential is preserved. These ideal human beings receive ideal forms of medicine.
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The habitat of the neonatologist struggles to strike a balance between science and humanism.
Babies in boxes. Small babies. Thin babies usually. Wires everywhere, bleeping noises and tubes. And unfortunately they all look the same. It’s a cliché to say that all babies look the same but babies in boxes really do look the same. It’s subjectively and physically hard to see past the perspex and the woolly hat and the NG tube. They all obscure the features that might make the baby look like a unique individual. But in neonatology looking like everyone else isn’t a bad thing. When your baby doesn’t look like the others you start worrying.
So how do the neonatologists do it? Hang on to the humane when presented with the bionic?
When approaching a baby in a box the first rule is to state the obvious and emphasise that a child is the subject of your examination; not the paraphernalia attached, hanging out of or surrounding it: “This is a baby boy in an incubator.”
Once humanity is established the science can be addressed as secondary and supportive to the initial premise.
In their ethos, neonatologists are uncompromising in their humanism. However science has to be harnessed to achieve the best results for their patients. This seems to be a guilty pleasure for the neonatologist. If you ask one what initially attracted them to the specialty many will answer that they liked intensive medicine. This translates into a statement about enjoying real time physiology and pharmacology. The NICU is essentially a living lab.
To soften the science for parents and the babies the walls are painted in pleasant colours with the letters of the alphabet, conjuring images of a nursery. The lighting is dim and voices speak in hushed tones. This is part of the science too: calm environment leads to calm babies and calm babies can put more energy into growth.
Like the physical environment and the science of the neonatal unit, a lot of thought has been put into the spirit and work ethic there. Attention to detail is important, it is not necessary to look at the example of Belfast to realise the vulnerability of the lives in the boxes. General hospital infrastructure has a lot to learn from the environment and methods of Cork’s neonatology centre. Everyone who works in the unit is a colleague, hierarchy exists but it does not intimidate socially, professionally or personally. All input is valued. The care is holistic and takes responsibility for wellbeing of patients in its broadest sense. This is a specialty that makes time to illicit feelings from families and staff. It is recognised by the consultants that their concerns may not be the same as those of the parent and unless both sets are addressed any meeting will be less than satisfactory. Ideal medicine for the idea of humanity.
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