Cold Hands

The year is divided into blocks. Each block is about 28 days, give or take a couple of days. Most times this means seven call nights. Each night a hellish segway into sleep deprivation and cathecholamine overdrive. For some unknown reason, this month I've only been assigned five call nights. I'm on NICU (Nick-U) or the Neonatal ICU. I'm in charge of 7 neonates, not just babies... little ones even smaller than usual babies.

They sleep in incubators. Plastic covered shells with entry holes on the sides and fancy doodads all around so that the humidity can be controlled. They mostly lay in colourful fleeces or patterned flannel. Like tubular cigars in a humidor. Most incubators are covered by more fleece or sometimes a quilt. Made specially by little old ladies. They are beautiful - the quilts that is. Most neonates are not very cute. They lack the fat of infants and mew instead of cry. Sometimes when they are critically ill, the covers are off and the neonates lay under the plastic box in the cold fluorescent light. All the better for the nurses to view them. When they are this ill, I look on and watch them in the artificial light. Sometimes, I feel like I'm looking at puppies for sale behind a glass window, and watch their tiny fingers and toes. Most are on High Frequency Oscillation. Its a mode of ventilation that shakes oxygen and air into their tiny lungs. The hope is that high numbers of teeny tiny movements of gas provides less damage to the lungs than small numbers of high pressured breaths by a conventional ventilator. When on the oscillator, their chest wiggle and they seem to do a strange supine, wiggly jig.

I go around all day, worrying about these little critters. I'm scared I'm doing something wrong, they are so tiny. Little pieces of muscle, arteries and veins connected by neural tissue to make a living, breathing, much loved thing. I worry if I look at them in the wrong manner they will turn against me, and all day (or night if I'm on call), I'll be fighting against nature. I worry so much that most times I examine them several times throughout the day. Each time, I either wash my hands or use the hand sanitizer. Its called Micro-San and smells like alcohol but taste like bitter almonds. One pump..then two. Rub your hands together and then with fingers splayed, wave them around until they dry. Usually this means that the alcohol evaporates and my hands get cold. Shake them around and wave it in the air, then vigourously rub them together in the hopes that they warm up. Most incubators are warm and moist. The neonates need to be unfurled from their cocoon of spotty-plaid blankets. They all wear hats. I pick up the stethoscope and listen. On the oscillator, this is futile, all one hears is "chugga-chugga-chugga". Go through the movements anyways, then take a feel of the belly. Poor things, if they are not as ill they squiggle and squirm with my cold hands. I feel it must be torture to be unfurled from warmth and poked by cold hands. They squiggle and I persists. They are usually warm, this feels pleasant to my cold hands. I worry and am sad because each time I do this, each time I care to touch, I know my hands steal their heat.