Thrown into the rose
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* Naila Ramji

The physician is having a hard time getting the tube into the 600-gram infant’s tiny orifices: mini nostrils and a mouth into which I could barely fit my pinky. The goal is to allow for proper and easier ventilation after many an oxygen desaturation, bagging and suctioning episode.

And what is my job? To hold baby down. This tiny little thing squirming and crying with its teeny-tiny limbs and tiny little rib cage moving up and down and baby abdomen twisting from side to side, writhing in distress. So I gently hold her limbs down and out of the way of the people who are trying to save her life, really. But I also proffer my finger for her to hold onto in her delicate, minuscule hand. And she squeezes hard, with all her might, through the whole ordeal. I am there to hold her hand. That is all I can do for her right now.

She is so small, but in all her anguish there is surprising strength in that grasp. She squeezes till her fingers and toes are ghostly pale. Her oxygen saturation plummets and then comes back up with every attempt to intubate, and she cries and writhes and squeezes my finger. I tap her feet to help stimulate her and also to reassure her that here I am, baby, I am still here, I am right here, here. It is torture to watch this little thing fight for her life, struggling relentlessly with every effort. And the tears well up, threatening to spring from my eyes. I hold it together — of course I do, that’s my job and my function here. I pray and I pray and I do what I’m told, and I help suction and I hold baby’s hand. And also I love her because everything we do in medicine is so vitally important, but love heals too and she needs my love in all that frenzy. So I just stand there and hold her hand and love her like she was a part of my soul. And then she is stable. She does not die in my arms as she had in the morbid image that flashed in my mind earlier that morning on the metro. She is alive and more stable than she was before the intubation.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/184/2/217/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/184/2/217/F1)

Image courtesy of © 2012 ThinkStock

That’s the rose: the spiral of fragrant petals, blood red, silky soft in its heart, and perilous anywhere else around it. It is beautiful, delicate and ethereal, blossoming, drooping, then perking up again. That’s where I flew for a few eternal moments in a long and difficult day for many a baby in the neonatal intensive care unit. In some ways, it’s true that you should not get too emotionally attached, but there is so much more to learn, to gain and to give if you do allow your heart to be opened. If you choose to go there, it is worth all the pieces of your soul and every breath of your life.