A Call to be a Neonatologist

Today I held a dead baby in my arms as I ran to the emergency department, which also doubles as a “critical care” unit.

We had seen the infant on morning rounds and she did not look good. She was breathing fast and had a temperature of close to 39 degrees Celsius (102 F). She was somnolent and Dr. Damian (again, the only doctor in the hospital) ordered ampicillin, gentimicin, and fluids for her.

I didn’t think to check on her all day...in the afternoon the nurses brought her limp body to the back of the Maternity Ward, which doubles as a nursery. When I saw them carrying her I knew she was very sick...and a sick thought crossed my mind that she was already dead. I came to help them assess her and watched her take one last deep breath….afterwards I couldn’t get a pulse rate or hear a heartbeat with my stethoscope. There was an eerie silence in her chest.

I started doing compression on her while the other student went to tell the Emergency Room doctors visiting from Columbia who had assisted in two neonatal resuscitation that week. They asked me to bring her to the emergency room and I did while another student did compression on her in my arms. We tried CPR for a few minutes but blood started oozing out of her mouth and her nose...I think she was already dead in the nursery.

I’ve never seen a dead baby, I’ve never held one…but I won’t soon forget it.

The mother was crying when we told her, but I was told that in Ghanaian culture we leave them to grieve with family and friends. Being that I only know 5 words in her language – Twi – I felt helpless at consoling her.

I changed by project to looking at the growing and much needed field of neonatology in Ghana. I want to focus specifically on identifying prematurity with the Dobowitz-Ballard Exam and comparing the gestational age found with that to reported maternal gestational age…and also to describe the risks of prematurity to new mothers.