Neonatal Care Quotes

Boy, these conservatives are really something, aren't they? They're all in favor of the unborn. They will do anything for the unborn. But once you're born, you're on your own. Pro-life conservatives are obsessed with the fetus from conception to nine months. After that, they don't want to know about you. They don't want to hear from you. No nothing. No neonatal care, no day care, no head start, no school lunch, no food stamps, no welfare, no nothing. If you're preborn, you're fine; if you're preschool, you're fucked.

SCBU (pronounced Scaboo) is the Special Care Baby Unit, NICU is Neonatal Intensive Care, PICU is Paediatric Intensive Care, PIKACHU is a type of Pokémon.

My own choice of a single-variable measure for rapid and revealing comparisons of quality of life is infant mortality: the number of deaths during the first year of life that take place per 1,000 live births. Infant mortality is such a powerful indicator because low rates are impossible to achieve without having a combination of several critical conditions that define good quality of life—good healthcare in general, and appropriate prenatal, perinatal, and neonatal care in particular; proper maternal and infant nutrition; adequate and sanitary living conditions; and access to social support for disadvantaged families—and that are also predicated on relevant government and private spending, and on infrastructures and incomes that can maintain usage and access. A single variable thus captures a number of prerequisites for the near-universal survival of the most critical period of life: the first year.

Surgery is the most masculine of medical disciplines, taking knives and penetrating the body to find disease and destroy it. It is a war game in which cold and shiny stainless steel is pitted against the unseen, sinister but discoverable and conquerable enemy. Pediatrics is in many ways the most feminine of medical disciplines, with its focus on small children, preventive care, nurturing. In terms of gender, neonatology seems to be somewhere in between.

You’re right: if there’s sentient life behind the border, it probably won’t share my goals. Unlike the people in this room, who all want exactly the same things in life as I do, and have precisely the same tastes in food, art, music, and sex. Unlike the people of Schur, and Cartan, and Zapata — who I came here in the hope of protecting, after losing my own home — who doubtless celebrate all the same festivals, delight in the same songs and stories, and gather every fortieth night to watch actors perform the same plays, in the same language, from the same undisputed canon, as the people I left behind. “If there’s sentient life behind the border, of course we couldn’t empathize with it. These creatures are unlikely to possess cute mammalian neonate faces, or anything else we might mistake for human features. None of us could have the imagination to get over such insurmountable barriers, or the wit to apply such difficult abstractions as the General Intelligence theorem — though since every twelve-year-old on my home world was required to master that result, it must be universally known on this side of the border. “You’re right: we should give up responsibility for making any difficult moral judgments, and surrender to the dictates of natural selection. Evolution cares so much about our happiness that no one who’s obeyed an inherited urge has ever suffered a moment’s regret for it. History is full of joyful case studies of people who followed their natural instincts at every opportunity — fucking whoever they could, stealing whatever they could, destroying anything that stood in their way — and the verdict is unanimous: any behavior that ever helped someone disseminate their genes is a recipe for unalloyed contentment, both for the practitioners, and for everyone around them.

No. 1, when you ask who’s interested in this, the usual answer is, terminally ill people with excruciating pain. False. Factually not true. It tends to be a preoccupation of people who are depressed or hopeless for other reasons. No surprise, actually, if you look at what leads to suicide: hopelessness and depression. You have to look at euthanasia or assisted suicide as more like suicide than like a good death. Second, this notion that there’s no slippery slope, as advocates have long claimed? Totally wrong. Look at Belgium and the Netherlands: First, it’s accepted for adults who are competent and give consent. Then, it’s “We’re going to extend it to neonates with genetic defects, and adolescents.” Any time we do anything in medicine, it’s the same way: We develop an intervention for a narrow group of people, and once it’s well accepted, it gets expanded. I think it’s false to say, “We can hold the line here.” It doesn’t work that way. Third, people say this is a quick, reliable, painless intervention. No medical intervention in history is quick, reliable, painless and has no flaws. In the Netherlands, there’s about a 17 to 20 percent rate of problems, something screwing up. Initially, when the Oregon people published — “We have no problems. Every case went flawlessly!” — you knew the data was wrong. It had to be wrong. Either you’re not getting every case, so the denominator was wrong, or people are lying. There’s nobody who does a procedure, not even blood draws, and it’s perfect every time. So this idea that this is quick, reliable and painless is nonsense. And the last and most important point is: You want to legalize these interventions to improve end-of-life care in this country? That’s your motivation and this is your method? PS: I don’t think people argue that–— ZE: [interrupting] Oh, people do argue that! That is the justification for these procedures: It’s going to improve end-of-life care and give people control. The problem is, even in countries that have legalized it for a long time, at best 3 percent of people die this way in the Netherlands and Belgium. At best, 10 percent express interest in it. That is not a way to improve end-of-life care. You don’t focus lots of attention and effort on 3 percent. It’s the 97 percent, if you want to improve care. The typical response is, we can do both. Hmmm. Every system I’ve ever seen has a bandwidth problem: You can only do so much. We ought to focus our attention on the vast, vast majority, 97 percent of people, for whom this is not the right intervention and get that right — and we are far from that. I don’t think legalizing euthanasia and assisted suicide are the way to go. It’s a big, big distraction.

In the book (Savvy Stories) you see some very real, very personal moments. The first week of Savvy’s life was the longest week of ours. We spent five days in the NICU (Neonatal Intensive Care Unit) worrying that our newborn daughter might die. It was touch and go for a while, and it was extremely difficult to write about. Chapter two gets a lot of people crying. But because we put that honesty out there, readers said “Okay, I can trust this guy.” Then they were better able to laugh with us, too.

Many NICU survivors have hospital bills of more than a million dollars and cannot be discharged from the hospital because their parents cannot afford a telephone at home.

Because the work that doctors do has moral urgency, doctors have a highly refined, professionally reinforced sense of right and wrong.

Informed consent is probably the most revolutionary, the most rudimentary, the most misunderstood and misused term in all of health law and bioethics.

there is something unforgettably compelling about having actually been there, alone, at two in the morning, gloved, masked, and robed like a latex-covered priest, receiving into my hands a blue, bloody, and lifeless baby and having to decide.

From the individual doctor’s perspective, it is far better to do whatever it takes to avoid litigation, even if it doesn’t seem to be the right thing to do, than to risk entanglement in this crazy system.

A whole hospital ward seemed to be crossdressing, nurses pretending to be mothers playing like boys with Tinkertoy babies.

infant deaths decline from about 100 per 1,000 births in the year 1900 to about 0.1 per 1,000 today as maternal and neonatal care has improved.

back to standing and listened. I needed to hear the truth. She gave me sound advice and recommended going to an appropriate emergency room if I felt anything suspicious with the baby. She said that our local hospital wouldn’t staff the neurosurgeons necessary to perform life-saving surgery, so we would need to travel to a larger city. Since we became more restless and hopeless every moment, Adam and I decided to drive the four hours south and crash the ER at an L.A. hospital. We went to Cedars-Sinai Medical Center because our midwife found great reviews about their Neonatal Intensive Care Unit