The Promise of a Rainbow

This story has been on my mind for many years but each time I sat down to write it, the words would not fall into place.  The other day, a family mentioned the concept of having a “rainbow baby” referring to a child born after tragedy.  Rainbows symbolize to me that even after the roughest storm, things can get better.  To see a rainbow there must be falling rain in the presence of sunshine.   Beauty and light will always return.  I have hoped for almost two decades a certain family found peace and was granted a rainbow baby themselves. 

During my final rotation in the Neonatal Intensive Care Unit during training, I attended a C-section with a supervising Neonatal Nurse Practitioner.  She said the newborn had severe congenital defects not compatible with life and would only live a few short hours.  Babies with this particular condition do not look different from healthy infants on ultrasound until they are in the final trimester, when it is often discovered and diagnosed.  These parents had made the difficult decision not to hold their child after birth. 

The newborn was handed off to me and seemed fragile as I placed him on the isolette table.  The family requested definitive genetic testing to determine the chances of having another baby with this abnormality in the future.   Back in those days, it required 12 teaspoons of blood (translation:  ALOT), collection of which seemed to take an eternity. 

He was not active and vigorous like other healthy infants.  He was taking small and shallow breaths.  My supervisor said to wrap him up and take him down to the morgue.  I was crestfallen at the thought of this tiny human being taking his last breaths on a metal table all alone.  I respectfully refused.  No one should die alone.  Another senior resident felt the same and the two of us brought this fragile newborn back to the NICU with us. 

My co-worker agreed to round on my patients while I held the baby in the rocking chair and then after an hour or so, we would trade places and I would pick up where she left off.  It went on like this for about 4 hours.  In my arms, he still had color in his cheeks just as his breathing rate began to slow and his father walked in explaining he wanted to hold his child.  Relief washed over me knowing this beautiful infant would be held by one of his parents before his untimely death.  We left the father with his baby to spend precious time, grieve, and say goodbye.   At some point, he emerged from the room and handed the newborn back to me.  After six hours, this tiny human being took his final breaths and his heart stopped. 

Over the years, I have thought most often about this experience while pregnant and nearing time of my delivery.   My birth plan has could always be summed up in one sentence:  do your best to get the baby out alive and place them on me to hold as soon as possible.  I had strong feelings about what should happen in case I ever had to say goodbye; I wanted my son or daughter to hear loving words from the voice they knew well.  

As physicians, we do not realize how much our life experiences can shape our perspective.  It is a side of medicine we rarely talk about.  Some of us become jaded, anxious, or fearful based on the patient cases in which we were involved.  Throughout our careers, we are privileged to share in the overwhelming joy of others, yet bear witness to much human suffering that leaves scars on our souls. 

I wish these parents knew how deeply their son touched us all in the NICU that day, including nurses, NNP’s, and two doctors in training who will never forget our time spent holding their infant while he fell asleep forever in the loving comfort of our arms.  Rainbows are not just a collection of colors as we look out upon the horizon; they are promises for our hearts.  I hope this family has seen much happiness and light since this day.  As physicians, we will never be able to prevent all suffering; however helping to heal another human being is absolutely priceless.  It is one of the precious rewards of being a physician.