Page 38 - WTP Vol. V #1

Tissue: A Scar Story (continued from page 14)
hospital: You need to get here right away, her nurse practitioner Ramona’s voice. They only
call in life-and-death situations because they know the sight of the phone number alone on the caller ID is enough to send any NICU parent into hysterics.
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An immediate ligation of her patent ductus arte- riosis was necessary; her lungs were filling with fluid. She was drowning. We anxiously signed forms listing all that could go wrong, including damage to the nerves of the left vocal fold—a detail that hardly seemed to matter in the face of the life-saving surgery. A detail that would only become relevant months later.
The burn unit buttered her with special salve and applied special gauze generally reserved for
burn victims, giving her a slippery barrier. She shone under the lights that made what was left
The surgeon went through her back, through her ribcage, to ligate the fetal heart valve that nor- mally closes at birth, but in preemies allows blood and fluid to fill their lungs. Poor lung function due to very small and incompletely formed lungs; heart failure from a heart too weak to pump oxygen-rich blood to vital organs. The form that I’d memorized and folded and refolded, and all those who had composed its warnings, wouldn’t stop shouting at me.
of her skin a window into the blue and purple of capillaries and the white of bones. With no fat beneath it, her skin was translucent; we were looking into her body. We could peer into veins pumping blood at visible intervals, point to where her ribs encased the heart struggling to beat. Ghosts were there in her skin, taunting us by revealing all that was wrong with her body; we could see everything, but we could do nothing.
After the surgery, however, her heart became stronger, there was less fluid for nurses to extract from her lungs, and her monitors’ distressing DINGs! happened less often. She had once again cheated death. But that was when her skin began to slide away. What remained wept and oozed. At this point in the womb, only one or two layers of skin are formed. Adults have nine, we were told.
She will be scarred all over her body from this infection, they said. And no matter how old they are, you can always tell a preemie by the track marks on their hands and feet. But scarring was the least of our worries then. Germs were ev- erywhere, magnified, propelled through the air, traveling from baby to baby on nurses’ scrubs, beneath our fingernails, in our breath, waiting. Every handshake was a threat, every surface
and every body a transport for contagion, every person who coughed a reason to leave a room. The nurses tried to do less, to touch and poke as little as possible through the portholes, the only barrier between her isolette and the open air of the NICU. Doing less meant a greater likelihood of maintaining the rainforest atmosphere inside her isolette—keeping the humidity high and the temperature constant. There was little more than wet tissue paper holding her body in, keeping ev- ery horror out, somehow bearing up the weight of our lives.
One or two layers of skin, thin as tissue paper. This is why, when the leads monitoring her heart rate and breathing were removed, they took her skin with them. This is why without those pre- cious layers, she had little to protect herself and developed an infection. A very immature immune system does not protect the baby from over- whelming infection. Without more time, she had few defenses.
I do not have to try very hard to remember what was nearly upon us, that hot breath at the backs
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Then a savvy thought from her nurse practitio- ner, Ramona: Maybe the burn unit has some ideas.