On Sunday, the last of my three night stretch, the wheezers finally arrived. Babies had been coming in all day long with the same “chief complaint”: resp dist, or respiratory distress. Every one of them had tested positive for RSV, and the admission board was packed with a sizable list of kids awaiting inpatient beds.
“I don’t know where you’re gonna put ’em all,” the departing doc said.
Once again, as it had on Friday night, there was no space to bring in any new patients because of those waiting to be taken to a hospital bed. And the kids being discharged from those hospital beds were departing very slowly, clogging up the ER. As I had two nights before, I started my shift by checking out new patients in the chaos of the waiting room.
Most of the moms and dads were watching the TV, the fishtank, or the busy toddlers, but one Indian couple sat quietly with their baby towards the back, both fixedly staring at the bundle in mom’s lap. I went to see what they were so worried about.
The infant’s face was an ashy gray, an appearance augmented by a rampant, scaly eczema that made his lips seem even drier than they already were. My first thought was that he wasn’t dead, because dead babies are bluer. I don’t remember if I said anything to them as I scooped the baby into my arms and rushed back to the ER, but I called out as loudly as I could to open up a room for a possible arrest.
The baby was breathing — rapidly and shallowly — but, as anyone who knows the basics of infant advanced life support will tell you, that could stop at any moment. We were lucky: a respiratory therapist was already present and an oxygen set-up was already hooked up at the nearest bed. A family was already in the room, but they took their child off the bed for us and with the flow of oxygen a pale, pink color returned to the Indian baby’s face.
Having bought ourselves at least another moment, the respiratory therapist brought an asthma treatment while the nurse rolled the crash cart into the room. If the baby’s color had remained gray, I would have had to put a breathing tube in within the minute. We all held our breath as the baby regained his and, moment by moment, he came back from the brink. The respiratory therapist attached a mixture of albuterol and atrovent, two asthma medicines, to the oxygen flow. After a minute or two, the baby had revived enough to give a weak cry. In five minutes he was grabbing for mom. In half an hour he had regained enough strength to sit and push away at the strangers: me, the nurse, the respiratory therapist.
The other doc, the one who was supposed to have left already, called out an hour or so later, when the lab result came up, “He’s RSV positive.”
“What’re you still doing here?” I asked.
She shrugged and half-grimaced. “Someone’s got to see all these babies while you’re playing around in there.”