Twins Blog: NICU Emotions

July 27, 2010, By Josh Katzowitz 5 comments

Josh Katzowitz

We were two weeks into our twins’ stay at the Neonatal Intensive Care Unit (NICU), and our babies were making good progress. Their breathing had improved and both no longer had a need for their intravenous lines. They had begun to gain weight one ounce at a time, and their faces were filling out. They began to look like real, live babies. Only a little thinner. A few days earlier, a new premature baby moved across the aisle from where our twins were staying. The father and I had nodded at each other a couple times, and a couple of “How are you’s?” were exchanged.

Which, now that I think about it, is an absolutely absurd question in this environment. Most likely, unless your kid is improving rapidly and only has to spend a few days or a week in the NICU, the answer is the following. “How am I doing? I’m terrified. I’m alone. I’m sad. I’m desperate. I’m helpless.” But we were polite, and we said, “How you doing?” and the other said, “Doing pretty good.”

One night, about 11 p.m., I was visiting and the father was there, watching his wife hold their baby – which entered the world at 27 weeks gestation weighing about a pound-and-a-quarter. She was, to put it mildly, infinitesimal. The tiniest human I’d ever seen. The dad told me the bodies of the mother and the daughter hadn’t gotten along, and the baby wasn’t growing well inside the womb. She was better off living outside her mother, and since mom had been given two rounds of steroids – which rapidly decreases the baby’s chances of respiratory complications once she’s emerged – they would have to take their chances by delivering the baby nearly three months earlier than expected.

The little girl, skin-to-skin against her mother’s chest, lifted her head, and she breathed without the help of a machine. That’s known as “room air,” and it’s two of the sweeter words you can hear in the first week of a preemie’s life. My daughter, for instance, was on room air from the moment she was born. My son, however, was on a ventilator for the first few days to help him breathe, and soon after that, he was moved for only a few hours to a CPAP machine – which provides pressure to keep the lungs open as the baby breathes on his own. Getting our son off a ventilator was an early victory for him, because babies that spend weeks on the machine run the risk of chronic lung disease, pneumonia, collapsed lungs and eye damage.

So, the fact this tiny baby, lying against her mother, took breaths on her own was almost miraculous.

The next day I returned to celebrate my daughter’s weight gain of 20 grams – and the poop-filled diaper that she bestowed upon me as a present – but the mood was much different. The mom of the 27-weeker was in her wheelchair crying. There was a man – a clergyman of some kind – chanting prayers with his eyes closed. There were looks of concern on each of the visitors’ faces. There were tears.

Worst of all, there was a ventilator, pumping oxygen into the baby’s lungs. She was off room air, and it was devastating.

This is the dichotomy of the NICU. This is the emotional overload that can change from one day to the next, from one second to another. This is why we say, “Doing just fine” when we get the “How you doing?” The truth is too painful.

I sat there and celebrated my kids’ improvement. Less than 10 feet away, a family was preparing themselves for the worst. I tried to put them out of my mind, tried to concentrate on my sleeping babies. But, every once in a while, I looked over my shoulder and saw the desperate eyes.

“I imagine you see this all the time,” I told my babies’ nurse. “But it’s so weird for me to be so happy over here and for them to be so miserable over there.”

“I know,” she said. “But that happens here quite a bit.”

“That must be tough.”

“Yeah, and a lot of people tell me, ‘I don’t know how you can work at the NICU. It must be so sad.’ And it can be sad sometimes. But it’s so awesome when you get to say goodbye to a baby because they’re going home with their parents. That’s the best part of this job.”

“Yeah, I bet.”

We both fell silent. I could hear my daughter softly cooing, and I could hear my son chirping out his hiccups. I could also hear, from 10 feet away, a nose sniffling and a man praying.

In the NICU, with my babies not yet 30 weeks old and with them struggling to get to three pounds, with my wife and I worried every day about their progress, with our lives upside down, with us treading water, this was the thought that came to me. 

“We are so lucky.”

Josh Katzowitz lives in Atlanta and covers the NFL for CBSSports.com. He is a featured contributor to ManoftheHouse.com and author of the book, Bearcats Rising. He's currently working on a book about pro football that is scheduled to be released in 2012.