Business as Usual: a Miracle Here, a Miracle There

If you read or watch TV, you may forever think of the Frustaci septuplets when Childrens Hospital of Orange County is mentioned. When the babies were born last May, they set off a mass-media stampede. People magazine, which normally doesn’t like to tax its readers’ attention spans, devoted a cover and 10 pages to the couple.

The three surviving Frustaci babies are still in the hospital’s neonatal intensive care unit, but reporters no longer phone in for hourly updates. Things are back to normal there--as normal as things get in a room substituting as a womb for babies born way too soon.

It doesn’t matter what you’ve read or seen on TV; it doesn’t really prepare you for your first visit to NIC, as they call it. You can tell in photographs that those babies are unnaturally small and fragile. When you actually see one, it’s hard to believe.

You walk into the room and at first you can’t even see the babies. The Formica-and-stainless-steel panorama is dominated by instruments and machines and racks and stacks of supplies. On one shelf is the familiar brand of disposable diapers, but they are the size of a lunch-counter paper napkin.

There are signs of deliberate cheerfulness hung around the room by the nurses--hand-drawn cartoons of teddy bears and ducks, hand-lettered signs telling the babies’ names and the nurses’ observations (“Fresh as a daisy and spunky, too!!”).

In one corner is hung a teddy bear in a basket with the message “Shhh . . . Baby’s Dreaming.” Blankets are pinned up to cut down the light. Beside them is a machine atop one of those stands that look like a rolling hatrack. “Infant Ventilator,” it says on the label. It pulses nearly every second, a needle on a gauge rises and falls, air hisses and the tubes going behind the blankets quiver. With every pulse, it forces air into the baby’s lungs. The baby might be able to breathe on its own, but with all the tubes in and around its mouth, “it’s like trying to breathe through a straw,” said nurse Pam Minton.

Minton’s charge is farther down the line, lying in what looks like a tiny plastic greenhouse with portholes in the sides--an incubator. The sign says her name is Ella. When you look at Ella, you are amazed.

It takes a while to realize she is a baby. Your mind wants to recognize her as a realistic miniature. Her hands are perfect, right down to the fingernails, but the whole hand is hardly bigger than the tip of your little finger. Her legs are the thickness of a chicken bone. But her skin seems unnaturally wrinkled, even saggy in places, making her appear old. There seems hardly enough room on her 1-pound, 7-ounce body to attach all the tubes and wires. A needle has been pushed under her scalp and left there. Welcome to earth.

A technician comes, puts his hands through the portholes, gently places one of Ella’s legs on a clean diaper, pricks her heel three times and squeezes out some of her blood. He will test it for blood gases. Every time the ventilator is adjusted, they must test for blood gases. Ella cries, but she can’t be heard.

Taped to her respirator are photographs mounted on crocheted disks. They show her parents at their wedding and her three brothers posing in some studio. Parents can only come in at certain times, and often they cannot touch their babies--not until they are large and well enough. Sometimes the nurses “cheat,” as they call it, and let the mother hold the baby while the incubator bedding is being changed. Perhaps the pictures are the next best thing.

Across the room, nurse Donna Wright is acting as surrogate mother for another baby, this one large enough to have taken his first real feeding. She tries to massage a burp from him and coos as she does it: “Come on, sweet boy. Oh, I know, this is not easy, huh? Isn’t that better?” She picks him up, and you see he’s trailing as many wires as a stereo receiver.

Nurses work three 12-hour shifts a week in NIC, and they have to wait three years or so for the chance to do it, said Therese Cosan, one of the nurses. “And then they stay--three to five years on the average--even though it’s a high-stress job.” No men hold the job, and very few ever have.

One of the nurses delivered a baby last week, and two more are due very soon. “A majority of them working in that unit want to wait a while for their own children,” Cosan said. “It’s just your reservations. You see the babies that have problems. You know what can happen.”

For a newcomer, it’s hard to sort out your feelings in NIC. These babies would have had no chance for life only a relatively few years ago. Yet they seem trapped in a hard, painful environment for which the nurses’ compassion can only partly compensate. Are you supposed to be happy?

“It depends on what bedside you’re at,” Cosan said. “Each cubicle has its own emotions. Someone can be going home, and next door someone can be dying.” The deaths are unavoidable. About one in seven babies dies.

“You learn to cope,” she said. “You don’t harden yourself, but you learn when to back off. Some nurses are better with it than others.”

Dr. Ralph Rucker, associate director of NIC, put it a different way. “They’re miracle-oriented,” he said. “They love to see such a tiny, fragile, little thing come back here for a visit in a couple of years. A lot of intensive care units burn their nurses out. This one doesn’t. I know that’s part of it.”