A Baby to Bind Them. Susanne Hampton

was the eighteen-year-old girl who had been told by the social worker that her parents had been killed. A heavily laden lorry had run a red light on the corner of Fairfax and Wilshire and they’d both died on impact. Jade remembered the distressed expression on the woman’s face as she’d delivered the devastating news. She felt certain the policewoman on the other end of the phone had the same poignant expression. She didn’t think that life could be so cruel and deliver her family the same overwhelming sadness twice. It was too much for one lifetime.

      For a moment, she stared blankly at the wall, seeing nothing through the blur of her tears. But Jade couldn’t fall to pieces the way she had all those years ago. Back then she’d had Ruby to tell her that everything would be all right and that they would always have each other. Reassuring Jade that she would always have someone to lean on through the hard times. Now Jade needed to hold herself together enough to stand strong beside her sister when she found out she had lost David. She had to be Ruby’s pillar of strength this time.

      Jade reached for her bag and keys as she brought herself back to reality, and to what remained of her shattered senses. She needed to get to the hospital. Ruby had just lost the love of her life and the father of her unborn child.

      With tears running down her face, Jade ran for the door, and taking deep breaths she focused on the task of getting safely to the hospital. Their home was barely ten minutes from the Los Angeles District Hospital but it felt more like a lifetime away as she was stalled by the heavy evening traffic on Wilshire Boulevard. Every minute she sat there her heart was pounding in her chest and her stomach was churning with the reality of the crash that had claimed David’s life.

      Only a few hours before they had been in the kitchen together, talking about the wonderful few days ahead and thanking Jade for arranging their short holiday. David had planned on painting the nursery when they returned and Ruby was already filling the cupboards with baby clothes in preparation for the birth of their first child. They had been overjoyed when they’d been told it would be a little girl, just as they would have been overjoyed if they’d been told they were having a son. They had been so thrilled to be starting their family. She would be the first of four children, David had lovingly teased his wife as he’d patted her already rotund belly.

      Finally Jade pulled into the hospital car park. Her tears had dried and she was steeling herself to be strong for Ruby as she stepped from the car. She had no idea that that was the same moment Ruby’s heart stopped. Her sister had died on the operating table only minutes after having an emergency Caesarean to save the baby daughter she and David had already named Amber.

      Jade wept openly and uncontrollably when she was told. Nothing the nurses or police could say would stop her tears. There was no amount of compassion or understanding that could stop her sobbing. She doubted the tears would ever cease and she knew her heart would never be whole again. This time she had no one to lean on.

      ‘Will she live?’ Jade asked, scared of the answer but still needing to know. She had kept vigil beside her tiny niece for every waking hour of the two days since her birth. She had dozed sitting upright.

      ‘Jade,’ the neonatologist said with an equal mix of warmth and authority tempering her voice, ‘you know that Amber’s having the very best care with the finest facilities.’

      Jade sat in silence for a moment, gathering her thoughts before the shaky response slipped from her lips. ‘I know, Dr Greaves, and I don’t mean to be abrupt, but I don’t want you to sugar-coat anything. I’ve been working here in the neonatal ICU for over two years now, so please just be honest with me about her prognosis.’

      Jade watched the neonatologist as she cast her eyes down and her lips formed a hard line in her somewhat tired face. She knew that the paediatric specialist had been attending Amber all night and the toll of her dedication showed in the morning light. Her naturally thin features were further drawn. But Jade was as tired as the attending physician and that brought her close to becoming a victim of her emotions. She would rather appear forthright and detached at that moment than risk her arm reaching around her in a comforting way and reducing her to a useless, snivelling heap of guilt. Melissa Greaves was that type of doctor. Professional but also motherly. Jade made a space between them to make it difficult for Melissa to reach for her. She had to do this alone.

      The doctor’s hesitation in answering confirmed Jade’s fears, and her stomach tensed with a hollow cramp. Her composed veneer of bravado was close to shattering.

      Melissa turned to her with a look that signalled she was about to deliver the harsh reality. ‘If complete honesty is to be the call then I have grave concerns for your niece. She’s dropped below her very low birth weight of two pounds, only marginally, but every ounce is critical, as you know, Jade, with VLBW patients.’ She paused for a moment as she slipped her pen inside her coat pocket.

      ‘Amber’s a little fighter but since you don’t want me to lie to you, if, and that’s a big if, she makes it through the day, I’d still only give her a fifty percent chance of survival. Her gestational age was twenty-nine weeks, so it was always going to be a struggle, but with the compromised maternal metabolic and cardiovascular factors brought about by the accident there are additional complications. With her mother trapped in the vehicle for almost two hours, there was decreased uterine blood flow and abnormal placental conditions prior to the emergency Caesarean, and she is a tiny baby, so Amber has a fight ahead if she is to survive.’

      Anxiously, Jade turned to the tiny figure lying behind sterile glass walls. A sea of wires, all linked to monitors, supported her fragile life. Jade gently reached her hand through the porthole door of the incubator and gently stroked Amber’s warm, wrinkled skin. She was like a tiny china doll. Despairingly, Jade looked at her tiny niece’s beautiful face through the transparent head box that was supplying a constant stream of oxygen to make her breathing less difficult. All the while a drip was feeding nutrients through the sole of her swollen foot as the veins in her spindly arms had collapsed and had ceased being of any use for intravenous nourishment. The innocent child was fighting to survive, unaware that her parents’ lives had been taken by the cruel hand of fate.

      ‘You know, if there’s a glimmer of light in all of this,’ Melissa added, and crossed to Jade and gently placed a hand on her shoulder, ‘Amber isn’t suffering respiratory distress and her tiny lungs appear to be coping so she didn’t need a ventilator. I am amazed and a little bewildered by this and it does give me reason to give you the fifty-fifty chance ratio. Without that, her survival would be much lower than fifty per cent. At birth, I placed her survival at less than twenty per cent.’

      Jade took another deep breath. The odds were improving. However, the slight degree of optimism the doctor had imparted didn’t bring her peace of mind. Jade wanted the one hundred per cent guarantee that she knew in reality no one could provide.

      This environment was second nature to her, yet now being in neonatal ICU made her fearful. Every day, as a neonatal nurse, she cared for premature infants, yet seeing Amber needing the same level of intense assistance made her feel vulnerable. She had to pull herself together. Not for her sake but for Amber’s. She had to be able to process what was happening and, if called upon, make the right and informed decisions regarding her niece’s care.

      ‘And you moved her from the open radiant warmer last night?’ Jade asked, appreciating and finding a level of comfort in the compassion she had tried to deflect.

      ‘Yes. When you fell asleep for a few minutes in the early hours I decided that the increased stimulation from light and noise and the associated risk of decreased growth and weight gain was greater than the disadvantages of the incubator. She is just too tiny to lose any further body mass. The next twenty-four hours will be critical.’

      ‘Then it looks like we’re here together for another long day, Amber, but you will get through this,’ Jade promised aloud to the sleeping infant, before adding silently, And I will never leave your side. Never. Trying unsuccessfully to quash her unshed tears, she turned away before Melissa witnessed her breakdown. Through a watery blur, she watched the shaky breathing of her niece’s tiny body and felt so helpless it was overwhelming.

      She had never felt so totally powerless