Work Text:
Alex gets the call in the middle of the night on his day off. A patient is in labor with triplets at 23 weeks. They'd tried to stop her labor, but it looked as though the delivery was inevitable. They need everyone in.
The operating room is packed with at least forty doctors and nurses, all prepared to whisk the babies onto the warmers and begin working on them. The anxious husband is not in the operating room, but in a private waiting room for their family.
The first one is born minutes after Alex arrives, a tiny limp body in the doctor's gloved hands. A son. The first team rushes to work on him, wheeling him out of the operating room just as soon as they can. He feels rushed too, like he barely knows the action plan.
(Later, Alex will learn that the mother had chosen to name him Stephen. He'll find out that Stephen weighed 390 grams immediately after birth. He'll be the one to weigh Stephen the day he dies, four days later, at just 362 grams. He'll sign off on the photographer taking pictures of Stephen for the family, because he's too small for it to be “routine.” The photographer will assure him that they can improve his appearance with a computer and that it will help the family, so Alex will nod and take the clipboard from him. He'll tell the photographer that he's free to take pictures of the two other siblings, too. He'll look a little puzzled when the photographer shakes his head, and the photographer will see this. “We're only photographing the ones that have already passed away for this family,” he'll say. “The family doesn't want these to be memories of them connected to machines.”)
Shortly thereafter, the second child comes into the world. The second team takes over her care, and she's smaller than the last one, but they work on her too. Alex watches, still so uneasy, because she's so small.
(Later, Alex will watch Ellen's baptism. She'll be 353 grams that day, her second. Alex will be there as she seems to hang on every day. He'll be there when she's diagnosed with a grade two IVH at four days old. He'll be there when, three weeks later, she dies from NEC. Alex will stare at a wall in his shower for an hour and wonder if they're doing the right thing trying to save them at all. She'll be 610 grams the day she dies, and she'll look painfully beautiful in the pictures that will be taken, perfect.)
The third one (the baby that's on his “team” in the operating room) is thankfully another girl. She's bigger than her siblings, the one who had been stealing all of their space and resources. Katherine is 476 grams the day she's born, a little fighter.
They send word down to the mother's family that all three of the babies have made it so far, that the mother is recovering.
(Later, Alex will comfort her parents when the news that Katherine has grade three IVH comes in. He'll do it all over again when their baby needs surgery to treat her PDA because it wont respond to meds. He'll hope for her parents, with her parents, as every week passes and this one final baby doesn't die. He'll hope as she transitions from the ET tube to BPAP and a nasal mask, as she gains weight, as her numbers get better and better.)
(He'll celebrate for Katherine when she's discharged five months after her birth. She'll weigh just over four and a half pounds, still tiny, but she'll be healthy enough to take home. She'll come back to the hospital again twice that next year, having caught an infection despite her parent's best efforts to protect her. She'll need speech therapy to help her talk and physical therapy to help her walk, and she'll probably never get very good at either of those things. Katherine will never be able to do well in school, or be able to live in the community without support, and she will never bring to life the usual dreams that parents have for their children's bright futures. Her parents will instead celebrate when she begins to walk with her walker at three, and begins to speak at four, and when she reads them a storybook out loud at eight.)
(Alex will wonder if they did the right thing whenever he looks back on that case. He'll wonder about the scrutiny others will look back on his generation of medicine with, about the fact that they'd made the choice to save babies before they knew how to give them good lives. His name will be mentioned in a magazine article about Katherine when she's two. The article will tell readers that there was a 6% chance that Katherine would survive her infancy without a severe disability, and ask them to ponder if (especially in light of the fact that neither she nor her siblings beat the odds) it was the right thing to do to save her at all.)
(On Katherine's first birthday, her mother will mail him a picture of her eating pureed fruit for the first time. On her second birthday, she'll bring her to visit and they'll discuss the upcoming article. She'll tell him that she doesn't blame him, that she loves her daughter. On her third birthday, she'll send him a picture of Katherine standing in her walker. The pictures will continue until Katherine is an adult, and he'll save them all.)
(It might not be right, but it'll be the choice they'd all made. Next time he'll be more cautious. Next time he'll be there earlier, and he'll ask the parents to make some tough educated decisions before the baby is born. Next time he'll explain the odds to the parents better, because while those numbers don't say if their particular baby is going to live (or live well), they still mean something. In the end, their actions will often be the same; they'll try to save the baby. Some of them will live, and some of them wont. None of them will keep him awake like those triplets had. Eventually more of them will live (and live better), more of them will send him pictures as trophies.)
(Katherine will outlive him by over a decade.)