Winter’s Story

Winter’s Story

From Chicken Soup for the Nurse's Soul Second Dose

Winter’s Story

A mother’s love for her child is like nothing else in the world.

Agatha Christie

December arrived and with it, the usual preparations for the holiday season. Our unit, an NICU, entered our hospital’s holiday decorating contest. Snowflakes and all, my helper elves and I transformed our workplace, abiding by the theme “Peace on Earth and Goodwill to All.”

Here in Scottsdale, Arizona, the daytime temperatures had dropped into the fifties. We had three solid days of rain, our equivalent of a midwestern snowstorm. The locals agreed that the last and coldest season of the year was upon us. Yet little did we know that winter was yet to arrive in our unit.

On December 5 during a scheduled Cesarean section for breech presentation, one of our neonatologists was urgently called to the operating room. All present were astonished by the baby who had just been born. Although crying and screaming, this little baby girl was encased in a thick layer of her own skin . . . her eyes merely narrow slits, her arms and legs flexed and contracted. It was as if this precious little girl had been born in a cocoon.

Our neonatologist immediately recognized this child as a collodion baby. She had seen this condition before and assured us that the yellow tight film, or dried collodion membrane, would undergo desquamation or peeling complete by two to three weeks of life. She assured the parents that although their baby would require special care, chances were that she would be okay.

Instinctively, the mother also knew that all would be fine as she received her child with open arms. Even through narrow slits, their eyes met and so did their hearts. Lovingly she named her new baby Winter.

I met Winter for the first time when she was three days old. When I approached her Isolette, I was shocked. I had never seen a baby like her in my nearly thirty years of experience. After report I had to step away and take time to compose myself. Several deep breaths later, I began my nurse-patient relationship with Winter, an experience I will never forget.

Cracking, leathery skin covered her entire body. She was able to move her arms and legs, yet range of motion was limited by the all-pervasive thick skin that restricted even the digits of her hands and feet. The same thick skin covered her ears, yet the ear canals were open. Winter’s eyes were narrow slits and her face was encased in the thick skin, yet her nares were open and she required no supplemental oxygen. Remarkably, she was able to suck, swallow, and breathe easily.

Needless to say, her condition required special considerations. Initially she was kept in an Isolette with 90 percent humidity, more like Florida than Arizona. Nothing could be attached to her skin, no skin temperature probe or monitor electrodes. No arterial or venous access could be maintained, accept via a single umbilical catheter. Winter’s care included protective isolation, sterile linen, rigorous skin care and diaper care, frequent application of emollients, lubricating eyedrops, and daily baths with gentle debridement.

Winter’s mother breast-fed her around the clock. She participated fully in her care, eagerly making suggestions. After she was discharged, she came to the hospital in the morning and stayed all day despite her C-section and her two children at home. She pumped her milk diligently so that Winter rarely had formula, even during the night. Winter’s dad spent long hours at work but visited in the evening and always told Winter how much he loved her. Grandparents provided support, visiting often and taking care of Winter’s siblings.

After that first day, I became attached to Winter. I took care of her every day that I possibly could. Special babies with special families usually attract an entourage of nurses who insist on taking care of them. Winter had her posse. No outsiders had a chance.

Gradually,Winter started to emerge from her cocoon. She was acclimating to our dry desert environment and moved to a regular crib. Those beautiful dark eyes became larger. A great deal of her leathery skin shed. She had freer movement of her arms and legs. As the thick skin came away, fingers and toes also appeared. She could grasp. Her skin became accustomed to cotton clothing, cute, mostly pink little baby girl clothing. Soon her medical needs would be provided on an outpatient basis. Soon we would say good-bye.

As far as needs, Winter actually was born with everything she would ever need. Sure, her unusual condition required NICU care but she had all the things that any baby needs, all that any of us really needs—a mother who loves her and believes in her and knows that everything will be all right.

Christmas Eve arrived. It was time to go home. Winter was all dressed up in her layette and bonnet, sitting in her car seat and ready to go. Her mother gave me a long hug and thanked me for taking care of Winter, for doing so much for them. Tearfully, I hugged her back, looked into her eyes and told her that they had done so much for me. They had become my inspiration.

Each December we are reminded to think of “the real meaning” and “the true spirit.” When snowflakes appear I will always remember a mother and her remarkable little girl. I will fondly recall Winter’s story, one of love and belief, a story of Madonna and child.

Christine Linton

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