poured out before bed
“Mom is HIV and HepB positive,” the resident says, handing me the chart as she makes her way out the door. “Can you write orders for acyclovir, the Hepatitis vaccine, and the HBV Ig? Consent is already in the chart. You can go interview the mom for an H&P, too. And, oh gosh, I almost forgot – mom’s a heroine addict so we need a methadone drip, as well. There’s a protocol in the system you can use. I’ve got to head up to the NICU but you can page me with questions.” She smiles as she sweeps by. “Welcome to the newborn nursery!”
I briefly flip open Infant Jones’ thin paper chart and begin to gather information about the pregnancy and delivery from her mother’s EMR. When I’ve a good idea of the major issues surrounding her new and somewhat precarious existence I take a quick peek at the little one. She is very small and quite irritable – one of the early signs of withdrawal – but her bedside glucose is normal, there are no focal neurological defects, tremors or signs of altered mental status, and she is breathing comfortably. I help hook up the methadone drip, pulse ox, and CRM and write orders for frequent vitals and dexi’s – not that I even need to, the nurses here are pros – then head off toward the mother’s room. Once outside the door I peruse mom’s paper chart, where I find a copy of the birth certificate and her sweet infant’s little inked footprints. The name is listed as “Shawnesa Miracle.” I knock and hear a groggy, “Come on in.”
The room is dark and quiet, but mom is awake, pecking at one of the iPads the postpartum floor lends out to new mothers.
“Oh, hi. These are so cool!” she says. She grins up at me, her pupils so small I can see the lovely variegated color of her irises. I note the scars, the fresh track marks on her arms and sigh inwardly.
“Good morning Ms. Jones! Aren’t those fun?! My name is Mullberry, I’m one of the medical students helping to take care of Shawnesa in the nursery. Congratulations on your new baby! How are you feeling?”
“Wait…what did you call her?”
“The baby? Shawnesa…I’m sorry, am I saying it wrong?”
“Oh gosh, it must be wrong in the paperwork. How should it be spelled?!”
“No it’s right, I saw the certificate. It’s S-H-A-W-N-E-S-A. The ‘D’ is silent.”
I pause for a moment.
Out loud I say, “Thanks for letting me know. Dashawnesa is a very pretty name, and she’s such a cutie.”
Inside I say, “Well that’s umb — and istressing,” making sure to note the “silent” D’s.