Working in the CVICU brought many first in my nursing career: the first time I did compressions, the first time I took care of a patient on ECMO, the first time I saw a patient come back from the operating room with an open chest, and the first time I ever withdrew care on my patient. In adult nursing, I helped my coworkers with post mortem care for their patients, but I never had my own patient pass away until Baby K.
This experience profoundly impacted my nursing path: I had to learn how to grieve as well as process immense trauma, anxiety, and self-doubt. It was difficult work. But I feel fortunate I had the time, energy, and support to do so. During this process, I wrote about her death from many different points of view. These narratives unfold in other pieces as I explored how this affected me and the ways in which I moved forward. But almost a year later, I feel grateful I got to witness her passing. And thank her for the lessons she taught me.
So, without further adieu, in two parts: First, her death and then second, my grieving journey.
Baby K died in her mother’s arms on a Thursday evening. It was the first and last time her mother got to hold her. Early that morning, one of our nurses had called mom and gave her a real update, voicing her concerns instead of focusing on the positive. She told her how worried she was about how her baby wasn’t turning the corner. We weren’t really fixing the problem, just making it worse. I think that’s the honesty the mom needed to hear since when she came in later that morning, she told us she wanted to withdrawal care. She had had a long difficult journey, born with a rare congenital heart defect and never managed to recover from the surgical repairs.
Her little body was swollen, so swollen her little eyes couldn’t open; her skin was tight, her limbs were cold, I couldn’t feel her pulses; when I pressed gently down on her hands, the color took many seconds to return. Too long. She felt like a plastic doll, unable to move her arms and legs, only her hands and feet, grasping on to any finger mom or the doctor or I slipped in her little hand.
That day, we did prints of her little hands and feet. Then, holding the breathing tube and managing her lines, we gently placed her into mom’s arms for the first time. A photographer came to take family photos with mom, dad, her two older brothers, and her grandmother. Mom held her baby girl all afternoon, and when she was ready, the doctor gave her a little morphine, the respiratory therapist removed the breathing tube, I and helped mom move her up to her chest, she held her close to as her baby passed.
Her death was beautiful and peaceful and pain free but the process after was not.
Mom and I gave her a bath with soap and warm water, we washed her hair, applied lotion to her little arms and legs, removed all the unnecessary lines and tubes, combed her hair, swaddled her in a fresh blanket, and put on a little hat. Then there was paperwork. We waited for the physician to discuss autopsy options, get all the necessary forms ready. The unit secretary handed me a shroud: we carry two sizes, big and extra big. Neither was a good fit so I delayed until the papers and security guard were ready to go. I hummed as I put her in the shroud, a white plastic dress bag that was too big for this little baby.
She was too little to be wheeled on a gurney so we wrapped the shroud in a blanket and dad offered to carry her downstairs. We formed a little parade as we filed out of the unit–the security guard, dad carrying the wrapped up bundle, mom, and then me. Down to the ground floor, into the bowels on the hospital, far from patient units, and any signs of activity. We arrived at the intersection of two hallways and the security guard informed the parents that they had to say goodbye. They knew they couldn’t go the whole way, but to say goodbye in a hallway to their baby wrapped in a shroud was not what I pictured. Then I took the baby in my arms and continued down the long passage with the security guard. We walked outside to what looked like a loading dock. I was confused. The guard motioned towards a locked door to the right; he jumbled some keys and opened the door to a cold room. Here we go. Inside felt like a massive refrigerator with shelves lining the walls. Most were filled with body bags, some big, a few medium sized ones and god knows what else on the shelves. There was blood dripping down to the floor. Plastic bags of belongings lying next to bags. I’m sure they were all marked with identification but I tried not to look and take in too many details. You can put it on the shelf. He said. I felt my insides turn. I had just gone from a very beautiful dying process to now feeling like she was an inanimate object. The security officer was just doing his job but the quick transition was too much. Too traumatic. I put her in one of the little slots, feet sticking out, thankful we had the blanket so she wasn’t too cold. Yes, I knew she was dead but it didn’t feel like it yet. This was a very real experience. Then I signed some papers and walked back to my unit, gathered my things, and left.
I cried all the way home.
A few days later, my family walked to the local Japanese garden. It had been years since I had visited but the koi pond and blooming wisteria brought back fond childhood memories. My mom came across a statue along the path. “Look at this,” she said, consulting the brochure, “It’s called a Jizo Bodhisattva who honors deceased children.” It felt like a symbolic encounter. I whispered a little prayer for Baby K and continued along the path.
That night while trying to fall asleep, I had a visualization:
I carried Baby K down the hallway towards the cold room. But outside on the loading dock, I bypassed that dark doorway and headed away from the hospital. I walked all the way down the freeway towards my little town. At the intersection, I crossed the street and walked up the sidewalk, passing the shops & restaurants, still holding Baby K. The Japanese garden came into view and I entered through the gates, crossed the bridge, and laid her down at the feet of the Jizo Bodhisattva statue. I visualized that Baby K stood to embrace the statue, wrapping her arms around it and then vanished into the stone. Then, butterflies appeared from the top of the statue, butterflies to honor the baby. They flew around the garden, circling the koi pond and wisteria pathway and then disappeared into the blue sky. I knew then that she was in peace.