Sunday, March 30, 2008

Crack Baby

When we turned onto Barlow, it was as if we had made right turn to the mean side of things. The side where baby’s are born in the dark, with little joy or hope. Where the father lies passed out on the couch. And the mother cries through her agony alone. It can take much of the joy of a birth away, but never completely. It is too much of a new life beginning with all that can mean. The date of birth was 4/28/88 at 2311. It was a small concrete block dark house with no rugs on the concrete floors, and no air conditioning on a short sandy dirt road. There had been a murder on this same street just recently. The front door was wide open. There was no one there to greet us and there were no lights on in the house. Jeff and I approached the door cautiously.

“Fire department!” I said.

“In here.” A female voice yelled.

We found a woman laying on a dirty double bed with the phone lying beside her. There was no other furniture in the room. Only a black light like those used in the sixties light the room.

“He came. He already came. Is he all right?” she said.

She still had her shorts and panties on, but there was a large bulge visible. As Jeff and I cut her shorts and panties off we questioned her.

“How many babies that lived have you had?”

“Six. The doctor said this one was late. May or June. I thought it was late April or May. Is he all right?”

When we had cut off her shorts and panties we could see the baby. He was so small. Almost too small to be believe he was a real baby. He looked like a crack baby. A full term baby that weighed less that three pounds. The umbilical cord still ran back into the mother.

The baby was not breathing. Jeff started to clean the baby off hoping to stimulate his breathing. Nothing. He began thumbing his finger on the soles of his tiny feet to get him breathing.

I dove into the emergency childbirth kit. Actually a very fancy word for a cardboard box with a bag for sterile gloves, paper sheets, bulb syringe, umbilical clamps, scalpel and paper blankets. I tore open the bag and handed him the bulb syringe so he could suction out the baby’s mouth.

Next I dug for the two clamps for the umbilical cord. You place two clamps on the cord and cut in the middle. Six inches from the vagina you place the first clamp, then two inches and you place the second. The clamps keep the mother and baby from bleeding out after the cord is cut. They both have large blood vessels within the cord. It is how the baby is supplied with blood, oxygen and nourishment during gestation. If you just cut it without a clamping it with two clamps you would lose both the baby and the mother. But I could only find one clamp. One clamp. How is world do I end up with the only kit in the world with only one clamp?

Jeff was working frantically to stimulate the little boy to breath, but was till having no luck.

The only light in the bedroom was a black light, a black light why were these births always in the dark. The black light made my hunt for the second clamp in the kit even more difficult. Jeff and I are holding our mini-mag flashlights in our mouths to keep our hands free. So was we talked our words a jumbled around the flashlights. If it was such a serious situation it would have been very funny.

“He is not trying to breath we need to get that cord cut.” Jeff says.

A baby will not try and breath on their on, as long as they remain attached by the umbilical cord. We needed to cut the cord to stimulate the baby’s breathing.

“I can’t find the other clamp.”


The engine company who had been dispatched with us has just arrived.

“We need another child birth kit.”

One of the firefighters turns and runs out to the engine to get the other kit. Jeff continues stimulating the baby thumping his finger repeatedly on the soles of the baby’s feet. He is starting to respond to Jeff’s stimulation. He has a good heartbeat but he is still not breathing well. The firefighter runs back into the room and hands me another kit. I tear it open and find a second clamp.

“Six inches from the baby.” I recite to myself.

I place the clamp.

“Two more inches.”

I place the second clamp.

I tear open the package containing the sterile scalpel and cut the cord between the two clamps. Blood flies everywhere. Suddenly I am very aware of the blood. The mother is obviously someone with the types of behaviors that could lead to AIDS. Now I am going to have to worry about an AIDS exposure if I am not careful, even with our gloves and goggles on. But there is no excessive bleeding. Good then the clamps worked.

Once the cord was cut the baby begins to try to breath, but he not moving much air.

“We are going to have to try and tube him.” Jeff says.

He grabs the lyrnascope, and a pediatric blade. I pull out a pediatric tube and compare its size against the baby’s little finger. That is the rule of thumb for the size he will need. It takes the smallest tube we have. Jeff tries to insert the blade into the baby’s mouth.

“He trying to bite the blade.”

Jeff reapplies the oxygen and again stimulates the baby by thumping the soles of his feet with his finger, the baby’s breathing gets much better. He pinks up nicely, showing he is oxygenating well. His color finally begins to look normal.

It is time to run for the hospital before any more problems crop up. But the ambulance still has not arrived.

“Rescue 7 to Dispatch can you give me an ETA for the ambulance.”

“Rescue 7 check standby.”

We begin to package up the mother and baby to get them ready for transportation when the ambulance gets there.

“Dispatch to Rescue 7 they are advising a six minute ETA.”

Jeff and I look at each other. Without a word passing between us we know that could mean a lot more time than six minutes. We do not want to wait that long.

“We going to have to transport.” I said.


Jeff is busy with the baby. So I grab a guy off the engine and we go out to the rescue. While we can transport a patient, but the rig is not ready. We have our fire gear on the floor in addition to other gear on the stretcher. I pulled the Thumper, an automatic CPR device and throw it on the bench seat. I pulled the backboard off the stretcher and cram it on the floor. I jam our firefighters bunker coats, pants and boots into the corner. I can finally pull the stretcher out of the back of the rig.

The firefighter and I are able to get the stretcher into the tiny apartment, but we could not make the turn into the bedroom. The father is finally starting to wake up with all of the commotion around him. He sits up groggily on the couch. We run over his bare feet with the stretcher, but he says nothing as he sits rubbing his eyes.

Jeff has wrapped the baby in everything the kit carries to keep him warm. The bundle seems too tiny to even be a doll much less a real baby. We load the mother onto the stretcher and struggle past the still groggy father. He says nothing as we leave with the mother and the baby.

I jump in the front of the rescue and Jeff jumps in the back with the baby and the mother. One of the firefighters off the engine jumps in the back to assist Jeff on the ride to the hospital.

I the radioed the hospital that we were en-route and what we had what appeared to be a crack baby. It was silent ride to the hospital and the mother rested and Jeff monitored the baby. When we pulled into the portico and unloaded the stretcher a physician and nurses from the pediatric intensive care waiting for us. We handed the mother and the tiny baby over to the waiting team. They rushed them into the emergency department.

We followed the team into the hospital. Walking into the emergency department was a startling contrast to the dark black light lit dirty apartment. It was a bright modern hospital with all of the best equipment and trained personnel waiting for the baby. We had jerked him from the poverty and hopelessness and thrown him into a high tech world waiting to try and save him so he could go back to the dirty black light lit apartment.

Jeff and I stood there watching as they work on this tiny human baby whose life was just begining. He turned out to be a crack baby, full term yet weighing only two and half pounds. Mom was a crack addict. Despite the circumstances I still felt a sense of joy at a new life starting, but it was colored by the realization of just what kind of life he was going to face.

Jeff and I watch them work on him for a while, then did our paper work. We re-stocked our supplies and went out to the rescue to put it back together for the next run. We had several more before we got off duty the next morning. I never check on him or how he did. I had learned the hard way over the years that did not always lead to any good answers. I still think about him and it has been almost exactly twenty years as I write this. I wonder how his life turned out.

1 comment:

Lodo Grdzak said...

Really interesting. Lots of medical stuff I never knew. I've been reading these archives from time to time. I think you said this was a book, right? You've got a lot of connected posts here. Very cool.