Writing in the Neonatal Intensive Care Unit
Every afternoon before I start my shift, I tuck my laptop next to my scrub in my backpack, hoping to find a moment between high-risk deliveries and neonatal ICU rounds to scribble a few lines. Most nights, I am too busy to write.
(How to Write a Hospital Scene in Your Novel.)
A baby struggles to breathe and I have to insert a tube in her airway. A very premature baby needs surfactant—the white oily substance that keeps open the tiny breathing bubbles—and I have to inject that elixir of life into her lungs through the same tube I had inserted before. Sometimes, finding and inserting a central vein catheter takes too long that I am exhausted to write a scene.
On those nights, I console myself that in the morning, when babies are slumbering in heavenly sleep, I will carve out an hour to write. With this hope, I take my laptop to the call room and pray for a morning blessing.
Once, one of my doctor friends asked me how I could possibly detach myself mentally from the stressful environment of ICU and write, a process that requires concentration and a calm space for my mind. I told her that over the years that I worked as a neonatal intensive care doctor, I learned to dissociate myself from the emotions that surround me and focus on the critical task of resuscitating a newborn baby. A skill that I acquired during the years of my graduate medical education and perfected through practice.
The birth of a baby is always accompanied by the joy of parents and the delivery room is not a place where people can hide their emotions. Tears well up in the eyes of a father who has been waiting for a child for years at the sound of his baby’s first cry. Mothers tremble with joy and excitement as they uncover their chests to hold their babies for the first time despite the pain of childbirth they have just gone through. These are the moments when human emotions brim, making it hard for the intensivist to make medical decisions for the patient. But I have been trained to distance myself from the emotional eruption in the delivery room and examine the baby as a living organism who is transitioning from the fetal life to the neonatal life.
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Unless I distance myself from the turmoil of the delivery room, I cannot make the right medical decisions for treating a sick baby, which most of the time are contrary to the expectations and desires of the parents. No mother wants to be separated from her baby right after birth and no father who comes with his baby to the neonatal ICU likes to witness the baby getting poked numerous times for blood draws or intravenous line insertion.
The ability to detach my emotions from the surrounding space has given me the possibility to write as well. It has enabled me to focus on words even when the stakes are high in the ICU. Early at dawn, in the solitude of our sleepy neonatal ICU, I face the tall trees of Washington Circle, open a poetry book by an Iranian poet, choose a ghazal or a piece of masnavi, and read the rhymes in my office. I let the music of poems settle in my soul and shape the words in my mind.
Then I open my laptop and surrender to the whiteness of the electronic paper in front of me, and let the words transfer me from one scene to another. As my favorite author Neil Gaiman says: “You sit down at the keyboard and you put one word after another until it’s done.”
This is how in one early morning, a scene is created or an important dialogue happens between the characters of my story. A year passes, hundreds of babies graduate from our NICU and I reach the middle of the book that I once dreamed of writing. For me, a writer-in-residence in the neonatal ICU, progress happens in those fresh early mornings among the isolettes of premature babies.