I was watching something on television the other evening, when there was scene, a brief scene, that reached into my memory box . A new father was doing the late-night-walk thing carrying a new baby. There was a close-up of the infant’s face, and you could hear its breathing. And I was reminded that there is nothing quite like a tiny child’s breathing. Nothing that sounds like it or looks like it.
In the work that I did, once upon a time, I spent quite a lot of time watching babies breathe. In any newborn nursery there are a whole lot of babies that are just fine and would have been just fine even if they had been born under an oak tree along the Oregon Trail. But there were a few, a very few, who were going to become ill, and some were going to die unless what was troubling them was discovered and treated early.
The trick of it all was to pick out those very few as early as possible, and to leave the multitude alone.
Much of what we call illness, especially infectious disease, has a moment when it is not there, and then it is. Let’s take septicemia as an instance. Sepsis is when a micro-organism gets into the bloodstream, where it multiplies until it becomes a threat to life. But when that organism first gains entrance, there are no symptoms. The child, the patient, the host may not know that there is anything wrong at all. But at some point, as one of my teachers used to tell me, you could show the patient to a horse and the horse could make the diagnosis.
The subtleties of many illnesses in the newborn nursery operated in this way. The problem was that the patient had so few ways to tell us that something was amiss. One of those was a change in breathing patterns.
So I spent many hours sitting in rocking chairs in normal newborn nurseries at two in the morning, holding infants who had done some small thing to worry a caregiver. Maybe they hadn’t eaten well at their last feeding, or didn’t seem as vigorous as the child in the next bassinet, or something altogether different. I would be called and brought onto the scene as a judge or referee. The question was always the same – is there anything wrong with this baby?
I would take the infant to a rocking chair and we would sit together for as long as it took for me to decide. I would listen to it breathe, and I would watch it breathe. I would open the hospital blanket, undo the fastenings of the hospital shirt, and watch the movement of its chest.
I would feel how the child responded to being carried and moved, and I would compare its muscle tone with all the other babies I had held in the past. And then at some point I would act. Either by returning the baby to its bassinet and going home to sleep, or by initiating a workup for sepsis (and other things).
Deciding to do the workup was not a small thing. It meant that I was going to have to talk go out and talk to the mother and tell her that there was a possibility of something very bad going on, something that might threaten her child’s life. Something she may not have suspected at all. And then I was going to have to get her permission to do invasive things to her baby. Which might include taking blood samples, doing a chest x-ray, performing a spinal tap, starting an IV and beginning antibiotic therapy. No matter how tactfully I put it, I was going to scare the very beJesus out of her, and there was always this – I could be wrong and all of it was for nothing.
Quite a lot to be brought back by that single movie scene, but there you are. It caught me with my guard down, and for just that second I felt that slow burn of fear I used to have … of being wrong … either way.
A very good article on the subject of the ongoing attacks on libraries, and therefore the attacks on thought itself: The Real Reason North Dakota Is Going After Books and Librarians.
An article that first made me smile, and then to understand. The story of the kung fu nuns.
Two more catalogs from nurseries have arrived. It’s pretty obvious that their customer base includes a lot of gentrified gardeners. When a single tomato-growing tower can sell for nearly $200, well, if you have a good year that would mean that after watering, feeding, and agonizing over all those pests you could grow your own, your very own tomatoes for only $10 each.
As a kid I perused such catalogs but they were printed on non-glossy paper where all you could buy were seeds and hoes and cultivators that you pushed yourself. Not a gnome or statue of St. Francis for sale in any of them.
But times change and the real stuff is still in there if you can ferret it out. We will have a modest container garden as usual, growing primarily tomatoes and salad greens. Generally easy to care for, fun to grow (when everything works out), and delicious to boot.
From The New Yorker
About two miles from home, there is a rural stretch of Ogden Avenue where the power lines parallel the road. Perhaps 50% of the times that we drive along this street we see an American kestrel on the wire. In nearly the same place every day. This is obviously its turf.
This week I didn’t see the little hawk for several days and I began to be concerned that something might have happened to it, which prompted a conversation between Robin and I as to – when birds die, as they all will do one day, why don’t we see their bodies more often? Except for the odd roadkilled pheasant we almost never come across their bodies. I ran across this explanation at Ornithology.com which sounds sensible, and since I am sharing it with you, I hope that it is also true.
When a dead bird hits the ground, it is almost immediately invaded by small decomposers in the form of bacteria and insects. Vultures and coyotes might also take part in the feast, but the tiny organisms are usually the quickest and most efficient. Being thin and light, a small bird decomposes into an unrecognizable blob in about a day and will disappear in three.Ornithology.com
BTW, yesterday the kestrel was back at its post again.