“I started medical school interested in pediatrics. As a fourth-year student, I did
a rotation in the neonatal intensive care unit (NICU), and fell in love with it. What
I found fascinating was that newborns can be such resilient patients. Babies can be
on the brink of death, and a few days later be ready for discharge. The majority of
babies successfully transition to extrauterine life with only minimal assistance in
the delivery room. There are multiple physiologic steps that need to take place; if
one of the steps doesn’t happen, babies can run into trouble. Our team is there to
assist them. . . . People say it must be a tough field because my patients can’t
talk. But we communicate and care for their families, too. We empathize with their
vulnerability. That’s the reason I chose the medical profession in the first place;
I wanted to help people heal. . . . Our ability to heal continues to evolve every
day. Today we are resuscitating babies delivered as early as 23 weeks’ gestation,
and now we are debating going as early as 22 weeks. Neonatology is a constantly changing
field. Beyond what is medically possible, a myriad of ethical issues surround our
work. We must consider how patients may develop and what degree of impairments they
will live with. All aspects of physiology are involved, and the job is very hands-on.
I’ll be called to the delivery room to resuscitate a newborn; I may have to put in
a breathing tube and perform CPR. During a single shift, I often have several infants
who require my constant attention. . . . A lot of physicians are experiencing burnout.
Neonatologists, as well as other physicians, have to figure out how to overcome it.
Working in the NICU is a very intense job with extended hours. Sometimes our patients
don’t survive, even with the technology. So, in those cases, instead of saving babies,
I have to discuss palliative care with the family so that we can ensure the remaining
life of the baby is as comfortable as possible. . . . Because of the clinical demands
of this job, I’ve found it helpful to develop another aspect of my career: research.
Through the support of an NIH-funded research grant, I have been able to study antibiotic
use in newborns. We are starting to see that overuse of antibiotics in the NICU, like
everywhere else, is a problem. At the same time, preterm babies are very prone to
infection. My research has shown that most preterm babies continue to get antibiotics,
despite awareness of overuse, and that treatment could have unintended consequences.
I am using maternal and delivery data to determine which preterm babies are at the
lowest risk of infection in order to see which ones may not automatically need antibiotics.
Research provides a change in pace from the physical demands of the NICU, but challenges
me professionally all the same. It lets me help babies in another way.”
© 2024 Philadelphia College of Osteopathic Medicine