"Sure'" I said, "babies get better and go home."
When we think of neonatal units, we tend to think of "micropremies", the extremely small babies who have high rates of complications, or of babies with birth defects. People have commented to me that neonatology must be an interesting but sad specialty, and when I review the subject matter of many of my postings - holoprosencephaly, drug addicted moms, extremely premature babies - I can see why they might think that. The truth, though, is that most of our patients do very well, and that neonatology is actually mostly a happy specialty. The kids are cute and the parents are pleased and (usually) grateful. For every 23 or 24 weeker with residual deficits, there are two or three 31 or 32 weekers who need just a little help and a few weeks of hospitalization and then go home healthy as can be. For every baby with severe birth defects, there are dozens of babies who have transient breathing problems and go home fine after 3 or 4 days.
And many of the babies who do well now would not have done well in the not so distant past. President Kennedy had a premature baby at 34 weeks gestation who died at the age of two days 43 years ago. Today, babies of that size and gestation, even with respiratory distress syndrome, have a survival rate approaching 100%.
The problem - and this is not really a problem - is that these babies who do well usually don't make for interesting stories. They are born, get better, and go home. So those of us who write about neonatology, either on blogs or elsewhere, tend to write about the more complex or ethically vague cases - cases that often have a sad ending.
This post, I guess, is my way of justifying all the stories here about less than happy things. So when you read them, don't get discouraged; just think about all the pleasantly boring babies whose parents are beaming but who didn't make the news.