"No, they live with their father." Bingo. They were placed in the dad's custody by Protective Services (P.S.) It's our hospital's policy to put a baby into the special care nursery instead of the mom's room if there is a referral to P.S., to avoid attempted abductions like the one we had last week. But this was her first baby in 12 years, meaning the other kids were taken away a long time ago, and she had three negative urine drug screens, and I just didn't have the heart to take her baby away from her, and let her stay in mom's room. The social worker gave me a little grief about it the next morning, when we moved the baby to special care, but hey, I don't always make my best decisions at 3 a.m., and frankly, the father of this baby was a really big guy.
It turns out that mom has syphilis, not treated in this pregnancy, so we have to treat the baby with antibiotics for ten days and do a spinal tap on the baby to make sure she doesn't have syphilis in her central nervous system. Mom was not happy when she heard this, and at first refused to give consent for treatment or the spinal tap. By the time I talked to her - my partner had tried first - she had consented to treatment but was adamant about not doing the spinal tap. I tried to reason with her but she was downright irrational, more than just the normal apprehension a parent understandably would have about all this. She said nobody explained anything to her, but when I started to do so, she cut me off after half a sentence. She accused us of experimenting on her baby. She said she was going to see her own doctor that day. I asked her who that was; she paused, then said, "He's an excellent doctor, and after I see him, then I'll let you know who he is." I then spoke with the dad, who said they would come to the hospital - mom had already been discharged - and discuss it further with us. By the time I left two hours later, they hadn't shown up yet.
I find myself hoping that P.S. won't send the baby to her but to foster care instead, because she really didn't seem normal. It's a terrible thing to hope for, in a way, but it's mothers like this that make us a little paternalistic towards our patients sometimes. My frustration with her is mixed with some sympathy, though, because I suspect she might be mentally ill. Parents: some can be so great, others just downright awful.
P.S. Say "hey" to Carrie at Neonursechic, a fairly new entry into the blogosphere.