Monday, March 16, 2009

Preemie -- An American Economic Parable

By Alan Gable

A long time ago in a galaxy far, far away, there lived and man and woman. The time came for them to start a family and they had a beautiful baby girl. Due to circumstances outside of the man and woman’s control, this baby was born 8 weeks before her term date. This baby now had a mountain to climb and she needed help from all those around her in order to grow into a vibrant and healthy young woman.

The child was admitted to the NICU and placed under the care of a newly appointed chief physician who had been highly acclaimed recently in the medical community. This doctor was handsome and carried himself in such a way as to inspire hope in the frightened parents. The man and woman put their confidence in the doctor but always reserved the right of final decision on the treatment of their child. They worried about their precious baby every minute of every day because she was the most important aspect of their lives.

The baby was premature and in fragile condition. Due to the nature of her condition, too much noise or light or stimulation of any kind could have devastating effects on her long term vibrancy. She desperately needed to grow and develop so the acclaimed doctor wrote orders for the NICU nurses feed the baby every 2 hours whether she was hungry or not. He also ordered consults with every specialty in the hospital from Respiratory Therapy to Psychiatry. For weeks, the baby’s tiny room was buzzing with traffic. Evaluations and recommendations came from every imaginable healthcare professional until the baby’s chart swelled into a large mass of notes and papers. Every time the man and woman came to visit their most precious, they were amazed by the sheer activity that surrounded their daughter.

For weeks this went on and the baby didn’t seem to be getting better. In fact, she was getting worse. The volume and timing of her feeds made her spit up and reflux with greater regularity. The endless stream of consults and evaluations from every different kind of therapist and doctor and nurse and random staff member seemed to cause her higher and higher levels of anxiety. The baby would routinely flex her arms and leg spreading them straight out because she was so stressed out from the constant over-stimulation. The man and woman began to panic and worried all the time. Were they doing enough? Did they need to make a change? The doctor’s reaction to their valid concerns was one of arrogance and hubris. He talked down to them because he was a highly acclaimed doctor and he obviously knew better than they. What could they do? They had already put all their hope in this doctor and their baby was only getting worse…