Dr. Robin Pierucci, a Michigan neonatologist, loves caring for the smallest babies, saying, ‘These little babies are sheer love.’ (Courtesy of subject)
Dr. Robin Pierucci Says, ‘Love is real medical management.’
Questions about a preborn baby’s personhood are all too frequently used only as weapons in the hotly debated abortion wars. But far from all the political grandstanding, in hospital neonatal intensive care units (NICUs) across the country, doctors known as neonatologists are busy caring for thousands of premature babies. One of these doctors is as awed by the “sweet little people” who are her patients in the NICU as she is by the medical advances that are an integral part of her job.
Register correspondent Sue Ellen Browder recently spoke with Catholic Dr. Robin Pierucci from Kalamazoo, Michigan, about the babies and the next generation of changes in medicine that are happening as a result of what these tiny, immature persons are teaching their doctors.
Let’s start by talking first about what it means to be a person. Pope Benedict XVI, when he was Cardinal Ratzinger, wrote that human persons are “relational” by nature, that we are born to be in loving relationships with others, that this is simply the way we are made. What do you think of that?
From what I’ve observed in the NICU, I think he’s right. From the minute they come into the world, these little babies recognize their mothers. As Mom comes near them, you can see their little eyebrows lift up. They hear her voice, and they literally lift up their heads. These little babies are sheer love. They don’t know anything else except to search for their loved ones.
Do they recognize Dad’s voice, too?
Assuming they have heard his voice during the pregnancy, absolutely. These tiny babies respond to the voices they’ve heard while in the uterus. This is especially noticeable when the parents hold their baby — you can see the baby relax.
How young are these babies who turn toward their mothers’ or fathers’ voices?
I’ve seen a response at the very edge of viability — in a 23-week preemie. The response is different at 23 weeks as compared to a baby who is 30 weeks, as compared to at-term, but the responses are real.
And how big is a 23-week baby?
About the size of your hand. These little babies would literally fit inside a Christmas stocking. Some of them weigh less than a can of Coke.
You said that at that age sometimes their eyes aren’t even open yet.
Yes, that’s another amazing thing. When they open those eyes and you look into them for the first time, there’s no doubt about it: You just know this is a real person looking back at you. To look into their eyes is to know you’re looking at a perfectly formed, pristine little soul. To see them look back at you is just breathtaking!
And yet you say there was a time — just as recently as two decades ago — when doctors didn’t think these little people could feel pain.
There was an actual study in 1992 where some babies undergoing cardiac surgery were given “deep” anesthesia while others were given so-called “light” anesthesia (meaning insufficient pain relief). As barbaric as this sounds, the doctors doing the study were trying to convince others that babies are in fact affected by pain. They went on to publish that the babies who received deep anesthesia had measurably lower levels of stress hormones, fewer complications — and better long-term survival.
And yet there still seems to be a lot of discussion in the abortion debate about how much pain babies feel. Why?
The whole pain issue has been taken over by abortion politics, which is a problem for multiple reasons. Because even if a baby couldn’t feel pain, that wouldn’t disprove that he or she is a real person! But, of course, babies do feel pain. Every parent knows this — even if their baby is born prematurely. This is not rocket science.
You said even tiny little premature babies are born with distinct personalities.
Yes, that’s another thing that I love about these little guys. They arrive with intact personalities, and nobody believes this until they see what’s going on. Twins are particularly fun because there’s usually one that’s kind of chill. Then there’s the more dominant, feisty one, and you’re thinking, “Oh, well, nice attitude!” I’ll jokingly ask the parents, “Which one of you is responsible for this?” and they’ll usually point at each other. Oh, yes, for some you can immediately tell … it’s like, “Oh, good luck arguing with this one!”
Should all these legislators who write abortion laws visit a NICU and see these little babies in action?
I dare them! But they’d better not make it a photo op, because I want nothing to do with that. But I would love for them to see that these little babies are real people. We have these big recliners for the moms, and we put the babies right on their mothers’ chests, skin to skin, for what we call “kangaroo care,” and you can see their impossibly tiny fingers relax. We even see many of them have more stable vital signs. They clearly are at peace! Ask their parents. These little ones are not “pretend people.” They’re not blobs. They’re not lumps of “tissue.” Tissue is what you blow your nose on. These are real people.
You say these little babies also get angry.
Absolutely. For some reason I’ve never understood, but of all the things we do in the NICU, one of the things that makes these little people straight-out angry is putting a thermometer under their armpit to take their temperature. That makes them screaming mad, and they yell at you. They take their little hands and try to smack the offender. It’s hysterical what goes on. You’re like, “Really? I’m getting beat up by a one-pound person!”
A recent paper in Newborn & Infant Nursing Reviews contained a fascinating statement. It said that “every touch and interaction the preterm infant encounters affects brain development and ultimately long-term outcome.”
Yes, this is backed up by measurable changes in outcome. When the NICU team pays better attention to all the different ways we interact with these babies, then not only is there increased survival, but they survive better — with decreases in complications of being born prematurely, such as chronic lung disease and hospital-acquired infections, as well as improved brain development.
There seems to be a new paradigm shift in medicine going on here. Can you sum that up in a few words?
The paradigm shift is that, while I’m deeply grateful for the improved technology, that doesn’t solve all the issues of any patient, much less those of a premature baby.
We need human contact. The love we share at the bedside is not just “nice.” It’s necessary because we are physiologically better when we have a loved one involved.
Tiny at-risk babies who have a loving mom and dad present are healthier and even more likely to survive. Love is real medical management — and we doctors haven’t given it enough credit. I live in such a world of extremes — both the tragic as well as the miraculous. And love is often a key ingredient in the miraculous (which is not the same as a good medical outcome).
Love and science are synergistic — when they cooperate, the medicine is made better. All this revolves around people caring well for each other, which includes recognizing the personhood of the smallest among us.