Carla and Elsie and Ludwig

On December 17 at 5:00 a.m. I was paged at home by a nurse from labor and delivery. A baby had been born with Trisomy 13 syndrome and would not live long.¹ The mother was asking for a priest, for baptism. I explained that it would take me about thirty minutes to get to the hospital and that in the meantime, in emergencies, it was permissible for anyone on staff, Christian or not, to baptize an infant. The nurse was not comfortable with this and wanted me to come as soon as possible.

When I arrived I was ushered immediately to the mother’s room. I introduced myself and expressed my sympathy. Grandmother and sister were also in the room, but not the baby. I was immediately suspicious, though I said nothing. If the baby is dying, why the high-tech care? Why can’t she die in her mother’s arms?The family was Spanish speaking. With the unit clerk’s translating help I confirmed with the mother that she wanted her baby baptized. I learned the baby’s name: Carla. I prayed for the mother and told her I would return after the baptism of Carla, who was in the neonatal intensive care unit. There was a brief discussion outside the birthing room with the grandmother and sister, because the grandmother had wanted a Roman Catholic priest, which I obviously was not. I explained that in an emergency it was permissible for me to baptize and she accepted this.

Accompanied by the baby’s aunt, I went to the unit and learned that the baby had already been baptized by one of the nursing administrators. Then one of the nurses brought us to Carla. She was on her back, naked, and cradled in a shell-like foam pillow, which was covered with a white flannel receiving blanket. Her position was like that of the baby Jesus in thousands of nativity paintings, legs crossed at the ankles, hands stretched out from her sides. I had thought this position was the artist’s vernacular to show Jesus’s divinity, but evidently it’s the natural form a baby assumes when it falls into life. She looked perfect. Her hair was black and straight, her sweet ears still a little smushed from the birth.

But the breathing was not right, shallow and struggling. I blessed her and prayed for her. Her skin was silky, also warm from the heat lights above her. I asked the nurse if we could hold her. I picked her up, together with the little pillow, disrupting the taped electrodes measuring temperature and heart rate. The aunt had held her at birth and now held her again, but soon gave her back to me, holding back her sobs. I was crying and everyone who came near cried too. The baby’s aunt went back to be with her sister.

The nurse had brought a chair, so I sat down holding the baby, cooing to her. The baby’s breathing was shallow, rapid; every few moments her mouth opened slightly and a weak cry came out. I didn’t know what to do. It seemed wrong to me that the baby was dying alone in a quiet corner of the NICU. So I held her. She felt so good in my arms. I held the oxygen tube beneath her nose and talked to her soft and low. After a while, because Christmas was near and she looked like Jesus, I sang carols to her, first verse after first verse. What Child Is This? O Come, All Ye Faithful. Away in a Manger. While Shepherds Watched. Go Tell It on the Mountain. I wanted to go on holding her until she died, but I was also anxious. What if my holding her made it more difficult for her to breathe? What if she wanted to move her arms and legs more freely? What if this was altogether too much stimulation, an irritant?

I put her back in her bed to go ask the nurse if it was necessary for the baby to be in NICU. “Is the oxygen making her more comfortable?” I asked. “Yes,” she said, “the mother wanted us to take care of her, and the oxygen helps keep her comfortable.”

I went back to the unit, found the Spanish-speaking clerk, found the mom and sister and grandmother. I told the mother about her beautiful baby and that I had blessed her and held her. I asked the mom if she would like to hold the baby again. She said, through the translator, “No, the nurses can help her more and take care of her.” I reassured the mom that, yes, the nurses were taking good care of her and that she was lovely and I was so sorry that this happened. I prayed with her again, said goodbye, went back to the baby.

Some staff members stood in a half-circle at the foot of Carla’s bed, like shepherds and kings, smiling and crying and talking to her. None of us could relieve her suffering. Perhaps not different than the suffering of any newborn, crying for hunger and cold, but how I wanted to ease her breathing, to give her breath! I touched Carla again, and said goodbye.

I had to go to a funeral. I thought of Jesus’s words to his disciples, that if they wanted to follow him they would have to let go of everything—don’t stop to bury your father, let the dead bury the dead. I was choosing the funeral, rather than the child.

On the way, I heard on the car radio that December 17 is marked as Beethoven’s birthday, as it’s the day his baptism is recorded. It was also the day of Reverend Elsie Smith’s funeral. She was a chaplain here before me, an accomplished, forceful, compassionate woman, who had died suddenly, cardiac arrest, although she had been in treatment for cancer for some time. The service was a beautiful tribute; her casket stood in the aisle throughout the service, shrouded in a splendor of goldenwhite brocade.

As for Carla, I had made a referral to a Spanish-speaking chaplain and to one of our Clinical Pastoral Education residents. Later that morning they celebrated a naming ceremony in Spanish and gave the mother a baptism certificate. The Spanish chaplain heard the story of the pregnancy. The mother had known, by amniocentesis, that her baby would die shortly after birth, but chose to carry the baby to term. I thought of Carla enfolded in her mother’s womb, loved toward her birth. Before she was born her days were counted, when as yet there were none of them.

The staff loved her too, for those few hours. I am not being sentimental. I think our technological deaths are crazy. Cultural habits and beliefs are complex and hard to change, but they will doubtless change. I don’t judge the mother for not holding her baby—how terrifying to love in your arms such fragile life, when you imagine that any movement could be hastening her death. Easier to let go, to release her. She was adored that day. She was praised, adored, loved. And the love was entwined with the suffering, inseparable.