My heart drops for this tiny little life. Olivia is only twenty years old, just married last year. Her husband is deployed and has been in Afghanistan for the past five months. She moved up to Pennsylvania to live with her mother so she wouldn’t have to be alone. The baby wasn’t due for several more months, and her husband would have been home for his birth. Now he’s here, way too early, and desperately struggling to live.

We see babies like this every day. Premature, not ready for this world. We do everything we can to make sure they get the care that they need so they can thrive and grow and go home.

“She named him today,” Becky whispers as her eyes glisten. “Benjamin.”

I suck in my breath and grab my chest. My father’s name. “Ben,” I say softly and hear my mother’s voice screaming his name. “What did you do to him? Ben? Can you hear me?”

“Are you okay?” Cassie asks, concern sweeping over her face.

“I’m—I’m okay,” I stammer and reach for the charts we’re about to review with Dr. Hagan.

“You sure? You don’t look so good,” she says and places her hand on my arm.

“Yup,” I force out my breath, regaining my composure.

“Are you ladies ready?” Dr. Hagan enters the room. The overnight nurses, Becky and Marcie follow close behind her, detailing the stats for the five babies in the NICU. Cassie and I listen intently, quietly cataloguing the precious details. I watch Olivia closely when we near baby Benjamin’s incubator. She stares at him with fear in her eyes. She’s too young to be dealing with the hardships in front of her and what may lie ahead with her son. A grade two bleed is bad, but a grade three bleed is worse. Ben could have permanent damage or worse.

Dr. Hagan makes arrangements for another scan for Ben and signs discharge papers for little Hope. Her family is going to be thrilled, and I’m happy that I get to tell them during my shift.

Becky and Marcie stop and say goodbye to Olivia, Marcie’s hand lingering on her shoulder. My heart grabs again as Ben’s monitors sound loudly. Marcie opens the incubator and softly presses his chest with her gloved hand. It takes a few moments, but his heart rhythm begins to normalize. Dr. Hagan nods toward the ventilator and Becky moves away to scrub her hands again. They’re going to put him back on the vent. “Mrs. Gibson, can you move out to the hallway for a few minutes? We’re going to examine Ben.” Dr. Hagan doesn’t tell her what we’re about to do, and I’m glad. Intubating an infant looks scary, but under her delicate hands, it will be effortless.

“Okay,” Olivia says feebly. She stands up, and her sterile gown practically slides off of her slight frame. Her dark, hollow eyes are sad and scared.

Once she leaves the room, Dr. Hagan gently places her stethoscope on Ben’s fragile chest. He’s so tiny; you can see his heart beating underneath his frail ribcage. Becky moves to her side, and soon he’s on the ventilator, the breathing tube safely inserted. My pulse races as I watch his chest move up and down mechanically. He’s sedated now but doesn’t look peaceful. My heart is breaking for this little guy.

“I’m going to get Hope ready to go.” I turn away and grab her chart. I don’t know why, but watching Ben struggle is excruciating. I’ve seen so much worse. Watched babies take their last breath and their families’ lives shattered. But Ben…

I attempt to smile at the little girl I’m washing up. Her tiny legs are kicking and her arms are flailing in the air. She moved into a bassinet last week and was able to drink from a bottle yesterday. She graduated from ‘feed and grow’ to ‘feed and thrive,’ and her parents were ecstatic. I hear Cassie on the phone with them right now, telling them to bring her car seat. Before they leave the NICU, they have to watch a video, explaining all that they need to look out for. Baby Hope is going home with a heart and lung monitor, so her parents have to meet with the vendor and get a tutorial on how to operate it and transmit the daily readings. She’s so tiny, only four pounds. But she’s eating on her own and has consistently gained weight every day this week. She’s the perfect NICU graduate.

“Yes, you are? Aren’t you?” I say through my smile. I rub lotion into her soft skin and say, “Our little graduate. You’re going to grow up to be a beautiful girl.” I hold her tiny feet in the palm of my hand, massaging the lotion gently. “These little feet are going to run along the beach and dance up a storm.” Her eyes search for me as her tongue peeks out of her mouth. I place a pink rubber pacifier against her lips, and she eagerly takes it, sucking on it like her life depends on it. Her eyes roll into her head and she falls asleep. All of this excitement tuckered her out. I swaddle her tight in her blanket and place my hand over the crown of her head. “I’m going to miss you, Hope. Grow big and grow strong.” I say this to all of our graduates—a private moment just for me and my patients.

I turn and look over at Ben. Olivia is back and curled up in her familiar position in the chair. Eyes glazed over, worry set in. She’s nodding her head as Dr. Hagan explains why Ben is back on the ventilator, and I wonder if she’s grasping the dire situation. He isn’t able to breathe on his own, and his heart rate has been dangerously erratic. With a significant brain bleed on top of this, I’m terrified that this is going to end very badly. This can’t end badly.

We can’t lose Ben.

Garrett

Past

Villanova, Pennsylvania

Age 15

I JAM THE PIECE OF PAPER into my pocket and quietly close my mother’s top dresser drawer. I can’t believe I’m invading her privacy like this, but I really have to take care of something, and she’s the only one who has the answers I need. I tip-toe out of her room and close the door behind me. I pass my room and go down the stairs, two at a time. Before I run out the front door, her voice comes from the den.

“Garrett?”

“Yeah, Mom?”

“Where are you off to?”

“I have a school project that I need to work on with…” My mind goes blank. There is no school project, and I can’t come up with a name to save this lie I’m about to tell.

“Who?” she asks, sensing my tension.

“Rob. You know, Rob Shultz. He has everything we need and he’s expecting me. So I better go.” Rob and I have been friends since third grade. He lives on the other end of our neighborhood, about a ten-minute bike ride away.

“Okay, Bill should be home by six. Will you be home in time for dinner?”

Bill Armstrong married my mother almost six years ago. We moved from Newtown to Villanova, leaving my childhood home behind. He officially adopted me last year after my father’s parental rights were finally terminated. Bill’s a cool dude, and he’s really good to my mother. She’s been happier with him than she ever was with my father, and that makes me feel good.

“I don’t think so. He’s ordering pizza for us.” I lie again.

She places a bookmark into the book that she’s reading on her lap and pulls off her glasses. Shit is about to get serious.

“Is everything okay?” she asks, and I shift back and forth, a bit jittery.

“Everything’s cool.” I wrap my hand around the doorknob and she speaks up again.

“Because you just don’t seem yourself.”

I let go of the handle and run my hand through my hair. “Mom, it’s all good.”

She puts her glasses back on, and the tension eases from my shoulders. She’s going to let me out without grilling me any more.

“Okay, if you say so.” She picks up her book again and opens it to the place where she shoved the bookmark. Her eyes drop to the pages and she says, “Tell Mrs. Shultz I said hi.”