Neonatology first whispered to me when I was 8 years old, in 1985. The guest speaker at one of my Girl Scout meetings was a pediatrician. I was mesmerized by both the stories she told us about her job taking care of kids and also by the fact that she was a female doctor. Up until then I did not think that women could become physicians, as all of the doctors I had ever known were male and all of the doctors on TV shows were men too.
Her whisper got a little louder when I was a teenager during the 1990’s. My mom’s best friend, Diane, was a Labor and Delivery (L&D) nurse at a local hospital that had a large obstetrical service and neonatal intensive care unit (NICU). I loved listening to her stories of all of the excitement during her L&D shifts, especially when she’d talk about how an increasing number of small, premature babies were surviving. One day during my junior year of high school Diane said something to me along the lines of, “You have the perfect personality to someday become a neonatologist.” I actually had to ask her what a neonatologist was as I had never heard the word used before! The next year, as a high school senior, I shadowed a pediatric ophthalmologist named Dr. Lavery for career week. My favorite experience with Dr. Lavery, hands down, was being able to watch her examine the premature babies’ eyes in the NICU at Rainbow Babies and Children’s Hospital in Cleveland.
I enrolled in the premed “Arts and Letters” track when I started my undergraduate studies at Notre Dame in 1999, which allowed me to take electives in some really cool subjects like anthropology and autism and developmental pediatrics. My professor of pediatrics, Dr. White, was also a neonatologist and medical director of the NICU at Memorial Hospital in South Bend, IN. Toward the end of the semester he took us on a class “field trip” to his NICU and we had the opportunity to meet many of the nurses and see their patients. I remember, as clear as day, that one of his patients had been born at 26 weeks gestation and the day we visited was his 100th day of being extubated (having his breathing tube out). I was enchanted and I felt like I was at home. Her whisper morphed into a normal speaking voice…
In 2003, when I started medical school at Ohio State, I had my career pathway narrowed down to either Pediatrics or OB/GYN. Although I loved obstetrics, I quickly learned that I was far more interested in what happened to newborn babies after they were born than core obstetrical tasks (like waiting for placentas to be delivered and stitching women up post-delivery). Toward the end of my 3rd year OB rotation I was present at the birth of a preemie. The NICU team called me over to hang out with them and watch as they resuscitated the baby with oxygen, positive pressure ventilation, and then CPAP. I helped them transport the baby to the NICU, observed the entire time as they situated the newborn and helped her breathe, and was given the responsibility of heading back to L&D to update her mother. Neonatology’s voice became louder and louder to me. I spent a month as an “acting intern” in the NICU during my 4th year of medical school, and dedicated my free time to reading every book and journal article that I possibly could about neonatal medicine. I wanted to learn and know everything about how to take care of preterm and sick babies. My favorite patients that month were a set of twins named Hunter and Fisher (names I will never forget!)
During the first few hours of my NICU rotation as a pediatric intern at UMass, in 2006, neonatology yelled and screamed at me. We were called to the stat c-section of a woman who was pregnant with 29 week triplets while we were in the midst of our morning NICU rounds. We ran to the delivery room. The NICU fellow, Dr. Kiley, resuscitated Baby “A,” our attending, Dr. Weiner, worked on Baby “B,” and the neonatal nurse practitioner and I took care of stabilizing Baby “C.” These triplets were my patients for my entire 4 weeks in the NICU and at the end of my time with them I was certain that I was going to subspecialize in neonatology. I applied for neonatal-perinatal fellowships the following year and was fortunate to be accepted into the program at Rainbow Babies and Children’s Hospital, which had been my first choice.
Neonatology no longer has to roar at me to get my attention, as she is the background noise of all of my nights and days. Through the years she has made me cry and has broken my heart many times, but she has also brought more hope and joy into my life than I ever thought a career possibly could. I feel like I am doing what I was called by the universe to be doing and it’s amazing to work backward and connect all of the dots that led me to where I now am. I am grateful that I listened to neonatology when she began to whisper to me during my childhood and adolescence, and also thankful that she was so darn persistent in getting (and keeping) my attention!
My advice to those contemplating a life in medicine is to listen to the whispers of the universe as she nudges you toward the path you are meant to travel on.
Jessica Madden, MD is a neonatologist in Cleveland, OH who has recently started a neonatology home visiting service called Primrose Newborn Care. She is also a mother of 4. Her website is www.novemaemd.com and she can be followed on Instagram @primrosenewborncare.