Saving babies, trying, or doing our best

(attention-grabbing headlines vs. nuance)

This recent Wall Street Journal article (“Doctors Can Now Save Very Premature Babies. Most Hospitals Don’t Try.”—yes, the headline includes the periods) prompted me to comment:

As a neonatologist I wanted to avoid reading this article. The care of "micro-preemies" is painful enough for them, their families, and hospital staff without making it into an intentionally polarizing, simplistic headline.  "Doctors can?" "Hospitals won't?"

As many who have already commented point out, there are more players --and more variables -- involved in a baby's NICU course and survival than "doctors" (give me a break; we don't save anyone on our own) and "hospitals" (too generic).

If "viability" means being able to survive on one's own, then the comment describing all neonates as nonviable is actually correct.

One sad reality is that we don't know ahead of time who's going to be able to survive in this "periviable" age group despite our provision of all-out, long-term, expensive critical care.  Another sad reality is that maternal health (much less appreciated) does affect babies' outcomes. Yet another is that resources are lacking-- in many and various ways.  For example:  in my own state there is no funding for (and hence no availability of) home health nursing for babies, including the handful of those who we have to send home every year with tracheostomies and ventilator-dependent --whose parents have to care for them 24/7/365 and are warned that even taking a restroom break could mean an inadvertent death. But they do the best they can.

The parents do their best, the babies do their best, and we do our best.  The system, on the other hand, could be better.