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Shetal Shah, MD

Arch Pediatr Adolesc Med. 2007;161(2):123.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

After several rotations in the neonatal intensive care unit, the 2-toned gong of the code bell rang directly in my spinal cord; reflexively, I found myself, along with the parade of respiratory therapists, nurses, and other health personnel, following the sound. A neonatal intensive care unit at night, a wise fellow once told me, is like a simmering volcano—always seething with the potential overflow of severe illness.

As the deep-throated gong rang again, the team realized which baby was "erupting."

We knew the situation wouldn't be good.

Baby J (not her real initial), a 420-g baby girl who was born at 23 weeks' gestation and had been emergently intubated and stabilized 8 hours before, now had filled her endotracheal tube with blood. The numbers that were previously hopeful suddenly became pessimistic. Advance directives with the parents—pleasant, affectionate 20-somethings—had been discussed. Comfort measures were initiated and no one, . . . [Full Text of this Article]

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