To the preemie I loved

joey Dear joey

Dear Joey,

I know you don’t remember me, but I remember you. We met during an incredibly stressful time, under the bright glare and nervous energy of an operating room in a near panic. I was in surgical scrubs, cap, mask and gloves. You were newly born and struggling to live.

It was a long time ago, and yet I’ve never forgotten that day. I wonder if you’ve heard the story of your birth? People usually hear of their birth from their mothers and fathers, but because your birth mother didn’t raise you and your birth father wasn’t around, I doubt they’ve ever been able to tell you. But I can.

And your family, your adoptive family, they weren’t there that day.  I’m sure they’ve told you what they could about your birth and the first months of your life, but they didn’t even know about you yet on the day you were born.

But I was there. I was your nurse, a newborn intensive care nurse, and my assignment that day was to rush to the emergency delivery happening in the OR. The room was pulsing with people, there to help both you and your birth mother. Both of you were in danger, both of you needed serious medical attention.

Amidst the beeps and chatter of  the OR, the doctors quickly delivered you by c-section, lifting your fragile, tiny body out into the world, placing you tenderly into my hands. I carried you ever so gently over to the warming bed, wrapped you in cling wrap to keep you warm. I told you happy birthday, and told you what a handsome boy you were. You didn’t make a sound or open your eyes, of course, but I smiled at you from behind that blue mask.


(you were actually much, much smaller than this)


You see, the trouble was that you were born very, very early. Seventeen weeks too early, actually. Babies born earlier than that often don’t survive. You were just big enough that we knew we had to try and help you live. So our job was to do everything we could to help you.

Joey, you sweet little thing, you did not make that easy.

Have you seen pictures of yourself in those first few days? Have you ever seen a baby so small? Very few people ever have, but I got to hold you in the palm of my hand. You were so very tiny – have you seen your footprints from that day? Not a whole lot bigger than a postage stamp. Impossibly small.

The first and most important job you had was to breathe, and that’s where we almost lost you. You needed help, of course, all 23 week babies do. But you had an extremely narrow throat, making it challenging to get a tube in to deliver life-saving oxygen to you.  Because it was so hard, the doctor had to try again and again. And in the meantime, your little heart started beating slower and slower, stressed without the oxygen it needed to keep you going. I used my two fingers to press down on your wee little chest, willing your heart to keep beating.

I kept talking to you the whole time, telling you

“You can do it, little guy” and

“Let us help you, sweetie.”

And I wasn’t saying it aloud, but I was feeling it in my heart,

“You are loved.”

joey you are loved

I thought you needed to know that. With nobody else in the room to say so, I needed you to know you were loved and there was a wonderful life ahead of you.

The circumstances behind why your mother, so young and alone, would not be keeping you were complicated. Truthfully I never did know the whole story. But I did know, at that moment of welcoming you into the world, that nobody in that room was going to be raising you, watching you grow, loving you. Nobody in that room was going to be your forever family – they hadn’t even been found yet, because your arrival was so sudden and unexpected.

So I welcomed you into the world all the more joyfully. In addition to helping you live, I made sure you came into the world feeling loved and celebrated and wonderful.

Finally, after maybe 4 minutes? Maybe 8 minutes? After what felt like an eternity of checking for heartbeats and trying to intubate and giving chest compressions and worrying about your fate, the doctor got the tube in, allowing us to deliver tiny, life-saving breaths to your lungs.  Just in the nick of time!

Once your heart got the oxygen it needed, we got you stable enough to transfer.  We very carefully moved you to the neonatal intensive care unit, which became your home for the next several months. You needed a ventilator to breathe, IV fluids to stay hydrated and nourished, and medications to keep you alive. You weighed just a little over a pound, with delicate translucent skin and eyes that weren’t open yet. You were very small and very fragile, but through it all you had incredible strength.

Your birth mother did visit you, once, the day after your birth. She looked at you for such a long time. She didn’t say a word or ask a single question. As tears streamed down her cheeks, I brought her tissues, and she just looked and looked, as if she was memorizing your every feature, every detail. I encouraged her to touch you, and for just a moment she reached in and laid her fingertip across the tiny palm of your hand. Maybe she knew it would be the only time she saw you. She carried you for 23 weeks, she visited you just one time, and then she was gone. As long as you remained with us in the NICU, she never returned.

But you were never alone, Joey, and you were SO loved. By all of us, your team of caregivers – nurses, doctors, therapists, volunteers. In the beginning, we showed our love by keeping your incubator dark, warm and quiet. We found the most beautiful blanket to cover your isolette. We all wanted to be your nurse, to shower you with extra attention and tenderness.  When someone was talking too loudly near your bed, we shushed them. Whenever you fussed, we rushed to comfort you.

As you grew, we showed our love by picking you up & cuddling you. We fed you ever so carefully when you were learning that challenging task.  Some of us sang to you, some of us rocked you to sleep, some of us read books to you. We shared our hopes and dreams for you. We were the only family you had, but you had us 24 hours a day, 7 days a week, and there were so many of us to love you.

You surprised us all with your strength. Difficulties that many preemies faced were not all that hard for you. You didn’t need oxygen as long as many preemies, you needed very few medications. You learned to take a bottle quickly, which is not an easy thing for babies born so early.  And you grew into such a cuddly, snuggly baby – you seemed content and you rarely cried. Sometimes babies born that early have a hard time cuddling and calming, but not you. We were so proud.

For much of the time you were with us in the NICU, you had no family to visit you. Other babies came and went, with their moms and their dads and their families to visit them. None of them probably ever realized that you had no family to visit you.

But then, of course, the day arrived when your adoptive family was going to meet you. Can you imagine how protective of you we felt?  You had been ours and ours alone for months. We had grown very attached to you, and we all wanted to be sure your new family was going to be good for you. Luckily, your new family was fantastic. They respected us as your first family, while at the same time being single-mindedly determined to know you and love you. They asked us all about you, they had millions of questions. They learned your likes & dislikes, and stayed by your bed for hours, just watching you grow.  They, too, read to you, sang to you, rocked you to sleep.  They were patient, but so eager to have you home and become a family.

Our collective hearts sang with joy, knowing you were going to a wonderful home, while at the same time sighing with sadness, knowing you would have to leave us someday soon. And that day did come. When you were strong enough to leave us, after so many weeks, your family packed all of your things (many of the nurses and therapists had brought you gifts over the months), we shared many hugs and happy tears, and you were gone. Off to live your life with your family, far away from us.

Your leaving us left an emptiness. Babies come and go everyday in the NICU, but you were different. You were extra special to us. We talked about you often, wondered how you were doing. Mostly, we missed you dearly.

Joey, it has been so many years since I held your incredibly delicate body in my hands and willed your heart to keep beating and to feel loved. I don’t know how those years have been for you, although I think of you often. I hope the years have been good to you. I know you faced many hardships right from the very first breath, and I’m sure you have faced many more. Health issues, perhaps? Or family struggles? I hope you have been able to face all of those difficulties with the same tenacity and vigor that you always did.

And I hope that my love, our collective love for you, stays with you always and gives you strength.

I want you to know the story of your birth, and the story of how loved you were, at a time when you can’t otherwise remember.  And I want to thank you for letting us be your first family, for letting us love you. I hope we gave you a gift you’ll always have, by loving you and treating you as our own family.

You gave us a gift by allowing us the opportunity to remember how it feels to truly love the babies we care for.  I loved you then, and I still do.

joey still love you


[I often wish I could write to my former patients, to tell them the story of their birth and their NICU stay, because many babies don’t ever know their birth family nor their birth story. It is healing for me imagine my former patients all grown up, happy, healthy, and loved. It is healing to believe that my good intentions and love for those babies is felt by them, in some way.  For privacy reasons, of course, I have had to change important details. Joey is not an actual patient, but is a compilation of different babies and stories from my years of experience.]

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21 Responses to To the preemie I loved

  1. Sonja November 26, 2013 at 11:08 pm #

    Beautiful. I’m crying tears of sadness and joy for all the Joeys.

  2. Sawastar November 27, 2013 at 6:09 am #

    Trish this is beautiful!!! Just beautiful!

    A true testament of the love that pours out of the NICU staff into the patients and families they care for. A perfect example of why you’ll be hearing from us for life…because we understand that you were just as much a part of his beginning as we were :-).

    • Trish November 28, 2013 at 1:43 am #

      Thanks! I look forward to hearing from you for life!!!

  3. Alana November 27, 2013 at 6:13 am #

    Well, this made me cry! Such a beautiful, beautiful story. As a preemie mom, I cannot ever speak enough about the very specific and unique type of gratitude you have towards the nurses who worked so hard for your tiny children. The ones who really got to know who they were, who took such incredible care of them and were there for them even when I couldn’t be. The ones who still check in on them and care about them even though they’re no longer little NICU prems. And, as a former preemie myself, almost 28 years ago now, this story also makes me wonder about the nurses who took care of me as well, the women whose names I never knew, who helped keep me alive and who must have been there for me when my own parents had to leave each day. I have never before seen so many individuals whose work is such a labour of love. It makes all the difference!

    • cheryl November 27, 2013 at 3:32 pm #

      Tears are streaming down my face after reading this for the incredible love and compassion you and your team have for the new babies born into this world. .. especially for the ones that struggle to survive. . Like our son , a twin , who you also helped deliver into this world and cared for so delicately during his stay in the NICU and followed over the next several months during his struggles at Fresno Children’s Hospital. I personally will never forget that time and how scared we were but always hopeful and encouraged by your support and confidence in his care and his resiliency and desire to live. Today he lives with SBS and is a thriving energetic and happy 15-month old, chasing his twin sister around and learning everyday. The joy a parent feels after having gone through such an ordeal is tethered by the delicate care and love of people like you who not only held our son in your care but held our hearts as well. Thank you is just the beginning.

    • Trish November 28, 2013 at 1:45 am #

      I feel so lucky to have the job that I do. Maybe we never hear from the families ever again, but I still like to try to bring joy and comfort during those important early days. It warms the heart to feel the parents’ gratitude, because of course it’s such a hard place for parents to be.
      Sorry to make you cry! Can I grab you a box of tissues? :)

  4. Tamara November 27, 2013 at 5:29 pm #

    Lovely story!!

    • Trish November 28, 2013 at 1:46 am #


  5. Tesia November 27, 2013 at 6:24 pm #

    So sweet reminds me of my Lil one…

    • Champa November 28, 2013 at 1:15 pm #

      This is so touching and sad. How could a mother walk away from her baby and knowing under what conditions he was born? But I guess that’s life, lucky for him he had the NICU nurses, who did a great job.

  6. Andrea November 29, 2013 at 4:35 am #

    Wow. I’m speechless and moved beyond words after reading this. Thank you for all you did and do to help babies feel loved. As a parent of a 23 weeker, it is comforting to know that when I left my baby alone at the hospital that his nurses were loving him like a person…and not just as a patient.

  7. Niki January 26, 2014 at 12:06 am #

    What a touching story. When my daughter was in the NICU, I would watch in awe as the nurses completely bonded with the babies. I often wondered how they could do that time and time again. Always thankful of the nurses who bonded with my daughter, and loved her so completely during her relatively short NICU stay.

    Thank you Trish, as you were the first :-).

  8. sparrow May 20, 2014 at 6:32 pm #

    Just found your blog through RockstarPreemies. This made me cry. What a beautiful letter. My twins were born at 33 weeks. What a bewildering time. It’s only now, a year later, that I feel like I can reflect on it a little bit. I have so much respect for the work of NICU nurses.

    • Trish May 20, 2014 at 7:02 pm #

      Thanks, Sparrow! It was really healing to write, and it’s lovely to hear from the readers who enjoy it too. So thanks for taking the time to reply, it means a lot! I checked out your blog – what beautiful twins, and what a fun blog!

  9. Matt Regusci July 1, 2014 at 7:11 pm #

    I’m so happy we were able to connect again today at the Sierra Vista event. This letter is so beautiful and my babies were so blessed to have the Sierra Vista NICU as their first parents.

    Day in and day out, you and the ANGELS in the NICU do millions of little tasks that may be route and mundane in your eyes but mean the world to our babies. Your loving words, parental smiles, affectionate touch, and motherly protection are so natural and the reason why my babies have no attachment issues today.

    Thank you for paving the bonding love for the babies we would meet, love and take home. It brings us so much joy that our babies are blessed to stay in the community surrounded by people that continue to have a bond that is unbreakable.

    • Trish July 1, 2014 at 7:21 pm #

      It was great to meet the entire family today! Thanks for sharing your story, your time, and your gratitude. Your boys are all so fortunate, as are we at Sierra Vista. I would argue that you guys are the angels, providing such wonderful parenting and love with your family. I’ll look forward to keeping in touch and watching those sweet little guys grow!

  10. Tracy Regusci July 1, 2014 at 7:56 pm #

    Totally ugly cry. That was beautiful. That is the type of letter/stories I want my boys to have. My heart aches to have things like this for them to remember and to know the fight they won. I never want them to forget those first people who loved them so unconditionally with all their hearts. Thank you for such a beautiful piece. I will read this to my boys, over and over again.

    • Trish July 1, 2014 at 8:15 pm #

      :) It was great to meet you, and I’m glad I had the chance to tell you about this story I wrote. While this story is different from your boys’ actual stories, it is true that they were loved like this, it’s true that they brought me and so many of us incredible joy. And the part about our collective gratitude for the amazing adoptive family? So very true. You guys are amazing. Thanks for being such fantastic people and parents.

  11. celeste July 2, 2014 at 6:12 pm #

    There was a small baby with no family when my 26 weeker was in the hospital, and I noticed how extra caring the staff was with him. They were all mother bears looking over that baby, even more than they were with the others. I didn’t think that could be possible, seeing how attentive they were with my son and how many questions they answered for me. But they were, and I noticed, and I will never forget that kindness.

    What a wonderful gift.

    • Trish July 2, 2014 at 7:40 pm #

      Thanks for sharing Celeste. It sounds like your son had incredible care, as did the baby without family. Isn’t it nice to know that some good like this can come from such a difficult time – the NICU? It’s so hard, but it can bring out the best in people. I appreciate your sharing!
      I have an idea – since your hospital sounds pretty awesome, why not nominate them this month for the giveaway over at our NICU specialty store EVERYtinyTHING? Each month we recognize the NICUs that families love and choose one to win some fun goodies. You can nominate them here: EVERYtinyTHING Giving
      Thanks again for writing!

  12. Carrie July 4, 2014 at 12:00 am #

    these stories are truly incredible.
    Gets me right where it counts – the heart!
    God bless you sweet babies and the nurses and families

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