The call came in the middle of a busy night
as we worked on a floppy baby with high fever,
a croupy toddler whose breathing squeezed and squeaked,
a pale adolescent transfusing due to leukemia bleeding.

It was an anencephalic baby just born, unexpected, unwanted
in a hospital across town, and she needed a place to die.

Our team of three puzzled how to manage a baby without a brain–
simply put her in a room, swaddled, kept warm but alone?
Hydrate her with a dropper of water to moisten her mouth?
Offer her a taste of milk?

She arrived by ambulance, the somber attendants
leaving quickly, unnerved by her mewing cries.

I took the wrapped bundle and peeled away the layers
to find a plump full-term baby, her hands gripping, arms waving
once freed; just another newborn until I pulled off her stocking cap
and looked into an empty crater — only a brainstem lumped at the base.

Neither textbook pictures nor cruel jokes about frog babies had prepared me
for the wholeness, the holiness of this living, breathing child.

Her forehead quit above the eyebrows with the entire skull missing,
tufts of soft brown hair fringed her perfect ears, around the back of her neck.
Her eyelids puffy, squinting tight, seemingly too big
above a button nose and rosebud pink lips.

She squirmed under my fingers, her muscles strong, breaths coming steadily
despite no awareness of light or touch or noise.

Yet she cried in little whimpers, mouth working, seeking,
lips tentatively gripping my fingertip. A bottle warmed,
nipple offered, a tentative suck allowing tiny flow,
then, amazingly, a gurgling swallow.

Returning every two hours, more for me than for her, I picked her up
to smell the salty sweet scent of amnion still on her skin as she grew dusky.

Her breathing weakened, her muscles loosened, giving up her grip
on a world she would never see or hear or feel to behold
something far more glorious, as I gazed
into her emptiness, waiting to be filled.

Dr. Emily Gibson is a family physician, farmer, poet, wife, mother and grandmother. She has worked in inner city Primary Care, community and rural health, detox and sexual assault centers, and as the medical director of a University Student Health Center for three decades. Both a photographer and writer, she shares daily about her life and work on her Barnstorming blog.

Dr. Gibson is a 2018–2019 Doximity Author.