{"id":39136,"date":"2017-05-15T10:24:43","date_gmt":"2017-05-15T09:24:43","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=39136"},"modified":"2017-05-15T10:24:43","modified_gmt":"2017-05-15T09:24:43","slug":"adhisivam-bethou-a-lesson-from-the-neonatal-unit","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2017\/05\/15\/adhisivam-bethou-a-lesson-from-the-neonatal-unit\/","title":{"rendered":"Adhisivam Bethou: A lesson from the neonatal unit"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-39146\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/Dr.-Adhisivam.jpg150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/>A few years back, when we were in the old block, our neonatal intensive care unit was small but had no dearth of tiny new citizens. Some of them were brief visitors: they would check in, hurriedly gobble up some oxygen molecules, and rush back to relish the colostrum in waiting. Some weren\u2019t that quick and would stubbornly secure a spot under the warmer, as if it was a Bodhi tree, and wouldn\u2019t vacate for days or even weeks. Sometimes things were worse: terrorists and sleeper cells\u2014nicknamed <em>Klebsiella<\/em> and <em>Pseudomonas<\/em>\u2014would clandestinely breach a newcomer\u2019s barriers.<\/p>\n<p>Our little friend, a \u201cvery low birth weight\u201d was in the middle of such a battle. He lay under the warmth of the Bodhi tree with mottled skin and a bloated abdomen, necrotising enterocolitis, sepsis, and shock. His body was barely visible under the camouflage of tubings, wires, plasters, and ECG leads. Infusion pumps laden with inotropes, antibiotics, and IV fluids had silently stacked themselves, giving rise to a Christmas tree next to the Bodhi tree. Our best antibiotic bullets gave no response. Surgeons believed exercise with their scalpel would be futile. So with the grave prognosis looming, we counselled the frail mother. She decided to take our little friend home but the sound of her sobs stayed with us.<\/p>\n<p>Six weeks later\u2014a Wednesday afternoon\u2014our usual under 5s clinic was brewing with the standard ingredients of injections, screams, and consoling mothers. From nowhere, our little friend showed up with his mother. Despite the old man looks, he was quite vigorous with preserved buccal pads of fat. He was alive against all medical odds.<\/p>\n<p>\u201cWhat did you give him?\u201d we asked the mother.<\/p>\n<p>\u201cJust my milk.\u201d<\/p>\n<p>Perhaps the separation from the nosocomial terrorists (including us?) plus the immune power of his mother\u2019s milk had helped our little friend survive.<\/p>\n<p><em><strong>Adhisivam Bethou<\/strong> is additional professor of\u00a0the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India<\/em><\/p>\n<p><em><strong>Nivedita Mondal<\/strong>\u00a0is associate\u00a0professor of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India<\/em><\/p>\n<p><em><strong>Nishad Plakkal<\/strong>\u00a0is assistant professor of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India<\/em><\/p>\n<p><em><strong>B Vishnu Bhat <\/strong>is professor and head of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India<\/em><\/p>\n<p><em><strong>Competing interests:<\/strong> None declared.<\/em><\/p>\n<p>Patient consent obtained.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A few years back, when we were in the old block, our neonatal intensive care unit was small but had no dearth of tiny new citizens. Some of them were [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2017\/05\/15\/adhisivam-bethou-a-lesson-from-the-neonatal-unit\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-39136","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Adhisivam Bethou: A lesson from the neonatal unit - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2017\/05\/15\/adhisivam-bethou-a-lesson-from-the-neonatal-unit\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Adhisivam Bethou: A lesson from the neonatal unit - The BMJ\" \/>\n<meta property=\"og:description\" content=\"A few years back, when we were in the old block, our neonatal intensive care unit was small but had no dearth of tiny new citizens. 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