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Dear Parent,
I am writing to you as a dedicated Respiratory Therapist (RT) who has spent years in the largest Neonatal Intensive Care Unit (NICU) in our province. We welcome the tiniest and most critically ill newborns, often transported from distances of up to 1000 kilometers (700 miles) for specialized care. It is these fragile lives that demand the utmost attention and expertise.
Every day, I worked to provide breath and life to these vulnerable beings. However, there were moments when, despite our best efforts, I had to be the one to provide their final breath.
For some families, this outcome is anticipated through prenatal scans and specialist consultations that reveal serious issues. For others, the diagnosis comes as a devastating shock at birth. Regardless of the circumstances, when a baby enters the NICU, it is a clear sign that they are in critical condition.
Common reasons for admission include congenital heart defects, congenital diaphragmatic hernias, intrauterine growth restriction, infections, chromosomal abnormalities, traumatic births, or premature deliveries. Each infant comes with unique challenges, and each condition carries its own complexities in respiratory care.
As an RT, one of my fundamental duties was to manage life-support systems vital for the survival of our sickest patients. Everything we did was focused on optimizing each breath—adjusting ventilatory settings, drawing blood samples, clearing airways, administering respiratory medications, and performing chest physiotherapy. Yet, part of my role also involved recognizing when to withdraw care when there was no longer hope.
The most severely ill babies occupied my attention, and out of both necessity and empathy, I invested countless hours at your child’s bedside. I was often there day and night, joining you in those harrowing moments. You shared stories about your other children, the origin of your new baby’s name, and I spoke of my journey to becoming an RT. Through it all, we remained focused on the precious life between us.
No family should ever have to face such heartache. The moment when a physician informs you that all options have been exhausted, that prolonging life would only extend suffering, is a moment no one should endure. It pains me to even recount this, but it is a reality we face.
When the time came, your family would gather in that small hospital room—a space that once held so much hope but now was filled with sorrow. Our medical team meticulously planned every detail to ensure the transition would provide you with solace, knowing your baby would find peace.
When it was my turn to act, I would confirm that you were ready to proceed. With a nod, I would deliver your child’s last breath, gently remove all the tubes and wires, and place your baby in your loving arms.
Though I felt a deep connection with you, I quietly exited the room. You didn’t need me there. There are no words capable of easing your pain. Instead, I offered you space—a space to memorize every detail of your child, to say goodbye.
In those moments, I concealed my tears. I wanted to remain strong for you, to reassure you that you were making the right choice for your baby’s sake. Because you were.
Now, as I reflect on that experience, I want you to know that I carry that heartbreak too. You should never have had to make such a decision, nor say goodbye to your baby. Your strength throughout this journey is something I will always admire.
As a parent myself now, I often think of what you endured. You displayed the most profound act of love for your child—bearing their pain to grant them peace. My hope is that you, too, have found some measure of peace in the aftermath.
Your little angel will forever remain in my heart, and their memory is a part of my journey as a caregiver.
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