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It's at moments when the world seems to be falling apart that people like Nurse Lois B. take over.
By THOMAS FRENCH, Times Staff Writer
© St. Petersburg Times, published February 28, 2003
ZEPHYRHILLS -- At night, when she has an hour or two to herself, Lois Bineshtarigh sits at her kitchen table and works on another gown for the babies. She traces the pattern herself, cuts the white cotton material, finds the lace for the sleeves and the ribbon for the neck, then sews it all together. She insists on hand-stitching, because she does not trust a machine to keep the seams straight when she is making a garment so small and so important.
Lois is 41, with long brown hair, dark brown eyes and an oceanic calm. For the past 18 years, she has been a labor and delivery nurse at East Pasco Medical Center, a small hospital 45 minutes north of Tampa. By her estimate, she has helped deliver about 2,700 babies. She has reassured the fathers, held the hands of the mothers, carefully escorted their sons and daughters through the first moments of life. She is one of those people who comes into work, day after day, without any fanfare and quietly holds the world together.
She does it because she loves it. Everything about newborns astonishes her. How they smell, how they squirm, the way their faces are so open and yet so complete. To her, they are proof of the divine inside the everyday.
"God," she says, "expresses himself through babies."
On almost every day of the year, the labor-delivery unit is a joyous place. But once in a great while, something unbearable happens. When one of those moments arrives, Lois wants to be ready. So she sews the tiny gowns ahead of time, making them as beautiful as she can, hoping they will never be worn.
On Tuesday of this week, not long before dawn, Steve Spittka came home to his sleeping family. Spittka, 38, is a security guard who works the night shift at a Zephyrhills subdivision called Timberlake Estates.
On this morning, when Steve ended his shift and returned to his family's mobile home, it was just after 5. His two daughters, a 5-year-old and a 11/2-year-old, were in their rooms. His wife, Mary, 37, was in the couple's bedroom.
Not wanting to wake her, Steve stretched out on the couch and drifted off. He's not sure how long he slept -- at least several hours -- but when he woke it was to the sound of his wife gasping.
Steve ran to the bedroom and saw Mary, leaning over the side of the bed. She was vomiting. Her body was convulsing. Her skin was white. Her lips were turning blue.
Grabbing the phone, Steve dialed 911.
"My wife's having a seizure," he told the person on the other end of the line. "And she's pregnant."
The call came into the East Pasco Medical Center a little after noon.
The paramedics didn't have many details, but the woman's husband had told them she had been previously diagnosed with pre-eclampsia, a condition of hypertension that can be dangerous to both mother and baby. In the midst of her seizures, the woman had stopped breathing. The paramedics didn't know anything about the baby's condition.
Lois B. -- her co-workers call her that in honor of her last name -- was the charge nurse in the labor-delivery unit that day. She grabbed a supply of magnesium sulfate, a medication used to control seizures, and hurried downstairs to the emergency room.
The moment the ambulance arrived, a handful of medical personnel -- Lois, a couple of other nurses and two doctors -- went to work. They started IVs and got the medication pumping. They wrapped a cuff around the woman's arm to measure her blood pressure.
"How many weeks is she?" they shouted.
"I don't know," said one of the paramedic. "Her husband said she's six months."
Lois did the math in her head. Twenty-four weeks, far short of a full term.
One of the doctors told Lois he needed her to find a fetal heartbeat. Using a handheld Doppler -- a wand used to listen for sounds inside the womb -- Lois scanned the mother's abdomen. There was nothing. No heartbeat. Not even the usual gentle swoosh of the mother's blood flowing in and out of the walls of the placenta.
An ultrasound machine was brought in. Even before the technicians said it out loud, Lois could see it in their eyes. There was no movement from the fetus.
The mother's seizures had stopped, but they had to stabilize her and get her blood pressure down so they could perform a caesarean section. Otherwise she might die, too.
Lois heard a series of questions cycling through her head. What next, what next, what next, she asked herself. What am I missing? What else can I be doing?
She saw Steve Spittka walk into the emergency room, asking about his wife. She saw a hospital chaplain take his hand and introduce him to the obstetrician who had been called in. Together, the chaplain and the OB led Spittka to a nearby room.
When Spittka came out, his eyes were red. He walked stiffly, almost staggering. He wanted to see Mary.
They brought him to her bed. He stood there, holding his wife's hand, squeezing her shoulder.
"It's gonna be okay," he told her. "It's gonna be all right."
Lois told him that they were going to take his wife upstairs for the C-section. When the baby was removed, she explained, she would be the one to take care of it.
"Do you want the baby baptized?" she asked.
The father nodded.
"Do you have a minister you'd like to call to perform the baptism?"
The father shook his head.
"We'll do that for you," she said.
There was no need to bother him with the details of who exactly would be doing it. But Lois already knew. It's common practice for delivery room nurses to perform this service.
Even now, she was bracing herself for how hard it would be.
Lois went up to the second floor to prepare for the surgery. Before she went in, she took off the diamond ring and the amethyst ring her husband had bought her in Tehran.
Jalal Bineshtarigh is a cook who works at the Clock Restaurant in Zephyrhills. Lois met him in college, when they were both going to school in Tennessee. Born in Iran, Jalal had given her the long last name that her co-workers could never pronounce. He was a Muslim, she was raised in the Church of the Nazarene. Together, they had raised two children. Their daughter is 20, their son 16.
Lois removed her rings and put them in the pocket of her lab coat, beside a wallet filled with photos of her children. She had her daughter's high school graduation portrait, a picture of her son and his girlfriend at homecoming. She always carried them with her. Lois scrubbed her hands and wrists, put on sterile scrubs and went inside the OR.
On most days, a C-section is a routine procedure. The doctors joke, the OR fills with chatter. But as Dr. Earl Gabb made the incision across Mary Spittka's abdomen, the room was quiet.
On the remote possibility the baby was still alive, Lois had brought a warmer -- a portable crib with a space heater, shining overhead -- into the OR. If the baby still had a chance, they would need to boost its body temperature.
The doctor pulled out the child. "It's a girl," he said.
Lois knew instantly there would be no miracle. Most newborns are curled and tensed, crying and clenching their fists. This one was limp. Her arms fell to her side. Her hands were open.
What startled Lois and the others in the room was how big the baby was. The initial estimate had been that she was 24 weeks old. This baby looked closer to 34 weeks.
Lois laid the child in the warmer, draped a blanket over the top of the warmer and opened the door to look outside. Not wanting to upset any of the other patients or visitors in the unit, she wanted to make sure that there was no one in the hall.
The hall was clear. Lois pushed the warmer down to the nursery and into a separate room in the back.
It was time to prepare the baby.
Decades ago, these things were handled differently. Stillborn infants were usually taken away quickly from delivery wards. Often there was no funeral. Many times the parents never even had a chance to see the child.
Today, most hospitals have embraced a more humane approach. At East Pasco Medical Center, the policy for more than a decade has been to allow the family to say goodbye to their baby with as much grace and respect as possible. Before that can happen, though, someone has to make the infant presentable.
At East Pasco, that someone is often Lois B.
This is not a job she relishes. But if someone has to do it, she believes it might as well be her.
For a long time, babies who died were tucked into the stocking caps that other newborns wear in the nursery. Since most of these babies are so small, the cap usually enfolded them like a blanket.
Then, a year or so ago, Lois thought of a new way. She was at home, sewing some Barbie clothes for her two young nieces, when it occurred to her that the doll clothes would fit the stillborns. And so she began sewing the gowns.
"I try to make them look as pretty as I can," she says.
Some of the mothers who deliver at East Pasco are poor and have little money for baby clothes. When their pregnancy goes wrong, and they deliver a stillborn baby, they often find themselves at the hospital many weeks before they even have had a chance to shop for their child.
The gowns, Lois has discovered, ease the parents' pain. Here they are, holding their child for the first and last time. Those moments are beyond precious. They are all the family has.
Lois doesn't have to sew many gowns. The last deceased baby in the unit was several months ago. Lois can still remember the young mother, crying over her daughter.
"Isn't there something you can do to bring her back to life?" she kept asking.
That night, Lois went home and sewed another gown. It took her several hours. Around the drawstring neck, she sewed a little pink ribbon. At the sleeves, she sewed pink lace, adorned with hearts.
She took the gown to the hospital and tucked it on a shelf in the nursery.
Tuesday afternoon, when Lois brought the Spittka baby into the back room of the nursery, she knew what to do.
First she rolled a screen in front of the window, so none of the other mothers in the unit would see. Then she weighed and measured the baby. She was 4 pounds, 4 ounces, and 17 inches long. Lois took the girl's tiny feet, pressed them to an inkpad and made two sets of footprints, one for the hospital's records and one for the parents to take home.
Lois placed a pink basin in a sink and filled it with warm water. Then she stepped outside and asked if one of the other nurses would witness the baptism.
A nurse, an older woman with grown children, watched as Lois lowered the child into the warm water, immersing her completely except for her face.
"I baptize thee in the name of the Father, the Son and the Holy Spirit," said Lois, dabbing the girl's forehead.
The other nurse was mesmerized. Over and over, she noted how perfect the child was.
"She's such a beautiful baby," she said.
Lois could only agree. Babies delivered by C-section are often especially beautiful, since their heads and bodies are not squeezed through the birth canal. But this girl was exceptional. As Lois washed the blood from the child, she studied her round head, her wisps of light blond hair, the soft expanse of her eyelids, her perfectly formed fingernails, the tributaries of veins stretching under her porcelain skin.
She was gorgeous.
Lois held her, thinking of the first time she held her own two children. She thought about this baby's mother, now down the hall in the intensive care unit, and thought about all the things the child and her parents would never get to experience. Visits from the Tooth Fairy, skinned knees on the playground, a first dance with a boy.
Trying to hold back her tears, Lois silently prayed, asking God to give the girl's family the strength and comfort to get through this loss. She often said this prayer and had it down to three simple words.
Strength and comfort, she said. Strength and comfort.
Lois washed the child's hair and the rest of her body with Johnson's Baby Shampoo. Then she dried her with a towel and rubbed her feet and her back with Johnson's Baby Oil. She wanted those two scents -- and all the associations that come with them -- to reach the family when it came time for them to hold her.
With the baby in her arms, she walked over to the shelf and got the pink-trimmed gown.
This child was almost too big for the gown. Lois placed her inside it and then dressed her with a stocking cap and booties made by volunteers.
She pulled a small wicker basket from the shelf -- a basket shaped like a bassinet -- and placed in it two tiny pillows that had been made by another nurse. Then she wrapped the girl inside a receiving blanket, placed her on the pillows and draped her with a pink gingham blanket. The blanket had been donated by some women from a nearby church.
By now it was 3:30. Lois had been working since 6:45 that morning. Leaving the baby inside the nursery for the moment, she sat down at a table a few feet away and picked at a salad.
"Lois," said one of the nurses, sitting down with her. "You're so calm."
Lois said nothing. She didn't know how to reply. On the outside, she may have looked her usual self. But on the inside she was a wreck.
It was right around then when Steve Spittka walked up to the desk, wanting to see his child. He had been home and showered and had tried to pull himself together. But it was no use. His wife was in ICU, unconscious; his baby was dead. He seemed to be moving in a cloud.
Lois was still fighting to regain her own composure. Another nurse got up, introduced herself to the father and offered to take him into the nursery.
The nurse led him to the wicker basket. She pulled back the blanket.
The father began to weep.
"She looks like you," the nurse said.
She asked about his two other daughters. Did this girl look like her big sisters?
"Oh yes," he said.
The nurse told him he could touch her. He reached out and stroked her hand and studied her face and tried to absorb what he was seeing and what had happened and what had been lost.
"Do you think your wife knew what was going on before the surgery?" the nurse asked.
"No. When she wakes up, she'll think she's still pregnant."
He wanted to know if his daughter could stay in the nursery until that evening. He wanted to bring his parents in to see her. Of course, said the nurse.
Then, he said, "She has a name."
What is it? the nurse asked.
"Lindsay Rose."
The nurse took the father over to Lois. She knew Lois would want to know, so she could write the name on the card with the footprints.
Lois turned, but the other nurse could not make her mouth say the name. The words simply would not come out.
"Tell her the name," she said to the father.
The father said it again.
Lois asked him to spell it, then got up to write it down.
There was so much to be done.
That night, Steve Spittka returned to the hospital with his parents and let them hold their granddaughter, and then on Wednesday he went to a funeral home and picked out a casket. That evening, after his wife had regained consciousness, he held her hand as the doctor and the chaplain informed her that their youngest daughter was gone.
She wanted to see her.
They'd been keeping the baby in the morgue for this moment. By now her skin was ice cold. She was still in the basket, wearing the gown Lois had made. The father had already asked if his daughter could be buried in it.
A nurse took the child from the basket and wrapped her and the gown in a blanket from a warmer, so that she would not be so cold when she was handed to her mother.
They took Lindsay Rose to the room and gave her to her mother and father. Everyone stepped out to allow the family some privacy.
From the slit under the door came the flash of a camera. Then another. Then another.
-- Thomas French can be reached at (727) 893-8486 or french@sptimes.com.