Primitive reflexes | First Person | Indy Week
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A young doctor reflects on the meaning of newborn babies' instinctual responses and the psychological significance of naming them.

Primitive reflexes 

February is commonly known as the abyss of a pediatric intern's depression. Months have passed waking in darkness and returning home in darkness, the hospital wards have been packed with children suffering from respiratory and gastrointestinal illnesses (which are passed along to the interns), and the chaotic effects of being awake for 30 or more hours in a row every fourth day have rendered each of us, at some point, emotionally labile.

Fortunately, though, I am spared the depths of this misery by being placed in the lightest rotation of the intern year, the normal newborn nursery.

For the first time in months, I do not have to dredge myself from bed. I am almost giddy at the thought of strolling into work at 8 a.m., swiping my card through the security box and scanning the nurses' station board for the new babies awaiting their first exam. They're all still sleeping, swaddled tightly in their blankets, wearing pink and blue caps (some order and separation in place even though many of them are unnamed), unaware that in a few minutes they'll awaken unhappily to my gentle, but cold and prodding hands.

I take great pleasure in these unrushed exams, the low census, happy that the previous May was short of storms or the sorts of conditions that stimulate baby-making. As I remove the babies' caps, I realize that they serve three purposes: to designate sex, protect from heat loss and cover some of the babies' rather misshapen heads. These babies look nothing alike. Some of their faces and bodies are remarkably unlined for all the time they spent in the saltbath of their mothers' wombs. Some eyelids are marked with a hemangioma or "angel's kiss"--a visible reminder of the network of blood vessels that course quietly beneath the skin, and others are mildly yellowed from a lack of mature liver enzymes. After listening to hearts that tick twice as fast as my second hand, and to the quiet bellows of their lungs, I press their bellies, feeling for what should not be there, examine the sturdiness of their joints and count their toes and fingers. I breathe a sigh of relief when all is found to be "within normal limits." I'm thankful that I chose pediatrics as my specialty, where sometimes all I have to be responsible for is telling parents that they have a beautiful, healthy baby.

I dutifully record the physical differences in the medical record and move on to the part of the exam that every child should respond to similarly. This most noxious test is saved for last, as a squalling baby with abdomen tensed permits no exam. With my hands cradled beneath the child's head and the back laid flat against my forearm, I release my hands from the head for a moment and simulate for the baby the sensation of falling. The baby spasms her upper limbs to the center of her chest as if praying and then relaxes them outward, evoking a cry. The scrape of a fingernail, not even one full fingerstroke, against the bottom of her foot elicits a grimace and the big toe flips backward and away in protest. Her cherubic mouth puckers toward a tickling finger near her lips. All the babies suck greedily at a gloved finger. We term these responses "primitive reflexes," but really, they are instincts, human instincts--protective and nutritive.

My exam is only partly completed, for now I must find those whose responsibility it is to protect and nourish these new lives. I assess these parental factors with my checklist, asking the requisite questions about car seats, smoking, rectal thermometers, support at home, etc. But most of all, I am interested in that propensity that seems wholly human--whether it be botanist, inventor, Web page creator or parent--to give each new creation a name. Will this child be named after a favored relative, a flower or a biblical figure? Will they (or sometimes it is only she) choose a name in vogue or because it sounds good with her surname? Or will she turn the pages of the Bhagavad-Gita and find a name that begins with the letters that belong to the page? I am less afraid of hearing the names Precious, Destiny and Heaven in this normal newborn nursery than in the neonatal intensive care unit, where such names hung on the tense air like poor omens. Here, I am only worried when the quiet mother who has lost previous babies to a bleeding disorder is slow to mention a name for her very healthy baby. Pale and anemic, she lies in bed without the usual happy chatter of a woman who had recently delivered. On the station board, the baby remains in limbo as Baby Girl ---- . Naming is nine-tenths of possession, isn't it? And possessing something or someone means that one must open oneself up to the possibility of loss.

I have been unable to finish reading many books because of time constraints or boredom, but there is only one I could not finish because it disturbed me: Gabriel Garcia-Marquez's One Hundred Years of Solitude. It was difficult to keep track of the characters whose names resembled each other and those of their ancestors, even with the help of the family tree. But what chilled me was when the inhabitants of the village began to forget the names of objects and in their distress placed labels like "chair" and "table" on the respective furniture. And then the labels peeled up and floated away.

I don't know how the book ended--if the villagers perished because they could not name, possess and remember, or whether like parents seeing their newborn children for the first time, they were so changed by the experience that they began seeing the world in a whole new way. EndBlock

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