On July 19 in the third year of her residency, Dr. Rachel Nebelsick, pregnant for the first time, was on rotation at Akron Children’s Hospital when she went into premature labor at 23 weeks.
The budding pediatrician was immediately admitted to Cleveland Clinic’s Akron General across the street. It was the start of an ordeal that no amount of medical training could prepare her for, and one that will forever change her as a doctor.
Rachel had a perfectly normal pregnancy. She was in excellent health, and meticulous about prenatal care. There were no answers as to why she went into labor 16 weeks early. But in a matter of hours, her entire focus became keeping her baby in as long as possible.
Neonatologist Andrew South and other doctors from Akron Children’s visited daily to check on her. They prepared her for what would happen. She understood the medical aspects all too well. But she couldn’t think like a doctor. She was a scared, first-time mom.
“A scared mom who has just enough knowledge to understand the worst things that can happen,” said Dr. T.J. Wolski, a friend and chief resident of pediatrics.
Her colleagues and friends at Akron Children’s held their collective breaths, knowing that babies born at 23 weeks have a slim chance of surviving.
Medical intervention and strict bed rest helped delay the birth. On Wednesday, Aug. 3 − just 2 weeks after she went into labor − Rachel gave birth to Westin at 25 weeks. He weighed 1 pound, 13 ounces.
“They took him right from me, resuscitated and intubated him,” she said. “They brought him to my room before taking him to Children’s across the street.”
Rachel and her husband, Jeremy, a manager of the orthopedic practice at Akron General, didn’t know what to expect in the first days and weeks in the neonatal intensive care unit.
“There are no words to describe how you feel when you don’t know if your baby is going to survive to the next day,” she said. “Whatever peace of mind I had, it was because I trusted the NICU (neonatal intensive care unit) team 100%.”
Westin thrived. After 2 weeks, doctors removed his breathing tube – a huge step forward. The newborn never needed it again.
“He was a rock star,” said Dr. Carly Gisondo, a third-year resident in pediatrics and a close friend. “He didn’t know he was only 25 weeks. He was tough. He was stronger than we realized.”
After 6 weeks, Rachel returned to work, comforted knowing that she was always just a short walk from Westin. Carly would sometimes text Rachel photos from the NICU.
Rachel was back and forth to the NICU during lunch and after work, often sleeping on a couch in the unit. Many days she didn’t go outside.
Rachel and Jeremy’s families live in South Dakota. The couple met in middle school there. Her colleagues at Akron Children’s were like family, bringing Rachel and Jeremy meals every day and offering unending support. A doctor’s mother who had never met Rachel stitched together a quilt for her and Jeremy. Other residents stepped up to cover for her at work.
“Without saying it, everyone understands that you take care of your own,” said T.J.
After 121 days in the NICU, Westin came home Dec. 1.
On a recent afternoon, he was smiling and cooing as Rachel held him in a recliner chair. His weight was up to 11 pounds, 4 ounces.
He has some ongoing preemie issues such as feeding difficulties, and has a nasogastric tube to provide extra calories. He receives physical and occupational therapy, and will need surgery for hernias.
“We still have battles, as any preemie parent does,” she said.
Her challenges include dealing with the emotional aftermath.
“I felt it was my fault. My body failed him,” Rachel said. “Accepting that part of it from day one has been a challenge. Sometimes you’re looking for answers for why it happened and there aren’t any.”
She has taken time off with Westin at home, and will return to work in February. Later this year, she’ll be a chief resident in pediatrics.
“It’s humbling,” Rachel said. “You never think as a doctor you’re going to be on the other side of it. It’s made me a stronger person. The fear of potentially losing my child is going to help me see patients in a different way. I can truly understand feelings of fear and helplessness.”