Abstract

Early in my career as a neonatologist, I was called into the hospital for a newborn who would not stop crying. Screaming, really. When I entered the unit, I was greeted by a loud, shrill, distinctive cry. After hearing the history and examining the baby, I just stood there for a while, watching and listening. It took some time, but eventually, I noticed a subtle regularity, a rhythmicity. I took off my watch, placed it on the bed next to the child, and found that the crying briefly grew louder about every six or seven seconds. This baby was having an atypical seizure. This preliminary diagnosis was followed by a conversation with the parents and a neurologist, transfer to the nearby academic center for an extensive evaluation, and the eventual demise of the child from a poorly understood disease. About a year later, I walked into the same unit and heard a cry I had heard only once before. I looked over to see the same mother at a newborn's bedside, with tears in her eyes, looking back at me. She knew what the coming days held for her and for her second child. That was over twenty years ago, but two images, or moments, remain with me. One is the watch on the bed next to the first baby; the other is the mother's expression of sadness the morning the second child was born. The image of the timepiece is perhaps instructive.