Spoiler alert: review of Casualty series 31 episode 28 ‘Five Days’ – watch online at BBC iPlayer. Photo credit: BBC
Despite being sick of the sight of hospitals, I’m a big fan of BBC’s Casualty and Holby City. I hadn’t registered at the end of last week’s episode (when nurse Robyn gave birth to her baby prematurely in a graveyard) that the show would be featuring Holby City Hospital’s NICU. When my mum came over for Mother’s Day, she cautiously asked if I’d watched last night’s episode. I’d fallen asleep at 8pm (not an unusual occurrence), so no. She warned me against watching and said it had brought everything back for her. So of course, I quickly loaded up iPlayer…
Yes, I did shed some tears. Although it was only 10 months ago, it was hard to comprehend that my own baby L was also so small. It is easy to forget that we were also separated by the wall of an incubator and I had to ask permission to touch my own baby. Of course, there were various inaccuracies or exaggerations which bothered me. But on the whole, I was impressed by the BBC’s efforts. The episode captured the raw emotion of Robyn’s experience as a new mother of a premature baby. There were subtleties that the average Casualty viewer might miss, but poignant to those that have lived through the NICU. If you still intend to watch the episode, look away, but the following scenes struck a cord with me:
- The sight of Robyn languishing on the maternity ward, alongside mothers and babies. Great progress has been made in creating specific areas for mothers who have tragically suffered a bereavement during childbirth or a stillbirth. But the only place for NICU mums is the general maternity ward. I was fortunate enough to have a side room on the postnatal ward, but I could still hear the cries of babies for six nights straight during recovery.
- The generic NICU environment is captured perfectly and brought back many memories. The room is lit by the blue glow of phototherapy lamps and alarms are constantly buzzing away. There are numerous shots of hand-washing, which is an all-too familiar aspect of the daily NICU parental routine. I even spotted a copy of Little Bliss on the NICU noticeboard!
- As Robyn prepares to meet her baby Charlotte for the first time, she dismisses the nurse’s medical update to get a glimpse at her precious baby. Unlike non-NICU mums, parents like Robyn are forced to wait many hours before they can meet their newborn for the first time. A mother will often need time to recover herself from the unexpected or surgical birth and will not be fit enough to visit NICU. It is incredibly difficult to meet your child for the first time in the presence of strangers. The abrupt nature of the nurse mirrors my experience too. Whilst NICU nurses are generally incredible, they can often forget the overwhelming experience of greeting your baby through a plastic box. The curt remarks aren’t intentional; I imagine they are desensitised to the sight of a 2lb miracle.
- The nurse’s general attitude is pretty rubbish, but again, accurate. Robyn is chastised for touching her baby too much. There is nothing more frustrating than being told what you can and can’t do with your own baby. But it happens. And like Robyn, I often left the ward in floods of tears or went outside to scream. I can remember the invisible brick wall of NICU vividly. NO-ONE WAS LISTENING TO ME! I had meltdowns in the middle of the ward. I would spend hours crying at home, on the verge of calling the Bliss helpline to ask what my options were. But like Robyn, I learnt to play the game and ask the right questions to the right people (specifically: always be around for the daily consultant rounds).
- But the nurse does show us her softer side. Robyn is summoned to comfort Charlotte before a procedure. A dejected Robyn has lost faith and asks “What difference am I going to make?” A familiar emotion in NICU. At times I just felt like a cow, rocking up to provide the milky goodness and do a token nappy change to make myself feel better. The nurse is proved right and Robyn takes comfort from her daughter’s calmness. The nurses I despised the most in times of crisis often turned around to be my biggest ally in making progress towards discharge. Sometimes there is a purpose behind the tough love.
- Breastmilk. A hot topic in NICU and for good reason; breastmilk is especially important for premature and sick babies. I am a huge advocate of breastfeeding and was fortunate enough to receive incredible support from my midwives with expressing. But I know many mums will recognise the pressure placed on Robyn by the nurse to keep expressing. I hope the scripted lines strike a cord with viewers – baby Charlotte only needs 2ml for her feed. However meagre Robyn’s attempts to express may be, she should be able to get enough for her baby’s tiny stomach. I loved the scenes of Robyn excitedly asking for photos of her baby’s first feed, administered by Robyn via a tube. It IS a milestone! And what an incredible achievement to feed her baby mother’s milk.
- Robyn’s friends and the nursing staff seem surprised at her eagerness to post photos on Facebook and share updates. She must be in denial, not realising the gravity of the situation. Is it such a crime to try and think positively in such a devastating situation? I could really relate to Robyn’s need to share snaps on social media. Once you reach a certain age, timelines are flooded with photos of gurgling newborns and chubby cheeks. Robyn has a legitimate urge to recognise her baby in the same way. I uploaded a photo of L a few hours after he was born, before I had even met him. It made the birth feel real to me. Over the next few weeks, I shared endless photos with cute taglines. It is only now I can see the tubes, the yellow tinge to his skin, how desperately unwell he was. But at the time, he was just my gorgeous newborn that I wanted to show off.
- But of course, the Beeb was bound to include some scenes which had us NICU parents shouting at the screen. Thankfully, L didn’t have the same medical issues as Charlotte so I can’t comment on the accuracy of the procedures. I did tut at Robyn being allowed far too many visitors around the incubator. I have no idea if there are different rules if you work in the hospital, but I doubt it. My hospital had various rules about who could visit at different times and it was always two around the bed maximum. Robyn’s position as a nurse seemed to entitle her to a full house.
- And her step-brother kissed the baby at the end! A NICU baby! I actually lol’d at this point. My mum was constantly watched for any signs of interaction when she came along to visit L. As a treat, she was allowed to touch him on her birthday until I got permission from the consultant for parental rights in L’s fathers absence. But touching is a big no-no on NICU. Everyone (apart from parents with their magical powers) is a germ-ridden infection risk.
- UPDATE: Catherine (@catjay79) kindly got in touch via Twitter to share her perspective on the episode as a mum of a necrotising enterocolitis (NEC) survivor: “The portrayal of a baby undergoing surgery for NEC was inaccurate and downplayed the severity of the condition. After surgery babies are often critically ill, kept ventilated and require intensive support. My daughter remained on a ventilator for 6 days following surgery and was bloated due to fluid retention. Holding her was simply out of the question; I could not hold her until 9 days later. The first 48 hours after surgery are crucial for these babies. Surgery is a huge risk and some tiny babies sadly don’t survive. We owe it to them to portray these things properly.”
I’m sure I’ve missed other exaggerated scenes. My focus was on the familiarity, the sounds and sights that I lived for six weeks. Five Days may not have been the perfect representation of my NICU experience, but it was a marvellous opportunity for prime-time views to peek into our secret world. Thank you BBC for showing NICU through the eyes of a struggling mother, rather than merely dramatising the plight of our tiny babies.