I enter her protected space and take in the scene: IV poles, ventilators, monitors, tubes, machines. Blinking lights, steady lights. Various pings and beeps break the silence.

     "Hey." I smile at Jamie, Aleeshya's day-shift nurse. "I see we're screened in now."

     "Yeah, since yesterday." Jamie looks up from her note. She smiles at me. "How ya doing?" she says.

     "Good. How are you? How's she?" I jut my chin toward Aleeshya.

     "Well, she had surgery last week."  

     "I heard." I raise an eyebrow. "How long are they going to keep this up?"

      Jamie puts down the chart and rubs her forehead. She opens her mouth to speak, but stops.

      "We talked to mom today," another voice says. Kristen, the Neonatology Fellow, a board certified physician now training to specialize in newborns, has stepped in behind me. "She's DNR now."

      "We told mom it's O.K. to stop?" I ask.

      "Yes."

      "Are we withdrawing care?"

      "No. But mom agreed to no resuscitation if Aleeshya codes."

      We absorb this for a moment.

      "Do you have her tonight, Diane?" Kristen asks.

      "Yep. Until eleven. Are you here all night?"

      "For a few more hours. I know she's in good hands with you." Kristen gives me a wink and a smile. "I'll check in later. Have a good night, Jamie."

      "Night."

      Jamie and I return our attention to Aleeshya. "When did you take care of her last?" she asks.

      "Em, about a month ago? She's been here so long, I've lost track."

      "Didn't you admit her? I think I remember her coming in."

      "Yeah. Either I admitted her or I was there for her delivery." I call back a vague memory of a scrawny baby, arms and legs flailing, yanked from a toxic uterus. Aleeshya's mother's soaring blood pressure poisoned the oxygen supply. She was pulled out in June, eighteen weeks too early. She was the length of a fast-food paper napkin and weighed less than a pound.

      For the newborn intensive care unit, she is not unique. Many of our babies arrive like this. Forceful hands free them from hot bellies and pull them into a cool antiseptic room. Their eyes fly open in disbelief, their mouths gape and gulp those first swallows of air. Relieved, they mewl their thanks to masked blue figures.

      Hands move everywhere; rubbing, pulling, touching, pressing urgently. These babies are in trouble after the first few breaths. Hands grab and tilt up delicate chins. A sterile tongue depressor forces open the small mouths and in slips a long plastic tube down into lungs to help them breathe. Like so many before her, this was Aleeshya's start in life.           

      Jamie hands me the sheet of paper that holds Aleeshya's information on it. "Anyway," she says. "You ready for report?"

      I flip over the paper and click my pen. "Yep. Go." Over the next fifteen minutes, Jamie summarizes Aleeshya's brief existence. I know most of it already.

      She was born at twenty-two weeks' gestation - essentially unfinished. For her entire life, we poked, prodded, infused, transfused, scanned, examined, stuck, and sliced into her. She's tenacious, persistently surviving each complication and intervention. Six months later, she has grown, but not improved. She is, in fact, worse. She requires mechanical ventilation to breathe. She has two large bleeds in her brain. She is blind. She is deaf. Recurrent infections and the antibiotics that cured them left her prone to fungal infections.

      A fungus came and formed a ball in her heart. She had surgery for that last week, which left her chest open but failed to remove the fungus. Complications like these are common in the NICU. For one baby to get them all, well, that's more unusual. We find the heart fungus particularly disturbing.

      We call her the Science Project; our moniker to distance ourselves from her. She is a glaring failure of how we've tried to help but made it worse. We know how this will end. But we can keep her alive, so we do.  

      Jamie gives me Aleeshya's treatment plan, her medications and lab schedule, and the day's details. "Her urine output is all but gone. Heart rate's down and so is her blood pressure," Jamie says. We stare at her monitors, which confirm the situation. "We're maxed out on pressors. We've cut her fluids as much as we can because of the low urine output."

      Commotion occurs beyond the screens. Faces peer around them - other night shift nurses. Everyone wants a glimpse of the Science Project. "She's still alive?" says Angie. "Oh, my God. She's huge."

      Gwen sidles in beside Angie. "You got the Science Project tonight? She looks pale," she says, her words harsh and clipped. "What are they going to do?"

      "Keep her alive," I say.

      Michelle, a respiratory therapist, is part of the crowd. "I can't believe she's still here". Michelle turns knobs and presses buttons on the ventilator. "I'm all for hope and miracles but this just looks like torture."

      "We passed hope a long time ago. Like two or three months ago," Angie says. We pause. That was about the time she ceased to be baby and she became our science project.

      My pen rolls between my fingers. "She can't possibly survive this," I say.

      "Should she?" asks Michelle. We cock our heads questionably. We've had this unspoken conversation for weeks.

      "I hope she's not in pain," Michelle says.

      "Her morphine is due in an hour," says Jamie.

      "Does it matter if it's early?"

      "Probably not," Gwen answers.

      Michelle strokes Aleeshya's cheek and gives us a sympathetic glance. "I can't believe they left her chest open," she says.

      "I don't know whether to be horrified or impressed that I'm looking at a living, beating heart," I answer. "You don't see that everyday."

"Doing compressions will be easy," says Pam. We stand quietly by Aleeshya, mesmerized by her heart - a damaged, beating fungal ball open to the world.

      "I heard there was a phone conference with mom this morning," says Gwen.

      Jamie answers. "Yeah. She's DNR now."

      "Good timing," Pam says. "Some nurses have been talking about going to the ethics committee."

      "For what?" I ask.

      "Withdrawing care," Pam says.

      "Aleeshya quit a long time ago; we refused to listen. We kept going. Now we're distressed, so now we say it's O.K. to stop?" I take a deep breath and sigh.

        We're silent, sharing the same thought that none of us want to say aloud.

She needs to die, but we don't want to tell you that.

        Someone else slips past the screen. This month's medical resident stands tentatively on the outskirts of our group. Her stethoscope is slung around her neck, and she shifts from foot to foot. This is her first night on call in the NICU. The doctors have changed. We have not. We've remained at Aleeshya's bedside, second by minute by hour, day by week by month; we've witnessed her slow decline.

        We haven't learned this doctors name yet. We ignore her, weary of another interloper and suspicious of new perspectives. Every month, fresh energy propels this experiment and we dread the continuation. The resident takes a step towards Aleeshya and pulls back. She looks at Aleeshya's monitor and scurries away.

        "I'm going to check on the other kiddo's," Michelle says. "I'll be back to suction her."

        "We'll be right here," I say.

        Pam leans over Aleeshya and caresses her head gently. "Go to the light Sweetie," she says softly. Everyone leans over to look at her once more. They brush past the screens as they file out.

        "Have a good night," Jamie says. Her mouth twists into a rueful smile.

        "Thanks. You back tomorrow?"

        "No."

        "See you later, then."

        "See ya."

        She closes the gap in the screen as she leaves. Its flat metal feet scrape the linoleum floor.

        It is the first week of December and the sun set four hours ago. Last week, the city's Grand Illumination kicked off the holiday's. White lights silhouette the downtown buildings. This will be Aleeshya's first Christmas. If she makes it.

        Alone with Aleeshya, I wash my hands and don a yellow barrier gown and gloves. I pause, lean up against her warming table and watch her. She is not the baby I remember from a month ago, and bears no resemblance at all to the active premature infant I helped into life six months ago, a tiny girl the color of café au lait, wide awake to her new world.

        Tubes grow from her head, mouth, arms, legs, chest, and bladder. She looks like a brown, bloated toad. She is sedated, but her face has a slight grimace to it. Her puffy eyes are squeezed shut, a dramatic contrast to the wide eyed-wonder of her birth. Her brown skin is pale and tinged yellow. Her tummy is hard, tight, and shiny. Droplets of fluid ooze from her skin. There is a one-by-two inch hole in her chest. Her tiny heart pulses hypnotically through clear flimsy plastic.

        I poise my stethoscope over the hole in her chest. Not there. I move it to the left of the plastic and listen. Her heartbeat is regular. Her lungs sound wet and coarse. I touch her leg. My finger dents her ankle.  

        I settle myself on the blue vinyl stool at her bedside and pick up her flowsheet. The flowsheet is heavy stock, printed on both sides. It folds out like an accordion. Patients get one flowsheet per day; Jamie's handwriting fills in the daytime. Mine will fill in the next four hours, adding to the rows and columns of numbers that document Aleeshya's existence and decline.

        I, too, participate in this experiment. I contribute with my care: I follow orders, enter data, and observe. I am an accessory to the situation. My vigilance keeps her alive, and my silence condemns her to this kind of life. We are all participants. We haven't advocated strongly; we haven't said forcefully enough that death, too, is an option.  

        The white screens surround us and the hum in our space is hushed. Outside, I hear the rest of night shift working. They're saving other babies - babies who will grow, get better, and go home. They're easing the passing of other babies who will die. I scooch the stool to the window to look at the lights and catch Aleeshya's reflection in the glass.

        What are you thinking Aleeshya? Do you know what a thought is? How could you? With those big head-bleeds on both sides of your brain, can you think? You've never babbled a word in your six-month life. Are you babbling now or are you screaming into your breathing tube? Are you drowning in all that sugary salt water that we pumped into you when we cut your chest open to get at your heart full of fungus?

        You're blind. You're deaf. You can't breathe. You can't eat. You can't talk. Your heart doesn't work.

        Your mother doesn't visit. Why are you still here? Why are we bothering? What is the point of you?

        Aleeshya's ventilator shrills. I look at her and check her monitor. Her oxygen saturations are 70% and her heart rate is 60. Both numbers are dropping. She is dying. Now.

        I jump up, my feet kicking the stool into the wall. "Hey, guys?" I say to the ceiling, loud enough for everyone to hear. "Aleeshya's coding."

        Michelle, Angie, Pam, and Gwen materialize immediately. Kristen and the anonymous resident appear shortly after. We circle Aleeshya's bed, gloving and gowning.

        "Heart rate's 60, 54, 53," someone counts.

        "BP 42/20," says Pam.

        "Angie," I say, "can you write all this down?"

        Aleeshya's monitors pierce, ping, and beep in time with her plummeting vital signs and warn us of her impending failure. Our fingers twitch to start chest compressions, open chest and all. She is DNR. All we can do is watch. We struggle, torn between the trained reflex to save her, and the human desire to let her go. Seconds later, she is gone.

        Kristen lays her stethoscope on Aleeshya's chest, just to the left of the plastic-covered hole. She holds Aleeshya's upper arm between her fingers. The plastic ceases its throb. The red and white lines that squiggled her heart rate and blood pressure lie flat.

        "9:02 p.m.," says Kristen, calling the time of death.

        Michelle disconnects Aleeshya from the ventilator. Pam and I unhook her IVs. Angie clicks off the monitors. Gwen turns off the warming table heater.

        "You want some help, Diane?" Angie asks. "Pam can watch my baby."

        "No, thanks. I got her."

        Someone audibly exhales. The experiment has ended. We don't have to do this anymore.

        They leave her to me and our corner is quiet again. I begin her post-mortem care with a bath and I plunge my gloved hands into the basin of warm water. Air in my gloves bubbles up a cushion between my hands and the latex. I run the washcloth down her arm. She feels firm but spongy, like a rotting cucumber. She is rotten, actually, and has been rotting for weeks, further proof this experiment should have ended much earlier.  

        Despite her spongy skin though, Aleeshya is hard, solid, and surprisingly heavy. Her illness, not rigor mortis caused this: her body, unable to make urine, saved fluid and stored it in her cells. When I turn her to wash her back, she lies like a rock in my hands.  

        I leave in the breathing tube and chest tube for the medical examiner. I replace the yellow ooze on her skin with lavender baby lotion and put a clean diaper on her. I take one last set of footprints, in case her mom wants them. I print her palms too. I swaddle her in a soft clean blanket.

        Aleeshya's eyes remain tightly shut, and her skin is taught, but she looks less clenched than she did two hours ago. I can see her better without the machines and wires that connected her to life. If I tilt my head and squint, she is a sleeping six-month old. She looks almost peaceful. Almost.

        I pick her up and rock her in my arms. I realize this may be one of the few times anyone has held her. She is still warm and smells of lavender. I carry her to the window. City lights twinkle in the distance.

        Pam pokes her head in. "You doing O.K?"

        "Yeah. I'm almost ready for transport."

        "Oh, my God. She's so pretty." I stop rocking Aleeshya. Pam ruffles the little girl's black curls.

        "I know," I answer. "We can really see her face now. I'll be done in a few minutes. Then I'll come help you guys," I say.

        "Take your time. We're O.K. out here."

        I return Aleeshya to her table. I wrap her snugly in another blanket. The white plastic body bag, made for a child, not an infant, is too big. I nestle her into it and fold up the bottom of the bag.  

        The wreckage of her area has my attention: stained sheet; strewn blankets; tape, scissors, and clamps; boxes of gloves and surgical masks, dangling IV tubing. I pack up Aleeshya's footprints and palm prints, her ID band, her hat, and her nametags for her mother. I fold away the white divider screens and prop them against the windowsill for housekeeping to clean. Another family enters the unit to visit their baby, two beds down. I hastily replace the screens.  

        An elderly man comes with a wheelchair. He will carry her body to the morgue. His name badge says "Leroy." I raise a hand to signal him I need a minute. He nods and waits at the unit door. I pick Aleeshya up and the body bag crackles. She is solid and heavy. I kiss the top of the plastic, where her head should be and embrace her a moment longer. I brought her into the NICU. I am bringing her out.

        Leroy drapes a clean hospital sheet over the wheelchair seat. I lay Aleeshya gently onto the sagging blue seat and cover her in white cotton. I squat to tuck her in and straighten the sheet. There is nothing left to do so I stand up.