Patricia A. Rolli is the PICU Clinical Coordinator at the Hospital Alvorada in São Paulo, Brazil*


In country after country pediatric Intensive Care Units (PICU) have undergone a major change since the start of the COVID-19 pandemic. Previously accustomed to humanized and family-centered care, PICU teams were comfortable with having families at the bedside, close to their loved ones, in addition to a liberal visiting policy. But now, in order to prevent spread of SARS-CoV-2, many caregiver and visitor restrictions have been instituted in children’s hospitals, including in the PICU

One day, as I started my morning shift in the PICU, the doctor who was leaving told me that a patient’s mother had expressed a desire to baptize her daughter. As visits had become more restricted and social distancing measures were strictly enforced, I thought that a baptism ceremony would be very difficult to perform. However, this mother’s request could not be ignored.

Our whole team of healthcare providers got involved and innovative ideas started to emerge to make the event possible in compliance with the current hospital rules. We decided to investigate the possibility of performing the baptism online.

Negotiations started to allow our little patient, who was just one month old, to be baptized. The first step was to convince a priest to accept performing the baptism ceremony virtually. The family went to a church in their community to ask a priest to perform the unusual ceremony, but she was met with closed doors. Not a surprise, since all churches were shut down as part of the pandemic response. However, nothing could stop the determination of this mother on a mission. Through a friend who was part of another church’s music ministry, she managed to reach a priest and plead with him to perform the event online. Even though this would be the first time that a virtual baptism would be held, the priest was touched by the situation and agreed to perform the ceremony.

Meanwhile, in the PICU, the patient had progressive abdominal distension, likely related to an intestinal sub-occlusion. Further diagnostic testing was necessary to determine if a surgical approach was necessary. But we still had enough time. We were all set for the baptism to happen via video conferencing on a cell phone so that the priest, parents, and the extended family could participate, albeit remotely, in the celebration.

To everyone’s relief, the ceremony went beautifully, with the PICU staff’s participation, all wearing their personal protective equipment. The whole ritual was also recorded. Luckily, during the celebration, in our busy unit, we had no codes, no unplanned extubation, no complications with other patients… everything was calm. It was an emotional experience for staff and gratifying to witness the happiness expressed on the mother’s face and the sparkle in her eyes. And we felt reassured that she felt relieved to have accomplished her mission of bringing blessings and the “Divine grace” to her daughter’s life, according to her beliefs.

In the following hours, the patient underwent surgery. However, her mother was encouraged and the whole procedure went well. Despite knowing that her daughter would still have to continue under observation and possibly having to undergo further procedures, the mother maintains an unwavering faith.

In the middle of this pandemic, despite all the barriers that existed, we were able to show compassion and honor our oath: “cure sometimes, treat often, comfort always”.

 

*Dr. Patricia Rolli wrote this article with input from her colleagues, Dr. Jose Colleti Jr., Chair of the Department of Pediatrics at the Hospital Alvorada in São Paulo, and Dr. Felipe R. de Oliveira, a senior consultant in the PICU at the Hospital Alvorada in São Paulo, mentored by Dr. Daniel Garros, Clinical Professor of Pediatrics in the Department of Critical Care, at the University of Alberta and Stollery Children’s Hospital in Edmonton, Alberta.

Editors’ note: The author obtained consent from the patient’s family and the priest to publication of this story.