The call came in the middle of a busy night
as we worked on a floppy baby with high fever,
a croupy toddler whose breathing squeezed and squeaked,
a pale adolescent transfusing due to leukemia bleeding.

It was an anencephalic baby just born, unexpected, unwanted
in a hospital across town, and she needed a place to die.

Our team of three puzzled how to manage a baby without a brain —
simply put her in a room, swaddled, kept warm but alone?
Hydrate her with a dropper of water to moisten her mouth?
Offer her a taste of milk?

She arrived by ambulance, the somber attendants
leaving quickly, unnerved by her mewing cries.

I took the wrapped bundle and peeled away the layers
to find a plump full term baby, her hands gripping, arms waving once freed;
just another newborn until I pulled off her stocking cap
and looked in an empty crater – only a brainstem lumped at the base.

Neither textbook pictures nor cruel jokes about frog babies had prepared me
for the wholeness, the holiness,
of this living breathing child.

Her forehead ended above her eyebrows with the entire skull missing,
tufts of soft brown hair fringed her perfect ears,
her eyelids puffy, squinting tight, seemingly too big
above a button nose and rosebud pink lips.

She squirmed under my fingers, her muscles strong, breaths coming steady
despite no awareness of light or touch or noise.

Yet she cried in little whimpers, mouth working, seeking,
lips tentatively gripping my fingertip.  A bottle warmed,
nipple offered, a tentative suck allowing tiny flow,
then amazing – a gurgling swallow.

Returning every two hours, more for me than for her,
I picked her up to smell her salty sweet amnion smell
as she grew more and more dusky.

Her breathing weakened, her muscles loosened, giving up her grip
on a world she would never see or hear or feel to behold
something far more glorious, as I gazed
into her emptiness, waiting to be filled.