She did. The warmth and pressure reminded her that Max thought they hadn’t done something lethally stupid, even though she suspected he was wrong.
Isaak and Batsa sat across from them in a booth and ate steadily. The hard, wooden seat was bruising her tailbone.
Batsa had stayed at the hospital a little longer to help if he could, and then he’d caught up with them.
He told them that yes, when he’d left, the baby was still alive. “They were pleased with her suckling response, and she had eaten two ounces of neonatal formula all by herself, not with a feeding tube. That is a very good sign. My premature daughter did not eat for herself for a week in the NICU.”
Isaak said to Dree, “The travel incubator you put together really was a stroke of genius.”
Dree shrugged and didn’t look up from where she was sopping up chicken chunks in tomato gravy with a piece of bread. “It was a stupid idea.”
Max said, “I don’t think it was stupid, and she might be okay.”
Batsa said, “The doctor seemed very pleased about her condition when I left. She doesn’t have a name yet. The mother didn’t tell her sister what she wanted to name her.”
A NICU doctor might be “pleased” with a preemie’s condition because half of their patients died or had significant brain damage. A nurse like Dree saw healthy babies all the time and could recognize a desperately endangered preemie when she saw one. That baby had a minuscule chance of survival.
Isaak said, “Whether this baby ultimately survives the ride or not, theideaof transporting a preemie in a warming cocoon is what’s important. All prototypes can use some refinement.”
“It wasn’t a ‘prototype,’” she said to him. “We weren’t in a medical device engineering lab running mathematical models of wind resistance and thermal insulation. We wrapped a premature baby in a frickin’ pashmina and drove her for hours on a motorcycle. I took a Hippocratic Oath, and today, I’m pretty sure I caused alotof harm.”
“She was alive,” Batsa said again.
“Not just for that baby,” Isaak said to her. “But like Alfonso was talking about, there are premature babies born in those villages all the time that probably would survive if they could be rushed to a hospital. If they are kept warm enough and got to a hospital in less than three hours, a heck of a lot more than twenty percent of them would survive.”
“But I won’t be there to do something so stupid and rash and take them on a damned motorcycle.”
Isaak reached over and tapped the back of her hand. “I don’t think you realize what you’ve invented. With the insulation, heat packs, and a wind-breaker outer shell, you can transport a preemie to a hospital instead of just letting them die.”
“But theycan’t,”Dree said. “Batsa knows. The reason that these people haven’t had medical care is that they don’t have transportation, and it’s a three-day walk to Chandannath. We can’t build a warmer that will last forthree days.”
Isaak’s bright blue eyes swiveled up, and he contemplated the water-stain on the ceiling. “We might be able to.”
“That’s it.” Maxence held a piece of bread pinched in his fingers. “Alfonso kept asking what we could do with his NICU micro-clinics. That’s not the right question. The right question to ask is,whyare we doing this? That’s therealquestion, thewhy.The reasonwhywe wanted to build those NICU micro-clinics is to save more premature babies. Therefore, our correct question is,how do we save more preemies?”
Isaak pointed at Max as punctuation.“That’swhat I’m trying to say. That’s what we need to ask,why?The way we save preemies is a transport capsule that’s a refinement of what you put together today, paired with an ambulance.”
“These villages can’t afford an ambulance,” Dree said. “It’s the same problem as with Alfonzo’s micro-clinics. The villages here couldn’t maintain a half-million-dollar ambulance full of computers and electronics. No one could drive it. It would fall apart and rust away.”
“Buta motorcycle,”Maxence said. “Motorcycles are simple to maintain and drive. That’s why the underdeveloped world has so many of them. It’s not just that they’re far cheaper and use a fraction of the petrol. It’s that people can be taught to fix them in a few days.”
Isaak nodded. “These villages could all use an ambulance motorcycle, anyway. There were so many of these cases that you treated over the last few weeks that should have been seen at a medical clinic. Plus, if there’s a disease outbreak or something, someone could travel to Chandannath to bring back help.”
Max nodded. “So, if the real question is how do we drastically increase the health and medical care in these villages, the motorcycle ambulance isalsothe answer.”
Dree blinked, but she just couldn’t get as excited as the guys. “Well, I’m glad I didn’t screw up too badly.”
Isaak reached across the table and jostled her shoulder. “You made something amazing out of spare parts, imagination, and love. You should be proud of yourself today. You gave that kid a fighting chance.”
Batsa nodded. “My parents told me about what life was like in their village before they left to go to America. The communities are strong, and they still miss their families and friends. That is one thing that we do not have in the United States, a strong community ethic.”
Dree nodded. “Yeah, I noticed that. No one came to the clinic alone. Even for a kid with a mildly infected cut, the mom arrived with three or more relatives or friends as backup. In the States, you get pregnant women driving themselves to the ER while they’re having contractions.”
“That would never happen here,” Batsa said. “There are always aunties and cousins and sisters around when a woman is in a family way. However, a motorcycle ambulance would be a blessing that would help everyone.”
Maxence said to Isaak, “We can begin writing grants tomorrow.”
Isaak said, “We can start delivery of ambulance motorcycles in a month or two. I can start working on schematics for Dree’s preemie pod tomorrow, too. Finally, it’s good to be an engineer. The heat pack will be tricky. I’m envisioning something that can be recharged in boiling water. I’ve got friends who are chemical engineers whom I can get in touch with when we get back to Kathmandu. We can have test models in production in a few weeks, and refined versions rolling out in a few months. This could change how premature babies are handled in all underdeveloped countries, not just Nepal.”
