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(p. 3 of 5)

INT--NEONATAL INTENSIVE CARE UNIT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT

DUPREE (V.O.)

The NICU. Where a success story is a baby who's healthy enough to cry.

DUPREE and several other NICU NURSES work in a nursery. The tiny PATIENTS are dwarfed by the array of MACHINERY keeping them warm, monitoring their condition, and dispensing fluid, nutrients and medication. Several PARENTS are also there.

DUPREE punches buttons on a monitor attached to one of two premature twin BABIES in the same incubator. Unsatisfied with the results, he turns to KELLY MALONE, a nurse nearby.

DUPREE

Kelly? Have they been having trouble with this monitor?

MALONE

Let me check it out.

MALONE comes over, looks at the monitor and into the incubator, reaches into the incubator and turns the stopcock on the arterial line of one BABY, hits a button on the monitor, then turns the stopcock on the art. line back.

MALONE

You have to re-zero the art. line.
(Pausing.)
Is it true you were a medic in Afghanistan?

DUPREE

Yes, Ma'am. 10th Mountain Division.

MALONE

You don't really seem like...I mean, I just wouldn't have...

DUPREE

Not everyone has your gaydar, Miss Kelly.
(Shrugging.)
They didn't ask. I didn't tell. Not much of a relationship, I guess.

MALONE

Were you in long?

DUPREE

Four years. It's a Dupree thang. Most of my family's in. Freedom ain't free, honey.

MALONE

Of course. I didn't mean...
(Pausing.)
Are you free, Trent?

DUPREE

Relatively. No.

MALONE

And being a medic, how was that?

DUPREE

Okay. Could get a little weird, savin' people's butts for an organization dedicated to kickin' 'em. But that's how Florence Nightingale got going with the British Army, guess it was good enough for me. I also learned that healing takes many forms.

EXT--BAGRAM AIR BASE, EASTERN AFGHANISTAN--DAY

On a dusty air base with a runway in the distance, military vehicles rumble past heavily armed Operation Enduring Freedom COALITION SOLDIERS, who move with a grim sense of purpose. Among other military buildings stands a FIELD HOSPITAL.

INT--FIELD HOSPITAL, BAGRAM AIR BASE, EASTERN AFGHANISTAN--DAY

Inside a large, open, dimly lit ward filled with cots and health care equipment. DUPREE, his upper body framed by a surgical lamp, lip syncs the first verse of Queen's "We Are the Champions" alone, using a stethoscope as a microphone 6.

The lights FLASH ON. DUPREE is surrounded by a group of COALITION SOLDIERS (including the wounded) and wounded AFGHAN SOLDIERS who all join in the chorus of the song.

INT--NEONATAL INTENSIVE CARE UNIT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT

MARCIA HAWK, the NICU's Clinical Nurse Specialist, approaches DUPREE and MALONE from across the nursery.

HAWK

Hi, Kelly.
(To DUPREE.)
Are you Trent?

DUPREE

Yes, Ma'am.

HAWK

I'm Marcia Hawk.

DUPREE

You're the Clinical Nurse Specialist. Great to meet you. I didn't think you'd be back this soon. How's your new baby?

HAWK

Guess I'll sleep when I'm dead. But he's great. Anyway, I wanted to give you a little more background on the twins before Mrs. Sanders gets here.

HAWK and DUPREE turn to the incubator which holds the two tiny SANDERS BABIES, KIM and ROBERT.

HAWK

They were delivered yesterday, a section at 30 weeks, 1,280 and 1,400 grams. They're fairly stable, but Kim's O2 sats drop intermittently. Mrs. Sanders has three others at home, and based on her history and what's happened here, she's at risk for postpartum depression. We're doing co-bedding, breastmilk per tube gavage, and kangaroo care.

DUPREE

Got it. She's coming for some kangaroo care tonight?

HAWK

Right. We've gone over the basics, she just needs some reinforcement.

RHONDA SANDERS, clearly still an inpatient at the hospital, enters and approaches HAWK and DUPREE.

SANDERS

Hi.

HAWK

Mrs. Sanders, how are you feeling?

SANDERS.

OK. Tired.

HAWK

I bet. This is Trent Dupree, he'll be the twins' nurse on the night shift.

DUPREE

Hi, Ma'am.

HAWK

Ready for some more kangaroo care?

SANDERS

I'll give it a try.

In the incubator, the SANDERS TWINS vibrate slightly from their high-frequency ventilators. Wires are connected to heart monitors and there are O2 sat. monitors, IV's and art. lines. HAWK reaches in, moves the chest electrodes to one BABY’s back, and carefully lifts the BABY out, as DUPREE manages the ventilator hose and wires and lines so nothing pulls out. HAWK helps SANDERS put the BABY under her gown, directly against her chest. HAWK and DUPREE perform this same process for the SECOND BABY, helping arrange the TWINS side by side on SANDERS’ chest. HAWK gives SANDERS a cloth to wrap around the three of them.

SANDERS

They’re warm!

HAWK

They’ll stay that way, as long as they’re skin-to-skin.

As DUPREE guides SANDERS into a chair next to the incubator, a MAN in his early sixties wearing a business suit under a white lab coat enters the nursery. He is WILLIAM OGDEN, SANDERS' longtime family pediatrician.

SANDERS

Dr. Ogden!

OGDEN

Hello, Rhonda. Is this...
(Noting all the paraphernalia attached to the infants under SANDERS' gown.)
What're you doing?

HAWK

I don't think we've met. I'm Marcia Hawk. And this is Trent Dupree.

OGDEN

Dr. Ogden. I'm Mrs. Sanders' pediatrician. I worked here years ago and have full privileges. Dr. Kenner's an old friend of mine.

HAWK

I'm the Clinical Nurse Specialist here in the NICU. Mrs. Sanders is giving the twins kangaroo care.

OGDEN

Ah...yes. But I'm afraid it's not appropriate here. You can go ahead and put the babies back.

HAWK

Why do you feel it's inappropriate?

OGDEN

Well...the pneumograms are going to include Rhonda's respiration. We won't get the apneic pauses.

HAWK

We have the chest electrodes on their backs to reduce that problem. And the temperature, heart rate and O2 sat. readings aren't compromised.

OGDEN

Is that so? And you're willing to take the risks of bradycardia, hypoxemia, and critical heat loss in intubated 30-week infants one day after delivery?

HAWK

We're monitoring the heart rates and the blood oxygen. And recent clinical trials show preterm infants maintain body warmth for hours of kangaroo care.

OGDEN

And what do you expect to achieve, in exchange for taking those risks?

HAWK

Well...decreased mortality, better weight gain, higher exclusive breastfeeding rates, better emotional and cognitive development, better maternal-child bonding--

OGDEN

That's all very nice, and this may be advisable at some point. But these babies aren't ready.
(To DUPREE.)
Mrs. Sanders will need some help putting the babies back.

HAWK

May I speak with you outside?

OGDEN

(Hesitating.)
All right. I'll be right back.

HAWK and OGDEN walk outside. SANDERS and DUPREE remain.

SANDERS

What should I do?

DUPREE

I think you should sit tight, Ma'am.
(Gesturing at the monitors.)
The twins are doing just fine.

HAWK and OGDEN stop just outside the nursery.

HAWK

Dr. Ogden, kangaroo care's well tolerated in infants like the twins. And here...it could be especially helpful. At least one study suggests it can lessen maternal depression.
(Hesitating.)
I assume you're aware Mrs. Sanders is at risk for postpartum depression.

OGDEN

What are you talking about?

HAWK

This is based on her reports about her emotional state, past pregnancies, the support situation at home, and her coping methods. But her symptoms of depression have improved since we started kangaroo care--even in one day.

OGDEN

Thank you for your concern. But for now, it's out of the question. The twins are simply not stable enough.

OGDEN starts to return to the nursery.

HAWK

Doctor, technology isn't the only basis for effective neonatal care.

OGDEN

These babies deserve science, not a poor substitute developed in some backwater country where they can't afford incubators, where was it?

HAWK

Colombia.

OGDEN

And I'll tell you something else--time was when a nurse would stand when a doctor entered the room, not question his professional judgment.

As OGDEN finishes, a man in his fifties wearing a shirt and tie under a lab coat approaches. He is MARTIN KENNER, the Chief of Pediatric Medicine.

KENNER

(To OGDEN.)
Bill! What're you doing here, old man?
(To HAWK.)
Marcia.

OGDEN

Just checking on a couple patients. Free for a drink later?

KENNER

Come by the office in an hour, we'll stop at the club. Or come with me now, you'd be interested in this patient--transposition of the great vessels.

KENNER starts to move on.

OGDEN

Say, Marty. Quick consult. There's been a suggestion we do this...kangaroo care on my patients, twins born yesterday at 30 weeks, both on ventilators. Strikes me as quite premature to be hauling them out of the incubator, risking respiratory and heart problems--

KENNER

I hear you, Bill. But it's no problem with monitoring, we do it all the time. Talk to Marcia here, she's the expert.

KENNER leaves. OGDEN watches him go.

INT--THE BURNING EMBER, BALTIMORE, MD--DAY

The five NURSES at the back of the bar are smiling.

DAY

Hey Jamila, are you late? What time do you have to be in?

SMITH

Not till 8:30. I have a few minutes.

MENDEZ

How you guys doing over there anyway?


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