In the autumn of 2011, Dr Suzanne Crowe was sitting in an uncomfortable, plastic chair in the neonatal unit of a French hospital.
Beatrice, her tiny newborn daughter, was lying in an incubator beside her. She had wisps of red hair above her small ears. Crowe remembers looking at her fingers and toes.
It had been a difficult labour, with Beatrice arriving prematurely at 23 weeks during a family holiday to France. Despite this, they were optimistic, discussing what they would do when they could finally bring their youngest baby home.
Crowe says she didn’t have “an inkling” that things weren’t turning out like she hoped. Until one day, when a doctor came into the room and there was a “change in the atmosphere”.
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The conversation, Crowe says, is one of her “clearest memories”. The doctor looked uncomfortable, she recalls, and asked her a number of times if her husband was nearby. He was in Dublin caring for the couple’s three other children at the time.
“She was kind of horrified and I could see that on her face. She didn’t actually say a lot, but I do remember very clearly she used the expression, which was ‘we see only a dark future for Beatrice’.”
The phrase, though she had never heard it before, really “landed” with her, she says. “In very simple terms, she painted an entire landscape of what life might be like for us and for Beatrice, and where she thought that things were going to go.”
She called her now late husband Barry. She cannot remember what she said to him over the phone; she probably just cried, she says. He flew over to join her as soon as he could, so they could say goodbye to their 19-day-old child.
In her memoir, Intensive Care: True Stories of Healing, Heartache and Hope from Inside Irish Children’s Medicine, Crowe describes that moment vividly, as if it has been etched into her memory.
Most people who work in healthcare would acknowledge that you probably do need to be a patient at some point. In order to see what life is like as a patient
“Barry and I held Beatrice together until her heartbeat slowed and faded away. It was short, and yet it was long. It could never be long enough, and I wish she were here now, but it happened as it did. Nothing can change that,” she wrote.
“As her mother I had felt her growing inside me, I heard one tiny cry when she was delivered, and I held her close on her last day.”
Throughout her book, the paediatric doctor speaks eloquently about the many patients who have had a profound impact on her. This year will mark 30 years since she qualified, during which time she estimates she has cared for about 80,000 people and their families.
Many of those patients and experiences “really changed my perspective”, she says, but none more so than the loss of her own child.
The memoir is an honest account of grief, but it also explores the complicated feelings many women can have when experiencing an unplanned or perhaps initially unwanted pregnancy.
When she first learned she was pregnant with Beatrice, it came as “an absolute shock” to herself and her husband. She was getting older, had had “difficult experiences” with her previous pregnancies and she “did not want to be pregnant”.
Throughout the course of her pregnancy, Crowe’s hesitation dissipated, replaced by excitement and love for her unborn child. When Beatrice died, however, Crowe battled with intense guilt over her initial reaction to the news.
In the throes of her grief, she remembers constantly picturing Beatrice’s little body in the French hospital’s mortuary, followed quickly by thoughts of blame that she hadn’t wanted her in the beginning.
“The fact that that whole mix of emotions had gone on in addition to her passing away meant that my head was just a complete mess. That led to a very difficult grief reaction. Now I have a lot more understanding around it. But it’s only taken me 13 years to process the whole thing,” she says with a smile.
At the time of her daughter’s death, Crowe says she was quite “old fashioned” when she thought about grief, and that you had to “just get over it”.
Her memoir is the first time she has spoken publicly about this loss. Until now, Crowe says she wore Beatrice like a secret; an “amulet that you hold close to your heart”, but now she is ready to share her story.
“We don’t talk about child loss a huge amount, and it’s hidden in a lot of families. I kind of thought, well, if I did speak about it, it might help other people to see that, in fact, you don’t have to get over it in many ways,” she says.
There remains a bridge between my experience with Beatrice and my love of caring for sick children
“You can continue the bond and you can create a really powerful meaning for you. You don’t have to express that to other people, but you take the pain of whatever happened, the loss, and you create a meaning that’s very individual for you, and perhaps actually helps you to kind of do good things.”
After her passing, Crowe knew she wanted to give her daughter’s life and death meaning. It was, she says, one morning near the end of her maternity leave when she was sitting on a rowing machine in the gym when she suddenly knew exactly what to do: return to paediatric intensive care.
Before this, Crowe had worked for many years in anaesthesiology, having worked full-time in children’s healthcare a decade earlier. Using Beatrice’s death to make a difference among other families was like a “lifeline” in those dark days, she says.
“There remains a bridge between my experience with Beatrice and my love of caring for sick children and children at the end of their lives. They are inextricable and one could not exist without the other,” she wrote in her book.
She was somewhat apprehensive in the beginning that working with sick children might trigger her own grief. Premature babies, in particular, were something she was anxious about. But actually, she found, it was therapeutic in many ways.
“One situation I can remember was looking after a child who just happened to have the exact same date of birth as Beatrice. So there was this little girl right in front of me. She even had red hair and Beatrice had a little bit of red hair,” she remembers.
“Now, she needed my help, and I obviously had to get on and do the job, but inside I was absolutely floored by that. That really, really took the wind out my sails.”
Each chapter of Crowe’s book opens with a quotation. One such quote is from American physician Dr Francis W Peabody, which states: “The secret of the care of the patient is in caring for the patient“.
This, Crowe says, is something she has taken with her throughout her career, particularly since she was on the receiving end of the doctor-patient relationship.
“I think most people who work in healthcare would acknowledge that you probably do need to be a patient at some point. In order to see what life is like as a patient,” she says.
Now, she says, she advocates for much more patient-centred care. Kindness in healthcare is incredibly important, she argues. And when looking after children nearing the end of their life, if she cannot help them live, then she believes it is important to give them “a good death”.
“The mortality rate in children’s intensive care is actually very low. But a good death is really important and helps you come away from that experience with a greater sense of peace. So the death itself isn’t distressing,” she adds.
Beforehand, Crowe, who is also president of the Irish Medical Council, believes she had been practising medicine with a more “traditional” approach of keeping her “emotions buttoned up”. But in recent years, she has become much more comfortable with showing emotion in appropriate ways.
“It doesn’t actually dilute our focus. If anything, I actually think it makes it much better, because we are all there fighting so hard, fighting, fighting, fighting, for what is really important,” she says.
“We, as doctors, we should kind of lean into it a little bit more, patients like to see the humanity of the doctor.”
But Beatrice wasn’t the only loss Crowe has suffered in recent years. Her husband of 20-years, Barry, died suddenly and unexpectedly in May 2019. Last year, her father died aged 83.
Each of these losses were different, she says, and affected her in different ways. But one thing that unites all three of them is how they illustrate the brevity of life and the importance of family.
“I definitely wouldn’t be who I am today without having experienced all of that. Life is so short and nothing’s guaranteed, so it’s kind of looking at the broader pictures as opposed to focusing on the daily things that can get us down,” she says.
“The big thing is just relationships, just really cultivating your warm, close relationships. That’s what makes the difference.”
Intensive Care: True Stories of Healing, Heartache and Hope from Inside Irish Children’s Medicine is published by Hachette
