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Waiting for Alex

BMJ 1994; 309 doi: (Published 17 December 1994) Cite this as: BMJ 1994;309:1666
  1. James Rankine

    “Can you come and look at this baby? He's not quite right.” This sounds ominous. I am a junior paediatrician, it's the middle of the night, and senior colleagues are where I long to be—far away tucked up in bed. I enter the delivery room. The parents look subdued. The baby is oblivious, energetically having his first feed. Silently the mother plucks him from the breast and passes him over to me. He looks healthy enough, resplendent in a hospital property gown, all traces of a bloody passage into the world washed away. But those oblique eyes that are intently scanning my face, that flat nose, and rather squashed head. Now is not the time to prevaricate with talk of chromosomal analysis, the porter could diagnose this one. This baby has Down's syndrome.

    No amount of medical education can prepare you for moments like these. I manage as best I can, discussing a diagnosis that the parents already half suspect. The father asks about adoption and I wish even more that I was somewhere else. I pass the baby back to the mother who cuddles him. As I leave the father follows me out of the room. “So what will happen …

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