Kyle Cook and Carla Saunders are neonatal nurse practitioners at a children's hospital in Knoxville, Tenn., where they've spent decades caring for infants. In the summer of 2010, their jobs began to change.
"We had six babies in the nursery who were in withdrawal," Saunders, 51, remembers.
The babies were inconsolable. They had tremors. "We couldn't fix it; we couldn't make these babies better," says Cook, 53. "Little did we know that was the tip of the iceberg. We had 10, and then 15, and then, at one point, 37 babies in the NICU that were withdrawing. We were bursting at the seams."
"We were completely unprepared and short-staffed," Saunders says. She remembers a nurse in tears holding a screaming baby. "We have got to do something," the nurse practitioner said, because what they were doing wasn't working.
Their small children's hospital in east Tennessee was at the time emblematic of the substance abuse problem happening all over the U.S. "And so we went looking to the experts, you know, let's call across the country, and let's find out what's the best way to treat these babies," Saunders says.
They discovered that nobody knew. "And who knew that we would become the experts?" Cook says.
The nurse practitioners wound up helping to establish one of the first treatment protocols for babies exposed to opioids and a program connecting mothers with treatment and therapy.
"When you see a baby, especially one that has been in your care for a long time, that has been off the charts in withdrawal, and you've done everything you possibly can and you finally get this baby acting like a normal baby, and then he smiles at you, and to know that you've made a difference in a mother's life — I mean, that will carry you through the darkest times, knowing that, my gosh, we did this," Clark says.