Shaken Baby Syndrome (Hum Magazine, November 2012)

By Arjune Rama, MD

I have never shaken a baby. I will never shake a baby. Until we had our own child I considered people who have caused Shaken Baby Syndrome to be some of the lowest examples our species has to offer. I used to think to myself, “What kind of animal could shake a baby so hard that she bleeds into her brain?” However, I am starting to understand why people do it. Although I neither accept nor endorse it, I recognize that the situation is more complicated than I once thought.

Considering that babies scream despite having been fed, changed, walked around, bounced, hugged, and kissed, I am amazed by how rarely parents talk about just how furious our babies can make us. I think about it frequently, especially in the context of the horrific level of global child poverty. I marvel at our daughter’s fortune to have been born into a family that desperately loves her and wants to provide her with everything. I hear myself angrily thinking, “How dare she treat us this way? Does she know how lucky she is?”

Those angry feelings sharpen to a point when her cry suddenly cuts through the quiet of our all-too-short nights. The English translation of that cry is, “Tomorrow your twelve-hour work day will be a groggy-eyed waking nightmare.” As the cry shifts into a throaty scream, in my half-awake/half-asleep state I feel a slowly growing animus bloom inside me. While I try to intellectualize away the possibility of hurting her, hardwired human feelings like desperation, hopelessness, and anger are frighteningly difficult to keep at bay. Nothing breeds desperation like hopelessness. And nothing fuels anger like desperation.

Perhaps surprisingly, I believe that this anger is directed much less at our baby than at myself. In these 4.00 a.m. confrontations I experience feelings of aggression in direct proportion to my perception of personal failure at the most important job of my life. In those moments I feel like my love is not enough or that if I were stronger or smarter, she would not be crying. As a physician training in psychiatry I thought that I would be better equipped to successfully navigate the emotional waters of childrearing. I could not have been more wrong. Although I am trained to manage my emotions in the context of a doctor-patient relationship, the degree of parental closeness I have with my daughter renders me unable to use my background in any meaningful way. In these tense situations, she is like a boxer who constantly clutches her opponent so tightly during a bout that both fighters are immobilized.

Shaking a baby is child abuse, criminal, and unacceptable under any circumstances. However, I believe that the anger from which it stems is not so inaccessible to even the most loving parent. I realize that we live in a climate of childrearing wherein whole sections of bookstores are dedicated to the craft and hours of armchair wisdom are seemingly available from every family member, friend, and grocery store clerk. While I do not intend to add to that forest of writing or earfuls of anecdotes, I would like to propose a single simple bit of advice that I use before I step into my daughter’s room in the middle of the night during a maddening crying jag. I remind myself that I come first. I love myself first. I realize that these statements are anathema in a world that screams, “Your child comes first!” However, if I can’t love myself despite my well-intentioned attempts to satisfy her frequently insatiable level of need, then I can’t really love her either. It’s like being on an airplane. In the event of an emergency landing, we are asked to secure our own masks before assisting others. If I tried to secure her mask first, I might not last long enough to do much of anything on her behalf anyway.