“Your staff seemed a bit chatty this afternoon,” I told the assistant nurse manager in our Neonatal Intensive Care Unit. “Oh, what seemed to be on their mind?” “Hope.”

“Well, chaplain, hope’s a good thing, right?” she asked, puzzled at my look of concern. “I’m hoping so,” I said, risking a bad pun to fill a difficult moment. “But if you have a minute, I’d like to say more.”

Stephanie shoved a chair in my direction. “It’s about our ECMO baby,” I said. ECMO (pronounced EK-MO) stands for Extracorporeal Membrane Oxygenation therapy. We use it to help babies suffering from severe heart and lung failure. ECMO essentially acts as a temporary heart/lung machine and gives the heart or lungs some rest so they can heal. It’s used as a last resort when a baby isn’t responding to conventional treatment.

In other words, we use ECMO when there isn’t much hope. And when this baby arrived on our unit three days before, no one was looking for much hope. She’d been transferred from a hospital across the state where she’d come hoping to fight an infection that was quickly robbing her heart of any chance of sustaining life. She brought two nurses in tow and was rushed into our NICU where a sterile field was readied for the insertion of the tubes into her neck that would pull the blood from her body and oxygenate it in place of the lungs. During this procedure, I sat with the parents outside our NICU. The mother’s shoulders heaved in reaction to the unspeakable news. This healthy baby that the parents had brought home only a month prior was now the subject of a discussion between doctors about the possibility of a new heart.

However, over the next three days, pediatric and neonatal nurses worked together to attend every need of the baby. They worked double shifts, communicated closely with doctors to make each and every minor adjustment and never blinked. Now as the assistant nurse manager and I sat talking, hope was seeping into our neonatal unit. Nurses were wondering aloud whether they should be nurturing the hope or suppressing the hope.

Nurses were showing “cautious optimism” as the echocardiograms were indicating steady improvement. Now our staff was struggling with their feelings, wondering, dare we hope? And even, for what should we hope?

Sometimes we can only hope that people will find the resources to make it though the tragedy. Sometimes we hope that the difficulty will not be a long one and that demands from the family every resource that they have – financial, social, and spiritual.

The truth is that what we hope for is most often tied to what kind of faith we have. But does hoping for anything less than a perfect outcome reflect a lack of faith? Writing to a group of Jews who had lost hope because of Roman occupation, the unknown author of the Biblical book of Hebrews suggested that hope had such a close relationship to faith that faith was literally, “the substance of things hoped for, the evidence of things not seen.”

For a week, this baby had a deep and unseen infection. Evidence was not in favor of a good outcome. Yet, for several days parents and nurses prayed and hoped for an outcome that seemed contrary to medical evidence. Eventually, as the tests began to indicate improvement, the staff and parents saw the evidence of the things for which they had hoped. And it was that “evidence of things hoped for” that brought the doctors to remove the baby girl from all external support and return a healing child to the arms of her parents.