Abstract
Student sonographers often ask what special talents or training are needed to become a pediatric sonographer. Instructors want to provide a prescriptive answer, but in essence, it is usually a life journey and personal experiences that point a sonographer in that direction. Such is the case of the journey of Robyn Natchtigall, ACS, RDCS, and this is a huge part of her calling to becoming a pediatric sonographer.
In our new hospital-based sonography program, we had 84 applicants for 14 admitted slots in the student cohort. When Robyn Natchtigall walked into the room and had her interview, we asked her a set of questions. One of the questions was, “Why do you want to be a sonographer?” She said, “Well, this is very personal to me. I had childhood cancer and had several echocardiograms during my chemo treatments. The sonographers were very kind, and early on, I knew this is what I wanted to do.”
When she finished this sentence, she paused and smiled. It was the very moment that our lives would forever be changed.
Robyn has a very unique smile, with a slightly crooked grin. I looked at her, and time stood still. It was in that moment that I knew that I had performed many of her echocardiograms as I worked at the Children’s Hospital at the same time she was going through her chemo treatments. I had to compose myself to listen to the rest of her interview. But after she left the room, I told the rest of the interview panelists that I recognized her smile and that I remembered caring for her as a child during her cancer struggle (Figure 1). She lost her leg but not her drive. I knew she would be a highly successful sonography student and also a dedicated pediatric sonographer in our cardiac echo laboratory.
Robyn has a thirst for knowledge and a quiet, respectful, and sweet demeanor. We could all use her as an example of how to treat other people. She successfully completed our adult echocardiography program and our pediatric echocardiographic program. Upon her graduation, our hospital saw her great potential and hired her as a full-time pediatric echocardiographer working directly beside me, day by day. During this time, she got married and delivered her first child, Ryan. She had exceptional sonographic skills and knowledge base and yet still strived for more. She entered the inaugural class of our first advanced cardiac sonography program. The skills that she learned in this program have propelled her to the most senior pediatric/fetal echocardiographer within our entire organization. She also passed the very rigorous ACS exam.
Robyn as a child during chemotherapy treatments posing with her mother and the nursing staff.
Her doctors warned her and her husband that children may not be a possibility due to her history of chemotherapy, but they had Ryan, so they started trying for a second child. One miscarriage after another occurred, leaving her wondering her fate. Finally, she became pregnant again, and I had the honor to scan her at about 18 weeks. It was a little girl! I looked at her fetus up and down, and the anatomy was absolutely perfect. This was a dream come true for Robyn, her husband, and for us, her colleagues.
Robyn was 20 weeks and 6 days, and it had been an extremely busy workday. We were all exhausted from this particularly hectic schedule. She mentioned to me she had had a little leak but no pain. I reassured her that this was common in pregnancy, but since it was Friday, we did a sonogram to make sure she did not need to go to her doctor. To my shock, her cervix was completely funneled and measured 1.1 cm. I asked her to wait there, got a wheelchair, explained the gravity of her condition, and quickly took her to the labor and delivery department. I called one of our perinatologists to determine what the next steps were and notified them that Robyn was being taken to labor and delivery triage. They admitted Robyn but said at this time the pregnancy was “previable,” so they decided to send her home and to readmit at 23 weeks at the hospital. This seemed like a very long wait time for Robyn and for our very worried staff. Robyn was admitted to our hospital at just over 22 weeks’ gestation because she had started to dilate and contract.
Due to HIPAA, we had no access to what happened next, but our pediatric echo team huddled and prayed. We just kept hoping that we would see baby girl Nachtigall-Hill on the NICU roster. Within an hour, baby Regan was born at 22 weeks 6 days at 1 lb. 7 oz. We were elated she was born and had survived but so scared she might not continue to thrive. Robyn, once again, showed tremendous strength and left it in God’s hands. Robyn and her husband Rob wanted to give their baby every chance to fight. I have never witnessed such a collaborative effort in trying to save this tiny miracle baby. Our neonatologists, nurses, surgeon, respiratory therapists, and the entire NICU staff worked tirelessly to save our little Regan.
Robyn asked me to personally do all ultrasound procedures or echocardiograms that Regan might need. I washed my hands a million times and prayed every time I touched her. My personal history of being a premature infant resonated, and I knew this baby could survive. I knew within myself that little Regan could fight and win (Figure 2).
Joy holding Regan’s hand prior to her first echocardiogram.
Despite having a bowel perforation that was repaired without a colostomy (our great surgeon), grade 1 only bleed in her head, and persistent PDA, she kept thriving. She was off and on the ventilator, which sent all of us into panic. But through all this, her mother Robyn remained composed and strong. As it turns out, her daughter was following in her mother’s footsteps—such courage and grace.
Robyn even got to perform one of Regan’s echocardiograms prior to her discharge from the hospital (Figure 3).
Robyn performing Regan’s echocardiogram prior to her discharge home.
This past month was Regan’s first birthday. Regan did not have a significant brain bleed, is meeting her milestones, and is left with only a G-tube. Her mother is the bravest, kindest, most knowledgeable, and resilient person I have had the privilege to know (Figure 4).
Regan at birth in the NICU and at the time of her first birthday. Happy birthday, Regan!
As we continue to deal with the adversity of COVID-19 and all the changes that it has caused in our personal and professional lives, we can learn a lot from Robyn. She embodies grace and stamina in the face of a multitude of personal and professional challenges. As my patient, student, and coworker, it is easy to see how she keeps focused on finding success. In pediatrics and all specialties in our field, we need to recognize our heroes and use them to motivate our future sonographers. I stand in awe of Robyn Nachtigall-Hill, ACS, RDCS, my hero and the strongest woman I have ever met.
In this trying time for all our sonographers, faculty, and students, we need to focus on success and those unique characteristics that make being a sonographer so special. What does it take to be a pediatric sonographer? It takes grit, determination, and a drive for success! Robyn and Regan, we salute you!