The Noisy but Silent Life of Annabelle Vital
Life and Death in the NICU
“Beep. Beep. Beep,” the pulse oximeter warns. “That’s 13; she’s having a rough day,” Nicholas calls casually from across the room. I respond, “I’ll turn up the vent, but there’s not a lot more I can give her.” #13 didn’t have a name. Born so early–23 weeks 5 days gestational age–her parents haven’t had time yet to choose a name. For now, her name is a number, the number of her NICU incubator.
13’s parents, Carly and Derek, are thunderstruck. Her early days balance on the threshold of death. Like a melting clock in the middle of a mysterious desert, 13’s life is surreal, dissolving toward an end so tragically close to her beginning.
Time is slipping away; time is difficult to measure. For Carly and Derek, time bleeds into time.
For 13, the bleeding is even worse; it is in her brain.
Sitting with 13’s parents, I try to comfort them as they await an update from Dr. Richards. “She’s having a good day,” I say, smiling warmly at Carly and Derek.
“Is she?” asks Carly nervously.
“Yes, her oxygen levels are stable and she’s been very peaceful.”
Carly and Derek look at each other, smile, and hold hands gently. Just then, Dr. Richards aggressively opens the door and thrusts himself inside, sitting down in a forceful manner, launching in, gravely: “Nurse Rosaline, Mr. and Mrs. Vital, the results of the brain scan are back.” Carly and Derek tense in their seats. “Intraventricular hemorrhage, this bleeding occurs in your brain’s ventricles, which are specific areas of the brain where your body makes cerebrospinal fluid–fluid that protects your brain and spinal cord.”
Carly and Derek are speechless.
Richards goes on in an affectless tone: “IVHs are graded levels 1 to 4, with 4 being the most severe. Your baby is level 3 on the right side, which controls the left side of the body and level 4 on the left, which controls the right. Your child’s brain–its matter–has been damaged, changed.”
“What will happen to her?” Carly asks.
Doctor Richards replies slowly, cooly: “We cannot predict how this will change her. We don’t know what she will be. When the brain bleeds in an infant, the possibilities are endless.”
“Will she survive?” asks Carly.
“Beep. Beep. Beep. Paging Dr. Richards, Dr. Richards,” suddenly squeals through the tiny room.
Dr. Richards stands up abruptly and excuses himself. I am left alone with grieving parents.
“The possibilities are endless,” Carly whispers to herself.
I quickly jump in to comfort them: “What Dr. Richards means is that we can’t know your daughter’s future, but we have to tell ourselves that one of the possibilities is that she’s going to be just fine.”
Carly and Derek smile unenthusiastically.
Controlled by tubes, ventilators, and IV lines,13 is a helpless, suffering infant, and none of us know if she’ll survive or not.
After my shift at the hospital is over, I head home and open the door. Simon purrs and prances between my legs. I scoop him up, clutch him to my chest, and then suddenly I see tears falling onto Simon’s fur. “Goddammit!” I whisper to myself.
I draw a warm bath and lower my tense body into it.
Will she live? If she does, will she have any quality of life?
Sometimes, I hate my job. I want to wash the smell of life and death off of me.
I plunge my body under the water, close my eyes tight, and submerge my head.
298 days later on Saturday, December 11th, 2004, Annabelle, named for the Hebrew word for grace and the French word for beauty, comes home with her parents to an uncertain future.
Root Cause
I walk into Dr. Amanda Lesile Buchanan’s cognitive behavioral therapy office. My leg is bothering me more than usual, but I don’t want Dr. Buchanan to see me limping. Dr. Buchanan knows, but I would rather not talk about it. The last thing I feel like doing is opening up and being vulnerable. I’m too tired to explore; maybe this will be one of those sessions where I hardly say anything at all. But the moment I walk through her door and she greets me with her warm smile, there’s a part of me that wants to tell her everything.
Dr. Buchanan’s office is small, dimly lit, and filled with artworks I admire. My eyes are drawn to one piece in particular. Dr. Buchanan looks through her thick sepia glasses and asks me, “Annabelle, every time you walk into my office, you look at this painting. What intrigues you about it?”
“When I was five years old, my parents took me to the Art Institute where I saw this for the first time. I was so transfixed by the painting that I put my head in this position (she tilts her head to the right imitating his posture). I felt his suffering. I wept bitterly; I wouldn’t budge, and my parents had to carry me out of there; I was out of control.”
I study the painting carefully. “He’s nameless, like me.” My long strands of dark brown hair are suddenly trapped in trails of tears.
“Annabelle, you’re 17 now, far from that NICU baby #13 before your parents named you,” Dr. Buchanan reminds me.
“I was born before my body was ready, before my parents were ready,” I reply, wiping my tears.
“How did you learn about it?” asks Dr. Buchanan.
“My parents told me, and I know how thoughtful they were about naming me, but I still always feel just like a number, like him,” I say while pointing to the old guitarist.
Dr. Buchanan pauses and asks, “Why do you think the old guitarist is depressed?”
“When Picasso painted him, Spain was in a time of deep poverty, even Picasso himself. Interestingly, Picasso didn’t know the old guitarist. Picasso’s inspiration started when a friend of his, Carlos Casagemas, passed away from suicide on February 17, 1901 because of a failed romance. I think the old guitarist is a figure for Picasso’s–and my own–struggles with depression: his blue color and discomfiting figure represent suicidal thoughts.”
“Do you know that you’re very intelligent?” asks Dr. Buchanan, stunned by my extensive knowledge.
“Oh no, I’m not anything beyond melancholic,” I reply sarcastically.
Am I intelligent?
Dr. Buchanan then turns around, gazing at the painting that I admired. She pauses for a brief moment and asks calmly, “What intrigues you about this painting?”
“I love looking at something as discomfiting, grotesque, and distorted as I am; it helps me think about something other than myself.”
“What do you think the root cause of your sadness is?”
“I don’t know,” I say, wiping my tears with my forearm. “I love my family. I have passions, but I lack enthusiasm. I am always stuck in the darkest of nights,” I say in a stilted voice.
“Do you feel alone?’ asks Dr. Buchanan, glancing at the painting.
Beep. Beep. Beep. A faint beeping echoes in my ears, blurred memories of needles, tubes, vents, pain.This is my nucleus. My life story has been told, and I am a number, not a name, a passive bystander, not the true hero.
“I do,” I whisper.
“Why is that?”
“Because I don’t know how to live; all I can do is study life, the science of life. I read about the science of life. Like a stupid modern-day Victor Frankenstein, I’m obsessed with the idea of overcoming death.”
“Okay, Victor,” Dr. Buchannan says with a flippant smile, “What have you been reading lately?”
“Lately I’m focused on Nanotech, little robots that could alter the human organism. If I could manipulate life, then maybe I can end the end.”
“If you could end the end, would you still feel depressed?”
“I don’t exactly know.”
“Have you been taking your antidepressants recently?”
“No, I hate the nausea, drowsiness, and headaches it causes me. It stops me from studying the science of life.”
The next morning, my classmates wake up with smiles on their faces while I wake up with melancholy. I can’t identify the source, the root cause.
Like thick impressionist brush strokes, my emotions fill the canvas of my heart.
Melancholia in the Cafeteria
Who is that girl? Sally thinks. Sally spots her eating her lunch. She looks like a complete creep. Sally then turns to Tess: “Do you see that girl over there?” “Yes, I do,” she replies unenthusiastically while looking at the girl for a brief moment, then rolls her eyes, and sits back down to eat her food while shooting a nasty look at Annabelle.
She looks like a vampire. Does she ever see sunlight? Black shirt, black leggings, black shoes. No makeup. All alone. Sad. A pale sculpture, almost beautiful, white skin perfectly contrasting against her dark brown hair and light blue eyes. I want to sketch her later in drawing class.
Maxwell watches Annabelle pick at her salad and comments cynically, “She’s not just goth: she dresses like that and acts like that because she’s a creep, a mental case,” Maxwell says.
Theo looks at Annabelle with a different perspective.
She pokes at her food, not interested. What is she interested in? It looks like she’s whispering to herself. Is she okay?
Blake elbows Theo hard in the side, and he tries not to show that it hurts. “You have a crush on that freak now,” he says in his best ass-holish voice, like the prick that he is.
Theo looks back at her; he didn’t want to be caught staring, but he couldn’t stop himself.
Her beautiful pale white face, pale white skin, her dark brown hair, and pale blue eyes. She’s lucky to be alone, and I’d like to be alone with her.
The next day as Annabelle limps down the hallway carrying an armful of science books, she turns a corner awkwardly and trips.
Theo walks over to her and bends down to help her collect all her books that were scattered all over the floor.
“You okay down there?” Theo asks while looking down at Annabelle with a smile.
“Yeah, I’m fine!” she says in frustration as she anxiously gathers her books.
“I’m Theo.”
“I’m Annabelle,” she replies reluctantly.
“Oh, you’re the girl from my biology class who knows all the facts,” he says to her while he flashes a quick smile.
He then helps her up off the ground and the two of them start to walk together.
“I’m totally about to fail biology. I’m getting a D, not good, my dad will kill me,” Theo says apprehensively.
“Bio’s not that hard,” Annabelle says obtusely.
“For you, but not for me,” Theo says in an embarrassed tone of voice.
Beep. Beep. Beep. I can hear his heart beat–insecurity and vulnerability.
“I tutor some kids at another school. I could probably help you.”
“Would you want to study with me during our 5th period free at some point?”
“How do you know I have 5th period free?” Annabelle asks suspiciously.
“I saw you one time in the study hall. I saw you pouring over your biology books.”
Overwhelmed, Annabelle says, “I’ll see you in the study hall,” as she limps down the hallway to her next class.
Annabelle and Theo sit in their school library in a private room located on the second floor. The room had a small white table with two black chairs facing each other, a whiteboard, and a couple of green lamps projecting in front of the two students as they sat down. “Annabelle, you’re a genius. This is great.”
“Theo, I’m not a genius. I’m just obsessed with the subject.”
Theo asks, “Why are you so obsessed?”
“Life for me is like a strict limitation. I want to transcend life.”
“Why do you want to transcend life?”
“I was born close to my death bed. I was born before my body was ready to be born.”
“Wow, that’s intense.”
“I survived, but I always feel alone, blue, somber.”
“You’re a miracle, then.”
Theo then gently leans forward and kisses Annabelle on the lips. At first, she’s shocked, mouth hanging wide open as if she didn’t quite understand.”
Without knowing why, she then kisses him back. She holds his body tight while kissing him until she becomes too overwhelmed from the experience that she runs away from what could have been.
“Annabelle, wait.”
“Just go away, Theo!”
Mrs. Pfingsten and the Prodigy
Poor Annabelle, all alone again. She looked bored and tired in the cafeteria sitting by herself.
She had that same expression two years earlier as a freshman during the first day of my biology class. I was insulted, so I kept her after:
“Annabelle, how do you feel about biology? You seem uninterested?” I asked.
She responded, “Mrs. Pfingsten, It’s not that I don’t like your class; I love biology; it’s just that…I’ve already studied this…”
“What do you mean you’ve already studied this?”
“I’ve studied biology since I was really young.”
“Really, what made you interested?”
“I’ve always been obsessed with death, and biology is the study of life: the polar opposite.”
I didn’t know what to say. She went on, “Life is full of noise and death is full of silence.”
Then, she said something I’ll never forget. “I want to live in a world full of noise, but I live in a world full of silence.”
She walked out of my classroom; I was stunned. I had to know her, to support her, to teach her.
Since her freshman year, we’ve worked together in independent study on everything from botany to cells to climate change to evolution and now nano-tech. Now as she’s 17 years old and a junior in high school, I had to bring in a university professor I know to keep her engaged.
She, herself, is like some sort of strange development of our species, exploring the viral permutations of diseases, cracking genetic codes that were mysterious riddles before her work.
She still sits alone in the cafeteria. She is so talented, and I want her to be at peace with herself. I see how everyone looks at her. She sits in a world of silence, but I want her to create a world of noise.
Clarissa and the Lab Rats
Dr. Annabelle Vital, Chief Medical Officer of NASA’s mission to the newly terraformed planet Bahazar, limps to the podium to address an audience of scientists and journalists all eager to hear her report.
She lowers the microphone, clears her throat, and says, “Clarissa has successfully passed our trials. We studied her for a total of six months. We subjected her to a series of viral infections and disease-carrying bacteria that would kill most humans. The Vitaliator, our nanotech implant, strengthened Clarissa’s response to all these biological threats. Over the six-month period, her cells remained unchanged: she was unaged. On the biological level, she is an Olympic goddess.”
The light reflected off the sea of cheerful faces in the audience as they applauded her accomplishments. Meanwhile, Annabelle was stuck in the darkest of nights.
The Vitaliator. What an ironic name? Thousands of dead rats in the pursuit of human immortality.
Back in her office, by herself, Annabelle looks through her early journals and reads her notes:
“Black rats have a twelve-month lifespan; my work seeks to expand their lifespan through a series of trials, inserting the Vitaliator, a nanotech robot, into their lungs. Mice and rats have long served as the preferred species for biomedical research animal models because of their anatomical, physiological, and genetic similarity to humans. Advantages of rodents include their small size, ease of maintenance, short life cycle, and abundant genetic resources.
My research objective is to triple the lifespan of both a male and a female rat. If at the end of year three, both rats display perfect health, then NASA agreed to develop the Vitaliator prototype and begin to test on humans and then possibly on the para-terraformed planet called Bahazar.
After a year of failed trials and thousands of dead rats, I begin to experiment on two rats: one male and one female–Adam and Eve. I notice remarkable progress in these rats. When they live beyond 12 months, my fellow scientists and I celebrate each additional day by counting down from 730 days (two years to our goal) on a huge poster in the lab, every day drawing a V. On the day I draw my final V through day 730, my experiment passes review; it is time to apply the Vitaliator to humans.”
Annabelle pushes her journal away and leans back in her chair.
“Beep. Beep. Beep,” Annabelle’s cell phone rings. She grabs it and she sees the name: Theo.
Probably calling me to congratulate me.
Nevertheless, Annabelle does not pick up his call–nameless, alone, suffering, blue, melancholic.
Life Without Death, Noise with Silence
“Beep. Beep. Beep,” the Vitaliator scanner sounds.
I am checking a Colonist, doing a routine vital body scan. She’s perfectly healthy. All the colonists are healthy.
The Vitaliator has strengthened their immune responses. They are essentially immortal. They are all grace and beauty.
Bahazar is all green, vibrant, and healthy. Right beside me stands an array of cheerful immortals.
I listen to their noisy, endless song of laughter and chatter, while I ponder in silence.
I’ve erased time, but I have not escaped my own melancholy.
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About the Author
Zachary Pietrafetta was born at 23 weeks, six days gestational age, under two pounds, and spent 198 days in the NICU. Doctors have diagnosed him with many labels: autistic, ADHD, CP, etc. These labels can be both helpful and hurtful. In his writing, Zach builds worlds with characters who refuse to be limited by labels, neurodivergent heroes who help change the world by working toward a utopian ideal. Zach currently resides in Wilmette, IL. He is working on a novel, Erasing Time. “The Noisy but Silent Life of Annabelle Vital” is the backstory of one of this novel’s main characters. Zach published a related fiction piece, “Unintended Effects,” in Wordgathering‘s Winter 2024-2025 issue. Zach published another related fiction piece “A Chemical Imbalance” in Kaleidoscope‘s Winter 2025 issue and in Breath and Shadow‘s Winter 2025 issue.