Writing the story below was as much an act of reconciliation as one of remembering. I wrote it over weeks, but without any revision or review. I haven't even read the whole thing yet, and it may be a while before I'm able to. I simply tried to relive the experience on paper. So, any inconsistencies or factual errors are indicative of my misinterpretation of events as they occurred.
- - -
It occurred to me that I should check the clock; I might one day need to know what time of day these events happened. It was 2:48AM. If this happens, I thought, I will never be able to let 2:48 go by unmourned. At 2:48PM, I'm usually in my office doing paperwork or research. At 2:48AM, I'm usually newly asleep or trying to get to sleep. Both fairly private times--will that make it easier or harder to get through them?
About ten feet behind me was a set of double doors with a small window. Twenty or thirty feet past that, I could see Beth standing outside our first labor & delivery room. I wasn't sure if she positioned herself there to support me, so that I wouldn't feel disconnected from everyone, but seeing her yet being unable to communicate with her actually made me feel more isolated. Then I understood that she was watching me for any signs of what was going on in the operating room, and this actually made me feel like a useful link in the chain.
And, of course, in front of me, through thick doors with tiny windows, the life-and-death drama was unfolding. This is why I say it reminded me of some absurdist play: the fates of my flesh and blood were being decided mere feet away, yet I could only glimpse a tiny, unexplained bit of what was going on.
I then experienced a disorienting, transcendant sensation that I will never forget: I felt that I was actually reliving the events of Julius' birth in my memory, from the future. I had the very real sense of walking down the deserted hallways of my memory, and peering in at the events of June 14th, 2008, through the small, foggy window that separates us from all such tremendous memories. For a moment, I was not sure whether this was happening or I was remembering it. Did I not know if Julius survived because it hadn't happened yet and I couldn't see in the window, or had what happened been so overwhelming that I couldn't fully glimpse it even in my memory?
I have been in many fraught, delirious, or otherwise memorable moments, and suddenly become aware of the memory being made. "I'll remember this day forever--just like this!" Of course, I don't always. But this was the first time I actually lost sight of the border between memory and experience.
This experience of "preremembering" was so shocking that even now I feel that I can't fully recall exactly what happened. Instead of replaying the events in my mind, I'm forced to look at a painting-within-a-painting. However, putting everything into another narrative form--this birth story--shows me that I actually remember quite well.
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By the time we reached the hospital, Heather and I were both exhausted and exhilarated, full of adrenaline yet barely able to stand. But stand I did, for 20 minutes, mere feet from the triage nurse's window. I leaned and bounced against the wall, hummed tunes, felt time pass. There were dozens of people in the emergency room, and I found myself annoyed at the ones who were chatting on cell phones, playing with the wheelchairs, telling jokes. I know they didn't want to be there any more than I did, but everyone's definition of an emergency is different.
While I was waiting there, Heather was in the car waiting for me, first alone, then with Beth, who eventually found someone to park my car (she couldn't drive a manual transmission) and sent Heather and me to labor and delivery. Any more waiting and it would've been too late, as we later found out, and as Julius was already trying to tell his mother.
"Hey, have you registered?!"
"No! Look--we need help!"
After spending a few quiet nights in the maternity ward, I know what a surprise our troubled midnight entrance must have been. I was worried that some Nurse Ratched would send us back down to registration, but they took a look at Heather and sent us in right away.
Heather and I had a few moments together, before the room filled with nurses, before even Beth returned from the parking lot. It occurred to me then that this might be our last moment of relative peace together until after the birth. I also knew that Heather knew that something felt wrong, but I wondered if Heather was allowing herself to realize it.
I didn't have time to dwell on such thoughts, though. Heather got in the bed for some quick monitoring. At this point I still had hope that we could follow parts of our original plan, and the nurses encouraged us. After she was checked, hopefully we could begin using wireless EFM and we could enjoy the process the way we intended.
The wait for Dr. Golden seemed interminable. When she finally arrived, I felt relieved, and even though we hoped to avoid any unnecessary medical intervention, I felt safer having her there. I knew that she would not push us to do anything we didn't want to do or anything unnecessary.
When Dr. Golden checked Heather, she was still at 3-4 cm--barely any progress after hours of hard labor at home. Heather began to cry, and this discouraging fact, I worried, would slow the process down. Then Heather's water broke. This was obvious, immediate, and natural, unlike the tentative, Pitocin-induced breaking at our first birth. Heather quickly went to 6 cm. I feel that, even though we could not deliver naturally, we truly experienced natural labor. If Julius was not distressed, he probably would have had a smooth birth from this point, even with his hand behind his head.
Then came the frightening part. Heather's water, under her blankets and covering, was a murky, sludgy brown pool. I saw it, and the nurse on my side of the bed saw it, but Beth and the other nurses didn't see it all. This was when I began to felt that I should worry. But what would the use of worrying be? Visible worry would make it worse for everyone involved, so I concentrated all my energy on looking Sure, and looking at Heather confidently. Be a rock.
After Heather's water broke, Julius' heart rate began to fluctuate. During contractions, it would slow down to 50 or 60....pause for a moment....then leap breathlessly back to 160 in the space of a couple of heartbeats. After a few of these--each of which was more gut-wrenching than the one before--they called for some "terp" to stop the contractions. (I assume this was Terbutaline.) The contractions were very close by now, and Julius' heartrate during contractions was even lower, down to the 30s and 40s at times. These precious heartbeats boomed heavily on the monitor, but the spaces between them were even more thunderous. Everyone seemed to be holding their breath. Some nurses began chatting during these silent intervals, obviously to try to distract us. "You know, I have a grandson who..." Or maybe to distract themselves.
Heather was plainly terrified. Beth was also terrified, but less plainly. I tried to be a stoic hub between the three of us. Maybe, I thought, Beth will see me looking confident, and communicate more of that confidence to Heather, who will look back to me for verification, and this will reinforce my own strength. In other words, I felt useless.
At this point, I knew what was going to happen. We did everything we could to control every aspect of this pregnancy, altering our diets, choosing carefully which tests to accept and which to decline, writing a comprehensive birth plan, and creating a special labor environment at home. And, under other circumstances, our birth would have worked. But, here, it was comical how out-of-control we were. I knew that a Cesarean was the right choice. I knew that intervention was necessary. After months of steeling ourselves for a battle to preserve our right to choose, we ending up choosing this. And it was the right choice.
I tried to communicate this to Heather with my eyes. She also knew what we had to do. Dr. Golden knew, too, but she let us come to terms with it and make the decision.
We were now waiting for the emergency team to arrive. I ran down to the car to get our camera. After going to the car, I ran back up to the room to get my car keys. Then I ran back down to the car. When I returned, Heather was gone and the room was quiet. This was my only real moment of disappointment during our experience, and the feeling was intense. I felt, irrationally, somehow abandoned.
Beth and I chatted nervously. I have no idea what I said during this time. I paced, sweated, pulled my hair, even though Heather warned me not to pull it out and look like a clown when the child was born. Beth brought me a Coke. A nurse finally brought me some scrubs, borrowed and too big. I sweated, paced, and chatted more. I have no idea what Beth was feeling at this time, because I was in "my own little world." Although, actually, I wasn't even there. I felt like I was hiding, outside of time, away from the event--shades of my wait in the emergency room.
Then, a nurse entered the room. It must have been about 2:45. "Come on, Philip. This way."
- - -
2:48. After I had waited a while, a nurse explained that I couldn't come in. I can't remember what reason she gave, but I understood. The operating room sounded like a busy cafeteria kitcehn. I saw them take Julius and put him on a small table, where he was immediately surrounded by doctors and nurses who gave him shots, slapped him, and suctioned him. This went on for quite a while. I could hear Heather gagging and retching, and I figured that they must be putting her to sleep.
During this time nurses ran in and out of the hallways. Since none of them looked at me or spoke to me, I assumed Julius was not yet alive. I kept watching the faces of those tending to Julius. I felt sick to my stomach every time I saw someone frown or shake her head. Every time someone laughed (which was only once or twice), I thought, "he must be doing better--surely they wouldn't laugh if a baby was dying in there!" Eventually someone stepped out, briefly, and me that it was a boy. I had a son!
Finally, a doctor stepped aside for a moment, and I saw one tiny arm wave feebly in the air for a moment. My son! "My sweetheart!" I said aloud, quietly, and I started crying. I wondered if I should come up with another pet name for him, if sweetheart was too effeminate. Then I realized that this was the first moment, in the whole hospital experience, that I was actually thinking about our future with him.
The body attached to his tiny, waving arm, though, was still not moving, and the air was noticeably absent of any cries, recalling the heavy silence between his slow heartbeats in utero. The doctors kept slapping him, and finally he cried, weakly. A few minutes later, the pediatrician spoke with me about his condition. This was when the staff first began to talk about the seriousness of Julius' situation. At first, before the surgery, we were constantly told, "this is totally normal." Now, we were told, "this is serious, but we'll be okay." By the time we left the hospital, they admitted, "I've never seen such a lucky child." Even some of the night shift nurses later admitted how worried they had been.
The pediatrician told me that Julius would have to be transported. He had no idea how long, and had no idea how much Julius' birth trauma had affected his brain or respiratory system. He explained meconium aspiration to me, and explained that the thickness and quantity of Julius' inhaled meconium was a cause for concern. He did not tell me that this often leads to cerebral palsy. He simply assured me that the baby was living, and would live. He told me he would come talk to Heather later, too.
Once I was back in the room, I met Beth again, but I wasn't sure what to tell her. We were both exhausted, and even now I don't remember what we talked about. I did ask her about my dilemma: should I wait for the doctor to explain to Heather? Or should I explain what I heard to Heather before the doctor came? As it turned out, I didn't have to decide; the pediatrician arrived just after Heather got settled in the room.
He went into a longer explanation of meconium aspiration syndrome. Heather kept asking questions, trying to get to the point. I realized that she didn't even know if we had a boy or a girl, or if he was alive!
"Oh yes! He's going to be fine!" said the pediatrician. The idea that we might have to commute to Florence for a week was much easier to take, compared to the idea that our child may not survive.
When McLeod's emergency transport team arrived, around 5:30AM, they wheeled Julius in so we could meet him. He was in a tiny transparent box, with a variety of tubes and wires running in, around, and out of him, like a bionic baby. His head, which had an oxygen-tent sheet over it, was turned toward us, and he looked so healthy and calm! And so big! I began to wonder if they even had to take him. Surely he'd be all right with a little bit of nursing and holding. But at this point, permanent brain damage had not been ruled out, and he had not recovered from his birth trauma.
It was just a little over twelve hours later that we saw Julius again, but those twelve hours were anxious, interminable, and excruciating. The emergency team returned Julius to us late the next afternoon, thanks to some bargaining by Dr. Golden. Heather demanded to nurse the child as soon as possible, which would greatly benefit his respiratory recovery. She was already pumping, and I was going to take an afternoon trip to Florence to deliver the milk. Dr. Golden, though, saw how important nursing and contact was to Heather and, for her emotional good and Julius' good, offered to give us a quick discharge so we could visit Julius. This was incredibly generous considering that Heather was in major surgery just hours before, but Dr. Golden may also have been bluffing to get Julius released from the NICU sooner..
McLeod called to update us around 7:00AM. Julius was already off oxygen and was improving immensely! We told them of our plans to deliver milk and nurse ASAP. This must have alarmed some lawyers and doctors at McLeod, because they called in the afternoon advising us not to come yet. Naturally, they didn't want a recent surgery patient from another hospital collapsing on their floor and requiring emergency care.
"He said he was very uncomfortable about Heather traveling so soon after surgery," we told Dr. Golden.
"Well, he's a pediatrician and I'm your OB, so I think I know what's best!" Dr. Golden was wonderful.
Finally, McLeod broke their own rules to avoid any liability for Heather. Any emergency transport patient has to stay for at least 24 hours for evaluation (and insurance purposes, I'm guessing), and even longer for shift changes and red tape. We got Julius back in 12 hours, which was another minor miracle, considering the way hospitals and insurance work.
We finally had our son! He didn't seem sick at all, and nursing was natural and easy. This was a major concern, after he had been fed bottles and IV fluids since birth, but there were absolutely no nursing problems. A couple of the more difficult night nurses forced us to leave him in the nursery for a few hours, but I was allowed to accompany him for his tests and evaluations. We wanted to stay with him at all times to strengthen the emotional and physical bond that was tested and stretched during his first 14 hours. It's a strange feeling, to be 70 miles from your newborn. I could feel the geographical separation within me, like Julius and I were both straining to look around the room but couldn't find each other.
And then came our overlong hospital stay. Most of the nurses were great. A few were controlling, condescending, and argumentative, and these few made me dread the shift changes each day. But the other nurses surprised us with their helpfulness and compassion. Sylvia and the grandparents visited several times. Sylvia immediately took to being a great big sister, instinctively cooing over Julius while she held him in the hospital chair. The Motyls (and Grandma, Grandpa, Nana, and Papa) were generous with food, clothes, gifts and company. Heather and I watched a lot of Food Network, I started reading Kafka on the Shore, we ate a lot of food from the nurse fridge. And then we went home.
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About a week before Julius was born, Heather had a vivid nightmare. In the dream, Julius was born healthy, but hospital employees took him away from us. When they brought him back, they had accidentally severed his head. When Julius came to us in his tiny emergency box, with his head under the oxygen tent, we knew Heather's dream had come true, in the roundabout way that dreams come true. But when we were finally released from the hospital, we knew that our dream of a new child to love and raise had come true too.
1 comment:
it was very therapeutic for me to read this.
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