MY MOCCASINS
It's a possibility expectant parents often don't consider. But a premature birth occurs once in every . . . But what if...
Put you in early December 1986. The tea is poured and ourselves is sitting before a bookish evening with not a care upon the meat computer. You've had those. Ah, but there is a switch. It is abruptly thrown in the form and person of the woman of the house standing, five months with child, an announcement falling from her lips with the grace of a fire hose, "We may have a problem."
Now everyone knows about switches. One turns your light on. Another makes your coffee. Imagine a switch that could redecorate your bathroom, or turn your coffee table into a swimming pool. Now you're getting into it! Conceive of a switch that picks you up by the little tiny hairs you feel standing erect all up and down your spine and throws you into...
...the hospital bed that raised and lowered the ends and the middle so you could do the hoochey coochie lying down. Then there was the gluey microphone stuck to her belly that connected to a hose hooked to a dishwasher sized thing that whooped like a beached whale. When it stopped whooping the nurse would move the pickup so that it started in again, whooping in chorus with the other women all up and down the hall.
A nurse, one of those saintly beings I would soon become very familiar with, came in and asked us what questions we might have. I had some saved from when I was three or four. They plunk you down on this planet, give you a body and a name and never tell you a bloody thing! She told us what a premature baby might be like. Most of it we knew or could guess. The most important thing, the one big question was plated in brass and a big as a piano and right in the way all the time as we danced around it. "What is going to happen next?"
You know, they never do tell you. They wait until it is over and then tell you what could have happened. "The first 48 hours are critical. Most women with broken water deliver within that time." We talk about a twenty-four week fetus. About a pound and a half. No surfactant to aid in oxygen transport through the lungs' cell membranes. Brain bleeds that can't be predicted. Maybe this, maybe that. My wife decides. "I am going to keep this baby." So.
There are those who would come to the hospital to visit if only they knew what to say. "Hey, you really stepped in sumthin this time dintcha." No, not quite right. Maybe, "Have you picked a name for the baby yet?" Ah well. Do they ever say anything anyway? Remember July the 19th 1984? Remember who you were with? What did they say? What did you say? See.
... down 35W and turn East on 35th ... over to Park Avenue and ... parking is free if you stay less than two hours. Ride the elevator to the sixth floor. Chelsea knows the buttons. See who the room-mate is today. The last one delivered and they took her away. And the one before that.
Geree does her meditations and her imagery. The nurses come around and ask what she is doing. She explains. She is a psychologist. For years she has been doing hypnotic stress reductions and using guided imagery in her practice. Everything comes together now as her resolve to foster the young life within her deepens. A neonatologist, a supportive woman, helps her visualize the "enemy"; those aberrant pieces of anatomy that aren't playing team ball.
There is very little amniotic fluid, but the baby doesn't mind. A chart on the wall shows how much the baby weighs today, yesterday, tomorrow. To hang on until twenty eight weeks... But thirty two would be even better.
We see her on the ultrasound machine about every ten days. She has a little face. But no name. She is she. We see a four chambered heart beating. This is good, they say. Little hands and feet. We even get a picture to take home. Geree listens to the stereo headphones. Vivaldi. Albinoni. Rimsky-Korsakov. I bring her books and magazines that she can't read because the magnesium sulphate being run into her arm by the infusion pump keeps her eyes from focussing the same way it keeps her uterus from contracting.
At twenty-six weeks the doctor tells us that the test of the amniotic fluid shows that the baby's lungs are making the life sustaining surfactant. She could breathe if she might. We bring the dog to the hospital for New Year's Eve. Try taking a dog into a full hospital elevator some time. We watch some movies on the VCR. The end of 1986 in another continuum.
Geree's mother Olga comes to help out on the third of January. She washes everything in the house that will fit into the washer and isn't biodegradable. It is the new year.
My father's birthday, January the fourth. He would have been a hundred and three. The contractions begin. This is like what they said it would be. The nurse says we are going to deliver, but it is up to the doctor. I take Chelsea home to grandma Olga. Back at the hospital the doctor proclaims that the delivery will commence. An operating theatre is prepared. We are all veterans in our wrinkly green shirt and pants. We even get to choose our favorite style mask.
Did you know that when you have a caesarian you get options? "How would you like your incision dear?" "We could stick you in the spine with this, or we could slosh some of that in the..." I am off to the side with a "family support staff member" to catch me if I wilt, or whatever. I'm bigger than her though. It's like a little party with everyone around the buffet table or in a cozy corner with one or two others. There is talk, and there is beep, and there is asthmatic wheeze.
The lights are very bright. The room is warm. They lift the little girl out and carry her to the corner where the neonatology staff has been waiting. She opens her eyes and looks at me, grasps my finger. She weighs two and a half pounds and has an APGAR score of six and eight. The woman on the operating table is no longer the star, so they sew her up.
We run, the neonatologist, two nurses, and I. We run through the tunnel to Children's Hospital pushing the isolette containing Baby Girl Robinson. She has a tube down her throat. An insectoid machine mindlessly flaps to drive her full of air. Another device beeps and flashes life's elegant tango. Should children come with light emitting diodes and alarm buzzers? Why not?
Neonatal Intensive Care. Every four feet stands a plastic case with a nurse in front of it. Lights that let you see deep down into your pores. Many more beeps and wheezes. And the preemies? Want to know what they look like all naked and wired in? Shave your cat. More of the eternal unanswered question, "What happens next?"
We think of a certain ambience, we do, about places where new babies are kept. We expect dim lights, soft voices, pastel colors, powdery smells. Now try this. The modern extrauterine gestation studio is a shining white place with bright lights along the ceiling and even brighter lights shining on the babies. People holler across the room at each other but no-one takes much notice for all the peeping and clacking going on. The babies are all wired into the machines which are wired into the ceiling. The man installing the new coat rack runs his drill and hammer. The babies cry in their isolettes, but you only see their little contorted faces. No sound comes out.
The next morning I arrive at my first day at the new job trying to look like a normal person. Nobody suspects my secret life as the twelve-hour father of a preemie. The desk they give me is solid metal and plastic. The office door shuts with a very real click. But reality is elsewhere that Monday.
After four days, the delay seeming to give us time to believe she is real, we give her a name. Baby Girl Robinson becomes Krystal Georgiana Victoria Robinson. Chelsea picked the Krysty part, and the rest came from my father George Victor.
Each time we visit Krysty we first scrub at the big sink with footpedal operated faucets. The soap contains a germicide and must be scubbed carefully over hands and forearms. Priority one is to check the little girl, examine her chart, talk to the nurse. Each visit gratifies us with some progress. We feel fortunate. We gaze mutely around the room. Many of the other babies look weaker than ours. Some have strange equipment attached to them which gurgles obscenely. We realize that some of these little ones won't be going home.
Milestones come and go. Thirty-six hours; the respirator comes out. Krysty breathes room air now, with only a little oxygen added. Over the next two days the supplemental oxygen is reduced to none, as blood gasses look good. But the equipment stays in the isolette for weeks "just in case".
On he second day the chest xrays show good clear lungs. She is breathing well. Some less fortunate must stay in the hospital for months because their lungs were too immature. The respirator gives life, but it can scar the lung tissue.
Eating is, well, a piece of cake, right? Not for Krysty. She has had an intravenous tube in her arm or leg or scalp, wherever a tiny vein can be had. Another tube enters her navel where the umbilical cord was attached. They take so much blood for testing of blood gasses, bilirubin, and liver profiles, that she needs fresh blood transfused back through one of these strange attachments.
Soon she is able to take food by mouth, or to be more precise, by nose. The tube comes out of the navel. The intravenous feeding is stopped to be replaced by nasogastric tube feeding. The lamp is taken away as the bilirubin level shows that the liver is taking on its load. The pulse oximeter still shows her blood oxygenation. The pulse and respiration monitor still complains when her heart rate drops too low or she forgets to breathe.
The scary parts are waiting for the skull xray results. A brain bleed is the rupture of tiny immature blood vessels in the infant's brain that can damage portions of the brain by subjecting it to pressure and oxygen deprivation. Minor ones can be tolerated. Major ones are catastrophic. You are given the numbers one to four to think about as you contemplate the possibilities and hope its not a "four".
Her xrays are clean. No bleeds. Another hurdle passed. The eye exam shows some ROP. That's retinopathy of prematurity for those of you who need an aerobic exercise for the orbicularis oris, those stumbling syllables having altogether too many bilabial phonemes; making one look like a fish to say them. To do the eye exam they insert an instrument under the eyelid and contact the eyeball. Why would one tolerate this if one were not a helpless baby? If the disease progresses new surgical techniques make it possible to prevent retinal detachment; blindness. But the exams leave bruises around the eyes and broken blood vessels on the sclera.
The latest test shows the eyes have cleared up. She is gaining weight from her low at two pounds three ounces. We wait for her to become less dependent on life-support. We wish for her to gain more weight so she can hold her body heat. All so she can be transferred from the intensive care unit to the transitional nursery. It is a graduation cum laude. We wheel her back through the tunnel to the other hospital. Again in an isolette. No running this time. No respirator.
Chelsea, at four, is a soldier all the while. We are organized. There are the many things to do at home, then the evening pilgrimage to the hospital. I have been working on the software business, but with my marketing person in the hospital trying not to have a baby, there is more than I can do or wish to do. I decide to take honest work again and begin contacting the headhunters and contract engineering firms.
Three weeks later some opportunities arise. One is a small company with just the right mix of adventure and tribal closeness. They are building devices which save enable the saving of energy. The work even has some social benefit; a rarity in engineering where much of it goes to building smarter bombs or otherwise adding to humanity's karmic burden.
It is two days before Christmas. I give Geree a sealed envelope containing a card. The card contains an offer letter from the company. The starting date is January the fifth. I have a few details to work out; making sure a transition in insurance policies won't harm us with the current medical expenses running the price of a good house in a nice 'burb.
Geree rests in her hospital bed and does imagery and meditation. The hospital staff say few have held on this long with ruptured membranes. Holding on. The imagery she does as a psychologist, but has been doing as a human being for many years. Under stress it all came together. The hospital staff wants her to work with patients up there on the high risk pregnancy unit.
The following Saturday Geree comes home. We have the house all clean and tell her "Now don't touch anything!" Notwithstanding, entropy ensues.
Olga goes home and my mother Laurette arrives from that Palm Springs of British Columbia, Spences Bridge. Krysty is still in the hospital. Home life is getting back to normal, even supernormal with Mom to help. Except for the nightly visit to the hospital. We scrub at the sink and put on gowns. Every week when they change the isolette we get to hold her.
Time, the only road, winds never straight to moments of great import. Blinkifyoumiss it blink! There was one. The great trick time plays is to only show us those places as they've just gone by. The great trick we play on time is to catch them and taste them. Krysty goes to the transitional nursery. Now we can hold her every night. Chelsea gets to see her up close. Grandma can hold her too.
On February the ninteenth we solemnly enter the transitional nursery. Krysty is lifted from her warming bed and wrapped in layers of sterile white blankets. We sign some papers and say goodbye and thank you to the nurse. We take a last look from the doorway at what was Krysty's home for six weeks. Outside the hospital, snow covers the ground. The sky is clear, and though our little girl can't see it yet, there has never been a brighter day.
She still has the preemie look; she isn't supposed to be born for another six weeks still. She sleeps most of the time. She wears a set of sticky electrode pads so she can be wired to her monitor. It tells us if she forgets to breathe or if her heart rate is too slow. We have taken an infant CPR class. We think we might be able to handle an emergent situation. We hope we never have to try.
Geree is getting back into her practice. She still sees people at her Park Avenue office, and some at home too. She gets an offer to teach in the graduate psychology program at St. Mary's College. The give her an adjunct position as assistant professor. The professor. She will be teaching classes on attachment. She is also working up some syllabi on infant mental health and imagery. The college has a high population of health care professionals such as nurses doing graduate work in psychology. It all fits.
At five months Krysty smiled and vocalized like a normal two month old baby girl. She started on solid food. More importantly, she had a test to see if she could come off the monitor. She passed. We took our time weaning ourselves from the security of the monitor. We hadn't had any emergencies, but it was easy for us to convince ourselves that we needed a bit more "insurance".
At thirteen months Krysty says "mama" and "dada", and stands without holding on for support. I am one of her favorite toys. When she sees me coming, she laughs and claps her hands. Enough of that and I am conned into a shoulder-ride. We think of her "real" age as the age she would have been had she been born at her normal time. She seems a ten-month-old to us now. Her development is on a par with that age, not her chronological one.
