Monday July 9th, 2007

By now I am used to nurses coming into the room in the middle of the night. They frequently come in for vitals and medicines as necessary. They always inadvertently wake me up as well. This time is different however. This nurse came in at 2am and is still here after half an hour. I have to go to work tomorrow and this nurse doesn’t seem to care. I later find out that she wasn’t there for vitals, but rather because the monitor was showing some patterned activity at regular intervals. She doesn’t leave until well after 3am. How incredibly rude of this woman to do her job while preventing me to get enough sleep so I can do mine. If an accountant doesn’t get enough sleep he can add wrong. What’s the worse that can happen if a nurse doesn’t do her job (To all you nurses, I’m kidding of course).

When I finally do get up at the proper time I get to do something I haven’t been able to do at any hospital thus far. We have our own bathroom complete with a shower! If this room did not have a shower, I would have had to go home last night, but thank goodness for small miracles. They probably charged me $5 dollars for the soap I used one time, but it was worth it. Soon it is time to tell the mama Ali goodbye again. The drive from Jacksonville to the house (I work near the house) is over an hour without traffic. The drive isn’t even the worst part, but gas is approaching two and a half bucks per gallon! That’s as much as a subway token – if this city had subways! In my mind I am not 100% sure if I am coming back to the hospital today. I’ll worry about that later. The last thing I tell her is to remember what I want for my birthday – nothing. I go straight to work. She calls me around lunch.

Ever since before we met, I wondered what my reaction would be when I got the call that the baby was coming. I never imagined that the main emotion would be dread. She says that according to the doctor the baby is still in the sac, and has stuck his foot out of the cervix without breaking the sac. It isn’t happening now, but it is happening today. In my mind I think ‘Push the foot back in!’ By now when I walk into my boss’ office with tears in my eyes he knows I have to go. Later I would feel terrible about missing so much work, but I also know that if he hadn’t let me go I would have quit in a heartbeat. I have to get back to Jacksonville – even if they charge me $3 per gallon!

I run to the house and pack my bag. I won’t be back until I’m a father. I’m a father. It made me so sad that it actually hurts to even think it. I start to cry again. This is so unf- who is calling me now! Two of my friends are calling to wish me a happy birthday. They start singing the song and they get halfway through before I cut them off. I am abrupt about it, but after I tell them why they understand. I know that for the rest of my life – good or bad – I will never celebrate July 9th as my birthday again. The drive to Jacksonville takes twice as long when you are afraid. As I would learn over the summer when you are afraid of death that drive never seems to end. I might have gotten there faster if I could just stop crying. I don’t know when it happened, but at some point I convinced myself the doctor was wrong. He was wrong and/or lying. The first doctor was wrong when he said she couldn’t last the weekend. This one must be wrong too. Or maybe he’s mistaken. The foot isn’t sticking out – it’s just the umbilical cord. The sac has somehow stretched thin and let a bit of the cord out. I’m just upset now. How could this idiot make a mistake like that? The baby is fine. We’ve already done 11 days, we can do another 11 easily. Friggin quack.

By the time I get to the hospital, we do the hand off. My in laws have been there all day. I get the evening. I want to see the doctor and give him what for, but I decide decorum is the better part of valor for now. I sit down with my wife and we look at each other for a few seconds. I think of everything she has worked for for the last 11 days and how she has so many more days to go. I feel…OUCH!!! We were holding hands and getting all emotional and she squeezes my hands like she’s mad at me. She’s never squeezed so hard. I look from my hand to her face – oh shit. Her eyes are closed. Her breathing is deep and rapid. There is a tear out of one eye. This is a textbook contraction. No one mentioned contractions. My wife is in labor. I look at the pain on her face and I finally, totally, and without reservation know that it is a matter of hours before we become parents.

No one ever mentioned any symptoms to me before this. All I received was one phone call from a woman who was probably in labor when she called. Her body was betrying her heart and mind after 11 days. I never found out for sure that the foot was sticking out, but it no longer mattered. Contractions were 15 to 20 minutes apart and by the time I arrived she was dilated past 6cm. More than enough for a 20 ounce baby. When the doctor finally checks on her again I forgot I was ever mad. This man was our only hope, but hope was the one thing he could not offer us. He asks which method of delivery we want. With c-section, when the baby is pulled out he could get his head bent back too far. Not a problem with 6 pounders, but at 1 pound and not many fused bones in his neck, it would be instantly fatal. With vaginal birth he could get his head caught in the womb while being… You know what? The doctor essentially asked us which way we want the baby to die. The odds were in our favor but as we would hear about everything between now and labor day, his size meant the odds were not good.

The most important thing now was to get the 2nd shot of steroids. If the baby came early, then so be it. However, the shot had to be given no earlier than 7 pm and should be given at least another hour after that to work its magic. We just have to hold on for another hour before we can even get the shot. Right now we just have to labor through it. As a man I won’t pretend to know how hard it was for her, but for me the next hour was the longest hour of the entire time in the hospital – even longer than the hour I drove to get up to the hospital. It was active labor and her body was contracting. There was no way to stop it and I know that she was fighting it with every ounce of strength she had. This wasn’t supposed to be happening to us now.

By the time 7pm rolls around we finally get the shot. I still don’t remember where it was, but it wasn’t the belly and the needle was big. Then it was time to relax. Except in this case relax means to lie in bed in complete fear while your body is in active labor. My job is to do a little bit of everything. I have to hold hands, but I also have to get her a drink of water which is on the other side of the bed. I have to wipe down her forehead. I have to call the nurse. I have to do it all at the same time. I am totally ok with it because I would much rather be going through the emotional pain rather than the physical and emotional even more. The mama Ali has wanted to be pregnant for the longest time. I think she was looking forward to pregnancy before we even met. She felt that it was her fault the she was in the hospital. That it was something she did wrong. Now she was in labor and she felt it was also her fault. It took me weeks to convince her that this wasn’t her fault. In fact, this whole thing started with her feeling bad and going to see her OB for an emergency appointment. I know within my heart that if the situation had been reversed I would have tried to tough it out and not gone to see the doctor. In that aspect it is her fault she is in the hospital in labor right now, because if the situation had been reversed it probably would have ended as a miscarriage at home a week earlier.

My sister in law Liz arrives soon to help but I am not leaving the mama Ali tonight. She wouldn’t let me if I tried. However, we start to settle into some sort of routine for the next hour or so. Then we are to receive the epidural. I am glad to see that we are getting the doctor and not an assistant for this procedure. However, things do not go smoothly. Over the last 11 days my wife has been poked, pinched, stuck, and shot more times than you can shake a stick at. Now she has to get another series of injections directly into the spine. Let’s just say that she was relieved when the epidural was finally over. There was no epidural for the emotional pain.

Too soon the nurse does her final exam and calls the doctor. There isn’t full dilation yet, but there doesn’t need to be at 23 weeks and 3 days. She notifies the doctor and it is decided that it is time for the pregnancy to end. We are in line to deliver the baby. There are some people in front of us and as we can (and should) wait longer to deliver, we are given time before we go into delivery. As the husband, I am given scrubs to put on. Then the 3 of us are left alone in the room. There’s nothing to say so I don’t even try. Fear, shame, excitement, anger, grief, it’s all good, and it’s all there. In a few minutes it’s time for the parents to go to the operating room. The new aunt gets left behind.

To this day I don’t know why they had us in an operating room when I remember clearly there was no surgeon at all or surgical tools that I could see. There was our OB, and two assisting nurses. There were also 3 nurses in the back of the room standing next to a door. That door led to the NICU. The operating room was filled with other weird machines and contraptions, and for some reason a computer with a keyboard. The doctor finally breaks the infamous amnotic sac and starts to work but it becomes apparent that the epidural needs to be turned up. While we wait for that doctor to arrive, we are all left kind of standing around. The OB can’t do his work, there are five nurses for the baby who can’t do anything, even I can’t do my coaching. I figured coaching would be taught in one of those classes that people take in the third trimester. Maybe next pregnancy. Within a few minutes I confess my attention begins to wander and I start looking at some of the machines and wondering what they do and how they do it. The mama Ali makes clear her disapproval and I snap back to attention. Soon the other doctor comes and turns up the drip on the happy juice and it’s finally time. I have lived 30 years, and been married 6. I have had some intense fights with my father, had some real wars with my sister, and even fought with my bride all day on our wedding day. The most difficult and painful words I ever had to say in my life was when I had to lean over and tell my wife after 23 and a half weeks of pregnancy, “OK baby, it’s time to push.”

Pushing did not last too long as I remember it, but the person pushing might have a different opinion. I do remember that the doctor cut the cord before the baby was all of the way out. I do remember that the doctor made no pretense at showing us the baby or congratulating us. I do remember hearing a cry as the doctor handed him to the nurses who immediately ran from the room. There was no placing the baby on momma’s belly. No wipe down of the afterbirth. No measurements. The baby would be able to take two or three breaths on his own and then suffocate without help. I would not hear the baby cry again for two months. I didn’t get a good look at him and he was out of the room before the mama Ali opened her eyes. I don’t remember what he looked like, but I remember how small he was. I remember thinking that in general grandparents usually say they could eat the baby right up. This baby looked so small that I believed they could. I remember looking up at the clock and it was 10 pm. It was 10 o’clock and I didn’t know where my child was. Nothing was the best present I could have gotten for my birthday, but this was definitely the second best present.

When we get back to the room, my sister in law is waiting to find out how it went. The delivery went as expected, but that’s all we know. We are told that they are working on the baby and that they will let us know when we can go see him. The nurse privately tells me that if for some reason he doesn’t respond to treatment, they will bring us to the NICU asap. She doesn’t mention that they would only do that so we can say goodbye. The mama Ali was still recovering from pregnancy and they wouldn’t let her get up, but at least she could now lie with her head above her feet. It was my job to call both sets of the new grandparents. Everyone else could wait until tomorrow because I was in no mood to talk. I just need to know how the baby is. I don’t bother the nurse because she doesn’t know and she will just try to placate me. I don’t need reassurance. I need information dammit!

When the neonatologist walks in, she is wearing one of those gowns that goes over the scrubs and to me she looked like the angel of death. I just knew that he didn’t make it and we didn’t even get to hold him. In reality, she gave us the best news that she could. The baby was stable. He responded well to the treatment so far and he was stable. She couldn’t say the baby was fine because I don’t think anyone said that about Jordan until August. She then went over some of the potential complications that could occur at anytime – some of which was beyond their control to treat. It was a rather grim conversation.

The nurses still want the the mama Ali in bed. They have to monitor her vitals for a while and she isn’t allowed to get out of bed. After a few minutes, the mama Ali tells me to go without her. I want to stay with her to show support, but she is right. We don’t know what is happening and the baby deserves to be with at least one of his parents if things get really bad really fast. After I am sure the door to the room is securely closed, I literally run down the hallway to the NICU. The nurse on duty tells me to scrub my hands for 3 minutes by the timer and then she’ll show me the way. I care nothing for washing my hands, but I know I am washing my hands for baby, not me. I just need to see him. As the nurse walks me through the NICU I feel like a condemned man walking to the electric chair. I see really little babies hooked up to lots of support. I am filled with sadness at the little suffering bodies who don’t know life yet, only medicine. The nurse interrupts my thougts by pointing out my son 10 feet ahead.

His area is a bay in the NICU. The back is a wall and the two sides are curtains. If necessary the curtains can be drawn across the front to provide privacy. The wall is decorated with kids drawings and accented with blue trim. The baby is also blue. He is bathed in this blue light that looks a lot like a tanning light, but it makes him look blue. Healthy babies aren’t blue! Had there not been a chair next to the ‘bed’ I might have collapsed on the floor in total despair. As I sat in the chair the entire weight of the last 11 days is coming out. I cry as I have never cried before. Compared to this, June 29th was a weep. There are no thoughts. No insights. All that’s happening is that this is my son, he’s going to die before he had a chance to live, and it’s not fair!

I have been fortunate in that the only death I have known previously has been that of older relatives. The youngest funeral I ever attended was for my aunt Carole and she was in her early 60s. At her funeral I cried because of the memories I had of her. Tonight I cried because of the memories I wouldn’t have. I cried because there would be no Christmas. No skinned knees. No temper tantrums in a crowded restaurant. I cried because July 9th just became the worst day of my life, not just the first. I cried for longer and deeper than I ever have. I was in a dark place that I was prepared to stay in for a very long time. I don’t know what happened, but I heard a voice that said that this is my son. My first born son was lying lying next to me and he’s going to die. Don’t let his only memory be the memory of his father crying. Don’t be afraid to show him emotions, but don’t let the only emotion he ever knows be grief. For the first time in an hour I open my eyes.

I never got the chance to really examine the baby before. He was lying on his back on a special table. It was surrounded on all sides by a 3 inch tall plastic barrier, but was otherwise open. There was a heater above keeping him warm and the tanning lamp next to him that made him look blue. He was lying on a foam pad about as long as my foot. He was surrounded above and on the sides by something the size and shape of a shoe box but made of clear plastic. A machine was pumping some sort of mist into the showbox. He was surrounded by blankets, but not covered so that the heater could keep him warm. He was wearing a mask over his eyes so that if he ever attempted to open his eyes he wouldn’t be blinded by the tanning lights. He had leads in several areas over his chest to measure his vitals. There are several I.V.s, but because it still works for now, they are all placed in the navel. His arms are no thicker than my fingers. He was just starting to grow hair. I can see the future hairline, but the hair is just barely starting to sprout. He has a tube coming from his mouth to the ventilator. It is a very unusual ventilator. Rather than attempt to have him breathe at a normal pace, it does the breathing cycle over a hundred times a minute. It actually vibrates his chest and many NICUs use it for the smallest patients. The baby was of course not completely developed so his skin looks kind of thin. The nurses inform me that the baby’s skin is so new that they actually don’t wish to be touched at all. It’s too sensitive. At any rate he can’t be held until he is off of the vent.

As my sister in law joins me at the bedside, my tears have slowed to a trickle. For some reason the thought of him filled me with fear, but the sight of him is completely different. I don’t want to say that I feel hope, but definitely an absence of fear. When my sister in law comes I introduce the baby as if I have known him for years. In reality we haven’t even officially named him yet (That was going to occur in the 3rd trimester). Again, I feel a sense of pride as he kicks, but this time I can see it. Five minutes after baby neets his aunt, a nurse wheels in his mother in a wheel chair. There is no introduction here. Mothers have a bond with baby and for 11 days she has done nothing but strengthen that bond. Baby doesn’t move or react in anyway, but he gets his mother to do something I haven’t seen in July at all. She smiles.

As difficult as the last 11 days were, the next 109 were going to be the most difficult of our lives. There were over 95 round trips made by us to the hospital equaling over 12,000 miles. We stayed at the Ronald McDonald house 6 times and in the NICU itself 3. My wife and I would have our most raw fears and emotions exposed which led to too many fights in the hallway outside the NICU. I personally would wash my hands at the scrubbing sink for some 150 times – about seven and a half hours in total. I would cook at home 5 times and gain about 20 pounds. I would pay over $3 for a gallon of gas and complain about it. We would be called by the doctor to spend the night at the hospital twice. The baby would have it harder. He would have a machine breathe for him for the first month of life. He would not know the feeling of no IV sticking him for another month after that. He would experience more X rays in 3 months than I have experienced in my life. Of course he would also experience many kangaroo cares, messy diapers, tube feedings, bottles, and one special car ride. Those 109 days days for the baby however, is an entirely different story.

Happy Birthday, son.