Someone Could Get Hurt: A Memoir of Twenty-First-Century Parenthood
There were tubes and wires sprouting out from all over his body. There were three wires running from his foot that went directly to a monitor that displayed his heart rate, his blood pressure, and the oxygen levels in his blood. Whenever the vitals got too high or too low, the monitor would beep like a smoke alarm and the nurses would come over to make sure the child wasn’t dying. Sometimes a baby will forget to breathe and his heart rate will plunge down to virtually nothing before the nurse gives him a nudge and he suddenly remembers, “Oh, hey! OXYGEN.” This is called bradycardia, or a “brady” for short. Our son bradyed a lot. It was fucking scary as hell.
All over the NICU, something was always beeping. If not our son’s monitor, then someone else’s IV. The nurses would rush to another alcove and I would find myself grateful there was a baby sicker than my own. I hated myself for thinking that. I had a hard time recognizing which beep was coming from where. Every beep was a chance to worry. The beeps rained down twenty-four hours a day, from all directions. The nurses had clearly gotten used to them. I never did. A handful of unlucky parents had to take the monitors home with them when their children were discharged, to keep tabs on their vital signs. Those home monitors often malfunctioned, beeping all night long.
For days after surgery, the baby’s stomach needed to be completely empty. The nurses placed a tube in his mouth that snaked all the way down to the inner lining of his stomach, to suck up all the excess fluids. Once we began feeding him, we would have to make sure that no nasty green fluid came back up. Otherwise it would be back to the OR, and without any guarantee that things would turn out okay a second time.
There was also a CPAP device, a cumbersome series of nasal tubes that made it look like the baby had a snorkel pasted to his nose. The tubes ran to a pump that periodically blasted air into the baby’s lungs because, although his lungs were functional, he didn’t yet have the strength to take in enough oxygen on his own. The tubes had to be held in place with clear plastic tape, and I could see the tape pulling at my son’s cheeks, dragging them up with the tube and giving him a deranged Joker smile that I didn’t want him to have. There was an IV running from a prick in his heel that delivered vital nutrients straight into his bloodstream since he wasn’t allowed to take food orally yet, plus fentanyl to keep the pain away. The IV was held fast in place by surgical tape that wrapped around his foot again and again, like a little mummy foot. I could see his toes turning red from all the capillaries being squeezed together.
There were two hard plastic flaps on either side of the isolette that swung open so that we could touch the baby, like nuclear plant workers carefully handling plutonium. One night, I stared down through the top panel and I saw my own hand reaching in to gently pat his chest. Then I kissed the plastic roof of the isolette as if it were an outer layer of his own skin. I whispered to him, “This is the only time you get to break my heart.”
I cried and I could see the tears dripping down onto the plastic, obscuring my view. That’s all you can do when your baby is in the NICU. You cry and you cry and you don’t stop crying until the child is finally home. You don’t even realize you can cry that much. I would cry low and soft, just a little “Ohhhhhhh . . . ,” the tears soaking my collar. I cried as if I had just broken something that I’d never be able to fix. Eventually, the crying became a nuisance, a hindrance to my wife and me being fully functional and able to solve problems like grown adults. I just wanted him to be home. I knew he had to be in the NICU for a long time—weeks, months, perhaps even half a year. He would die otherwise. Still, I wanted him out of this horrible place. If I could just get him home to his crib, to his mother and brother and sister, then everything would be fine. I knew it.
The isolette itself was a remarkable piece of machinery. It had a retractable roof, like a new stadium. And it had little foot pedals so you could make the entire thing go up and down and up and down, which was good because sometimes I had to stoop to reach through the flaps and then my back would hurt and then I’d feel like an asshole for worrying about my back when my kid was in intensive care. A few days after the surgery, I visited the baby on my own late at night after work while my wife rested at home. I pressed a button on the isolette out of curiosity and the roof came off, sounding an alarm and causing a nurse to sprint over to close it back up.
“You can’t open it,” she said.
“Holy shit, I’m so sorry,” I said. “Did I kill him?”
“No, no, he’ll be fine. But the roof needs to stay closed so that we can control the temperature of the air around him.”
“So this thing has air-conditioning?”
“And heat. It’s the Mercedes of isolettes.”
I immediately wondered what the Mercedes of isolettes cost, and how that cost would then be passed on to me, Mr. Health Care Consumer. I tried to avoid thinking about money while the child was in the NICU, but it was difficult with new thick envelopes from the insurance company arriving every day, listing out very large numbers that scared the piss out of me. Part of me wanted to get my son home just so that the paperwork would stop piling up. I thought about what the final tally would be. Millions? Billions? Trillions? They could have presented me with any figure and I wouldn’t have been shocked.
“I’m going to need you to sign a consent form,” the nurse told me.
“For what?”
“Dr. Earvin says that your son needs a minor blood transfusion.”
“Is that normal?” That’s what I asked the nurse or doctor every time something insane happened with our new child. Oh, he needs intestinal surgery and a blood transfusion? That’s normal, right? I needed constant reassurance that all of this was routine, that somehow my son wasn’t the only one to suffer through this particular gauntlet of conditions.
“I mean, it’s not normal normal, but it’s perfectly safe.”
“He’s not gonna get the infected blood, is he?” I worried that I would sign the form and there would be no clean blood, and they would have to give my son the filthy, herpes-ridden backup blood instead.
“No, no. The blood we use in the NICU is the cleanest blood possible. It’s way cleaner than the blood we give adults.”
“Holy shit, don’t tell me that.” I pictured a bag of donated adult blood with eight used Band-Aids floating around inside it.
“Rest assured, the blood we give him is sterilized to the nth degree.”
I signed the form.
“Do you want to do Kangaroo Care?” the nurse asked. Kangaroo Care is when you hold a shirtless preemie against your bare chest. The skin-on-skin contact calms both the parent and the child.
“Sure,” I said.
She wheeled in a hospital-issued recliner with cheap vinyl upholstery and drew the curtain around the alcove. I unbuttoned my shirt and sat down, maneuvering the recliner as close to the isolette as possible. She raised the roof of the isolette and flipped down the side, then carefully gathered up all the wires so that none of them would snag. She unswaddled the baby so his warm bare skin could press up against mine. I could see the smear of dried surgical glue holding the two-inch incision on his belly together. She handed him to me and I kicked back with him nestled in my chest hair. It was like holding my heart in my own hands. I wanted to cut open my chest and hide him in my blood, where nothing could touch him. I felt the same way I did back when I was in eighth grade and I was in love with this one girl who didn’t love me back. My heart ached the exact same way, though I don’t know why. I kissed his hairy little head and began to sing to him.
Baa, baa, Black Sheep, have you any wool?
Yes, sir, yes, sir, three bags full.
One for my master and one for my dame
And one for the little boy who lives down the lane.
Baa, baa, Black Sheep, have you any wool?
Yes, sir, yes, sir, three bags full.
The NICU didn’t allow such tender private moments to g
o on for very long. The families in the NICU were all packed together, and the alcove curtain offered only the illusion of having your own room. On the other side of the curtain was another parent, a mother tending to her infant. I could hear the other mother singing to her baby too: a low repetitive drone that I thought was lacking in creativity. I sang a little bit louder to drown her out, but then she sang louder, and now we were trying to upstage each other like we were the Supremes. Eventually, I relented and stopped singing, holding the baby close and pretending that we were the only people in the NICU, the world, the universe. Just us.
“I’m gonna get you out of here,” I whispered to him. “I’m gonna get you out of here and when I do, you will see everything. There’s so much more out there waiting for you. You have no fucking idea.”
I drove home that night and passed by a car fire on the side of the highway. The flames engulfed the entire vehicle, like something out of a cheap Mob film, and rose up to three times the car’s original height. I always tried to mentally rank the car accidents I passed by on the road, trying to remember if I’d ever seen a worse accident. I gave bonus points for the sight of a gurney. I had never seen an accident like that before. Ever.
• • •
There is a list of benchmarks that a baby has to meet in order to be discharged from a NICU. It has to weigh a certain amount. It has to be able to breathe on its own. It needs to maintain a steady body temperature. It has to stop bradying for a full twenty-four to forty-eight hours. And it needs to be able to take food by mouth without emesis. The progress it makes toward hitting these benchmarks is not a straight upward trajectory. Preemies can make progress, and then regress, and then get back to where they were, and then regress even further back. Every time there’s a regression, you feel utterly demoralized, as if you can’t stand it any longer. Our son was eventually cleared to eat several times, only to throw everything back up and go back to relying exclusively on IV nutrients.
Every morning I would wake up and call the NICU to check on the baby’s progress during the night. Was he alive? Did he have any bradys? Was he able to eat? Did he shit? How big of a shit was it? TELL ME, TELL ME, TELL ME. The nurses changed shifts at seven thirty in the morning and I would always ask who the new nurse on duty was, praying the baby would get one we liked. When the baby had a nurse we liked, we would hold out hope that the nurse would decide to work a 128-hour shift. We hit for the cycle with the NICU ward nurses. We managed to get every single one of them. Most of them we liked; some of them we didn’t. All of them admirably performed a job that I myself couldn’t possibly stomach. Sometimes I wondered how many babies died on a nurse’s watch each week. What happens when you have to stagger home after witnessing that, after watching devastated parents wail their souls out?
I came in one night to visit the baby (I often went to the hospital alone after work; my wife would stay with the other two kids after being at the hospital all day). They had placed the suction tube back in his mouth, so I checked in the receptacle under the isolette that was used to collect anything that had been sucked out of the baby’s stomach. I saw greenish fluid in the container and immediately began to freak out. I checked the baby’s nose and there was dried snot caked all over the CPAP. He had been drooling and little crystals had formed around his mouth near the tube. It made him look neglected and I became silently pissed at the nurses for neglecting him, which was actually a cheap way of covering up my own guilt for not being at the baby’s side every waking second—for leaving him here in this place, so alone and helpless.
There was no nurse nearby and I grew white with anxiety. The fluid is green and now he has to be split open again and maybe he’ll die this time and we’ve come too far for this to end this way now please. The curtain to the alcove was open and there was no giraffe blanket covering the isolette. I felt like my son had been left naked out in the open to rot under the fluorescent lights. I pulled the curtain and put the blanket back over him, trying to close the space between the flaps so that the lights couldn’t get to him—the horrible, horrible lights. I dabbled at his face with a wet cloth to clean the snot and drool away. I scoured the unit with my eyes, desperate to find a nurse to make stern eye contact with. I heard strange voices coming from the isolette next door and I realized that the baby in that isolette was a new arrival. I could hear a nurse talking to the mother . . .
“Are you going to pump while you’re in rehab?”
Holy shit.
“We have to keep her on methadone for now, to wean her off the heroin because that was still in her bloodstream.”
HOLY FUCKITY FUCK.
I peered around the curtain to get a look and saw a sixteen-year-old girl in a hospital gown. It wasn’t her first child. The nurse sensed my presence and gave me a firm “I’ll be right with you.” But she wasn’t. Minutes passed and I grew pissed off at the white trash heroin addict next door who was siphoning away precious nursing time from my own child. Meanwhile, I could hear the poor heroin baby screaming, and I felt a keen sense of dread for the life that awaited her. Outside of this NICU, things would get no better.
I reached into the isolette and rubbed my son’s tummy. Every second that I spent waiting for the nurse grew more pronounced. When she had given her final warning to the mom next door to stop using heroin, she came to see me and I poured out all my worries.
“There’s green stuff in his container and his face was dirty and the CPAP doesn’t look right on him.”
“Sir, sir. It’s okay. That greenish fluid is just residue from prior to the surgery. If it were greener, we’d be alarmed. But this older kind of residue is completely expected.”
“So he’s not going to need another surgery?”
“No. He’s actually had a great night so far. You can try to feed him again.”
I started to cry. “I’m just so scared, I just saw that green stuff and, God, I just want him to be okay, you know?” Then she put her arm around me and I didn’t feel so alone. I had a blanket from the baby’s isolette that I had nicked from the ward to bring home so that I could catch his scent whenever I slept at night, whenever he wasn’t close by. But the blanket had begun to lose his scent, so I swapped it out for another one in his isolette that had more of him embedded in its fabric. The nurse pulled the baby out and checked his weight and his vitals while I dutifully texted his progress to my wife and my mother and my sister and brother.
They took him off the CPAP respirator and gave him a cannula, one of those little plastic nostril tubes you see on old folks who wheel around oxygen tanks. The night had turned. His lungs were getting stronger. I texted the news to my wife excitedly, as if the baby had struck oil. I got home that night and debriefed my wife on what I’d seen.
“The mom next to us is a heroin addict.”
She sat straight up in bed. “WHAT?!”
“Calm down, calm down. I mean, it’s not like the mom is gonna stab our child with a used needle.” Though now that I mentioned it, I couldn’t stop picturing it happening.
“Is the baby addicted to heroin too?”
“Yes.”
She began to cry. “That’s so sad. It’s just a little baby.”
“I know.” I put my arm around her and she cried some more.
• • •
At one point, my parents came to visit the baby. I put on a brave face, telling them that their new grandson would get out of the NICU any day now, when I didn’t really have any clue. One afternoon, I was in the kitchen and couldn’t keep up the facade. I broke down in tears with my father in the next room over. I think I wanted him to hear me. I didn’t bother trying to hide my distress. He took his cue, walked into the kitchen, and, without saying anything, wrapped me up in his arms. He was wearing this big leather jacket and I burrowed into it like a three-year-old. For a minute, it was nice to be more of a son than a father.
• • •
The baby sti
ll wasn’t eating enough. We kept trying to feed him orally but he’d swiftly throw it all back up. They ran a feeding tube up his nose and down to his stomach to help supplement the oral feedings. Sometimes there was blood in his spit-up because the feeding tube would irritate his digestive lining. We would try to feed him again a day later—trying out bigger nipples and crosscut nipples to see if that helped—and still get the same result. Every text my wife and I exchanged became a simple inventory of how many cubic centimeters of fluid the child had taken by mouth that day. Five. Ten. Zero. The number he needed to hit to get out of the NICU was fifty. It seemed eons away.
To supplement both the feeding tube and the attempted oral feedings, he was still getting some nutrients intravenously: lipids and proteins and sugars. But now the nurses were struggling to find usable veins to tap. Like a heroin addict, a baby in a NICU soon runs out of suitable entry points for a needle. Our son had now exhausted virtually every spot on his arms, hands, legs, and feet. I was in the hospital one night when the final viable tapping point came loose.
“Oops,” said the nurse. “His IV came out again.”
“Can you find another?” I asked.
“I can try, but you might want to leave the room for it.”
“No. No, I’ll stay here with him.”
I deeply regretted it. I took his hand as the nurse swabbed his tiny little foot and dug the needle in, trying to break through an all-important vein wall. He shrieked for help, confused as to why all this was happening, why he had to endure the lights and the beeps and the needles. I felt as if I were the one stabbing him, as if I were the one inflicting that horrible, unexplained pain upon him. I held his hand but didn’t feel like I had earned the right. I had betrayed him. I had made him suffer through this. Eventually, the nurse backed off.
“What now?” I asked.
“We may have to go through his scalp.”
She brought in one of the neonatologists on call and I overheard them deliberating. They were going to shave a portion of his scalp and tap a line there: a PICC line—a special, long-term IV with a catheter that runs all the way down the vein to the entrance of the infant’s beating heart. I heard them deliberating and pictured the baby being held down and sheared like a lamb. NONONONONONO. I walked up to the nurse and the doctor, knowing full well that I had little chance of overruling them.