At home I sat in a chair by the window, watching Frisbee players in the park, cars pulling into the gas station. The hospital had been a natural setting for a crisis, its waiting areas filled with worried relatives who blinked at our footsteps then retreated back into themselves when they saw we weren’t doctors. We walked from my maternity room to the intensive care nursery to the cafeteria to the offices of social workers and neonatologists. It wasn’t abnormal to feel upset in a hospital. Our baby daughter, born the night before, had been diagnosed with meconium aspiration syndrome and persistent fetal circulation, her lungs constricted closed after delivery complications. We watched the ventilator puff her chest, the only visible movement of her body, which was paralyzed with muscle relaxants. We watched and waited, her illness a variation on our rapidly expanding idea of the birth experience.
I hadn’t minded too much that the other women in the maternity room had their babies parked bedside in plastic bassinets, because mine was right down the hall with other babies who breathed through turquoise tubes, attended by other mothers who shuffled in cotton gowns. But to arrive home—after a stop at the dirty Haight Street McDonald’s, as if we couldn’t stand to be in our apartment just yet—without Cade was a blow. The car seat waited by the door. The tiny yellow sleeper suit and blanket were still wrapped in a plastic bag, stuffed in the duffel that now sat, zipped shut, at the foot of our bed.
The crib lay in pieces on the floor of the nursery, which we also used as a study. We hadn’t wallpapered a room, made curtains, or hung a mobile. Though the middle of my pregnancy went well, it was framed by events that made the chances of a healthy baby feel less than guaranteed: I experienced bleeding in the first trimester and preterm labor at seven months. The baby clothes Betsy had sent were still in boxes. We’d bought diapers, medical supplies and a sleeping basket to put next to our bed—the minimum equipment to bring a baby home. We hadn’t taken much for granted, as if it would have brought bad luck to presume.
I felt battered. Even my ribs, arms and neck were sore. I kept looking out the window, feeling sorry for myself. I didn’t want to talk to anyone. Planning for uncertainty didn’t give any comfort now. I should have made a perfect nursery. Then I could have sat in the rocking chair, surveying a row of silly-faced, terry cloth animals and a stack of freshly washed blankets, and I could have cried and cried for my losses. If the baby died, people could say, Can you imagine, she had to pack away all the little clothes. But in our cautious household, the clothes were still packed.
Fred called the nursery, identifying himself as the father of Cade. How strange that sounded. I was the mother of Cade. Across the park and over the hill, we had a baby. The nurse gave the phone to a doctor, who told Fred that they were hyperventilating the baby now, in an effort to improve her oxygenation. She was receiving 120 breaths a minute. She seemed stable for the moment. We imagined her chest fluttering up and down. The triangle of skin under the center of her ribs would rise and deflate, too quickly to count at that breath rate, alterable with the turn of a dial, as if our baby were merely an extension of a machine. Later, I slept on my back, which I hadn’t done for months, since that position can reduce the flow of oxygen to the baby.
At 6 a.m. on Thursday, Cade was almost a day and a half old. I called the intensive care nursery, and the nurse said that she had experienced a “circular night.” She had improved but then worsened, and was “in crisis” between 3 and 4:30 a.m. Two doctors were working on her now. We would have to wait and see. “OK,” I said. “Thank you. We’ll come in.” I told Fred what she’d said. We didn’t like to panic. We’d felt—having made phone calls, dealt with the breastpump, rented a car, talked to doctors and understood them, read the ICN orientation packet—we’d felt that we could handle the business of the day. Take it as it comes. But a crisis happened while we were sleeping, not with her, and we didn’t even know what had happened. I was desperate for words. What did “in crisis” mean? I’d read a shelf’s worth of pregnancy books, but there was no book for us now, no translation of hospital language. What were the two doctors doing right now? The nurse had seemed to speak reluctantly, uncertainly. Why was I sleeping in my bed while my baby was suffering? Fred enclosed me in his arms so I couldn’t see anything, and I cried hard against him. Then we dressed in the clothes we’d thrown on the floor the night before and drove to the hospital.
The nurse was writing on a clipboard. Fred fastened his gown as he walked quickly into the nursery. “How is she?”
“Holding on.” She smiled sympathetically. “She had a bad time there.”
“Two doctors were working on her?” I asked. The ICN seemed tranquil now, as if nothing had happened. No doctors were present. Cade looked the same as when we’d left the night before—body stilled, eyes closed, head turned to one side, tube in her mouth.
“They worked to improve her oxygen saturation.” She pointed to the monitor at the foot of the bed, where blue numbers glowed against a black screen, showing a “sat” rate, or rate of oxygen saturation. They were giving her 100 percent oxygen, but her body was not absorbing that much. Her body was only oxygenating blood at a minimal rate. The sat number was the rate, and represented an estimate. The real rate was obtained by taking blood via her umbilical catheter and testing it in the lab for oxygen. The nurse’s explanation made sense, but I still didn’t know what the doctors had done. We only learned much later from reading medical records that they had taken the baby off the ventilator temporarily and manually resuscitated her. They had discontinued the paralyzing Pavulon and the morphine to prevent respiratory failure, then cautiously restarted them at 5:30 a.m.
It disturbed me that no one had called us when Cade was in crisis. I didn’t want to answer the phone at home and hear someone tell me, Your baby died; I wanted someone to call before that. But we didn’t want to make a fuss now, figuring we’d save any unpleasantness for important matters, in the midst of an emergency, who had time to telephone the parents? We were peripheral; if doctors were working on her, we wouldn’t even be allowed in the nursery. Still, I’d rather have been at the hospital than sleeping at home. A formal act of panicking might have been as therapeutic as a formal act of grieving, the equivalent of a funeral. We could have paced the halls all night, waiting for someone to emerge and give us news. If she were going, it would help us to hold her hand and say goodbye before she left us. Now we could only sit on our stools in numbness, behaving reasonably, asking logical questions in the daylit room.
Dr. Hanover stepped in and leaned back against the sink, his arms crossed.
“She had a difficult night,” I said.
Fred tried. “Do you think she’s improving?”
He scratched an eyebrow. “Early to say.”
“For the blood gas,” I said. “What are good numbers?”
“A lot of parents focus on the numbers,” he said. “When they really shouldn’t. There’s no absolute good number to look for.”
What else did we have to focus on? If a lot of parents focused on the numbers, then surely it was out of a natural need. Cade’s mouth hung open, her lower lip free of tape; the bottom of her mouth looked as if she’d fallen asleep sitting up. Her top lip and the space between her mouth and nose were plastered with translucent white tape, which held the respirator tube in place. Her chest fluttered up and down. Her face looked puffier, the bags under her eyes yellower. Hanover said she might have a little jaundice, nothing to worry about, and that she was eliminating fluids fairly well.
“Her kidneys work,” he said. “That’s good.”
I hadn’t considered that her kidneys might not work. What else were they worrying about?
The nurse asked us to leave so they could check the baby’s breathing tube. We wandered the halls, not knowing that her oxygen index was approaching 40, a number that indicated an 80 percent chance of mortality and warranted the lung bypass machine, or ECMO. As they had done at 3:30 a.m., Jim Spicer, the respiratory therapist on duty, and another therapist were disconnecting the ventilator and manually pumping air into her for a minute with a green rubber balloon to find a rate and pressure at which her lungs would absorb oxygen. The resident examined Cade, advising that the pressure and breath rate should be lowered that day, to avoid life-threatening lung injury. When she’d finished, the therapists hand-bagged for three minutes, then reconnected the baby to the ventilator. We came back in briefly before rounds, the two-hour period when we couldn’t be in the nursery; the medical team would assemble before each baby and consider its case. The rounds summary sheet for Cade read simply, “Too sick to discuss.”
By late afternoon on Thursday, Cade had not stabilized. She was receiving double-strength dopamine at the maximum dose, to raise her blood pressure. The monitors beeped often, when her pressure or oxygen saturation dipped too low, and Hanover stayed in the nursery, leaning against the sink. Fred and I sat on cushioned stools pulled up to her table. The stools were awkwardly high, like barstools with backs, and stuck out in the small space. Dr. Hanover stood only two feet behind us. Fred turned on his stool. “What’s the thinking on ECMO now?”
“We’re watching her numbers,” Hanover said. “It’s a definite possibility.” We all stayed silent for a while.
“Is ECMO always the last resort?” I said.
“Depends.” He scratched his beard. “The machine allows the lungs to rest and possibly heal.” As we learned later, putting a baby on the lung bypass machine involved inserting a tube into the right carotid artery to drain blood from the right atrium of the heart, running the blood through an oxygenation process, and returning it to the body via the jugular vein.
“So whether you use it depends on what,” I said.
“It may not be appropriate, if we’re dealing with advanced pneumonitis, for instance.”
“Then you wouldn’t use the ECMO?” Fred said.
“Antibiotics might be more efficacious.” He waved his hand. “No sense talking about hypotheticals.”
I’d been focusing on the lung bypass machine, thinking that if she were going to die, they’d put her on that first. We could feel safe because they’d tell us she needed the ECMO; it was a barrier before death. She wouldn’t just die at any minute on her warming table. If she didn’t stabilize, we would be discussing the risks of transport, familiarizing ourselves with the intensive care nursery at the better-equipped University of California at San Francisco Hospital, keeping our vigil over Cade and her new machine. Obviously there were scenarios I hadn’t conceived of. We’d been told Cade might die, and although I’d considered the impact of that idea, I didn’t imagine the physical process of my baby dying, her dead body, wouldn’t cast that blue shadow over her like a smothering wing. She lay bathed in the perpetual white-gold light of warming lamps, the nursery dim around her. We all watched her chest beating, 74 times a minute now. I shifted my weight. Hanover asked, “Are you getting some rest?”
“You need rest now,” he said, with grandfatherly kindness. I flushed at this unexpected attention and turned back to the baby, distracted. Beyond her table surrounded by equipment was a clear plastic isolette with a tiny infant inside, Baby Ashley. Baby Ashley’s mother was sitting on a stool, her yellow-gowned arms stuck through two portholes to change her baby. I thought her clothes were tacky: a bright, jungle-print blouse with stretch jeans and new, white, aerobic sneakers. She wore pastel-colored eyeshadow, blusher and lipstick, and her long brown hair was permed into crinkles. The yellow sterile gown looked almost as ugly on her as it did on me.
I wondered why Cade wasn’t in an isolette, like Ashley. Maybe only preemies lived in them, being too fragile to come outside. When Hanover ducked out for a minute, I asked the nurse why Cade was on a table. So they could get to her quickly if they had to, she explained. And the warming lights regulated her body temperature better than an incubator, whose portholes allowed the air inside to heat and cool.
I’d taken her being on this table as a good sign, evidence that she was more robust than other babies. My assumptions were being corrected too often, and I began to feel out of kilter. I remembered when my sister tripped and fell flat as a child, cracking her cheekbone on the neighbor’s brick terrace. Two doctors had questioned me separately and I’d realized—oh!—that they thought someone had hit her. And I recalled finding my grandmother’s lovely white teeth in a motel-room glass. Recent love letters from a high school girl in the underwear drawer of a man I lived with. These moments occurred years apart, so I didn’t have to feel bewildered; I could still be at home in the world. In this hospital, I was making too many mistakes. How could I get better at knowing what the hell was going on?
The nursery consisted of three rooms in a row, with dividing walls of glass from waist level up, and open doorways between rooms. We were in the first room on the left. I could see only into the middle room, which held three babies in incubators. So Cade was the only baby on a warming bed. Was she the sickest one, sicker than the red-skinned babies half her size? I couldn’t believe those tiny, sick-looking babies had a better chance than she did. When Hanover came back in, I said quietly, “So I just want to know, it’s very possible she may not make it.” I knew he thought that was an unnecessary question. Fred probably thought it was a stupid question, which it was. Both of them looked for a long moment at me, the dull one who needed everything spelled out.
Hanover said, “She might not.”
Outside the nursery, I told Fred we should tell our parents they could come and see her. I felt panicked with guilt over my mother. She wanted to come, and I’d kept her away. My mother and I were extremely close, but Fred and my mother still had a certain distance between them. I’d hesitated to have my mother come help with the baby, fearing that Fred might be pushed aside. When Cade was ill, I felt even more strongly that Fred and I needed to lock together and that we couldn’t afford to have him feel left out. But it was my mother’s first grandchild, the first grandchild on my side of the family. Cade might die, and my mother wouldn’t have seen her. I insisted that we call all of the grandparents.
I began to believe, too, that if Cade died unseen, it would be only Fred’s and my loss. She wouldn’t seem real to anyone else. And maybe if Cade died I could forget her, too. I needed a collective memory to give mine authority. Fred and I had sat up in bed and decided that if she died we would take a long trip to Indonesia. Her death would be a terrible episode in our lives that we would recover from; maybe we would have no children, then, and become minor tragic figures, expatriate writers with a dead baby. There was a self-important glamour in that, an allure to the idea of drinking ourselves into oblivion on a beach somewhere. We would survive our child’s death, more or less. But we were here. The baby was still alive.
My mother wasn’t home, and I didn’t want to leave an unsettling message. Fred reached his mother. He said, “Hi. She’s not doing so great. We thought—”Then he started to cry, the only time I saw him cry during this, and he blindly pushed the phone at me. I explained that we didn’t want people coming out for us, but that if they wanted to see Cade, they should feel free to come. I really couldn’t bear the thought of people snuffling and hugging me, talking about me in lowered voices while I lay resting in the afternoon, the bedroom blinds pulled down. Stiff and stoical was my preferred posture. Carol was matter-of-fact, as always, so it was possible for me to remain composed. She had been pragmatic when her husband lay near death for several months in a Milwaukee hospital. She researched his heart condition and all the surgeries and questioned the specialists who worked on him. She knew his treatments and several times had to correct the nurses when they gave him the wrong kind or amount of medication. She was tough. I liked talking to her.
When I called my father, my stepmother answered; he wasn’t home. It was 8 p.m. on the East Coast, and she’d had a few drinks, which wasn’t unusual for that time of night. I liked to call them on Saturday afternoons, after my father had played tennis, before the cocktail hour. I made my statement, and rolled my eyes at Fred as she started asking questions. This wasn’t about my father, she said, this was about me, wasn’t it? I needed him to come. He didn’t need to come. What would she tell my father when he got home, I wondered. She persisted—wasn’t this really about me? What did I need? Yes, the request was for me, but it was also for him, I tried to explain. If my dad didn’t get the chance to meet his first grandchild, he might feel sorry. I hated her booze-slowed psychologizing, as if anyone had time to figure it all out just then.
Dr. Hanover wrote notes in Cade’s chart at 6 p.m. Thursday. The baby had been alive for almost two days. He must have been tired. “Have been in attendance since 0800,” he began. His notes, usually in almost-fluid prose, were cryptic scrawls. “Paralyzed,” he wrote, and “Persistent fetal circulation—severe.” Oxygenation was difficult.
“Will prob need TX in next 1-2 d,” he wrote, indicating the need for a blood transfusion. He described us as “in to visit/touch for long intervals.” The equation of visit and touch is telling—he always wanted us to touch her, even as alarms went off and nurses glared at us for disturbing her. He believed in the laying on of hands. We were aware of our baby’s “grave condition, without much room to spare should oxygenation decrease—also aware of possibility of transfer to ECMO if condition worsens.” He wrote sideways in the margin, maybe to add a hopeful note, “Lung fluids much clearer!”
In the ICN, we were learning more from the nurses, some of whom explained numbers and monitors to us. Cade had many different nurses during her stay, and we often felt disconcerted to walk in and see an unfamiliar one. That night a new nurse taught us about pH and PaCO2, the measurements of acidity and carbon dioxide in Cade’s blood. Blood gas tests revealed these numbers, which we remembered watching for Fred’s father. When the numbers came within a certain range, the blood vessels in the lungs might dilate again and allow blood to pass through. Now, the ventilator forced air into her lungs, and the longer she was on the ventilator—especially with high concentrations of oxygen, which damaged lung tissue— the higher the risk became that the ventilator would blow a hole in her lung. A hole in the lung, the nurse explained, could be fatal if it happened outside a hospital. You stop breathing, and surgery is required immediately. If Cade had a hole, it would set her back, but it probably wouldn’t cause her to die.
How harsh all of the treatment was on her body—the ventilator, the toxic oxygen, the Pavulon that paralyzed her, the morphine. Her whole body appeared yellowish to me, especially where fluid had accumulated to form bags under her closed eyes. Her hair, never washed or brushed, matted darkly on her scalp. An IV had been moved to the top of her head, and, out of a mass of tape plastered at all angles, the needle stuck up at a tilt.
“Good veins up there,” the nurse commented. “Have you thought about a music box? Some parents bring in a tape player or music box.”
“We’ll get one,” Fred said. “Today.” He looked as stricken as I felt—we hadn’t thought of it. Baby Ashley’s isolette was decorated with puffy stuffed animals and pictures taped to the sides. Every time we left Cade we felt as if we were abandoning her, and we’d been leaving nothing of ourselves behind. Toys and pictures seemed absurd—she couldn’t move, her eyes were closed. Yet if these things could possibly help, she should have them. I wondered what else ICN parents did that we had overlooked.
The nurse invited us to stay while she did a blood gas, which made us feel welcome, as if we belonged there. She untwisted a plastic cap from the end of the skinny tube coming from Cade’s umbilicus and screwed on a syringe. Bright blood came up into the curling tube, looped a loop, and flooded the small chamber of the syringe. She detached the syringe and laid it on a tray, recapped the tube, shook the syringe, dropped it in a plastic bag which she sealed and labeled, placed it on a bed of ice in a plastic tub, and carried it to the dumbwaiter in the next room. She called the lab to say it was coming. The results would be sent in half an hour.
In the closed snack bar, Fred unstacked two chairs and pulled them up to a table. We lifted food out of a bag our friend Alan had brought and exclaimed over it: fried chicken, green salad, a round loaf of bread, cookies, mineral water, an egg-sized chocolate truffle in a shiny white box. We ate everything with our hands, by light that slanted in from the hall, hardly speaking because we were hungry. We laughed over the image of Alan standing in front of the deli counter at a grocery store, ordering chicken and wildly picking up everything else he saw around him.
When we returned to the ICN, Cade seemed more stable than the night before; the lab tests indicated no change. Her blood pressure had improved, and her dopamine dosage had been reduced. “Maybe she’s turning the corner.” The nurse tilted her head, inviting us to agree.
“Hmmm,” Fred said, and I said, “Good,” but we didn’t let ourselves believe her.
I called my mother from a hospital pay phone, anxious to reach her, since I’d already told the other grandparents they could come. She said she’d get there as soon as she could, probably Saturday.
“Cade is going to make it,” she said. “I just know it. She’s 7 pounds, so strong!”
“But Mom,” I said, annoyed. “Only full-term babies suffer from meconium aspiration. The smaller ones can’t have a bowel movement.” Meconiurn, a thick, tarry substance, is an infant’s first excretion, sometimes in utero. Babies can swallow small amounts of it before delivery, which isn’t serious, and can inhale what’s in their mouths after the umbilical cord is cut, which is what happened to Cade.
“I still think she’ll be fine,” she said. “She’s got good genes.” I gave her a loud sigh. She would obviously say whatever illogical thing she could think of to convince me. I didn’t want to be convinced that the baby would live, demanding instead that my mother accept reality and listen to me. I wavered from serenity to fretfulness to despair.
I complained about Dr. Hanover’s unwillingness to tell us much. He acted evasive, defensive, condescending. What if he were defensive because he didn’t know what he was doing? How could we find out about his professional reputation? Mom said she would make some calls in the morning and learn what she could; if he wasn’t a good doctor, we would find another one.
I didn’t think in large amounts of time, then. I thought in minutes, in hours. When I was pregnant I could think in years, of putting a child on the schoolbus, of walking in the woods and collecting leaves to press in a book. I used to have a leaf-pressing kit. “Having a child will bring out the best in us,” I’d said to Fred. We’d be curious again, we’d invent rituals to mark the seasons, we’d rent a cabin some summer and teach ourselves to fish. Now time had shrunk. I felt shut down, alert only to physical sensation, facts and numbers. Was it shock, or fear, or a practiced autopilot?
I’m sure some of my stubborn inhabitance of the moment came from practice in childbirth class of focusing on the present contraction, the present pain, and not panicking about the 50 increasingly painful contractions yet to come. This was added to years of practice at staying relatively serene, after having been diagnosed with manic depression: I was hospitalized at a psychiatric facility in November of my senior year in high school. I was on an open ward, with other suicidal types, heavily drugged schizophrenics and a couple of incorrigible alcoholics. The ward felt safer than my high school culture, which crackled with sex and heavy drinking around a nucleus of academic work. The academic work was fine, except for my certainty that no good college would accept me. My parents drove me for college tours and interviews from Duke in the South to Wesleyan in the Northeast, and all the while I felt like a tainted specimen, too small, too shy, too unathletic. My private high school was full of healthy children of the rich, who played soccer and lacrosse and vacationed at Aspen; they’d frightened me when I’d first seen them as eighth-graders, in their bright madras clothes and silver braces. Now I am curious about them, in their adult forms as New York City stockbrokers and interior decorators. With their stone houses in New Jersey, their Scotch, their extramarital affairs, their antique furniture, golden retrievers—they’ve become the parents of children I knew, the parents who scrutinized me, an outsider, as the most likely conduit to anything nasty their children might be indulging in. Their children had already secured a place in the world. Who was I?
Boys liked me for a girlfriend, and so I got invited in. The story of the next years doesn’t belong; I hope it is enough to say that while I made friends I still have today, and worked hard for inspiring teachers, I also engaged in an excessive social life and became repetitively, but not terminally, self-destructive. One day, I met for one hour with a psychiatrist and was committed to the hospital for observation. (My mother must have been relieved; having a daughter who swallows all of the Tylenol in the house and then calls you at work to tell you so is surely no fun.) And it was fine there, with many amusements—making leather bracelets, writing poems about feelings, doing jumping jacks in the gym with people on Thorazine who couldn’t even clap their hands together. When I left on a day pass to watch a soccer game at school, I couldn’t wait to get back to the hospital, where everyone felt uncomfortable with themselves. And yet I wouldn’t ever want to do it again. I was still a child at the time, and my failures could be covered up by my school headmaster, who attested in my college file that I had missed school due to pneumonia. My weaknesses could be addressed by my mother, who wouldn’t leave me alone. I slept for a while in the bedroom next to hers, a warm, narrow room filled with her old, sustaining books by Virginia Woolf and Doris Lessing.
My discharge diagnosis was manic depression. Lithium had no effect on me, but the clinic psychiatrist told me I’d not live a normal life without medication, and he prescribed antidepressants. The doctor was wrong, of course—my medicated life lasted only two months, it ended when I despairingly swallowed a whole bottle of antidepressants (with minimal effort since they looked exactly like tiny, spicy red-hot candies) soon after my boyfriend told me he had a crush on someone else at school.
I distrusted my hospital doctors, who could label me so peremptorily and absolutely as manic-depressive. And while their diagnosis felt wrong, I also distrusted myself, knowing that every feeling of euphoria would be followed by a crash, knowing, over the years, that Plath and Woolf didn’t commit suicide because of a new, especially profound depression, but because of the sheer tedium of repetitive suicidal desire. It’s happening again, I would think bitterly, as I sat in my apartment in one city or another, unable to pick up the telephone or eat or take a shower or vacuum or change my clothes. So during the in-between times, which gradually have stretched farther and farther, I’d always think: even keel. Keep the keel in the water. I pictured a white sailboat keel in cold greenish water, the brine of Nova Scotia of an Elizabeth Bishop poem, or of Maine where my dad took us sailing. If we didn’t keep the proper balance on the boat, it would heel to the side, and the keel, the long, planar sharkfin of it, would threaten to whoosh to the surface as we all got dumped overboard. Falling into water is fine. But falling toward the extremes of what’s now labeled bipolar illness is not. So I’d tell myself, Don’t scream, don’t shout with joy, don’t drink too much. Much happiness has come to me this way. If you think this willful numbing of emotion is wrong or sad, please don’t. I still drink a glass of wine, sing when my friend plays the guitar, and love my husband; I just don’t drink the whole bottle, sleep with strangers, or regard razorblades as instruments of release from a shameful life. Sometimes emotions, as fashionable as they are, don’t help me. When my baby was in the hospital, I often retreated to a more primary source of being: my body. What did I see, hear and touch, and what did it mean? Isn’t this how infants learn the world?
That night, while we slept, the baby opened her eyes in the nursery. The overhead warming lamps must have been very bright for her. She was immediately given Pavulon and morphine, and within 30 seconds, she closed her eyes again.
My father woke us by 7 a.m. Friday morning to say that he’d be arriving in San Francisco in the evening. I was stunned. Except for our visits to him near Christmas, he had governed as a father from afar, ensconced in a comfortable house with his wife and stepdaughter. Our relationship was almost not a relationship, though he had been warmer and more attentive during my pregnancy. He and Maureen had visited while I was confined to bed in June. They sat uncomfortably in our garage-sale chairs. We discussed their trip and the weather. I’d accepted that my father and I, who looked alike and were both stonily stubborn, had already passed our best years together. When I was a child I knew he loved me, knowledge that could last my whole life, even if he didn’t like me much anymore. But he’d made efforts during the visit, reading the paper and watching tennis on television, buying me a 50-foot telephone cord, bringing in takeout food. He seemed to be taking his grandfather’s role quite seriously. I failed to give Maureen any credit: As I discovered later, it was Maureen who had insisted they come to the hospital right away, buying airline tickets as my father mentally reviewed his work calendar for a less-busy day.
When we arrived at the hospital, as became our habit, one of us rushed in to see Cade while the other deposited chilled breastmilk in the nursery freezer and piled our jackets and bags in a parents’ room. I hurried to the nursery first, and Dr. Hanover stopped me in the anteroom. “People are calling me from Washington,” he said evenly. “I can’t give out details of this case; it’s confidential information.” He slapped down a manila folder on the desk. “You know that.”
I didn’t step backwards, though I wanted to. “I’m sorry.”
“Who do you want me to talk to? Why don’t you ask me what you want to know?” He was getting more and more nettled. “Who is in Washington?” he said loudly, and the unit assistant looked up at him. “I’ve got the head of hospital calling me and asking to be briefed on this case. Who is ordering these telephone calls?”
“My mother is in Washington,” I said. “I asked her to get some information.”
“I will be glad,” he sniffed, thoroughly put out, “to speak with her personally after rounds.”
“Thank you.” I turned away from him to wash my hands, and he picked up his file and opened it.
At home during rounds, I called my sister, who was in Washington visiting our mother before graduate film school started again in Los Angeles. I had to talk to her, but I didn’t want to; I was too tired. With Mom I talked facts, with Cecily interpretation, and I couldn’t articulate my feelings yet. When she’d been ill earlier in the summer, she’d gone to the hospital over and over for invasive tests with disturbing results, and I couldn’t really feel what that was like, I could only wish she didn’t have to feel it. How could she feel what this was like for me? I didn’t even know what this was like for me, or what it even was. A terrible thing was happening to me, and yet it wasn’t happening to me, it was happening to my baby. “I’m so tired,” I said.
“I know,” she said. “Mom keeps saying the baby will be fine.”
“Nobody knows if the baby will be fine,” I said vehemently.
“She’s driving me crazy.”
I laughed. “Is she clicking her nails on her coffee cup?” Our mother always signaled us when we’d lingered too long at breakfast and should be getting out and about.
“She’ll hardly sit down.”
“I know,” Cecily sighed. “So you’re going back and forth to the hospital?”
“All day. We’re in a routine.”
“It’s good. We have very little time to think.” It was odd that she happened to be at our mother’s house instead of her apartment in Los Angeles; I felt flung back in time to when she was in high school and I’d left for college. I’d call in with all my big news from the world, like how many slides we had to memorize for the art history exam, or what I’d done on Saturday night. “I do icepacks and sitz baths, and there’s breastpumping. Fred sterilizes the pump every morning.”
“I am never having a baby,” she said firmly.
As we talked, our mother was at work, waiting in a hallway of the Senate Office Building for a hearing to finish. She called the HMO representative in Washington again, who told her that he’d heard the situation was critical, and the baby might not live. If it were him, he said, he’d get on a plane for California. Yes, she told him, she’d already reserved the first seat available. When she recounted this conversation to me months later, I was surprised that she’d known how ill Cade was. I thought she didn’t realize it, that she wasn’t listening to me. I was also startled that the hospital’s official word had been that the baby might not live. The doctors and nurses and respiratory therapists went about their work calmly, of course, since critical illness was routine for them in this nursery. They never brought up death, and I’d begun to feel as if I were extreme or hysterical to focus on the possibility. In the ICN, we seemed to exist in a futureless present tense, in which we could discuss medications and strategies, but never a prognosis.
After rounds, Baby Ashley’s mother sat on a stool beyond Cade’s table, her back to Ashley’s isolette. Dr. Hanover faced her from a low chair. We usually minded our own business in the nursery, not wandering around to look at other babies, not listening too closely to the nurses discussing cases, or weekend plans, not often meeting the eyes of other parents as they came and went. We acted the same way everyone did. All of the families seemed to crave privacy, to create an invisible perimeter around their baby’s area, bounded by respirators, IV carts and a nurse in a chair. But we could not help overhearing Baby Ashley’s mother say, “Part of her brain is missing?”
“The tests seem to indicate,” Hanover said, and we couldn’t hear the rest.
The mother straightened up on her stool; she looked pinned to it. “Which part?”
“It’s not a very important part,” Hanover said affably. “It’s the kind of lack you can make up for by reading her lots of books, that sort of thing.” I saw her struggling to formulate questions, and I knew her struggle. Hanover would give a morsel of information, and I would think, What is the question? What is the question I can ask that will elicit more information? If I don’t ask a precise question, he won’t tell me anything. She asked something about the cerebral cortex. I knew those words, but only as I heard her say them; I couldn’t have summoned them up and asked that question. Where was her husband, and why did Hanover look as relaxed as if he were discussing the Sunday paper? Read her lots of books. I was ashamed to have thought of Ashley’s mother as tacky. She persisted with questions while the doctor looked blandly back at her.
My mother was silent when I called from home to tell her Dad was coming that night. She would come the next night, Saturday, and leave Monday morning. Grandparents’ visiting hours were from 1-2 p.m. and 7-8 p.m. every day. One grandparent could be in the room with one parent. It made me tense to think about portioning out the time between my father, his wife and my mother.
My mother said, “The director has asked around about Dr. Hanover, and the word is, he has an excellent reputation.”
“Critically ill babies from other Bay Area hospitals are often sent to him.”
This news gave me tremendous hope. If he could save babies that other hospitals couldn’t handle, then Cade was getting the best possible care. “Who cares if the man won’t talk?” I said lightly.
“Exactly” my mother said. “As long as he saves our baby.”
We rushed back to the hospital to be there at 7:24 p.m. Cade would be 3 days old, and Fred had decided that we should be with her at her birth time every day; I had only just caught on. We quickly scrubbed and gowned and pulled up two high stools to her table, one of us on each side. I sat between her table and the door, pulled up close so people could walk behind me. On the other side of the table, Fred sat with his stool carefully placed among a nest of wires. To his right was the ventilator, a blue box on a stand, with digital readouts of breaths being given per minute, percentage of pure oxygen and something called “PEEP.” The blood pressure and heart rate monitor hung over Fred’s left shoulder. On the wall, the pink-and-white “I’m a Girl” card with Cade’s birth information now had “Dad – Fred” written on it. We softly touched Cade’s arms and said, as we always did, “Hi honey, it’s Mom and Dad. We’re here.” We told her she’d made it through three whole days, and how brave she was, and that grandparents were coming to see her the next day. Her head was turned so she was facing Fred. We took out the things we’d brought for her: a photograph of the two of us that my mother had taken at Christmas, when I was nine weeks pregnant, in which Fred has his arms around me, and we are leaning back in a restaurant banquette, looking happy; a black-and-white terrycloth puppy with a red bow around its neck, chosen because the nurse said babies see only contrast, not colors, at first; and a wind-up music box. We taped the photo to the clear plastic barrier she faced and placed the puppy below it. We put the music box out of the way at a bottom corner of the bed. I felt much better having brought these tokens, as if they would give her comfort, as if we could bring pieces of home to her. The intensive care nursery couldn’t have been less like home, with its sterile paper gowns, electronic sounds, equipment housed in metal boxes. Yet it was a human place. Ashley’s nurse shook out her blond hair and talked with Ashley’s mom about aerobics class; another nurse called his little girl at home to say goodnight. While Fred and I stared at Cade as if willing her to wake up—though medicine, not sleep, kept her eyes closed—we listened to the almost inaudible sound of a country-western song being played at low volume in the anteroom, the unit assistant tapping time with his pencil on the desk.