Thursday, June 25, 2015

Deliverance

We were the only ones up and stirring at that hour of the morning.  Despite our proximity to the just-past Summer Solstice, the sun had not yet made its way to our view of the skyline this early in the day.  School had just let out for the summer, or was about to be let out.  Schedules were changing for the season.  It was a time of transition, it was a time for vacations, a time of graduations, a time for commencement. 

We let ourselves out of the house as quietly as possible.  The cats assumed it was time for breakfast, and they got fed the usual.  The cats always think it’s time for feeding.  Once in a while, they are right.  The livery car was early.  We were earlier.  As soon as the black town car pulled in front of our house, we were locking the door, down the steps to the driveway.  The driver made no effort to assist with the bags.  I was unimpressed.  A dozen or so times, a black car has pulled up in front of our house in the stealth of early morning.  We’d be eagerly waiting for the ride, to the airport, for vacation, or sometimes we’d greet the ride less eagerly, and only one of us would get in the car if it was travel for business.  This black car was not airport-bound.  There would be no departures.  There would be no landings.  Today, there would be an arrival.

The cushy, wide back seat left plenty of room for the two of us, plus the arm-rest was down in the center, with water bottles resting in its build-in cup holders.  No eating, I told myself.  We were on local roads, and yet I wasn’t driving, so I sat back and enjoyed the chance to be chauffeured.  We headed north on the Hutch, red and orange sunrise streaking the sky, though still dusk enough that opposing traffic twinkled their headlights.  It was set to be a nice day.  Maybe not a perfect, crystal-clear, low humidity June day, but a good one nonetheless.  The back seat was so ample and roomy, I stretched out my legs, crossed my ankles, and a melody filled my head:

Why do stars fall down from the sky
Every time you walk by?
Just like me, they long to be
Close to you
On the day that you were born the angels got together
And decided to create a dream come true
So they sprinkled moon dust in your hair
Of gold and starlight in your eyes of blue
                                                     
                                                  -The Carpenters (lyrics: B. Bacharach, H. David)

Best birth-day lyric ever: ‘On the day that you were born, the angels got together, and decided to create a dream come true’.  Sums up how I feel about both of my kids, even the off-the-wall little boy and, of course my littlest one, about to be evicted in three hours, more or less. 

The black car got off the Hutch and switched to I-95, which was basically empty at this hour except for a few trucks.  But they were the big trucks, the semis and the freight haulers.  A few feet from our exit for the hospital, the driver realized he’d have to cut across three lanes of interstate and wove the car between two gasoline tankers.  I shut my eyes and gripped the door handle, and kept them that way until we were in the emergency bay of the hospital.  A few more feet of crazy driving like that and I’d be in that ER on a gurney and not walking myself through the door.  Crazy livery-car driver man had gotten us to the hospital quite early, mostly due to his general disregard for the speed limit and flammable tankers on the road.  An ER staff person wheeled me up to the third floor for Labor and Delivery.  The wheel chair ride was nice and slow and avoided colliding into anything or anyone, though at 5:30 in the morning, there was little hallway traffic as well.  Even the ER seemed to be having a slow night. 

I was deposited into a pre-op room, an internal room with no windows (I was hoping to catch more of the sunrise), but there was a monitor with all the Labor and Delivery patients’ doctors names, delivering some graphic data to the screen in medical shorthand, I killed time guessing the logic to the codes and hypothesizing which patients were faring better than others.  I saw my doctor’s name on the monitor, so he had another patient here already.  I sat on the bed in the pre-op room and looked at my phone a bunch of times but there just wasn’t much going on at 5:30 in the morning on a calm Thursday in June.  Rob sat in a nearby chair and did the same.

By now, the sugary-mellow Carpenter’s tune had left my head.  The near-death experience on I-95 and the beep-beep of medical telemetry were clearing my head and sobering my mood, just the way a nice, strong cup of coffee would have done (I’d prefer the coffee – but no pre-surgical eating!)  The baby is coming, it’s just a few hours now!  But I wasn’t excited.  I was excited.  But I wasn’t excited.  There was this one last, very big step, before the baby would arrive, so that I could be, well, close to her.  Though pretty much everything went fine during the last thirty-nine weeks of pregnancy, from taking my vitamins, to tests and blood pressure readings and sonograms, this was not a difficult pregnancy, it surely had its uncomfortable moments, but we weren’t in the high-risk group.  Yet it all came down to this.  The actual delivery of the baby, the final step.  There would be no labor.  Just delivery.  Just deliverance.  Repeat C-section.  Relax, you’ve done it before.  Lay down, have baby surgically removed, recover, easy-peasy!

Just before six A.M. I received a face-time call on my phone.  It was Nick.  “Mommy where are you?”  OMG, child, don’t guilt-trip me now, I’m really very new at this balancing act called ‘Mother of Two’.  I snuck away in the early darkness and left you sleeping soundly in your bed with your Grandma for a good reason.  It’s been a long day and it hasn’t even gotten started yet.  I told him “Sister is coming, I’ll see you soon”.  There was some other chitchat about eating breakfast and ‘go to school!’ (I later found out my mom let him stay home), but I wasn’t sure I convinced him to chill out because I couldn’t convince myself to chill out.  I had to get to deliverance.  Then I could chill out.  (Yeah, right!)

A nurse and a tech came in, and gave me the run down.  I changed into a gown, and got poked with an IV line for a few tries, then I got hooked up to a monitor and my metrics were now on the telemetry screen too.  I was on deck.  This was getting serious.  A nurse took my medical history, and I guess now was as good as time as any, even though this information must have been supplied somewhere prior, in my pre-certification or from my doctor’s office or from the first time I had a baby, somewhere, no?  (I have to interject – the pre-certification form asks if you are in the hospital due to an accident.  I assume they mean by cause of a workplace or motor vehicle accident, but I’m thinking pregnancies could go either way.  I checked the “no” box.)  We were approaching 7AM and the turmoil of shift change, so many different nurses and techs were in and out.  Many of them asked me if this was my first child, to which I replied “no”.  Once you identify yourself as a repeat delivery or experienced mom, I think the conversation takes a different turn.  When you have your first, you get responses like “Congratulations”, “Best Wishes”, “He/She’ll be lovely”.  When you have baby #2 or beyond, you get a look like “Welcome to Extreme Exhaustion Again”, “You Know You’re Crazy” and “How old is/are your other child(ren)”.  If the nurse/tech also has kids, and it seems like most do, it opens the door for them to tell you about their kids.  Whatever the combination or permutation of children, age ranges and genders, all responses are met with a few, pre-set answers; polite, superficial, small talk.  These conversations are all followed by the same, desperate, tired look, of nurse-moms ending their shifts, in need of a vacation and a martini.   Ladies, I hear you.

My obstetrician, Dr. Bob, came into the room.  He seemed worn down from his other patient.  I was concerned.  “Go get a coffee”, I said (and I need one too, OK?) I quickly glanced at the monitor to compare beeps and graphs with myself (doing nothing) and his other patient, doing, well, I don’t know what.  He seemed happy to see me, a scheduled, lower-risk, repeat C-section.  I think we all know why he wa$ happy to $ee me.  I wa$ a patient with a very predictable circum$tance.  Repeat C-$ection.  Fully in$ured.  We all knew the drill.  I wanted to say, let’s go grab a coffee and chit chat about some other light conversation we’ve had during this third trimester:  my new dishwasher, your trip to Myrtle Beach, the up-coming wedding of one of your nurses… anything.  He seemed to be looking forward to the predictability and precision of a surgical delivery.  And even though I felt he had done a very good job delivering Nick, I just wanted to get it all over with, the surgical part, the part where they put a needle in your spine, the extreme nakedness part, the part where you stop breathing until you hear baby's first cry, the part where everybody is in your business, and I mean IN YOUR business in the most literal sense.   I just wanted a coffee.  Does anyone want to let me have a coffee?

No.

Coffee addiction aside, I was nervous about this delivery.  You have your first child all starry-eyed and hopeful, but you have your second (and subsequent) child(ren) knowing full well what can go wrong, with either of you, because now you have experience, and you have more mommy-friends, and you have their experiences, and you have context.  And in the back of your logical, prepared mind, you know that the possibility of health issues that can arise is both broad and multi-variable.  When you deliver a second child, who is healthy and intact, you can’t help but think it was nothing short of miraculous.  Forget modern science and in$urance coverage.  Nothing short of miraculous.

Dr. Bob stepped out and the anesthesiologist came in and introduced himself as Dr. L.  He asked me if I was allergic to anything.  I thought to myself, well this would be a hell of a time to find out? “No.”  I’ve never had an allergic reaction to anything, even if I’ve lied in the past and told people I was allergic to hot dogs just so I wouldn’t have to eat them.  I doubt hot dogs would make their way into the spinal, but you never know. 

It was go time.  Game faces on.  The OR was ready.  Dr. L was ready.  Dr. Bob introduced the second surgeon, but he was a blur, so I’ll call him Dr. X.  I have a feeling he was a student.  I hope he had had enough coffee, and enough sleep.  Dr. Bob announced we were delivering a baby girl today, and everyone seemed on board.  A fourth doctor came into the room, Dr. T, a neonatologist.  He was tall and bearded and a bit Santa Claus-ish.  He would take care of the baby, once delivered, alongside two neonatal nurses, plus two other maternal/OR nurses.  4 (or 3.5) doctors, 4 nurses, one scrub-clad daddy and me in my breezy hospital gown and compression booties.  I’ve gone to cocktail parties with less people (though not lately). 

I sat on the edge of the bed, hunched over and waiting for the spinal.  There was an issue with my medical bracelet, well, basically, I didn’t have one, so they had to fix the bracelet printer thingy.  We waited for a new printer cartridge.  And we waited.  And we waited to print a bracelet thingy.  And we waited a little more.

A few weeks earlier, the Wall Street Journal ran articles about the horrid conditions of maternity hospitals in India, and the pressures on their health system given the growing population.  I also read a story about how the biggest challenge to labor and delivery in a southern African nation was how the hospital kept running out of electricity.  A non-profit group was distributing the equivalent of flood-light back packs to help assist with night time procedures.  And here we were, in Greenwich, Connecticut, unable to print an ID bracelet – something we could technically assemble by hand.  Four nurses, a hospital with plenty of electricity and air conditioning, not to mention computerized equipment, a Greek neonatologist, an anesthesiologist from the former Soviet Union, a Jewish obstetrician originally from Queens, a daddy from the Bronx, a mommy from Brooklyn, a fourth physician at our disposal, so insignificant I can’t even remember his name (sorry, Dr. X) in a hospital with a wing named after a client of the Private Bank for which I used to work.  They say it’s not about where you start in life, dear baby, it’s where you finish.  Thursday’s Child has far to go.

As the anesthesia took over, I just felt this overwhelming sense of dread, heaviness in my limbs, and nausea.  I did not want to have surgery.  I wanted to have my baby, but I didn’t want to have surgery.  Having never been through labor, I really didn’t want to have a labor either.  I didn’t want a labor.  I didn’t want a surgery.  I just wanted my baby delivered through, I don’t know, reverse osmosis or whatever.  Just come out, baby.  No fuss.  No booties.  No four doctors and as many nurses in my room.  No needles in the spine.  No recovery.  No trauma.  No drama.  No stitches.  Just my baby.  Just a healthy baby.  (And a coffee).

It would just be a few minutes now, I told myself, trying to self-soothe, as I lay back on the table, limbs splayed and being gutted like a fish.  One arm outstretched with a blood pressure cuff.  The other with the IV.  Dr. L at my head asking if I was alright.  I couldn’t even answer.  Drs. Bob and X were chit-chatting about a restaurant.  That was my signal that things seemed to be going OK if their banter was casual.  Just a few more minutes, I told myself, but I was mesmerized by the overhead lamp, a wide circle filled with several little light bulbs, their heat pored into my skin.  I was on fire.  I was cold.  I was really nauseous.  I felt drunk.  Dr. L was speaking in tongues.  Rob was missing. No he was there, but I couldn’t understand anyone, surgical masks muffling all dialogue.  I was on a trip, or maybe a hallucination.  Later I found out I was on morphine.  I thought they only used that stuff on terminal patients.  What was to be my fate?  Whoa.  There was pressure, and pulling, and more pulling, and a lamp searing into my soul.  I was ready for this to be over.

I felt a release of pressure and the baby had been delivered.  Though none of the doctors seemed worried, two seconds, perhaps even only one second passed before she cried.  But in that fraction of time and in my hallucinogenic state, I aged ten years. 

I had only been in this new, upside-down position for only a short while, and it wasn’t all that comfortable anymore.  I was relaxing, waiting for breakfast to head my way, but today things seemed out of routine.  Our usual night time rest seemed shorter than usual.  By now, Mom would have had some coffee, if not a full meal.  I’m not sure what was going on, so I went back to my usual games of staring at my hands and sucking on my fingers, these things taste good!  I was going to start stretching out my legs for the morning, as my little home was closing in on me and I wasn’t sure how much longer I could take such cramped confines.  Suddenly, and without warning, a light shone into my little space.  It was bright and blinding. And things were getting loud, lots of voices, but where was Mom?

I was pulled out of my little, warm, cozy and squishy nook and now found myself in a bright, cold, vast space surrounded by masked people in blue.  I was so disoriented, I paused for a moment, and as the cold, dry air was starting to chill me, I let out a wail. 

And then I heard it.  A nurse recorded it at 08:27 Eastern Standard Time.

Everybody was talking.  But I was listening.  Everybody was busy.  But I was trying to focus.  I needed to hear it.  I needed to hear the sound of baby’s first cry, of baby’s first breath.  That was my confirmation.  That was my deliverance.  There was my little love.  There was my miracle.  She was my blessing, and she was here, pink, gooey and breathing. 
  
Some gloved hands put me down to rest on papery, blue sheets.  I was cold and confused and blinded by this huge lamp with hundreds of eyes.  I shut my eyes and cried.  I didn’t like this set up.  I was not a fan.  I then felt some tugging on my food tube.  ‘Umbilical Cord’ was the phrase I heard them say and then, snap!  They cut it off!  Wait, what about breakfast!  What about the coffee?  I needed that!  That was my source of food for my entire life! 

This day was going from bad to worse.  One blue-masked man picked me up and handed me over to another blue-masked man, who walked me across the room and put me in a box with clear sides.  I was poked and prodded and measured and then they smeared some goo over my eyes.  I was basically being tortured, starved and frozen.  This was the worst day of my life.

This was one of the happiest days of my life, even though I felt like crap.  I could see Dr. Bob hand the baby over to Dr. T. and then the staff split themselves into two teams: baby care and mom recovery.  I caught a glimpse of her, and she was tiny and cute and splotchy and had the look of ‘WTF?’ on her small face.  I’ll see you on the flip side, little one.  Now I just had to keep it together, or rather Dr. Bob had to sew me back together and I had to get off this morphine-induced magic carpet ride.  I either had had a baby, or had a hallucination about having abdominal surgery.  I’m pretty sure it was the former.  My job was done.  (Ha! My job(s) were only beginning!)  My body returned to carrying only one heartbeat, instead of two.  A new soul had entered the universe.  The world gained another pair of feet, ready to explore, another set of hands, ready to grasp, another set of eyes, ready to observe, another heart, ready to love. 

I was pretty furious over my eviction, so I cried some more, and then I peed.  A lady put a diaper on my tush and a little cap on my head, but I was still pretty cold.  The blue-masked man kept booming out statistics with his big voice and gesturing with his arms like he was flying.  “Seven pounds, eleven ounces”, he seemed to be shouting.  “She’s twenty inches long”, “What will be her name?” His voice reverberated across the room.

“Kate.”

Wait a minute, I recognize that voice! It’s Mom!  Where is she?  I can’t see her.  I heard another blue-mask ask her if she was ready for a third child, and then I heard her again, laughing, almost wildly so.  I cried louder thinking, Mom, if you can hear me, I’m being held captive and I need your help!

Mid-surgery, Dr. Bob asked me when could he expect baby number three.  Despite my nausea, I laughed, if not partially choked.  Hold your horse$, sir.

Third child?  Who else are we talking about?  Then a bracelet was put on my wrist and another one looped around my ankle, they matched but one had a little box on the end of it.  Maybe that’s where they put the food.  I was getting kind of hungry.  I was scooped up and wrapped in two blankets, tightly tucked in and starting to warm up.  The prodding and measuring was over.  Maybe the worst of today was behind me.  Just as I was settling into my swaddle in a clear box, I was scooped up again and whisked across the room.  I was placed in the arms of another blue-clad man.  He brought me close to his face and I saw his big, green eyes taking stock of me.  “Hi, Kate”, he said, the voice was familiar.  It was Daddy!  Thank goodness, I thought.  Dad, you will not believe the day I’ve had!  I could use some cuddles.  Dad kissed my cheek and swiveled around on his stool, placing my cheek next to the face of a woman.  Her eyes looked tired but her smell was so recognizable!

“Hello, my sweet baby.”       

Mom!  My parents were here!  This day was getting better by the minute.  She kissed what little parts of my skin were exposed, and not wrapped in a blanket nor covered by my cap, and she whispered to me:

On the day that you were born the angels got together
hmmmm….mmmmm….mmmmm…
Just like me, they long to be
close to you…

And with that sweet tune, my snug-ness re-secured and my parents near, I drifted.
Off.
To sleep.

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