Authors: Hope Jahren
Bill assures me that it's okay for me to just stay home. “Seriously, no one is going to come in here; you don't have to guard the place at night.” He looks around surreptitiously and adds, “Not with all the knives and shit I have in here,” as he pretends to fumble nervously with one of the cabinets. This preposterous statement represents a new high-water mark in Bill's desperate efforts to make me laugh, or at least to provoke a sign of the old me when our paths do cross. Although we are both at a loss as to how to kill the despondent zombie that has taken over his best friend's ballooning frame, he does keep trying.
“Jesus, you look miserable,” he says. “Why don't you go slaughter a pig or something? Isn't that what makes your people happy?” Bill is exasperated.
“Well, I am hungryâ¦,” I offer.
With much effort, we walk (I waddle) to Bill's house and then watch reruns of
The Sopranos
while I eat the box of doughnuts that we bought on the way. At nine o'clock, when Clint comes to pick me up and drive me the three blocks home, he opens the back door and hands me in, and tears roll down my face as we pretend that our car is a taxi.
It is a good omen when you observe an experiment closely, prepared for the data to be subtle, but what you see is clear, forceful, and obvious beyond misinterpretation. I have been warned repeatedly that water-breaking could be ambiguous, but later that evening while sitting on the couch, I spontaneously find myself immersed in about a gallon of fluid. As the tide rises, I set my jaw and remark to Clint that we should probably go to the hospital.
As he helps me up, he notices that my hands are shaking. “We are going to the best hospital in the world,” he reminds me calmly, and his confidence proves contagious. I gather my weak determination and we pack up and drive downtown. It is about ten-thirty in the evening, and as we pass through the miles of Baltimore urban housing projects I see people trudging home after their long day out, needing rest but not anticipating any.
We enter the hospital, and I am immediately comforted by the bright lights and buzzing activity, and strangely enough, an old feeling of safety comes back from my hospital pharmacy days. Each one of these busy people has a mission, and taking care of me is just a routine part of their huge, choreographed collective task. Whatever happens, I will not be alone, and somebody else will be the strong, prepared, alert, and responsible one. A plan is coming together: everybody will stay up all night and we will figure this thing out. I start to relax.
We share the elevator up to the maternity ward with an older patient who is being wheeled elsewhere by a young and bored orderly. She looks at my mammoth abdomen. “You ready for this?” she asks, and then shakes her head in wry amusement when I stare back at her dumbly, unable to formulate an answer.
When we get to the registration desk, a huge woman swoops in after eyeing me and says to the receptionist, “I want her; she's got good veins,” and thus designates herself as my nurse. I look at the backs of my hands that are like my father's and upon which the blood vessels have always stood out clearly, and I decide that this is also a good omen. The nurse leads us to a private room and ushers Clint toward a chair in the corner; he is to sit near the foot of the bed and keep himself out of the way. He complies.
“This is not about
you,
” she explains to him over her shoulder as she guides me into the bathroom.
With great effort, I use the toilet and then change into a hospital gown. The nurse helps me up onto the bed and swabs both of my wrists with alcohol. She then pulls out ten or twenty needles, electrodes, clamps, and bands and begins to attach them to me in myriad ways and places. After she finishes she plugs each one separately into the machines and monitors that have begun to crowd around my bed as if they are eager to be included in whatever is going on. Once everything is turned on, I am surrounded by their friendly electronic faces on all sides, and each continuously repeats to me its own soothing story, as if they all understand that there is no upper limit to the amount of reassurance that I will require during my ordeal.
The physician's assistant walks in. “Will you consider medication to help manage your discomfort during the birth?” he asks.
“Yes. Yes, I will,” I answer, using his same dry tone that belies the fact that I have never been more passionately sincere in my whole life.
“Good for you,” mumbles my nurse under her breath. “Ain't no
reason
for you to be in all that pain.” When I hear this I realize that I have just made her shift a whole lot easier.
Every couple of hours a different doctor who is also a professor herds a gaggle of medical students through my room and introduces me as a case study. He summarizes the results of all of my prenatal visits and lists the medications that I have taken in a terse and disjointed monotone, making the whole thing sound like an e. e. cummings poem that didn't quite make his editor's cut. Then he asks his cohort, “So what do we surmise about the fetus in this situation?” and the group responds with the same dumb silence one would get upon querying a flock of sheep.
Finally my nurse breaks in, saying, “Well, look at her. That baby ain't premature, and it ain't underweight neither.” As she shakes her head in disgust, I see one of the students standing in the back yawn massively while looking right at me, and without even bothering to hide it.
I suddenly become incensed and it probably shows up on the electrocardiogram to my left. Instantly thrown back fifteen years, I am again a college girl who desperately wants to go to medical school but knows from the start that she doesn't have the money and has no way to get it. I came from a line of women who could catch and pluck an owl, boil it up for the kids and crack the marrow out for the baby, then drink the boil water because that was all that was left. I was the girl who could pull leeches off of herself and wasn't afraid of spiders, snakes, dirt, or the dark. I am suddenly again the girl who, having secured a scholarship that also paid for books, immediately went to the bookstore and bought all the medical texts in addition to the course books that she actually needed.
There these medical students are, on the other side of a heavy iron door that has been locked against me, and instead of glorying within the inner sanctum, they seem to be throwing it all away. I then proceed to wonder indignantly why these little bastards think they are even fit to measure my cervix. My rage awakens a bit of the old me, and in my head I edit the version of these events that I will relate to Bill, and here insert myself yelling: “Write it down, motherfuckers; I'm going to be on the
test
!”
The professor interrupts my internal tirade by announcing, “She has a severe risk for postpartum psychosis and will be observed accordingly,” and just like that, he has given voice to something we all suspected but that love and hope had both conspired to keep silent. I perk up, damned interested in what he might say next. Upon receipt of this novel tidbit of information, the students visually scrutinize me anew and appear so nonplussed with my sane presentation that I consider feigning a hallucination in order to validate the professor's point.
While looking around the room in consternation I lock eyes with Clint, who is sitting meekly in his corner chair with his legs crossed. Using the telepathic bond peculiar to married couples, we communicate our mutual recognition of the moment's absurdity and I burst out laughing for the first time in weeks. It then occurs to me that I am feeling the best that I have in months, now that I am perched securely in my wiry little nest of beeping machines.
Immune to both mirth and sorrow, the doctor consults his watch and walks out, with the students trailing behind like the world's lamest paparazzi following the world's most uninteresting celebrity. My anger relents when I suppose that they also have a long night ahead of them. My cooler head then leads me to consider the possibility that dreaming of being a doctor and the reality of navigating medical school are maybe not the same thing, and I also admit that my own demeanor during the past several months hasn't put me in a good position to condemn flat affect when displayed by others.
A surgical nurse enters with what looks like a rolled-up beach towel and proceeds to unroll it across the length of two stainless-steel trays. As he does this, I see that the inside of the sterile cloth is lined with dozens of scalpels, scissors, and various small glinting bladed objects. The assistant leaves and then returns with another towel, identical to the first, and repeats his actions onto two additional trays.
“Oh boy,” I observe. “That's a lot of knives.”
The nurse looks at me and continues with his task, explaining, “Yeah, this doctor likes to have a second set ready, in case something drops.” I am not as comforted as I should be by this assurance that duplicates will be at the ready once the blades start to fly around, but I keep my misgivings to myself as he walks out.
I am gratefully surprised to see my breast-feeding-neutral doctor walk in and announce that she will be attending the birth; I had been told repeatedly to expect any of the doctors who populated my “caregiving team” and was prepared for a virtual stranger, unable to recall even half of the medical characters who had traipsed across the stage of my life during the past nine months.
“I am glad that it's going to be you,” I tell her with the trust and affection of a child.
She looks over my chart. “How are you doing?”
“I'm scared,” I say, because it is true. I have always been convinced that I will die during childbirth. This is not only because I could never imagine myself as a mother; it is also fueled by my suspicion that this is how my maternal grandmother died. My mother never says much about her own mother, nor her brothers and sisters, except that the ones who survived childhood numbered more than ten.
Diskutere fortiden gir ingenting
(You can't change the past by talking about it).
The doctor stops and looks at me. “If something happens to you,” she assures me, “we can have you prepped and in the operating room in forty-five seconds,” and I am momentarily enthralled by the idea that there must be another room around the corner with even more numerousâand far more sophisticatedâinstruments in it than this one.
She then turns to Clint. “That being said, if something happens to you, like you faint, we will kick you to the side and keep going.” Clint's mother was a prominent obstetrician in Philadelphia and complicated births were the dinner-table conversation of his childhood, so there is no danger of him fainting, but he nods his acceptance of the scenario described.
She examines my cervix and concludes, “Everything looks good.” She adds, “I'll be back after the epidural unless you need me,” and then walks out.
A couple of hours go by, during which the blood pressure cuff squeezes my arm encouragingly every twenty minutes and reminds me in happy beeps that I am doing just fine. Then the contractions get really bad and I begin to groan slightly with each one.
“Lord, you sure don't say much,” observes my nurse while changing the IV bag.
Taking this as a compliment, I admit, “Well, it wouldn't help to carry on.”
“No, it sure don't,” she agrees while opening the line that connects the IV to the veins in my arm.
The contractions get much worse and I begin to plead with Clint, quietly begging him to help me in wild-eyed whispers. He stares at me with the calm, friendly face of a Saint Bernard who has just dug you out of the snow and who assures you that a rescue team will be here any minute, and would you like to suck on some ice chips while you wait?
After what seems like hours, a distinguished-looking doctor walks in, accompanied by some sort of lackey, and introduces himself as the anesthesiologist. “Have you ever been treated with ropivacaine before?” squeaks the sidekick while he examines the lower vertebrae of my back, causing me to wonder if this is really something that he expects the average person to know.
After a pause my nurse answers for me. “Probably. Her chart's two inches thick.” I begin to suspect that these smart-aleck answers are her hospital trademark, given the practiced way that everyone ignores her.
“Hell, I might be on it right now,” I add gamely, my voice shaky with pain, and while looking in her direction. No matter what you say while in the hospital, doctors won't laugh at your jokes. I suppose the official medical school position teaches that no matter how hilarious your patient thinks her condition is, it is not your role as a doctor to guffaw and up the ante, but it still exhausts one to play to such a sober audience.
Fascinated by the fact that they are actively slipping a needle into my spinal cord, I wish desperately to watch the procedure in the same way I had goggled while the nurse poked my arm full of intravenous ports hours earlier.
After a pause the doctor says, “Well done. You are in the right line of work,” to what I guess must be an intern who had performed the insertion.
“Yeah, bravo,” I add. My thighs start to tingle and I soon feel comfortably numb from the waist down. The pain isn't gone but something has turned the volume knob way, way down.
Presently my doctor comes back and explains how I can use one of the monitors to figure out when a contraction is imminent and then push accordingly, thus adding my voluntary muscular work to the involuntary component. Under her supervision, I do this. For about three hours.
“Okay, new approach,” she says brightly. “Did you grow up somewhere where it snowed?”
“Yes,” my husband answers for me, “she did.”
“Okay, you know how when a car gets stuck in a ditch, you have to rock it outârock and then pushâto get it moving?” she asks.
“In Minnesota, that's just how we park,” I reply while panting, and the smile that she gives me is like a hundred-dollar bill that I can stuff into the pocket of my heart.