Banal chores in a surreal world

Our nurse in the NICU yesterday was Jill, a confident and bubbly gal, probably a couple of years younger than Anna. Each NICU nurse rotates between two babies, and but for lunch, dinner, and the occasional restroom break or supply run, they stand (or sit) between them for the entirety of their shift. Anna and I haven't seen the parents of Frankie's nearest neighbor, the other baby under Jill's care at the moment. That leaves the three of us more or less alone for long stretches of time that lend themselves to conversation. Given the intimate nature of the situation into which we've been thrown together, our talk begins at a very personal level. After an hour or so of increasingly self-revelatory banter, she offers as a clarification appended to her standard issue sympathetic condolence w/r/t our situation, "I mean, I don't have any babies of my own, but I can just imagine...I mean, I know I can't really imagine...I mean, it's just so..." Her voice trails off because she, like 95% of the doctors, nurses and technicians we've dealt with, is incredibly sensitive to our feelings, which should apparently be more fragile than mine seem right now. Perhaps it's denial or some related, subconscious defense mechanism, but I feel confident that Frankie is going to be okay, even if we've got a ways to go before he gets there. I realize this is a totally irrational optimism to which I subscribe, but it seems to be working. And so, when Jill stumbles awkwardly onto sensitive ground, I redirect the conversation with a question that's been on my mind since we arrived here Thursday. "Does being a NICU nurse make you think twice about having babies?"

As I've mentioned at least a dozen times, we were totally unprepared for this little adventure. We survived as well as we did because of sheer luck and the support of family and friends. Everything from flexible bosses and sympathetic employers to above-average insurance coverage have made this whole thing manageable. But for our good fortune, this could have been a soul-crushing experience. What few advance preparations had been made before all of this began were primarily a result of Anna's innate proclivities. We certainly didn't plan for this, largely because nobody suggested it as a possibility. And it's not like we weren't actively seeking information. I've complained before about the woeful inadequacy of our birth and baby care class, and I can honestly say that I can't recall a single mention of the possibility of preterm birth, other than a blithe dismissal of one expectant mother's concerns about the subject. "That won't happen to you," or some such misguided reply. And the pregnancy books aren't much better. In Planning Your Pregnancy and Birth by The American College of Obstetricians and Gynecologists, discussion of preterm birth and premature babies is limited to four pages at the end of the book, in the chapter on "Complications of Pregnancy." It's here, on page 366 (of 422), that we are finally informed that "about 1 of every 10 babies born in the United States is born preterm." See, to me, 10% is kind of a large number. Every tenth baby born in the United States arrives before the end of the 37th week. Now, admittedly, those born after 36 weeks suffer very few of the complications generally associated with preterm birth, but still, that's a lot of babies. What little information PYP&B offers on the issue of preterm birth and preterm babies is limited to identifying the symptoms of preterm labor and describing the process for preventing its progression. Less than half a page is dedicated to the discussion of preterm babies. The remaining references to preterm birth, premature rupturing of the membranes, and preterm babies are scattered throughout the latter pages of the book, always in association with a discussion of some risk factor, such as drug use, alcohol consumption, smoking, sexually transmitted diseases and other medical conditions or physical abnormalities, none of which applied to Anna. Nothing in this book indicates that we should have been even slightly concerned about preterm birth. The Mayo Clinic Guide to a Healthy Pregnancy is slightly better, boasting both a 4-page section on preterm birth in the last part of the book, "Complications of Pregnancy and Childbirth," and also an 8-page section on premature newborns in the chapter "Your Newborn." Still, there's nothing in the book to indicate that we should be concerned. If these books are to be believed, the ten percent of birth parents who go through preterm birth must be two-pack-a-day, diseased drug addicts, not tobacco/alcohol/drug-free women who go to the gym four times a week and subsist on a diet comprised entirely of organic foods. So naturally, we weren't prepared.

But what were the books and birth instructors supposed to tell us? That every woman is at risk of preterm birth, regardless of their medical history or the precautions they've taken throughout pregnancy? That nobody really knows why membranes spontaneously rupture months ahead of schedule? In short, yes. Everyone should be aware of the risks going in. Even if there's nothing you can do to prevent pre-term birth (although I'm not convinced that's necessarily the case), preparing yourself financially and emotionally ahead of time can certainly soften the blow. I guess I just wish I could've seen it coming. Like I said, we got lucky. How many among the unfortunate ten percent don't?

I suppose I really don't know that it's possible to prepare emotionally or psychologically for preterm birth. The question about whether or not being a NICU nurse made Jill more reluctant to have babies stemmed from my own uncertainty about whether or not knowing about this in advance would've really helped. Would knowing this was a possibility have changed anything, or would it have just added another element of anxiety to an already overburdened mind? Like Jill said, sometimes knowledge is counterproductive. Still, I think I'd like to have known.

There are certain things that can only be written in hindsight. Some moments over these past few weeks have been unspeakable until now. For instance, from the time we checked into the hospital at the end of June, right up until the time Frankie arrived, I had a frequently recurring nightmare. I can't remember any of the dream but the very last moments, and it was always the same. I'm holding Frankie in the palm of my hand. His head rests near the tips of my fingers, his bottom against the ball of my thumb, his tiny legs dangling on either side of my wrist. His chest is heaving, his breath keeping pace with his racing heartbeat. His eyes are closed, and he reminds me of a featherless baby bird, fallen from the nest. When I was very young, probably six or seven, my cousin, my sister and I found such a bird on the concrete breezeway outside of the reception hall where my great-grandmother and great-grandfather celebrated their fiftieth wedding anniversary. In the dream, the sight of Frankie in the palm of my hand conjures vivid memories of that event. As I'm staring at Frankie, thinking of that dying baby bird, I remember that I couldn't save it, and I become panicked by the thought of just how fragile my son is. I don't know how long I am transfixed by this terrifying image, but each time the nightmare ends with Frankie's tiny head lolling to one side, his tiny chest collapsing, then motionless. And then I'd wake up, lying on a cot next to Anna's bed, my heart pounding as I strained to hear the reassuring thuka thuka thuka of Frankie's heartbeat on the monitor across the room. My sister took a picture of my dad and I shortly after Frankie arrived, before the doctor told us about the complications. The ecstatic expression on my face is at least partially attributable to the huge sense of relief I felt when I saw how big Frankie actually was. And of course, the nightmares stopped immediately thereafter.

You don't have to be familiar with Freud or Jung to parse that particular dream, but I find it interesting that it is the only one I can recall in any detail. Throughout our pregnancy, I remember few dreams about Frankie. I definitely had a couple, but they were infrequent, and for the most part unremarkable. I don't think I ever thought about one for any longer than it took to finish a first cup of coffee. But this nightmare stuck with me. Not only did it occur on multiple nights, but the image haunted me at various moments throughout the day, when my mind would wander into the forbidden territory of Things That Could Go Wrong. I employed the usual tactics of distraction and misdirection to exorcise my imagination, with limited success.

If this post seems disjointed, it's because I'm grappling with a series of events that make little sense to me, but which have utterly consumed my life. I wasn't lying when I said that I am optimistic about the eventual outcome, but the moments between are strung together with doubt and frustration. As fortunate as we've been, and as positive as Frankie's prognosis is, this has been the most emotionally taxing episode in my life. Somehow, telling y'all about it seems to help. Now, I'm going to buy groceries.