MORE ABOUT THIS BOOK
My first child, my girl, was born just before seven on a spring night, perfect. She was compact and fully formed, a little over five pounds. She smelled like sliced apple and salted pretzels, like the innocent recent arrival from a saline world that she was.
But the midwife was worried. “She’s small for gestational age,” she kept saying. “Any problems or issues during pregnancy?”
I wanted to ask her if heartbreak counted. If sharing a bed with a good-hearted dog, rather than the baby’s father, might do it.
“Also,” the midwife said, “she looks a little jaundiced.”
“That’s just the Greek side,” my mom cut in, “we’re all yellow.”
The midwife finally handed her over, a waxy, pinched little thing. Gory and unkempt. Not serenely smiling like the dolls of my youth. But a real baby, mine.
When I breathed her in, a straight, bright synaptic path lit up the center of my brain. Every neuron said to its neighbor, yes, yes, yes, yes, this is the one, yes. This reaction is hardwired. Animals identify their offspring by scent. But to me, it felt like magic. Smelling her elicited euphoria akin, I imagined, to the unadulterated delight of smoking crack cocaine for the first time. After a few hours of life outside the womb, she began to smell less like apples and more like an element, tin or iron. Something practical, a garden tool or an old coin, sprung from dark soil and delivered into the palm of my hand.
After months of waiting to see who this child would be, after fending off the broad hints of a sonographer who was dying to give away the mystery of her gender, after sleeping alone in a thicket of unhappiness, after praying to skip over incubation to active motherhood—here she was. A little football of a person, tucked into the oval between my arm and torso, breathing on her own, making minor noises. Preoccupied with the job of being alive. Under a fringe of downy hair, at the base of her still soft skull, I found a pale pink birthmark, strawberry shaped.
For the next ten hours I lay awake, breathing her in, stunned to find a small human body nestled against mine. I couldn’t figure out where on earth she came from. The biology I understood; I knew about the genome, the dim lights, the Richard Buckner music, the curved helix of DNA. But none of that could account for her. Her birth was both an utterly quotidian event (245 new children are born into every minute) and a jaw-dropping miracle to rival loaves and fishes. There was no one. And then, poof—her.
I didn’t sleep. I couldn’t sleep; I didn’t want to miss anything. What if she sighed or pursed her lips or splayed her fingers or jerked her arms upward?
I was still awake, a little before 3 a.m., when a gentle-faced nurse came in. He didn’t seem surprised to find me up, smelling the baby. Typical new-parent behavior. He said, casually, that they’d like to take her to the nursery for a few tests. The oddity of routine tests at three in the morning didn’t register. It was obvious that my child was totally healthy; what harm could tests do?
Healthy babies were all I knew. The array of placid baby dolls I’d spent hours clucking over as a girl had smelled faintly of vanilla. They had coy smiles and carefully molded plastic hair. I tucked them in. I burped them. I crooned into their plastic ears. None of them ever ran a fever or broke out in hives. Even baby Jesus (the biggest celebrity baby of all time) was a robust little soul. Holy infant so tender and mild.
The nurse promised to bring her right back. Without her, I was at a loss. I motored the bed up and down, edgy, unfocused, waiting for my fix. An hour later the nurse came back empty-handed. “Where’s my baby?” I said, sounding, even to myself, absurdly panicked.
He gave me a pointed look, half sympathy, half crowd control, and said, “We’d like to run a few more tests.” At the door he added, “The doctor will be in to talk with you in a few minutes.” I didn’t know anything about hospitals yet; I didn’t know enough to be terrified that an actual doctor would appear bedside before daybreak.
When I had imagined threats to my future children, they’d been external. Strangers hovering at the edge of playgrounds in loose, gray sweatshirts; rotting rope swings fraying over jagged rocks; cars, everywhere, callous, steely-eyed killer-cars. These were possibilities I could conceive of. Illness had never slunk across the screen of my anxieties, with its curved spine and sallow cheeks. I probably wouldn’t have recognized it even if it did. Serious illness, life-threatening illness, was outside the realm of my imagination. If pushed to consider the question, I might have responded that I was protected from the possibility by the mere fact that it had never occurred to me. I might have said, “If I can’t imagine it, how can it happen?”
On my first date with the father of this five-pound girl we went to an intimate place on the corner of Jane Street in Greenwich Village. The kind of place where, to reach your table, you’re obliged to wedge sideways and apologize to strangers whom you’ve brushed with your hips. Seated, we leaned over the small table to breathe the same air and figure each other out. He said he’d read recently that everyone has a personal “happiness quotient,” that your happiness in life is essentially set, regardless of circumstances. He reckoned his was low, and guessed mine was high.
I’d never heard of a happiness quotient. I’d never stopped to consider happiness as anything other than an assumed default state, a place to return to after the occasional thick fog. If, as a kid, I had been asked to state the one thing I believed to be true about my future, I’d have said, “I’ll have a happy life.”
Not that I’d had a blindingly happy childhood. I hadn’t. I’d had a childhood of being profoundly loved amid serial chaos. I grew up as the only child of a warmhearted, fleet-footed single mom who was always exploring her options, in men, jobs, lifestyles. It was California in the 1970s. For a while I attended school in a geodesic dome on a hilltop. A herd of goats grazed on long, golden grass outside the open door. Sometimes we ran among them without shirts, boys and girls alike. One of the male teachers enjoyed watching, too much. Everything in my world moved fast, and my job was to hang on. Still, I’d emerged with the idea that my own adult life would be happy and essentially free of adversity. The optimism of youth, which I’d somehow hung on to until thirty, thirty-one even.
A happy life, at the time of that Jane Street first date, did not include, from my point of view, being the mother of a child who required extensive neonatal medical care. Or spending a pregnancy alone, heartsick. Those possibilities weren’t visible from the corner of Jane Street; all I saw was the man before me in a pressed blue dress shirt, delivering literary jokes with a shy, sly humor. The amused look in his eye when I chirped with surprise at the arrival of our salads. “Do you always greet your food so enthusiastically?” he asked. “Not always,” I said. “Only sometimes.” Only now.
The 4 a.m. doctor was short and bespectacled with a round, soft face. A pleasant-looking bearer of bad news; he seemed personally pained by what he was about to say. He started by explaining the baby had high levels of something I didn’t catch, emphasizing the need to transfer “the patient” to a larger hospital. “Right,” I said, trying to muster a little dignity in my flapping nightshirt. “But what is actually wrong with her?”
“Your baby is at risk of brain damage or”—he paused and glanced around the room as though looking for something he’d mislaid—“death.”
I felt embarrassed for him; clearly he was in the wrong room. He’d confused my baby with another baby. I tried to break it gently, “This is the baby born at seven p.m., the five-pound, five-ounce girl, with a strawberry on the back of her neck.”
“Yes,” he said. “I know.”
Still, I refused to apply these words—death or brain damage—to my swaddled and fabulous-smelling daughter. Death was ludicrous. And brain damage was out of the question. Way, way, way out of the question. In fact, the question and brain damage didn’t even know each other. The question was: when can I take her home? Still, the doctor was in earnest. I decided to play along. “OK,” I said. “OK, right. OK. Then what do we do?”
He explained that her red cells lacked stability and were breaking apart in the bloodstream. The iron inside each cell was spilling into the blood and floating freely throughout her body, at risk of lodging into the soft tissue of her brain. “So you are saying what, exactly?” I said. “She’s at risk for rust head?” He looked at me, appraising. A long silent moment went by. “That’s humor,” he said finally, “common coping mechanism.”
At the door he added, “We need to clean her blood immediately. We’re transferring you to UCSF Med Center. The ambulance is waiting.” University of California San Francisco Medical Center, the place I’d elected not to give birth. The big-city hospital. The tall, silver fortress on top of the hill, across the Golden Gate. The last place on earth a brand-new baby wants to go.
On our second date, we ate at a bright, loud diner along Seventh Avenue. If harshly lit Formica can feel romantic, I told myself, then this is foreordained. He asked me to list my “diner worries,” those anxieties so slight they could be jotted onto the waxy parchment of a placemat. I have no idea what I said. I likely made things up, things to make me seem Frenchly philosophical or politically courageous or, failing all this, mysterious. I was young, I owned an apartment in New York City, had a good university job, and was on the cusp of what might be a relationship with a serious, kind man. Diner worries were in short supply.
But I loved that he asked, that he wanted to etch a record of my preoccupations onto a placemat. Later I would learn that he often took notes about things his students said, their goals, their literary heroes—to keep them straight, to accumulate an understanding of what they hoped for. At first this seemed excessive. But later it struck me as intrinsic to his way of being. He wanted to know, understand, remember who people were. How they were. And the best, truest way he knew to burrow toward the truth was to write things down. On the page he could add up a girl’s diner worries and see what they amounted to.
The ambulance driver told me to ride up front.
“What about the baby?” I asked.
“She’ll ride in back, with the paramedics,” he said.
“The paramedics are great,” I said, “but they don’t really know her.”
“We’re just going over the bridge,” the driver said, “she’ll be fine.”
At this point I became what was probably noted in the trip log as combative mom. Logically, I knew the driver was not responsible for my girl’s precipitous need to be transferred, at less than twenty hours old, to a neonatal intensive care unit—but neither did he grasp how my entire world was encased in the plastic box that was her incubator. My job was to stick with the plastic box, no matter what.
“Actually, I’m going to ride with her,” I said, trying to make it sound as if, after weighing his various options, I’d settled on this. Somehow, that worked.
In the back of the ambulance were four people: two paramedics, me, and her. It was just beginning to get light as we crossed the Golden Gate, leaving Marin County and entering San Francisco. In between the black mass of the bay and a gray bank of clouds, a pale, thin line of pink wavered. Daylight. I relaxed a little. Surely nothing catastrophic could happen during business hours.
My mother’s car was trailing the ambulance. I knew she was filled with worry. Worry was undeniably called for given the situation: ambulance, dawn, newborn, bad blood. But the baby sleeping peacefully under my hand defied worry. She had a rosebud mouth and delicately veined eyelids. She didn’t stir, not even when the driver turned on the siren to speed through red lights. I stroked her forehead and tried to get my mind around our situation. Inside this tiny person, microscopic red blood cells were falling apart. She was a stressed creature, straining to deliver sufficient oxygen to the outposts of her body. How could she appear so serene?
The repertoire of reptilian brain function—fight, flight, denial, play dead—is great for emergencies. It wedges space between the event and the self. I had been swinging between denial and fight (my two personal favorites) from the moment the round-faced doctor said ambulance. Now, sitting with the baby, I felt the unwelcome return of higher reasoning. I began to pump the paramedics for information: What would happen when we arrived at the hospital? Would I be allowed to stay with the baby? How long would it take to clean her blood? What were the odds for babies in this situation?
One of them explained that the method for cleaning her blood was called an exchange transfusion. An exchange transfusion works, she said, by removing all the blood from the body, passing it through a device that extracts excess iron, warming the blood back up, and returning it to circulation.
Are you insane? I wanted to ask. Bloodletting? So clichéé. So over. So Middle Ages. Consider your reputation, if not the baby.
I sat there in silence, trying to visualize what a blood cleaning/warming machine might look like and how they would attach it to her. It dawned on me that the next few hours mattered, really mattered, and that even babies who smelled just right might drift off.
I looked down at my girl, sleeping, gathering air, converting it into oxygen.
“All the blood? Out of her body? At the same time? “ I asked. “Is that prudent?”
The paramedic touched my shoulder and said, “She’ll be OK. They’re much stronger than they look.”
Through the small window at back of the ambulance, I could see a steady streak of green. My mom’s Volvo sedan, behind us. I had the sense that she would follow us anywhere, no matter how fast, no matter how far. When I had called my mom, only an hour ago, she’d been asleep. “What do you mean rusty blood?” she’d said. “Is this about the baby?”
“Drive here,” I’d said. “We need you.”
She’d arrived in time to catch the ambulance’s wake. For her, I was the girl, and this whole ambulance was the plastic box.
After our third date, we went back to his apartment. He was a studio dweller on the Upper West Side, twenty-sixth floor, a view of the George Washington Bridge, which he revered. A wall of windows and little else. He had a single pot and stacks of books. Against the barrenness, he’d waged the smallest possible stand—a decorative postage stamp. Joe Louis.
That is how I began to fall in love with Brian, all that emptiness, and then, suddenly, a black-and-white postcard of Paris or Beckett; the hidden trapdoor to something more.
The art in my apartment was as big as I could afford it to be, giant posters from foreign museums, hand-carried on the plane ride home, trying always not to dent them, destined for cheap oversized Ikea frames. My favorite was by the Mexican painter Rufino Tamayo; it showed a figure, sitting facedown at a table, the circumference of his head dominating the space in pinks, yellows, violets. Man Radiating Happiness.
In contrast to Brian’s, my daily life was erratic, unorganized, and subject to an appetite for salty snacks, phone chats, trashy magazines, generalized rose-sniffing. My mornings were spent teaching drama in public schools with kids all over the city as an “actor-teacher” with the Creative Arts Team at NYU. Afternoons, when I should have been doing my own schoolwork (I was a grad student) or rehearsing a new solo piece, I would instead lollygag about town. If I did rush home, it was to watch General Hospital and eat ice cream. If a friend called to say let’s go to Battery Park and check out the river, I was game. Even if I had a pile of more pressing things. Around 11 p.m., when the hourly studio rates fell, I would go rehearse. If I had a performance coming, I’d focus. Otherwise, I was a creative malingerer.
But Brian knew how to work. His life was ordered, boundaried to the extreme. A man who, by his own admission, ate broccoli with brown rice and garlic sauce every night for dinner. A man who pruned back the trivial decisions, who wore French Blue dress shirts and black pants every day of the week, for consistency’s sake. A man with an embedded internal clock, which told him to sit and write at the same hour, day after day. A man with a gift, and the dense garden of habit grown around it for protection.
We were a study in opposites; hopelessly attracted. We floated about from dinners to concerts to parties with friends. Holding hands, touching each other’s clothes. When we walked through the Village, along Sixth Avenue, shoulder to shoulder, I had a liquid sense of well-being. We were in the throes of infatuation, soft-minded and easily persuaded of our rightness for each other by sexual thrill. But there was a bedrock quality beneath the giddiness, something I hadn’t felt before. Being with him gave me the unfamiliar feeling of being what I was—a grown woman.
Within minutes of arriving at UCSF Medical Center we were hustled upstairs to the Neonatal Intensive Care Unit (NICU, pronounced nick-u). I stood beside the baby’s incubator; it had two portals you could slip your hands through, to touch your person. This was the extent of what you could do for your baby in the NICU—stand beside the box stroking a finger or toe or tiny elbow beneath the blanket. I stroked my girl’s knee.
A petite doctor with a blond bun crossed the room.
“Listen,” she said, nodding in the baby’s direction, “she needs a central line placed into her umbilicus, immediately, for the exchange transfusion.” The doctor projected the air of an overachieving-homecoming-queen-valedictorian-tennis-champ. Probably played Rachmaninoff’s harder pieces for fun and relaxation. “Please sign this release. It’s just a procedure, not surgery. The umbilicus is numb, so she won’t feel a thing.” Beneath her lab coat, visible at the collar and cuffs, was a heavy silk blouse, cream colored. She was too young, too pretty, too sure of herself to be a decent doctor. But she was who we had. I tried to parse what she’d said: just a procedure, not surgery. She wanted to attach a tube to the baby. That much I got.
I wanted to talk to the nice doctor with the soft boyish face and glasses, from Marin General. But he had sent us to her. The blond doctor was waiting for my answer; would I allow her to attach the tube or not? She held out the form and a pen.
Would a plastic part really improve the baby per se?
What would Brian do? I tried to summon some of his steadiness, his ability to lever rationality into crisis. I signed. She exhaled, her shoulders dropped. Astonishing! This woman was as nervous about my judgments and decisions as I was about hers. A nurse scooped up the baby and left the room.
Copyright © 2017 by Heather Harpham.