baby – MARY PAN

Narrative Medicine Monday: In Search of Collateral Beauty

October 28, 2019 No Comments

Writer Kat Solomon is “In Search of Collateral Beauty” in her recent Ploughshares essay. Solomon describes being wheeled into the Neonatal Intensive Care Unit to see her premature newborn, noting that “time has slipped away” but that “now, I am a mother.” Solomon provides a vivid description of the NICU, the “little room [with] its own symphony of beeps and blips,” the “plastic isolettes and incubators.” Her baby has arrived five weeks early. The first night, untethered to any tubes or isolation, her daughter is simply monitored, Solomon told she may be released the following day.

The next morning, though, they find the situation drastically different, their baby “sleeping in an enclosed isolette with an incubator like the kind I have seen on television, and she is connected to several wires and blinking machines.” Solomon has difficulty registering the change, and reaches out to touch her daughter: “I put my hand through the sleeve in the incubator but before my fingers reach her forehead, a nurse enters behind me. ‘Don’t touch her!’ she snaps. ‘She has a long day ahead of her.'” As medical providers we often forget that this is a foreign world to our patients and their families, a point Solomon expands on throughout her piece.

Though assured otherwise, Solomon can’t shake the thought that her baby’s feeding difficulties “must have happened because I was not there—would not have happened if I had been with her.” Solomon’s irrationality is relatable. As mothers, we often, even with evidence to the contrary, blame ourselves.

The language of the NICU strikes Solomon, a writer, as rich with metaphor. She Googles preterm infants and finds that “thirty-five weekers” are called “changelings.” Solomon sees her daughter as a changeling, noting the ephemeral quality of existence: “I’ve made a life, I think, but only now do I understand that in doing so I have also made a death.”

The young NICU doctor asks Solomon and her husband to sit and she realizes that this is an ominous request: “he has bad news, like on television.” The doctor explains that their daughter needs more tests to determine how best to treat her persistently distended abdomen. Solomon asks if it will resolve on it’s own, but the doctor replies that spontaneous resolution is no longer likely.

During Solomon’s experience in the NICU, she thinks of Lorrie Moore’s story “People Like That Are the Only People Here: Canonical Babbling in Peed Onk.” Moore’s story describes a child who suddenly becomes ill and her mother’s experience in the other “country” that is pediatric oncology. Moore’s short story is insightful and even humorous, and is one of my favorites to discuss with health professionals. The mother in Moore’s story finds a way to navigate this foreign land of pediatric oncology, but not without difficult interactions with medial providers, and the system, along the way. Solomon, too, finds much in Moore’s story relatable.

Solomon has a wrenching wait while her daughter has more tests, and eventually is called with the good news that the blockage resolved. She is, of course, relieved, but also angry, “directed completely at the doctor who told us that this outcome was no longer likely.” Can you relate to her experience? For those of us saturated in the medical world, it’s easy to forget the impact our prognosis, our words, may have, the fear they may instill.

Remaining in the NICU for observation, Solomon’s daughter has a “spell” where she stops breathing and this, the nurse informs them, means five more days in the hospital. This frightening episode ends up being the last of their “trials” in the NICU, but Solomon later reflects that, similarly to the mother in Moore’s story, there is a grief inherent in the “imagined version of the way things were supposed to go, the false sense of security that bad things only happen to other people.” I think those who suffer from severe illness, or care for those who do, often feel this kind of grief. Even when things improve, we, like Solomon, know in comparison we should feel “lucky” but can’t help but can’t help but mourn the loss of a cocooning naiveté.

Writing Prompt: What comes to your mind when you hear “changeling” or “spell?” What are some of the words we use in medicine that have other meanings, and what effect might these have on the patient or their family? If you’re not in medicine, think of words that you’ve heard in the hospital or clinic that conjured a different thought or a metaphor. Alternatively, read Lorrie Moore’s “People Like That Are the Only People Here: Canonical Babbling in Peed Onk” and consider if you agree that, even with illness, “there’s a lot of collateral beauty along the way.” Write for 10 minutes.

Ramblings

Free Write Friday: Pool

July 14, 2017 No Comments

2017

I hold her squirming, slippery toddler thighs, evasive like slick eels. She clomps her feet down, uneasy steps in the little pool, even with the extra buoyancy of the chlorinated water. She likes to open her mouth, like a great whale, letting the pool seep in, then out through her widely spaced teeth, two on top, two on bottom. She, surprisingly, exults in going under, seems to fall purposely: Oops! Silly me! Throwing her head back, eyes squeezed tight shut as she leads with her upturned chin, mouth open, nostrils flared, beckoning the water toward her until she is fully immersed, sinking, trusting that I’ll catch her, lift her upright to breathe clear air. As she emerges, a look of unadulterated glee followed by just the faintest hint of melancholy. A mermaid she wishes she could be.

1990

She is so thin and graceful, wearing an electric blue bikini, mousy hair. I’m surprised when she approaches me poolside. Overweight and awkward, I wear my pudginess like armor; it keeps me humble, it keeps me introverted. I long to be charming, liked. Don’t we all at this preteen age? (At every age.) I can’t believe it: friends with me? She’s inquisitive, chatty, polished. I feel more elegant just being near her. It is revealed eventually, this is the truth: I am just a means to her end, a conduit for connection to my tall, older brother. He has reached the golden age: past gangliness, past acne, post-braces. I’m in awe of him too.

1983

I’m learning to swim in the side pool, previously a hot tub but converted to what we call “the baby pool.” A bridge of dark brown tiles, just an inch under the surface, divides the tiny pool from the larger. Like a stumpy appendage, a bleb of an outgrowth, the small pool protrudes. The older kids like to coast back and forth on their tummies, sliding like monk seals. I can barely touch the bottom, on my tippy toes I bounce along, suspended for just a moment, like a moonwalking astronaut. A perimeter ledge for seating, I leap from side to side arms outstretched with orange inflated “muscles,” skinny legs flailing behind me. Sometimes I sink under with the effort, sour liquid up my nostrils, eyes stinging from chlorine. I grab the a handhold of smooth tile, turn, and try again.

Motherhood, Ramblings

Free Write Friday: Relics

May 26, 2017 No Comments

I’ve pulled them from the attic before, stored them in the basement closet. Now the youngest is standing, feeding herself, almost one. She doesn’t need the propping, the overhead entertainment. She’s outgrown the bedside crib, the Jumperoo, the molded foam seat that kept her back upright.

The equipment is garish or cutesy. It’s plastic and bright. It’s overwhelmed our home, fixtures that fade into the landscape, the background of a cluttered family environment. Still, it’s hard to say goodbye.

I know it all needs to be tossed, given away. After three babies, or more since many were hand-me-downs, the stuff is all worn, outdated. I see the new moms today with sleek strollers that keep the baby situated as if sitting on a dais, the stylish bouncers that blend into a post-modern home. Our items are now obsolete in function and style. One of our old baby-propping cushions has been recalled for safety concerns. There’s no reason to keep these things around.

I remember my oldest baby, now in kindergarten, loving the bouncer, thick legs pumping, broad smile punctuated by a high squeal of delight. Her wispy infant hair swaying with the movement like thick reeds of seaweed undulating with the tide.

I remember my middle baby, he didn’t like to be confined; any seat with openings for his legs was too constricting. Instead he squealed for release, wouldn’t sit down even in his high chair, ate his meals standing on the floor or on our laps.

I remember my youngest baby, how we couldn’t find one leg of the baby swing when we pulled it from the attic, rendering it useless. We borrowed another one whose motion was too gentle to soothe her squeaking cries. Eventually we gave up on the swing altogether. We finally found the missing leg long after she was able to sit up, roll over, stand on her own. We disposed of the swing, no longer needed.

I gather the rest of the items slowly, sequentially, as they expire from their usefulness. I contemplate the memories held within with each passing on. There’s a sentimentality to these baby relics, covered with slobber, patted with the chubby hands of three active babes over the years.

As I sort through, I wonder what the contraptions will be like when my babies have babies; how they’ll differ, how they’ll tap into the enduring infant affinity for jumping and rocking, squeezing and swinging.

Motherhood, Ramblings

Free Write Friday: Pump

April 27, 2017 No Comments

She’s pumped in bathrooms, in locker rooms, in economy class on a six hour flight wedged between the narrow aisle and a couple on their honeymoon. She’s pumped on a Washington State Ferry, in the passenger (and driver’s) seat of a car, at her desk at work over a harried lunch. She’s pumped at writing conferences and medical conferences and her own weekend island retreat just to get 24 hours away. She’s pumped while consulting an orthopedist, a psychiatrist, a radiologist; she paused her pumping before calling a patient with the difficult diagnosis of breast cancer.

She’s pumped to get colostrum while her newborn was in the Special Care Nursery, to avoid clogged ducts while at a national bioethics conference, to build up a freezer supply of breast milk for the long days she’s at work. She’s pumped while reading books, while eating soup, while watching bad cable TV in a hotel bedroom. She’s pumped through frustration, through ambivalence, through hot desperate tears of new motherhood.

She’s spent the last six years pumping, off and on. She’s pumped for her three children: willful and strong, eager and growing. She’s pumped for herself: time to work, time to write, time to be something other than Mother, an unclipping of the tether, if only for a few hours. She’s hated pumping, championed pumping; she’s become indebted to the contraption. It’s allowed her to be free, to be connected, to be a distributor of sustenance and maintain her vocational and social and creative aspirations. She gives thanks for the pump, pays homage to it, lays it to rest with gratitude and an easy goodbye.

Motherhood, Ramblings

Free Write Friday: Chair

March 10, 2017 No Comments

I found the chair on sale at a furniture store on the Eastside. Strolling past birch bunk beds and white washed dressers, I pause to consider the price and design of each rocking chair. Tucked in a corner in the back of the large display room, I sink down in the buttery striped cushions, rocking gently in a natural way. A bonus! Pulling a concealed lever reclines the entire contraption; head back I can snooze, envision holding my first baby in my tired arms.

A carefully orchestrated nursery in my parents’ basement bedroom, painted a gender neutral green. Mid-winter in a chilly basement, as a new mom I dutifully get up every couple of hours to feed my newborn, wearily lower myself into the reclining chair, sturdy in the corner. Freezing, chest uncovered, I shiver uncontrollably in the black hours of the night, hormones swinging hot and cold. I lash out tearfully at my unsuspecting husband, begging for space heaters to warm my weary body.

The chair fits two: a toddler and a newborn baby boy, story time for extra cuddles. It sits comfortably in the newly remodeled bedroom corner, flanked by a large window and floor lamp. We know better now, use it mostly for reading and rocking, not for middle of the night feeds. It’s still the most comfortable place to nurse, cocooned by cushy armrests, a gentle flex of my toes provides the soothing back and forth. I look out the window at our backyard, a hill of our city beyond; I look down and find my two arms full.

It’s wedged at the edge of the baby’s crib, a twin Jenny Lind bed frame lodged against the opposite wall. The two girls share now, eventually the oldest will turn preteen and retreat to the basement bedroom but for now she savors sharing space with her little sister. My youngest baby is almost a baby no more, a few short months and a toddler she’ll be. I savor the early morning and bedtime nursing, rocking gently in the dark quiet room. Occasionally the door bursts open with exclamations from my three year old about treasure maps, from my six year old brandishing school artwork to admire. My baby and I pause for a second, then resume the rocking, suckling. She gazes up at me through long lashes, wrapped in a patterned throw my grandmother crocheted of flowers and hexagons decades ago.

Ramblings

Free Write Friday: Baby Food

March 3, 2017 No Comments

She starts kicking her legs vigorously as I place her in the high chair, a physical exclamation at the excitement of an anticipated meal. I can’t get the candy-colored bib fastened to her neck soon enough, can’t assemble the tiny coated spoon or stout glass jars fast enough. She’s impatient for nourishment.

There’s a pop as I twist open the jar of apples and blueberries, banana cinnamon oatmeal, sweet potatoes and chicken. Her legs kick again, pistons pumping. Her tiny mouth opens mechanically, a trap door to her gustatory system: open, shut, open, shut. She knows the loaded spoon is coming and the hatch complies. I know when she’s eager like this she’ll complain if I don’t shovel fast enough, if I don’t keep up with her hunger for more.

If I feed her a taste she disapproves of there’s a pause in the rhythm, she considers for a moment and gives a tiny grunt. She might accept another small bite of the spinach and peas or grainy carrots. I imagine her letting it roll on her tongue but the texture or consistency or substance just doesn’t agree. So she’ll shove out her lower lip in defiance and reject the offensive flavor, sealing her mouth tight to reject the advances of my spoon.

I quickly switch to an alternative option, a fruit I know she’ll accept: the old reliable apples or pears. A little dribble of saucy food on her chin, I scoop it up and into her mouth. This is a dance between us two, coordinated and practiced, we each anticipate the next step. It takes effort, these three meals a day. It’s messy and repetitive. I’m still nursing in between the solid food servings and the combination makes some days feel like my only job is to provide her sustenance.

I look at my two older children who shovel their own food, who can make their own pb&j sandwiches, who can take their own dishes to the sink and help unload the dishwasher. It won’t be long before this baby won’t need me; she’ll be able to feed herself.

I know when she slows her tempo, I can follow suit. Her legs stop pumping so frantically, her squeal of impatience subsides. She looks around the room, turns her head to the side, regards her siblings. I imagine her savoring the food a bit more carefully, considering what this mama of hers is providing, developing her own tastes, her own preferences, becoming the person she is.

Motherhood, Ramblings

Free Write Friday: Dressing

January 27, 2017 No Comments

The stomp of his feet as he clambers upstairs, whiny pitch to his voice as he exclaims: “Mommy, where my clothes?” His big sister is dressing and he’s beside himself. He wants to follow suit. Three years old, he can choose his clothes and dress himself, but an older sister trying to be helpful stifles his independence by doing it all for him.

When he was a toddler he writhed this way and that, twisting his torso with wild intention as I tried desperately to diaper and clothe him. I was surprised he was so particular about what clothes he wore. The shirt had to hang just so, the waist of the pants a specific elasticity, the fabric itself not too textured, not too rough.

Now we lay all the next day’s clothes out the night before in a green laundry basket. After bedtime bath, they each choose clothes for the following day. Sometimes an argument ensues: a sleeveless dress in the chill of winter, pants that have long been outgrown, a shirt already stained and dirty from wear earlier in the week. The compressed morning requires this evening ritual, whether mommy is working or not. I’m either tasked with getting the oldest out the door to before school care or hauling all three to morning drop off by the the elementary school bell at 7:55 a.m.

The baby is easy. No choice in the matter, she wears what I choose, what the nanny decides. On work days I arrive home, sometimes surprised at what the nanny has chosen, more or less layers than I would have picked out, leggings matched with a top I hadn’t considered. If I’m home for the day, often I’ll leave the baby in her pajamas; an easier non-choice for a harried mama of three.

After dressing, my eldest moves on to accessories. She carefully selects a headband, brushes her hair, the front part at least, to a gleam, considers her reflection in the mirror. She tries on a turquoise ring, takes it off. She adorns herself with a beaded necklace, or two. Sometimes she practices her ballet moves on the blue step stool in the bathroom, lifting a lithe leg, pointed toe, reaching up behind her like a flamingo’s pink neck, extending to the sky. The elegance and simplicity of the moment gives me pause before I rush her, rush us all, finally clothed, out the door.

Ramblings

Free Write Friday: Goodnight Moon

December 30, 2016 No Comments

Her sister loved the book, requested it every night. Her brother, not so much. He wouldn’t sit still to listen to any board book; made me worried about his attention and future schooling prospects. The words rush back to me now with this littlest one, memorized at some point years ago with the repetition I endured. Every night: “In the great green room…” I rock the baby and read.

She tries to eat the thick pages, colored with orange-red, yellow, kelly green. She too takes to the silly story of bidding goodnight to the bears, to the mittens, to the bowl full of mush. I discover I now find comfort in the rhythmic cadence, the sentences fall out of my mouth sing-song, lyrical and pleasing.

Maybe that’s why she listens quietly, transported to the simplicity of a warm room, a rocking old rabbit, a nightly ritual of farewell to all the little things that surround us – the comb, the brush, the little toy house, and all the big things too vast for us to comprehend – the stars, the air, nobody, the moon. Goodnight to it all. Goodnight to the immediate and the immense. Maybe this still appeals at a time when everything seems virtual, intangible, rushing by. It’s nice to stop and acknowledge, step into the present space and recognize the greater cosmos above.

Motherhood, Ramblings

Free Write Friday: Monitor

December 9, 2016 No Comments

Grainy pixels coalesce into view with the push of a button. Static and then there she is: a babe in a cushioned box. She’s still, motionless, but I can’t stop watching. I peer closer, hoping to perceive the rise and fall of her chest under the sleep sack, a substitute for the blankets now outlawed due to associated risks. Today’s crib is a barren landscape of one fitted crib sheet. That’s all. No stuffed animals, no crocheted blankets. No binkies, no dolls. We even sacrificed introducing a lovey, modern parents that we are, saturated by the tragic news of the information age, too paranoid about accidental asphyxiation.

I am entranced, can’t take my eyes away. Sometimes she moves, rolls this way, then that. I glance up, glance back to find her lying perpendicular to where she was before. One side of the crib, then the other. When her eyes open they glow neon with night vision, bright discs punctuating the darkness, signaling wakefulness. Sometimes there’s a pause before she erupts in cries that echo out her bedroom, through the house, through the monitor, ringing in my ears, ricocheting through my head.

It’s easy to get obsessed with voyeurism. I can watch her every move, scrutinize her intentions. I want to predict: Will she wake now? How long will she sleep? And I wonder: Is she comfortable? Is she breathing? Is she dreaming? What about? I peer into the pixels, as into a crystal ball, willing the future to take form. Who will she be, this rolling, round-faced, murmuring babe?