Express Delivery

EDITOR’S NOTE: This is the second part in the story about Lucas’s birth. Also, I really wanted to write “EDITOR’S NOTE.”

It’s strange to me to spend time in a hospital these days. I logged so so many hospital hours when I was growing up—between my epilepsy, nighttime seizures, and a bout with the once-named pseudotumor cerebri, I knew the floor plans of at least three medical centers—that there are strange factoids about these places that persist in my knowledge. Rounds happen way too early. Vitals are taken every four hours. Every fifth blood pressure cuff sucks. And nurses come in a vast variety of specializations and competence.

When I spent a week at the Children’s Hospital of Philadelphia, I learned I had two clear favorites, though at this point their names are lost to me. One was taller than a Redwood pine, the other a stout, short woman who cast fear into the hearts of doctors. The tall one always had a compliment. The short one always told me the truth. And when the line of residents came into my room to see how messed up my retinas were, all carrying their own blinding penlight, short nurse was there to steer them away after a couple of minutes.

I realized early on that hospitals are spaces of contradiction. They make people well, even as they’re the easiest place to catch a cold or communicable disease. They’re full of kindness in the light of progressive, inescapable illness, which is anything but kind. Their personnel have a wealth of knowledge about physiology, hematology, pharmacology, surgery, and so on, and often they don’t know anything at all related to an individual’s specific problem. Health care providers have been asked to absorb the latest and greatest in the scientific literature and retain their fundamental training. And because they work the middle of a normal distribution like flies to a cherry pie, an outlier’s power to confound is heightened.

When I yanked on the string coming out of the wall next to the hot tub in Susanne’s birthing suite, I knew it would light up a button at the nurses’ station, and/or sound a buzz. I knew someone would come by, and since this was the maternity ward, they’d probably come quickly. (Not that anyone shuffles to the ICU.) I had expectations, based on years of being the best patient possible.

“What’s going on,” asked our chatty nurse.

“Susanne is feeling like she needs to push,” I said. I wanted to take my worry and send it down the tub drain. I looked to the nurse to calm my concern.

“Uh, okay, really? Let me do another pelvic.” She rushed to put on a couple of gloves, but couldn’t get a good angle on Susanne.

“Can you stand up in the tub?”

Susanne obliged, and held onto the grapple bar on the wall, and then she said in a low voice:

“The baby is here.”

Cue the stream of curse words that flooded my brain, crashing against my frontal lobe whose job it was to keep me from speaking them.

“Uh, let’s get her out of the tub,” said the nurse, who had lost all of the blood in her face. I thought fleetingly: This is our second labor. It must be your hundredth. Right?

Susanne sat on the edge of the tub looking pained and pulled her legs around, and I got up under her arms and scooped her up. I must have had a deluge of adrenaline because she felt no heavier than Emile. I put her back in the bed soaking wet, and looked down and saw the top of the baby’s head. And again, I thought:

HOLYMOTHERFUCKINGSHITHOLYSHITSHITSHITHOLYMOFOOHMYGODITSTHEBABYTHEBABYISHEREHOLYFUCKNUGGETTHEBABYISFUCKINGFUCKINGHEREOHMYGOD

I looked over and the nurse had the phone in one hand and was struggling to get on a sterile glove with the other. I looked down and POP came the rest of the baby’s head. It was purple. The blue umbilical cord was around his neck. The nurse put a gloved finger under it and it slid off of the head.

Then the baby’s eyes opened and just after that, its mouth, and I heard the baby take its first breath. The baby seemed awfully confused about what had just happened.

OHMYGODOHMYGODOHMYGOD

And then:

THERE’S NO DOCTOR HERE. WHAT DO WE DO?

In all of my years of hospitalizations, probes, x-rays and CAT scans and MRIs and nights on the children and adolescent wards, I knew there were quiet times in medical centers, when they’re down to skeleton staffs and the doctors, technically on call, are at home with their families or asleep, or somewhere nearby but not in the building. I knew this, I’d experienced it. But I’d never had an emergency in a hospital where no physician could come to my aid. I was nearly as surprised as the newborn.

The nurse was still messing around with her second glove.

“Forget the gloves,” I said, “the baby is here!” I put my hands over its head so it wouldn’t fall off the bed with Susanne’s next push.

Another nurse ran into the room. We had no warming tray set up, no basin, no towels, no bulb syringe, no clamps, no scissors. Susanne, baby head, bed, and one no longer sterile glove. And now two panicking nurses.

“Get the cart,” said our nurse to the one who’d just arrived.

“What, how could she be, there’s the head, oh my God–”

“GET THE CART,” I shouted.

She ran out of the room and came back with a baby cart. The rest of the baby came out like a greased cucumber.

“It’s a boy,” I said.

His head was purple. Not purple-ish. Not tinged. Purple. I put him on Susanne’s chest and threw a blanket over him. He looked at her with his gray-blue eyes, the color I know is probably temporary, and I tried to wipe the wax off of his head. His pink little hand fluttered on her chest.

“I’d like to cut the cord,” I said, and the second nurse handed me the scissors. It was a thick cord. It took two cuts.

“Why is he purple,” Susanne asked me, since the nurses were running around doing I don’t know what.

I got in close and looked at him. His nostrils were flaring a little, but his lips were red and full.

“I don’t know why,” I said.

“He’s purple. I’m worrying. Is he okay? Is he okay?”

I brought my attention back to the room. Still no physician. I wondered if they’d called Susanne’s doctor. I pulled our nurse over by her elbow the way my mother used to do to me to get my full attention. Pulling someone on their elbow is definitely a direct tactic for getting attention.

“I need you to look at the baby and assess him. If he’s okay, please tell my wife because she’s starting to panic, and we don’t want her to panic.”

“Okay,” said the nurse, looking at me in the eyes.

She bent down and looked at the tiny human.

“He’s okay. See, his lips are red. It’s okay that his face is purple.”

“Okay,” said Susanne. We tried to get the baby to latch to nurse, because that’s what our nurse did when Emile was born. We cooed at him and told him happy birthday, but the feeling of duress hadn’t left the room.

Our doctor walked in, wearing sweatclothes and with her hair pulled back in what I imagine occurred during her quick car ride from the Oregon border to here.

“So, hi guys,” she said, taking in the room. She walked over to the baby and looked him up and down, and did an assessment.

“What’s the time of birth,” she asked.

Nobody had noted it when it had happened, so we guessed it had been 3:25 or thereabouts. That meant from Susanne’s water breaking to delivery was less than four hours. This is otherwise referred to as a precipitous delivery. We’d had no idea such a thing had even existed, other than to read the occasional story about women giving birth in taxis or hospital parking lots. The doctor helped Susanne get the placenta out, and the nurses, back on nurse duty, weighed the baby and measured his length (I held out his leg for the measurement), and got the vernix off of him, finally bundling him up properly. APGAR scores were 8 and 9. He was seven pounds, four ounces, and twenty inches long (although one week later he measured 19.5″).

The purple head was bruising from coming through the birth canal so quickly. It also meant his head hadn’t had much time to get cone-shaped. He stayed awake for two hours, and then we drifted over to the postpartum room to recover.

The doctor shook her head, meaning what I wasn’t sure, but she said to Susanne:

“If you ever have another one, just call me when your water breaks, and I’ll come right away.”