The nadir

this newsletter is my longest complaint yet!

I’ve told Ilya’s birth story so often by now to friends, family, strangers and medical professionals that it’s become calcified, full of bits of shtick. I have a short, casual version, a mid-length version, and a full-length version for birth nerds or people who really care about me or are being paid to listen. It’s hard to access genuine memories from that day already.  At the time I thought it was really dramatic and crazy, like, the craziest thing that had ever happened in my life; it’s a good story with a beat of dramatic tension in the middle and a quick, satisfying resolution. It took a week for it to be eclipsed as the craziest thing that had ever happened in my life. 

We had all been sick that week, the week before my due date, Raffi first, Keith next, then me, as usual. We had a gross summer virus that entailed a fever and a terrible headache. I had the most excruciating headache I couldn’t take anything stronger than Tylenol. I was freaking out, of course, but my midwives weren’t; they were confident that I would recover before I went into labor. I got sick on Thursday and on Friday I started having contractions. I wasn’t immediately Defcon 1 about it because I’d been having contractions on and off for weeks – real ones, not painless Braxton-Hicks. I thought I would probably drink a lot of water and lie on my left side and they would go away, as they had before. But I still called the midwives, and I still called my mom, who’d been planning to drive up from DC with my dad after work, and asked her to take a train and get here asap.  On the off chance that I was going to have the baby I wanted Raffi to be with my parents. I know some people in the home birth community have very joyous experiences of having older siblings witness their births and that sounds awesome if you think you and/or your kid could remotely handle that, but Raffi and I were not about to suddenly transform into calm hippies. He needed to be far from the premises.

My mom arrived, we had lunch and then she left to go pick up Raffi, and I continued to feel like garbage with intermittent contractions and a 101 degree fever – the kind that makes you feel shivery and achey all over. I spent a lot of time in the bath trying not to have a fever and I watched 30 Rock season 3, the ultimate in comfort TV. I ate chicken broth made from bouillon cubes and mochi crackers from Trader Joe’s and drank a lot of ginger ale.  I started to say “ow ow ow” during the contractions but they still weren’t lasting longer than 30 seconds, or coming at regular intervals.  When I started crying because I felt so sorry for myself, though, Keith decided it would be a good idea to call and get the midwives and doula on their way. They all arrived around 7pm.  This part is starting to get a bit blurry; I remember being in the bath when Emily, the doula, came and then I guess putting on some kind of clothes and lying on a yoga mat on the floor of the living room while Karen, the midwife, and her assistant listened to the baby’s heartbeat. They were concerned because the baby’s heartbeat was too fast, and as soon as I heard that I was like “let’s go to the hospital!!!!” because I had a feverish fantasy of the hospital as a place where my illness would be immediately cured, and also maybe the baby would be taken out of me by magic.

Karen was also completely ready to go to the hospital but wanted to rehydrate me with a bag of IV fluids first; she explained that the only difference between laboring at home and at the hospital would be that they would automatically send the baby to the NICU as soon as he was born because I’d had a fever in labor, and that they wouldn’t automatically give me a C section, and that they wouldn’t give me anything stronger for my fever than Tylenol, which I was already taking. Also, she said, maybe my contractions would slow or stop once I was rehydrated – maybe I could have the baby some other time, when I was feeling better. That sounded great to me!!!

It took Karen a couple of tries to get the IV needle in my arm and I had a contraction while she was doing it – this was the low point of the whole experience, because I couldn’t writhe around or move, and it was the strongest contraction I’d had so far. Karen felt very apologetic about this! I reassured her that it was ok; obviously she doesn’t put in IVs every day, so it was impressive to me that it only took her two tries. The IV drip in my vein felt weird and good and I lay on the floor while it was happening and took a tiny nap and had no contractions for, maybe, ten minutes? When it was done Karen measured the baby’s heartbeat again and it was normal.  I had another contraction and this time it felt different – worse and better, and a little bit like I needed to take an enormous shit.  “Uh … guys?” I remember saying. “Something’s … happening.”

I got on all fours, I got my sweatpants off, Karen and Thalia rushed around throwing plastic sheets over everything and finished just in time for my water to break in a water-balloonish explosion.  It was a murky greenish brown – meconium, baby poop, a sign that the baby could be in distress, I knew. I also knew that it cut the time I’d be allowed to labor at home, because there’s a higher risk of infection, but that didn’t seem like it would be a concern because I was definitely pushing with each contraction now and it felt, actually, fine?? It didn’t feel exactly painful. It just felt like work, like “labor.”

Up until this point I had been fixated on the idea that this birth would be just like Raffi’s birth, which took place in textbook stages – water breaking, early labor, transition, active labor, pushing, birth – and which took almost exactly 12 hours, start to finish: half a 24-hour day, a full workday of labor. So when it became clear that this was going to be completely different, it took me a few minutes to catch up, mentally. As I pushed the baby out I still hadn’t fully wrapped my head around the fact that I was pushing the baby out RIGHT NOW and not, as I’d expected, in several hours.  It was a little bit anticlimactic, actually!  I had steeled myself for so much work and so much pain. I did experience one more moment of wild agony as I had to wait for a second contraction to get his body out after pushing out his head (Keith apparently saw this, Ilya’s purple head just hanging out outside my body and the rest of him still inside, and I am amazed and also grateful that I did not see this.)  But basically I rolled over carefully onto my back and held my baby, the midwives cut the cord (Keith declined, very reasonably, their offer to let him cut it),  lay on my back to deliver the placenta and then waddled gingerly into the bathroom, a few feet away from the spot on the living room floor where I’d been lying, and took one of the most refreshing showers of my entire life. It was so good not to be pregnant anymore, to be alone in my body. 

We spent the next few days recovering – Ilya from being born, which is very taxing, and me both from giving birth and from my virus, which I still had! On the night after the birth I woke up shivering with fever and called the midwives in a panic. They are always much more cheerful than you’d expect about being woken up in the middle of the night; I guess it is their job and they’re used to it.  I was concerned that I was experiencing some kind of sepsis and was at risk for waking up dead, like that girl who had a botched back-alley abortion in the affecting and creepy Alias Grace miniseries, which you should definitely watch if you haven’t already.  Martine reminded me gently that I was sick and that fever spikes at night.

I woke up the next morning feeling mostly okay, apart from having recently given birth. Ilya’s birth was much easier to recover from than Raffi’s; pushing for a few minutes rather than for several hours makes a big difference, in terms of being able to walk around without feeling that your vagina might fall out.  On Friday, a week after the birth, I ventured outside for the first time – a downside of home birth, if you live in a walk-up, is that you’re essentially trapped in your apartment til you can negotiate stairs.  I wobbled down to the community garden on the corner and made Keith take a photo of me smiling triumphantly in the sunlight with Ilya strapped to me in a carrier. Looking at this picture now makes me cringe. I look like someone who thinks that the worst is over.

That night we put Raffi to bed and I got in the shower. As I was drying off, Keith knocked on the door to tell me that, on a hunch, he’d taken the baby’s temperature, and it was over 100 degrees.  If your infant is under a month old and he runs a fever, you have to go to the hospital immediately. My parents were still in town, staying a block away, but we didn’t even wait for them to arrive before we called a car to take us to the hospital.

The driver didn’t try to chat with us, either out of sensitivity or obliviousness.  He didn’t turn off the radio, which was playing some kind of Friday night party music, so I lean towards obliviousness. We held hands in the backseat and didn’t talk to each other. We were both in hell. The baby felt warm on my chest in the Ergo, probably I was imagining it but he seemed to be getting warmer and warmer.

There is a separate E.R. off to the side of the main one, the pediatric E.R., and we had never in three years of parenthood been there before. If you have children you have probably been to a pediatric E.R. and you know, as I now know, that it is the worst place you’ve ever been. The pain and illness of your own child is only part of its badness; the other part, which I experienced as the primary bad part because Ilya was so tiny that he didn’t even know he was sick or in a hospital and was asleep in a carrier on my chest, is the pain and illness of other people’s children, their parents’ suffering. We were all terrified and sad and also intensely chagrined that we were waiting to be led to one of those curtained cubicles where at least we can all have some privacy and some protection from each others’ pain and, frankly, each others’ pathogens.  The waiting room teemed with sick school-aged kids, sick toddlers. I didn’t want my week-old baby breathing the same air as them but we had to, we were just standing there, slightly in the way because there were no available seats. We waited for such a long time. Somewhere in that warren of cubicles another baby was wailing.  A woman holding a sleeping toddler was quietly weeping the entire time that we were waiting. I overheard her telling a nurse that she had dropped her child. Her fear and guilt and misery was palpable, enormous. Later I saw them leaving the hospital, the child happily walking and smiling.  Thank … something, thank chance, the mercy of this child’s being okay and also the much more minor mercy that I’m not still wondering what became of her.

A team of matter-of-fact nurses took the baby’s temperature and weighed him, and then another team of young residents who were so attractive they could easily have been on a network medical drama came and talked to us about what would have to be done, performing a welcome exaggerated mixture of competence and kindness. Doctor Realness. The baby’s fever probably meant that he had contracted our virus, but because he was so young they had to rule out any other kind of infection, like for example meningitis which could kill him in hours.  To do this he would need lots of tests, including a spinal tap. They described how a spinal tap works. He would have to be catheterized to collect urine in order to rule out a urinary tract infection.  He would get a chest x-ray to rule out respiratory infection. We were in the room, holding him still, holding his arms down, for the catheterization. No one enjoys having a tube threaded into their tiny urethra but these doctors were gentler and better at it than the ones who’d once had to perform the same procedure on year-old Raffi, an experience so harrowing it actually led us to switch pediatricians.  The baby wailed, red-faced, seeming shocked at the world’s betrayal; aside from being born, this was his first experience of pain. I kept trying to remind myself that he sometimes cried just as hysterically while having his diaper changed, but there’s a note of genuine terror you can hear in even a small baby’s cry, especially if you’re his mother.  We had to leave the room for the spinal tap because they needed to sterilize everything, and so we heard but did not see his reaction. Still, it was better than seeing it.

We waited a long time. We took turns holding the baby and falling semi-asleep in a chair. Around 3am, the baby was admitted to the Pediatric ICU, and we were given sheets and pillows so that we could sleep next to his hospital cot-crib on fold-out chairs. He had an IV that delivered a steady drip of antibiotics and the tape and needle port and bandage covered almost his entire tiny arm. Nurses came in every two hours to take his temperature and check his vitals.  We woke up throughout the night but when the sun rose it was a relief to fold away the bedding and begin what would pass for a day; a day at least had the promise of visits from doctors who would be able to tell us what was going on, and of escaping from the hospital, though not with the baby and never together.  The baby had to stay until we knew what he had, and we didn’t know how long that would be. For now, we were on infectious disease protocols, which meant everyone who came into our room had to wear masks, gowns and gloves.  My parents could bring Raffi to visit us, but I couldn’t imagine him being obedient enough to keep a mask on, much less gloves.  Instead, I arranged to have my mom bring him to the neighborhood of the hospital where I would meet up with them somewhere child-friendly and have an hour or so to visit.

I’m trying to convey how bad this situation was, how in order to survive it from moment to moment it was necessary to disassociate so that I would not be forced to acknowledge how bad it was.  In extreme situations I tend to fixate on my physical needs, which were especially hard to ignore a week postpartum. I needed to eat a lot at all times, and I needed to change my bloody pads, and I needed to nurse the baby often enough that my breasts wouldn’t go rock-hard and painful. These bodily requirements kept me tethered to a routine. Thinking about how I would go about meeting my needs gave me something to think about so that I wouldn’t be able to think about what would happen to my baby, or what was happening to Raffi.

At the same time it seems now, as it seemed them, like the situation wasn’t really all that bad. My baby was receiving expert medical care and was being monitored constantly and was blessedly not in the NICU, not separated from us, not in a warmer or breathing through a tube. The separation I felt much more painfully was not being allowed to go home to Raffi. He had been apart from us with my parents once before, but this was different – not a vacation, not planned, not finite. And the mere fact of the baby’s existence, even before the baby got sick, was a separation between us, a permanent one that neither of us had even begun to get used to. A friend who’d given birth to her second child some months earlier had described her relationship with her firstborn as feeling like a breakup; at the time, I hadn’t understood what she meant. Now, I did. That was it exactly, the kind of breakup where you still love each other yet both know that it’s over and you keep trying to console each other but it only makes it worse. Raffi was no longer the center of my world, and he knew it. He didn’t know how to count to five, or how to reliably pee in a toilet, but he absolutely knew that he had been demoted from only child to firstborn child. Not being able to put him to bed and see him first thing in the morning during the second week of his older-brotherness, imagining him alone and missing me in those vulnerable moments broke my heart.

While I was losing my mind missing my bratty 3 year old who was being cared for by my mother less than a mile from the hospital, thousands of parents were being separated from their Raffi-aged and younger babies and children at the border of our country by agents of our government. Some of them would eventually be reunited, but not all. This is still going on. The fact of it has receded, supplanted by fresher horrors, and as I write this I realize it’s been a while since I thought about it.

When my mom brought Raffi to be reunited with me outside the hospital I could tell that he was at the end of his tiny tether, and sure enough he had a complete meltdown on the sidewalk of 7th avenue. My mother and I both took turns appeasing and then attempting to discipline him, getting upset at each other for failing to keep him from thrashing around in the middle of the street over not being given the right color of Paw Patrol band-aid. I held him as he screamed at me. We waited for the seen-it-all waitress at one of Park Slope’s many kid-oriented “organic” burger joints to clear a table. When we were seated they gave him crayons and he threw them, hard, all the way across the room. 

I put my head in my hands and started crying. Bawling, really, like a bratty child myself.

Generally, I keep my emotions under control in public. It’s much easier for me to get angry than it is for me to feel sad enough to cry, and I also hate (HATE) to show any vulnerability in front of my mom, partly because I never want to worry her and partly because I never want to give her ammunition for expressions of well-intentioned concern that somehow always feel like scathing critiques to me.  I also generally try to keep my shit together in front of Raffi. All of this effort broke down simultaneously. I was sobbing hysterically in Decentburger or whatever it was called. My whole psyche was fucking unraveling. I had spotted Leslie Jamison on my way in, eating on the patio with her adorable child, and in some corner of my sleep-deprived, hormonally ravaged and rapidly deteriorating mind, I found space to be worried that Leslie Jamison would see me and, I don’t know, judge me? (Especially because what I did next was order a glass of pinot noir and down it like a shot.)

My crying shocked momentarily shocked Raffi out of his brattiness, at least. “Why are you crying, mama?” he asked. “Because this is the only time we have together, and you’re RUINING it,” I sputtered. Our breakup was getting messy.


That was the nadir. After that, things got better. Even that dinner got better – Raffi watched TV on my mom’s phone, we ate (delicious) burgers, I had a second glass of wine for the first time in ten months and got pleasantly numb, and we said goodbye without more tears on anyone’s part.

Back at the hospital, the infectious disease protocols were lifted. We had to stay there for several more days – we were there for five days in all, until the last test results came back and confirmed that the baby’s illness was just a virus, our good old family virus. He didn’t even run a temperature after that first night. In spite of seeming incredibly small and vulnerable in his big hospital cot-crib, he was resilient, healthy and fine.  My dad went home to Maryland and my mom heroically stayed with Raffi alone, bringing him to camp and then picking him up and bringing him to eat takeout with us in our hospital room. In the PICU playroom, we met another family with an infant who’d run a fever who were splitting their time between caring for their hospital-bound baby and caring for their Raffi-aged toddler. We weren’t special or anomalous at all. This happens all the time.  It’s probably one of the better things that happens in the PICU; these babies who come in with a fever and get tests and IV antibiotics and turn out to be fine. The nurses probably look forward to seeing these babies and tolerate their nervous parents, parents who are plunged into the world of the sick for an five-day jolt that’s just an aberration, not the beginning of a longer, far more harrowing story.

Ilya is four months old now. Raffi no longer remembers a time in his life when he didn’t have a little brother.  When Ilya was still new, I told someone else with two children that Raffi was having a hard time with the transition. “Well yeah – it’s the worst thing that has ever happened to him,” this person said. I thought that seemed harsh, but I’ve realized that it’s true. Ilya’s birth is the worst thing that’s ever happened to Raffi, and I hope that remains true for a long, long time. What happened after Ilya was born was the worst thing that’s ever happened to me. We’re so lucky.