measuring the odds

One machine counts their heartbeats with implacable exatitude. The ultrasound registers their position, movements, reactivity to touch and breathing patters - even hicups. The doctors measure their tiny bones and come up with their weight, with 7% measurement margin of error. Baby A weights as much or more than 35% singletons at same gestational age - 30 weeks. Baby C scores around the 26th percentile. And Baby B, always behind their siblings, falls bellow the 10th percentile - which grants her a diagonis of "restricted growth". In fact, while her sisters are getting fat with the cocktail of nutrients flowing throught the umbelical cord, Baby B fights for what her placenta can make available - relatively less.
With all these numbers come the risk analysis. 90% of preemies born at this point will be viable - maybe with sequels to be dealt with in a lifelong journey. If we postpone birth, the pre-eclampia thickening mom's blood and weakening her liver may creep in and increase the odds of more damage. Doctors consult with each other and we, parents, have to deal with the uncertainty expressed by the probabilities and the quantified information. The heart doesn't do well with numbers: during the shadows of the day I think about my baby B, weighting less than a kilo (1 pound and 10 ounces). But then the ultrasound shows her breathing - a sequence of effortful movements opening the tiny ribcage - and I start to believe that, as her father says, that she will do just fine - because of her 100% strong determination to live.

Nice Sunday visit

We had a happy visit this afternoon at the hospital. Marina and her great friend Luana came along. Luanna took photos -- we are making fun of the pictures that the young Brazilian couples get done when they are celebrating their pregnancies. I am supposed to be bragging here about my masculinity, I suppose. Anyway, you can see we are pretty happy (and silly). Luciana is in good shape, very cheerful and full of ideas and preoccupations. We all went down to the only restaurant in the hospital, an abysmally operated Au Bon Pain. Luciana had to stay in a wheelchair. I wanted to get her some fresh air and tried to push her outside through the revolving door, which occasioned a good deal of hilarity. Luana showed us how to use the Blackberry Messenger service, which is pretty much the same as IMing. We are getting to be very digital. It was a happy time.

I see this picture and think of the innocence of these two creatures. To be in our fifties and still able to jump into life with the innocence of young adults. I'm sure this is madness and folly - and essential Life itself. What choice do you have? Keep living or start dying.

Writing this blog, I often have the uncomfortable impression that I will "look at this someday" and feel very differently. I suppose, I fear feeling regret, I fear feeling foolish. So I am going to respond to myself by quoting myself -- this comes from an email I sent my son Felix this morning.

Felix had told me Friday that he was going to participate in a school academic competition on Saturday -- for people who know Felix, the idea of him taking part in an academic (or any) competition is a bit startling. He had to get up at 6 am to catch a 7 am bus. This morning (Sunday) I got in touch to ask how the competition went. "I didn't make it. My alarm didn't wake me up. No one called me until 11 am. I told them how bad I felt for missing it because I really do feel bad."

I IM'ed back a few short phrases, because the MMS message system only allows brief thoughts. I like it because it forces me to come up with fortune cookies:

• Regret is a feeling that passes with time
• Opportunities come and go, never to return
• People remember who shows up for them
• Their memory of you is all they know of you

My effort in life is just to keep showing up when I can, and to take the opportunities as they come, and to let the regret wash past me in waves just as it likes to do.

Nesting

I have been resisting, avoiding, mocking and generally keeping an arm's length from Luciana's nesting behaviors the past couple of months. It was a big concession on my part (arrived at by cogitation rather than through the heart) to go along with her and Karen to Babys 'R Us six weeks ago. (Memorable to me mainly due to my daughter's outburst against babies in general and these babies in particular, and due to our encounter with a friend who had recently had a near-death experience from eclampsia.)

Today I have crossed the line into nesting, and I find I'm loving it. Luciana is in the hospital, so it really is down to me to arrange the twigs and string and leaves into a nice little place for the babies. What I have found is that moving things around, painting walls, buying cribs etc all puts the babies right in front of my focus in a very direct way. It seems obvious I suppose to anyone who isn't partially autistic but it's a pleasant surprise for me! I have been feeling close to the girls (we think they are all girls) this morning as I tote things around and work at preparing the room. Tears are often in my eyes, just from an overflow of feelings.

The United Nations of Care

They come one by one, running tests and sharing their diagnostic thinking, with various degress of proficiency and power. The nurses may differ in the way they deliver their educated gentleness but are very skilled into breaking and entering the private territory of our bodies as if we were being born again, without the original sin - or shame.
The residents cant hide the enthusiasm of novelty, fascinated by the movement of three little babies in the womb, paying attention to details not necessarily related to medical purposes - I've learned for example that their heart rates vary in unison because one "provokes" the other into moving. One could say they are playing.
Fellows don't come to the room unless the team has met, discussed and made important decisions. Their faces reveal the seriousness of their commitment to care, to solve and to do what is right. They don't get much distracted by personal histories.
In this hospital, they come from all over the word: India, Algeria, China, Portugal, Israel, Greece, Cyprus and various ethnic pockets of the US. They meet every morning to discuss cases, trespassing centuries of animosity and prejudice. I wish medical professionals like the ones visiting my room had a place at the table where peace agreemenst are discussed: they know the the sameness of flesh and the unique value of Life.

Getting serious

Okay, it's getting serious now.

I went home on Wednesday (two days ago) at lunch time to check in with Luciana, and took her blood pressure. 171/92. Alarm bells went off for me.

Unfortunately, I was in the middle of my own medical crisis. Two days earlier a slowly resurging problem with trigeminal neuralgia suddenly went critical, subjecting me to very intense attacks of pain in my lower and upper jaw and around my right eye. I had gone to the doctor that morning and had started on tegritol, which I used in the past to control the symptoms, but I knew I was facing anywhere between 3 to 5 days on ongoing pain attacks before the tegritol would control the problem (and then I could enjoy the experience of being medicated with this anti-convulsant, which leaves me feeling a little delayed).

Alarm bells lead to a couple of things:

• my face pain escalated rapidly
• I called the hospital and they told us to come in
• Luciana went into her "Stop over reacting, this is not a big deal, and help me pack up my school-related work so I can be productive in the hospital" routine
• Luciana went into her "let's call someone we can pay to drive me to the hospital so you can keep seeing clients this afternoon" routine
  

It only took us about 20 minutes to get out of the house, but by the time we were on the highway I was really ovewhelmed. The pain was terrible, and I was very upset because she was telling me that when we get to the hospital I should drop her off at the front door and go back to my office. I started crying, partly with pain but mainly because I couldn't tolerate her pushing me away. Crying actually helps -- not with the pain, but with the interpersonal problem. She agreed I could park in the driveway and join her at labor and delivery.

We got a bed at Labor and Delivery without any problem. The people there are really great. They are very used to people showing up in all kinds of mental states. They took her blood pressure -- of course, it was back down to a health level. But they checked her urine and blood - there was protein in the urine and her hematocrit was low. So they elected to keep her in the hospital at least 24 hours to study the situation.

That was Wednesday. Yesterday was relatively calm. I spoke to her last night -- unfortunately just when I was having an awful pain attack, so she thought I was in terrible trouble. I wasn't in terrible trouble, I was just suffering pointless nerve pain.

Today we got the news. They have officially diagnoses her as having pre-eclampsia. That means that the babies may be having an adverse affect. Somehow pre-eclampsia and eclampsia affects the placenta's capacity to supply the baby with oxygen and nutrition. So she is going to stay in the hospital for the duration, and at some point the balance will shift. Right now, it's better for the babies to be in the womb. At some point the balance shifts, it gets too dangerous for Luciana to keep the babies inside and it begins to degrade their health as well. That's when they decide to deliver.

We are now officially waiting for the balance to shift.

My amazing wife

When I read the entries in the blog that Luciana writes I am always humbled by her spiritual strength and her beautiful prose. Ila miglior fabbra

cleft palate

I could hear beneath the curtains in the triage room. She was 33 weeks pregnant, checking her baby after a bad fall in the icy walkways of New England. We both waiting for the nurses with their well practiced amiability and their expertize. This is her first baby and the grandmother sits at a glider nearby, listening and consoling the woman: the baby has cleft palate and something wrong in both feet. The fall was not the most important issue, considering that this child was already marked as atypical, marked and - horrible fate - not beautiful. Protected by the fragile privacy of the curtain, the young mother allowed herself to vent her sadness and frustration, looking for explanations as if that would minimize the pain. In and out, the nurses participated in the conversation. Does it run in the family, yours or his? No, dear, it has nothing to do with anything you have done...We are going to check on his heart rate, don't worry...
The mother questions God - whose sins would bring down to life a suffering inocent - and give it to me as my first son? I closed my eyes and thought about it for a while, consoled by the fact that I was no longer looking for a God measurable by the human rules of justice and love. I had given up on miracles, and felt good about it. Until I heard the high-pitched voice of a nurse, telling mom,
- Oh I am so happy you came on my shift! I was a cleft palate child and I love when they come my way!
What followed was a sequence of reassurance, compassion and hope that dismantled my theory about the distant God. Someone had sent that nurse, bending the inertia of randomness. I turned my big belly to the other side and let my soul rest over the plastic pillow.