Sunday, January 4, 2009

Lacuna

Hi everyone - this is Sue's husband, C. She asked me to guest-write the next part of the story - not so much because she doesn't think she can as because at this point, details get spotty for her in a way that they don't for me. She'll have stuff to add to this, I'm sure. [And there have been lots of details I've already written about. I added my thoughts and details in red and parens, like this. You all know about the "after" stuff, the social workers and forms. I'll follow up soon.]

Brace yourself. It's long and difficult.

So we end up at a hospital where they can actually, you know, do what they're supposed to. Not the fault of our local hospital, unsuited as they are for anything but healthy pregnancies and the sort of injuries one obtains as a function of being a college student. Everyone there expressed their frustration with the ridiculousness of the State Attorney General's ruling that nurses couldn't push drugs for a preterm delivery. The ugly intersection of personal morality and public policy. The doctor was more reserved in his opinion, but I definitely got the sense that nobody was a fan of the policy. Small comfort*, yes, but if I'd had people all disapproving and shit up in my face, it would have been even worse than it already was. This is a new mantra in our household: It can always get worse. It can always be worse.

[*I think C is being generous here. It was all I could do not to completely lose it at the local hospital. You know, that quiet before the complete freak out.]

So we're in the University hospital, in an exam room because they were exceedingly busy and didn't have a labor & delivery room open yet. Also, the wing was in the middle of being remodeled. The first doctor we talked to talked to us about the paperwork required by the state: Apparently, along with the whole "nurses helping with preterm delivery are performing abortions" thing, there was a requirement that women attempting to deliver their children preterm had to be counseled about the availability of "alternatives" and had gone through a 24-hour waiting period. Because apparently, so many women drop by the hospital to abort their babies on their way to their mani-pedi appointments. To this hospitals' credit, we never saw that paperwork. The doctor to whom we spoke said, in essence, that it was bullshit and appalling that we'd ever be asked to do such a thing, and they'd already filled it out and filed it. [Thank god.]

I know, based on Sue's last post, that you all have a sense of the many of the things that went wrong or badly. Not everything did. With only a few (notable) exceptions, everyone was sensitive and compassionate, and even in some cases where things did not go well, I got the definite sense that the choices that got made were made in an effort to make it as quick and (relatively) painless as possible for us. But there we were, in an exam room, a transitional room, Sue hooked up to a contraction monitor, waiting. [Waiting: for our last ultrasound, for a real room away from the hubbub.] A fetal heart monitor was audible from next door - someone's healthy baby, heart beating away. A nurse was nice enough to turn it down for us [after only one request].

Another doctor came in to talk to us about the procedure, all smiles and bouncy...until she read the chart and saw why we were there. She outlined the approach they were going to take: Push a shitload of pito.cin fast [in increasing doses] to kick-start labor. Get it over with and done, both to keep from prolonging an awful thing and to help keep her out of the OR. Sounds good to me. We'd already been left hanging once.

Sometime after this (my internal clock went completely to shit once we were admitted - windowless rooms, days of shock and uncertainty. Hospitals are a lot like casinos: You have no idea what time it is, your money vanishes faster than you ever thought it would, and you may very well walk out with nothing to show for it.), we were moved to a labor & delivery room. A small, cramped, old labor & delivery room. One of the un-remodeled rooms. They kept saying they'd get us to a better room as soon as they could, but it wasn't to be.

They were getting slammed, from the sounds of it. Mostly because we were surrounded by the sounds of women delivering, celebrating deliveries, fetal heart monitors, and happy families. At one point, I walked out into the hallway to use the restroom (we shared one with an adjoining room, and the other people kept forgetting to unlock our door when they were done in there) and my head was filled with the heartbeats of other people's children. They followed me down the hall and crowded everything else out of my head.

Sometimes, I think I can still hear them. I still get uncomfortable listening to ultrasounds or heart monitors on television. [I get just a twinge.]

More waiting. More waiting. MORE waiting. Apparently, the pharmacy saw the amount of pito.cin the doctor had requested and said "this can't be right", but didn't bother to follow up. Doctor was not happy about this. Sue's already talked about the epidural, so I don't have much to add, other than the only thing that even partially redeemed the procedure was Nurse Bob. The nurses were, almost to a one, amazing, but Nurse Bob deserves special commendation. His compassion and sensitivity and gentleness were immeasurable. He was one of the things that kept it from being worse. [He held me as I got the botched epidural; one small comfort.]

We were there a long time. I don't know how long. The pitoc.in had [sort of] started to work and then plateaued. Eventually, someone figured out that the line wasn't sealed right or something and she wasn't getting the dosage she should have been for awhile. A big puddle of pitoc.in all over the floor. Her family came and went in different combinations. I don't remember much of this anymore. I was mostly focused on Sue anyway. I remember they kept asking me if I wanted them to spot me while I took a walk or something. I couldn't imagine being anywhere else other than Sue's side.

They kept fiddling with the amount of anesthetic she was getting in the epidural because it wasn't spreading to one side well enough. [They also tried rolling me to one side, hoping gravity would help distribute the meds. It didn't.] Lots of sitting, waiting, talking to people, waiting for the drugs to kick in. This was not going to be quick. Finally, at some point, Sue was getting nauseous, from what I don't really remember. [I think it was the empty stomach. I hadn't eaten all day.] She'd been hyperemetic throughout the pregnancy anyway. She was given some phener.gan to help the nausea. It also pretty much knocked her out, as phene.rgan is wont to do. [I remember family members coming in and out at various times,but I think it may have been later than this, after the boys were delivered.] It must have been getting late at this point, because Sue's family was talking about going back to their hotels. So she's asleep, and I'm standing outside her room refereeing while her family figures out what they're going to do.

At this point, Sue's brother-in-law is starting to get cranky, probably because his routine has been disrupted. He's extremely rigid, bordering on pathologically so, and the only reason I can think of for why he even came is because Sue's sister, A, is both his wife and in some ways his caretaker. Which has hampered her efficiency somewhat throughout the whole ordeal, because [A] wants to be taking care of Sue, and he wanted [A] to be taking care of him.

So we're trying to figure out where people are going to go (we live about 45 minutes away), and brother-in-law keeps whining about how if they just left now, they'd be home by 11pm or something, as if that were the only thing under consideration. Finally, tired of all the back and forth, I make an executive decision: Her father and brother will get a room at a nearby hotel, and her sister and brother-in-law will go back to their original hotel room. This was as much to get him out of my sight as anything else. I agreed to text Sue's father once it was all over.

Sue was mercifully asleep for most of this. Unfortunately, it meant she was mostly asleep for what came next.

Sometime after giving her the phene.rgan, the next doctor (did I mention this took so long that we went into the next shift?) decided to switch her to cerv.adil, which started working quite well, quite quickly. This means she was woken up by the increasingly powerful contractions, which she felt completely on one side of her body [this I remember]because the fucking epidural never completely took. Everything started happening quickly after that. A blur of the doctor telling her when to push, and her saying she couldn't, [I remember this, too] while I said she could and holding her hand and stroking her forehead and telling her that I was there and wasn't going anywhere. I have no idea how long it took. There was nothing else in the world for me but her.

Sue doesn't remember much of this, and feels guilty for it - she seems to think that she was asleep for it, but I don't think it was so much that as being in enough pain and under enough stress that she didn't really form any memories of the experience. (There's a bunch of pedantic bullshit I could pull out about interruption of encoding and disruption of consolidation, but I won't. She had bigger things to deal with than remembering the moment.) [I talked to Dr. Shrink about this, and he said that under extreme stress the body takes care of itself by dissociating from what's going on.] Once the boys were delivered, Sue fell asleep, mostly from exhaustion. Once it was all over and I realized Sue was asleep, I messaged her father, leaned back in the recliner and closed my eyes, totally exhausted.

The next thing I remember was Sue screaming.

See, she still had to deliver the placentas. [Apparently,] this is much more difficult in a preterm delivery. They're more firmly attached. I opened my eyes to something like a nightmare. The doctor was giving orders to the nurses with some urgency, the room was dark except for an examination lamp, stark, sharp shadows everywhere. [I remember this like you remember a nightmare, clearly.] I could see blood on the doctors' arms up to the elbows. Sue was half out of her mind with pain, and kept asking for Tylen.ol. The doctor asked if she was sure that was all she wanted, and she said just give me something for the pain. The doctor told the nurse to push morphi.ne, then Sue screamed again, and the doctor increased the order of mo.rphine. [I remember all this, too. All of it. Clearly. She asked for 3 mg, then 5. I don't know why I asked for the Tyle.nol first.]

The doctor kept saying that she knew this was hard and painful, but they didn't want her to have to go to the OR for a D&C (which she had to get later anyway, when it turned out some tissue remained and went all necrotic). [I don't know why a D&C would have been worse at this point. How could it have been worse?] Blood, and my wife screaming. The whole time, I couldn't move. That's what I feel guilty about. My wife in agony, and I was so exhausted and shocked that all I could do was sit there, like a nightmare in which I am helpless to do anything. [All I remember is the pain, and the warnings about the D&C. C has nothing to feel guilty about.]

At some point, it was over. There was a lot of blood (enough that later she would need a transfusion before she could leave the hospital). Finally, Sue fell asleep, the morphine doing the work of Morpheus. I've never been so happy before or since to listen to her snoring.

[I recall a sponge bath and a change of sheets of the bed I was on once it was over and before I was transferred out of L&D. Somewhere in my head I realized I hadn't the strength even to feel modest. I just let her move me where she needed me, without a word of protest.]

Sometime around 6am, they moved us to the antenatal wing, into a cushy room. The nurse had already made up the couch bed for me, saying to us "when I saw it was you (she'd been a nurse when we were in for the initial consults after Christmas), I knew your husband would be right by your side." And I was. I waited until Sue was settled in, changed into something resembling sleepwear, and closed my eyes again. This time I slept until noon the next day. [He even slept through my family arriving, lunch arriving.] Time ceased to have any meaning, all ideas of normality were burned away. I wasn't even sad. I was just tired. I just wanted to sleep, knowing that I'd be waking up entirely too soon.

[I didn't have the heart to wake him. I remember moving around a bit, talking to the nurses as they took my vitals, helped me to the bathroom. Every once in a while a flash of joy over the birth of my boys, and then remembering. It happened a few times, and then I was so grateful for the distraction of my family's arrival.]

18 comments:

Newt said...

I am in tears reading this. I am so sorry. It has the quality of a nightmare, even on the screen. I am so very sorry.

Mrs. Spit said...

I'm sorry. I'm sorry that any of us have to be in the awful place.

((((hugs))))

Aunt Becky said...

I wish I had something more palpable to say than I'm sorry, and I'm holding your hand from afar.

loribeth said...

Oh Sue. Oh C. I am in tears reading this too. And just so, so sorry.

k@lakly said...

Words are not equipped to express a sorrow such as this, they just aren't. And so I have nothing worthy to say.
Except that I can feel my heart breaking, more than it already has, for both of you and the boys.
xxoo

Tash said...

You two are tremendous parents, couple, and a team. I hope you know that.

I know you're trying to talk us back from the ledge because of course things could be worse! this scenario could've played out while we were refugees in Darfur! but you really have *two* nightmares to unpack and unravel -- the heartbreaking one, and the one of horror movies. And untangling the sad part from the angry part has got to be difficult beyond measure.

Of course it could be worse. You don't know how relieved I am at the end of reading this to know that each of you had the other. You, and your boys, are in my thoughts tonight. I'm so sorry any and all of this happened.

gusin08 said...

i know you know how terrible your story is. i'm a little stunned, though, to realize that i didn't really process how truly awful it is. i am so amazed, and touched, and grateful, that you have the strength to re-tell it. and so sorrowful that you have it to tell, at all.

much love to you all,
--c.

m said...

dear Sue and C., your words and your experience is so vivid for me. We lost our girls 4 weeks ago at 21 weeks. It is crazy how some moments in time are crystalized. Forever.

I think you are both amazing. In your strength, in your love. I know that's small comfort. But please know, there are people here that are reading and remembering your boys, and gathering strength from your love and courage. Thank you.

CLC said...

It is so painful to read this, knowing that the pain doesn't ease. I am so sorry you two had to experience this. I am glad you have each other, and hope that gives each of you some small comfort.

Julia said...

What a terribly heartbreaking part. All of this is unfair, as any story of loss is, but some of it is horrific in its unique, this can't really be happening, can it?, way. I am so sorry it did. And though I am not one for literal belief in the afterlife adjudication, some days I want to be. This is one of them, so that the jackasses responsible for the part of the horror that is state rules can be held to account for the completely unnecessary portion of your suffering caused by their showmanship. I am so sorry.
And, like Tash, so glad you had/have (and continue to have) each other.

luna said...

absolutely a nightmare. I like what tash said about the heartbreak and the horror -- so true. hopefully the reliving and retelling is cathartic. we are all here to help you unravel that heavy load, a year later. so very sorry you had to live through it.

you each know how lucky you are to have the other, so I"ll just say I'm glad about that too.

c. said...

It just sounds so incredibly awful and sad. I'm sorry, Sue and C. I mean there are no words profound enough, big enough to offer in response to the experience you describe here. So, I'll just say: I'm so sorry.

And, you are absolutely right. It can always be worse.

XO.

Anonymous said...

I'm at a loss for words.
I admire your strength and ability to relive it as you tell your story.

jodie38 said...

My heart just breaks for you both - nightmare is the closest thing to describe your experience. I'm so very sorry.

And I agree whole-heartedly with your mantra. It can always, always be worse.

You and C are such a team - I'm so glad you have each other.

Heather said...

My heart just breaks for you, for us. Remembering your boys, as always.

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