Prologue to an Epitaph: a story of mental illness, teen pregnancy, and the struggle of her preemie

Prologue to an Epitaph Excerpt:

The NICU

The taxi service picked me up about 3:30; it took a little longer today. I chatted with the driver about the weather and the convert at the convention center. He said his kids were my age. They’d be preparing for dinner out with friends before getting all excited over the top forty rock band that highlighted the performance. The driver just prayed that his kids didn’t party too much. He asked if I’d known what he meant. I chuckled then looked away.

The taxi service owners were an older couple. This new driver talked to them about getting me a lower rate, since I’d plan on using them so much over the upcoming months or so. It worked in my favor: I’d be taken back and forth to the hospital at half price. That was cool. And they even tried their best to plan ahead on pickup times so I wouldn’t have to keep calling. The plan would be to call when I didn’t need the ride.

It was often a little uncomfortable when they asked questions about my mom and why she didn’t join me on visits to the hospital NICU. But after a while, I think they drew their own conclusions. The most common excuse I gave was that my mom was ill which seemed closest to the truth. She was ill in a sense: passed out drunk after a night driving around town with her boyfriend. But I didn’t want the world to know that because it already made me feel worthless. I didn’t want anyone else’s judgments hovering over my head.

When I arrived at the NICU’s scrub room, I heard wailing beyond the swinging doors. Something was going on in the extended care nursery. Through the square windows on the swinging doors, I saw a familiar boy’s parents around his crib. He was an older baby that had been in the hospital since his birth—which had been almost a year earlier. I peeked around the corner to see the boy’s large family grouped together outside the far windows that encircled the NICU. Distraught expressions covered every single face. Once inside the unit I heard the preacher talking about turning off the boy’s machines. His mom started crying first, then wailing erupted out in the hallway. It terrified me so much that I tried not to think about it any longer. Suddenly, an alarm sounded and the wailing increased tenfold. The gut-wrenching screaming went right through my bones.

I leaned into Ashley’s incubator and shuddered. Cathy (Ashley’s main nurse), who obviously had just been crying as well, walked over and gave me a false smile. She told me how happy she was to see me again. I couldn’t figure out why, since I’d been there every day for the ten days since I’d given birth. It was like she anticipated my absence every day. But I let it slide. I was preoccupied with what just happened on the other side of the room. Cathy hugged me and explained how that little boy’s situation was entirely different.

That little boy was born with bilateral, grade three intra-ventricular hemorrhage with hydrocephalus (IVH). This meant that he developed brain bleeds from the tiny blood vessels bursting. He already had surgery to put in shunts. Cathy explained that the more premature and tiny the baby is the more likely it is for a baby to get IVH due to the large amount of thin and tiny capillaries there are at that early stage of development. She said the immature brain is more vulnerable to injury; particularly with the physiological stresses from a difficult premature childbirth. Then there were the labor complications of an incompetent cervix. She went on to explain there are many different things that can happen to the baby; so while the boy’s status may have been terminal and irreversible; many of the other preemies can be brought through the stresses without long-term damage. She was the most optimistic nurse that I’d ever seen. I just couldn’t figure out why she always expected me to be a no-show.

I gently touched Ashley and her alarm sounded. Cathy responded, “Remember, it’s a natural response that decreases the amount of oxygen in the blood. The more you touch her, the more she gets used to the feel. Then it doesn’t alarm her, literally and figuratively speaking.”

Throughout my visits at the NICU, alarms sounded all around me. The nurses and lab technicians have to prick and prod the preemies quite often for tests. Cathy whispered that it’s only reasonable that when a baby senses someone touching her, that she might tense up and flinch. Despite Cathy’s reassurances, it just seemed like Ashley didn’t connect with me the way I see other babies bond with their moms. Did Ashley sense that I was just some dumb teenager that got pregnant and messed up her life? All these other moms and dads in the unit are like in their thirties and forties and have everything in their lives worked out. Maybe Ashley wishes that one of them were her parent instead of me. It hurt my feelings that Ashley’s damn alarm kept going off. Cathy thought I was nervous about what just happened with the little boy that had his machines turned off. She suggested that I go into the parents lounge for a few minutes to try and relax.

Once out in the hall, the elderly volunteer that hung around during Ashley’s birth greeted me. I don’t know how she saw me but she seemed to feel the need to reassure me as well. “No parent expects to be in this intensive care nursery. Every mom or dad thinks they’ll be over in postpartum with their healthy baby beside them. This is usually a shock for most parents. It’s understandable. Most adult parents feel like they did something wrong or aren’t helping out enough. It’ll get better when your preemie gains weight and strength. Okay?” I just shook my head because I didn’t want to hurt her feelings.

She entered the lounge before me to help another mother cuddle with her preemie. The NICU recommended exposing the preemie’s skin to the mother’s body. They thought it aided in bonding. If the preemie was strong enough, the nurses brought the baby out to the lounge where the new mom would take off her blouse and set the preemie up against her skin. Because of the low birth weights, there weren’t enough fat stores compared to the typical newborn. The elderly volunteer whispered to the mother and her preemie. “Body fat is important because it helps to aid in regulating the temperature in the baby’s body.”

She spoke more but I couldn’t focus on anything else but the crying emanating from that little boy’s area down the hall and across the nursery. The sounds consumed my thoughts and numbed me. I walked back out into the hallway and watched the panic-stricken family comforting each other. I stepped closer and saw the boy’s mother. She held his limp, pale body in her arms. Her tears streamed down her red cheeks and onto his. Next to where she sat in the wooden rocking chair with its pastel yellow and green chair pad was a tiny mobile dressing table with little army green and khaki colored doll clothing in the style of little military figures sold in stores. I remembered days previous when the little boy’s grandmother showed me the clothing. I thought back to the grandmother and how she chuckled at how awkward it was when she had purchased her grandson’s clothing from the toy section. Being the decent seamstress that she was, she altered the clothing to make it fit better. I had giggled back then with their family at how cute the boy was in the photographs that they taped around his crib area.

Since the boy’s arrival in the NICU—which was nearly a year prior—he had gained fifteen pounds. Watching his mother hold him, I stared at his round, pale arms with dimples in the elbows. They appeared heavy when they drooped down his mother’s side and off the wooden rocker. At nearly the same height as his mom’s head was the end of the large metal crib. On it there was a white sheet of paper that began with the large, block letter’s which read: DNR—Do Not Resuscitate.

I felt nauseous. I wanted to go back in time and study myself out of the situation that I was in. Ashley didn’t deserve this crap; she didn’t deserve me. I walked around the NICU unit to the other side. In one of the semi-private pump rooms, a new mother was using the machine to pump breast milk into the small, clear plastic containers that the nurse behind her held up to the light. She measured the amount and patted the nurse on the back.

Out in the hall, I heard one of the boy’s family members recount his trip home the previous day. Apparently, his family was able to take him home on oxygen for three hours. The bright-eyed, forty-something described the white limousine that his family hired to take him home. The woman said that when they first arrived home, the boy’s dad took him past the shed and showed his preemie son the riding lawnmower that his wife gave him for Christmas. The relative went on to say that the boy’s parents wanted to show the preemie his bedroom with it’s cartoon character wallpaper and matching border print that his mom hung all by herself during the exciting time that approached his birth. The woman continued that the boys mom wanted to change him on the brand new table that his uncle—a master craftsman—made for his preemie nephew. The boy’s mom also showed the preemie the woven white wicker bassinet and matching dresser with all of the clothes that his loving family gave him at the baby shower.

The woman spoke of how the boy’s mom held him tightly in her arms while they sat in his bedroom and opened months old Christmas presents for him. They never wanted to bring the gifts to the hospital; because they were worried that might jinx things and they may never have him come home. After the boy’s visit home, the parents brought him back to the hospital where they then signed the DNR paperwork.

I walked back and focused on the boy’s dad attempting to pull the baby out of the mom’s arms. He pleaded with her to hand the preemie over to the nurse at their side. When she did so, the father pulled his wife’s head into his stomach and they both shook with tears. Family members nearby banged on the windows and cried. When the nurse laid the baby down on the sheets, his mother stood up and threw fists at her husband. While she yelled at the man, he held her tightly and attempted to control her swings. They stood there for minutes. The wife pounded him and he held her tighter. Nobody moved in to stop it. Suddenly, the mother just fell into her husband. Her body went limp. The neonatologist ran forth and prevented the mother’s body from hitting the floor. Immediately, the couple was encircled and shrouded from our view.

I wandered the hallways a bit then went downstairs to the cafeteria for a soda. All of a sudden the whole pregnancy and childbirth sunk in and terrified the hell out of me. Could it be any worse? Families started gathering in different corners of the cafeteria and their chipper attitudes were getting on my nerves. I decided to take the stairs beyond the elevator and past the gift shop. Happy relatives usually abound outside that store. That annoyed me.

Upon exit from the stairwell on the second floor I bumped into an elderly couple following a new father in his mid-thirties. The dad coddled an infant in his arms. The baby was dressed entirely in pink and appeared to be adrift in a secure world all her own. When the dad saw me, he glanced up and smiled brightly. He tipped his head and looked back at his little girl. He was lost in utter awe and must’ve thought everyone else felt the same way for him. He returned to the windows just outside the postpartum nursery where the healthy newborns slept.

It made me self-absorbed and angry that there was no sign of despair in his eyes or that he didn’t know utter despair. No sign of worry about things not returning to normal or at least getting better. The elevator sounded down the hall and another couple of family members exited and rushed the way of the father daughter pair. I could see the dad hold his daughter up for the new couple to view. He was so damn joyous.

Suddenly, my break from the NICU was interrupted by a yell from down the hall. A nurse that I didn’t recognize called out to me. She waved for me to run in her direction. I’d never scrubbed my hands that quickly in my life. The nurse helped me into the sanitary gown required in the unit. She didn’t say anything to me; but my heartbeat pounded in tune to the painful throbs in my temples. What the hell was going on now? When I entered the NICU, nurse Cathy stood red-faced next to Ashley’s incubator. The neonatologist was in the process of resuscitating my preemie. I stood still—ten feet away. The damn alarm on her machine kept sounding. Nurse Cathy looked like her child was dying. She never looked over to me. Those few minutes felt like hours. The alarm ended and the neonatologist’s shoulders relaxed. Cathy still faced down towards Ashley. The director turned toward me and asked me what religious beliefs I had. He told me that if I were Catholic there was a rectory next door to the hospital. It would probably be a good idea if I went down and set up a baptism.