Happy Endings

by Sally Quinn

“The best case is that you have a baby who can breathe. You will not have a thinking, feeling baby who can walk and talk and coo. You will have difficulty with seizure control, probably with infection. You could take it home, but it would be extremely hard to find care, especially the twenty-four-hour kind of care that it would need. And eventually there would come a time when you’ll say you’ve given it a good try and you’ve seen the outcome.”

  “It.” There was that horrible word again. Kay Kay was she now. If they let her die she would get to stay a she. But if she lived she would revert back to an it. And Allison wouldn’t be a mother anymore. She would be a caretaker. But this was not a decision she could possibly make. How could she decide to kill her child? How bad could it be anyway, if she had this beautiful baby to hold for the rest of her life? She hadn’t been allowed to hold her yet.

  “I want to hold her,” she said. She knew she wasn’t focusing but she didn’t want to focus. She wanted to hold her baby.

  “What will it be like?” asked Des.

  What the fuck was he asking that for, as if it were a foregone conclusion? She hadn’t decided at all that Kay Kay should die.

  “The oxygen levels go down very quickly once you withdraw support,” the doctor said softly. “There is some terminal gasping but it’s unlikely there is any real suffering. We give the baby fentanyl just in case… after death the heart will often beat for an hour or so…”

  Allison put her hands over her ears.

  “I don’t want to hear this,” she said, choking down her words. She jumped up.

  “I want to hold her. I want to hold her now. I’m not ready to make this decision.”

  Dr. Farmer stood up. She put her hand on Allison’s arm.

  “You don’t have to decide right now. I’ll convene the ethics committee and you two will have a chance to talk it over together. We can meet later with the social worker, the chaplain, anyone you like. But the most important thing now is that you should hold Kay Kay. Let’s do that first.”

  They took her into the family room and wheeled in the isolette. Pale pinks and blues, with a bed and a comfortable rocking chair. It looked like somebody’s bedroom, not a hospital room at all, a place where you could pretend everything was normal.

  Allison sat in the rocking chair. They took Kay Kay out of her isolette, still hooked up to all the tubes, and placed her in Allison’s arms.

  It was as if all the love she had ever felt in the whole world, in her entire life, all the emotions she had repressed, all the feelings she had ever had, began to flow out of her body and into her baby’s body and back again in a circular motion. She could actually sense this forceful gush of love, almost like exchanging bodily fluids, like she was transfusing her blood into Kay Kay and back, so strong was the sensation. She had never known anything like it before.

  She looked down at this tiny bundle and saw herself, saw Des, saw her mother and her father, and she was overpowered with happiness and anguish. She felt her body clutch Kay Kay to her and she knew that she could never let her die, even if this was all she would ever be able to have of her. She could not give this up. Her skin was rough and red now, slightly dehydrated. She smelled of alcohol and medicines. But she was still the most beautiful baby Allison had ever seen.

  She put her finger in Kay Kay’s mouth and felt her begin to suck. Suddenly she had an enormous tingling sensation and surge of pain in her breast as milk began to flow out of them. She had forgotten about her breasts. She had planned to breastfeed. Now that would be impossible. They were feeding Kay Kay through tubes. She would have to pump her breast milk in case Kay Kay recovered… or pack them with ice in case Kay Kay… didn’t recover.

  The doctors had left them alone with their baby. She really didn’t want to be alone with Des. She had not been able to look him in the eye since this had happened. Part of it was because she felt inexplicably ashamed. Ashamed that they had had this imperfect child? This child who would never be normal? Ashamed that they, these two successful, take-charge people, were rendered so helpless in the face of such a calamity? Partly she couldn’t look him in the eye because she was angry. It was odd how Allison felt now about Des, how angry she was at him for no reason that she could determine. Maybe she was angry because he had let this happen to her, to their child. Maybe she was angry because he wasn’t doing anything to stop it. He was so rational, so calm, so reasonable. Unplug the baby and let her die? Okay, sure, no problem. Only they didn’t call it that here. They called it “withdrawal of support,” a fancy euphemism for killing the mother. Because that’s what would really happen.

  Maybe she was angry at him because she was angry and there was nobody else to blame it on. She didn’t believe in God so she couldn’t blame it on Him/Her. If only she could. It might make the whole thing so much easier. She could pray. Get down on her knees and pray to this humane, loving, caring, all-powerful being who had decided in His/Her wisdom to make her suffer like this. “Thank you, God, for lending me your baby even for so short a time.” That’s probably what a really religious person would say. It was such bullshit, such utter outrageous bullshit.

  “I would like to have her baptized.”

  She heard Des’s voice somewhere in the background saying those words. It was almost as if he had read her mind and was playing some cruel trick on her. She couldn’t believe she was hearing it. How could he possibly even suggest such a thing, knowing how she felt? It would be a violation of everything she believed in, it would make a mockery of her pain.

  She didn’t answer. She wanted to make him say it again. If she felt shame, she wanted him to feel it, too.

  “There’s a nun here, Sister Madeleine. She’s a chaplain to all faiths,” he added quickly. “I’ve spoken to her about it. She says it’s important to do it sooner rather than later. I’ve called my brother. He can get here from Massachusetts…”

  She sat there holding Kay Kay, her breath coming in short little gasps exactly the way her baby’s were. She couldn’t have spoken even if she had wanted to.

  “I thought maybe tomorrow morning.”

  There was a pleading tone to his voice.

  “I remember you saying that you had a christening dress that belonged to Sam somewhere in a trunk. We could get that out and—”

  “Stop it. Stop it right this minute, Des. You can forget a baptism. I will not allow my child to be a part of some pagan rite, some celebration of this monstrous God you worship. Besides, there’s no need. There’s no need. She’s not going to die. She’s not. I won’t let her. You have to have the consent of both parents. I won’t let them or you persuade me to kill her. Ever. Under any circumstances.”

  There was silence. Des didn’t speak.

  “Don’t you see?” she said very quietly. “It just hurts so much.”

  Even though she wasn’t looking directly at him as she spoke, she could see through the corner of her eye that his cheeks were streaked with tears. She still couldn’t cry.

  * * *

  He had gone to the office for a few hours to catch up on things and, she suspected, to get away from her and the intensity of everything. She had taken a taxi home after he left, to get some clothes. It was late afternoon. She wouldn’t leave the hospital overnight now that she had been discharged from Sibley. She was still in a great deal of physical pain, but she didn’t want to be away from Kay Kay in case… in case they needed her. Children’s had a wonderful parents’ waiting room, a special bathroom with showers and lockers and a sleeping room with recliners for parents with kids in the I.C.U. or the N.I.C.U. When she wasn’t with Kay Kay she was sleeping or resting in the darkened room on a recliner.

  The doctors had come to do some procedures on Kay Kay, so she had stopped off at the cafeteria to get something to eat. There would be nothing at home. She wasn’t hungry but she knew she had to force herself or she wouldn’t be strong enough to stay. She had eaten something, was it mashed potatoes? Apple sauce? She had already forgotten, but it was something comforting, b
aby food.

  In the cab on the way home the driver had gone past St. Matthew’s, the Catholic church at the corner of Connecticut Avenue. There was a big sign on the front that said, “Come Home for Christmas.” Passersby were scurrying to and fro with packages under their arms, their bodies braced against the freezing December wind.

  As they drove by, Allison looked up and saw Des. He was coming out of the large doors, looking disheveled and exhausted, his tie askew, his hair rumpled, circles under his eyes, his trench coat open, oblivious to the cold. He looked so sad that it broke her heart. She realized for the first time that she was not the only one suffering. In some way, if she was feeling helpless and alone and ashamed, then he must be feeling it, too. Even worse because he was a man and the man is supposed to protect his wife and his child. It was so primitive on one level. Yet it was that primitive side of Des that she had fallen in love with in the first place; that side of him that she called masculine when she was feeling good about him and macho when she wasn’t.

  She realized she didn’t know this person she was married to. This man she would have sworn was not religious until their first confrontation over their wedding. Now he wanted to have his daughter baptized, now he was going into a Catholic church to pray. Who was he, except a person in a great deal of pain? Would it really be so terrible to let him have this silly little ceremony for Kay Kay if that would help him? She only wished there were something that she had that would help her. How could she deny him this? It would be too cruel, like denying someone in physical pain an anesthetic even though it was ineffective for her. She would let him have the baptism. It wouldn’t hurt Kay Kay, and that was all she really cared about.

  * * *

  Kay Kay couldn’t wear Sam’s christening dress because of all the tubes, so they had to lay it on top of her little body. Des had brought a camera.

  They had the ceremony in the family room. The three of them stood up. Somehow it seemed right. More formal. Dr. Farmer was there and Tamsin Cooper and all of the nurses and doctors who were taking care of Kay Kay. Everyone had gotten so involved with her, with Allison, with Des.

  Des’s brother had come. Sister Madeleine officiated, though he assisted as he had at their wedding. He brought the Shaw family Bible with him. When he and Des hugged each other, for some strange reason, it nearly brought Allison—Allison of the stoic face—to tears. Men’s grief always seemed so much more touching to her, perhaps because one saw it so rarely.

  Sister Madeleine was tiny and round, like a miniature female Santa Claus, with wide twinkling eyes, rosy cheeks, a curled-up lip, and a nose like a cherry. She had such a sympathetic manner, so unproselytizing or unctuous, that she won Allison over despite her dismay at the mere fact that anyone could be a nun.

  Allison had a red, green, and black plaid full shirtwaist dress that hid her still expanded figure and leaking breasts. It was pretty and dressy and Christmasy and cheerful. This was to be a happy occasion. She held Kay Kay tightly.

  Sister Madeleine began solemnly.

  “Kay Kay was conceived through love, carried in love, nurtured in love, and born into love,” she said. “Allison and Des have shared with each other and now they share with this beautiful baby.”

  Des reached over and put his arm around her, encompassing Kay Kay as though he were trying to shelter both of them from any more pain or sorrow.

  Sister Madeleine touched Kay Kay’s forehead.

  “It is with great joy that we welcome you, but it is also with sadness that you are here in the hospital. It is also a time of sadness for your mother and dad who love you so much and know that they will have to let you go.”

  Allison froze. She looked up panic-stricken at Des. He squeezed her arm. She didn’t say anything. She didn’t want to spoil this for Kay Kay.

  Sister Madeleine made a sign of the cross over the baby.

  “Des, Allison, I invite you to do the same so that Kay Kay may have eternal life as she goes to the Lord.”

  Des made a sign of the cross. Allison did not.

  “Allison, would you like, in your own way to bless your baby? All of us bless our children in special ways. We may kiss, touch, stroke, or lay our hands on them.”

  As turned off as she was by the sign of the cross, she was grateful to Sister Madeleine for including her. She did all four, surrounding her child with as much physical love as she possibly could.

  “Mom,” Sister Madeleine continued, “I know that your consent for this baptism was a real struggle and that you are doing it to help Dad. That’s what love is all about. It shows character and integrity and respect for him. It’s almost harder than if you were both two consenting Christians.

  “Katherine Kimball Sterling Shaw, I baptize you…

  “Father in heaven, I ask you to be with Allison and Des as they continue their journey with Kay Kay, a journey that is filled with pain and tears and wondering why because ‘it just hurts so much.’ We stand here in silence before you and in silence we cry out. Our Father, who art in heaven, hallowed be thy name…”

  Des began to repeat the Lord’s Prayer, as did the others. Allison didn’t but she found the repetition familiar and comforting, like a nursery rhyme or a Christmas carol.

  “Their journey is walked in love and courage. Be with them Lord. Fill them with peace and your healing presence. Amen.”

  CONFIDENTIAL

  PATIENT CARE CONFERENCE ON BABY S. DEC. 24

  … At the case review, the neurologist presented her findings, which consisted of the following: (1) a large cystic, circumscribed lesion in the right frontal lobe of the brain which is believed due to an infarct rather than primary hemorrhage; (2) jitteriness; (3) paresis of the left upper arm; and (4) a “dysmature” EEG. She felt that it was extremely likely that Baby S. will be severely mentally retarded and will probably need custodial care. Because of poor prognosis for cognitive function and the possibility that the child cannot be weaned from the ventilator, it was felt that parental discretion should carry more weight than it might if the child were less severely affected.

  Attendees at the meeting agreed that it was reasonable to try to reach an agreement with the parents as to when extubation might be tried and, if the child failed without the ventilator, whether she should be reintubated. Furthermore, there should also be agreement with the parents as to whether sedation (which might hasten her death) should be given if she shows evidence of discomfort while off the ventilator.

  Although the parents expressed satisfaction that they were now more informed, my impression was that the mother did not accept everything that was told to her. Discussion centered on Baby S.’s unstable condition, questions about her degree of suffering, and future expectations. It was apparent during the discussion that there was some difference in the views of the parents in terms of steps to be taken for Baby S. They were encouraged to reevaluate the situation and to meet with the doctors at the end of the day.

  Merle Johnson,

  M.D. Office of Ethics

  Christmas Day. Her first Christmas as a mother. Her last day as a mother. Kay Kay was to die today. It had been decided.

  The doctors had decided for her, really. Des had decided for her. She had not decided. She would not take responsibility for killing her child.

  “They” had decided that Kay Kay was to have her support “withdrawn” at 10:00 A.M. Christmas morning. She had sat with her all night, alone, and she had asked to be alone with Kay Kay in the family room for about an hour after they had “withdrawn” the support. No doctors or nurses, no social workers or nuns, no Des. She hadn’t thought about friends. She hadn’t seen or talked to any of her friends since the night Kay Kay was born. She hadn’t wanted to. Sprague apparently had been at the hospital every day, but she had refused to see him. She couldn’t bear the idea of people feeling sympathy for her. Any sign of sympathy only made it harder for her to control her emotions. Des relayed messages, brought notes, told about flowers being sent to the house. She tried to put it out of
her mind. As long as she stayed in this silent humming cocoon nothing was real and none of this was happening and she was safe and Kay Kay was safe.

  Des had gone home to shower and change, then had come back and had gone into the parents’ waiting room and slept most of the night on the recliner.

  She couldn’t possibly sleep or leave Kay Kay alone. She kept her vigil. This was her last night and she had so much to tell her child. She told her about her father Des and how proud of her he was. She talked to Kay Kay about her grandmother Katherine, about how much she had loved her even for the short time she knew her. She told her about Sam and about Nana. She talked about Uncle Rog and Aunt Molly, Jenny, about her old boyfriend Nick and about Julian. She wanted her to know everything before she died. She told her fairy tales and sang her nursery rhymes. She and Kay Kay had their own song. She sang it softly to her over and over.

  “You are my Kay Kay, my only Kay Kay, you make me happy when skies are gray. You’ll never know dear, how much I love you. Please don’t take my Kay Kay away.”

  It was the happiest night of her life, being able to sit there in the rocker with her baby and croon to her, and she pushed everything else out of her mind. Until the morning. Until they came. Until it was time.

  There were so many of them. They all wore white coats except for Tamsin Cooper and Sister Madeleine and Des. They hovered around. They all had worried and sympathetic expressions on their faces. They kept patting her. Des kept putting his arm around her, trying to get her to meet his eyes. She couldn’t look at him. From some other zone she recognized that he must be in pain, but she couldn’t focus on it, deal with it.

  They took Kay Kay out of her isolette. They had removed the tubes. They handed her to Allison with Des sort of holding on, too. Both of them stood there for a while, just looking at Kay Kay.

  “She has to be one of the most beautiful babies I ever saw,” Tamsin said. Everyone murmured in agreement.

  “When you’re ready,” said the doctor.