by Ann Leary
The nurses at University College Hospital wore uniforms that consisted of a navy dress topped with a crisp white apron. The dress was belted at the waist, and a name tag was pinned to the apron’s breast pocket. One of the nurses told me that the type of dress and the color of belt indicated the rank of the nurse, be she ward matron, staff nurse, or nursing student. I have to say that these uniforms gave the nurses an air of professionalism that can’t be conveyed in the baggy green scrubs that our American nurses wear. The British nurses also used more formal manners, and it was the first time since my marriage that I was routinely referred to as “Mrs. Leary.”
One of the hardest things for me about having a baby in a neonatal unit was coming to terms with my feelings toward the staff. On the one hand, I was filled with gratitude and respect for these overworked professionals. They were my baby’s saviors, and his life depended upon them, but this dependence made me feel … well, redundant. I had tried to produce a healthy baby, had failed horribly, and now the doctors and nurses had been forced to step in and sort out the whole mess. I felt like an actress who’d been replaced by somebody far more talented, but nobody had the nerve to tell me to get off the set. Actually, there was one staff member who I suspected might happily do the dirty deed of firing me as a parent, and that was Miss Eugenia Borthwick.
I met Miss Borthwick when Jack was a day old. I had decided to walk to the unit that morning, which took me a while due to the fresh cesarean scar, but when I arrived, I discovered that Denis had returned! I found him in three-day-old clothes, smiling into Jack’s isolette. He had one hand inside, and Jack’s impossibly tiny hand was actually wrapped around Denis’s pinkie. One of the nurses brought me a chair, and Denis and I just sat there for a while, gazing at our son. Later that morning Denis went out to find some breakfast, and my mother was with me when Miss Borthwick appeared next to Jack’s isolette. My mother was wearing her little suit and her heels, and Miss Borthwick’s immediate disapproval of us was almost palpable. Miss Borthwick wore the highly starched uniform of a senior nurse. Her white-gray hair was pulled back into a tidy knot, and she carried a clipboard and a three-ring binder.
“Mrs. Leary? I’m Miss Borthwick.”
“Oh. Hello,” I said.
“It appears that you forgot to sign in to the unit when you came into the SCBU today.”
“Um,” I said. “We’re supposed to sign in?”
“Yes,” said Miss Borthwick, after a weighty silence.
“Oh, sorry, nobody told us.”
“No, I’m sure nobody had the time. You’ll notice we’re quite busy most of the time, as we’re seriously understaffed. Perhaps in American hospitals, nurses have time to explain ward policies to parents in person. Our nurses have all they can do administering to the needs of the babies. There’s a large sign on the wall by the entrance that explains the signing-in policy.”
“Oh, okay,” I said, suddenly feeling as if I’d barged into Miss Borthwick’s own bedroom uninvited. “I’ll go sign in now.”
I turned and started to limp back to the entrance, but Miss Borthwick said, “Mrs. Leary, I’ve brought the sign-in sheet to you. It’s right here.”
I thanked Miss Borthwick profusely as she handed me the clipboard. Under NAME I wrote “Ann Leary,” under PATIENT I wrote “Jack Leary,” and under RELATIONSHIP I wrote, with trembling fingers, “Mother.”
* * *
I HAVE NEVER felt so much in the way as I did those first days in the Special Care Baby Unit. Fortunately, several of the nurses were sensitive to this. One who was particularly kind was Joan Dyer. It was Joan who told me that when a mother gives birth to a premature infant, her milk contains special nutrients not found in the milk of a mother with a full-term infant. These are nutrients that preemies are lacking and very much need. “Isn’t the human body remarkable?” Joan said cheerfully, in her Belfast brogue. I can’t begin to describe how empowering it was to learn that there was something I could do—that only I could do—to help my baby. Back upstairs on the ward, Denis was with me when a midwife arrived with the breast pump, a surprisingly large, medieval piece of metal machinery with which I would develop an intimate love/hate relationship during the months to come. The midwife showed me how to attach a piece of sterile tubing to the machine. On the other end was a suction funnel, which was placed precariously over my nipple.
My breasts are small. I don’t really know how else to describe them. It seemed to me that the nipple should fit tightly into the funnel, but instead the funnel haphazardly covered almost my entire breast. “Do these things come in smaller sizes?” I asked. Then the midwife turned on the machine, and it was like I’d stuck my breast into the world’s most powerful vacuum-cleaner hose. “OH, MY GOD,” I said, and then I was shocked into silence as I watched milk flow from my breast and into a sterile container, destined for Jack. I had finally discovered a part of my reproductive equipment that wasn’t faulty, and I beamed with pride.
“Well, what do you think about that?” I asked Denis.
“I think we’ll have to take you outside for a nice graze after we’re through in here, Bossy,” Denis replied.
JACK WAS BORN at almost twenty-eight weeks’ gestation, weighing two pounds, six ounces. The fact that he hadn’t needed to be ventilated immediately after he was born was a very good thing, we were told by the neonatology staff. Jack’s main problem was that his body was not mature enough for the real world. He had no suck reflex, so he received my breast milk through a tube that ran through his nose and down into his stomach. Although he could breathe on his own, his respiratory system had not developed to the point where it could regulate itself, and he routinely experienced apnea (a terrifying pause in breathing) and bradycardia (a horrifying slowing of the heartbeat). We were told that if all went well and Jack didn’t develop any setbacks, such as an infection, he would be ready to leave the hospital around his due date, which was still twelve weeks away.
We had no money, but we had a plan. Denis would exchange my first-class return ticket for an economy round-trip ticket and fly back to New York. His manager had booked some comedy gigs for him, and he would stay in the States for a few weeks and work. The only hitch in the plan was that I needed a place to stay, and we couldn’t afford even the cheapest hotel rooms in London for three months. Two days before I was due to be discharged from the hospital, one of the midwives, Beth, told us that there was a social worker in the hospital who might be able to find us emergency housing. She said that she’d spoken to the social worker about us already and had arranged to have her meet with us the next day. Beth told us that the social worker needed her to get some information from us, and that she would stop back later that day.
“What kind of information?” I asked.
“Oh, nothing really,” said Beth. “She just wants to know that a real need exists.”
Denis and I couldn’t have felt needier.
Later, when Beth came in, Denis was gone, but my mother was with me in my room. Beth had a notebook with her, and I introduced her to my mother.
“Is this your first trip to London?” Beth asked my mother.
“Oh, no,” my mother replied. “We come every year.”
That’s enough, Mom, I thought.
“Every year?” said Beth. “Do you have relatives here?”
Just say no, I thought. Then don’t say anything else.
“No,” my mother said. “No, we have good friends who live in Henley-on-Thames whom we visit each year. We come each June for the regatta and—”
No, this can’t be happening, I thought. She’s not going to utter the words “Royal As—”
“—Royal Ascot!”
Not exactly the picture of neediness that I had hoped to portray.
After Beth left, my mother and I took the elevator down to the SCBU.
“Mom,” I said, “maybe it would be better if I meet with this social worker alone tomorrow.”
“Why?”
“Because when you talk about yo
ur wealthy friends and Ascot and everything, it’s likely to make her think we’re rich and I can afford to stay in a hotel for three months.”
“Why would she think that? What does my visiting the Thwaites with Steve have to do with you?” My mother was tired. The words came out short and hard.
“Well, you’re my mother,” I said shakily. “That nurse who just interviewed us probably thinks that you’re married to my father and that we all go jet-setting around the world like the Kennedys, so …”
“Maybe it would be better if I wasn’t here at all,” my mother said, and we rode the rest of the way down to the unit in silence.
* * *
THE NEXT DAY I met with the social worker alone, and she told me that there are two nurses’ dormitories, where some of the nursing students and residents live. One was a few blocks away, on Gower Street. The other was right across the street from the hospital on Huntley Street. There was a vacancy in the Gower Street residence now, and I could move there when I was discharged. In a week there would be a vacancy at the Huntley Street residence, and I could move and spend the rest of Jack’s hospitalization there. The price was only ten pounds a night, and the only proviso was that Denis couldn’t stay with me, as it was a single room. This was fine, I told her, since Denis was leaving the next day.
MY MOTHER HAD planned to stay for a week, and now she was scheduled to return home. My parents had pooled their frequent-flier miles and purchased a ticket for my sister, Meg, to come to London for a few days after my mother left. Then, after Meg left, the plan was for my father to come see me. This was a great plan in theory, but somehow, the day I was discharged from the hospital, none of my family was in London. Denis and my mother had left, and Meg wasn’t due to arrive for another two days. My belongings were packed in a large blue hospital bag that had SANITATION printed in large block letters on the front, and I walked out of the Women’s Hospital with the bag thrown over my shoulder like a hobo’s sack. I had only two maternity outfits to wear for the next several months, and I made my way down Huntley Street swathed in an outsize tunic and leggings that I felt perfectly accented the utter deflation of body and soul I was experiencing.
I couldn’t stop crying. I cried on my way to my new lodgings. Cried when the puzzled manager gave me my key, and then, when I was alone in my dorm room, I really cried. Later I was able to stop crying long enough to go see Jack, and I ran into Joan Dyer, who told me she’d found a spare breast pump I could borrow, so that I could use it at night. I was so grateful I burst into tears again. “I’ll drop it off on my way home,” said Joan. “It’s too heavy for you with that fresh cesarean scar.” Later that night Joan hauled the heavy breast pump all the way to my room on the back of her bicycle.
I started to meet some of the parents of the other, very ill babies in the unit, and I learned that preemies are usually healthiest when they are first born and that it’s the stress of leaving waterworld that causes common problems such as intraventricular hemorrhages (brain bleeds), respiratory distress syndrome (collapsed lungs), and necrotizing enterocolitis (rotted intestines). Those first few days, when my mother and Denis were with me, Jack was relatively healthy, but as soon as I was discharged from the hospital, he had what the doctors called a setback. The apneas and bradycardias increased, he developed a temperature, and they began culturing his blood to determine what was wrong. Jack’s little hand and foot were pricked for blood twice a day from the day he was born in order to detect infection before it was too late. Because there was so little blood in his tiny body, these blood tests made him anemic, and he needed to receive numerous blood transfusions. There were parts of his arm where the skin had been completely pulled off from the IV bandages. His blood saturation dropped, he was placed in an oxygen hood, and I was warned that he might need a respirator, he definitely did need a spinal tap, and just when I started having romantic thoughts about hurling my body into the Thames, I walked into the unit and found my dear sister, Meg, standing next to Jack’s isolette.
Poor Meg. As if the shock of first seeing her tiny anemic nephew weren’t enough, she now had to reckon with me, a potbellied, wild-eyed shell of my former self. But this is the great thing about Meg. She’s an organizer. My mother and I actually think it goes beyond that and borders on obsessive-compulsive territory (you should see her cabinets), but organizing was exactly what I needed. Within hours of her arrival, Meg had assessed my requirements and had acquired bus maps, tube maps, and street maps. Maps in hand, we got on a bus and found a market and a pharmacy. Then, because my mother and Steve had generously offered to loan us money, we opened a checking account in a local bank so that they could wire it from home. Then Meg, who was only twenty-four years old and earning little more than minimum wage, took me to the Gap and bought me some jeans and T-shirts. Back at the nurses’ dormitory, Meg looked at the other residents walking in and out and said, “There’s a cafeteria here someplace.” Upon further investigation she found the cafeteria for hospital workers and students, which was cheap enough for me to eat in every day. When we returned to the SCBU, Meg spoke with the doctors about Jack and was able to listen and actually retain information that had eluded me earlier. Later that week she helped me move from the Gower Street residence to Huntley Street, and right around then—perhaps somehow aware that Meg was a force to be reckoned with—Jack improved. His temperature dropped, and by the time Meg left at the end of the week, he was out of the oxygen hood.
TEN
ON THE EVENING of my second day in the Huntley Street residence, I decided to walk through the underground tunnel to the hospital. The social worker who’d found my room had told me I should walk through the tunnel at night, rather than cross Huntley Street alone. Until then, Huntley Street had seemed perfectly benign to me, with its bright streetlights and quaint Victorian buildings, but I thought maybe there was something I didn’t know. Maybe a criminal frequented the area, a ripper or a strangler, so I took her advice and walked through the shabby lobby to the tunnel stairs.
There turned out to be a lot of stairs, far more, it seemed to me, than were needed to reach an underground tunnel. When I finally got to the bottom, I found myself at an intersection in what I came to discover was a labyrinthine series of dimly lit halls. I was faced with the choice of going left, right, or straight, and because I had just descended a twisting staircase, I had no idea in which direction the hospital might be. I listened for sounds from the hospital, but I heard only the hissing of water pipes. Far down the hall to the left, I could see signs posted high on the wall, so I started in that direction. Every few seconds I heard a loud clunking noise, and I held my breath and quickened my pace. My footsteps echoed above and behind me, and I tried to keep all thoughts of rats and rapists from my mind. Instead I thought about the many people who must have found shelter here in this long subterranean hall during German air raids. This is a shelter, I told myself, not a tomb, and when I arrived at the signs, I was relieved to discover that one said WOMEN’s HOSPITAL and the other said CHAPEL, both with arrows pointing in the direction I was going.
I turned a corner and saw the door marked CHAPEL. I’d been wanting to find a church since Jack was born and had been meaning to locate one close to the hospital. I imagined entering a historic cathedral and sinking to my knees in prayer. There, in the rich warmth of an aged pew, I would beseech God to spare my baby, and I was sure that I would gain some kind of understanding and perhaps be fortified by the experience.
I opened the door to the chapel. It was a small, empty room with several rows of pale wooden benches facing a stark altar. A large metal cross hung above the altar, and I gazed at it, wondering how many others had stared at this same cross with bleak questions aimed at its center. It seemed to me that this chapel was designed for mourning, this austere room in the bowels of the hospital, and that no solace could be found here for people like me, who just wanted to place requests.
I left the chapel and finally found the steps leading up to the hospital. I walked int
o the neonatal unit, and the crisp, antiseptic scent of rubbing alcohol, the ticking of monitors, and the smart rhythm of nurses’ feet—all of it was suddenly familiar and comforting. Jack lay asleep in his isolette, his arms and legs limp and straight but his chest rising and falling. I watched him breathe as I had so many times, and after each breath I willed him to take another. Again, I thought over and over, and his chest rose and fell obligingly.
Whenever I arrived in the unit, I would check the clipboard that hung from Jack’s isolette. It held a chart where the nurses recorded every bradycardia and apnea episode Jack experienced each hour. He got an X each time he forgot to breathe or his heart forgot to beat. Some days these things happened to Jack several times an hour, and his chart would be dark with this information. The nurses also wrote Jack’s weight on the chart each day. In the beginning he lost some of his precious ounces and went down to about two pounds. Then he began to gain, and each ounce gained was like an affirmation of life itself. (Breathe, digest, grow. I actually tried to will Jack to do these things by staring into his glass case and thinking the words, like a chant, each time his weight went down or his heart balked too often.) If the attending nurse wasn’t busy with another baby, she would give me an update on Jack’s progress. One nurse who had a remarkably cheerful demeanor would say, “I’m afraid Jack was a bit naughty last night,” meaning he’d had too many “bradys,” and the first time she said this, I envisioned him leaping from his isolette, snatching the pen from her hand, and running down the hall shrieking with laughter, leads and monitor lines trailing behind him. I was often surprised by the way the staff talked about the babies. Doctors were always saying things like, “I’ve never liked this baby’s lungs” or “Little Sam looks knackered. Let’s up his oxygen.”