Alex By Jeff Stimpson Print
Birth Stories - Premature Birth Stories
Tuesday, 03 February 2009 07:36
This is the story of Alexander Lee Stimpson. It's a short story, because he was born only a week ago, and it's a little story because he was born weighing a pound and five ounces. So far it's also an ongoing story.

In a perfect world -- and the past week taught Alexander's father than this is not a perfect world -- the story wouldn't have begun for another two months. Instead it begins last Sunday morning, five days after my wife Jill had checked into the hospital.

I charge into Jill's room at 11 o'clock. We peck. "Well," she says, "we're having a baby."

No shock. For months Jill and I have been hypothetical parents, pinballing from sonogram to sonogram to let doctors probe Jill as if hunting for a submarine. About a month ago, one of the doctors began to sigh a lot and start to use the word "miracle" in a bad way, and not long after that four new letters landed in our lives: IUGR, or intrauterine growth retardation.

I denied IUGR. The doctors were dating growth from before conception, which made no sense to me. Then as our little submarine dropped further and further down a "percentile" chart of fetal growth, the doctors began wondering when intensive care might be best. "Let's just hope you make it to 28 weeks," the doctor sighed. "Then 29 weeks. Then 30 ..." But as her numbers climbed, the doctor's hands waved and waved in wider and wider circles, and she felt compelled to add that she'd "be praying for us." The bottom fell out of Jill's stomach.

Jill went on bed rest, sentenced to rented movies and my cooking. She rose only for sonogram appointments, which jumped from once a week to twice a week to once a day, which pretty much killed time until she was ordered into the hospital.

So we come to that Sunday, when Jill gives me the news and I say OK. She does the Times crossword while hooked to the fetal monitor, and in the background we hear the heartbeat of the coming stranger.

"I just hope the kid isn't too shocked," she says, looking out the window, her hand on her belly where the kicks continue. About 400,000 premature infants, "preemies," are born in the U.S. every year. A preemie is born before the 37th week of pregnancy; full-term infants are born between 37 and 42 weeks after the last menstrual period.

Jill and I, and this kid, are looking at 29 weeks. Jill returns to the crossword, and three minutes before they wheel her to the OR she tells me she needs a World War I battle site, seven letters.

I have to wait outside the OR while they get Jill ready. Helen, a recovery nurse, talks to me in her Irish burr while a few patients lay wordless in the dark. Twenty-nine weeks isn't bad, Helen burrs, "but 19 weeks, there's not much chance ... " I check in at the waiting room where Jill's sister Julie waits with Jill's mom.

Julie hands me lunch: a Baggie of malted milk balls and cherry tomatoes. "Ma ate everything else," Julie says.

Then it's back to the OR, where Jill will be awake for the operation. I'm beside her, and a green sheet hangs between us and the action around her midsection. Tick tick tick goes the heart monitor -- whose heart? -- as I tie on my papery surgical mask and wonder how life is about to change. Wondering how I'm going to screw up this kid. Wondering if I'll get the chance. Wondering. There is nothing to do but pet Jill's head, listen to the surgeons chatter and remember the comforting words of "The Neonatal Intensive Care Unit Parent Information Booklet," a hospital handout that begins with the observation, "We know this can be a very stressful time."

Tick tick tick. Chatter. Tick tick. Then it is 1:10 p.m., and somebody yells "Boy!"

Everything I used to want turns to mist when someone sails past with a baseball. Later I learn it's his head. I remember it as gray. I peek on tiptoes as a clot of doctors dive onto the "Boy!," and beyond their gowns I glimpse hands and feet the size of a GI Joe's, legs and arms only as thick as a magic marker.

"He's so small," I whisper. So small. So small. So small it kicks my chest. They slide him into a clear plastic box and wheel him away. Not too fast, but already my son has no time to hang around with his parents.

About a half hour later one of the surgeons takes me up to intensive care, or the NICU (nick-YOU) to really begin this very stressful time. The NICU looks like a baby hatchery, with a clean, gluey smell and crammed with carts and medical gear and clear plastic boxes called isolettes. Inside the isolettes, most of the arms and legs don't move; probably their owners are pretty tired. Cries are muffled -- one infant sounds like a crow -- but red and green numbers on monitors constantly set up alarms, bleeps and bells that shatter any sense of a home-like nursery. Jill has told me preemies can hear, and some parents fill a few cassettes with recordings of the NICU to play for their baby when it comes home.

I see someone has stuck a piece of white tape across the front of my son's isolette and written "Hi! I'm Alexander!" No other baby has a piece of tape.

Tubes run into Alex's isolette. Blue tubes, green tubes, clear tubes, fat tubes, fine tubes. One carries in warm, humid air. One runs into his pinhole left nostril, and a wider clear tube down his throat. He opens his mouth wide, but no sound comes out because the clear tube is between his vocal cords. My kid is a palmtop, painstakingly crafted with miniature versions of my feet and knuckles the size of these letters, my finger monstrous in his hand.

"Hi, Alex. I'm your dad. Alexander..."

In a premature infant, the lungs, digestive and circulatory systems are undeveloped. Preemies' most common health problems affect breathing and heart, brain and body heat and eyes, the latter of which may result in permanent blindness (Steve Wonder was a preemie). Premature babies are at increased risk for apnea, in which breathing temporarily stops for 20 seconds or more. Maybe a lot more.

His eyes are closed, wrinkles rippling across his forehead just like they did on the forehead of my father, who also had thin hair. Alex has my nose. I open the porthole of the isolette and peer in. His lifeline is long.

"He is one tough little kid," his doctor tells me, then reiterates what can go wrong when you enter this life two and a half months too soon. As recently as the 1980s doctors were brutal with the parents of preemies, standing over isolettes and spraying predictions of everything from a quick death in infancy to a bad social life in grade school. Don't touch them, they'd say, don't bug them, their nervous systems aren't formed and the case is kind of hopeless anyway. These days the medical profession has wised up a little -- some nurses encourage holding, for instance -- but nobody will predict anything more than a day, sometimes an hour, ahead.

"Some babies fall apart within six weeks," the doctor says. "Some take right off. Your experience will probably be somewhere in between."

I've never been a parent, but I already make a prediction of my own: Years' worth of worry, helplessness, highs, lows, daydreams and dread crammed like isolettes into the next eight weeks -- at the soonest -- until Alex can come home.

"I'm optimistic," the doctor says.

Optimism floats us through the first week. Jill and I get plastic hospital ID bracelets, hers with "Mother" and mine with "Father" and both with the number "64092." My life becomes a pattern of days spent at work, then meeting Jill at the hospital over Alex's isolette. We cradle his head and touch his palms, watch him squint and learn to yawn. I write a letter to Alex, telling him what Michael Jordan and his dad did, separately, on the day before he was born. "You are part of that river of humanity that has had billions and billions of bright sparkles upon its surface. You're one of those sparkles now," I write to him.

Meanwhile Jill, reminded that she is a mammal, must hook herself to a pump to begin trying to lactate. But the stuff comes hard, and soon she hates opening the door of the pumping room fridge and seeing the full beakers of the other mothers; soon she speaks about full-term moms and their "bully" babies in the same tones she once used to describe other drivers on the Beltway.

Each night at 9 o'clock that first week I leave Jill, who's still recovering in the hospital, and head home, arriving about 10 to feed a starving, dying cat, and spend two hours juggling phone calls. Amazing how a 21-ounce person has set phones ringing from Tucson, Arizona, to Waterville, Maine. "Awful big name for such a little baby," my sister says. "Little guy, isn't he?" my brother says. The phone rings and rings until I get about four or five hours' sleep a night, and feel like a parent. Only Alex doesn't call.

Because he's busy. When the big ventilator gets to be too much, they attach a device that makes his chest flutter. They wiggle a tiny stocking cap on his head to preserve body heat. The dial controlling the percentage of pure oxygen in his air tube goes up to 70, down to 25, and gradually settles around 30 to get him used to breathing air (which is about 21% oxygen, even in New York City). I look at Alex and I know that he doesn't know what he's doing here.

He doesn't know what a "transfusion" is when he needs one on Tuesday night. He doesn't know what "jaundice" is when it sets in, and they haul out banks of purple lights and bake him while he lounges like a preemie movie star in a pair of tiny black eye shades. His right fist finds his mouth. We learn he may qualify for Social Security. Around that time, a grandma new to the NICU walks past Alex's isolette and looks at him as she would a car wreck. We tell Alex he's just met his first jerk.

This is how the first days go, before Alex turns one week old on Father's Day. To celebrate, Jill's mom sticks her head near the isolette port and breaks into "99 Bottles of Beer in the Wall." He sleeps through it; Alex is already one of the strongest people I know. This is how the first days go, while our world goes up and down, mostly up: good heart, cloudy lungs; firm kick, yellow color. He pinks up, twitches on a way that gives me a precious glimpse of the baby that my child will become.

This is a very stressful time. Day to day I try not to stare at the babies and little boys on the street -- hordes of them, a mob, a terrifying many because all, all are bigger than Alex. Time after time my stomach will not stop catching when I enter that bright room ("Hi! I'm Alexander!") and go once more into the bleeps, praying that no bell tolls for him. Praying, as I look down at my boy through the clear plastic and realize that I am the one who feels so small.