If You Lived Here You'd Be Home by Now

by Christopher Ingraham

  “And what will happen in the spring?” she said.

  “It’ll, uh, it’ll dissolve maybe? And then it’ll be all gone, and we won’t have to lift a finger. It’s not about working hard, you see. It’s about working smart.”

  “Mm-hmm.”

  The turds dissolved, all right. But they didn’t exactly disappear. When the snow began to melt, turds previously separated by strata of snowfall, like fossils in limestone, were suddenly revealed, joined back together during the cold nights, disintegrated by the warm sun the next day to form a soupy brown porridge that turned into a fetid swamp covering the entire front lawn. The mailman started delivering packages to the garage door rather than wade through the filth. Briana was mortified.

  “I don’t know what else I’m supposed to do,” I said. “Maybe next year I’ll go out there with a jackhammer in February?” The swamp eventually dissipated, but three years later the mailman still has not returned to the front door. We didn’t figure out a system for dealing with the poop until the winter of 2018 and 2019. Every few days I’d head out to the yard with a suite of tools: a potato hook, which is kind of like a small pitchfork with curved tines; a pooper scooper consisting of a turd rake and a turd basket on a stick; and a plastic bag. First I’d go through and pick at the turds with the potato hook, freeing them from their icy prison. Then I’d make a second pass with the scooper to pick them up. Finally it would all go into the plastic bag, which would go into the garbage. When I was out there hacking away with the potato hook it felt like nothing more than literal turd farming, which, in a sense, it was. But come springtime we were spared the fragrant soupy mess of prior years.

  By mid-April in 2017 we were ready for spring, real spring, even through there was still snow covering most of the ground. The warmer weather brought preparations for our own little Minnesotan—the baby would be a boy, we found out, and he was due to arrive in mid-June. We decided he’d be named William Jeffrey Sean Ingraham—Jeffrey for my stepdad down in Tampa, and Sean after his godfather in Baltimore.

  The twins had been born at Johns Hopkins in Baltimore, one of the finest hospitals in the world. Because they’d been so early—six weeks—they spent a lot of time in the neonatal intensive care unit, hooked up to the machines that kept them alive via various tubes, cables, and electrical leads.

  Charles, first out of the gate, was impossibly scrawny at 3 pounds, 12 ounces. He was gaunt, a little wizened old man, a miniature Benjamin Button baby. When we were finally able to hold him he felt so tiny and fragile that my stepfather remarked it was like holding a squirrel.

  Jack, meanwhile, was a full two pounds heavier than his brother for reasons the doctors were never fully able to figure out. He was swollen with fluid when he came out and resembled nothing more than a tiny purple version of my own father. It was strange to look at him.

  The twin pregnancy had been a harrowing affair. Keeping two tiny humans alive in your belly is a complicated process, and there had been issues with early labor and alarming bouts of contractions that we’d had to drop everything and run to the hospital to deal with all throughout the summer of 2013. By the time they finally came into the world via an early labor that was irreversible, we had steeled ourselves for the reality that they would arrive well before their due date and that their first few weeks in the world would be highly fraught.

  William’s pregnancy, by contrast, was completely by the book. There was just one of him, after all. It was a hassle, as all pregnancies are, but he hit his prenatal milestones right on schedule without the slightest sign of complication. In contrast to the twins, William’s pregnancy felt easy. Relaxed. We didn’t fret too much over preparations since we knew we had plenty of time, that there was essentially no risk of a preterm birth. By April we hadn’t even visited the delivery ward at the hospital in Crookston where William would be born. There was no need, no rush. I joked with friends back home that the “hospital” was probably just a workshop in some guy’s barn.

  Then, without warning, Briana’s water broke on April 28. Six weeks early. Just like the twins.

  It had been an unremarkable Friday. I was in the office wrapping up the day’s stories and pitching ideas for the next week to my editor. Briana burst through the door looking stricken. There was a towel between her legs.

  “I’m pretty sure my water just broke,” she said, with panic in her voice.

  “What? Are you sure?” It was an idiotic question.

  “One hundred percent sure,” she said.

  I felt the bottom drop out of my gut. Memories of our previous ordeal in neonatal intensive care came crashing back—our babies with tubes protruding out of them at every angle, nighttime vigils in front of machines flashing numbers that held the keys to whether they would live or die. Tiny, impossibly fragile creatures not meant for this world, with paper-thin skin you could see their heartbeats through. When they were born we didn’t even get to hold them for days. They were pushed out and then wheeled out of the delivery room in a flash. The circumstances of their premature birth were fraught, and the delivery staff at Hopkins were so hard-assed about keeping babies alive that there was no time for niceties like holding the babies, putting their hands in ours, offering them some comfort, however small, in the cold, bright, terrifying world they were cast out into.

  I still remember, with crystal clarity, the sound of every single alarm in that NICU. There was one for a heart rate too high, and a separate one for too low. There was an alarm when the nutrient broth delivered to the babies by nasogastric feeding tube was empty. There was one for Jack’s ventilator. One for the CPAP he was on afterward. One when the dissolved oxygen was too low. One when the incubator temperature was too high. One when a lead fell off. Then there was the big one, the alarm that resonated across the entire ward, when somebody’s impossibly fragile little baby went code blue. The staff would immediately drop everything and rush in the alarm’s direction. Sometimes it would be a false alarm and they’d all walk away relieved and smiling. Sometimes it was the real deal and they’d walk away stone-faced and grim. The best thing I can say about Jack and Charlie’s NICU stay was that the big alarm never rang for them.

  We lived like this for weeks. You could tell exactly what kind of day you’d have in the NICU the moment you walked in just by looking at the nurses’ faces. Sometimes Jack and Charlie had a good night. Some numbers on some machine had moved in the right direction. Maybe Jack was breathing well and they were able to step down his oxygen. Maybe Charlie’s heart rate had risen just a little bit. On days like that the nurses would relax the rules a bit; you could hold the babies for a while, change their diapers, let them squirm around next to each other in a crib. Then there were the bad days, when the numbers had gone the opposite direction. They’d had to put Jack back on the CPAP. They’d tried to feed Charlie orally but he choked. Then the rules were strict, the road to discharge foggy and uncertain. Sometimes one of them would have a good night while the other regressed, and those were the most confusing days of all.

  There is only one question on any parent’s mind during a child’s NICU stay: when can my baby come home? But the doctors and nurses there don’t think like that. They’re fixated on the moment, on the vital signs, on the numbers flashing on the screen. It’s not clear to me whether the staff at Hopkins were specifically trained not to offer any long-term prognoses to anxious parents, or whether, due to intense, highly specialized training and a laser focus on the here and now, they were simply no longer capable of thinking about time in linear terms. As a result you, the parent, become incapable of thinking that way, too. You become tethered to the moment. Time disappears. The NICU stall where your baby is becomes your whole world. Lights on a screen, the soft whoosh of a ventilator, tiny cries heard off in the distance. Afterward, if you’re one of the fortunate parents who gets to bring their baby home, you can no longer tell whether your NICU time was measured in hours or days or months. There’s a black void in your memory that you stay far away from because
you know, beyond doubt, that it encompasses the absolute worst days of your life.

  Four years after Jack and Charlie’s NICU stay ended I was standing in the office with Briana asking her what we were supposed to do now. We both struggled not to panic. The kids were running around upstairs, unaware anything was amiss. We hadn’t packed an overnight bag. We’d barely discussed what we’d do with Jack and Charles when it was time to deliver, although at one point Ryan Brumwell and his girlfriend, Kristin, told us they’d be happy to take the boys on short notice when the time came.

  So we called Ryan. No answer. Kristin. No answer. We tried Jason. No answer. Curse these Minnesotans and their perpetual industriousness! We called Dick. He answered. We told him what was happening. “I’ll be right there,” he said. Less than five minutes later, he was.

  When he saw the looks on our faces he immediately understood the gravity of the situation. We tried to give him a crash course in everything the twins could conceivably need that evening. “Shut the fuck up and don’t worry about it!” he said. “Just go!”

  “What’s the matter with Momma?” Jack asked as he saw us preparing to leave.

  “Momma’s sick, we have to go to the doctor,” I told him. “Be good for Mr. Dick and listen to what he tells you.” He and Charles fidgeted anxiously in the doorway. They could tell something was terribly wrong.

  We raced down the county highways toward Crookston, past fields covered with a fresh coat of snow from the night before. Briana was breathing hard, straining. The contractions were very close. I tried to keep up a steady patter of reassurances for both of us—we’ve been through this before, there’s only one this time, he’ll be bigger, he’ll be healthier.

  “I can’t do this again,” she said.

  “Yes, we can,” I said. “We have to.”

  In truth I felt the same way she did. When we’d found out we were having just one baby this time, the first words out of my mouth were “Well, no matter what else happens we won’t have to go to that goddamned NICU again.” Now we were headed toward a NICU at the edge of some cornfield in the middle of nowhere, our support network consisting of near-strangers and people we had known for less than a year. I floored it. If nothing else I was determined to not have to deliver William myself in a Honda Civic on the side of a rural road.

  It was all a mistake, I kept thinking to myself. The decision to move here, the decision to have a baby, everything that had happened since that first dumb story. I should have just left things as they were, moved on to other stories, continued living the D.C. life the way I had been. I’d be in the newsroom now, surrounded by colleagues, probably preparing for some TV or radio hit. Our lives would be smaller, circumscribed by the commute and the costs and everything that made us want to leave in the first place. But God damn it, at least we wouldn’t be about to bring a strange new baby into the world six weeks prematurely in a frigid field in the ugliest county in America.

  We made it to the hospital. I found a wheelchair and wheeled Briana in the main entrance. We had no idea where to go. There was a kindly old woman sitting at a volunteer station. We ran over there.

  “Labor and delivery?” I asked.

  “Well . . . let me see,” she said, slowly rifling through a stack of papers on the table. “Hmm. Okay. All right. Now then. Could I get you to sign this pa—”

  “WE’RE ABOUT TO HAVE A PREMATURE FUCKING BABY WHERE IS LABOR AND DELIVERY??”

  Some of the staff overheard the outburst and quickly shuffled us off in the proper direction. They got us set up in a room and strapped the fetal heart rate monitor across Bri’s belly. Two pieces of good news: we weren’t going to deliver him in a field, and his heart rate was strong. Doctors and nurses came in, asked batteries of questions, checked monitors, and went out. Eventually several came in at once.

  “Your baby is very early,” a doctor said.

  “Yes, we know.”

  “We don’t have the facilities to handle a baby that premature here,” he said. “You’ll have to go to Grand Forks.”

  Bri and I looked at each other.

  “We have an ambulance ready with a team to accompany you,” the doctor said. “If need be they’ll be able to deliver the baby on the way.”

  “Only had to do that once so far, in seventeen years!” a chipper voice volunteered from the back of the crowd, the ambulance driver.

  They loaded Bri on a stretcher with various machines and monitors in tow. They told me to follow in the car, and to not bother trying to keep up. “We’ll be going fast and don’t need any accidents,” the driver said. Fine with me. I walked back to the car. I got in. I drove. As I crossed the bridge over the Red River of the North thirty minutes later, it struck me that we’d be having a North Dakota baby, not a Minnesota baby. It seemed so strange, and foreign. A child of the West, a frontier baby. To my knowledge no Ingraham had ever been born anywhere west of Niagara Falls. What the hell were we doing out here?

  I got to the hospital in Grand Forks and found Briana in an upstairs delivery room. It was quiet and the lights were dim, almost peaceful. Back at Hopkins the twins had been born under harsh lights in an operating room with about two dozen people present, separate teams for each of the babies and one for mom in case things really went south. Here in North Dakota things were more laid-back, partly a simple function of there being only one baby. They gave Bri an epidural and kept an eye on her dilation. Jason texted asking if we needed anything. I sent him a list of things I had forgotten—my meds, a wallet, a phone charger.

  About two hours after the contractions first started William was ready to be born. Like his brothers, he wasn’t one to dilly-dally. A couple of doctors and nurses came in, Bri pushed once, and suddenly there he was: purple and wriggling, hollering his strange, raspy yowl. His vitals were good. His APGAR score was good. Miraculously, Bri got to hold him to her chest and sing to him for a few moments before they wheeled him away.

  The NICU in Grand Forks was completely different than the one in Johns Hopkins. The Hopkins NICU was home to rows upon rows of stalls, each of those home to a tiny person in an incubator. There were dozens of babies there. In my mind’s eye it’s vast. The memory of it reminds me of the scene in the Matrix where we see the massive facility housing the gel-filled holding cells where the robots harvest energy from twitching humans. The Grand Forks NICU was a single room, smaller than an elementary school class. There were one or two other babies in there but it was quiet. There was hardly any sound of alarms.

  When we first went to see him, a few hours after his birth, William was sleeping peacefully on his back in a tight cozy swaddle, a blue and white cap keeping his head warm. His hair was dark like mine but he had a face like Briana’s. He weighed a tad above five pounds, heavier than Charles had been but lighter than Jack. He arrived at almost the exact same gestational day of his pregnancy as his brothers had. Briana is nothing if not consistent.

  I was rather snobbishly prepared to look down my nose at the NICU doctors—what deficiencies in their training had caused them to be out here in the sticks, in Grand Forks, rather than at a world-class facility like Hopkins? But of course this was stupid of me. The doctors were incredibly knowledgeable. When I offhandedly mentioned some protocol I had observed there that had been different than what they’d done at Hopkins with the twins, one of the doctors told me that new research had come out in the intervening years concluding that the protocol they were now using at Grand Forks was superior. This put me at ease: if these docs were up on the NICU research published since 2013 it was clear they knew what the hell they were doing.

  More to the point, they were warmer toward us than the Hopkins doctors had been, almost more human. With just a few babies to manage they had time to talk to us, to answer our questions, to give us a clear sense of how William was doing and what we should expect in the days to come. He was a champ, as it turned out, mastering breathing within a few hours and getting a solid grasp on the breastfeeding stuff within days. The doctors kept w
arning us that he would probably crash, that NICU babies always do this, that after two or three days of progress something would go to hell and we’d be back at square one. Miraculously, it never happened. While the twins had spent six weeks at the hospital, William was on his way back to Red Lake Falls in less than five days. Our North Dakota baby was coming back east, coming home.

  The temperatures warmed dramatically during those five days. There was still snow on the ground when we drove to the hospital in Crookston in a panic. Five days later it was 75 and sunny. The flowers were coming up. It was finally spring.

  William’s infancy was an odd paradox. On the one hand, it was infinitely easier to deal with just one baby at a time rather than two. On the other, having two toddlers to manage on top of the baby, with one of them on the autism spectrum, presented its own set of challenges.

  But the greatest difference between William and the twins was time—time we simply hadn’t had back in Baltimore. As an employee of the federal government Briana had a fairly generous paid-leave policy to draw on and she ended up taking about four months off following the birth of the twins, half paid, half unpaid. Four months is a lot, relative to the U.S. average. Nearly one-third of employed new moms don’t take any maternity leave at all, according to federal statistics. The national average is just ten weeks. Among moms who do take time off, fully one-third are not paid for any portion of their time. The United States is the only country in the developed world, and one of the few in the entire world, that fails to mandate paid leave time for new moms.

  Even though we knew we were fortunate, four months still felt like hardly enough time to spend with two tiny babies who had spent the first weeks of their life tethered to machines in an intensive care unit. But with William we didn’t have to make that trade-off. Bri could be here, with him, giving him the direct parental care that he—and all babies—truly need. With William we’ve been able to experience and share his full childhood—the big milestones like walking and talking, of course, but thousands of little ones, too. His joy at seeing one of the cats jump off a table. His wonderment at a truck driving down the street. The touch of his tiny hand on one of our cheeks. The sweet smell of his round little head as he nuzzles into one of our shoulders to drift off to sleep. We felt, and still feel, incredibly fortunate to be able to have these everyday moments. We wish that we lived in a world where we didn’t have to feel privileged to be able to have those moments together.