by KG MacGregor
“How much?”
“Two pounds, twelve ounces, just a hair under the average for twenty-nine weeks, but that isn’t unusual with twins.” Kathy made all the connections and the room came to life with a mechanical hum. “Her immune system isn’t fully developed, so we have to be very careful about bacteria, especially for the first couple of weeks.” She directed Anna to scrub her hands with antibacterial soap before demonstrating how to use the inverted pockets on the side of the incubator.
Anna tentatively pushed her hand through the opening and tickled her daughter’s clenched fist until it opened and closed around the tip of her finger. Nothing had ever felt so miraculous.
“That’s it, Mom. You’re officially bonding.”
She watched mesmerized as the baby’s spindly toes spread and curled, and her chin—Anna’s chin—twitched in what appeared to be an effort to adapt to the strange new tubes.
Darla had sneaked up to stand beside her. “She’s a cutie-pie. Your son will be out in a minute. He gave us a little trouble, but then boys tend to do that.”
Anna sucked in a breath as her stomach tightened with fear. “What kind of trouble?”
She shrugged. “Nothing we ain’t seen before. Lily said she had a name picked out for him and wanted you to go ahead and name this little girl.”
“Here, you can write it down,” Kathy said as she pulled a card from the slot at the bottom of the incubator.
Anna looked again at her daughter. Strong, Dr. Saint-Laurent had said. “Eleanor. Eleanor Cristianna Kaklis after both our mothers.”
She cooed and smiled as she held Eleanor’s tiny hand, trying not to panic over why it was taking so long to bring her son out.
“She’s as close to perfect as you can get at twenty-nine weeks.” The new voice belonged to Beth, who was still in her scrubs and sweating around the collar.
“How’s Lily?” The next question she hated to ask. “And our baby boy?”
“Lily’s fine. The surgery went just as it was supposed to, and she’s in recovery now. Someone will come and get you when it’s okay to go back and see her.” She ran her hand lightly across the top of the incubator as if caressing the glass. “Dr. Saint-Laurent is still with your son. As we feared, his lungs are very immature. He had some problems with an air pocket and she had to drain it, so I want to warn you that you’ll see a little tube coming out of here.” She indicated an area in the middle of her chest. “And he has a breathing mask. We call it a CPAP. It pushes air into his lungs until he’s strong enough to inhale on his own. Almost all of them can do that by thirty-four weeks or so, even the ones that have problems.”
“Is he going to make it?” Her voice rattled with fear.
“He’s in good hands, Anna, and he’s active. Those two things matter more than anything else.” She dropped her doctor persona to draw her into a hug. “I’ll be checking in on Lily for the next few days, but I’m handing you off to Dr. Saint-Laurent. She’s the miracle maker now.”
“Thank you, Beth…thanks for everything.”
“You’re welcome. Nothing will make me happier than to watch all of you leave here together.”
It was another thirty minutes before Dr. Saint-Laurent appeared. Her surgical gown, which had tiny smears of blood on the chest, was pulled off by a passing nurse and stuffed into a waste container. Underneath she wore gray knit pants and a Montreal Canadiens T-shirt. “Apologies. I was called out in the middle of breakfast.”
“How’s my son?”
“He’s a pistol,” she answered, clapping her hands for emphasis. “If he gives you as much trouble as he gave me, you’re going to need a lot of therapy.”
A nurse entered pushing a second incubator and Anna rushed to look inside. Even though Beth had prepared her, she was shaken by the sight of all the tubes leading to and from his doll-like body. All of him would fit in her open palms. “How big is he?”
“Two pounds, two ounces. Quite a little one but we’ve had much smaller. By now they’re riding their bikes and playing baseball.”
Darla bounded back in. “I have two messages for you. Here’s the first.” She handed Kathy a name card, which she slid into the end of his incubator.
Anna looked at her tentatively before peering around to read the name. George Stewart Kaklis. “Oh, my.” Her eyes flooded with tears.
“And the other for you is to stop crying and go see your wife.” Darla tipped her head toward the two incubators. “Kathy’s got your babies. She won’t let nothing happen to them.”
Dr. Saint-Laurent wrapped an arm around her waist and steered her out the door and down the hall. “This is going to be a long and difficult journey for you and Lily, probably six weeks here in the hospital and then special care for a few more weeks at home. But your children will grow bigger and stronger every day, even as they seem to struggle. No one expects the two of you to carry this burden alone. When people offer to help you, let them. When they tell you to rest, tune out the whole world and go to sleep. It is the only way all of you will get through it.”
It was compassionate advice for someone not known for her bedside manner, Anna thought. “We also have a five-year-old.”
“He is on the journey too. He can help, but he also needs his time, just like you and Lily will need yours. It’s a mother’s instinct to sacrifice herself for her children, but meaningful martyrdom went out with the Middle Ages. Search for the joy in all of it because that will sustain you. And then one day you’ll realize your fear is gone.”
Anna entered the recovery bay to find Lily sitting up, her bruised eyes pronounced against her pale face. Her expression was a mixture of exhaustion and angst. Anna planted a kiss on her forehead and smiled, determined to show nothing but joy. “I’ve noticed that every time the biggest day of my life happens, you’re right there…the cause of it all.”
A flicker of relief passed Lily’s eyes, and she looked for a moment as if she would cry. “I had nothing to do with the earthquake.”
“No, but that wasn’t the biggest thing that happened to me that day. Far from it.” She pushed a lock of hair off Lily’s brow and caressed her cheek, which now seemed to have more color than only moments ago. “They’re both precious, sweetheart…and the doctor promises me that everything’s in place to help them along. Now it’s up to you to get better, and to rest up while you can. Life’s about to get crazy.”
“I didn’t have a chance to see our little girl.”
“She’s perfect. But I think the nurse might have misunderstood what you meant to name our son.”
Lily chuckled lightly and pressed her lips together in a tight smile. “I figured that would guarantee us free babysitting for life.”
“I don’t think there’s any doubt about that.”
“And what about our daughter? Is she Ruby?”
“No, sorry. I went with something else.”
Lily could barely contain her excitement as Kathy helped position her in the recliner. From the beginning Eleanor had shown an interest in physical contact, and Dr. Saint-Laurent had determined she was stable enough to move to the next phase. That was Kangaroo Care, so called because Eleanor would be laid against her bare chest to experience her warmth and nurturing. To get ready for the delicate exchange, Lily untied the top sash of her gown, a soft cotton wraparound, opening it from her hip to her neck.
Kathy then eased the sleeping infant into the valley between her breasts. “Support her bottom with this hand and hold her head with the other.”
She was immediately captivated by the splendid feel of Eleanor’s skin next to hers. Her tiny fingers curled into a ball, which she tucked beneath her chin. “This is heavenly.”
“Apparently she thinks so too. I can’t believe how fast she settled down. They usually wiggle at first and some of them even cry.”
“I’m the one who feels like crying.” Beth warned her the days of raging hormones would return, but not to fear, that she would be quicker to cry with joy than anger.
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�No need for tears. You can hold her for as long as you want…hours even.” Kathy fingered the gavage tube that stretched from the incubator to provide continuous nourishment. The oxygen cannula also remained in place, and the heart monitors continued to beep. But the tubes and wires, and even the oversized diaper, did little to detract from the glorious skin-on-skin contact.
Lily eyed the feeding source, a bottle of her own milk expressed only hours earlier using an electric pump. The urge to feel Eleanor’s mouth on her nipple was almost overpowering, but Kathy had said it would probably be two more weeks before they could attempt breast-feeding, and with that came the caution that some preemies had problems getting the hang of it, while others simply found it too exhausting. Each baby was different, she said, as if Lily needed any proof.
From where she sat cuddled with Eleanor, she was able also to keep a steady eye on George, who remained connected to his CPAP, though the drainage tube had been removed from his chest after only one day. Beyond their health issues, the physical differences between George and Eleanor were astonishing, especially considering they had the same anonymous father. Unlike his sister, who presently sported a head of thick dark hair, George had only light brown fuzz on his crown. His digits were small in relation to his hands and feet, while hers were long and lively. The one thing they had in common—and which set them apart from everyone else in the Kaklis family—was their brown eyes, clearly a gift from their Latino father. According to Beth, blue eyes or green eyes were subject to change for the first couple of years of life, but these brown eyes were here to stay.
“If we could bottle that look, we could sell it as world peace.”
Her eyes had been closed and Dr. Saint-Laurent’s voice startled her. “They were already growing up in my mind’s eye.”
“It will happen before your real eyes soon enough.” She scrubbed her hands before slipping on gloves and a sterile gown. Then she opened George’s incubator and inspected him thoroughly. “He is stronger already but he still has far to go. It will be a while yet—perhaps two weeks or more—before he is able to sit with you that way.”
The ache to hold George against her had begun almost the instant Eleanor settled on her chest. It wasn’t just her need, but his too. In such a fragile state, what child would not yearn for the touch of his mother?
“How are you feeling?”
Lily sighed wistfully. “To be honest, I’m feeling pretty good…which is bad, I guess. Under normal circumstances I’d be chomping at the bit to get out of here. But getting out means leaving my babies behind and I don’t know how I’m going to be able to do that.”
The doctor pulled up a chair and propped her feet on the trashcan, revealing wrinkled blue socks decorated with pink kittens. It was funny to think only a couple of days earlier she had given off such a stiff clinical image when, in fact, she was as down to earth as anyone Lily had ever known. Her attention to the care of their babies was enough to win them over, but she had gone beyond that to offer her friendship, even insisting they call her by her given name, Sylvie. They would be spending a lot of time together over the next few weeks, she said.
“I already gave your wife the lecture about taking advantage of every opportunity she had to rest.”
“She told me all about it,” Lily said. “I just think it’s a lot easier to rest when I’m with them or when I know they’re just here in the next room. Don’t get me wrong. I like everyone who works here, and I trust them. But if I went home now I’d feel like I was leaving them at the very moment they needed me most, to say nothing of the fact that I doubt I could sleep away from them anyway.”
“Rubbish. It isn’t as if they’ll take their first step or call someone else Mama while you aren’t here.” She nodded her head in the direction of George’s incubator. “Even that one over there…he knows who his mothers are already. Not that he actually knows what a mother is, mind you. But he knows that the ones who come and hold his fingers for hours are his people. And I believe he knows this even when you’re gone.”
Lily dipped her chin as Eleanor mildly squirmed on her chest. “I’m not as worried about their missing me as I am about missing them. I hadn’t planned on being away from them at all until September when I went back to work, and now it’s going to be tomorrow. I know it’ll kill me because it already kills me to be away from Andy.”
“I bet you’ll see one very happy boy tomorrow when you’re discharged.”
“At least I have that to look forward to.”
“That and a whole night’s sleep.”
In her own bed with Anna’s arms around her, and with Andy just down the hall. She had to admit she was looking forward to that feeling.
Sylvie tugged up her fallen socks and stood. “For your sake and everyone else’s I hope you’ll come visit for only a few hours a day. Let Anna have her time here too, maybe in the evenings while you’re having special time with Andy. She can give them Kangaroo Care too just like you, and while I always recommend my mothers breast-feed, you and Anna will have your hands full with two of them for at least a couple of years. It’s very likely they’ll take the bottle first anyway, so I see no reason you shouldn’t let them do that sometimes. They’ll still be drinking the nourishment you provide, and the two of you can share the load.”
“What about all the research that says it’s best to breast-feed?” It was easy to imagine all the ways Anna would help with the babies, but she had never really considered bottle-feeding her babies.
“Most of that argument is nutritional. As long as you’re providing breast milk, the emotional and physical advantages of mother-child bonding can be realized by Anna as well, which in my view, more than evens the tally. Besides, I’d never advise you not to breast-feed, just to let Anna help where she can. She seems excited to do it, and certainly capable.”
“If there’s one thing she is, it’s capable.” She gently rocked and watched with amusement as Eleanor’s fist tightened and relaxed in rhythm to the sway. Once Anna held her daughter this way, she would never want to stop.
When Anna showed up at six o’clock with Andy, Lily dressed and took him downstairs to the cafeteria for dinner. Anna took a turn holding Eleanor and, as Lily had predicted, was so captivated she didn’t want to leave.
“You have to get this young man to bed,” Lily said, and hugged Andy. “I’ll be there to help tuck you in tomorrow.”
The neonatal ward always quieted in the evening, with nurses popping in for occasional checks and attending physicians making their circuit through the ward in the middle of the night. Lily loved these peaceful hours when she could commune with her babies. Deidre, the night nurse, helped move the recliner next to George’s incubator so she could be close to him too as she held Eleanor. It was easy to imagine nights at home like this, rocking one of her babies while the other slept. She could probably get used to sleeping in the chair too…
“Get the attending, and page Sylvie at home,” a woman’s voice snapped.
Lily’s eyes shot open to find Deidre examining George’s connections, and two other nurses coming to her aid. The clock on the wall said a quarter to ten.
“Susan, help Lily put Eleanor back in her bed so we can move that chair out of the way.”
“What’s happening?”
“Tachycardia…rapid heart rate. He’s in respiratory distress.”
It was all Lily could do to wait for Susan’s help with Eleanor. By the time she was up the attending physician had arrived and was calling for new IVs to deliver chemicals and drugs she hadn’t heard of before. The other nurse reported that Sylvie was on her way.
Deidre patted her arm. “Dr. Tomlinson knows what he’s doing, Lily. Maybe you should step out and give Anna a call. She might want to be here with you while they make decisions.”
Lily was in full-scale panic mode, so much that she dropped the phone twice before finally dialing home. “George is in trouble. I need you here.”
Sylvie arrived at twenty after ten and took the lea
d. After a thorough assessment, she pulled Lily aside. “It’s called respiratory distress syndrome…not at all uncommon for preemies, but I had hoped we’d gotten past the rocky part.”
Anna rushed in, dressed in jeans, a T-shirt and denim jacket, her hair tied back in a ponytail. Andy was draped over her shoulder, still pajama-clad and clearly half asleep. Deidre took him and laid him in the recliner, which had been moved to the corner, and covered him with a blanket.
“What’s happening?” Anna gasped.
Sylvie delivered her update again. “We need to do an endotracheal intubation.”
“Why something so drastic? I thought he was already getting air from that mask.”
“The CPAP pushes air into his lungs, but his body still has to do all the work inside, and right now his lungs are at risk of collapse. The intubation ensures the appropriate gas exchanges whether he’s able to breathe on his own or not.” She took a set of papers from Deidre and drew a pen from her lab coat. “We need a consent form. We do this all the time, but the procedure isn’t without risk. His airways are tiny and there’s always the danger we’ll nick something on the way in. But I’ll be honest with you. If we don’t do this tonight, his condition will deteriorate rapidly.”
Anna didn’t bother to read the forms, going straight to the back page to affix her signature.
Lily tried to get closer to George but realized her knees were weak, and she grasped Anna’s arm for support. “Oh, God…we could lose him right now.”
“No, no.” Anna drew her into an embrace, cradling her head as she murmured assurances. “He’s in good hands. Sylvie does this all the time. She said that. He’ll be okay.”
Though it pained her to watch, she followed Anna’s lead and looked on as Sylvie assembled her tools and ordered the CPAP mask removed. She made quick work of inserting the thin tube and attaching it to a hand pump, which she gently squeezed several times while Deidre assembled the tubing for the mechanical ventilator. As soon as it was ready, Sylvie made the switch, laying the tubing alongside George’s tiny body and taping it into place over his mouth. The whole procedure took less than two minutes.
