Love, Mum
Embarking Together
Christopher Adam O’Brien was the most beautiful baby. Born on 16 October 1981 he had light blue eyes, blonde hair and pale eyebrows, so fair that a colleague of Chris’s compared him to a milk bottle. He was named after his father but known as Adam.
His delivery had been traumatic. The labour lasted twenty-one hours and included a failed forceps delivery that damaged Gail’s sciatic nerve and caused her to walk with a foot drop for weeks. Adam was finally delivered via a crash caesarean section, but was flaccid and turning blue. A young anaesthetist fumbled when intubating him, tempting Chris to grab the tube out of the young man’s hands and do it himself.
But Adam was physically robust from the beginning and quickly started to breathe on his own. He was naturally bright and inquisitive. He would lean out of Gail’s backpack as she carried him around, peering and smiling at people with interest. ‘What a great baby!’ a stranger said as Gail wandered through the Balmain markets. He grew up to be a healthy, strong little boy, athletic and coordinated, mastering things quickly, riding a bicycle without training wheels at the age of three.
Chris and Gail were living in a terrace house in the cramped inner-city suburb of Balmain. They brought their baby home and introduced him to the neighbourhood. One neighbour, Rex, had a giant basset hound that also happened to be called Adam.
‘What’s your baby’s name?’ Rex asked Chris.
‘Well, actually, it’s Adam.’
‘Adam? But that’s a dog’s name.’
‘No, Rex is a dog’s name, Rex.’
Money was tight. Chris had sacrificed his resident’s salary to complete a master’s degree in surgery. He was studying microvascular surgery — a surgical technique that involves operating on tiny blood vessels perhaps only three millimetres in diameter. He and Gail were living on a research grant and needed to find a more affordable home. Chris happened to be turning into Westbourne Street, Drummoyne, at the moment when a real estate agent was putting up a sign in front of a semi-detached house: ‘For Sale: Deceased Estate’. Chris asked to see inside.
‘Are you ready for a shock?’ asked the agent as he swung open the door.
It was a derelict house with an outdoor toilet and crumbling kitchen. But it had high ceilings, a view of Five Dock Bay and it was larger than any of the apartments they had seen. Chris and Gail quickly made an offer and moved in before anyone else knew the house was even on the market.
‘We seem to have luck on our side,’ said Gail.
‘Three togethers forevers,’ Chris said as the small family made the house their own.
Two years later on 1 February 1984, I was born and ‘four togethers’ didn’t have quite the same ring. Asthmatic, I didn’t have my brother’s robustness and I certainly lacked his coordination (requiring training wheels on my bike until I was seven) plus I had the bandiest little legs anyone who knew me had ever seen. But I was placid and generally healthy, and my dark hair and olive skin formed an apparently pleasing ebony contrast to my ivory brother.
After my mother had given birth to me, she saw her obstetrician. ‘How are you?’ Dr Bob Lyneham asked.
She felt sore and frumpy. ‘I’m not the woman I was,’ she told him.
‘Better,’ he replied.
A few months later Gail pushed her double pram up the hill towards a supermarket, while cars roared by and the forty-degree Sydney summer heat radiated from the pavement. An elderly lady passing by smiled at my brother and me, looked up at Gail and said, ‘These are the best days of your life.’ God help me, Gail thought. Her world had shrunk considerably since her second child was born. Feed. Walk. Feed. Sleep. Feed. ‘I just feel like a mothering machine,’ she confessed to her mother-in-law.
For the time being Gail was a stay-at-home mother. She had returned to part-time work briefly when expecting me and had not enjoyed dragging heavy medical machines into nursing homes when heavily pregnant and coming home to a baby and husband to feed. A return to work with two young children would have required some serious logistical planning. But she didn’t miss physiotherapy. She wanted to be a mother, the primary carer of her children.
My father’s work and surgical training were becoming more focused. He told Gail he planned to specialise in head and neck surgery, which made her recall those poor ‘commando’ patients whose tracheotomies she had changed as a young physiotherapist. But Chris’s research had put him on the leading edge of a revolution in surgery that would see a dramatic improvement in quality of life for head and neck patients. Newly developed reconstructive surgical techniques meant that major operations on the mouth, tongue, mandible and neck, formerly so disfiguring, could have radically improved outcomes. Chris’s training required stints overseas to work in multidisciplinary teams. He successfully applied for placements at London’s Royal Marsden Hospital and the comprehensive cancer clinic at the University of Alabama in Birmingham (UAB). Chris and Gail packed up my two-year-old brother and five-month-old me, and we flew to England.
In Chelsea, London, our apartment was in a dilapidated building with dark hallways that smelled of curry. The flat was just one room with a shower in the corner. As Chris had signed for the keys, the landlady had looked at Gail, Adam and me and said, ‘I don’t think your wife is going to like it here.’ The landlady was right, but the prospect of finding anything better on their limited money from the university grant was remote. However, within days Chris and Gail discovered that postgraduate accommodation had just become available in the north London suburb of East Finchley. This was a flat with a separate kitchen and bedroom and a small garden. Most importantly, it had friendly neighbours who were like our family — young doctors, new mothers and small children. ‘The lucky O’Briens strike again,’ Chris said. It would become an oft-repeated line.
After a year we moved to Birmingham, Alabama, in the USA’s Deep South. The city felt like a moonscape with wide, flat, hot roads, giant cars and tornado warnings. Gail missed the network of young families that had surrounded us in London. Chris would leave for work in the morning and without a phone or a car she had no way of contacting him. She was stuck at home with a two- and four-year-old with nothing much to do except occasionally go to the mall. But once again she showed her adaptability, making friends with Japanese, Chinese, English and African-American neighbours, joining a club of ‘international mothers’ and volunteering to teach dance classes to children with disabilities.
Over the next two years Chris and Gail built up lives and social circles, but no sooner had Adam and I perfected our southern twangs than we were packed up and moved again. This time we returned to Sydney and Chris went back to RPA. He was appointed visiting medical officer (VMO) in head and neck surgery, an important milestone that meant he had his own consulting rooms. The rooms became almost an O’Brien family business, with Gail managing the practice, overseeing staff, finances and logistics and working as secretary when necessary. The decision that Chris and Gail would run the practice together completely entwined her life and work with that of her husband.
As she worked in the rooms, Gail was acutely aware of the tragic pathologies of some of Chris’s patients. A young female patient arrived one day and Gail saw on her file she was to undergo a ‘commando’. It was the first such patient she’d come across for years. Her heart went out to the woman, who she envisaged would be stuck in the hospital for weeks as the flap of skin took. But a couple of weeks later, the same woman returned. After her surgery she looked terrific, with a patch of skin — probably taken from her forearm — sewn neatly and subtly along her jawline.
In that moment Gail fully understood why she and their two small children had been leading an almost nomadic life and surviving on medical research grants. She knew, of course, that Chris had been working with surgical teams and studying microvascular surgery techniques, but until then she hadn’t been able to put a human face or experience to this abstract quest. Now here was this young woman, recovering from this ma
jor operation in a way that would have been unimaginable a few years earlier. The new flap of skin was already nearly healed with a healthy flow of blood to the new tissue, thanks to Chris’s ability to sew the tissue’s blood vessels to those surrounding it. She could not have felt more proud of her husband.
Early in 1989 Gail was twelve weeks pregnant with her third child. She had just seen her obstetrician (everything seemed fine) and was hurrying down Market Street in central Sydney to catch a bus. She felt something running down her legs and looked down. It was blood. A scan revealed placenta praevia, a serious condition where the placenta completely covers the cervix. She was admitted to hospital immediately and advised that she would need to stay for a number of weeks. ‘I can’t possibly,’ she said. We had moved to a larger house a few streets away in Drummoyne and the renovations were ongoing. Adam and I were both at the local public school, with a busy schedule of after-school activities of sports, dance and music classes. Chris was working long days and weeks and Gail was still managing the ever-expanding business.
After a few days, she was allowed home under strict instructions to stay in bed. She would prop up her head as much as she could while still remaining horizontal, helping Adam with his homework, supervising my scratching on the violin, doing the practice’s finances and arranging house renovations. But after waking in the night to find the sheets and mattress soaked with blood, she was finally transported to King George V women’s hospital via ambulance. She stayed in hospital for the next ten weeks.
My father found this period immensely difficult, requiring military-standard coordination to manage all the needs of two young children plus dealing with long operating lists and consulting days. Family helped — Gail’s mother, Grace, would stay with us for a couple of days at a time to be replaced by Chris’s mother, Maureen. A nanny supervised some afternoons and cooked dinners that I considered foreign and strange. The carrots were cut the wrong way and the lamb chops had a peculiar flavour. Adam, buoyant as always, was indifferent to such details, but I was — and still am — uncomfortable with change. We were both oblivious to any strain on our dad. He’d arranged his days to start work a little later, and I loved having him brush my hair in the morning. He would pull it back into a ponytail gently and tenderly, in stark contrast to my grandmothers’ tugging.
From her hospital bed in King George V, Gail continued doing administrative work for the practice and even took the time to become an Australian citizen. The other women in her room revealed a range of pregnancy complications: Martha had gestational diabetes and would suffer diabetic fits; Sue was expecting triplets; Therese went into labour six weeks early and, despite being pumped with steroids to stop the birth, had a premature baby.
On 25 October 1989 Gail was collected from the prenatal ward at seven in the morning, ready for her scheduled caesarean section. She felt confident that nothing would go wrong with this delivery, and she was right: a few hours later she was on the postnatal ward with a baby boy. He was named James Michael.
Sore and uncomfortable, Gail was trying to breast-feed James without being able to sit up properly. James pulled away from the breast and coughed in a soft whimper several times. Then his lips started to turn blue. Gail called out to a nurse and James was taken to the neonatal intensive care nursery for observation. At five o’clock the next morning a nurse came to tell Gail that her baby’s condition had worsened.
Gail, in a wheelchair, looked at her baby in the humidicrib and ached at the sight of his tiny body surrounded by medical machinery. He was artificially ventilated with air being forced into his lungs at high pressure and multiple tubes leading in and out of him as drugs tried to dilate the vessels of his tiny lungs. The diagnosis was pulmonary hypertension, meaning his respiratory and circulatory systems had not adapted to breathing outside the womb. A lung collapsed and James’s oxygen levels refused to stabilise. Each day brought more dire news. He wasn’t expected to survive. Over the next few days his little body became so swollen with fluid that he looked twice the size of his birth weight and positively huge compared to the premature babies in the nursery. Gail struggled to grasp the reality, believing that surely at any moment someone was going to say there had been a mistake and James would survive. She stroked his little head, spoke his name and tried to get to know him. A tube was inserted into James’s scalp when there were no more available veins elsewhere on his body. A young nurse named Serena (by name and by nature) clipped some of his hair for Gail to keep. Gail was handed the little memento, thoughtfully wrapped in plastic, which it seemed would be a reminder that once she did have this little boy, for a short time.
Gail had been moved to a single room, considered better for women who had given birth but didn’t have the child. She felt isolated and alone. She sat on the edge of the bed, feeling so depressed she was unable to even lift a brush to tidy her hair. On top of all this she was enduring the usual post-natal night sweats and breast engorgement.
Needing help with the breast pump, Gail pressed the buzzer to summon a nurse. There was no answer and she pressed again. Eventually a harassed-looking older woman in a nurse’s uniform pushed the door open and sharply asked what was wrong. Gail politely made her request and started to explain that her baby was in the nursery.
‘We’re very busy, Mrs O’Brien,’ said the nurse. ‘There are other babies in the nursery too.’ Then she left. Gail felt like a naughty schoolgirl. Stunned, alone, hormonal, in pain and exhausted, she had no idea whether the nurse would bring the pump or not. She phoned Chris, wanting a few words of love and comfort. But as soon as she heard his voice she became distraught, sobbing as she recounted what had happened. Chris reassured her gently, not showing that he was enraged. He left my brother and me with a friend and drove straight to the hospital, making phone calls to the nursing hierarchy at King George V. When Chris was angry, he could be fearsome. He demanded that the nurse be sacked, and was senior enough to elicit an immediate reaction. The superintendent of nursing, looking official in her white coat, went straight to Gail’s room. With Chris now standing by Gail, the superintendent apologised, although it seemed motivated more by a pragmatic calculation than genuine remorse. ‘You do realise you are day three, and therefore prone to the third-day blues?’ she said.
‘Yes, I know all about the day-three blues,’ said Gail. ‘This is my third child and I’ve worked on the pre- and post-natal wards here.’
The woman tried another approach. ‘Do you really want this nurse to be dismissed?’ she asked. Chris was adamant and prepared to insist but Gail said no, she genuinely did not want that. Later, as Chris and Gail walked towards the nursery, arm in arm down the main aisle of the ward, they passed the nurse. She looked at them with an apologetic and meek expression. Gail offered her a sympathetic smile, but Chris firmly stared ahead.
My father deplored bullies and was intolerant of anyone who he considered was preying on frailty in others. In these circumstances he was just the type of person you’d want on your side: gentle and loyal to his people, but fiercely tough on intimidators. My mother is more inclined to see the best in people and quicker to forgive.
That evening, with the baby making no improvement, Chris said to Gail, ‘I’d like to get a priest for James.’ On the fourth day after James’s birth the hospital chaplain Father James Collins blessed him and administered last rites.
After the ceremony, Chris and his sister, Carmel, walked up Missenden Road to a church to attend mass. Gail was concerned about her husband. He was pushing through the pain of their son’s condition to continue working, consulting with patients and doing major operations into the night. As Chris walked inside the dim building and looked towards the altar, he saw a long white banner hanging from the ceiling. Large golden letters running down it spelled out the words, ‘He Lives’.
When he returned to the hospital, Gail was still sitting beside the humidicrib. Her eyes were shining as she said, ‘It seems like he might have turned a corner, Christie.’ Although Chris and Gail
had been advised to prepare for James’s death, Professor David Henderson-Smart had not given up, administering an experimental drug called prostacyclin. For the first time, James’s oxygen levels had stabilised as the drug took effect, distending his blood vessels and finally reducing the blood pressure in his lungs. His survival simply seemed a miracle. He Lives. Chris and Gail brought James home six weeks later. Our family of five was complete.
Riding High
I must have been about nine when I arrived home from school one afternoon to find my mother at the kitchen bench with the tail of a huge, dead fish in one hand and a large knife in the other. The beast probably weighed ten kilos and Mum was ripping the knife down its long carcass, causing shiny little scales to go popping off in every direction. ‘Wow, what’s that for?’ I asked. I noticed her face was red.
‘A patient gave your father this fish and he’s invited twelve people over tonight to eat it,’ she snapped. ‘It’s still frozen . . . and unscaled.’ She scraped the knife down again and a few more tiny, translucent pieces flew through the air. Exhaling loudly, she spat, ‘How am I meant to cook this . . . this . . . fucking fish?’
My jaw dropped. I’d never heard her say that word before.
I adored my father and am certainly not the person to provide an objective view of him. But I now understand that, as my mother has said, it actually took great stamina, patience and a certain cunning to be married to Dr Chris O’Brien.
He was on full throttle most of the time from early morning rounds to late-night operating sessions and packed weekends. His production of academic papers was prolific and he squeezed exercise into his schedule, if necessary, by jogging in the extreme heat of a Saturday afternoon.
My parents’ social calendar was exhausting: I have many childhood memories of Mum’s perfume and Dad’s cologne, the softness of their freshly powdered or shaven cheeks as they kissed me goodbye and swept out the door on the way to some function or other. The dining room was often filled with laughter and lively conversation as Dad hosted and Mum served extravagant multiple-course dinners. Dad invited people home every other week, displaying generous hospitality whether they were friends, ‘orphan’ trainees from overseas, or junior or senior colleagues.
This is Gail Page 3
