What I Thought I Knew: A Memoir

by Cohen, Alice Eve

  There was no cry, no sound.

  “APGAR score, four.”

  “Alice, it’s a girl. Her genitals are fine,” the nurse said quietly.

  That was good to hear.

  Michael mopped the sweat from my forehead and hair.

  The nurse called out the second APGAR score. Six.

  They cleaned the baby, raised the back of my bed, and put her on my chest. Michael perched on the edge of the hospital bed with me, his large hand cradling our baby. I wished we’d chosen a name for her.

  She was tiny. Her legs were folded tightly into her belly, making her look smaller still. Her skin was pale. Her red lips formed a miniature rosebud. Her one wisp of hair, wet and matted to her head, was nearly blond. Blue eyes. She had a large forehead and a small, sweet, funny-looking, lopsided face, as if her features had all slid down from her forehead into a puddle near her chin. She was a girl, with tiny, perfectly formed labia. She weighed exactly five pounds.

  I was prepared for a penis, but somehow I wasn’t prepared for blond. I expected her to look Mediterranean, like me, with darker skin and hair.

  I wanted to be in love with this baby. I had hoped for instant love, which would redeem the previous months of not wanting to have a baby. My baby. I was in love with her beautiful rosebud mouth, her impossibly small fingers, which I caressed with my gargantuan fingers. All I wanted was to take care of her, to help her to get strong. I was not instantly in love. Nor was I not in love. She needed a name.

  “Why is she so small?” I asked.

  “She’s not so small,” said Tara. “Five pounds is in the normal range.”

  “Why is her head lopsided?” I said.

  “Their heads get squished during childbirth,” she said. “All babies look like old men with wrinkled faces when they’re just born.”

  Julia didn’t. Brad and I were at Julia’s birth. When she was born, she looked perfect. Julia’s birth mother, twenty-year-old Zoe, used no painkillers, and she pushed for only thirty minutes. As Julia’s head crowned, the Jamaican midwife announced exuberantly, “I see a lot of black hair, I see a lot of black hair.” And then glistening, big, strong, beautifully formed Julia flew out of Zoe with her arms over her head, her enormous hands, fingers outstretched, into her new world. Newborn Julia large and robust and aware. Broad cheekbones and dark, wide-awake eyes. Loud crying in her first minute, then lying on Zoe’s chest and scrambling for her breast, which she energetically sucked. “Alice and Brad are crying,” said Zoe, which we hadn’t realized until she said it. I loved Julia instantly without expecting to. Once she was wrapped in swaddling, the nurse handed her to me. Her eyes looked at my face, Brad’s face, mine, his, mine, his, preternaturally alert and curious and perceptive. Our friends didn’t believe she actually looked at us at such a young age—“Newborn babies’ eyes can’t focus,” they said—but she did.

  My new baby was tiny and silent and limp and lopsided.

  I wanted to be totally in love with her. I hoped nursing her would bring the love on.

  She showed some interest in my breast. When I lay her on my chest, she rooted, moving her mouth in the direction of my nipple. But her mouth was so small and weak, my breast so big and hard, and my nipple so flat that she couldn’t get it in her mouth, and she quickly lost interest.

  A male attendant wheeled Baby and me into my recovery room—a double, partitioned by a pale green curtain, furnished with a vinyl chair, a plastic bassinet, and a hospital bed. The sterile space was redeemed by a wall of windows. The dawn sun streamed in over the East River, lighting Brooklyn’s industrial shoreline, and sky, sky, sky, the clouds still painted pink with the fading sunrise. In the water far below, miniature red tugboats heroically pushed barges twenty times their size. To the south, the Roosevelt Island tram flew back and forth, drawing an arc as it carried early morning commuters from small island to big island.

  The attendant transferred me from the gurney to the bed, and we started our new family life.

  Everything hurt. My vagina was torn. My body felt as if it had been turned inside out. I had enormous hemorrhoids, like two bunches of large grapes, one bunch ringing the inside of my anus and a second bunch outside. Even on the doughnut-shaped pillow supplied by the hospital, I could barely tolerate sitting for ten minutes while baby-girl Cohen and I made futile attempts at nursing. Every two hours, the nurse gave me painkillers, which dulled the pain and made me groggy and disoriented.

  Barbara, back on call, sat on the bed and squeezed my hand. “Your body is traumatized from two days of childbirth. It’s very hard to give birth at your age. By nature’s calendar, you’re a very old woman. Twenty-five-year-olds bounce back very quickly. After thirty-five, every year is exponentially more difficult for the mother’s body. It might take you six months to recover.”

  Dr. Melina Christopoulos from endocrinology sashayed into our room, her white lab coat over a miniskirt, grazing the top of her thigh-high black leather boots. Michael perked up.

  “Let’s see if she has a penis,” she said cheerfully, unwrapping the flannel blanket. “No penis. You have beautiful genitals, baby girl. Look at your perfectly shaped labia. You have a lovely clitoris and a gorgeous vagina!”

  Now that’s some baby talk. Dr. Christopoulos spent a long time looking at the baby from head to toe.

  “Okay, guys, good news. No penis. Was only temporarily androgenization from hormone pills. I’ll be in touch with you. Bye-bye.” She kissed me and Michael on both cheeks.

  The fat, humorless lactation nurse known on the floor as Nipple Nazi marched in and commanded me to nurse.

  “We’re trying, but it doesn’t work.”

  “Of course it works!” she barked.

  “I don’t think the baby’s getting any milk.”

  She frowned, muttered something unintelligible, stormed out of the room and returned a minute later with the heavy artillery, in the shape of a refrigerator-sized electric pumping machine. Thirty minutes of pumping yielded a tablespoon of milk and very sore nipples.

  “It still isn’t working,” I said on Nipple Nazi’s next visit.

  She lunged at me with both fat hands. I thought she was going to choke me. Instead she grabbed my breast, hooked me up again to the electric pump, and turned it up to high. When she saw for herself how incompetent I was, mammarily speaking, she sent for reinforcements.

  A young smiley nurse came in and took Baby’s vital signs. “Her blood sugar is low. I’ll need your permission to bring her to the nursery to bottle-feed her.” I signed the permission slip and with some gratitude handed my baby to her. Michael napped in the vinyl chair and I drifted in and out of a drug-induced stupor.

  When I woke up I had a roommate, who I watched through the gap in the plastic curtain. A young black woman with a robust newborn who looked like a little boy already, with glistening skin, plump arms, big hands, and a passion for kicking his solid legs in the air while making loud and excited baby noises. His delighted mother laughed and sang to him, and covered him with kisses.

  Smiley Nurse brought back our baby, whose blood sugar was much better after a bottle of formula. She slumped limply in my lap, her fingers, tinier than I’d remembered, tinier than my imagination would allow, wrapped halfway around my big finger with the barest hint of a grip.

  Passersby peeked in and made boo-hoo sad-faces. “Preemie?” they asked, and hurried on without waiting for an answer. We had frequent visits from Smiley Nurse, Nipple Nazi, and Birth Certificate Lady, who kept coming by and pressuring us for the completed birth certificate. Miranda was our default name, the only one that Michael, Julia, and I all liked. It was fine last week, but Michael and I agreed that Miranda was not the right name for this baby. “Can we fill in a temporary name for now and change it later?”

  “Yes.”

  Michael reached for the form. The nurse pulled it away. “This has to be filled out by the mother. You’re not married, so the name is the mother’s legal decision.” She handed me the form and waited fo
r me to fill it out.

  “Okay, Alice, what’s her name?” asked Michael testily, angry at the inequality of our legal relationship to our baby.

  “As a placeholder, let’s write Miranda. When Julia meets her, we’ll choose a name together.”

  I swallowed two more painkillers and lay down, impatient for the drug to work. The room beginning to swim, I watched Michael hold the baby. She was swaddled tightly in a hospital-issue cotton blanket, white with pale red and blue stripes at the edges. Michael unwrapped the blanket to change her diaper. He wiped her and threw away the soiled, preemie-sized diaper, then lifted her by her ankles and laid a fresh diaper under her bottom. He looked at her naked. Even without the swaddling, she was still folded tightly in the fetal position. Michael touched her toes, gently pressed her knees to straighten her legs. He repeated this a few times.

  The narcotic was working. . . . I was drifting into sleep.

  “Alice. . . . One of her legs is smaller than the other.”

  “What?”

  “One leg is smaller.”

  I climbed out of bed. Michael gently pressed her knees down. Her right leg, outstretched, didn’t quite reach the ankle of her left leg. It was skinnier than the left leg, proportionally smaller, like it belonged to a different baby, a much smaller baby. I panicked and burst into tears. A nurse came in to see what was wrong. My sister Jennifer arrived at just that moment, to meet her baby niece.

  In my drug-induced haze, the ensuing parade of doctors launched an avalanche of medical terms and release forms. Michael had to leave to pick up Julia from school. Jennifer stayed with me.

  “Hemihypertrophy . . .” “Hemiatrophy . . .” I heard these two words over and over. Asymmetry. One side abnormally large and one side abnormally small. They didn’t know for sure which side was the abnormal length, although it was clear to me that the right leg was the dwarfed one. A slew of specialists examined her and pointed out that it wasn’t just her legs; her entire body was asymmetrical. The right hand was tinier than the left, the right arm shorter, the right buttock smaller, her right cheekbone and jawbone smaller than the left. When they asked if I understood what they were saying, I told them I had just taken painkillers and wouldn’t remember anything they said. So they talked to Jennifer.

  With Jennifer’s guidance, I signed release forms. An X-ray of her legs. A CAT scan of her head. An MRI of her whole body. Tests you don’t imagine your newborn will have on her first day in the world.

  A dour neurologist shook his head and said she’d had a stroke.

  An upbeat orthopedic surgeon said she’d be a good candidate for leg length surgery when she was older. He gave us his business card.

  The supercilious head pediatrician said she thought the neurologist was completely off base, and there was no way a stroke could have caused this.

  After a stroke was ruled out by the MRI, the dour neurologist attributed the asymmetry to my bicornuate uterus, suggesting that the left side of the fetus developed in one compartment of my uterus and the right side of the fetus developed in the other compartment of my uterus.

  A geneticist rolled his eyes at everybody and said this was obviously a genetic defect, advanced maternal age the most likely culprit.

  “Time to pump!” bellowed Nipple Nazi, rolling in the electric breast pump and parting the sea of doctors.

  By the end of the day, when the MRI and CAT scan had come back negative, when the X-ray confirmed the obvious—that one side of her body was a lot shorter than the other—the uneasy consensus was that Baby’s abnormality was idiopathic. Jennifer explained to me several times that this meant “without known cause.”

  As my painkillers wore off, a young, cheerleaderish pediatrician had me sign some forms and promised, “Your daughter is entitled to Early Intervention therapies, a free service provided by the State of New York to babies and toddlers with special needs. Because the hospital identified her special needs at birth, you won’t have to go through the application procedure. You’re very lucky. It can be an extremely time-consuming process otherwise. And you’re lucky you’re in New York.” She pointed out the window, across the Hudson. “In New Jersey they make you jump through hoops to get services.

  “Meanwhile, our team would like to work in tandem with your baby’s pediatrician. With your permission, we’d like her to be seen by Dr. Elizabeth Creighton. She’s in your neighborhood, she’s affiliated with New York Hospital, and she accepts your insurance. We’ll make the appointment for you. Your baby’s going to be seeing the doctor a lot.”

  Nipple Nazi thrust Baby to my breast, then denounced us for our mutual incompetence and hooked me to the electric pump, ramming the lever to the highest setting like a deranged scientist in a horror flick.

  I kept taking pain meds.

  In the late afternoon Jennifer left.

  My exuberant roommate and her son were discharged.

  Michael was home for the night with Julia. She had spent the previous two nights with her friend Sophie.

  Smiley Nurse took my very quiet baby to the nursery to bottle-feed her and monitor her vital signs through the night.

  I would spend the night at the hospital alone.

  I lay in my bed and cried. The night nurse asked what was wrong. Through gulping sobs I told her.

  “I really, really, really wish I could do something. But there’s nothing I can do.”

  I believed her. Everybody who worked in this neonatal ward really, really, really wanted to do everything they could do to keep the babies and the mothers safe and healthy. Usually they were successful, and the babies were born healthy, the mothers recovered, and happy parents took their babies home. But once in a while the babies were not put together properly. Their hearts were outside of their chests, their two eyes were on one side of their face, like a flounder or a Picasso painting, their brain didn’t function, their lungs didn’t work, or their limbs were different sizes. When the babies were not put together right, the parents were sad and scared, and cried gulping, desperate tears in the middle of the night. But all the king’s horses and all the king’s men and all the doctors in the hospital couldn’t put baby together again. The entire hospital staff of doctors and nurses and janitors and receptionists really, really wished they could do something, but sometimes there was nothing they could do.

  Michael brought Julia to the hospital the next morning. Her round cheeks were flushed red with December chill and excitement about meeting her little sister.

  Michael put tiny baby into Julia’s big, warm hands. “Hello, new baby sister!” she whispered, nuzzling Baby’s tiny nose with hers. Then she whirled her around too fast, tripping at the end of her turn, beginning to topple over.

  “Careful!” Michael and I shouted, lurching to catch Baby. Julia was having a growth spurt, and with her big feet, she was like an oversized puppy, with a tendency to trip over furniture and drop breakable objects.

  “I love you, little baby, little sister, I love you so much!” She kissed Baby’s forehead. “Mom, she’s so beautiful and she’s so little and cute. You’re so cute and little.”

  Julia was oblivious to her sister’s deformity, and oblivious to my despair, which was a huge relief to me. Her happiness filled the room. Her euphoria was infectious.

  “You’re the cutest little baby in the whole wide world.”

  She plunked down on the vinyl-cushioned window seat, held Baby in her lap, and had a heart-to-heart. “I’m your big sister, Julia, and I’m nine and I’m in fourth grade. Did Mommy tell you that I was so surprised when I found out she was going to have a baby? This is what I was like. I was like, ‘Excuse me while I drop dead for a minute.’ Like this. Bleh!”

  Julia flopped over with Baby. I gasped, while Michael jumped up to catch Baby, just in case Julia dropped her, which she didn’t.

  “I’m going to have so much fun with you, cutie-head. I’ll teach you how to read and how to play soccer. What’s her name? Did you guys decide without me?”

  We unanim
ously agreed that this baby was definitely not a Miranda.

  “I think her name is Eliana,” I said.

  “You don’t think it’s a little bit flowery, a little too pretty?” Michael asked.

  “I think it works for her,” I said.

  Julia said, “Eliana is a good name for her, cause she’s the prettiest baby and Eliana is the prettiest name. And we could call her Ellie, which is a really cute nickname for such a little cutie.”

  “Whatever you want,” said Michael.

  I thought, but didn’t say, that a name meaning “My God Has Answered Me” might serve as a talisman, a magical good luck charm, a perpetual prayer, an expression of gratitude, a way of keeping a higher power close to her. My tiny baby with idiopathic deformities could use a higher power close by. I could use one too, even though I was a committed agnostic. We were a family of agnostics. Even Julia, who was immersed in her Hebrew school studies and Bat Mitzvah preparation, and Michael, the only one in our family who believed that examining one’s relationship with God was a priority in life. I was far from certain that there was a higher power, but in that moment I was absolutely certain that my baby and I needed one.

  Michael shrugged his shoulders. The name Eliana seemed a bit ornate to him, but this was his new role, adjusting his life and his wishes to please the women in his family.

  The hospital changed Miranda to Eliana on all their records, but the birth certificate form had already been mailed to the Department of Records. Her legal name was Miranda. We would have to apply for a legal name change.

  “The Birth Certificate Lady said that we could fill in a temporary name and change it later.”

  “We’re so sorry that you were misinformed.”

  I stayed in the hospital for three nights while they tested Eliana, and while I was monitored—for pain, for vital signs, for depression.

  When it was time to leave, Michael dressed Eliana in the zero-to three-month Baby Gap outfit we got at the baby shower. It was pathetically large on her, or she was pathetically small in it. Her arms and legs, lost somewhere in the torso section, didn’t begin to reach the sleeves. We bundled her the best we could for the chilly December day, strapped her into the car seat, and checked out of the maternity ward. As the elevator doors opened, we saw the dour neurologist.