Happiness--A Memoir

by Heather Harpham

  “What’s your name?” I asked, making a mental note to write it down in my notebook later as “kind one with crucifix.”

  “Marybeth.” Her attention was on the baby.

  Marybeth put down Gracie’s arm and picked up a foot. “I’m just looking,” she said. “Just looking, baby.” On the inside of the ankles are large veins, the saphenous veins. Over time I learned that nurses don’t like to use them for IV insertion because it is hard to keep pediatric patients from kicking the IV off. Plus ankles are surprisingly sensitive, dense with nerve endings. But in a pinch the saphenous veins are your man. The ankle is easy to rotate, and its veins are big enough to enter. Marybeth liked the look of the left foot. She turned to me. “The more you can nurse her, keep her hydrated, the better,” she said. “That makes the veins plump up. But don’t worry, I’m usually lucky.”

  I didn’t want to rely on luck; I wanted someone with skill. Someone stellar at threading a tiny needle into a tinier vein. But I didn’t protest when she wiped the baby’s ankle down with alcohol and picked up the IV needle.

  She felt around the inner ankle with her fingertips, searching for the pulse. She took a short breath and slid the needle in. Done. Gracie, who had been dozing, woke with a scream and a jerk. She opened her eyes and shut them instantly in a wince, winding up into a rhythmic cry. The needle had an open back, and blood began to drip out that end. Marybeth taped the needle against the skin and screwed on a syringe to collect blood. I was allowed to pick up Gracie and comfort her. She quieted down.

  “Thank you,” I said. “The last time that took six or seven tries.”

  “Don’t thank me.” She twisted the delicate chain of her crucifix with one index finger and pointed upward with the other. “Thank him.”

  A sample of the baby’s blood was sent to the lab. I waited with her in a rocker in the NICU. Once again, we’d landed in a room with plastic boxes holding sick babies.

  A young couple nearby was trying to commune with their preemie son through the plastic incubator walls. They looked like they’d wandered off a movie set into the totally wrong room. The woman’s hair hung in a sleek sheet halfway down her back; the man was tall, athletic, and wearing pale green suede loafers. Their baby was fit-in-a-teacup tiny. He had wires and leads running off every limb. The man glanced up at me. Even in his expensive shoes, he was rumpled and half-mad. I offered a wan smile. “They are stronger than they look,” I said. But I thought, Nothing can protect you: not youth, beauty, true love, not money, not Italian loafers. Anyone can end up bent over their child, helpless and afraid.

  Anyone.

  At a little under six pounds, Gracie seemed huge in comparison to the preemie babies. I smelled her head, an intoxicating mix of curdled milk and burnt sugar cookies. I wanted to take a bite. Or swallow her whole, put her back out of harm’s way.

  The nurse Marybeth found us with Gracie’s lab results. “Well, she’s real low,” she said. “But she’s gonna be a whole lot pinker in a few hours.”

  I looked down at Gracie, about to receive her second blood transfusion at three weeks old. “This is becoming a bad habit,” I said. “A really bad habit.”

  Dr. Eric came by to tell us what to expect. “Giving blood to infants is tricky,” he said. “You have to be careful not to give too much blood, or it can overwhelm the heart.”

  “Right,” I said, “I remember that from the first time.” If the whole baby weighed under six pounds, how big could her heart be: the size of a prune or a cotton ball? How could they possibly calibrate the volume precisely enough to avoid overwhelming a cotton ball?

  “Let them do the math,” my mom said. “That’s what they do.”

  “Plus,” Dr. Eric continued, “the blood has to be typed and crossed, to make sure that the donor and the baby are fully compatible.” He explained that this screening process was necessary because incompatibility could induce adverse reactions, including anaphylactic shock. He handed me a release form, spelling all this out. I signed in big loopy illegible letters, thinking, If this goes south I’ll disavow the signature. Near the door was a crash cart, with the paddles, the electric current to restart the heart. “Don’t worry,” Marybeth said. “We almost never use it.”

  Dr. Eric added, “To reduce the possibility of a reaction, she’ll receive washed blood.” Washed blood? Wasn’t it all washed? I definitely didn’t want her to get dirty blood, off-brand blood.

  I called Brian. “We’ve been readmitted,” I told him. Surely the worry of two parents, even on separate coasts, was better than the worry of one. I added that the new hematologist seemed nice, like a Midwestern grandma, who happened to be summa cum laude from Harvard, and that we were waiting to be transfused, again, and that they planned to wash the blood even though washing a liquid sounded ludicrous, and that the baby’s heart was no bigger than an apricot pit, so the doctor would try not to overwhelm it or chill it. Brian was silent except for the sound of pen on paper.

  I waited for him to say, “I’ll be right there.”

  He said, “I’ll call you in an hour.”

  When our blood arrived, Dr. Eric said, “We’ll run it extraslow, to give the heart a chance to catch up.” I had an image of Gracie paddling furiously upriver in a canoe, chased by her heart in a tiny canoe of its own.

  “Do I have to put her in the incubator?”

  “Holding her is fine,” he said. “Just keep her leads on.” The leads were the only link between her interior and us. If anything went wrong, the leads would let us know.

  But no alarms sounded; her cotton ball heart beat happily on, un-overwhelmed, filling with the blood of an anonymous stranger. Gracie was surviving, literally, on the kindness of strangers. This was stranger number two. I tried to fathom who these people keeping her alive might be. Winos in need of a buck? Handsome good Samaritans dropping by the blood bank on the way home from Google? Soccer moms with spare time? Whoever they were, I wanted to make out with them. Just for a minute or two.

  The next day we were allowed to go home. Crossing the parking lot, I broke into a run.

  At home she was a brand-new girl. She stayed up for hours at a stretch, looking at me, looking at Lulu, looking at the mysterious objects, unseen by me, that she saw in the middle distance. She was pink. Not yellow. Pink! She gurgled and cooed and swished her hands through the air. She cried. She was a proper baby, at last. A baby with enough blood, oxygen, and energy to make her needs loudly known.

  “Baby,” I told her as she nursed with force, “you are an Olympic nurser!”

  Later Brian called. “We’re home!” I said by way of answering. “Beautiful news,” he replied. We’d begun to share an esoteric tongue made of medical jargon and new-parentese. “Is she still doing the toe bendy thing?” he’d ask, or “Have they mentioned an arterial access as a way to get in?” I could feel his worry, his attention, the force of his care beaming toward us. I fed him vocabulary from the doctor, and he spent hours on the Internet, looking things up, comparing medical sites, taking a crash course in transfusion medicine. Trying to figure out what the hell was wrong with her and how we could help her hang on to every one of her red cells.

  I pictured Brian as Captain Kirk from Star Trek (for whom Brian, intellectual though he was, harbored an adorable, abiding regard). It felt as if he was returning via transporter, from a long journey, rematerializing in our lives, particle by particle.

  8

  The whole studio smelled like Nepal. Suzi was cooking a Nepali dinner for us. She’d made the basic—dal bhat (lentils and rice)—plus tarqadi (veggies) and aloo ko achar (potato relish). Aloo ko achar was my favorite, boiled potatoes covered in sesame seed paste with lime and chili and salt ground in. It was almost impossible to make the way we’d had it in Nepal when we’d lived there together. But Suzi, when she puts her mind to a particular project, is unstoppable. She once applied a faux finish of “fleck stone” to aging countertops and gross appliances throughout an entire kitchen, one spray can at a time.

>   I dipped in the edge of a spoon. “It looks legit, Suz. Yum.”

  “I know, right?” She smiled.

  The three of us, Suzi and David and I, spent almost a year in Nepal together as college students at World College West—a tiny liberal arts college founded on the belief that all students should, by graduation, understand themselves to be citizens of the world.

  World College West required you to pick a developing nation in which to spend your junior year. The choices were China, Mexico, the former Soviet Union, or Nepal. All the students coming back from China said it was freezing in the dorms and that they ate meat of indeterminate origin, three meals a day. The Soviet Union sounded too … forbidding. And Mexico was somewhere we could go on our own, later. So, Suzi and David and I all picked Nepal, a lifelong happiness choice. And David came home as Dawa, his Nepali name, which we’d called him ever since.

  Even now, ten years later, we often spoke Nepali to each other for fun or discretion or just because we could. Sometimes I dreamt in Nepali, speaking like a five-year-old. Nepali has a great sound, lyrical, rhythmic, and full of onomatopoeia. Rungi chungi means “colorful.” Geeli meeli means “bright and sparkly.” We were charmed by the entire country. Its physical beauty, the green terraced rice fields under the white peaks of the Himalayas; its cultural richness. There was a festival nearly every week, often complete with a festival princess clad in red silks, paraded above the celebrants’ heads on a hand-carried wooden dais. Nepalis were, hands down and on the whole, the nicest people I’d ever encountered. If you spoke a few broken sentences of Nepali to a shopkeeper, the next thing you knew they’d be offering you milky, sweet tea.

  Suzi and David and I longed for Nepal, and to make Nepali food was always an act of comfort-giving.

  Suzi and I sat on the couch with Gracie tucked between us and tried not to spill spicy food on her as we ferried it to our mouths. After dinner I said, “Dawa, will you get us some New York Super Chocolate Fudge Chunk?” And off he went to the store, always ready for a mini-adventure.

  Suzi and I sat in silence; we each rested one fingertip on the baby’s stomach as it rose and fell.

  “She’s your child,” Suzi said. “You have a child.”

  We’d known each other since we were nineteen and twenty-one. Since we stood in the corner at parties and gossiped, since we hitchhiked from San Diego to the tip of Baja and somehow survived, since we wondered whether or not to take Ecstasy with our assorted boyfriends.

  “I guess we’re grown-ups,” I said.

  “Do you talk to Brian?”

  I hesitated. When it came to Brian, Suzi was not, at present, a fan. “Yeah,” I said, “but never about us, just her. He takes a lot of notes. He looks stuff up.”

  “He takes notes?”

  “He researches things I tell him. Like when I said the baby screamed when they placed the IV, he looked up pain reduction in infancy. Sugar helps, apparently. But how do you give an infant sugar? He’s fretting about her.”

  “From afar.”

  I didn’t tell Suzi that our conversations were often laced with wide, impenetrable silences. Places where we each refrained from saying anything, for fear of saying something incendiary.

  After dessert we watched a movie. Something with guns, muscle cars, and explosions. I fell asleep with my feet on Dawa’s lap and my head on Suzi’s shoulder. The baby was asleep on top of me, and neither of them wanted to wake us. Lulu stayed on the cool tiles. When the movie ended the quiet woke me.

  “Thanks, guys,” I said. Not just for dinner, dessert, letting me sleep on you both at the same time as if you were a human La-Z-Boy. Thank you for this year of friendship. Thank you for all the dinners while pregnant and miserable when I spent the night on your huge and comfy couch. Thanks for buying a huge and comfy couch when I was pregnant and alone and you knew I’d sleep on it often. Thanks for walking with me to go get coffee, thanks for driving like crazy to make it to the hospital in time for Gracie’s birth, even though you didn’t quite make it. Thank you, thank you, thank you.

  In Nepal people don’t say thank you easily or often. Not because they are ungrateful but because assistance, casual acts of kindness, of community spirit are expected, woven into the fabric of everyday life. To say thank you is quite formal. And Suzi and David and I shared that understanding; thank you was not usually part of the currency of friendship we exchanged.

  “You’re welcome, Harpo,” Dawa said, and hugged me.

  Suzi stood at the door. “She’s sleeping,” she said. “Don’t wake her up.”

  After they left I spent a good hour staring at the baby and absentmindedly petting Lulu with my feet.

  The next few weeks, and months, passed much in this same fugue state. Dinner with my mom or brothers or Suz and Dawa or Cassie or even just Lulu. Days doing errands, rocking the baby, feeding the baby. The baby doing her three-step: eat, sleep, poop.

  Amelia-Grace would be happy, pink, robust, and full of little squeaks. And then, as her red count dropped, she was a toy whose winding mechanism slowed to a stop. Pale baby. Nonresponsive. The very definition of transfusion dependent.

  “At least I can count on her for consistency,” I told my mom. “She’s spunky with blood and droopy without it.” We went through the same drill of paging Dr. Koerper and returning to Marin General for yet another blood transfusion. This was followed by a week or so of bliss when she cooed and flapped her hands at me and latched more vigorously to the breast. I could sleep without watching her breathe. And then exceedingly long naps, a de-energized bunny.

  I’d check under her lower eyelid. Pink? Whitish pale? I’d press down on her fingernail beds. If they remained rosy, that was a good sign. Blanched white, bad.

  As soon as my anxiety reached an unbearable level, I’d page Dr. Koerper. She would set up a blood check, and we’d find out definitively whether or not Gracie was “holding her numbers,” a phrase that was thrown around like candy, the sweet possibility of something just out of reach.

  Dr. Koerper was mystified over the cause of Gracie’s unstable cells, but that didn’t dim her optimism. She seemed willing to more or less make up possible answers if she didn’t know them or at least to err on the side of psychic comfort over statistical probability. She kept making promises and then revising her own deadlines. “This will most likely resolve at three months,” she started out. At four months, she said Gracie would “hold her numbers” by six months. When, at six months, Gracie still needed regular blood transfusions, she told us the disease might “spontaneously resolve” at one year.

  I loved the sound of that, spontaneously resolve. I wanted to spontaneously resolve as well; to become more humane, more patient, less combative with medical staff, more intelligent, kind, sound, and if possible, an elegant lounge singer, overnight. But nothing resolved; no numbers held; the promised cure was always a month or two away, a wavering mirage that we marched toward without reaching.

  By the time Amelia-Grace was three months old, she had had four blood transfusions. Four times she had been readmitted into the hospital. The staff poked and poked to obtain samples of her blood to compare with the samples of the donor blood. Poked and poked to get an IV into her infant veins. Hung the bag of blood above her head, attached the tubing to the IV, attached the leads for the heart and pulse/oxygen monitors to ensure her miniature organs were not swamped by the flood of new blood. Waited for the slow drip. Unhooked the leads, slid out the IV needle, and discharged her. Four times.

  Brian hadn’t been there for any of this. Not one second of one hour of one day. He’d heard about it all in detail. He’d looked at it from every angle on medical websites. But that was nothing, just words, images, information. Not a lived moment with a breathing baby.

  And then one night he said, “How would it be if I came there?”

  I wanted him to want to see her. I wanted him to demand to see her. I was determined not to poison Gracie’s relationship with her dad with my own lingering anger or expectations.
My mother had always, even when she was furious with my dad, fiercely protected my right to love my dad, to know my dad, free from her critique. I would try to do the same for Gracie. But personally, I wasn’t sure I wanted to see him.

  We’d been talking about the heat wave in California and how the baby had an angry red rash of minuscule raised bumps.

  “What I want to know,” I’d said a moment before, “is whether this rash is nothing or a serious symptom, heralding some exciting new medical problem.”

  “Chances are heat rash.” And then, “How would it be if I came there?”

  How would it be? Too late, insufficient, enragingly inadequate, confusing, and disorienting. It would be bad, the worst. And also the best. Nothing could be better. As long as we both understood, as Brian seemed to, that he was coming to see his daughter. Not me.

  “That sounds like something to talk about,” I said.

  “We are talking,” Brian answered. “What do you think?”

  I thought I wanted to hate him for the pain he’d caused me. And that I wanted to forgive him for Gracie’s sake. I wanted Gracie to have a dad in her life but not on his terms. I wanted her to have a dad who was there when she needed him. Regardless of whether or not he was “ready.” But Brian was her father; she didn’t have another. Even if he could only be there for her in a limited way, it seemed better than not at all.

  “Meeting her is step one,” I said.

  “I want step one.”

  “You do?”

  He repeated himself, not just then, but the next time we spoke, and the next, until I began to see that the balance of love versus fear had shifted in him, had created some psychic wiggle room. We made a plan; he would come in early August, when Gracie was four months old.