Monday, June 30, 2008

The Road Not Taken

Ah, Irony, funny lady.

Yesterday my accident-prone child, for whom it now takes two hands to count the number of bloody noses she's had in her short life, pitched a fit in the "big pool" claiming she wanted to swim by herself. Fat chance. She was given the choice of a time out, or retreating to the kiddie pool. She chose B, where within seconds she had gashed her knee on a broken piece of pool tile.

(No problem, I'll wait. I laughed too, fate that little fucker.)

It was a long, deep cut in the fleshy part of the knee that didn't appear to be wanting to close itself. I did the best I could with skin and industrial band-aid provided by pool, and made the executive parental decision: I had no fucking clue if this warranted stitches or not and wanted someone with medical training to tell me if it did.

Off we trudged to the local Emergency Room in soggy clothes -- because we weren't staying long and presumably headed straight home for lunch.

(Of course I didn't pack dry clothes or snacks, what do you think I'm prepared for the unexpected? Bwah! Dude, put a plastic bin of dry clothes and snacks in your car right now. You'll thank me when Armageddon comes.)

Cut to the chase, at 5 p.m., exhausted and blinded by hunger, we emerged from the ER: Bella was thrilled that her mother's mad, latent EMT skillz had collected the bloody mess together under the temporary bandage so well that stitches were no longer necessary after a four hour wait. A butterfly band-aid was all we got for our time. Fuck me. Yay me.

Thus was an afternoon I'll never get back spent in the confines of my local ER.


One evening, when I was 14w pregnant, one week into my new house, still tripping over boxes and obviously without a new doctor yet, I felt what was a now-familiar gush of blood between my legs. I calmly prepared dinner, and then drove myself to the local emergency room knowing nothing better to do with myself.

Bleeding pregnant women are apparently high on the triage list because I didn't wait long at all, but long enough to decide that this particular hospital -- while extremely convenient -- was not quite the warm yet comforting clinical environment conducive to laboring a child. I'm not sure if it was the dilapidated ceiling tile, the snail's pace of bureaucracy, the sullen faces on the employees, or the fact that I had to wait 45 minutes for the OB ultrasound tech to drive in from home at 8 p.m. on a weeknight, but I decided I would need something a bit more homey and sterile and, well, prompt. If that combo was indeed possible.

The nurse who treated me was nothing short of a compassionate delight, and after regaling me with the trials of her problem pregnancy, recommended her OB.

Who became my OB.

The doctor, a young, attractive, and extremely attentive and concerned man, said something cagey to the effect of: "This is going to sound weird seeing as how I work here, but I would deliver at [another named hospital]. My wife is delivering there."

That recommendation became my delivery hospital.

At the end of that night I had some excellent, clear pictures of Maddy, the reassurance of spot-on measurements and a healthy heartbeat, and some group commiseration with the gaggle of nurses who came to share in the photos while I awaited my paperwork.

I also had a trajectory, of what would be. And a rather spooky shadow of what could've been.

I know without doubt that had Maddy been born at local hospital, she would've died within hours. Their NICU non-existent, she would've been transferred -- but to where? A larger NICU or directly to Children's? And with the snail's pace I saw, the lack of a fire for anyone with some need of urgency, it wouldn't have mattered. I'm convinced she would've died before or shortly after transfer.

And we would know nothing.

Which sounds odd, because we know nothing now, but at least now I have no doubts. No doubts to the medical care my new OB suggested, which in turn led to ultrasounds every 3-4 weeks, which turned up nothing indicating a problem in my uterus. I do not stay up at night wondering if someone missed a sign, and know there was nothing I could've done during my pregnancy to stop things from growing into a disaster. No doubts as to the care of the NICU at our lovely delivery hospital, who within minutes detected some serious issues, and began the long roller coaster descent into medical hell. Nothing short of awe for the compassionate head of the NICU who, as it turned out, was a former student of the head of genetics department at Children's, who with one call cleared our path for transfer there. No doubts as to the care at Children's, where they were simply trying to amass and ascertain as much information as possible before letting Maddy expire peacefully on our terms.

Of course the cells and DNA and autopsy and research and presentations at conferences and farming out of slides to medical ringers around the country have led no where meaningful for us, but at least I know it was done, the steps were taken, and we were given the absolute best care the whole way around that this city had to offer.

All because I landed in my shitty little local ER on a hot August night almost two years ago.

It was these thoughts that exhausted me yesterday, in the same place where at my last visit I saw Maddy flickering on a screen. Bella was beyond fine, chipper and feisty and hungry, and I had no fear of witnessing anything worse than I had trying to seam her knee together under a mass of tape a few hours earlier. The promise of ice cream at the end of it all kept us both within the limits of patience (no pun intended) in our damp clothes. What occupied my mind was the the horror of what could've been, in that sad little hospital with the bad wallpaper, where I would've undoubtedly been met with shrugged shoulders and doubt. And the shadows of the past, right down that hall, where I was given promise and a road map to follow.

A map which led me here, wiping tears away in the car en route to a much needed pizza dinner, with a smiling, bandaged, only child in the back seat.


Aunt Becky said...

You had me in tears, Tash. As usual.

G said...

These memories and what might have been just stick to us like our shirts are made of fly paper.

I am glad Bella is ok. And now I want some ice cream.

Newt said...

And I want pizza.

I'm glad Bella is OK, too. And I'm glad you don't have to have any regrets about Maddy's medical care. Even such a small blessing.

debbie said...

I just think it's so amazing you managed to have Bella, first. Not to diminish anything about Maddy's painful short life or your pain, but for myself, having found out about our genetic curse prior to experiencing the joy of giving birth, it warms my heart to know that there is at least someone out there who was able to have a child otherwise unaffected by a DNA mess in spite of the odds that she would be. I wish I could do that.

Julia said...

The small bruised blessing of knowing everything possible was done. I have it too, and I feel so bad that not everyone does.

Which Box said...

Serendipity is one of my favorite words - as a word, I mean. I like the way it flows. And I like the way it works, when it works.

As usual, your post brought a lump to the throat and tears to the eye.

Although, I also have to say I have a very calm, quiet nearly three year old. And I live in dread fear of the first trip to the emergency room. I know we can't avoid it at some point, but it strikes dread fear in my heart.

CLC said...

Hi Tash- I am sorry you had to spend time there yesterday thinking about what could have been and what now is. It's like bad elevator music that won't stop playing. I am glad Bella didn't need stitches. Hopefully you won't be back there any time in the near future.

I am still away till Sunday, but I am counting on meeting you for a drink(s) in the near future!

iheartchocolate said...

Big hug. Tears and hugs.

janis said...

My heart is with you Tash. ((hugs))

sweetsalty kate said...

My heart's all stuck in my throat. I know just how that must have felt. xo

niobe said...

I think I'm taking the other road. Last time, I had the high-risk group at the high-tech hospital equipped with what I've heard is an excellent NICU. Given the results, I'm perfectly comfortable with going the clueless ob, woefully understaffed, NICU-less, local hospital route this time.

Because if doing everything I possibly could didn't help, what difference does it make?

luna said...

this is a beautiful post, tash. haunting and beautiful.

I suppose peace of mind not wondering about the what-ifs and left to only ponder the why is no small solace. but still. sad all the same to revisit what was and is.

glad bella is ok. you must be living at the pool in that heat.

Kymberli said...

Giggled at your telling of Bella's big bang at the pool, choked up at your telling of Maddy's care, tears at how you pulled it all together.

k@lakly said...

I suppose the only comfort, little as it is, that we can hope to take away from a nightmare such as ours,is that we did do everything we could and gave them every chance, even if in the end it wasn't enough.
I hope the ice cream soothed the wound, if not the broken hearts that wore and cared for it.

c. said...

You did everything you could and it all started with that hospital visit at 14 weeks. I did what I could. So many of us did all that we could. I'm still looking for someone to blame though. Still looking for that someone I can hold responsible for our tragedies. I keep coming up with nothing. Just. Nothing. So I have to know, for myself, when did you stop looking for someone to blame?

Glad to hear Bella is okay. Ice cream and pizza are wonderful cure-alls.

Alice said...

Thanks for the post. There is some comfort in knowing that the hospital did what they could. It's like that for us as well - although after that time the hospital were shit ... which upsets me now.


charmedgirl said...

it really never ends, does it.
all roads lead to it, yet we never get there.

tiff said...

I love how you write. You make me laugh and cry all in one post.
So real and brought back memories of my own all that could be done was done moment.

Searching said...

Glad Bella's no worse for the wear. Kudos on your excellent bandaging skills. I firmly believe everything possible (and even THEN SOME seems to apply- I am in awe of the amazing skill and caring Maddy and your family got. I want to work there) was done. I am so sorry it just wasn't enough.