Sunday, October 25, 2015

On Tristan Walker, the first of his generation

I was not part of my sister-in-law’s birth plan and yet there I stood, holding my brother’s baby’s tiny hand as the nurse pricked the heel of his flexed foot to take yet another blood sample. “You are strong, little man,” I said, biting back tears. “You are strong like daddy. You are going to be fine.”

But I don’t know that any of us really could fully believe that. Because our sister, Rachel, wasn’t fine, she was never fine. When she was born, she looked complete and perfect, though small. But her heart never fully formed in the womb and by the time the doctors discovered her unfinished heart two months after her birth, it was too late.

Rachel’s memory was the string, connected and vibrating through my mother, my brother and me in the days after my nephew’s birth: Sometimes babies die, for no reason at all. Sometimes babies die.

“How could this be happening to us again?” we thought. It’s one of those irrational human thoughts, as if enduring one loss means we should be spared anyone else dying for the rest of our lives.

It was not supposed to be like this at all. The baby’s due date fell a week before my spring break in my Pre-Med coursework. I was supposed to arrive in D.C. on Sunday and be presented with my week-old nephew, the first of his generation, and get to snuggle him and with tears in my eyes say, “Well done!” while shaking my brother’s hand.

Instead Tristan’s birth was a week overdue and 51 hours long. Sunday morning, I was on the Orange line platform at Roosevelt headed to catch my flight at Midway when my mother called me to tell me that the baby, only a few hours old, was having trouble breathing. He was being transferred to the special nursery on oxygen and antibiotics. The medical team suspected TTN, transient tachypnea of the newborn, a complication of the long birth involving excess fluid remaining in his lungs, making it difficult for him to breathe. It wasn’t serious, reasonably common, and I needn’t worry. But I come from a long line of overachieving worriers. We go above and beyond when it comes to worry. We are the first to volunteer to worry when we needn’t. If others aren’t worrying enough, as community servants, we will worry on their behalf.

So I worried until I arrived at the hospital and made my way up to the special nursery where I found Tristan in an incubator, wearing a full-face breathing mask with my brother asleep in a recliner next to him. The scene was heartbreakingly sweet, despite the newly arisen medical complications: my baby brother sleeping next to his sleeping baby.

Tristan and his dad.
March 22, 2015

Countless poets and writers have said it more eloquently than I throughout all of time, but I think it bears repeating: love is torture. To love is to have your heart broken again and again by things not going perfectly and painlessly for those that you have the great honor to love. To love is to watch numbers flashing on an oxygen monitor and attempt to will those numbers higher with your mind and a prayer to a God you hope is listening… If you’re being honest, a prayer to a God that you hope exists. To love is to allow yourself to rejoice in the good news that the oxygen levels are stable only to have your heart broken again a day later by the news that the baby, despite being on antibiotics for the TTN, has a fever.

From the way the hospital staff reacted, we could tell it was a very bad sign. My brother refused to leave Tristan’s side in the nursery. His wife, my mother and I slept in the postpartum room, awaiting any news.

A nurse practitioner entered the room and roused us from sleep. Without any lead up or warning whatsoever, she coldly pronounced, “We’ve ruled out everything else, so it’s most likely meningitis. We are going to transfer him to Bethesda to perform a spinal tap and continue treatment.” Now I’ve not been to medical school yet, although I have been accepted to matriculate next fall, but I’ve learned enough from shadowing the Doctors Quinn and House to know that meningitis in infants is a devastating disease and that process of elimination is not the surest path to diagnostic success.

Attempting to remain calm, I said to the doctor, “Can you please explain to her what that means?”

Indignantly she went on, “Well, you can get an infection anywhere in your body and meningitis is an infection in your brain,” which has to be the absolute worst way to explain meningitis to a woman who has been awake for 3 days and spent 51 hours pushing an 8 pound human out of her body.

At that point, my brave, stoic sister-in-law fell apart. My mother held her as she wept and mouthed to me, “Go get Stephen.” I tore down to the hall to where my brother was holding a hysterical Tristan’s hand as the nurse attempted to draw yet another blood sample.

“She needs you,” I said.

“I’m not leaving him here alone,” he replied.

“I’ll stay. You go.” I took Tristan’s hand out of my brother’s and the nurses generously said nothing about breaching the protocol dictating that only wrist-banded parents be alone in the room with the newborn. So that’s how I ended up alone with my nephew who was fighting for his life in the primal, fight-or-flight sense of the phrase. Separated from his mother and surrounded by wires, he was being restrained, starved and attacked from all sides with needle after needle. I had never seen something so small in so much pain.

As I held his hand, I experienced a fascinating combination of fear and love… not for the baby himself, whom I had just met, but for my brother. I felt depths of love for him previously unknown to me. I didn’t know I loved him this much. I feared selfishly how much his loss would pain me. How could I look my brother in the eye if something happened to this baby? What would I ever say to him if his son died? It wasn’t supposed to be like this.

My brother and his wife appeared in the nursery just as the mobile NICU team arrived from Bethesda and began preparing Tristan for transport via ambulance. The doctor leading the transport team approached us and began to explain their plan to my brother.

I gazed down and read the name embroidered on her coat. It read, “Dr. God.” G-O-D. I leaned over to my sister-in-law and whispered, “His doctor’s name is Dr. God…” The doctor could tell we were talking about her and caught my eye. “Yes it is. It’s my married name and, believe it or not, my father-in-law is a Reverend.” Reverend God.

She went on, “In order to take the best care of him, we have to prepare for the worst, in this case, meningitis, but let me assure you, your baby is not in acute distress. He is alert, hungry and really mad, all of which are good signs so we are not in a rush. We’re not going to turn on the siren or the lights. We’re not going to speed and we don’t want you to either.” In fact, she advised us to delay our arrival until after the spinal tap had been performed, a procedure probably too traumatic for a parent to witness. Her optimism and gently commanding demeanor calmed us and everyone stopped needing to choke back tears.

As they wheeled him down the hall towards the ambulance dock, I turned to my mother and said, “Mom, he’s in God’s hands now and God is a woman.”

In Dr. God’s hands, he arrived safely at Bethesda, the spinal tap came back negative for meningitis despite antibodies in his bloodwork, his oxygen levels remained stable for days, and his fever never returned. After 4 days in the NICU, to our relief and disbelief he was sent home. He was fine.

We’ll never know what happened in Tristan’s tiny body and the range of possibility is vast. On one end, maybe it was as simple as a faulty thermometer. Maybe he never had a fever while on the antibiotics in the first place. On the far other side of the spectrum of possibility: maybe there was a miracle and my mother’s hysterical prayers for healing in the hospital chapel were answered as quickly as we could say “Dr. God.”

The truth, of course, is probably somewhere in the middle where science and the divine intertwine. Perhaps the precautionary antibiotics already in his system for the TTN fought off whatever other infection briefly surfaced. Perhaps the little bit of fluid in his lungs saved his life.

We don’t deserve anything and yet we ask for so much. So whenever something doesn’t go my way in the future or a prayer is left unanswered, I hope I remember the one big answered prayer we got in March of 2015 when Tristan Walker, the first of his generation, didn’t have meningitis. I’ll say it again: love is torture and I want to be tortured by my love for that kid for a lifetime. And with God’s grace, I will be, even if God is just an M.D.

Tristan and his dad, wearing noise canceling headphones.
September 2015