When

03.31.03

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Here it is. What I haven't been able to write about in 5 years.

Owen's birth story.

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I know how annoying this is, but I do believe that everything, everyone, happens for a reason.

For 5 years, Al and I were very good at not getting pregnant. Once the decision was made to have a baby, we got pregnant on the first try.

We found out that Owen was coming on July 2nd, 2002.

I spent my entire pregnancy confident that I was carrying a perfectly normal baby. Al endured the pregnancy consumed with worry that something was going to go wrong.

Besides gaining a ton of weight, my pregnancy was unremarkable. I had a few extra ultrasounds because of my impressive size and a family history of large babies.

I went into labor at work on Sunday morning, 6 days after my due date, around 10am. I didn't think I was in labor. My coworker and friend Mary, insisted I was and I didn't believe her;

"Stop trying to take a shit and go to the hospital. You're in labor".

I finished my noon med pass and headed home. It was starting to snow. One of the snowiest winters in decades was just winding down. My Subaru Outback with studded tires wasn't scared of a few flakes. I was home in 15 minutes.

I got home, called my midwife Marge, took a shower, and took a little nap. I woke up around 3pm. Feeling actual contractions now, I called Marge again and told her we were going to head in. The hospital was around the corner from where I worked, only 15 minutes away.

It was snowing harder as we made our way down our winding country road along the river. Almost at the end of our road was a road block. A car had gone into a snow bank and the road was blocked off. We were forced to turn around and take the scenic route into town, through the woods along dirt roads.

We weren't bothered by our little detour. Now we'd have a story to tell about our baby's birth -  how we got turned around during a snow storm and had to crawl along a dirt road, slowing down for the bumps once my contractions got stronger. Our 15 minute drive into town would end up taking an hour.

By the time we got to the hospital, around 4pm, I was in some good pain. I spent the next 12 hours in hardcore back labor, running around the room naked, hating the shower, the hot tub, the ball, and any other non narcotic pain relieving technique they threw at me.

My labor wasn't progressing, I was only 4cm dilated. I was being threatened with a C-section if we didn't see some action soon. At around 4am I waved the white flag and asked for my epidural.

At this community hospital in the woods of Vermont, there wasn't an anesthesiologist in the building. He had to be paged. It would be an hour or so before he got his car cleaned off and got to the hospital.

Once my pain relief arrived, everyone took a nap. Marge asked if we minded, and crawled into an empty bed on the unit. I was the only patient at the time. Al slumped in a chair and snored.

I snoozed for a little while and when I woke up around 6:30am, things felt different. The contractions were in the front, not in my back. I asked the nurse to check me. I was 10cm.

Marge was called in. She told me to push when I felt like it. The pushing was so easy, a relief knowing the pain would be over soon and we'd be enjoying our baby any minute.

At 7:07am Monday March 31 2003, my baby entered the world - Silent.

He was put on my chest, skin on skin for three seconds while the room held it's breath and waited for the sound.

For three seconds Al and I beamed at each other and at our beautiful son.

He managed a pathetic, strained squeak that in no way resembled the expected wail of a newborn, and was immediately whisked away.

Marge had noted thick meconium as he was born. We all figured he'd be suctioned and start screaming any second.

To my right, my baby was placed on an isolette, as the ER doc, Dr. N., ran in to assess him.

To my left, Al crumbled to the floor.

Marge called for the NICU transport team from Burlington, just as a precaution she assured us. We'll probably send them away as soon as they get here.

Minutes later, he still wasn't breathing, and Dr. N. didn't know why he was having a hard time intubating him. Dr. K, who I'd worked closely with at the nursing home for the past 4 years, ran in, still in his parka and snow boots. He was walking to work and had been paged. He didn't even look at me, he just ran to help Dr. N. He didn't know it was me until later that day.

Finally intubated, my baby was taken across the hall to be assessed by the NICU team that had just arrived.

Al and I were finally left alone. I did my best to assure him that everything would be ok. He didn't believe me. I didn't believe me either.

My primary care doctor, Kim, soon came in. A chest x-ray had been done. We had a diagnosis that she described as a "surgical emergency".


Congenital Diaphragmatic Hernia.


My nurse brain deciphered it right away. Big deal. A hole in his diaphragm. How bad could that be?

Bad. Really Bad. Worst case scenario bad. The hole in the right side of his diaphragm had allowed his liver and intestines into his chest, squishing his lungs, preventing them from doing their important gas exchange job. Even though he was intubated, his lungs wouldn't hold out for long. He needed NICU. He would likely need ECMO.

Clock. Ticking.

A nurse ran in and handed me a polaroid.




She asked us if we wanted him baptized before he got on the ambulance.

Because he wasn't going to live.

We declined.

We were urged to decide on a name before we left.

It would be a shame for him to die without a name.

I'd torn badly during the delivery and Marge stitched me up through tears. She was just barely done when my coworker, Mary, appeared in the doorway, smiling, holding a bouquet of flowers. I made Marge fill her in. I felt so bad for Mary, having to go back to work and tell my little family there, all waiting anxiously for the good news, that the news wasn't good.

I was encouraged to go and see him before we left for Burlington. I was wheeled across the hall to the little room where the doctors and NICU staff were working feverishly to keep him alive. I stood up to get a good look and to touch him. I almost passed out. I told everyone in the room to get us the hell to Burlington.

I remember the shocked faces of the hospital staff as I was wheeled down the hall, their tear streaked cheeks, their agony for me. The guys in my ambulance didn't know what to say to me.

The pained looks on every one's faces; That poor woman.

It was an hour drive to Burlington. My baby's ambulance was right in front of mine. Al ran home to grab the dog and drop her off with friends.

I spent that hour hanging out in my mind with the Tulpen and Al that had a healthy baby. They were all sitting in the hospital bed together, my newborn was nursing, Al was making all the happy phone calls to all the happy family, sharing all the happy details.

We got to Burlington and I was dumped off in the hall of the ER. A few minutes later, I heard my baby's name being called on a radio, a second after that, he was rushed by me. At least 6 people running behind the isolette - RUNNING. I hated seeing this alone.

The next few hours were spent making the worst phone calls I'll ever have to make. Friends and family all picked up the phone, eagerly anticipating the great news, and were all pushed off the same cliff Al and I had fallen off of.

Al showed up in less than an hour. We went to the NICU a few times. My boy looked worse every time we saw him; doctors came to my room to update us frequently on his worsening condition.

It's very difficult to get oxygen into lungs that are being bashed against organs that aren't supposed to be there. He was on a vent, but the breaths it was delivering to him were becoming less and less effective, and every breath caused damage to his little lungs.

A nurse came in with another polaroid.


A chaplain of some sort came by and asked us if we wanted him baptized; more polaroids, offers of baptism - more people thinking he was going to die.

It was late afternoon when we learned that he was going to be med flighted to Boston to be placed on ECMO.

The flight nurse met us in the NICU. She sees the most critical patients there are. She looked worried. She was straight with me. His chances of dying in the air were better than landing in Boston alive.

Other Tulpen was getting ready for her first night with her baby. Wondering how much sleep he'd let her have, not that she cared; she was happy being able to provide everything that he could possibly need.

I handed my son over to a group of strangers. He wasn't mine. He was theirs to keep alive.

Al and I were afraid to speak for most of the hour long drive back home. We were thinking the same thing. He finally said it;

"He's not going to make it"

"He has to", was the best I could do.

Rational thoughts weren't coming easily as we drove, as my child flew through the air. One sentence, over and over, screamed in my head;

"Put him back, put him back, Put Him Back!!"

He was safe inside me. He was healthy. He wasn't hurt until he was born and tried to breathe. I wanted him back inside me where he was whole.

I tried to make it not so. I mean I physically tried to make it not be happening. I thought if I wanted it bad enough, through sheer force of will, I could change it.

We got home around 10pm. I took a shower. I made more awful phone calls.

I don't remember crying that day, but when I finally laid down, in my home, without my baby, not knowing if he was alive or dead - crying doesn't describe what I did.

At midnight the phone rang. A surgical Fellow at Children's Hospital Boston, Dr. Yang, was on the line.

My baby was alive and on ECMO. Critical but stable.

Alive.

I'd been up for close to 48 hours, I'd run a marathon, been hit by a train and had my heart ripped out of my chest.

Alive.

I set the alarm for 3am and went to sleep.