I just really dispute the premise that to write your story is to claim that it’s exceptional, or worse than, or more interesting than anybody else’s story—it’s just what you’ve lived. It’s…just using what you have. ~Leslie Jamison, Interrogating Sentimentality
I must have been born prematurely. I’m not sure how early I arrived into the world, but I was small. Four pounds, thirteen ounces. Small enough, it seems, that maybe I wasn’t guaranteed survival because it was 1971, and I had an infection in the marrow of my left femur. Or maybe it was as easily cured then as now, but that doesn’t explain why, for the first six months of my life, I was a patient at the University of Minnesota Medical Center in Minneapolis. I had a name, Lezlie, but I no longer had a mother.
The mother who gave birth to me was young, seventeen. She surrendered me into the care of Lutheran Social Services, and I would be available for adoption when I became well enough. I often wonder who gave me my name. I wonder if it is just standard procedure, to pick a name for the unowned, like assigning a Jane Doe, but gentler. I often wonder if the nurses held me. If there was one in particular I loved above all of the others. I wonder too if I was lonely when there were no arms available to hold me. I’ve read online that just like Humane Societies use volunteers to walk dogs, adoption agencies also solicit help to hold infants. Because I didn’t have a mother to sit next to my incubator, bright with bilirubin, and stroke the back of my hand, I wonder, who did?
It’s strange to think of those months–a half a year–I spent in the hospital as a newborn because I am bewildered by the idea that I, just an infant, was no one person’s property. Or no one’s personal property. (Motherhood, I now know, is a state of constant conflict between keeping and shedding. This boy is mine. This boy is his own.) Who fed me? A bottle, no breast. Who helped me learn to walk? And when I did, who or what did I want to catch me? Who took on the responsibility of my safety? Because the whole point of my stay was survival, or maybe cure–who knows what my prognosis was then–, who insured that the doctors took great care with my care? There was no one to consider multiple options, to say yes or no, to regretfully but convictingly say, yes, you can do that procedure, if you think it is for the best. No doubt I had a caseworker, but we know how busy they are.
The infection in my leg is termed osteomyelitis, and the internet tells me at one time it was considered a death sentence. Now it’s treated with a boatload of antibiotics, but it does it’s damage during its stay in the marrow. I have accepted I was born that way, had contracted this bacteria in utero, likely through my bloodstream. That’s called hematogenous osteomyelitis. And it’s more common in premature babies, so perhaps I was. But it’s also possible the infection occurred during or after birth, through staph or sepsis, but I can’t begin to imagine that scenario no matter how many web entries I read. Anyway, the hows seem irrelevant. More compelling to me is, did she know? My mother? Did she know that her baby wasn’t well, and did that matter when she made her final decision not to be my mother?
The doctors were concerned the infection had spread, and I remember being told they scraped my bones, including my skull, for samples. When I was little, I checked my body all over to find where they might have done the scrapings, looking for evidence like suspecting an alien abduction. Most likely I had biopsies. I know that now, but I imagined a greater invasion. I am just thankful amputation was not necessary.
For a short time, between the hospital and my adoption, I lived with a foster family who had planned to make it official until their circumstances changed. My name then was Stephanie, and how must it have been for that little girl to have had to say goodbye to another mother? That I came to my adoptive parents with two big black garbage bags full of toys, many with “Stephie” written on masking tape to label them as mine, was a story told and retold. Perhaps that detail was meant to convey love, that I had been loved, and treated well, and maybe even spoiled with toys, toys that belonged only to me. My mother changed my name because, she said, she didn’t want me to be nicknamed, “Stuffie.” Considering my childhood allergies, she likely made the right choice, though knowing I’d been robbed of a name ripe with possibilities, I was sullen for years about my mother’s choice. Sally didn’t even have an “i” that I could adorn with a stylized heart.
I have always been particularly conscious of the generosity with which my adoptive parents welcomed me, a child who would be a considerable financial and emotional drain on them all of their lives. My father had an 8th grade education and a job with the county; my mother was a stay-at-home mother, formerly a 1st grade teacher. I wonder sometimes if they knew the stress a lack of money would press down on the family, if they would have taken me in, made me their own. So many people now make choices of convenience, but maybe not. Maybe it just seems like we have less room to move within the strictures of our expectations. As someone who has had her expectations blown to bits time and again, I can understand why another woman would want to tightly protect her own.
I’ve never had any yearning to look for or meet my biological mother. I’ve always just been thankful to have found a safe place to land, and a mother to call my own for the twelve years I had her. Maybe my lack of curiosity about who my biological mother was stems from a kind of adaptive independence. Maybe I learned before I even knew how to learn, that I would always, in some way, be alone. Or maybe I’m afraid of the instant intimacy that may be required when meeting the woman who birthed me, when intimacy is difficult for me even when earned. What if she doesn’t meet my expectations? Though I suspect the truth lies more in my fear of rejection: she let me go once, and now that I’m no longer full of potential, what would be in it for her?
When I was pregnant with my son, Noah, I requested my adoption file from LSS. In Minnesota, in the early ‘70s, families were not required to update their family health histories, but my mother had provided more information when I was finally adopted at 16 months. I learned that she lived on a horse farm, and that all of the women in the family (and it is a large family, far larger than my own) enjoyed sewing. For the record, she told the adoption counselor that she gave me up because she wanted to become a nurse. I wonder if she did. I don’t doubt her desire to make something of herself; I literally mean, I wonder if she became a nurse. I hope that she did. I can be satisfied with having been given up for adoption in the name of her achieving the kind of life she needed. It’s a decision I think I would have made in her place. Motherhood has been an uncomfortable role for me since before my son was even born. I bear her no ill will, and really, only the hope that she had a happy life and no second thoughts about the daughter she would never see grow up.
There are questions I have about that early span of my life, of course, but these are questions no mother can provide me. I’m less curious about the who and the why than I am in the how. How did she come to grips with her decision? I struggle with the simplest of choices, never wanting to make the wrong one, never wanting to face the consequences of error. And I wonder if that part of my personality is a result of my having been giving up, passed between families, grateful for being adopted but nervous that a misstep could mean dismissal, return to sender.
What happens when a baby has no mother, no father, no regular? Did I imprint on no one? Attachment parenting advocates closeness, but to whom was I close? Who did I want to be mine? How often did I need that which wasn’t there to be given? How does that track down the line of that baby’s life, into my adult life? We are told the first three years of life sets a pattern, determine tendencies. I can’t be angry because whatever I am, I am resilient, and maybe that too came from those days when a blanket may have slipped off my baby body and there was no one there to slide it up to my shoulders, tuck it under my hips, and soothe me with a kiss on the forehead.
While I rarely wonder who she is, now that I’m a parent, and now that I’m no longer young, and neither is she, I do wonder if I am my biological mother’s one unanswered mystery. If she is still alive, only 63, does she wonder what became of me? Did she know I was sick? Did she talk to me before I was born? When I had hiccups in her womb, did she stroke her stomach to soothe me? Does she wonder if her sick baby got better, or does she remain relieved to have rid herself of my accompanying burdens? Does she sit, even just for a moment, when the morning light is just a certain way, and she feels young and full of memories, if that baby had the kind of good life she must have wanted for me when she said goodbye to the body she had built with her own body, fed with her own blood, and, I believe, loved in some way, in the right way.
For nearly five weeks, my mother sat beside my hospital bed. Each day, she arrived early, from the bare-bones lodging across the street from the hospital, and idled straight-backed in the room’s lone orange vinyl chair with angular brown wooden arms, as we waited for the doctors to slowly pull my left leg apart. She absorbed every blow: my tears of pain and tears of boredom, anger at what she was allowing them to do to me, anger at what unfairness I was forced to submit to. I didn’t wonder at the time, how she felt. Any parent who has ever held her child while he received a vaccination, or a strep test, or stitches in a wound, knows the anguish, the exhaustion, of cooperating or being complicit, in the infliction of pain. I have no recollection of being empathetic enough to imagine she felt anything at all, even as she made impossible decisions meant to make me better, while also making me scream.
Born with an infection in my femur, my left leg grew more slowly than my right, the whole leg like some underfed conjoined twin to my sturdier right leg. At the time, this surgery–to attach an “apparatus” to the outside of my leg via pins inserted through the skin, like a dock pillared into water and sand, that would then be cranked apart millimeter by millimeter each day until the space between the two separated sections of my left femur grew to 2 inches–was rare. It took nearly a month of minute progress toward a particularly scary resolution for me: another surgery, this one to remove bone from my hip to graph into that gap in my left leg, and for plates to be placed along the bone to keep the graph in place until my bones accepted and assimilated the new addition.
So we waited, my mother and I, for my muscles to be stretched, my split skin to mend, skin cross-stitched with dark thread like that pulled from her embroidery skeins. A crafter and knitter, my mother didn’t often do embroidery, but this needlework was portable and complex, perfect for the minutiae of a long hospital stay. Just a hoop, a square of cloth, limp figure-8s of glossy thread, needles, wooden darning mushroom. I spent much of those weeks in a large wooden reclined wheelchair, warding off boredom in the children’s lounge doing arts and crafts, eating microwave popcorn–that futuristic treat!–in the dining lounge, neglecting the homework the teachers sent, watching the day’s soap operas, but also waiting for my mother to let me take a turn with her embroidery hoop. I so wanted to try my novice hand at the delicate work, but she simply wouldn’t allow me the chance to make a mistake amid her tidy stitches.
It was a large and tricky project, an intricate Christmas tree, and each ornament was a different type of stitch. She had to teach herself each one from the instruction sheet. I remember silver knots like those metallic decorative candies we are no longer allowed to eat. I remember gold threads layered, criss-crossed, to create stars. There was a patchwork puppy in a gift box under the tree, a nutcracker soldier nestled in the branches, and a yellow-haired angel on top. Each night she would tuck all of the embroidery paraphernalia in a worn plastic bag, and when she rose from her chair, a cut in the vinyl was revealed, like a wound that was covered with her presence but unchanged each night when she left.
One of those mornings that I was in the hospital, she didn’t return to her seat near my bed, because she’d had a heart scare on her way to my room. It may have been a true attack–by the time she died two years later, she’d had several–but at 10 years old, I didn’t understand, or maybe I didn’t want to understand because all I wanted was my mother to be there, in her chair. Instead, I was the one left waiting to visit her, maybe my father, or a nurse, now wheeling my chair to the third floor of the same hospital. There was no arts room on her floor, no decorative smocks on the nurses. I don’t remember how long she stayed, or how I managed the rest of my own treatment without her presence, or how sick she was when I finally arrived home. Because I was in a body cast, from waist to toes, and because of her wavering health–small dark bottle of nitroglycerin always at hand–, my father had air conditioning installed. I wonder where he got the money to do that when there was no money to be had. My mother and I, we had used it all up.
That summer, I learned hospitals were places for recovery, and maybe even miraculous feats of medical engineering, but also places that simply stalled death, didn’t solve death, though adults embroider the truth into something more hopeful. My mother would have many more days and nights in the hospital in the final years of her life. The diabetes she developed when very young had taken its toll on her organs. I would spend some of them, twelve years old and inconvenienced, in a chair at the side of her bed. As an adult, I would carry that plastic-framed embroidered tree to every apartment and house I moved into, as well as the sense that, unlike the picture, there will always be something started but left unfinished about my childhood.
Eventually, my skin healed, pale railroad track scars lacing my leg, and my bones knitted themselves back together. Now, six varied scars graffiti my lower body in a successful twenty-one year series of surgeries to make me functional. The doctors reassured me that as a result, my leg would be even stronger than before. I suppose that’s the theory of hearts as well.
Well, Noah had a bad November. And of course that means we all did. On the 6th, he had a seizure when he came down with a bad cold virus. Not atypical for him. But the weird thing was that I could tell the afternoon before that he was going to have one. That was rare. His seizures are usually so unpredictable. Anyway, seeing what I saw, I should have given him his Clonazepam as a safety net but didn’t pull the trigger.
I don’t know why I have such a difficult time giving him the medication he needs. How is that worse than having to give it after he has a seizure? Maybe I don’t know how to trust my own instinct. Even worse, maybe I’m in some kind of denial, and I don’t give him the medication because I want to believe a seizure won’t happen if I don’t acknowledge it. Either way, I find it difficult to take action though taking control makes all sorts of sense, since I want nothing more than control. But then, nothing about this makes any sense. Observation is the name of the game, but I’m never quite sure what I’m looking at.
Anyway, that first week or so, we thought he was just weak and tired from a virus. But some days, when he was tripping and buckling at the knees as he was walking and I was holding tight to his hand to keep him from falling, it seemed that maybe the curse had descended. Our fear has always been that he is a ticking time bomb, that he has an unidentified syndrome that will bring upon him a decline. For the first time in years, we decided to stay home for the holiday to see family and give him complete rest. Today was his first day back at school since last Tuesday and he was sharp as could be, so the rest seemed to do the trick. When I picked him up, he had a welt on his cheekbone and bridge of his nose; he’d fallen twice.
A trip to the neurologist and we likely have a new seizure type to add to his many others. The Physician’s Assistant is pretty certain these are drop seizures, which are bad. Bad, hard to understand and prevent, and dangerous. So the plan is: to interrupt this new seizure habit his brain has formed by putting him on a load of the Clonazapam for 3 days, and then taper it down over 6 days. That might be enough to “reset” his brain. Who knew such a thing was possible? It’s a total torque to our schedule because he will want to sleep through the days. I can’t imagine we will be able to send him to school. Then we will do a 24-48 EEG in the next few weeks. Then we will talk seriously about inserting a VNS (nerve stimulator) under his arm which, we hope, would begin to interrupt his seizures without medication. Even though I know it could help keep him safe, and it’s not unlike a pacemaker, which rarely anyone blinks at, it seems so much more invasive. But that may be a choice we have to make.
Noah’s epileptologist, once he heard the PA’s report, is so worried about him that he found him a bed in neurology ward almost immediately. We’ve done this kind of stay before, and while the boredom of keeping a young child occupied in a closed room for several days is nothing I look forward to, the deepest trauma comes from the actual application of the electrodes. For whatever reason, the techs will not allow him to sit up for the procedure, and while it seems like nothing to me–just globs of wet, smelly paste and cold blasts of air to dry it–Noah can’t bear laying back and giving in to what he can’t see happening. We try all the cajoling and distracting, but ultimately have to hold him down and make him submit. I flashback to when I was a kid, when I was forced to allow doctors to perform inspections and procedures I couldn’t fully understand, and the pain doubles.
The testing, as always, is inconclusive. The EEG didn’t show evidence of anything we can assign as new or even causal, and the follow-up MRI was normal, so now we look at adjusting his drugs, thinking the polypharmacy–three seizure medications, not counting the on-demand Clonazapam–is impairing him. Generally speaking, seizure disorders and epilepsy are best treated by monotherapy, and polytherapy has been shown to improve control in only 10%. So we are going to start a bridge med (4!) called Onfi while we begin to reduce the Felbamate, which I never thought was effective anyway. They offered to adjust his medications in hospital more quickly over just three days, but we couldn’t bear the thought. So we will do a 6-week wean at home instead. How can we possibly know what’s right? We can’t. It’s an experiment with our child’s brain and welfare which offers us no right answers beyond effort.
Neuro meds are always an experiment. Or so they keep telling me. (How odd to become a specialist in something, an epileptologist, just to know that you don’t know enough about the brain to actually be effective a high-percentage of the time.) We expect doctors to have answers, but all people process meds at different rates, and all meds interact differently when put into play with one another. I just want answers and there are none to be had. In Noah’s case, because there is no cause of his symptoms, it becomes even more difficult to find the right drug out of many. As one website puts it, the door to a solution is locked and you need to discover the right unique key to unlock it; so it is possible that Noah’s meds no matter how many, nor how effective for other children, will not gain us access to seizure control.
Noah has been admitted to Children’s ICU isolation. They think he has Nontypeable H flu with pneumonia. We’d been syringing liquid into him, hoping to keep him hydrated, thinking he’d rouse if we just tended to his symptoms and waited. For a kid who loves presents, he couldn’t even get excited for his Christmas gifts yesterday. That’s when we knew he’d fallen away from us. The good thing is that his vitals are stable and they are getting fluids and antibiotics into him, and hopefully food via tube. He’s still unresponsive, however, so that’s frightening to us all. The usual tests they do to stimulate a reaction–pinch fingernail beds, run a sharp point along the bottom of the foot–aren’t doing anything. One of the ER doctors looked at us after ordering a number of scary tests, like for meningitis, “You do realize that your child is very, very sick?”
They are taking this opportunity to observe him via EEG and tweak his seizure meds. At least he wasn’t conscious enough to freak out about the electrodes. It’s possible the seizure meds played a part in masking the severity of his symptoms to us, or his body’s ability to fight the illness, or even caused the pneumonia by allowing him to inhale liquid as we tried to force him to drink. Lots of moving parts. Lots of regrets. He looks so small in the hospital bed. And I can’t help but wonder if we will get him back intact, or has this illness compromised him all the more?
All is ok again with the EEG and CT too, so far. It feels like we are playing chicken with his seizures in regards to his meds, but the Critical/Acute care people feel like he may just be a kid particularly sensitive to “benzos”–the Onfi, the Clonazapam, and even the Diastat we use in emergencies, that has always knocked him out for a couple of days– and that’s what is causing a good portion of the problems with his alertness and may give the impression of his being sicker than he actually is. (I continually remind myself that we are good parents.) So there is a bit of push and pull between neuro and the acute care pediatrician to decide whether to put him back on all of his seizure medications. The neuro wants to resume status quo, but the pediatrician believes it’s the medications themselves that are to blame, especially the new Onfi. Here we thought we were helping him, when it seems we were putting him in danger instead.
So it is New Year’s Eve. What…to make of all this? A new year, more of the same–Noah sick, me struggling–, yet all more difficult because he’s not himself. He is week and listless, and not my son.
It’s been overwhelming today. The sadness. Tears have come easily. I feel as though my hands have been amputated. I want to put them to work on healing my son, but my efforts are completely ineffectual, even phantom, as there is nothing any amount of mothering can do.
Stabilized. Probably in the hospital for another week. I’m on my way to New York for work. I can’t believe I’m leaving him, and yet, isn’t this what we have learned over the past 10 years? To live as though you don’t have a dark shadow following you around everywhere you go? One of the hardest parts of suffering is suffering over the suffering. At some point, you have to turn it off, cap the faucet, cut the wire.
Noah is still in the hospital. Day #23. He will be having surgery Thursday to put in a G-tube. The pediatrician at the hospital thinks she’s figured out what’s at the bottom of Noah’s decline: he doesn’t have enough nutrition. And his weakness, and those episodes they thought were drop seizures, may have been malnutrition due to a growth spurt during which he didn’t have enough calories to power him up. So all that extra dosing of the seizure meds? Likely unnecessary. I cannot tell you how that feels. I cannot help but wonder what kind of mother I am to have drugged my child to the point of starvation. And now, to realize that I cannot satisfactorily feed my child in any way. That I have been naive in thinking I have made the right decisions.
So we have agreed he should have the surgery, have a hole put in his belly, carry that scar for life. But if that eases the strain of giving him medication by mouth when he’s sick, and provides him with nutrients that he must be missing, then it’s the right decision. I think. I hope. Because that’s what I’ve thought before. I wonder if there is any way to know what the right thing to do is, until you learn that it was the right thing to do, which likely had very little to do with you and a lot to do with a confluence of factors you will never truly understand. Perhaps that is the closest thing I will ever get to the truth of mothering: good intentions are the only thing that matters because the end results will always be out of my hands, beyond the strength of my desire.