I

Wonder

I was born prematurely. I’m not sure how early I arrived into the world, but I know I was small. Four pounds, thirteen ounces. Small enough, it seems, that survival wasn’t guaranteed because it was 1971 and I was very sick. For the first two months of my life, I was a patient at the University of Minnesota Medical Center in Minneapolis while being treated for an infection in the femur of my left leg. Having been given up for adoption immediately, I had no birth mother to tell me the tale. Instead, I have three sheets of paper from Lutheran Social Services that spins out a narrative written by an administrator named Jackie, to tell me what I cannot remember.

It wasn’t until I was pregnant with my son that I requested my adoption file. In Minnesota, in the early ‘70s, families were not required to update their family health histories, but my birth mother had provided additional information when I was finally adopted by my birth parents at 16 months. For $60, the narrative I received was surprisingly detailed.

Your mother was an eighteen (18) year old, single, high school student at the time of your birth. … She was physically described as five (5) feet eight and one half (8 ½) inches tall, one hundred and sixty (160) pounds, with brown eyes and hair and a fair complexion. … Her interests were listed as sewing, reading, and swimming.

It’s strange to think of the two months I spent in the hospital as a newborn. Two months. I was perhaps placed under guardianship of the state and I am bewildered by the idea that I, just a newborn, 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. My birth mother bore me. My birth mother surrendered me.)

Who fed me? A bottle, no breast, I guess. Who took on the responsibility of my safety? Did a nurse think of me when she returned home after a long day of work, when she poured a drink, or tucked her own children into their beds? Who insured that the doctors took great care with my care? Was there an advocate assigned to my case who might consider multiple medical options, to say yes or no, to regretfully but convincingly say, yes, you can do that procedure, if you think it is for the best?

I’d always believed I was born with the infection. I’m near certain my adoptive parents told me just that time and again, and it’s become my answer anytime I’m asked about my limp, about my scars. “I was born with an infection in my leg.” But Jackie’s letter seems to imply something different, that the bacteria was introduced into my bloodstream, took residence in my femur after my birth, by an errant pinprick perhaps.

One report indicated you developed jaundice and another letter indicated at the time of transfer to the U of M you had experienced sepsis, were premature as well as being diagnosed with osteomyelitis, an infection in your left leg.

I had been so clear my whole life that I’d been born prematurely due to the infection, but with the letter, my understanding of the events around my birth has become slippery. It’s possible my parents did indeed tell me that, but the reality is that anything I know about the first sixteen months of my life isn’t anything more concrete than the messages passed during a game of Telephone. Everything I know about my birth, my babyhood, is a story told to me by someone who was told a story.

Maybe the when is irrelevant, and it doesn’t change the question I’ve always wondered about: did she know? My mother? It’s safe to assume my prematurity was the source of some alarm, even if my illness didn’t occur until days later. Did she know that her baby might not be well, and did that matter when she made her final decision not to be my mother?

When I was well enough, I was placed in a foster home and named “Lezlie.” Jackie’s chronological rendering of this time is somewhat unclear so it’s difficult to know the order of these two events. I find it hard to believe that I had no name at all before being placed with a foster family, so was it a social worker who named me? Was it standard procedure, to pick a name for the unowned, like assigning Jane Doe to a identity-less and lifeless body, or picking a name for adoptable animals at a shelter? I wonder what it’s like to choose a name for a child who is not your responsibility, to turn that child toward the future with the name Lezlie with a “z”? I wonder what version of myself I might have become had I remained Lezlie?

Via her narrative, Jackie is flattering: “the LSS social worker described you as a “beautiful baby” and that you were doing well in foster care.” And, in a letter dated October 4, 1971 the LSS social worker described you as, “small for her age” but that you were doing well in care and had a “tremendously happy, charming personality for a baby.” (Then as now, my seemingly genetic inclination toward positivity worked in my favor.) In early 1972, my foster family renamed me Stephanie and planned to adopt me, until their circumstances changed. My adoptive parents would later tell me that the father got sick and the family could no longer keep me. Jackie’s pages tell a different and possibly more tragic variation of the story.

You remained with your first family until August 1972 and then that prospective adoptive family’s situation deteriorated to the point where they were unable to care for you. According to the records, your pre-adoptive father experienced some mental health issues for which he was hospitalized and he then passed away in September 1972.

I feel sad for his wife, my foster mother, who must have been suffering, suffering her loss and then also giving me up, a child she presumably had wanted as her own. And what must it have been like for the toddler I was, who hadn’t yet had a family, to have to say goodbye to a mother and father when I was taken away?

Two more foster families cared for me, Jackie reports, until I was placed with my adoptive family when I was nearly a year and a half old and named Sally. I was told many times by my parents that I “came with” two big black garbage bags full of toys, some with “Stephie” written on masking tape to label them as mine..Perhaps that detail of the story was meant to reassure me that I had been loved, treated well, and maybe even spoiled with toys, toys that belonged only to me. (Or were there so many kids in the foster family that we had our designated toys? Did a social worker label my toys when I moved to the next foster home?)

I have always been conscious of the generosity with which my adoptive parents welcomed me, a child whose health issues would be a considerable financial and emotional drain on them over the years. And I’ve never had any deep yearning to look for or meet my biological mother. I’ve always just been thankful to have found a safe place to land, the locus of a pretty typical childhood. And I was lucky to have a mother for the twelve years I had her. It’s like I made a deal with my adoptive parents before I even knew I was signing on the dotted line: you take me in, and I take you in, and we will become us, no take-backs.

Or maybe my lack of curiosity about who my biological mother is stems from a kind of adaptive independence. Maybe I learned before I even knew how to learn, when I spent those hours and days in the hospital, months in foster care, that I would always, in some way, be alone, my own representative. Or maybe I’m afraid of the instant intimacy that may be required of me by reaching out to 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 a fear of rejection, or maybe worse, disinterest: I am a middle-aged woman with a special needs child; she let me go once, what on earth could we offer her?

A letter from the county social worker in August 1971 explains your birth mother’s wishes. She was enrolled and planned to attend a vocational school. Further, she did not plan to marry your alleged birth father and therefore, felt adoption would be in the best interests of both you and her.

It’s a decision I think I would have advised her to make if I had been her friend then. Motherhood has been an uncomfortable role for me since my son was born. In fact, I wasn’t sure I wanted children, but I made a choice. I’m unsure now, had I known about Noah’s disabilities early, that I would have chosen to give birth to him. Everyone makes tough choices in the “best interest” of both parties. What would mine have been had I known about the seizures, the hospital stays, the sadnesses. Jackie closes her story with an update from 1973:

It was also learned … that your birth mother had completed vocational school nurse’s training and was employed as an LPN.

I am impressed she followed through. Proud of her, even. I spent a lot of time being cared for by nurses while I was hospitalized, and I’ve spent a lot of time grateful for the care nurses have given my son. I bear her no ill will, only the hope that she had a happy life and no anguished thoughts about the daughter she would never see grow up.

Still, I wonder what happens when a baby has no mother, no touchstone for the first year and a half of life? Did I imprint on no one? Attachment parenting advocates closeness, but to whom was I close? Who did I want to be mine? Who helped me learn to walk? And when I did, who did I want to catch me? How often did I need that which wasn’t there to be given? How does that track down the line of baby-me’s life into my adult life? We are told the first three years of life set 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.

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 question. If she is still alive–only 64 by my count–does she sit, even just for a moment, when the morning light is a certain way and she feels the press of memories, if her baby had the kind of good life she must have wanted for me, if it had been the right decision to say goodbye to the body she had built with her own body, the baby she fed with her own blood, and (I believe) loved in some way, in the right way.

II

Wait

My mother sat beside my hospital bed for nearly five weeks. Each day she arrived early, walking from her 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, held vigil as we waited for the doctors to slowly pull my left leg apart. She absorbed every resentful blow my 10-year-old self could deliver. She tolerated my tears of pain and of boredom, tears of anger at what she was allowing them to do to me and anger at what unfairness I was forced to submit to. I didn’t bother wondering how she felt. Now I know better. 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 as she made impossible decisions meant to make me better while also making me cry.

An infection in my femur at birth caused my left leg to grow more slowly than my right, the whole leg like some undernourished conjoined twin to my sturdier right leg. This procedure–to split the bone and attach an “apparatus” to the outside of my leg via pins inserted through the skin, like a dock pillared into water and sand, that was then 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 in 1981. It took over a month of minute progress to allow my skin and muscle to acclimate to the forced growth. The end goal was a scary proposition 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 leg to be stretched, my split skin to mend just to be opened again, skin cross-stitched with black thread like something pulled from the embroidery skeins she brought to my room every day. 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, because I wasn’t allowed to sit up, warding off boredom in the children’s lounge doing arts and crafts, eating microwave popcorn–that futuristic 80s treat!–in the dining lounge, neglecting the homework the teachers sent, watching the day’s soap operas, but also wanting my mother to let me take a turn with her embroidery hoop. I so wanted to try my novice hand at the delicate work she performed at my bedside, but she wouldn’t allow me to try, 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, readying to return to her guest room, she would tuck all of the embroidery paraphernalia back in a worn plastic bag. When she rose from her chair, a cut in the orange vinyl seat was revealed, like a wound that was covered with her presence but opened again each night when she left.

But one morning, she didn’t return to her chair near my bed. My father arrived instead, told me she’d had a heart scare and been admitted to the hospital herself. 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, paying attention to me, paying penance for my pain. Instead, I was the one left waiting to visit her. Maybe my father, or maybe a nurse, occasionally pushed my wheelchair to the third floor of the same hospital to park next to her bed, but I rarely stayed. There was no arts room on her “adult” floor, no colorful smocks on the nurses, no distractions to speed the minutes.

I don’t remember how long she stayed in the hospital, but I managed the rest of my own treatment without her presence by attaching myself to a variety of nurses or candy-stripers like I had attached myself to the teen neighbor-girls who babysat my brother and me at home. I often visited a little boy who had been badly burned. His toddler body was covered in white bandages until they were removed, revealing his brick red skin, shiny as a newly polished floor. He had curly strawberry-blond hair, so sometimes he looked like he was still on fire. I don’t remember his family visiting, his mother sitting vigil as mine had. I was drawn to him, maybe to my own feelings of nobility when I persisted in staying in his room while he cried, which was most of the time. Or maybe I just stayed to witness, finally, a pain greater than my own.

Nor do I remember how sick my mother was when I finally arrived home, miserable in a body cast on my left leg, from waist to toes, during the hot summer. Because of my discomfort and her wavering health–small dark bottle of nitroglycerin always at hand–, my father had air conditioning installed. I wonder now where he got the money to do that when there was never any money to be had. My mother and I had used it all up, trying to get well, be well. But our relationship never recovered. I wanted her to be the mother I wanted, not the one I had. I wanted my life to be the one I wanted, not the one I had. I continued to rage about all the unfairness inflicted upon me. I didn’t know then that my anger was actually my fear.

I was ten that summer when we were both in the hospital at the same time. Then I was 11, then 12, and then she was dead. The last time I was at her bedside was the day before she died. That heart attack had been severe. I suppose they knew. The doctors. Maybe my father. There was nothing they could do. The diabetes she’d developed when very young had taken its toll on her organs so none of the preventative measures to elongate her life could be executed. My brother and I were ushered into her hospital room, and I’m not sure what I expected except that I’d imagined I’d be able to sit next to her as she slept, grasp her hand in mine and wait until she woke like I’d seen in soap operas.

Instead, her bed was raised high, almost arm-pit height. It was no ordinary hospital bed like the ones I’d resided upon. And around her were machines on wheels, tubes and wires strung this way and that like a particularly knotty game of cat’s cradle that kept me at arm’s length. Or a prison that contained her. I could barely reach my mother’s hand. There was nowhere to sit. There seemed no reason to be there after only a few minutes, because truthfully, I may have sensed she wasn’t there either.

How long had she been heart-sick? I don’t mean medically. I mean, how long had she known she was likely to die before she could see her children grow into adults? How did she live with the knowing, the waiting? I couldn’t understand when I was young why she was always so thin-skinned. She would fall apart in an instant over nothing. Over my brother and I sparring over what TV program we would watch. Over my dislike of the dinner she had cooked. Over my rude disdain when I came home from school and she asked how my day was and I refused to tell her.

My mother had been older than my peers’ parents and retained a kind of formal idealism that women who lived through a war had, who believed in God and country and well-behaved children. I still remember so much about her. Her perfectly oval fingernails, the cotton-candy swirl of her brown curls, a fine covering of freckles over her forearms, her small straight teeth and the smell of her breath after her morning coffee. And I carry that plastic-framed embroidered Christmas tree into every apartment and house I have ever lived in, as well as the sense that, unlike the picture, there will always be something started but left unfinished about my childhood.

By the end of my tenth summer, my skin had healed, reddened railroad-track scars laced my leg, and my bones had knitted themselves back together. Now, at 46, many scars of varying lengths and shapes still graffiti my lower body from the many additional surgeries I would undergo, many of them without a mother to sit by my bedside. The doctors reassured me each time that as a result of all the bone-knitting, my left leg would be even stronger than before. I suppose that’s the theory of hearts as well.

III

Want

12/2/2014

Dear B,

I’m sorry it’s been so long since I’ve written. Noah had a bad November. And that means we all did. On the 6th, he had a seizure when he came down with a bad cold virus. I could tell that afternoon that he was getting sick, and seeing what I saw, I should have given him the Clonazepam he’s been prescribed to prevent him from having a seizure. But I didn’t want to pull the trigger.

I don’t know why I have such a difficult time giving him the medication. How is drugging my child to prevent a seizure any worse than drugging him to stop a seizure? Maybe I don’t trust my own instinct and the seizures force my hand. That way, I don’t have to choose; I just have to do. Any way I look at it, I’m complicit in him having had a seizure, the thing I want least.

A trip to the neurologist and we likely have a new seizure type to add to his many others. The doctor is pretty certain he is having drop seizures, which are bad. Bad, because they are hard to understand and prevent, and dangerous because they are so sudden and unpredictable. There are so many sharp corners in the world once you start looking for them. So the plan was: interrupt the new seizure habit that his brain was forming by putting him on a load of that 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?

Noah’s epileptologist, once he read the PA’s report, was so worried about Noah that he found him a bed in the neurology ward. So we are in the hospital now. They will do a 24-48 EEG and after we will talk seriously about inserting a VNS (a nerve stimulator) under his arm, which would act like a pacemaker of sorts to interrupt his seizures without medication. There’s a part of me that would be relieved to have a non-medication-based solution to his seizures; there’s another part of me that feels like once we go down this road, we admit to some kind of failure, a failure of conventional control methods.

12/5/2014

The test results, as always, were inconclusive. The EEG didn’t show evidence of anything new or causal, and the follow-up MRI was normal, so now we look at adjusting his drugs. A new hypothesis is that the polypharmacy–three seizure medications, not counting the emergency Clonazapam–is impairing him. Generally speaking, seizure disorders and epilepsy are best treated by monotherapy, while 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 (that I never believed was helping anyway.) They offered to adjust his medications in the hospital more quickly over just three days, but we couldn’t bear the thought of inciting seizures by ripping the proverbial Band-Aid off. Instead we will do a 6-week wean at home. How can we possibly know what’s right? We can’t. It’s an experiment with our child’s brain which offers us no right answers beyond our best effort. It’s best not to think too hard about the fact that no one, not even the specialists, know what to do to help him.

Neuro meds are always an experiment. Or so they keep telling me. All people process meds at different rates, and all meds interact differently when put into play with one another. I want answers but there are none to be had. In Noah’s case, because there is no known cause of his symptoms, it becomes even more difficult to find the right approach. As one doctor puts it, the door to seizure prevention is locked and you need to try a lot of different keys to discover the right one to open it. So it is possible to change Noah’s meds, no matter how many, nor how effective for other children, will not gain us control, the one thing we want most.

12/27/14

A twist to the tale. Noah has been admitted to Children’s Hospital Intensive Care isolation unit. They now think he has Nontypeable H flu with pneumonia, but when we first arrived at the ER they suspected meningitis. We’ve been struggling with Noah’s seizures and medications and health all winter, but things took a turn for the worse the week before Christmas. It was hard to discern just when or how he’d become so sick, but we’d resorted to syringing liquid into his mouth, hoping to keep him hydrated, thinking he’d rouse if we just tended to his symptoms and waited. We stayed home for the second holiday in a row. For a kid who loves presents, he couldn’t muster the energy to open his gifts.

His vitals are stable and they are getting fluids and antibiotics into him, and hopefully food via a tube in his nose. He’s still unresponsive, however, so that’s worrying. The tests they do to stimulate a reaction–pinch his fingernail beds, run a sharp point along the bottom of his foot–aren’t doing anything. He doesn’t even flinch. One of the ER doctors looked at us after ordering a number of scary tests, including a spinal tap, “You do realize that your child is very, very sick?”

12/29/14

We’ve agreed to take him off all his seizure meds, because the Critical/Acute care people suspect he may just be a kid particularly sensitive to “benzos”–the Onfi, the Clonazapam, and even the Diastat we use in seizure emergencies–and may be causing his lack of alertness and the impression of his being sicker than he actually is. The neurologist isn’t in full agreement, but I’m inclined to believe the people who are looking at Noah’s full self rather than just looking at his brain. I continually have to remind myself that I am a good mother even when it seems the decisions made put him in danger instead of keeping him safe.

12/31/14

A new year, more of the same–Noah sick, me struggling–, yet more difficult because he’s not himself. He is weak and listless, and not my son. I’m overwhelmed today. The sadness. Tears come easily. I feel as though my hands have been amputated. I want to put them to work to help Noah, but my efforts are completely ineffectual; there is nothing any amount of mothering can do.

1/5/15

Stabilized. He will probably be 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 I have learned over the past 10 years? To live as though I don’t have a dark shadow following me around everywhere I 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.

1/18/15

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: it wasn’t a new type of seizure; it wasn’t the medications; maybe not even the severity of the flu; he has been malnourished. His weakness, and those episodes they thought were drop seizures, may have been because he didn’t have enough calories. So all that extra dosing of the seizure meds? Likely unnecessary. Though maybe it made him too lethargic to eat, unaware he was hungry. I cannot help but wonder what kind of mother I am to have drugged my child to the point of starvation. What kind of mother am I that I have been unable to adequately feed my child or identify his nourishment as the problem?

So we 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 the nutrients he is missing, then it’s the right decision. I think. I hope. I’ve said no every time a G-Tube has been suggested before, and now I don’t even remember why. And I think I was wrong.

I sit at his bedside and watch him sleep, so small in the middle of his hospital bed like a pearl in an oyster, and I feel utterly incapable of meeting this moment. And yet, for the first time, I believe I will. Because I finally understand something I’ve fought against since Noah was born: this is the life I have, this is the kind of mother I am required to be, it’s not what I wanted, but I’m not going anywhere.