Research: Journals
The Journal
Past Issues
29.2
Kristin Kovacik
A Short History of My BreathMy daughter, my second child, was born on January 12, 1995. It was a long labor, twenty-four hours or so, and a "natural" birth--that is, I labored without medication, my steady husband at my side, and the doctor caught the baby, sweet Rosalie. This had not been the plan.
Veterans of my son's birth sixteen months earlier, we knew just how to do it. We knew which Lamaze exercises worked (mostly slow breathing) which music to bring (slow R&B to hook the slow breathing to). We knew how important it was to stay calm and focused: because panic, even nervous laughter, interrupts your breathing and brings its own, separate pain. And most important, we knew which pain medications to ask for and when. I faced my second labor with fewer illusions and more strategy, and was prepared for the satisfactions of doing something a second time.
What I wasn't prepared for was a disappearing obstetrician. From the morning we entered the hospital, to the time of Rosalie's birth that night, he did not visit us. Though everyone assured us he was in the hospital and could be paged, we were led to believe that the criterion for "paging" him was some kind of emergency. Jim and I, champions of calm, could not bring ourselves to cry wolf. We figured the doctor was busy with hysterical laboring couples and that he would eventually stop by and see me, as my former OB had done, to help me time my medication. But the doctor did not come, and so we breathed, to stay focused and calm, hour after hour. Still he did not come, and we breathed and we waited, like shy customers dining at a busy restaurant, waited for the overworked doctor to come and offer us a cocktail, while the pain mounted and my stamina flagged, and the nurses mostly ignored us, we seemed so in control. And the doctor did not come, and we breathed and held on, to the voices of Sam Cooke and Aaron Neville, and I worked myself into a kind of furious calm, which Jim later described as a coma, but which I experienced as an intense duet with Sam Cooke on "Change Gonna Come,"--until the pain was so great that I lost my focus, and cried out, "PAGE the doctor."
But it was too late, the baby was coming, and the cocktail hour had passed, the bar closed, and I pushed through a pain so beyond what I had known that I screamed in surprise--It hurts! It really hurts!--dismayed that no one, not the lazy doctor, who'd apparently been sleeping while I labored, and now fumbled with his gloves, not the nurses, who were so distant before and who were now yelling at me, and not by a mile my husband, fellow soldier of the breath, who looked, bizarrely, happy--no one would catch my alarm. I knew then that I was alone with the pain, there was no sharing or translating it or singing it away. I was certain I would die from it. I have never been so frightened.
Later, after the pain stopped, after the shakes and warm blankets and the first real meal in days, after a day or three spent gazing at Rosalie's lovely, wizened face, I started to wonder what all that pain had been for. What good had it done? I raged, anew, at my incompetent doctor and my own passivity in the face of what clearly was an emergency. Would any less pain and fear have made her less perfect? Her birth less joyful and miraculous? The experience of natural childbirth is supposed to be an empowering one, I know, connecting women to our awesome mythic strength, but I did not feel like a goddess. A mother already, I knew how quickly the high drama of birth dissolves into the more ordinary work of care. I was not a goddess; I was a chump, a weak consumer--satisfied with the product, but disgusted by the service in that joint. Pinned to a nursing infant while my toddler tore books into bits at my feet, I fantasized about demanding my money back, about suing the bastard, but of course I was too exhausted to pursue this.
Flash forward almost seven years, September 28, 2001, and I am in the hospital again. My son Ramsey, just eight, is having a Nissen fundoplication--a last-resort surgery to abate his chronic gastro-intestinal reflux disease. In short, everything he eats comes back up into his mouth, and no drug in any quantity will stop it. He is fragile and anemic and flops around like a marionette after he eats. There may be a name for his problem, Sandifer's Syndrome, but not a clear treatment. It's taken us four years of medical specialty care to get to this moment, and what the surgeon will do today is detach his stomach from the abdomen wall, lift it from the top, and wrap it around the bottom of his esophagus. Then he will stitch it there, his stomach like a cravat that with luck will create just enough pressure to keep his food in, yet still allow him to swallow. It is this part that still gets to me--the not swallowing, a side-effect called disphagia. I can't dislodge the lump in my throat.
I ask my son if it tickles when the surgeon marks, with a pen, blue X's on his abdomen. I force myself not to remember how tender his skin is, there and everywhere. I look straight into his eyes and nowhere else, not his wrists, braceleted and taped, and surely not his neck, where he is most a child. He tells me that now he knows for sure he'll be a professional hockey player like Mario Lemieux when he grows up, because he will already have had surgery.
He is brave, which is to say he trusts us. I think about how bad he's going to feel before he can possibly feel good again.
But I am clear-eyed, all business, with a few more questions for the doctor as they wheel him off. In the wake of my hospital labors, and the years spent diagnosing and treating his condition, I've transformed myself into a militant medical consumer. No more waiting to be served. I ask questions, get second opinions. I challenge doctors and keep detailed notes. I read everything I can and show what I know. I am probably obnoxious. But I've learned the hard way to do this, to keep everyone around my son awake and concentrating, and I think this is what will save him--this vigilance, and the best procedure at the best children's hospital with the best surgeon in the region.
When the swinging doors close behind him, I start to cry into my husband's shirt, but the tears feel dangerous. The last tears I shed were just two weeks ago, in my classroom full of high school students, all of us crying silently from our desks as we watched television, the tiny people and their tiny, futile banners, waving from the top of the World Trade Center. If I begin to cry now, I feel I will weep without stopping, everyone will begin to weep, and we will all stop being vigilant, now when it seems most necessary.
When they bring him back to us, the surgeon tells us he is pleased, but of course we won't know for some time. He explains how his stomach has been filled with air, and that now, with a fresh suture at the top of it, his stomach has to release the air, and he will feel pain when it does. "How much pain?" I ask, but of course I know the answer--pain is untranslatable, unquantifiable. The surgeon prescribes morphine at six-hour intervals. I look at the clock and note the dose.
Informed as I am, I am unprepared for the pain when it arrives. First he calls my name, Mom? , like the prelude to a question from the back seat of the car. Then he calls more plaintively, like a request for some help in the bathroom. Then he calls my name in the voice all parents know is hurt for real, and which is received by your entire body. His eyes have closed, and his head is thrashing from side to side exactly like an epileptic in seizure. His face, sweet and soft, and which I have adored for eight years, contorts into a silent, grotesque scream. Jim and I, helpless, watch our son drown in his pain, and then we watch him emerge, maybe half a minute later, panting, an exhausted swimmer. We are all terrified.
But when the next wave comes, the soft call, my body, as if of its own accord, knows what to do. I climb into his bed. I touch him everywhere I can, my skin on his skin; I touch my face to his; I put my mouth in his ear. My body knows to go down there with him, to let him feel me there. And somehow I know, like in dreams where you speak a new language, exactly which words to say. I tell him I am with him, and that we will breathe together, slow and steady, to blow the pain away. I tell him that I know it hurts, but that it will not last forever. I tell him that what he's doing is amazing; he's the bravest boy in the world, braver than Mario Lemieux.
I feel his eyelash flutter on my cheek when it is over. He pushes out one more slow breath, laced with morphine I can taste. "Thank you," he says, and his politeness at such a moment makes me laugh. Until I realize that he means it, that he felt my presence in his pain, and that it felt like a gift. I tell him we will handle this together; he will not be alone, not for a single second.
The doctors we summon have nothing more to give us. The morphine cannot ease the pressure that has built up within him. They are mystified and alarmed about why he thrashes so. It's either a childish reaction to pain, or he's developed another, more serious problem--dysphagia or something neurologic. The doctors leave us to "see what develops," to wait for the waves to come, and to face them down together, all the while wondering whether something worse is lurking. This, I understand, will be our labor.
Through the night, and the following day, my son and I row the sea of pain, becoming an efficient crew. He calls, I come, we breathe, and the dark wave washes over us. Occasionally he naps, and I stare at the dear face of memory--my perfect, sleeping child--but I don't sleep and I don't dream. I am vigilant. In the middle of the night, I prevent a sleepy resident from triple-dosing his meds. In the morning, the toilet breaks, flooding his room, and I make the nurses move him to another. I am difficult to everyone but him. I lose track of time and forget to eat and suddenly it's night again. Jim comes to force me home to bed, and while Ramsey naps, I show him the ship of our rituals--where to touch, how to breathe, what to say. As I leave I make a wifely prayer that he will perform this routine exactly as I described, without any masculine variation. But as I watch him settle next to our son, I can see in his face how much he too is suffering, and I understand he will find his own way. I remember our own long night together, laboring to bring forth this very child. It is, coincidentally, the anniversary of our marriage, though neither of us can mention it.
The garage beneath the hospital is empty; it's a long walk through black spaces to our car. I sit behind the wheel and stare out into it, the threatening dark, and it surprises me to notice that I don't feel afraid. I imagine Ramsey waking above me, and I will him to remember how to breathe. I swallow the stale air of the car. I am not afraid and not merely exhausted, though I haven't slept in days. I am something else--another feeling, deep and new. And though a name for it doesn't arrive (and perhaps doesn't exist), it has something to do with use. I feel I have been used. Every part of me, every molecule concentrated to ease his suffering. I am a worrier by nature, a temperament now pathologized as "anxious," and which my own doctor helpfully described as "unconsciously holding your breath." And so it startles me that here, at the darkest hour, is where anxiety dies, where I breathe without thinking.
I don't know if my son will be okay. But I feel, at this moment, elated, or rather, entirely alive and on the verge of disappearing. I know now, of course, what the pain of childbirth had been for, what good it was. It was for this work I have to do now, and this pure feeling of purpose. Perhaps I am finally, entirely, a mother.
Strangely, it occurs to me that it may have been this feeling--not pleasure, or pain, but this strange state of grace--that was perverted to make men fly planes into buildings. Suddenly I can imagine it, can feel their deadly calm. We all want to be used, the body cries for it, though we don't often listen to its call. And it is perhaps a kind of holding in--of our astonishing usefulness--that makes everybody I know seem a little anxious.
Two years later, I will watch our president, in response to the bombers, deliberately ratchet up everyone's anxiety, creating a need for crisis--something as dark and heavy as war--to stop the worry. In the young men and women called up, the parents wrapping yellow ribbons around trees, I would see the strange elation that comes with knowing exactly what you're supposed to do, the paradoxical relief in facing down a big, bad thing. They would seem imperturbable, undismayed, unlike the rest of us on the margins of the action--or perhaps this is merely what's visible through the lens of our nationalistic media.
Now that I'm a mother, and the mother of a child in pain, I see through pain. It is perhaps no more accurate a view than any other. But I would like to believe that my son, too, sees differently, now that he is completely, perfectly well. His teacher has reported a new confidence at school, building upon the glory he received eating cheeseburgers with a straw, flashing the constellation of tiny scars on his belly. Mainly, he feels better; he can eat normally, voraciously.
But I secretly believe that he felt it, too, the grace of suffering. That he remembers being on the other side, inside pain, connected to the outside world only by the tether of his breath, and his mother's voice. And I believe that he knows, if only in the body's memory, which is incorruptible, that it was enough to pull him through.
