Noble, Part III

The curse of having such clarity with these memories is that I get to revisit them every day. Each visit involves second-guessing myself, thinking about what could have been done for a different outcome. If it seemed like a different time, a different life, my wish is that the story would end differently as well.

Nothing was working, it seemed. At 12 hours our OB/GYN went off shift and another doctor took his place. When she came on shift (herself 5-months pregnant), she said no to the possibility of a caesarian. The waiting and anxiety would have to continue.

After about 17 hours, X finally dilated to 10cm and it was decided she should start pushing. As the nurses turned of the epidural, we put our Lamaze to bear, hoping that we’d finally started the final lap.

Unfortunately, despite her efforts, X could not get the baby to move. Eventually, she had to be put on oxygen to assist with her breathing and give her enough of a boost to get through the delivery. It was then that the fetal monitor lost its signal.

The baby was, the delivery nurses thought, into the birth canal and it was not unusual for the fetal monitor to lose its signal at that point. That’s OK the nurses said, no it’s not, said I, get it back fucking working -- now. I was furious, frightened, and pretty belligerent. The nurses called the doctor.

The doctor came in and assessed the situation, saw how freaked out I was and how exhausted X had become. She asked if X could continue trying to push but X was defeated, no, she said, I can’t do this anymore. The doctor suggested a forceps delivery to which X was adamantly opposed. It was then that the doctor ordered the C-section.

Bringing my video camera into the operating room, I stood off to the side, next to the incubator, watching while X’s stomach was rubbed with betadine and a drape was placed like a wall over her chest to block her view of the operation.

Noble was lifted from the womb, purple, lifeless, his little eyes black, his mouth agape but silent. The delivery nurses hurried him to the warmer table and immediately began a respirator bag. I overheard a nurse saying that his heart rate was 5 beats per minute. If I’d thought that things could not get worse, I had sadly miscalculated.

Lowering the video camera, stunned, I asked what was happening, if he was alright. A voice said, “Get him out of here,” and I was quickly escorted from the room.

While I changed back into my street clothes, Noble was rushed past me, the incubator hidden by a contingent of nurses and doctors, none of them acknowledging me. When I tried to ask questions about where Noble was, how he was doing, I was directed to wait, news would be given to me when the doctors knew something. Eventually, I learned the X had been taken into the recovery room and I decided the best thing to do would be to wait with her, there. At least, in our fear, we would have each other to hold onto and combine our hopes.

In the recovery room, X had been given morphine and Ativan. She was barely coherent and completely unaware of what was going on. Just as well, I thought, my sense of doom overwhelming, a suffocating sense of the world, out of balance, caving in on us with all its weight. I held her hand and stroked her hair, cautious caresses that avoided the numerous tubes and wires attached to her. Fighting her nod, she asked how Noble was. I had to tell her I didn’t have a clue. It was scant comfort for her as she drifted into slumber.

With X out of it, I went to the Neonatal Intensive Care Unit to see my son, to try and find out what I could about the situation. The NICU opened into a broad hallway and looked like a dark cave lit with blinking indicator lights and the glow of incubators. Everything inside was hushed, solemn, funereal, the maternity ward’s macabre version of Purgatory.

At the door, I overheard the NICU doctor telling a nurse clinical assessments and in the midst of it I heard, “Anoxic for over 30 minutes.” It was if someone had punched me in the stomach.

As he walked towards the hallway, I pulled him aside, introduced myself, told him about my education and credentials. “Look,” I said, “I know what ‘Anoxic for over 30 minutes’ means. I know this isn’t just ‘not good’, it’s tragic. I need you to be candid with me, you can’t sugar-coat this. I need to know right now.”

He apologized that the staff had not been able to prepare me for this but admitted that it was best that he just went ahead and gave it to me straight. The best prognosis, he said, if Noble survived, would be severe Cerebral Palsy and profound mental retardation – he’d never develop mentally beyond an infant. Right now, without life-support, his chances of survival were only about 5 – 20 percent but those chances increased with each passing hour. We would need to decide, soon, if this was the quality of life we wanted for our son and if this was the quality of life we wanted for ourselves.

I asked him what kind of window of opportunity we had to decide, would he suffer if we did decide to take him off of life support, was there any chance at all that he could be rehabilitated in the future if we decided to keep him on life support, and what kind of care we’d be looking at if we held out for that hope.

His demeanor was grim. Constant care, he said, 24/7, millions of dollars over the course of his lifetime, a lifetime, he added, that would never be assured certain survival and no rehabilitation would ever improve his condition. If we decided to pull life support, he would not suffer, he said: Noble’s brain was far too damaged for that. Basically, he said, his brain was too damaged to support his heart and breathing and was incapable of registering pain.

There was some small comfort in those words. Noble would not feel any pain. All the pain in the situation would be carried by X and myself.

Click here to read Noble, Part IV