Sam is breathing like a frog. I show my mother. I tell her, "I gave birth to a frog."
She says, "They are going to be beautiful boys."
I tell the nurse that Sam appears to be heaving more than Gus. "They push the preemies here to see what they can handle," she says. "He's working hard, but we'll see what the doctor decides to do during rounds. He might want to put Sam back on the respirator. They have to keep testing the babies to see if they are ready to come off."
My mother wheels me back to my room, and when she and my husband, Dan, go down later to check on the twins, they learn that Sam is indeed back on the respirator. One of his lungs has collapsed.
"I knew it," I say. "I knew it. How could those nurses not have seen that something was wrong with him? Why did the doctors wait so long? They were pushing him too hard."
Dan paces around my hospital room. "Dr. Vanderbilt said you have to start walking," he says. I don't even try. I do not want to recover. Later that night, I am lying in my hospital bed sipping ginger ale. Dan is flipping through TV channels when Alex, a nurse-practitioner from the neonatal intensive care unit (NICU), knocks on our door. He says that Sam has taken a turn for the worse and we need to sign a release for a blood transfusion. Sam is in bad shape; his system has shut down, and his oxygen levels are low.
Alex tells us that we probably want to come downstairs.
Partly because I am disoriented from painkillers for my c-section, I still have no idea which turns we make to get to the NICU despite having made this trip several times. Dan wheels me through the glass doors. The head nurse-practitioner says, "Sam is very sick. He is not responding to our treatments. We are going to try him on an oscillator, a machine that will shake air into his lungs. It may be our last resort."
Dan wheels me back to the elevator, through the maze, to my room. I rest all my weight on my arms and push myself out of the chair and into my bed. I slide away the tray with its stack of unopened puddings. It is two weeks until Thanksgiving. The cribs I ordered haven't even arrived, and now I don't know if I will need two. I begin to cry uncontrollably.
I believe Sam will die. Over and over I keep thinking, Terrible things happen, there is no protection from them. I am beyond anger, beyond the dread of having to go home from the hospital tomorrow leaving one of my babies here clinging to life and the other fading fast. He should not be here yet. He has arrived and he will leave in a flash, without being hugged by his mother or father, without laughing or speaking, without our ever knowing who he really was.
I've had no more than a glimpse of Sam's fair hair and remarkably symmetrical face. He is the restless troublemaker, Baby B, who kicked a hole in his sac, atypically breaking his water ahead of Baby A and hurrying his brother out. He is a heartbreaker who struggled mightily to breathe, until he collapsed. My love for him is both unconditional and nontransferable. I love Gus equally and separately. If Sam dies I will be left reaching out for a baby that I never even held.
From the book The Early Birds, by Jenny Minton. © 2006 by Jenny Minton. Published by arrangement with Alfred A. Knopf, a division of Random House, Inc.
Saturday, November 16
Four days after the boys' unexpected arrival 31 weeks into my pregnancy, Sam's condition has miraculously stabilized. The crowd around him has dwindled to three, including a doctor who says, "Your son is very, very sick." It's the first time someone has referred to Sam as my son.
They have rendered him unconscious with Fentanyl and laid him on the oscillator. His tiny arms and legs are spread out and pinned down. His stomach is distended. He looks like a baby prisoner being electrocuted. He is being drugged so that the powerful vibrations will not cause him pain.
We take the elevator back up to the maternity floor, and a resident discharges me. No longer a patient, I walk out wearing my maternity jeans, which are horribly loose. We stop for pizza on the way to our apartment.
It is Saturday night and the restaurant is bustling. People smile as we pass them on the way to a table. They think that I am still pregnant. I have my first beer in eight months. Dan says to me, "Even if Sam doesn't make it, he still lived. He will always exist. Samuel Minton Quigley was here."
Tuesday, November 19
At one week old, Sam comes off the oscillator, skips over the respirator, and moves straight to a thin tube delivering air through his nose like the one Gus has had taped to his cheek since Friday. The nurse adjusts Sam's tube. Then, all of a sudden, she turns off the nozzle on Gus's oxygen. For the first time in his life, he is breathing on his own.
Wednesday, November 20
Dan and I arrive at the NICU on the eighth day in the boys' lives, to discover that Sam's nasal air tube has been removed. He's breathing fine. Feeding tubes delivering my pumped breast milk through the boys' noses have replaced the catheters in their veins. The IVs have vanished.
Last night, before I left, the nurse-practitioner suggested I try breastfeeding today. As the lactation consultant squashes Sam's face against my breast, I feel a slight pull. "He's got you. He's latched on," she says excitedly. Sam closes his eyes and holds on. I feel another tug or two, after which I'm certain Sam has fallen asleep, but I don't move for half an hour. I let him sleep against my breast and pretend that he is nursing.
Dan arrives with his camera. I tuck my breast away and we snap our first pictures of the boys, which we quickly develop at a Motofoto before heading out for Thanksgiving dinner with my family.
The boys have been in the hospital nearly six weeks. Initially, the nurses predicted that they would come home for Christmas. Then they said without a doubt by New Year's. Now they laugh and say, "Well, they surely won't be here for college."
Today the boys are six weeks old. Dan and I attend a Mass, and then we visit the boys at the hospital, where I drop off more breast milk. At noon we leave to celebrate at Dan's sister's house. The house is filled with Dan's brothers and sisters, plus cousins, babies, children, parents, aunts, and uncles. There is Christmas music, a fire, and a big tree in the corner wrapped in white lights. Everyone has brought gifts for the boys.
After I open a pile of presents, I slip into the kitchen to see if Dan's sister needs any help. One of their cousins, who is heating up some gravy, says to me, "It must be hard, feeling like you have had your children but you're not a mother yet."
I nod. She is expressing sympathy. But in truth what I feel is that absolutely the only thing I am now is a mother. Not a mother who breastfeeds her baby, like another of Dan's cousins is doing on the couch in the living room, or who changes diapers. But a mother who for the past six weeks has been recording herself singing lullabies on cassettes that she sets inside a pocket recorder in the corner of the crib at night before leaving the hospital. Who cannot focus on the newspaper or the television or keep up her end of a conversation because she is worrying about her children.
New Year's Eve
Dan and I head out at 8 p.m. to a pub en route to the hospital. We drink big pints of beer and eat tasteless potpies before heading to the NICU.
We sit on the vinyl hospital chairs watching our boys sleep. We don't say much for over an hour. My mother-in-law worries about me sitting here for hours at a time. She sends her daughters into the city to take me to lunch. What she doesn't understand, what no one can, is that the only time I find any peace is while keeping vigil over my children. At midnight the nurses go out to their station and exchange New Year's greetings. I kiss Gus first and whisper, "Happy New Year, baby."
It always takes me at least a half hour to leave. I kiss Sam, then Gus, then Sam, then Gus. The boys were here for nearly two months before I realized I could kiss them, that I wouldn't be giving them germs. One of the friendly NP's had leaned over me and affectionately placed a kiss on Sam's forehead. "He's going to have a thing for you," I said. "You're the first person to kiss him."
"You haven't kissed him?"
"I didn't think I was allowed." I was suddenly ashamed.
"I feel so terrible," she said. "It's awful that you didn't get to kiss him first."
"Oh, no, please," I said, still trying to carry the joke off. "I have a feeling he's going to be liking blondes from now on." And then I smacked a loud kiss on Sam's cheek. Later I heard her telling one of the other nurses how bad she felt about it.
I have dreamed about this day.
On their due date, a nurse tapes probes to Sam's and Gus's feet and attaches them to portable heart and breathing monitors before pulling the lead wires off their tummies. Suddenly our boys are no longer hooked up to the hospital computers. They are free.
And then there I am with my boys, in the waiting area, everyone smiling at us, not even glancing at the emergency oxygen tanks behind the couch.
"Don't you feel as if we've stolen them?" I ask Dan on the drive home.
"Shhh," he says, concentrating on navigating the city streets as if it were his first time behind the wheel.
The cribs have been made up for weeks; the diapers are on the changing table. I remove the boys' hats, and Sam and Gus open their eyes. I lift Sam from his car seat, and Dan unzips and pulls off the white down snowsuit not really necessary for the five steps to and from the car. But bundling the boys up like Eskimos had been a joyous rite of release, like throwing tasseled caps to the sky at graduation. Our two small souls are home.
We drop the boys off with Dan's parents for the weekend so that we can go to my brother's wedding, in California.
Sam and Gus are intrigued by their grandparents' German shepherd, and I wonder if I will eventually have to get them a dog. Sam has just started to sit unsupported. Gus still flops forward awkwardly even when propped up with a Boppy pillow. Why can't he just sit up? Even if I adjust for his corrected age, which is 7 months, according to the books he should be able to sit without support by now. Will excitement at Sam's achievements always be undermined by our wanting his brother to catch up, and vice versa? Dan and I play a game my brother invented on his last visit in which we press our noses against theirs and say "near," pull our faces away and say "far" in silly nasal voices that make Sam and Gus laugh and laugh.
Out in California, my brother, Will, and his fiancèe, Lane, are married outdoors under a perfect blue sky. If I am with Sam and Gus, making eye contact or laughing with them, I can note their intelligence. But across the continent, worry clouds my recollection of them and questions resurge. Why is Gus so much easier to engage in toys and books than Sam, who can seem remote? Recent studies suggest that the stresses of preterm birth might derail the normal development of brain cells. When will I start to define motherhood according to my experience of having boys rather than girls, twins rather than children of different ages or an only child, as a parent of a lanky brown-haired boy and a smaller blond boy, instead of primarily as a mother of preemies?
A study of preemies who struggled with behavioral and learning problems during childhood and adolescence concluded that they led well-adjusted, normal lives once they reached adulthood. The Essential Guide for Parents of Premature Babies says that most reach average weight and height, though often not until late adolescence. If I can just make it through 18 more years, will the shock finally subside?
My brother and his bride exchange vows, and I start to cry. Not because they look so happy together, which they do, but because there will be difficult times ahead; because minutes after the service ended, Will has already requested a strong Scotch from the bartender, and the day is achingly beautiful; because we are unable to see splendor without contrast; because there will always be near and far.
Jenny Minton is a freelance writer.