The Apneic Event

NICU photo

At about 6:30am, or, as the doctors were soon to put it, “at about one hour of life…”, Sam seemed awake enough that Noelle thought it would be a good time for him to try breastfeeding.  Brooke held him up to her left breast.  He started sucking, and Noelle showed Brooke how to break the airtight seal that forms.  After she did this, Sam’s head sunk down below Brooke’s breast.  Brooke said “did he go to sleep?”

Noelle said “maybe, let’s…” and picked his head up, but it fell right back down.

He wasn’t breathing.

Right then, the new baby nurse (Lucia had rotated out) stuck her head in the door for a routine check – “how’s everything going in here?”

“Good timing actually” Noelle said, “he just looks a little…”

“Let me just take the baby over here and look at him.”

The nurse calmly took two steps towards the mini-OR-looking area in the corner of our room.  She must have pressed a silent alarm or yelled something out the door, I honestly don’t remember.  Within 10 seconds there were six people in the room.  One doctor (we had spoken with him a few hours back, he had just stopped in to introduce himself as the doctor on call), and several nurses, physician’s assistants, or nurse’s assistants.  I don’t think Joy was there.

The next few moments — this is a real challenge to describe, the feelings were so frightening, terrifying, and still are.  People use the phrase “I shudder to recall…” and most of the time they’re speaking figuratively.  I am not.  Every time I have told people this story in the past six months I have had to fight back tears and a tremble in my voice.  It’s causing me great difficulty even to type (and now to edit) these words.

I’ve gone over again and again how to describe this moment.  As the baby nurse carried Sam over to the table, I stood up involuntarily but could not move.  It felt almost exactly like it feels in a dream when your legs can’t move, except it had this added terrifying aspect, which was that it was real and I knew it was real.  Usually when that happens in a dream is about when it dawns on you that you are dreaming.  It’s scary because maybe you’re running away from someone who is trying to kill you, but it’s reassuring because you know right then, you intuit right then, that you’re dreaming.  But here, I felt the same inability to move, the same surreal drifting and inability to act, but I knew that this was really, truly happening to me.

I thought I was watching my son, who was one hour old, die.  This is how it looks on TV when someone dies.  A group of doctors rush in, then huddle over a table and execute deft and efficient movements, communicate in chopped sentences, and then a resigned doctor holds his wristwatch to his face and says “time of death, 6:34am.”

While I stood there, Brooke got my attention and moved with her eyes, gestured me to go over there.  She couldn’t even stand up yet.  I drifted over past the end of the bed but stood in the corner, still unable to move.  I felt a deep instinct to do something but I did not know what to do and I was unable to do it.

It will perhaps sound melodramatic for me to say this but I have concluded that this was the single most horrifying and sad moment of my life.  One of the reasons I’m sure of this is right then, while I was standing helplessly staring on as a few doctors massed around my helpless son, I quickly and involuntarily ran through a list of all the other most terrifying and saddest moments of my life, and just as quickly and involuntarily concluded that this was worse than each of those.  I considered each of them singly, felt the sting and hurt each of those moments had caused, and then felt this one in comparison each time, and it felt worse.

I thought and felt many other things in this moment, one that likely lasted no more than 7 seconds.  After thinking through all these other horrible moments in my life, I thought about how profoundly sad it was, all the time, effort, waiting, hoping — and this was how the last almost-year of our lives – Brooke’s, mine and Sam’s – would end.  I thought about Abraham carrying Isaac to the altar, and the rest of my religious experiences (especially the Jewish ones) raced through my mind.  One thought that stuck: I thought of “dayenu,” the Hebrew word that names a song, and the refrain from that song, sung at my family’s yearly passover seders.  “Dayenu” means “it would have been enough.”  The song is about all the things God did to help the Jews from captivity to freedom, and each verse ends with “dayenu” – “it would have been enough.”  “Had god brought us forth from Egypt but never built for us a temple, it would have been enough.  Had god built us a temple but never hallowed our lives with commandments, it would have been enough.”  There are 10 refrains, echoing the earlier 10 plagues upon Egypt.

I thought – if Sam now died, after having been here for just an hour, it would have been enough – or really – it would have to have been enough.  That might sound laconic but it felt anything like that in the moment – the contradictory and powerful emotions locked up within “dayenu” – such an ancient word – it couldn’t help but seem onomatopoetic, spread out over millennia of transmitted experiences and burst forth into my soul.  What I thought was “it will be the saddest thing that has ever happened in my life, a thing from which I will never recover, but if he was here only for that time, it would have to be enough.”

I heard in that Hebrew word something I’d never heard before, which was a deep longing, a deep desire on the part of human collective memory to believe something we cannot believe, or believe but could not feel.  Or could feel but could not accept.  It was a feeling of inevitable and ultimately sad acceptance, Kierkegaard’s “infinite resignation.”  I had no faith that Sam would survive; in the height of the moment, I could not undergo Kierkegaard’s “double movement.”  I found no strength in the absurd.  I didn’t find the absurd, only a sense of total absence, failure and pain.  My hearing all went fuzzy except for the beeping of the monitors and the shuffling of doctors and nurses, but there was a profound silence supervening upon it all.

It may seem odd or unrealistic that I thought about all of these things and felt all of them, but I really, truly did.  That whole “your life flashes before you” thing turns out, at least in my recollection of my experience, to have been true.  Those 7 seconds stretched forth as a huge, yawning abyss, because like a camera in slow motion, my mind was operating at so many more frames per second than it ordinarily does.  I was able to think about my whole life, my son’s whole life, God, and the doctors all terrifyingly instantaneously.

I remember being able to tell immediately that all of the medical people knew exactly what to do.  There was no hesitation.  Everyone stood at the side of the table equally spread around in a circle as though in positions that had been assigned to them.  A light was on.  The doctor was touching Sam but I couldn’t tell what he was doing.  My first guess was that he was administering CPR, which would mean, as I knew well, that his heart had stopped beating.

While I stood there, I felt like I was melting into the floor, diagonally receding into oblivion and uselessness.  The final, frenetic and minor/chromatic moments of Bach’s 6th English suite played in a terrifying, compulsive loop in my head and I thought everything was spinning far too fast for me to react.

The next thing I remember is the doctor said “has he been breathing like that the whole time?”  It sounded from his voice that he was breathing too hard or too quickly.  He directed the question at the baby-nurse and for just a moment I thought he was blaming her for this, as if to say “you (womanly) fool, why haven’t you handled this?”

But, student of Bertrand Russell and the subtleties of the English present-perfect that I am, my deductive mind knew that “has he been breathing like this” meant that he WAS NOW BREATHING.  I grasped onto this while the action wound down.  It wasn’t CPR I saw, what I had seen instead was the doctor using a horn with a squeezable ball at the end of it, to blow air through Sam’s mouth.

They wrapped Sam up in a blanket and watched him for a few more minutes.  Convinced that he was stable, they then brought him over to us, let us hold him and kiss him and told us they would be bringing him to the NICU (the neonatal intensive care unit) to do some tests on him and make sure he was okay.  Before he left, I remember holding him up and tearfully looking at him before my eyes and asking (quietly, so only he could hear) “are you ready for this world?”  I honestly didn’t know.  It was not a rhetorical question: I wanted him to answer.   Abraham and Isaac at the altar again rose up in my feelings.

The doctor (who turned out to be perfectly nice, and not sexist) sat down and spoke with Brooke and me for 10 minutes or so.  He explained that around once a month, this just happened: babies just sometimes “forget” to breathe, and 99% of the time they were fine.  He explained that they were going to attach him to an IV to give him some glucose, because trauma like this could take a lot of energy from a newborn, and they were going to start giving him antibiotics too, just in case this was related to an infection he might have.  They were going to test for the infection, but since that would take almost 24 hours, just to be sure, in the meantime, they would give him antibiotics.

After Sam left, I collapsed on the bed next to Brooke and started crying uncontrollable.

Some time after that, I sent that text – “So we just had a scare…”, probably near 7:30am.  Noelle had just left (but promised to call us to follow up in a few hours, which she did).  We were left holding a piece of paper on which they had made Sam’s footprint impression.  I sat there looking at it, thinking this was all we had, that our son wouldn’t make it, this was all that would be left.  I texted a picture of it to my family.

Abby replied: “10 toes!”



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