Atticus and the PICC Line

Part of the guilt of having a baby in the NICU was that your baby went through so many things without you.

Many of these things were unpleasant. We were assured Atticus wouldn't remember the procedures and painful encounters. This was a relief, but it also bothered me at times. How would his body process all of these experiences? How would we explain to him later about this time, if we so rarely saw all that he went though? Someone needed to be a witness, to validate that it had happened.

Atticus needed a new PICC line so that he could receive sustained medication treatment for the Group B Strep infection. He also needed a spinal tap so they could check him for meningitis (Max covers the lead-up to all of this wonderfully). I asked if I could stay to watch these procedures. Or I lingered and made it obvious I was going to stay. Either way, like something in a dream, it was happening and I was there.

For the spinal tap they almost had to bend him in half so that they could get to his spine. His body was still so tiny, though also long and lanky. Watching them handle him was a totally unnerving experience. It was like he was both human and dough. They touched him deftly, carefully, but they also moved him into whatever shape their procedure required.

I had taken a needle in my spine for the epidural a few weeks earlier. I'd had to fold myself into as tight of a bend as I possibly could, while having contractions. As I watched them bend him it was the only time I felt like I might have experienced something my son was going through. But even then, there was no real comparison. In my memory I was a big person on a table choosing to bend myself, while he was here, a tiny person who was being bent.

The bending was quick. They squished him up and inserted the needle, but there was no liquid to draw. Apparently Atticus was too dehydrated to give any fluid. Even the staff seemed deflated after this, but there was still the PICC line to go.

Our doctor introduced me to the technician who would insert the PICC line. She was a slender, confident woman about my age, whom our doctor recommended with great praise. I greeted her, probably without shaking hands, to relieve the pressure to go wash our hands again. Then I tried to find a place where I could commence my mighty witnessing while also standing out of the way.

This was often a problem on the NICU, trying to find the balance between being present and not getting underfoot. The unit was primarily open, with 'rooms' sectioned off by curtains. At this time Atticus was still on C-hall in a cosey corner that had a wall on one side and a long curtain that could be pulled around our space for extra privacy.

The physical presence of this curtain was both comforting and maddening. I was often lingering among the fabric of it, feeling it brush against my back as I waited off stage in the wings while my son shone in the excruciating light of painful experience. Standing there watching other people care for him, I felt useless. There was sufficient time to deeply question my as-yet-unknown ability to parent, should I be fortunate enough to take him home after all of this.

I stood behind Atticus's incubator as the PICC line nurse and her assistant flipped latches on the incubator and, low and behold, Atticus was lying in the open air with a heat-lamp nearby to keep him warm. They dropped the sides down so they could reach him easier.

He was moving (he was always moving). He could move so many parts of himself at once with his tiny, sinewy muscles. His feet and hands floated up in the air, fingers splayed, his skin still moist from the incubator. They moved him so they could get to his legs. I'd been told that they would try to insert the line through his leg or foot, since the previous location on his wrist had been compromised by the infection. They began to wipe down his leg with alcohol swabs.

At some point they produced purple cloths which looked a lot like restaurant napkins, and placed the cloths over him, covering up the parts of his body they weren't working with. They even laid one over his head. When they were done he was a mound of purple cloth with a leg poking out of the bottom. He was still moving and wiggling. It was the friendliest little leg.

A PICC line is a long, thin plastic tube that can snake through a vein. The nurse rolled up her sleeves to begin inserting it. She broke the skin on his foot near his ankle and began to push the little plastic tube bit by bit. It was awful to watch. She had a strong hold on his leg and he couldn't really do much, but he was trying. I could see the purple mound moving more energetically, could hear his soft little cry. 

It was so slow, the pushing of the line, and at one point she stopped and gave up because it wouldn't go any further. Then she pulled it back out and tried at different place on his leg, somewhere below the knee. This one also refused to go through.

I could tell my anxiety was making the staff nervous. I now couldn't bear to continue looking at the procedure. When she moved to try the second leg I had to step away and stand by the windows at the front of the hallway. I could tell I wasn't helping, and though the problem seemed to be his dehydrated veins, I might've made it all worse by making them nervous. All I could do was try not to hate myself for the luxury of being able to move away from this scene, and pray that they would succeed, quickly.

Each time we visited Atticus we would say the 23^rd psalm to him, and we prayed sometimes together, out loud. This gave the outward impression of great devotion, a sanctity not really reflected in our church-less lives, but hell. It was a coping mechanism that surfaced at that time, and I'm glad it did. Praying gave us a way to unite with each other and the multitudes of people who were also praying for our son. It gave us something useful to do while we waited in the wings. It also felt like the right channel to tune into, for surely if God were present anywhere, it was with all these struggling little bodies. And with all of us parents bent low. I stood by the window and prayed.

Atticus got the PICC line; I think they tried again a while after I left. He got his antibiotics, his body slowly hydrated, and he began to heal. I went home that night shaken and hopeless, having born witness, but hoping he would only forget. Forget all of it, including my useless words to him as he was contorting under the cloth.

Why Emily Dickinson (Part 3)

I have a tendency to not look at things.

During the C-section I looked away from the screen that showed me what was happening below my waist, behind the curtain. It was too bizarre. Something on a TV screen at eye level was happening to me, and I couldn't feel it due to anesthesia. It was a three-times-removed sensation of a birth that I couldn't actively participate in, couldn't feel, and could only watch on a TV screen. So I didn't watch. I waited for it to be over, for the nurses and doctor to tell me that Atticus hadn't made it.

If I'd known the outcome I would have felt differently, and would have participated in a different way. But at this point I was all vehicle, a shopping cart in a grocery store, with items being placed on the check-out counter for final transaction.

There was a well-meaning anesthesiologist at my end, going on about how wonderful a c-section was. I was grateful for his presence, but wished he could have been silent. This was so far from what I'd wanted. I'd never felt this utter and complete sense of helplessness and dismay.

I'd followed Atticus's progress on ultrasounds and in books that gave week-by-week updates on his development. But my experience of having a person growing inside me made it hard to imagine him being really like a person yet. I didn't know how Atticus could come out whole. It felt like he should still be a part of me. I couldn't picture what they would remove from the strange hole.

This process could only be assisted by medical professionals, and I felt safe in their hands. I knew I had done all I could to bring Atticus here in one piece, and for whatever reason it hadn't worked. I couldn't deliver him. So all I had to do was lay back and they would get him out.

Emily Dickinson, in her poems, is acutely attuned to her emotional reaction to the world. Part of her ability to do this comes from the way she explores her own mind. She's so familiar with her thoughts she can catalog the presence of new and old:

A thought went up my mind to-day

That I have had before,

But did not finish,--some ways back,

I could not fix the year,

Nor where it went, nor why it came

The second time to me,

Nor definitely what it was,

Have I the art to say.

(from Selected Poems XLVI)

And she has so explored the contours of her own mind that she forms a structure out of it, with physical dimensions:

It dropped so low in my regard

I hear it hit the ground,

And go to pieces on the stones

At bottom of my mind;

(Selected Poems CXVIII)

So her mind has both a stone floor, and in the first poem, something like a flag-pole that a thought can rise on.

When difficult events befall, I am often more interested in living in some corner of my mind, as if there's a TV that's more interesting there than the one with my surgery on it. I live in this corner and watch it as if it will tell me what to do next.

I think this is the place in my mind from which poems happen. In trying to write about Atticus's birth and the NICU, it feels like stepping into a different space in which these memories are contained.

* * *

Entering the Room

Turn the handle. Inside it's bigger than you thought.

Sounds close in: beeping monitors,

sinks spraying. Babies are there.

Some of them are crying. You are downstairs,

you have yet to be in this room but your son

has come, watch them bring him

in a plastic bag to hold his warmth,

the ventilator white and round over his mouth.

Other parents gawk at the newcomer.

He comes out of the bag, they clean him,

settle him into the incubator

black velvet to protect his eyes,

a wire taped to each limb. Under the bent lamp

he slowly begins to wave the crooked branches

of his body like coral in the ocean.

Your husband comes in, gowned, upright,

fresh from the OR. When the tiny hand

closes around his pinkie you're still downstairs,

they rolled you to the place where people wake up.

Upstairs they explain handwashing, visiting,

how long this all might last.

December thirteenth. Your son's first night

never gets dark. The city sings to itself outside the window.

Downstairs you are yourself still

and also you are the one who birthed.

The cut where your son came out

is now a glued-together split.

You're trying to hold your arms and legs in place.

In the morning at shift change your son

sleeps behind the covers of his plastic house.

They have already drawn a little blood.

He's official: he has a clipboard and a team.

Here you come, in a wheelchair

to meet him, the first time

you've seen him outside yourself.

You know him & don't know him.

He's in the wrong place, red-raw

separated & unprepared for this.

You will watch him suffer,

you will carry him away

on a cold bright day in March,

blessed that he lived.

Having lived yourself

so close to his death for days

you will never quite close that door.

Why Emily Dickinson (Part 2)

A month or two after we brought Atticus home I realized all my mental escapes were gone.

There was no time to watch movies or read books for hours; there was precious little room for visits with friends. I'd quit playing bass at church a year ago when Atticus first went into the hospital.

The external input in my life had dwindled. I was going to work, coming home and taking care of Atticus, and going to work again. The lack of other spaces and people pressed in on me.

This is when I really turned to Emily Dickinson. I wanted to think about someone else's life and hers, the little I knew about it, was fascinating. I wanted to insert myself into it and look around. So I invented a new character in her story, a child that could shadow the great poet, to help me open up a door and look inside.

This idea still has an appeal to me. But after reading even a little of Robert Sewall's biography "The Life of Emily Dickinson," it seems like a waste of a chance to explore and re-imagine her actual, documented life. 

What strikes me often is how fascinating she is to so many people. A quick scan of the literature explaining Emily Dickinson at the college where I work gives me almost two shelves worth of biographies, criticism and interpretation. 

What is known about Emily Dickinson is based on poems that were found after her death, letters she's written to others, and personal accounts from documents of people who knew her. This would be like reconstructing your life from emails and texts you'd written to others, emails or texts which they'd kept because they liked you, or still happened to have them after they discovered you were famous. 

So it's basically an educated guess at what the people were really like, what moved their hearts, and what drove them to make the decisions they made.