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.