Sally lay motionless in the hospital bed. Asleep. The night-light’s amber glow kept me company in the dark as I dozed, woke up, shifted in my chair, and nodded off again. Each time I woke, there was a moment of hope that none of this had happened, and that I was at our apartment, and that Sally was beside me, still pregnant. But the side rails of Sally’s hospital bed, and the quiet murmur of the nurses’ station across the hall, brought me back to this chair. This room.
Sally’s hair fanned out against the pillow. Her breathing was quiet and regular. Sarah was in a bassinet in the newborn nursery. I’d held her earlier, so tiny, almost weightless in my arms. I’d been relieved to hand her back to Sally. I stood and stretched, and looked out of the window again. The sky was still black—the stars washed out by the mercury lights above the empty parking lot adjacent to the hospital. Doctors’ parking. Across Manning Drive, cars came and went from the parking deck, all night. Family members. I sat back in the recliner, and closed my eyes again.
Anne-Marie, an intern, knocked quietly on the door and tiptoed into the room. I must have dozed off again. I checked my watch. Five forty-five. Anne-Marie was pre-rounding: checking on her patients before morning rounds, during which she would update the attending—the doctor in charge—on each patient’s status. A couple of months earlier, during my rotation on obstetrics, I had been assigned to her team.
“Good morning,” Anne-Marie whispered, as if hoping to check on us without waking us completely. I appreciated her thoughtfulness: when the other intern on the team entered, he would snap on the lights and bellow out, “Congratulations. How’s my favorite mother and baby doing on this beautiful morning?” The couple—if the father was present—would startle and blink.
“I like to find out if everyone is okay before I say too much,” Anne-Marie had told me, late one night, on the labor and delivery ward. “It’s easy to assume that people are happy about a new baby. But you never know.”
Anne-Marie used her penlight to check the bandage across Sally’s lower belly, from the C-section. She pulled on a pair of exam gloves and gently prodded the white silk tape. “Clean, dry, and intact,” she whispered. She knew that Sally was a nurse and knew what to look for on the bandages after surgery. “I need to check your lochia,” she said. Lochia is the postpartum vaginal discharge—blood, mucus, bits of placenta. Anne-Marie hooked a finger under the elastic band that held Sally’s menstrual pad, pulled it forward, and shined her penlight onto Sally’s crotch. “Good down here, too,” she said, as she pulled the covers back up to Sally’s waist. “Breasts okay?”
“Just a little sore,” Sally whispered back. “Not bad.”
“Good,” Anne-Marie said. “See you again in an hour or so.” She turned to me. “You okay, Paul?”
“I’m fine,” I whispered back.
At seven o’clock, Anne-Marie and Dr. Gage came by. The rest of the team—medical students, interns, third- and fourth-year residents—all stayed in the hallway, instead of herding into the room as they normally would. I didn’t know if this was because I was a student here, or if it was because our baby had Down syndrome. Either way, it was fine with me. I really didn’t want to see anyone unless I had to.
Sally had breakfast, and dozed in the hospital bed. I was in the vinyl-covered recliner, my back to the window. The morning sun was warm on my right shoulder. The cushions of the chair sagged: I was not the first new father to sit in this chair.
Probably not the first one to feel trapped, either. But Sally and I were better off than a lot of new parents. During the second year of medical school, in genetics class, I had learned about an entire universe of human maldevelopment. Our textbook was filled with black and white photographs of malformed humans: page after page of disconjugate gazes, pigeon chests, and extra digits. Dwarves holding hands, acromegalics with bulging foreheads and protuberant jaws.
The dispassionate tone of the textbook didn’t erase the feeling of a carnival freak show. Some pictures looked like mug shots: one view facing forward and one from the side. Others were full-frontal photographs: breasts with small dark nipples, thick thatches of pubic hair, small phallic nubbins shrunken from cold or fear, arms to the side with palms turned forward, eyes staring straight into the camera. These were subjects. They were specimens. Some of the eyes were covered with a black stripe, to protect the individual’s privacy. I was never sure whose shame those stripes were meant to assuage: the person in the picture, or the person staring at it.
The most photogenic children were the ones with Down syndrome. Those smiling faces seemed less scary, more approachable than the others. Guileless. But when I read the printed text beneath the photographs, I was stunned by the list of dysmorphic features. Epicanthal folds—a downward tuck of skin at the corner of the eyes that give a slanted appearance. Brushfield spots in the iris—small white specks in the pigment’s periphery, focal aggregations of connective tissue. A small nose with a flat bridge. Small, low-set ears. Flattening of the back of the skull. A tendency of the tongue to protrude. A single crease in the palm of the hand. A wide space between the big toe and the second. Depression. Alzheimer’s. Heart defects.
I shifted in my chair. Sarah had two heart problems: a VSD—ventriculo-septal defect, which is a hole in the wall between the two lower chambers of the heart—and a patent ductus—a remnant of the fetal circulatory system. She’d had the cardiac ultrasound; the defects were small and wouldn’t need surgery.
I looked at Sally. Her eyes were closed and her respirations easy. Sleeping or resting; either way, she was closed down.
Sunk back into the comfort of the vinyl chair, my body was tired, but I was wide awake. There was no way out.
My eyes felt tired. I closed them. The August sun felt good on my shoulder, but the room was air-conditioned to the point of being chilly. I could go to the nurses’ station and ask to have the AC turned down, or ask for a blanket. Probably could get a warm one. But I might see a classmate and have to answer questions about Sarah.
I settled back into the forgiving, cushioned chair, and felt myself drift toward sleep.
I woke with a start, and looked around the room. Sally’s eyes were open. I’d drooled in my sleep. I wiped my chin with my palm, and then wiped it against my jeans, and wiped my face again. “Reminds me of studying in the library at UNC,” I whispered, unsure of why I was whispering since it was daylight outside. “Surest way to have a good-looking woman sit nearby—doze off and wake up with your face covered in drool.”
Sally smiled, but her eyes didn’t crinkle.
“We okay?” I asked.
She shook her head. It looked as if she were saying she wasn’t sure. She might have been saying no.
“Oh, Paul, you’re going to learn so much.” Elaine was one of our first visitors. Her hands were clasped together and she leaned forward, her forehead creased, eyebrows raised at the center, sloping downward. “You’re going to learn about patience, and acceptance, and unconditional love.” Her eyes were light blue, and sharply focused on mine. A small meniscus of tears formed in each lower lid.
I felt myself leaning away from her.
“You didn’t know, did you?” Elaine touched my arm. “My Tony. He has Down syndrome.” She looked over at Sally, sitting in the bed. “He’s twelve.”
Elaine and I had worked together in the ER when I was a nursing assistant paying for college. A fit woman about my age, she always wore a white turtleneck, dark blue scrub pants with an elastic waistband, and a light blue jacket. She’d sometimes laugh along with us at the cynical jokes in the nurses’ station. She was a competent nurse, but never the first to grab a dying patient’s arm and start poking with an IV. She was more likely to be one row back, documenting the code as it went along, or going to get the crash cart, or calling X-Ray to say we needed a STAT portable chest x-ray. She lacked that hard little edge that seems useful in an emergency, as if she was too emotionally porous, or too aware of how high the stakes were, to be the one the docs called out for when a patient was dying.
“It gets better,” she continued. “Easier.”
“Thanks,” Sally said. Her voice was still hoarse from the day before.
“Is the baby all right?” Elaine asked. “Otherwise?”
“Small VSD,” I said. “And a patent ductus. Neither needs to be fixed.”
“Good.” Her tone was emphatic, and her ponytail bounced as she nodded. “Tony needed open-heart. He did great, but I’m glad your kiddo won’t need it. Boy or girl?”
“Girl,” Sally said. “Sarah.”
A nurse I hadn’t seen before stood in the doorway, holding our daughter. “Knock knock,” she said.
I twisted in my chair to see her. “Come in.”
“Someone’s hungry,” the nurse said. She jostled Sarah gently.
“May I?” Elaine stood, and pulled open the corner of the receiving blanket. “She’s beautiful.”
Sally smiled. I did too. Reflex. Our daughter wasn’t beautiful, and I knew it. But I liked Elaine and appreciated her effort to help us. And I was quickly learning to pretend. I had missed my chance to be a proud new father. But I could fake it.
“I won’t intrude any longer,” Elaine said. She handed Sally a scrap of paper. “My name and number. Call any time. Any reason.”
“Thanks.” Sally’s eyes filled with tears. “I will.”
Elaine turned to me, holding her arms out for a hug.
“You take care of yourself,” she said. The force of her embrace surprised me.
Sally pulled down a small triangular flap on her nursing bra. Her breasts were swollen and hard.
“Engorged?” the nurse asked.
“Maybe a little.” Sally prodded her breast with two fingers. “Sore.”
“This’ll help.” She handed Sarah to Sally.
Sally caught her lower lip between her teeth as she guided Sarah’s mouth to her nipple. Sally relaxed back against the pillows.
When Sarah was done, Sally placed her against her shoulder and burped her.
I rewrapped her in the flannel receiving blanket, and held her in my lap.
Someone had sent us a flower arrangement—pink carnations and roses, surrounded by baby’s breath. I pulled a small carnation free and broke off the stem, and slipped the flower behind Sarah’s left ear as she slept. Sally smiled. Her eyes crinkled, for the first time in two days.
I looked back to the flower beside Sarah’s downward-slanting eyes. I felt my face flush hot, paralyzed by the simple fact of a newborn and a flower.
Later, when the nurse came to take Sarah back to the nursery, she laughed and silently clapped her hands when she saw our daughter snuffling in her sleep. “Look at you,” she said. “The prettiest girl at the party.”
I was relieved that the flower looked playful. It’s how I had meant it: playful and hopeful. My daughter didn’t belong in a black and white photograph with a black stripe across her face in some textbook. See? She has a pink carnation behind her ear.