5

A twinge of pain hit my lower abdomen, followed by a light gush when I shifted in the glider. Uncertain of what was going on, I waddled to the bathroom and quickly noticed a pale pink streak of blood lining my underwear. My breath quickened. I wiped myself with a tissue, and found more streaks of light red.

“Eric!” I cried, suddenly feeling nervous and sick to my stomach. “Can you come here? I need you.”

Hearing the urgency in my voice, Eric appeared almost instantly. He held the plate of cookies in his hand.

“It’s blood. I’m spotting and I don’t know why.” I held the tissue up to the light and panicked again when I saw it.

Eric took one look and set the cookies down. He left to get the phone. I could hear him talking to the nurse who was clearly telling him to bring me into the hospital.

“They want to check you out, hon,” Eric said. He rubbed my back and wiped away my tears. “Just think. This could be it! Remember what they told us in our prenatal class. Early labour often starts this way.”

He guided me to our closet and I threw on the first outfit I could find. Eric grabbed the packed hospital bag that was waiting patiently beside my dresser, packed two months earlier, and held my hand as we walked down the steps.

Eric called his parents to fill them in on what was going on as he ushered me towards the car. “Yes, yes . . . I think she is fine. We’re just taking her in to check her out. Plus the nurse thinks it could be the onset of early labour. I’ll call you as soon as we know anything more.”

“Slow down!” I cried as Eric peeled out of our driveway and raced down the street. My knuckles turned white from holding onto the car door so tightly. “I know we need to get there, but we aren’t going to make it if you crash this car!” Ignoring me, Eric blew through a red stoplight. I cranked my head to look behind us, hoping that I wouldn’t find rotating cherries on top of a police car. I didn’t, and Eric kept his foot securely pressed on the gas pedal.

About halfway to the hospital, my lower abdomen started to contract and I knew I was in labour. The on-call baby doctor, who introduced herself as Dr. Marlow when she walked into the room where Eric and I were waiting, checked dilation and quickly agreed with my self-diagnosis. Despite being a few weeks shy of full term, our baby definitely wanted out.

Putting her hand on my knee, Dr. Marlow explained that, typically, a woman in such an early stage of labour would be sent home. It could be days of labour before Ella actually made her grand entrance. But Dr. Marlow wanted to watch me for a few hours to check my progress.

It was at the precise moment that Dr. Marlow was explaining all of this that my water broke in a huge gush, making the linens I was lying on sopping wet. “Well, looks like you just bought yourself an admission. This is the real thing!” Dr. Marlow smiled. “Let’s take a quick look on the ultrasound to assess final position and we’ll go from there.”

The nurse wheeled in the portable L&D ultrasound and squeezed the familiar jelly — this time not warmed — onto my aching abdomen. She narrowed her eyes at the black and white TV image before her. She frowned. Every muscle in my body matched the contractions that were going on in my gut.

“What is it, Dr. Marlow?” Eric asked, his hand squeezing mine a little too tightly.

“Looks like your baby is breech. Frank breech, to be exact,” she responded, her eyes still squinty and focused. They never strayed from the ultrasound picture. When she appeared to feel confident with her image interpretations, she removed the transducer from my belly and wiped away the gel.

“What does that mean?” I asked. Sweat beads lined my forehead and I struggled to breathe through a heightened contraction.

“There’s nothing to worry about at all, but your baby is upside down. She must have turned last week and now her bum is where her head should be. A vaginal delivery with a breech baby is risky so I’m going to book an OR and give you an urgent C-section. It is a very routine surgery and it will happen very quickly. My guess is that your baby will be here in the next hour or two, depending on when we can get a room. I’d call your folks or whoever else you might want to be here. This is really it.”

Eric squeezed my hand again, but this time it felt lighter and more excited. “I’ll go call our parents and tell them to come now. You okay if I leave you for a few minutes? I can’t get reception in the hospital and need to step outside.”

“Yes, yes . . . you go call them. I’m clearly not going anywhere.” I smiled at him, wanting to take in every moment of the milestone. In front of Dr. Marlow Eric gave me a long kiss on the lips, which made me blush with embarrassment.

Fifteen minutes later, Eric returned along with the nurse who had been put on my charge. She introduced herself as Nurse Nancy, which I knew Eric would have found amusing in a different situation, and told us that she needed to take me — without Eric — so that I could be prepped and given my spinal. Eric would be able to join me once I was completely frozen from the waist down and the thin blue curtain that we had seen in almost every episode of Grey’s Anatomy had been set up to separate us from the blood.

I waddled to the OR and was introduced to the on-call anesthesiologist, Dr. Tam. Nancy helped me on the operating table and told me to sit on the side and round my back so that Dr. Tam could stick the needle in my spine. She promised to stay in front of me so that I could prop my body up against her and hug her shoulders.

“The biggest thing is that I need for you to stay completely calm and remain still,” Dr. Tam murmured from beneath her surgical mask, as though it should be easy breezy to stay perfectly still when curled over a protruding, pregnant belly and someone is about to stick a six-inch needle into your lower spine.

“Squeeze tighter,” Nancy instructed. “It’s okay, honey, it will be over soon.”

And so it was. Within moments, almost the entire surgical team, who had entered the room while the needle had been in my back, were helping turn me over and get me into position. “We have to go quick,” Nancy explained. “We only have a few moments before you will be unable to move.”

When Dr. Marlow was satisfied that I was completely numb from the waist down, they called in Eric, who had changed from his street clothes into head-to-toe hospital scrubs, including something that looked like a big, blue shower cap on his head. He walked through the small operating room and took his position at my head. My arms had been spread out and strapped down on either side of me, my body making a big T position on the table, and Eric reached out to take my right hand in his.

Although I felt no pain, the intense tugging and pulling going on inside of me was severe enough to make me wonder if the ring of fire that accompanied natural births would have been better. I had no idea what they were doing, and didn’t want to know, but it felt like someone the size of a Mack truck was doing a line dance on my stomach and lungs.

“Here she comes,” Dr. Marlow called out over the blue curtain, only minutes after the surgery had started. I was shocked at how quickly things were moving. “Give me about one more minute and your daughter will be here.”

“This is it, Nic. We’re finally going to be parents,” Eric whispered into my ear. “I love you, baby.” I tried to take in the moment, but my brain would focus on nothing but the obese line dancer jumping all over my belly and preventing me from being able to breathe.

“Here she is!” Dr. Marlow held our beautiful baby over the blue curtain and we got our first glimpse of our angel. She was red and puffy with icky, white vernix all over her bald head. And she was perfect. “She is definitely a girl!”

The doctor handed Ella to the nurse who whisked her to a table about six feet from my head. I cranked my neck in an attempt to get a glimpse, but couldn’t see anything more than the nurse’s back. A few pink blankets were being thrown around, but I couldn’t get a glimpse of Ella.

I strained my ears to hear her cry, but heard nothing. I waited some more, but only heard my own heart beating in my brain, its sound echoing into my eardrums.

“Eric? Why can’t I hear her?” I tried to move off the table, but got nowhere. The pressure on my gut had ceased, but my body was still filled with lead and I couldn’t move a millimetre, not to mention Dr. Marlow was still putting me back together and stitching me up.

“Shhh . . . shhh. It’s okay. Ella is with the nurse, who knows what she’s doing. I’ll go have a look.” Eric gave my hand a squeeze and went to stand beside the nurse, who was hovering over Ella. He whispered quietly with her, before returning to my bed to retake my hand. “Ella is breathing on her own, which is great, but she’s having a bit of trouble, so the nurse is going to give her some oxygen. She said that babies often don’t cry when they’re born by C-section. Makes sense though. Right, Nic? Many times they are sleeping when the doctor reaches in and lifts them out, so they barely make a noise. Ella is in good hands, doll. She’ll be okay.”

Yet I could see the doubt registering on Eric’s brow. He also felt the unspoken medical diagnoses that had been dancing around us since Ella’s birth. Something wasn’t right, but what we did not know. Without needing to say a word to each other, I knew both Eric and I were wondering whether or not the doctors were aware of the problem and not telling us the update — or if they were completely unsure themselves.

After about two minutes of the nurse working on Ella, a second one joined her. From what Eric told me, they were aggressively rubbing her all over, trying to get her blood moving and her breathing stabilized. Five more minutes passed and the nurses told Eric that they felt Ella should go to the nursery. “It’s just a precaution,” the nurse who had joined Nancy explained. “She’ll be in a better place in the nursery where we have more available to us to get Baby’s breathing under control.”

It irked me that the nurse wasn’t calling our baby by her name. From the minute she entered the world, we had given her the name Ella, and the nurse had heard us calling her by her name.

The nurse continued, “Dad can come with Baby, if you’d like, or he can stay here with you. Whatever you’d like.”

“Our baby is Ella. Would you mind calling her by name, please? And Eric should go with her. I’ll be okay.” I grimaced, pain starting to hit my body, but not from the staples being punched in by Dr. Marlow. “Go, go, Eric . . . I’ll be fine. Please, I want you to be with her.”

Eric squeezed my hand and kissed my cheek before hurrying off in his head-to-toe hospital scrubs. He followed the nurses who were wheeling Ella in a baby cart — lined in a multitude of pink blankets — out of the room and down the hall to the nursery.

Caught up in my own rampant hurricane of thoughts, I didn’t even notice that Dr. Marlow had finished the surgery. I was lifted by a medical team of four onto my hospital bed. They wheeled me into the recovery room, but said nothing. I was grateful for the silence. I couldn’t speak and I didn’t want to.

After an eternity of waiting, Eric joined me in recovery and told me Ella’s breathing had improved slightly, but still wasn’t where the doctors wanted it to be. They had intubated her, and she was in an incubator.

“Dr. Lorel, the pediatrician on call, has ordered blood work so we can better understand what is going on. They said they will come and get us once they have the results.” Eric squeezed my hand again. “Your parents are in the waiting room, and mine are on their way. She’ll be okay, Nic. She’ll be okay.”

“I’m scared,” I squeaked out, interrupting him. The voice coming from my throat wasn’t my own. “And I’m supposed to be holding her right now. She needs her mommy.”

“I know, baby. She’ll be with you soon. Right now she’s in the best spot possible for her. Dr. Lorel isn’t leaving her side. And we’ll know more soon.”

“Can I see my mom?” I asked, suddenly wanting no one but my own mother to hold my hand.

“I’m sure it would be okay, given the circumstances. I’ll go to the nurses’ station to make sure. You sit tight.”

Eric returned with my mother in tow. She walked straight to my bedside and gingerly took me in her arms, kissing my head, careful not to strain my post-surgery body. “I know, sweetheart, I know. It’s very scary. We’re all scared. But Ella is with the best doctors and nurses, who are taking great care of her.”

She let go of her hug, and took my right hand in her own. On the other side of my bed, Eric took my left hand and the three of us waited together, linked by hands, until the doctors came to give us more information.

The doctor who had been watching over our baby girl was a man about my mother’s age. He had a thick neck and green eyes. He walked through the recovery room door and frankly handed us our fate, albeit gently.

“Your baby is struggling. We’ve intubated her, but she isn’t responding in the way that we’d like. She’s going through some cyanosis, which means she has some blue colouration in her skin and mucous membranes, caused from the higher counts of deoxygenated hemoglobin in her blood vessels.” The doctor cleared his throat, and continued, “I ordered blood work, and we learned that the albumin levels in her blood serum are abnormally low, which is something called hypoalbuminemia. I say that word in case you hear other doctors speak about it. Your baby is also severely hypoglycemic, meaning that she has drastically lower than normal levels of blood glucose. And she has coagulopathy, meaning that something is going on in her body to prevent proper blood clotting. We’re concerned given that the coagulopathy has increased her susceptibility to bleeding. We need to carefully monitor that.”

Eric dropped my hand. My mother held on. The doctor continued, “To be honest, we don’t know what is going on right now. We’d like to transfer her to Mount Sinai and admit her into the NICU for continuing intensive care and more tests. They are better equipped to handle her medical condition, and she’ll be transferred by a specialized neonatal ambulance that is already en route from Mount Sinai to pick her up. You are more than welcome to go with her, or you may stay here to recover. If you go, you will need to be transferred by a second ambulance at a later time. But, please, know that wherever you are and whatever you decide, your baby will be getting the best possible care with the physicians at Mount Sinai. They are some of the top doctors in the country.”

In a foggy blur, semi-induced by morphine, I somehow managed to communicate to Dr. Lorel that, yes, I would be going with her to Mount Sinai. Of course I would be going.

The nurses, who had been hovering outside the door while we spoke to Dr. Lorel, quickly entered the recovery room to start preparing me for transfer and then wheeled me to the Labour and Delivery entrance doors. Both ambulances were already there, one in front of the other.

The nurses stopped my rolling bed to let Ella pass. Warmed and protected by a small transport incubator, our precious angel and her entourage of transfer team specialists flew by us at a frightening speed. My heart collapsed as I took in Ella’s transfer device and all of its complicated gadgets, including a ventilator, various beeping monitors and a bunch of attachments that looked like itty-bitty baby pumps. The hurricane of activity — with our daughter in the middle like the eye of the storm — disappeared into the first ambulance.

I was next.

My own team of nurses and the paramedics who had been standing by transferred me onto the waiting ambulance gurney and, within moments, I had also been swallowed up. I watched from the inside as my tear-streaked mother pulled at her neck. My panic-stricken husband looked blank and absent.

“Are you coming?” I asked Eric who seemed to be frozen to the ground.

“I . . . uh . . . I . . . I can’t. I can’t. I’m sorry. I’m so sorry. But I can’t. I can’t.”

I felt all the blood drain out of my already panicked body. This wasn’t happening. My mother stepped up. “I’ll go. Eric, you stay here with your parents. We’ll call as soon as we know anything.” Dumbfounded, I watched as my mother — not my husband — climbed into the ambulance and took my hand.

My mother and I said nothing to each other the entire ride to Mount Sinai. But she never let go of my hand. Not once during the entire ride.

Three hours later, Eric walked into the private Mount Sinai hospital room where my mom and I were waiting. His eyes remained focused on the ground, his hands jammed into his jean pockets. I could see through the door that his parents were with him, but had waited in the hall.

My mother was still at my bedside, holding my hand. She had spent the past few hours crying with me while we impatiently waited for updates from the doctors. None had come, and they were still taking tests and trying to figure out what was wrong with Ella.

“You decided to come?” I said, more sarcastically than I intended.

“Nicky, I . . . uh . . . I don’t know what to say. Everything happened so fast, and I panicked. Is she . . . is she okay? Is Ella going to be okay?”

“We don’t know yet. The doctors are still examining her and taking more tests. I haven’t been allowed to even see her yet. No doctor has come by. We’re just going on what the nurses are telling us.” I refused to waste my energy on him. My focus needed to be on Ella.

Eric awkwardly stood next to the bed, looking as though he was near tears. Neither of us knew what to do or say. The spiral of complicated emotions seemed to encircle the room at increased speed with each passing minute. The morphine I had been given after my C-section was beginning to wear off and I needed to remain perfectly still to avoid the searing jabs from tearing through my lower abdomen.

“Why don’t I give you two some privacy?” my mother asked, standing from her chair. “Nic, will you be okay if I take a walk and get some coffee? I’ll bring you back a latte.”

“Yes, thanks Mom. That would be great. And I’ll be okay. Thanks for being here and staying with me.” I failed at my attempt to smile at her, but wanted her to know I was grateful for her support. Plus, I was unable to prevent myself from throwing a verbal dagger Eric’s way.

When exiting the room, my mother patted Eric on the shoulder, as if to tell him that it was okay. I knew she understood everyone reacts differently in tragic situations. She had been handed some doozies in her lifetime and had come to believe that it is not possible to know how you will react in a bad situation. That is, until you are in it.

I was not as understanding. I was devastated by all that had happened, and insurmountable panic was consuming every inch of my body. I was scared, oh so scared, about what lay in our path. And like the cherry on top of our squashed cupcake, my husband had crushed me when he had abandoned Ella and me at a time when we needed him the most.

Eric and I sat in silence. We said nothing to each other. The agonizing minutes crawled by at a pace slower than dial-up internet. I didn’t trust myself to speak. I didn’t even trust myself to look at him. He had taken my pain to a higher, more explosive level, and I was worried about what would come rushing out of my mouth if I began to talk.

Forty minutes later, after my mom had returned with my father, Eric’s parents and six lattes, an exhausted and visibly upset doctor came into the room. He didn’t introduce himself, but his badge read Dr. McKinnon.

After confirming we were Ella’s parents, he cleared his throat and stated, “I’m sorry to tell you that your daughter is very sick. We’ve been running tests all afternoon, and we suspect she has something called neonatal hemochromatosis. It is a very rare condition in which toxic levels of iron accumulate in the liver and other tissues of a fetus. It occurs while the baby is developing in the womb and occasionally, but not often, can be detected in utero by ultrasound.”

Dr. McKinnon paused, and let us take in what he was saying. I could hear Eric’s mother crying softly in the corner and my mother went to her side to comfort her as she wiped away her own tears.

“What does it mean?” Eric asked, suddenly seeming more angry than afraid.

“She has liver failure and now her other organs are shutting down. She doesn’t have much time,” Dr. McKinnon said gently. “You should come and spend time with her in the NICU. I suspect she has only a few days. We are doing everything we can for your daughter. We have the pediatric liver specialists from SickKids Hospital suggesting experimental treatments for us to try, but so far she is not responding to our resuscitative measures.”

My breath left me. I struggled to move. I needed to get out of the bed and go to her. But I was tied to the bed by catheter and IV. Dr. McKinnon gently guided me back down, and explained that I would be able to see her as soon as the nurses cleared me to go in a wheelchair — probably within an hour or two. Dr. McKinnon turned to Eric and told him he could visit the NICU with him if he would like as he was returning there immediately.

“Can you bring Ella here to the room?” Eric demanded, squishing his face into an expression I didn’t recognize. His eyes seemed both disturbing and new — even to me — his wife and partner of almost fifteen years.

“We need to support her breathing and organs right now, and I think it’s best if she stays in the NICU. An entire team is doing everything we can for your daughter.”

“Will she . . . can she . . . is there a chance this might get better?” I was clinging to hope.

“Occasionally, but not often, some newborns have been known to overcome the effects of neonatal hemochromatosis. But you need to know that Ella’s condition is severe — the worst we have ever seen. You need to prepare yourselves. . . .” He paused, almost at a loss for words. “I’m so sorry.”

“When will you be back?” I asked, desperate for the doctor to stay, yet knowing it was better if he was with Ella.

“One of our team members will bring you updates. I will try and come back later this evening, but the nurses are also here whenever you need them.” Dr. McKinnon paused, his gaze shifting from Eric to me as an empathetic sadness filled his eyes. “I’ll ask a nurse to see if we can get Nicky into a wheelchair soon. So you can both come together and see Ella in the NICU.” He quickly left, seemingly uncomfortable and anxious to exit the room.

“Thank you, doctor,” Eric replied, barely above a whisper. He sank into the chair at the end of my hospital bed, and buried his head in his hands, shoulders shaking with his sobs.

My mother came to my side and sat gently on the bed to make sure she didn’t tug at my catheter or cause pain to my fresh C-section wound. Gingerly, she pulled me into a warm hug so we could cry together.

Yet my tears didn’t come. I was numb. In shock. Denying everything the doctor had told us. For some reason, at that moment, I felt absolutely nothing.

Brian stood awkwardly in the corner, moving his hands from his pockets to his side, while Amelia sat on the arm of Eric’s chair, her hand placed firmly on his shoulder. Brian muttered something about needing air and quickly left the room, shooting his wife an apologetic look before he disappeared, promising he would be back soon.

From my bed, I could hear Amelia’s soft words, whispered through her sniffles. “Go to her, Eric. She needs you. You need each other.”

Slowly, Eric stood to full height and crossed the room. He stood beside my bed, and awkwardly patted my back in a way that reminded me more of a proud father congratulating his son after scoring a goal than a husband consoling his wife in a tragic time of grief.

I turned from my mother and held my arms up to Eric, as though I was a toddler wanting to be picked up. I was desperate for him. I needed him.

When Eric finally kneeled beside my bed and opened his arms to me, I buried my head in his chest, my arms clinging to his neck. His strong arms wrapped themselves around me in an embrace that felt more familiar to me than anything I had ever known.

I collapsed into him. And then the tears came.

A short while later, Dr. McKinnon reappeared at my bedside. He gently placed a hand on my shoulder, and said the words I would never, ever, forget, in a voice that was filled with softness and compassion. “I’m so . . . I’m very sorry to tell you this, but Ella has taken a turn for the worse.” The doctor paused, almost as though he were waiting for something, or someone. Then, he cleared his throat and continued, “We’re going to bring her to you now so you can be with her in the short time that she has left.”

I stared at him, letting the silence fill the room. Panic pulsed into my throat, threatening to suffocate me.

“How long do we have?” I croaked, unsure of where my words had come from. I recognized my own voice as much as I did Eric’s eyes, which seemed to have adopted a foggy glaze.

“Maybe an hour or so,” Dr. McKinnon replied softly, his voice barely above a whisper.

“Shouldn’t you be keeping her in the NICU? You said that was where she needed to be — that you need to support her. . . .” Eric questioned. The doctor shook his head sadly and, from behind him, a nurse appeared, carrying a tiny baby wrapped in a pink blanket and a knit hat. My baby. My Ella.

The nurse handed me our beautiful angel, and my heart went through emotions that were so mixed I somehow felt numb. It was as though I had managed to sleep on every part of my body in the wrong way, and every limb and tip was asleep with pins and needles.

I held our baby girl, and forced my memory to snap the picture that I would hold forever in my mind and heart. No one said a word as tears slid down my cheeks, anointing our baby girl and all of her beauty.

I begged God for help. Begged Him to make her better. To turn Ella into a healthy newborn with glowing pink cheeks and a little smile that took over her face when gas bubbles formed in her tummy.

But my prayers went unanswered.

It happened quickly. Eric was at my side, holding her entire hand with his pinky finger, and all four grandparents were cuddling in.

Ella’s eyes fluttered open, only for a moment, as if she was greeting us, and taking in our faces before moving on.

And then our precious baby girl took one final breath, and she was gone.