play it again: a season of sowing

Originally published October 14, 2012

Fall has finally arrived here in the Central Valley. Last week the temps were in the 90’s or more but over the weekend, slowly but surely, there was a cooling trend until finally there was but a trickle of rain by the end of the week.

It was about time! That’s all I can say!

But Fall here in the Central Valley often finds me feeling a little down and a little homesick. Sure there are pumpkins galore and a fabulous corn maze. The vineyards and orchards are being harvested and the grapes are being crushed. It all creates the most amazing, fruity, almost syrupy smell as I drive around. But the colors are so pale, so anemic compared to back home. I was reminded of that seeing friends posts of Fall color on their Facebook walls.

I wish I took this shot! I wish I was there to take in this incredible view! Alas, but no. This image is from my dear friend, Sue’s Facebook wall. Like me, she longs for the vibrant colors like these that can only be seen back East. Nothing out here in Cali compares. Sorry.

So instead of trying to find Autumn color in an area where everything pretty much is brown, I decided to sow a little with a nod to Edwin Teale.

For man, autumn is a time of harvest, of gathering together. For nature, it is a time of sowing, of scattering abroad.

Next to the glorious colors of Fall that I miss so much from back home, I love the colors of Spring, especially when the daffodils and tulips break through the frozen ground amongst the melting snow with their blooms. I can’t wait to see the colors that these will bring come next Spring here around the Big Top.

This week’s Focus 52 prompt is Autumn Color.

play it again: discovering the heart of the ocean

Originally published October 13, 2011

A boy and girl from differing social backgrounds meet during the ill-fated maiden voyage of RMS Titanic…

And now my fifth circus clown discovers Titanic. We are right on schedule too as he is around the same age as his four sisters before him watched this epic story as told by James Cameron. For the girls it was the star-crossed lovers story that lured them in. For Daniel it is the fact that Jack Dawson is cool…oh, and when the ship sank. THAT was really cool!

My favorite part watching it with him?

When he turns to me and states, “You know this really happened, Mom. There really was a Titanic and it is at the bottom of the ocean.” That’s my favorite part, my favorite part each time I have watched it with each of my circus clowns for their very first time.

Of course this means that my Little Man is growing up. Up next in the horizon up ahead, god help me, puberty.

play it again: sorting and searching

Originally published October 12, 2008

While many are panicking as they pull their money out of banks and the stock market, my darling daughter #4, Jodie, is ready to put her little stash in the bank. Yes-sirree! The faith of one 12 year old is going to restore everyone’s confidence and end this financial clusterfuck for us all, gosh darn it all to heck! Jodie earned a little over $60 tap dancing her little heart out on a street corner at the Manteca Pumpkin Fair and rather than attempt to blow it all in one place, she decided that perhaps she should SAVE it.

Is this really my child?

Seriously, I was glad to see that she was listening to my words of wisdom rather than my years and years of poor financial action or perhaps she was making this decision based on the pile of bad money management in my personal history. Either way, I couldn’t help but be proud of her decision. She does have savings that we established when she was still a little carpet crawler but it is safely and quietly growing in a credit union account in the Bay Area. One of these days, I tell myself, I will move it closer to home but there is always something else to juggle. In the meantime, Jodie wants to open up her own personal savings account at a bank just down the street. In her perky, golden-blonde goodness she imagines her stopping there after school to add even more money to it when she gets it so she can save, save, save and watch her money grow, grow, grow.

See? I told you she will restore America’s financial confidence.

After a little discussion, I agree this is a good idea for the money she earned and suggest that we go together to the bank and open up her own personal savings account. All I need to do is get her social security card and off we can go.

Easy-peasy.

Not so easy-peasy.

I have the three youngest children’s social security cards filed safely away. The only problem is I can’t exactly remember where they are filed safely away. The obvious, logical place would be my filing cabinet where I have filed “important” paperwork like past income tax forms, my continuing education certificates, the kids’ birth certificates, Daniel’s adoption papers and medical records, insurance policies and other stuff like that. But I am not necessarily a logical, obvious kind of person. Still I am stubbornly certain that those cards HAVE to be in there so there I was this past week, sorting through my files piece by piece trying to find those cards.

During my process I come across one important document that I kind of forgot about…but actually I haven’t. A four-page Traffic Collision Report # 01-054-0734 of the incident that occurred February 23, 2001 at 1615 hours on Camden Avenue just 51.6 feet north of Merrill Loop. Party #1 had no driver’s license number, was 4 ft 5 in tall and was perceived (incorrectly) to be 80 pounds. The report also states that she was 9 years old which was also incorrect. She was 8. She was traveling east on Camden Avenue (it runs north to south) at an undetermined speed. Party #2 did have a driver’s license, was a foot and a half taller and twice the recorded weight of party #1. He was also more than 50 years older. He was traveling north on Camden at an estimated 35 mph. the report goes on for three more pages with detailed illustrations of the point of impact and the 95 feet of tire skid marks up to the point of impact on Camden Avenue. The three witnesses’ accounts completely support the evidence in the street: the skid marks, the stopped flatbed truck with the one ton trench digger secured on the flatbed, the crumpled, battered and bloodied body of the 80 pound 50 pound, 4 ft 5 in tall, 8 year old body of my daughter Zoë and the banged up razor scooter lying curbside.

The sorting and searching of my files stop as I slowly re-read and re-live every detail of that horrible, horrible afternoon. I feel my breath catching and my heart pounding as I scan each and every line of Officer # 3495’s carefully printed and typed report. More than 8 years, 12 inches and approximately 60 pounds later I still haven’t forgotten. I will never forget. How could I possibly forget? I just have it filed away very neatly in my file cabinet…and in my heart and in my mind.

I never did find the social security cards. I stopped searching. After my little afternoon of recollection, my heart just wasn’t in it, I guess. I know they are somewhere, safely filed away and they will turn up right around the time I receive the replacement cards I requested.

play it again: boundaries

Originally published October 11, 2010

As parents, we are forever putting up and enforcing boundaries. It’s our job. Our kids believe that we enjoy putting up barriers and roadblocks to hinder them and hold them back in spite of our assurances that we do not enjoy this part of our job…let’s keep it our secret that we enjoy this part…a lot!

But seriously, as parents we encounter boundaries and barriers all the time that are put into place by our own hand, our own words and our own heart. We don’t expect that there will be barriers and boundaries that keep us from our own children. Thrown into the vortex of the NICU or the PICU with a critically ill newborn or child is definitely one of those places where a parent will suddenly find that they have little if no control at all. Even worse, from my own personal experience, is when you, the parent, is also a medical professional. Your child, your baby is critically ill and you have a very good understanding of exactly what is going on. For any parent, it is very easy to bump up against the boundaries of a NICU or PICU setting. For the parent who is also an experienced nurse, a physician, it is almost a given that the barrier between parent and medical professional will be broken down. What else could possibly happen. We, as parents, are frightened to near death seeing our own child in crisis. As pros, we can run through our mind the worst case scenario and outcome with a few blinks of an eye. It’s painfully hard not to try to intervene. We’re parents…we’re good parents. We just have bumped against the barrier that separates us the mom or dad and us the nurse or doctor.

I recall one night in the NICU where I pretty much blew down the barrier between me the mom and me the NICU nurse. Daniel required a ventilator to breathe for him for the first 11 weeks of his life but he often would self extubate knocking loose or even grabbing a hold of and pulling out the breathing tube he needed. What can I say, he was a fighter who drove his care team crazy. This one particular night, I was visiting and helping his nurse bathe and weigh him when…oops, he did it again. As his nurse, respiratory therapist and neonatologist prepared to re-intubate him, there I was standing over him watching him become paler and seeing his little chest caving in exposing every single rib as he struggled with each breath. His care team gently tried to have me step aside but I could not be moved.

“I think he can do this. I think we need to give him a chance.”, I stated as the alarms on his monitor argued loudly otherwise.

It was then that Daniel’s doctor, a colleague and a friend of mine, demanded that I step out of the room now. Before I could argue back, she told me she would come get me when she was done. I stepped out of that room and it suddenly hit me. I crossed that line. I actually crossed it in such a way that I was hindering my own child’s care. My behavior was putting him into jeopardy. Just thinking that brought the flood of hot tears. I ran out of the unit crying.

After what was certainly an eternity, Daniel’s doctor came out to the waiting area to get me. Hugging me, she assured me that Daniel was easily re-intubated and back on the ventilator, pink, stable and now sleeping in his bed. She then faced me colleague to colleague and asked me pointedly if I honestly, as a NICU professional, felt that Daniel was ready to breathe on his own…if he was my patient and not my child, would I have argued with her that way. Of course I knew the answer was no. No, of course I wouldn’t and I knew that. It was then that Daniel’s doctor built up that boundary brick by brick that separated me, the NICU nurse, from me, Daniel’s mom. In order to be the very best mom for my child, I could not, should not, would not be my child’s nurse. It wasn’t easy. It has never been easy as Daniel’s mother or as Zoë’s mother or as Jodie’s mother and certainly as Holly’s and as Hazel’s Mi-Ma. I can’t offer a how-to. All I can offer is that sometimes, for the sake of our children, there are boundaries for us, the parents. Of course we don’t have to like it, we can even push against them if we dare. But just like the ones we build for our children, these boundaries are there for the sake of our children.

play it again: behind that NICU door

On call for work tonight. The census has picked up and, yes, I’m (finally) working more doing one of the things I do best. I can’t even begin to describe how good it feels after literally weeks and weeks to be doing one of the things I am most passionate about. This job reminds me every day that not only is life is precious but that human beings are a helluva lot stronger than most people can ever understand…especially tiny human beings who literally fit into your hand when they are born 4 months too soon like the bravest, strongest human I know, my son, Daniel.

I have been doing what I do for over 24 years and although some days (nights) can be horribly tough and emotionally exhausting I am so grateful that this is what I do. I am also kind of surprised that not everyone in my life really gets what it is that I do…nor do they appreciate what it is that Daniel (and his parents and sisters) has lived through. Then along comes something like this that (hopefully) opens their eyes to perhaps some understanding and (maybe) appreciation.

It’s the best job ever. It’s the hardest job ever. It’s what I do and it’s what I love.

originally published September 29, 2013

Heading into work the other day, I walked past a group of people gathered in a small circle just outside the entrance of the NICU. Another Labor & Delivery tour in progress. I know this because most of the ladies in the group are visibly pregnant and because I hear their tour guide explain that behind that door is the Neonatal Intensive Care Unit, where if a problem with their baby should arise, they will receive the very best of care. As I swipe my badge to open the door and enter the unit, I see out of the corner of my eye the expectant parents lean forward a little to get a peek of what exactly is behind that door. Some rest their hands protectively over their pregnant bellies as if to somehow keep their babies out of there.

I smile to myself because I get it. I did exactly the same thing while on a Labor & Delivery tour of the hospital where I was planning on having my baby girl, Hollie. I was definitely curious as to what was behind that door but the last place I would want my baby to be was behind that door.

Then I discovered my passion, working as a Neonatal Intensive Care Registered Nurse in that very unit. It really is, to me, the best job ever. A job that no one close to me has ever completely understood unless they found themselves in there, behind that NICU door. I have done this job long enough to know this to be true with my closest of friends, my darling husband, my children, my family. Unless one works there or has sat vigil beside the isolette of a sick, tiny, fragile human they don’t know what I do behind that NICU door. Nor do they understand truly what my son’s life was like behind that NICU door…or his parents’ lives…or his sisters lives. They have no clue of the rush of adrenaline and trepidation I feel when I get the assignment that is listed as “23-24 weeker”. Nor do they understand the helplessness Bill and I felt the night my water broke 14 weeks too soon while I was pregnant with Jodie as the neonatologist on duty came in to talk to us (to Bill) about the very real possibility that our baby would be admitted into the NICU and all the potential complications and disabilities she would face. It’s scary stuff no one understands unless they spend any length of time behind that door.

Check out NPR’s Radio Lab this Sunday.” was the message I received. Curious, I do. You should too…if you really want to understand what it is that I do…what I have been doing since 1990 when I started my career working in one of the 500 hospitals in North America, Europe, and Japan that had been enrolled in clinical trials of different surfactant replacements, many of which also gained FDA approval.Or maybe you wonder what it is really like to be a parent of a tiny human born at the cusp of viability…a baby who is more fetus-like than newborn baby-like. The story that belongs to Kelley Benham, Tom French and little Juniper is not new to me. I read Kelley’s three-part series, Never Let Go several months ago thanks to a posting shared in the Micropreemie Parents Facebook group I help moderate.

I certainly can imagine all that Kelley and Tom went through as the mother of my own micropreemie. Bill and I too have jumped at that middle of the night call telling us we need to come to the hospital now. Our family learned to accept and understand Daniel’s real age and his adjusted age. And we celebrated too that day we were able to disconnect Daniel from all the monitors and remove all the wires and took home our baby boy.

I also know too well how hard it was for Tracy, Juniper’s primary nurse, to take on the responsibility to be her primary nurse. I totally get why she worked overtime, not wanting to leave Baby Juniper when she clearly was going to die. Like Tracy I also enjoyed many conversations with the babies I have cared for and their parents. I also have enjoyed dressing up “my babies” and taking pictures of them to share with their mommies and daddies the things we did together in the middle of the night when the rest of the world slept. I’ve listened to mommies sing hymns, sweet lullabyes and even Guns n Roses “Sweet Child of Mine“and daddies read countless stories while keeping watch over their tiny ones whom they could not hold. I’ve fallen in love with many of these babies and their families…yeah, I fell completely in love with one whom I now call son too.

While I would never, ever want to experience the absolute fear that I had the night my water broke much too soon while pregnant with Jodie, I am thankful that it did happen. Thankful? Yes, so very thankful. It is because of that Bill went behind that NICU door as a parent to see where his baby might end up and listened to the doctor discuss percentages, potential outcomes and disabilities. That NICU tour and discussion Bill shared with the doctor on duty prepared him, prepared both of us to be parents for a baby born on the edge of viability with pretty much most odds against him. Only days old, when Daniel precariously clung to life, needing emergency open heart surgery, Bill declared that the tiny patient I fell in love with who was all alone needed a father, needed a mother, needed a family and we should be that for him. If that was Jodie wouldn’t we be doing just that regardless of the overwhelming odds that she would have died or be profoundly disabled or moderately disabled, he argued. Yes. Yes we would and so we did just that for Daniel as parents who end up behind the NICU door do.

Check out Radiolab’s 23 Weeks 6 Days