The Family Man
The unexpected heat wave engulfed New Brunswick, New Jersey and weighed it down like a lid on a pot. Brian wiped his brow and loosened his tie. The Mustang's air conditioner had quit, so he'd rolled both windows down in a futile attempt for cross ventilation.
by Susana Maria Rosende
The traffic on Easton Avenue had slowed to a crawl. Brian anxiously watched the only visibly moving vehicle in his rear view mirror. It was a motorcycle, weaving its way through traffic by riding between the lanes. It soon passed him, and Brian watched it until the driver's bright red Rutgers t-shirt was a meer dot on the horizon.
"Crazy kid," Brian muttered enviously, remembering the chances he took when it felt safe to NOT play it safe.
A car pulled out suddenly from the curb in front of Stuff Yer Face restaurant. Brian swung into the inside lane, cutting off a gray Honda, whose driver honked and swore. Brian returned the insults as he darted into the space in one move. He was parked on an angle, but straight enough to avoid a ticket. Throwing his tie on the seat, he locked the car and then ran the rest of the way to St. Peter's Hospital.
Lily was already sitting on the mat, surrounded by a dozen or so expectant mothers in varying stages of pregnancies and their "coaches."
"You're late," Lily greeted her husband, glancing at his sweat-stained shirt.
"Traffic," he gasped, sitting behind her and setting his stopwatch.
After Lamaze, Lily left for her English Lit class, and Brian rushed home to pay the sitter. Two-year-old Michael was sound asleep in his brand new bed. He had given up his crib for the baby, yet he lay sucking his thumb, looking very much like a baby himself. Brian kissed the top of his brown, curly head and went to the kitchen to see that Lily had prepared spaghetti and meatballs -- again. He covered the pot and put it in the fridge, untouched.
He scanned the contents of the fridge, then pushed aside rolls of film from Lily's photography class to grab two Molson Goldens. Before shutting the fridge, Brian took a long swig from the first beer, nearly finishing it in one gulp. Then he took the second beer into the living room, where he accidentally knocked over one of Lily's easels. The oil paint from the canvas smeared into the rug. "Shit," Brian exclaimed. He brought a washcloth back from the kitchen and scrubbed at the stain, remembering their uptight landlord. He didn't care about the painting. He knew Lily could fix it. Starting his third beer, he laughed at the smudged painting. He thought it improved somehow. Now it had a modern, abstract style.
Brian sprawled on the couch and grabbed the remote control. Yet, he couldn't keep his eyes off her paintings. The small rental house was cluttered with Lily's easels, paintings, drawings, sculptures, and photographs. He turned off the TV and stared at her art as he drank his beer. Everywhere, images of himself stared back at him. There were even more portraits of him than there were of little Michael. Brian found that odd, especially since they rarely had time for each other any more. He couldn't remember the last time he posed for her, much less anything else. She was always so tired now. As he finished his third beer, all he could think about was how he'd always preferred plain walls.
When Lily returned from her class, Brian was at his desk, wrestling with the budget in an effort to cover the monthly bills.
"Did you eat, Brian?"
"Was Michael asleep when you got home? Is he okay with the new bed?"
"Sure, yeah...everythin's fine."
"I'm going to check on him. You coming to bed soon?"
Lily hesitated in the doorway, then she turned back to her husband and offered him a wan smile.
"I love you."
"Okay," he nodded distractedly.
"Brian," Lily sighed, "what's wrong?"
"What do you think? I'm trying to pay bills here."
Lily sighed again. "Oh Brian, you've been drinking." She turned away, but Brian stopped her.
"Look, Lily, I hate to bring this up, but you're just going to have to quit school and go back to work after the baby's born. There's just no way we can afford two kids on my salary."
"Brian, please, I'm exhausted..."
"Look, you're going to have to face it sooner or later. You have to quit school again. There's no other way."
"Brian, that's not fair. I quit until you graduated. And worked two jobs while you were in school. It's my turn now!"
"Well you got pregnant again. That changes everything."
"What? You had nothing to do with this?"
"You have to work! There's no other way!!"
"I DO work. I go to school, take care of Michael, cook and clean, AND have a part-time job!"
"FULL-TIME! YOU - HAVE - TO - WORK - FULL-TIME!" Brian accentuated each syllable by pounding his fist on the desk, knocking the bills to the floor.
Lily wiped away tears as she waddled down the hall to Michael's room. Then she climbed in bed next to her son as her husband continued to curse in the living room.
Brian lay awake for hours that night, agonizing over the bills and the ever-evasive savings account. As he heard his wife snoring from their son's room, he could almost hear the baby growing inside her, ticking like a bomb.
Rolling over to grab the phone, he considered calling his buddies for a night on the town. Although they had all graduated the year before, they still frequented the Frat parties and college bars. Lily wouldn't like it, but she didn't like his friends anyway. She still held a grudge from the time they carried Brian home after a night of bar hopping, with lipstick on his collar.
Unlike his friends, however, Brian couldn't afford the beer money, nor another hangover at work.
It was only when his thoughts turned to Ginger, the Systems Analyst on his project team, that Brian was able to relax. As he drifted off to sleep, visions of her smile, swingy brunette bob, and trim little figure both soothed and excited him.
He fantasized about cornering Ginger in the copy room and lifting her petite frame onto the copier, while he kissed and disrobed her. He knew she wouldn't object. She always brushed up against him in the halls, intoxicating him with her scent. And if they were in the same meeting, she would manage to catch his eye whenever she removed her blazer to reveal her low-cut, sleeveless blouse.
He was awakened by a kiss, and was surprised to see Lily standing by the bed, her long blonde curls pulled back in the pony tail she wore whenever she cleaned the house or worked in the garden, her belly button pushing through the maternity dress that barely contained her huge belly. She held an overnight bag in her hand.
"Good morning." She smiled as she rubbed her belly. "I've already called the doctor, and the sitter's on her way."
"The baby. It's time."
Brian bounded out of bed, and quickly pulled on his jeans.
"Are you sure? You're a month early!"
"Yes, I'm sure. It's not a month, just two weeks."
"Jesus. Why didn't you wake me? What time is it?"
"It's 7:15. The contractions are 20 minutes apart. Relax, we have plenty of time."
After twelve hours of pushing and tears, Lily gave birth to Christopher, a pink seven-pound baby boy. Unlike his older brother, Christopher had a full head of dark hair. "Look at all that hair!" the doctor called as he delivered their son.
As the obstetrician attended to Lily, Brian watched the nurse clean the baby. Christopher was making gasping noises. Brian asked the nurse, "Why isn't he crying?"
Instead of replying, the nurse urgently paged on the intercom, "Floppy baby in here!" and Brian was pushed aside as a dozen medical personnel rushed into the room, crowding around his son.
"Brian, what's wrong with the baby?" Lily asked weakly as she tried to sit up.
"Your baby is having trouble breathing," a doctor said flatly, while someone paged a pediatric respiratory therapist. "We're going to take him to the Intensive Care Nursery for tests. You may hold him for a few seconds, now."
Someone placed little Christopher in Lily's arms. The blue of his face was rapidly matching his blanket. Lily gently kissed his head and handed him to Brian, who quickly handed him to the doctor.
As he followed the doctor out of the room, he heard Lily cry out, "Brian, stay with him!"
Brian stood by his son's incubator while doctors explained Christopher would need surgery to correct a birth defect that had impeded lung development.
A stern-looking young doctor began, "Your son has a congenital birth defect in which the diaphragm, the large dome-shaped muscle that separates the chest cavity from the abdomen, fails to completely develop. This condition requires immediate surgery to repair the damage caused by the defect."
" You see, the incomplete diaphragm has a large hole through which the abdominal organs can pass or herniate into the chest cavity. Most commonly the hole occurs on the left side, in almost 90% of cases. In this condition, the fetal lung nearest the hernia is compressed, preventing full development, and thus interferes with breathing after the infant is born."
Brian asked, "Why? What caused this?" remembering the sips of champagne Lily had on New Year's Eve after several friends and relatives urged her to, insisting that one glass would not hurt. He thought about the chemicals in her art classes. He also remembered Lily's car pool to her part-time job, and how several of her co-workers chained-smoked.
A short, old kindly doctor sensed Brian's anxiety and responded, "There is no known cause. It is a rare defect, with, the incidence of congenital diaphragmatic hernia being approximately 1 in 2,000 births. All that is known is that somehow boys are more commonly affected."
Brian was deep in thought. Then he asked, "But, the ultrasound at 20 weeks...everything was fine. They were even able to tell us the sex of the baby."
Both doctors nodded. The younger one replied, "The diaphram closes at about 22 weeks. At that point, everything may have still been fine. Sometimes, unless the organs have pushed the heart to the center of the chest cavity, it is never detected until birth, as in your son."
"Generally, this birth defect is detected in three ways:
chest X-rays show the diaphragmatic hernia, the baby has severe breathing difficulty or respiratory distress shortly after birth, or in
a prenatal ultrasound, after 20 weeks gestation."
The elder doctor added, "If we had known, we could have suggested fetal surgery, but it's a relatively new procedure only done by a couple surgeons in California. At the very least, your wife could have given birth in a Children's Hospital...one with a lung bypass machine."
"What can you do now? Will the surgery help at this point?" Brian wondered aloud.
The young doctor explained, "We will attempt to move the abdominal organs from the chest cavity to where they belong. While the infant is under general anesthesia, an incision is made in the upper abdomen, under the ribs. The abdominal organs are gently pulled down through the opening in the diaphragm and positioned into the abdominal cavity.
The hole in the diaphragm is repaired and the incision is stitched closed. If a large defect is present, a plastic patch is used to cover the defect in the diaphragm. A tube is placed in the chest to allow air, blood, and fluid to drain so the affected lung can re-expand. This tube remains in place after surgery for a few days."
"Are there risks?" Brian asked.
Both doctors answered at once. "Yes, yes there are always risks with any surgery."
The younger doctor explained, "Risks for any anesthesia include reactions to medications, problems breathing. And risks for any surgery include bleeding and infection. Other possible complications include collapsed lung or pneumothorax, and/or failure of the affected lung to expand or mature."
The older doctor interjected, "Diaphragmatic hernia is a life-threatening condition that requires surgery as soon as symptoms develop, usually in the first 24 hours of life. The outcome depends on the lung development on the affected side.
Most babies require ventilator support, which entails the use of a machine to help them breathe after surgery. We have all ready put in calls to several children's hospitals in the tri-state area, as we don't have such a machine here. Generally the prognosis is very good for infants with adequate lung tissue."
Brian asked, "What about nursing the baby? Lily nursed our first born and she was planning to nurse this baby, too."
The doctor responded, "These babies may require several weeks of hospitalization after surgery depending on how long breathing needs to be supported with a machine. Feeding is begun after the first bowel movement is passed. However, it is usually done through a tube into the stomach or small intestines until the breathing tube is removed."
The young doctor then delivered the final blow. "We must be honest with you. Your baby has a 50/50 chance of surviving the surgery and may never be able to breathe on his own. The lack of oxygen at birth could result in brain damage."
Numbly, Brian followed the doctors to the recovery room. Lily seemed as numb as he, as she listened to the doctors explain the situation. To Brian, it seemed to sound even worse the second time around. Lily asked no questions except to see the baby. A nurse wheeled her to the Intensive Care Nursery.
The Intensive Care Nursery was unusually quiet, except for the whirring of machines. The babies were too small or too sickly to cry. Ironically, at seven pounds, Christopher was the biggest infant in the ICN. But, his fragile condition was confirmed by the many tubes attached to his body.
Lily and Brian gently touched their son, careful not to disturb the tubes. When Lily kissed the baby's head, he was startled awake. The ICN Nurse offered to take pictures with a Polaroid. She also complimented Christopher's soft curls, and offered to cut a lock of his hair. Lily smiled and nodded, as she wiped away tears. When Brian met her eyes, he knew she realized the hair and photos might be the only part of their son to take home.
Her next words confirmed his thoughts. Lily asked the Nurse for a Catholic Priest to baptize their baby. The priest arrived soon after she was wheeled back to her room.
Father John was old and gray and impatient. Brian felt they must have interrupted his dinner. Or perhaps the priest felt uncomfortable around sick infants.
The priest sat at the foot of Lily's hospital bed and got right to the point. "You both Catholic?" he asked.
Uh oh. Here it comes, Brian thought, wondering if he were obvious. He swallowed and answered, "No. I'm Jewish."
The priest seemed to cringe. "How do you plan to raise the child, then?" he asked.
"Well," Brian answered,"We plan to teach him about all of his heritage. Our first born son was both brissed and baptized."
"Can't do both," Father John stated as he sighed and shook his head. "You have to decide on one faith. How do you expect your children to..."
"We CAN do both," Brian countered. "Michael celebrates both sets of holidays. He goes to Mass with his mother and Temple with his grandparents. Our children are part of both of us and..."
The priest raised his hand and rose from his chair as if to stop Brian from speaking.
"Father," Lily interrupted, "please baptize our son. I promise you, if he survives, I will raise him Catholic."
Father John sat back down and took papers and a pen out of a brief case. Without further discussion, he said, "I need your names, address, parish..."
When Lily and Brian visited Christopher's incubator again, they noticed the Baptism certificate. It read, "Non-demoninational."
When it was time for Christopher's operation, a nurse wheeled the baby to surgery. Another nurse pushed Lily's wheelchair while Brian followed behind. Brian and Lily were given a few moments to say goodbye to their son, as he lay in his portable incubator, his big brown eyes focusing on his parents.
"I wish I could hold him," Lily whispered, "just one more time."
Over the next six hours, Lily waited in a room built for four patients, but crowded wih eight. Tears fell when the other babies were brought to their mothers for feedings.
A nurse moved Lily to a semi-private room. Brian went home to rest.
At home, the sitter was gone, and his parents were taking care of Michael. Brian hushed his parents as they bombarded him with questions. He was trying to listen to the messages recorded on the answering machine. There was one from Ginger, wishing his family well. Brian felt his face grow warm at the sound of her voice.
The next message was from the hospital. The doctor's voice sounded urgent.
Brian returned the call, and the doctor gave him the dreaded news. Christopher had survived the surgery, but the gas levels in his blood never stabilized. The doctor stated bluntly: "The baby boy expired. Do you want us to perform an autopsy on the baby boy?"
Tensely, Brian interrupted the doctor to say "The baby's name is Christopher. Please call him Christopher."
The doctor was surprised.
"You named him?" he asked.
When Brian hung up he went over to Michael, who was playing with blocks in the corner of the living room. He picked up his son and held him close. Michael squirmed to get down and back to his toys.
When he put his son down, Brian looked at his parents, who were anxiously waiting to hear about the phone call. Brian sighed and said, "He didn't make it."
Brian's mother sobbed and tears flowed down his father's face. Little Michael called out, "Granma! Granpa?", his lower lip puckering and looking like he was ready to bawl himself. As his parents both tried to hug him at once, Brian asked them to keep calm for his son's sake.
Then he left for the hospital, wondering how to break the news to Lily.
As soon as Lily saw Brian in the doorway, she knew. He sat on the bed next to her and held her as she sobbed.
"I can't stay here," Lily whispered, as a nurse brought her roommate's baby in for a feeding.
Brian automatically asked the nurse to discharge his wife. Then he called his parents to tell them they were coming home. Methodically, he dialed Lily's parents, and his boss, relaying the news without emotion.
He dialed the phone one more time, his hands shaking slightly as he dialed the funeral home he'd called just two months before, after the death of his grandfather.
Lily was still crying as a doctor examined her so she could leave the hospital. Brian left the room, and then the hospital. On the front stoop, he sat on a bench, barely noticing the rush hour traffic, blasting horns, and jovial college students flocking around the fraternity houses across the street.
It had rained, and the heat wave had lifted. Brian almost shivered in the breeze.
A taxi pulled up to the hospital entrance then. A happy young man escorted his wife out of her wheelchair and into the back seat. A baby wrapped in a blue blanket snuggled contentedly in her arms.
"Hey! I'm a father. I just had a son!" The young man beamed, as he ran up the entrance steps to hand Brian a cigar.
Brian gripped the cigar tightly, and blankly watched the taxi drive away.
"It's just too hard," he whispered to himself. Then he covered his face with his hands and wept.
For more information about Congenital Diaphragmatic Hernia (CDH) or parent support sites, see: