There’s nothing that can prepare you to touch your father’s arm and find that it’s frozen. I should have known, of course. Doctors had told us what they were doing and said he’d be cold. But it’s one thing to know he’ll be cold. It’s another to feel it. When I think back on the time spent in the ICU with my dad in a coma recovering from a massive brain bleed, one of the most visceral memories I have is the feel of his hand.
He had gone in for emergency brain surgery that morning to relieve the pressure on his brain caused by a massive brain bleed which had, in turn, been caused by a reaction to a clot-busting drug administered to break up life-threatening blood clots in his lungs. To help him recover, they cooled his body to 91 degrees. They said this gave him the best chance at recovering. So for three weeks we kept vigil by his bed, watching and praying for any sign that he was waking up. When we were alone, I would read to him. Sometimes I read from Scripture, sometimes from Thomas Watson’s “Divine Cordial,” and sometimes sections of books I particularly loved—the scene at the end of Return of the King when Frodo wakes up and finds the world changed, the scenes of remembrance as Sheldon comes to terms with his beloved wife’s death in A Severe Mercy.
Mom spent the most time in his room, but his parents and sisters were there a lot as were a number of friends from church. In a weird way I’m not sure I’ve ever felt more proud of dad than when I saw the sheer number of people coming out to visit us and who asked if they could go back to see him, a request we tried to grant as often as we could. It almost began to feel to me as if my responsibility during the peak visiting hours was less to keep watch myself and more to help other people to do it—the people who loved him and weren’t sure what to do or say. I don’t even know how many times I walked the hallway between the waiting room we made our own and the doors into the ICU during those three weeks. It felt right in an odd way. If a person is going to die, they ought to be visited by so many people. They ought to mean that much to that many.
We’re now just over 18 months out from that awful day and he has regained a lot. He’s walking with the aid of a cane. His long-term memory is excellent. He can use his right hand. His sense of humor, I can assure you, is fully intact.
While still in the rehab hospital he sometimes would mess with my mom by pretending that something that had just come back—being able to move his leg, improved vision, etc.—had gone away again. Thus:
Mom (holding dad’s leg so he can show a guest that he’s able to push with it again): OK Rob, push.
Mom: Push Rob!
Mom: (bows head)
Dad: (starts laughing, then pushes leg)
He’s back. And back in ways that I don’t think we ever really anticipated during those cold, dark days in the ICU.
Yesterday we even grilled burgers and hot dogs and had a Father’s Day backyard dinner with mom plus my wife and two kids. Life has settled into a kind of normal. But sometimes I still think about that day in December and those three weeks in the ICU that followed.
I was reminded of those days when I read a friend’s email last week about the New Yorker piece on the opioid crisis in West Virginia.1 There were a number of things in that essay which shook me and still more things in my friend’s email. This was the worst thing I read and may be one of the worst things I’ve ever read:
The most crippling effect on me, mentally, has been the stories my wife has told involving mothers and newborns. The hospital where my wife rotates expanded their NICU within the last several years to care for the influx of prematurely-born and/or drug addicted babies. One new unit, the Neonatal Therapeutic Unit has space for 15 infants at a time. It is solely used to wean newborns off the opiates their mothers took during their pregnancy. Volunteers and nurses will cradle these infants while they suffer through physical withdrawal. The folks who volunteer there are limited to two-hour sessions; there is only so much a person can take listening to the most primeval, dependent screams a child can make. The NTU is routinely full.
My only experience in any kind of intensive care unit is sitting in my dad’s room holding that cold hand, praying that he would wake up. I don’t have any lived experience with being in the NICU but I imagine it must, somehow, be an even sadder place than the ICU since all its patients are babies. And I don’t think I’ll ever be able to fathom the way that having to expand the unit to accommodate shrieking, drug-dependent babies would change a person. And I certainly cannot imagine how seeing the sights and hearing the sounds of such a place on a daily basis would shape a person. When I look at that sort of suffering, I don’t even know what to do save praying the Psalms.
This is how these two scenes relate to each other: The two places in this piece, the ICU at Bryan West in Lincoln and the NICU at this West Virginia hospital probably look a lot alike, particularly when compared to all the other sorts of places that people frequent on a day-to-day basis. I imagine they’re both clean, fairly modern looking spaces. There’s a sadness about them—how can there not be? And there are almost certainly brief punctuations every day of frantic activity as new patients are brought in or current patients suddenly need attention.
The thing that I imagine being the most different between the two places is the sound. Dad’s room was quiet. We were asked by doctors to keep it that way and so we did. We spoke in whispers. We probably would have done that anyway though because the feeling that you are in the presence of someone who may soon meet God has a way of silencing a person. Often the main sounds you could hear in the room were the beeping of machines, the “breathing” of the ventilator, and whatever hymns we were playing on a low-volume in the corner of the room.
The sounds of that NICU are something altogether different. I don’t even know how to describe what they might be, having not been there myself. But those screams are not simply a product of the pain that infant is feeling due to withdrawal symptoms. They’re the product of a place literally dying from hopelessness and aloneness:
We were driving away from Hedgesville when the third overdose call of the day came, for a twenty-nine-year-old male. Inside a nicely kept house in a modern subdivision, the man was lying unconscious on the bathroom floor, taking intermittent gasps. He was pale, though not yet the blue-tinged gray that people turn when they’ve been breathing poorly for a while. Opioid overdoses usually kill people by inhibiting respiration: breathing slows and starts to sound labored, then stops altogether. Barrett began preparing a Narcan dose. Generally, the goal was to get people breathing well again, not necessarily to wake them completely. A full dose of Narcan is two milligrams, and in Berkeley County the medics administer 0.4 milligrams at a time, so as not to snatch patients’ high away too abruptly: you didn’t want them to go into instant withdrawal, feel terribly sick, and become belligerent. Barrett crouched next to the man and started an I.V. A minute later, the man sat up, looking bewildered and resentful. He threw up. Barrett said, “Couple more minutes and you would have died, buddy.”
“Thank you,” the man said.
“You’re welcome—but now you need to go to the hospital.”
The man’s girlfriend was standing nearby, her hair in a loose bun. She responded calmly to questions: “Yeah, he does heroin”; “Yeah, he just ate.” The family dog was snuffling at the front door, and one of the sheriff’s deputies asked if he could let it outside. The girlfriend said, “Sure.” Brian Costello had told me that family members had grown oddly comfortable with E.M.T. visits: “That’s the scary part—that it’s becoming the norm.” The man stood up, and then, swaying in the doorway, vomited a second time.
“We’re gonna take him to the hospital,” Barrett told the girlfriend. “He could stop breathing again.”
As we drove away, Barrett predicted that the man would check himself out of the hospital as soon as he could; most O.D. patients refused further treatment. Even a brush with death was rarely a turning point for an addict. “It’s kind of hard to feel good about it,” Barrett said of the intervention. “Though he did say, ‘Thanks for waking me up.’ Well, that’s our job. But do you feel like you’re really making a difference? Ninety-nine per cent of the time, no.” The next week, Barrett’s crew was called back to the same house repeatedly. The man overdosed three times; his girlfriend, once.
When dad was in the ICU my mom told me a story about him from a few months before. During the days leading up to the injury, it was clear he wasn’t well. He had trouble breathing and often felt faint. In hindsight we know that’s because he had massive, life-threatening blood clots in his lungs. On one of his rougher days, he had made plans to help a young woman from church run an errand that required a pickup truck—which he had. This young woman came from a divorced home and had essentially been abandoned by her father. My mom told him to stay home and reschedule because she would understand. Dad wouldn’t hear of it. He told my mom that he was never going to tell that young woman that he would do something for her and then not do it. It’s a powerful story, but not an exceptional one—that’s my dad. He is loyal, gentle, and full of compassion.
Job tells us that man is born to trouble as sure as the sparks ascend upwards. He’s saying that as certain as it is that sparks will go up when they jump out of a fire, that’s how certain it is that we will suffer. Job would know, of course.
So in that sense, the ICU my family knows and the West Virginia NICU are not surprising places. We expect such places to exist because, this side of Christ’s return, we need them. That’s not what disturbs me. What disturbs me is thinking about those babies in West Virginia and the people involved in their existence, mothers, fathers, grandparents, siblings, and friends and how so many of them are now afflicted by opioids. What disturbs me is that a place has become so hollowed out by the disintegration of both the family and the economy that drug-addicted babies are now common. What disturbs me is thinking about a place where addiction is so normal that it touches everyone and so pervasive that no one quite knows what to do about it. And what disturbs me is that it seems like places like that are an almost inevitable consequence of the way we live today.
The picture at the top of this post is from the day my dad came home, roughly six months after his injury. The look that he shares with my daughter isn’t simply about their knowledge of each other, though it is that. It’s my daughter looking up and seeing her “pa,” the man who rocked her as a newborn, helped her “fix” things, and who, alongside my mother, provided her with something of a second home. Even now my son, two years younger than my daughter, will shout “GAGI AND PA’S HOUSE!” when we turn onto their street. The exuberant shout is almost always followed by “I SO EXCITED!” It’s not just knowledge you’re seeing in that look; you’re seeing love brought about by a sustained pattern of care and affection. You’re seeing the safety that Davy feels with her grandparents. You’re seeing my daughter’s experience of home as it was created for her by my parents.
What fills me with fear is contemplating a world where those places do not exist.
UPDATE: A friend of mine with more experience in NICUs than I have left this comment on Facebook which I’m still mulling over but that really shifts the image for me a bit, I think:
The babies in that NICU were crying. That actually should convey to us that it is a hopeful place—no one cries out unless he has hope that someone will hear his cry and respond. I have spent many weeks in NICUs, some of them in the company of drug-exposed babies, and I find them to be places of great hope and beauty: ordered rhythms and schedules followed by attentive professionals, all set up just because very small, often very poor, often very sick, children have dignity. Think of it—in WV, well trained professionals spend their days and nights loving children that other people might just throw away. The NICU you described is an oasis of love—a fount of hope in a desert of hopelessness.