Detour

(IT HAS BEEN A WHILE — HERE’S WHY)

On April 6^th,2022, we welcomed Joshua Alexander to the world. He was born at 25 weeks gestation- which is three and a half months early. I was a teaching pediatric resuscitation class at the reservation hospital when my water broke. I waddled to the OB ward and STAT paged my husband there from his clinic. On his arrival, we confirmed what I had feared. Though I was not in labor (yet), my water had indeed broken. What little stoicism I possessed was now gone. I let out a cry from the depths of my soul feeling that all we had done to get us this far in the pregnancy, still was not enough.

Lucky for my sake, the nurses did not wait for me to compose myself before starting the process to give us every fighting chance they could. In minutes, I had two large bore peripheral IVs with fiery magnesium running through my veins. This was intended to prevent me from laboring and to protect Joshua’s still developing brain. I was given an intramuscular shot of steroids to assist his premature lungs and then I was slated for a helicopter ride to the nearest high risk obstetrical hospital in Phoenix (a 90 minute flight). In the blur of action, I was confused to see my personal OB – who was off that day- and friend walk through the door. She had driven 90 miles in what seemed like 60 minutes to meet me at the bedside and offer her hope and comfort before I flew out. If there was ever a reminder that medicine is so much more than a job, this was it.

The helicopter ride was so noisy that I had to text the nurses updates about how I was feeling – including once Joshua started making me contract. On landing, I was greeted by the OB hospitalist and a neonatologist. They wanted to tell me all that could happen if our baby was born that day: what his chance of living would be, and what his chance of illness would be. I had heard the talk before. Heck, I had given the talk. The neonatologist pulled out a pocket card so I could see the statistics. After all this talk though, I don’t remember actually being asked if we wanted everything done to save Joshua. Maybe it was the look on our faces that said we at least needed a shot. Maybe in one moment, our eyes conveyed the culmination of loss we endured in the preceding years and that we desperately needed a reason to believe in miracles again.

The following morning, Joshua was born via an urgent (but absolutely flawless C- section). He was 820g or 1lb and 13 oz. He was given a breathing tube and connected to a ventilator. The nurses placed a feeding tube in his mouth and he was started on IV antibiotics to treat any infection he might have. When we first saw him after the surgery, he could not open his eyes. Though in an incubator, we were able to touch him. As I took his hand and laid it in mine, perspective was granted. His entire hand was the size of one knuckle.

Over the next 115 days in the hospital with Joshua, my identities warred relentlessly: mom versus doctor. The neonatologist would say, “Just be his mom.” And in my head, I would scream, “Lullabies don’t fix heart defects.” and then think in despair, “And also, I have never been a mom – I don’t know how.” Yet, even while being more comfortable as a pediatrician, I struggled deeply to voice my concerns – afraid of traversing the hair strand that separates the invested, knowledgeable mother from the overbearing, and “difficult” parent.

In time, I accepted my dual citizenship. I saw my pediatric knowledge as my strongest asset to Joshua and so did his care team. Todd and I can say with certainty that we are better doctors because we have been patients. We have experienced the drowning fear and the exhausting uncertainty of sitting on the other side of a hospital bed. We know firsthand that nothing happens quickly enough in the care of your critically ill child, and also acknowledge that the doctors are doing their absolute best with what they are given. We know what it is like to bring a child home from the hospital – to be elated for their survival, but overwhelmed with their remaining needs. We have needed to rearrange daily plans around pump feeds and we have argued to tears with supply companies for a reasonable number of oxygen tanks. But in every situation, we had enough to get us through.

Today, Joshua is 17 months old and entirely healthy. He needs neither oxygen, nor feeding tube. He has no eye or heart problems. He is talking, walking, and best of all ALWAYS (ok, almost always) happy. He is a living testament to not only the advances of medicine, but also the power of prayer, and the goodness of people. We have in front of us a reason to be grateful each day and we simply cannot ask for more.