In the Making
By Kari Nguyen
It is October 2013. Quintessential New England fall. Our afternoon walk is slow as we pass under trees already turned for the season. There is hardly a breeze, and the leaves above us hang suspended, not quite ready to descend save for the few scattered on the sides of the road. The sunlight, lengthening but still warm, casts us: a band at peace. My daughter’s purple sneakers keep up easily over the pavement and her warm hand fits familiarly into mine. I snake the retriever’s worn leash through my opposite hand, repositioning the grip, and he seems to understand. There is a break in my daughter’s conversation, her little voice petering out as her mind is captured for a minute by something beyond our gazes. The quiet penetrates and it is difficult not to reflect. I am thinking: this is all I need. This and nothing else. It has been a couple weeks now, and I’ve been moving around with the airy relief that comes with lifting a heavy decision. We will revisit in a year, we tell ourselves, when our daughter is older, but my mind is all but made up. We are complete. This is enough, more than enough, and to try for more would be asking too much. Past the pregnancy, the sleepless nights, the spiral of postpartum. Soon my baby, this girl I love with a fierce, unwavering devotion, this child I have given all of myself to, time and again, will be out of diapers. I can feel the ground as we step forward and it is sturdy. I am thinking: we’ve made it. We’ve come through. I’ve admitted to myself, finally, that I can’t be sick again, can’t go through another pregnancy, that I’m not brave enough, that I was scared. My daughter swings my arm. This is happiness. Elation. A perfect afternoon, a perfect walk, my favorite season. It is my thirty-second birthday. The beginning of a new year.
In the evening we eat dinner as a family; my parents will come tomorrow to babysit so my husband and I can go out, celebrate. After my daughter is asleep I shower, a habit now, as mornings can be hectic. Dizziness and nausea hit me in waves. I emerge, panicking. Stop worrying, my husband tells me. There’s no way you’re pregnant. He is calm, reassuring. He dangles a bottle of red, the birthday wine, and I force a smile. He suggests a test, to ease my mind, and I grab one from the bathroom cupboard, left over from the months prior when we thought: we’ll try this again. Before we decided we wouldn’t. You’ll feel better knowing for sure, he tells me. I agree to it, but only if he’ll read it. I’m shaking as it is, and while we wait I pray. The seconds tick by. See? he says. Not pregnant. I told you there was nothing to worry about. Overjoyed, I place my head into my hands and burst into tears. Don’t worry so much. He turns to leave the bathroom and I follow, looking for the first time at the stick on the countertop. In an instant I know. One pink line, and another. One strong and one very, very faint. Later, after I compose myself, my husband offers the wine. I stand at the sink and pour it all away. I have taken for granted, all these months and years, that it’s been me reading the tests, not him.
It is August 2010. My husband and I sit alone in a small waiting area and watch as the nurse at the counter hovers over the results. We have driven over an hour through early morning, unable to believe that we are, in fact, expecting. We are here for confirmation and, should we truly be pregnant, our next steps. Just days before I was researching surgeons, insurance. Reviewing the doctor’s notes on endometriosis. All of these papers are tucked neatly into the thick folder on my lap. I’m too nervous to open it, to fidget. The nurse knows; we can tell. There is a pause. No, I don’t think so, she says. I’m sorry. It says negative. My heart drops and I’m surprised, even though it felt too good to be true. Tears well and our doctor rounds the corner with his quick step, his How are we doing?, and then he is standing with the nurse and looking where she is looking. That’s positive, he says, then turns to us. That’s a positive test. He turns back to the nurse, telling her she can never put someone through that, and then he is beckoning my husband and me to follow, apologizing profusely, our conversation distancing the sting with each step. I hear, Congratulations. I beam and wipe away the tears. I’ve never been so happy.
It is the morning of my thirty-second birthday. My daughter and I play “house” together at Mommy & Me, the parent-child class in town. I try to give my daughter space in these classes, mingle with the adults, give her a chance to hang with the other two-year-olds, but she is adamant. I’m to stay by her side. I sit cross-legged on the linoleum and help her with the furniture and the plastic people. Another woman and child join us. The boy loads up a minivan and runs it into my feet. I choose a bed from the plastic bin and set it into one of the bedrooms, and then find the mother of the family and lay her onto the bed. That never happens in our house, the woman next to me complains, and I think later how I should have said: this is fantasy. Every mother’s wish.
I’m five weeks pregnant when the nausea overwhelms all else. I fight against it, refusing to believe this pregnancy will be the same as the last. We could get lucky, we’d whispered late at night, after the test. Every pregnancy’s different. Now I think back to the first time, with my daughter, when I was unable to care for myself those first months. She weighs heavily on my mind and I wonder what we have done.
I lie on the examining table, at seven weeks pregnant. Our doctor has ordered an ultrasound because I can’t eat or drink and can barely walk. Another doctor in the practice is performing the ultrasound and she’s nearly done getting everything ready. So if it’s twins we’ll be able to see it? my husband jokes nervously. Oh yes, she assures. We’d be able to see that. She asks my husband to get the lights. The room does dark and the instrument goes in and the doctor quickly says, Did you see that?
It is March 1987. Something distracts my play and I look past the rows of cubbies to the preschool entrance. Someone familiar is standing there just inside the door, talking with my teacher. He’s a family friend, the athletic director at the adjoining high school where my grandmother also works, and where my father coaches. The two of them look over at me and I wonder. I watch him nod and leave. The teacher returns and asks us all to get into a circle on the rug, and as we plop ourselves onto our mats she places a chair down. For me. I take the seat, lone child in a chair. I’m not sure what is happening and I think maybe the teacher is going to give me a sticker, but instead she shows me how to bend and cradle both arms, like so. Then she places a doll in each of them. Now Kari will have two babies at home! she explains to everyone. Her mom just had twins. I swell with pride and hold the dolls like trophies for everyone to see.
We want to be sure, before we tell our daughter about the babies. We don’t want her getting attached, just in case.
I lie in bed, at seven weeks pregnant, because there is no choice. The nausea is constant and unrelenting and is made worse by light, movement, and sound. I’m suffering, again, from hyperemesis gravidarum, aka HG, a pregnancy disease, rare and severe. The lights are off, curtains drawn, covers drawn up around my ears. We keep the bedroom door closed because I can smell cold food when the refrigerator opens in the kitchen down the hall, one of a thousand smells I cannot stomach. I can’t hold food or liquid down, and any time I move my body reacts, then weakens further. I’ve been hospitalized and released, with orders to come in at any time, a rotating door, though it is not that simple. I’m lucky: no job to lose, no longer a paycheck at stake, insurance to soften the blow of medical expenses. A supportive spouse. Pregnant, with not just one but two. Many would kill for this, a dream come true.
My husband arranges a meeting with a family counselor at the hospital. When we arrive he lowers me into a wheelchair at the visitor’s entrance and pushes me through the wide sliding doors, our daughter walking at our side. She is complaining loudly that she wants her own “stroller” which is what she is calling the wheelchair. We are approaching the information desk where we are to ask for the counselor, who will meet us and take us up to her office, when our daughter bursts into tears and runs back the way we came, heading for the sliding doors and the line of wheelchairs on the other side. My husband runs after her and I break down, turning back from the scene of my family running away, tucking my head to my chest, hoping no one can see us. My husband returns carrying our daughter and places her slight, sobbing body next to mine. The counselor appears in front of us; I look up at her face and notice she is trying not to cry at the sight of us. We enter an elevator, and the counselor, on reaching the floor needed, opts for a private waiting room in lieu of her office. We begin talking and the counselor soon points out to me that I’m smiling through my tears as I speak about my daughter, who is climbing on the wheelchair spokes. She asks if I’d noticed, saying it’s important to recognize my ability to smile through illness and pain and uncertainty. It takes me a second to understand what she’s saying because I’ve just realized that the grease from the wheels has rubbed off on the seat of my daughter’s pants. There is a large black smear over her orange and pink stripes and I know, just seeing it there, that it will never come out.
Each day and night is nausea, without relief. My body, weak without food or water, begins to feel like it’s shutting down, rejecting the pregnancy, dying. I try to breathe, to move my mind over memories, to be anywhere but here. At the hospital they insert a PICC line, a small tube which runs through a vein, up my arm and over to my heart. VNA nurses come to the house. Each night, after he’s pushed injections of medicine into my line, my husband plugs my arm into an IV machine now stationed beside our bed. I crush a sleeping pill between my teeth and sink into sleep, waking occasionally to the beeping of the machine, signaling that I’ve rolled over onto the tubing. The VNA nurse who comes regularly tells me I will be up in no time, that the IV treatments make all the difference. Days later, when I still can’t stand, she tells me I’m the worst case she’s seen in eighteen years.
It is September 2010. I lean on my husband’s shoulder as we make our way to the lab. This is our new routine, every other Saturday, to draw my blood so it can be sent for testing. We’ve been told that there are hormones that need to be at a certain level to sustain the pregnancy and that it’s imperative to keep them up there, because we are at risk. I’ve been following the regimen of supplements, careful to skip the right days before we go to the lab. We want to know what my body’s actually doing so that we may understand what it might still need. I am fearful at all times of losing all that we have. My husband pulls open the door to the waiting room and it’s busy. There aren’t many seats, and you can tell the folks sitting near the open ones are hoping we won’t sit near them. My face is a quilt of red, pinpricks and spots, where the blood vessels have burst from vomiting. I want to say, I’m not contagious. I want to say there’s no reason to worry.
We enlist family to care for me and for our daughter. Parents and siblings rotate, staying over to help on the days my husband has to travel or when he can’t work from home. My mother is pale and I worry she’s sick. I’m too ill to see much beyond my own skin, to understand my own fears reflecting back: that seeing your child helpless is the most helpless feeling in the world. No one in my family, to my knowledge, has suffered in pregnancy this way. My mother-in-law rubs my back while I hide my face in the pillow and I wonder what she thinks of me. She and my father-in-law fled from Vietnam with their two children when my husband was just a toddler. They were later detained at a refugee camp, where their third child was born. After the family made it to the United States, their fourth and final child arrived. To seek a better life at such cost, such risk. To leave the only life they knew behind, for their children. It’s all for the kids, my father-in-law always says. Everything for the kids. Twins are virtually unheard of in Vietnam; in my family, this will be the fourth generation in a row. My dad’s voice comes back to me as it did through the phone, You’ll find a way, as we talked about how things will change, our first call in the car driving back from the ultrasound.
To live through hyperemesis gravidarum is to be trapped and isolated, subject to a physical suffering akin to torture. I dream of the day my babies will be cut from my body. I pray and then apologize for my prayers. The family counselor and I speak once more, on the phone, and I lay out my fears. She reminds me to live in the moment. I want to run screaming from these moments but I’m too weak to explain. I lie in the darkened room and think of my body as a vessel. I hallucinate regularly. There is enough light around the curtains to see the numbers appearing in the wood grains of the closet door, floating, suspended, sometimes for days at a time. I imagine the numbers as clues to the length of suffering: days, weeks, months. We can only be pregnant for so long, of course. This time is finite. But one week feeling this way is longer than forever, and days and nights stretching across weeks is excruciating. Some women suffer all nine months. Purple and pink elephants parade near the ceiling in the dark like creepy carny acts, like cartoon friends on crack, and I am disappointed by my mind’s lack of imagination. It’s almost laughable. Most of the time my daughter is kept from the room, but it’s difficult for her to stay away. She climbs into bed and hugs me. She asks when I will play with her, when I’ll be done being sick. I whisper back that I love her. I tell her it won’t be long. Sometimes she brings a book into the room, one of many I read regularly to her, and she remembers enough of these to “read” them back to me as she sits on the floor next to the bed. She watches the actions of the VNA nurse and her father as they care for me, often trying to mimic their actions: administering medicines and flushes intravenously, hooking me up to the “tube,” cleaning and changing dressings. She helps my husband give me a shower once a week. Together they wrap my PICC line arm with Saran Wrap and secure it on both ends with medical tape. Then they slide my arm into a waterproof sleeve and we make the slow walk to the bathroom, to the folding chair in the shower. Our daughter gets a kick out of all this; I try not to throw up on everyone.
It is Sunday morning, the week of Thanksgiving. My husband unhooks the IV drip and pushes in medicine, then flushes the line. He tells me it is snowing, and I want to ask him, so badly, to bring some of the snow to me. But I know it would sound silly, and I can’t ask him to do any more. Already, he’s lost close to twenty pounds from stress, from watching his wife suffer and caring for her and his daughter while trying to work his full-time job. Already, the medical bills are in the thousands, and we are to add two more lives to our family. So instead, I ask him to open the curtains, something I never do. I stare outside into the brightness, unable to see much from my vantage point, but I imagine the snow-covered ground and trees. I want to feel the snow on my cheeks, on my forehead, to ease the unbearable heat coursing through me. I want to forget. I know that I could live in that moment. The cold would shock me so that I could breathe and then intake my breath and not suffer.
Not long after my husband closes the curtains, the bleeding begins. It doesn’t end for some time.
We call the hospital. They tell me to rest, that there’s not much they can do at this point so there’s no reason to rush in. We reach our doctor and he says the same. We have an ultrasound scheduled for the day after Thanksgiving, which, we’re told, should give us enough time to know for sure what’s going on. The scenarios: Both are gone. One is gone. Both babies remain. My bedroom door is closed but later I can hear the VNA nurse and my husband talking in the living room. She’s worried, and tries to put it delicately. We all know it’s likely we’ve just lost them both. I lie in bed and try not to think of the woman I know of who endured nine months of HG, in a twin pregnancy, only to lose both babies shortly after birth. I lie in bed and wait to feel better, the tears a twist of loss and release.
There are some sensations unlike any other, and so the next day, when I feel a tiny stirring, I know. It seems much too early but having been pregnant before, I’m certain. One of them, at least, is still in there, and I wonder how anyone could have survived.
It is the day after Thanksgiving. We emerge from the elevator and my husband pushes the wheelchair across the shiny lobby floor to the hospital’s main entrance. It is bitterly cold for so early in the season and the wind is relentless. We pass through the first set of sliding doors and my husband leaves me in a hurry and runs off for the car, parked way down in the lot. I can barely make him out because the sun is streaming in, a reddish golden haze through the other set of sliding doors several yards in front of me. I call after him because he’s left me in the middle of the walkway and people are altering their paths to get by. The heat in this between space is blasting to combat the chill forced in every time the outside doors open, and my eyes water. The speakers above are piping in Christmas music and the Trans-Siberian Orchestra’s “Christmas Eve (Sarajevo 12/24)” begins to play. I’m a mess, tears streaming down now, my slumping red jacket a sad nod to the season. I’m wrapped in a hospital blanket, balancing my emesis basin on my knees, clutching a chain of sonogram pictures, looped and folded. It is difficult to see with the glare but I look down at my hands again, to the photograph that shows four legs side by side, like synchronized swimmers in near-perfect unison. In my head I write the rest of the story, and in this version the song never ends and the sun hangs suspended, rushing the doors to flood everything in its path. I wait for my husband to return, to take us all home.
We tell our daughter the reason I’m sick. And that it’s not just one, but two. She is excited, and asks many questions. I ask her to bring in her two babies, the dolls in her room, and in a minute she is climbing onto the bed with them both. I try my best to show her how to gently hold them. She plays nicely with them for a minute before sliding down to another game of fantasy. The dolls she leaves behind. I’m too spent to move them so I lie back and close my eyes. Later that day I find one of them stuffed into a clear plastic box on the bed, lid locked into place. The other one’s gone. Later still, when I’m able to move around the house, I’ll find the second doll stuffed into the oven of my daughter’s play kitchen, vacant eyes staring back as I open the door.
Very slowly, over weeks, my condition begins to improve. Nothing tastes good but I can keep down sips of chocolate milk and bites of a couple different foods for short periods of time. I try walking out to the couch, and spend a little time each day sitting there, until the light, sound, and smells send me back into bed; at first it is only a few minutes at a time, all that my body can handle. Gradually, the extreme sensitivity lessens. In January the few drops of water I try stay down. The next day I attempt a whole bottle, crushing it in my hand as I force the liquid in. It doesn’t come up. I still feel sick all the time, and terribly weak, but now I can take a pill. I can stomach the water. At eighteen weeks pregnant the PICC line comes out. I rely on the anti-nausea pills to get through the water, to get through the day, to make it onto the couch. I drink sixteen to twenty glasses each day, unable to get enough, my body craving it like nothing else. As I fight to regain strength and give two tiny, growing bodies the nutrition they need, I watch my daughter play. She is a nurse, she is a doctor, she is a singing, dancing star. She takes her stethoscope to my belly and assures me she can hear the beats.
I struggle with days, with caring for my daughter, with fighting through the HG. There are ultrasounds and consultations, appointments and tests. High-risk equals close observation. Miraculously, the babies seem okay, but we are practically guaranteed an early delivery, and every day matters. At twenty-nine weeks pregnant I’m hospitalized to stop contractions and prevent labor; later I’m released with bed rest orders. At thirty-three weeks we return, a race up north, shortly after midnight. I spend the night as a precaution; they’ll release me in the morning as this is not the real deal. My husband and daughter make the long drive home, as there’s no point in staying. I labor through the night, alone in a dark hospital room, despite the medicine I’ve been given. I’m unaware until hours later, and try to sleep, but the pain is significant, so I lie still and breathe. Later that morning an ambulance takes me to a higher-level facility. The paramedics monitor me and tell me not to push.
At this next hospital, my husband sits by my side. I breathe through the contractions, which are frequent and strong. Nurses come and go. From the delivery bed I can see the two warming stations set up on the other side of the room, labeled Twin A and Twin B. Every now and then we hear a bell go off in the hall, which means a baby has been born. We are new to this hospital. We think the bell is cute. The time has come, in this new place, and we are ready and I could die of relief, of excitement. Of the fear that something will go wrong. And then a funny thing happens. The contractions begin to subside. For three days my husband and I stare at the empty stations and listen to countless bell tolls and then it is finally clear. The babies have decided to wait.
I’m discharged and sent home. It could be hours or days. We know the next iteration of labor will likely be quick. I’m afraid of delivering babies in the car. My husband returns to work. My daughter returns to me. I take my nausea medicine and try not to move, to stretch the pregnancy. It is best for the babies, for all of us. Every day they wait is less time for them in the NICU. Every day means they will be bigger and stronger and more likely to thrive without intervention. Beyond our wildest dreams. We look at our calendar and make our predictions. The high-risk specialist urges us to thirty-four weeks, then thirty-five. He is doubtful we’ll make it to thirty-six, based on a number of factors. Every cramp, every contraction, is a giant question. Will this finally be it?
And then, again, it is midnight.
Thirty-seven-and-half weeks along. My mother is with my sleeping daughter at the house and this thought comforts me more than anything as my husband speeds through the dark. I’m not sure I can hang on much longer, but we make it. The hospital is slow to admit me; we’ve just switched to a new practice, this new hospital, not wanting another ride in the ambulance. I can’t even reach the new doctors on the line. We try to stay calm, to answer questions. I’m examined and a flurry of activity ensues. We’re told there’s very little time, that the doctor is on her way. Epidurals are standard for women expecting multiples as most deliveries happen in the operating room. The epidural goes in, but it misses the mark, so a second one is prepared. This time it works but this is not an operating room, and so I push.
Later that morning, my husband wheels me from the room; I cradle our son to my chest. We stop in the hallway per the nurse’s instructions and someone takes a picture of the three of us, a hospital tradition. After he is prompted to do so my husband reaches over to the wall and presses a button. The bell sounds throughout the floor. Ring it again? my husband asks, and the nurse nods. Another bell sounds.
It is over twenty-four hours, but that is all. The next day our second son leaves the NICU and joins us in our room. I hold them together in my arms and it is overwhelming, all that we’ve been to each other.
It is early June, but the babies wear knitted hats, their small bodies wrapped in blankets. We’ve been told to bundle them up these first few days, as their temperatures are a concern. Right now they are warm as can be, sleeping soundly in the crib which is pushed against a wall in the bedroom, feet from where the three of us spent long, long months. They will sleep here together until they learn to roll, until they need more space. They are blissful and unaware of me studying their faces and expressions and the way their lips quiver their little sighs. My happiness is deep and profound and unlike anything I’ve ever experienced. I still can’t believe them. That they held on so long. That everyone survived.
My daughter grabs me. She wants to be sure I’ve seen the sign on the front door, the large Welcome Home. It’s bright orange and adorned with her stickers; I saw it from the street when we pulled in. The orange reminds me of coming back that day from preschool, to a living room filled with black and orange balloons. Not your typical baby colors but my dad’s team’s colors, which is probably why I remember it at all. I hold my daughter close and wonder what she’ll remember.