Jodi Picoult: Small Great Things

The experience of watching Louis being born affected us all differently. Christina had her baby via surrogate. Rachel had five. Me, I became a labor and delivery nurse.

When I tell people this story, they assume the miracle I am referring to during that long-ago blizzard was the birth of a baby. True, that was astonishing. But that day I witnessed a greater wonder. As Christina held my hand and Ms. Mina held Mama’s, there was a moment-one heartbeat, one breath-where all the differences in schooling and money and skin color evaporated like mirages in a desert. Where everyone was equal, and it was just one woman, helping another.

That miracle, I’ve spent thirty-nine years waiting to see again.

THE MOST BEAUTIFUL BABY I ever saw was born without a face.

From the neck down, he was perfect: ten fingers, ten toes, chubby belly. But where his ear should have been, there was a twist of lips and a single tooth. Instead of a face there was a swirling eddy of skin with no features.

His mother-my patient-was a thirty-year-old gravida 1 para 1 who had received prenatal care including an ultrasound, but the baby had been positioned in a way that the facial deformity hadn’t been visible. The spine, the heart, the organs had all looked fine, so no one was expecting this. Maybe for that very reason, she chose to deliver at Mercy-West Haven, our little cottage hospital, and not Yale-New Haven, which is better equipped for emergencies. She came in full term, and labored for sixteen hours before she delivered. The doctor lifted the baby, and there was nothing but silence. Buzzy, white silence.

“Is he all right?” the mother asked, panicking. “Why isn’t he crying?”

I had a student nurse shadowing me, and she screamed.

“Get out,” I said tightly, shoving her from the room. Then I took the newborn from the obstetrician and placed him on the warmer, wiping the vernix from his limbs. The OB did a quick exam, silently met my gaze, and turned back to the parents, who by now knew something was terribly wrong. In soft words, the doctor said their child had profound birth defects that were incompatible with life.

On a birth pavilion, Death is a more common patient than you’d think. When we have anencephalies or fetal deaths, we know that the parents still have to bond with and mourn for that baby. This infant-alive, for however long that might be-was still this couple’s son.

So I cleaned him and swaddled him, the way I would any other newborn, while the conversation behind me between the parents and the doctor stopped and started like a car choking through the winter. Why? How? What if you…? How long until…? Questions no one ever wants to ask, and no one ever wants to answer.

The mother was still crying when I settled the baby in the crook of her elbow. His tiny hands windmilled. She smiled down at him, her heart in her eyes. “Ian,” she whispered. “Ian Michael Barnes.”

She wore an expression I’ve only seen in paintings in museums, of a love and a grief so fierce that they forged together to create some new, raw emotion.

I turned to the father. “Would you like to hold your son?”

He looked like he was about to be sick. “I can’t,” he muttered and bolted from the room.

I followed him, but was intercepted by the nurse in training, who was apologetic and upset. “I’m sorry,” she said. “It’s just…it was a monster .”

“It is a baby, ” I corrected, and I pushed past her.

I cornered the father in the parents’ lounge. “Your wife and your son need you.”

“That’s not my son,” he said. “That…thing…”

“Is not going to be on this earth for very long. Which means you’d better give him all the love you had stored up for his lifetime right now.” I waited until he looked me in the eye, and then I turned on my heel. I did not have to glance back to know he was following me.

When we entered the hospital room, his wife was still nuzzling the infant, her lips pressed to the smooth canvas of his brow. I took the tiny bundle from her arms, and handed the baby to her husband. He sucked in his breath and then drew back the blanket from the spot where the baby’s face should have been.

I’ve thought about my actions, you know. If I did the right thing by forcing the father to confront his dying baby, if it was my place as a nurse. Had my supervisor asked me at the time, I would have said that I’d been trained to provide closure for grieving parents. If this man didn’t acknowledge that something truly horrible had happened-or worse, if he kept pretending for the rest of his life that it never had -a hole would open up inside him. Tiny at first, that pit would wear away, bigger and bigger, until one day when he wasn’t expecting it he would realize he was completely hollow.

When the father started to cry, the sobs shook his body, like a hurricane bends a tree. He sank down beside his wife on the hospital bed, and she put one hand on her husband’s back and one on the crown of the baby’s head.

They took turns holding their son for ten hours. That mother, she even tried to let him nurse. I could not stop staring-not because it was ugly or wrong, but because it was the most remarkable thing I’d ever seen. It felt like looking into the face of the sun: once I turned away, I was blind to everything else.

At one point, I took that stupid nursing student into the room with me, ostensibly to check the mother’s vitals, but really to make her see with her own eyes how love has nothing to do with what you’re looking at, and everything to do with who’s looking.

When the infant died, it was peaceful. We made casts of the newborn’s hand and foot for the parents to keep. I heard that this same couple came back two years later and delivered a healthy daughter, though I wasn’t on duty when it happened.

It just goes to show you: every baby is born beautiful.

It’s what we project on them that makes them ugly.

–

RIGHT AFTER I gave birth to Edison, seventeen years ago at this very hospital, I wasn’t worried about the health of my baby, or how I was going to juggle being a single parent while my husband was overseas, or how my life was going to change now that I was a mother.

I was worried about my hair.

The last thing you’re thinking about when you’re in labor is what you look like, but if you’re like me, it’s the first thing that crosses your mind once that baby’s come. The sweat that mats the hair of all my white patients to their foreheads instead made my roots curl up and pull away from the scalp. Brushing my hair around my head in a swirl like an ice cream cone and wrapping it in a scarf each night was what kept it straight the next day when I took it down. But what white nurse knew that, or understood that the little complimentary bottle of shampoo provided by the hospital auxiliary league was only going to make my hair even frizzier? I was sure that when my well-meaning colleagues came in to meet Edison, they would be shocked into stupor at the sight of the mess going on atop my head.

In the end, I wound up wrapping it in a towel, and told visitors I’d just had a shower.

I know nurses who work on surgical floors who tell me about men wheeled out of surgery who insist on taping their toupees into place in the recovery room before their spouses join them. And I can’t tell you the number of times a patient who has spent the night grunting and screaming and pushing out a baby with her husband at her side will kick her spouse out of the room postdelivery so I can help her put on a pretty nightgown and robe.