Journal of a Premmie
Liesl Jobson

 


28 April
Gail was born today—a mere 2 pounds 6 ounces. This is, theoretically speaking, a good birth weight for an infant born 12 weeks early.

Her father took a photograph of her and brought it to my bed. She looks like a spatchcocked chicken—or rather, that part of her that can be seen. Mostly, she is covered in headgear and pipes. I will be wheeled in to see her once she has been stabilised. I don’t know if I can bear to look.

She’s lucky to be a girl, they say. Girls do better in these circumstances. I wonder if she will survive.

I do not think I am lucky to be a girl. There is no champagne in this ward tonight.

29 April
How shall I love this child I cannot hold?

30 April
No weight reading until she is off the ventilator. A nurse said I am fortunate that Gail weighs so much. At Baragwanath Hospital, they do not bother to ventilate babies weighing less than a kilo because they need the machines for “more viable” cases.

2 May
My daughter’s fingers are long and beautiful. If she lives—and is not retarded—she will have perfect fingers for playing the cello.

6 May
Gail is 8 days old, but technically at 29 weeks gestation. She weighs a whole 2.73 pounds. I held her for the first time today. The nurse had to show me how to hold her. “Put your hands side by side,” she said, “like a beggar.” The nurse then draped a sterile cloth over my palms, then placed Gail on top. Her head rested in one hand, her back and buttocks in the other.

She has been moved off the ventilation table and into the incubator. Her blood saturations are erratic and her patent ductus valve still wavers open-close-open.

The charge sister showed me how to stimulate her when the monitor signals an apnoea attack.

Gail’s eyes still roll in opposite directions. It will be some days before they both stare in the same direction, and some weeks before she can focus. Doctor explained the "harlequin effect" where one side of her back is pink and the other half is blue. The blood is flowing in two different circuits through her body. This will settle down once the valve in her heart closes.

I dreamed there was a fire in the hospital. I discovered the doctor wheeling her incubator between the stairwell. He couldn’t push it down stairs without her tipping to the front. Her skull’s tectonic plates shifted into each other and the brain sheaths sheared. Blood gathered between the ventricles and poured out her eye sockets, her ears, her mouth.

I woke up at 3 a.m. and drove straight to the hospital.

10 May
How the nurses gossip! One let slip that when she worked at Baragwanath Hospital, a colleague was known to turn down the volume on the monitors of the sickest infants. That way, nobody hears when a baby needs resuscitation. I was horrified. She quickly assured me that this was only done to babies that were clearly deformed.

“They were doing the mothers a favour…”

“A favour?”

“Well, if you live in a shack without lights and water, your man is unemployed, and you have six healthy, albeit hungry, children, it’s not a great help to be saddled with a disabled child, now is it?”

Perhaps it is not.

12 May
There was a hideous frenzy of activity in the unit today when an emergency call came in. I overheard fragments of conversation, “… ruptured placenta at 32 weeks… patient off the street… haemorrhaging hugely…”

The charge sister and paediatrician prepped themselves with great haste and dashed off to theatre, green gowns flapping like silent birds. Another nurse wheeled in a new ventilation table in anticipation of another tiny patient, folded a sheet over the mattress, and placed a number of tubes and vials on the counter in readiness. She said she might have to ask me to leave the unit shortly and asked for my co-operation in such an event.

I am knitting a cap for Gail. Her head is the size of a small apple. I learned to change her nappy today and she has had fewer apnoea attacks than yesterday. I should be feeling happy because my daughter is doing so well, but when the charge sister returned from theatre walking slowly, I thought I would throw up. The nurse wheeled the empty ventilation table back out of the ward and I had to get to the bathroom quickly where my stomach emptied violently.

I dreamed the Neonatal Unit was terribly busy, with hundreds of emergency cases arriving simultaneously. There were rows of incubators, each with little flags posted—red, orange, green. The deformed babies got orange flags, the terminally ill ones got red. Gail’s incubator got a green flag, but as each new admission came in, she was shunted further and further away from the nurses’ station. There were not enough nurses to look after all the babies. I watched them turn down the volume settings on the monitors with red flags. When Gail’s monitor signalled an apnoea attack, nobody heard because she was too far away.

18 May
Heavyweight hits 3.7 pounds!

20 May
Gail weighed in at 3.8 pounds today but has a viral infection.

She shivers and judders. I think she has had a brain bleed too. Maybe she will be retarded. Her eyes, which were finally pointing in the same direction, now roll back into her eyelids.

Later, I demanded to know what’s happening because I am no longer allowed to take her out of the incubator; she is too sick. The nurse fobbed me off. I am so afraid she is dying.

I started crying and the nurse called the doctor to the neonatal ICU. He, at least, was straight with me even though he was irritated with my hysterics. He explained why Gail is “jumpy”—the electrolytes in her little system are out of kilter because of the diarrhoea and not because she has had an intraventricular haemorrhage. She is back on a drip, a patch of her head has been shaved. She looks a funny colour.

I dreamed the laundry staff didn’t see Gail in the incubator when they cleared out the NICU bedding. She was so small that they mistakenly threw her in the laundry bag with the dirty sheets and baby blankets. I was in the hospital laundry, wailing in despair, sorting through mounds of bloodied, pus-encrusted hospital linen, searching for my baby. “Gail, Gail, Gail! I’ll find you, baby, I’m coming, don’t die in this cold place, I’m coming, Gail…” But she couldn’t answer me, her cry was too weak, and it was cold. She couldn’t regulate her body temperature and if I didn’t find her soon she would die.

Mom woke me. She couldn’t sleep and heard me crying.

31 May
The nurse in charge today asked me to stop singing.

4 June
Four pounds—such a big girl these days…

A premmie romper arrived from Johannesburg. It is pink and comes from my neighbour who had twins at 28 weeks. It is intended for Gail’s first travels. We fly to Johannesburg in an air ambulance tomorrow. I will dress her like a doll. She is rooting for my breast when I hold her and soon, the nurses say, soon I will start breast-feeding her. Not a moment too soon. I’m so tired of the electric thumping breast pump. I do not feel like her mother. It seems she is the child of the hospital.

I dreamed Gail disappeared from her incubator. I searched the sluice rooms, the passages, the stairwells. In the basement of the hospital I found a graveyard with all the broken beds, decrepit drip stands, and rusted trolleys that are no longer in use. There is a wall of boxes, like shoeboxes. I knew she was in one of the boxes, but I couldn’t find which one. I was tearing through the boxes, and a pile of chaos grew like a wall around me. I knew she would be fine because I would not stop searching till I got to the right box. It was warm near the furnace.

7 June
The baby in the next incubator has not come off the ventilator yet although she arrived soon after Gail. I don’t think it is doing very well. I smile at the mother but she doesn’t seem to see me, lost in her own bewilderment.

10 June
The baby in the next incubator has been a greyish colour for a couple of days. A consultant paediatric cardiologist has been called in from the university. The mother sits in silence, rocking and holding herself, while the nurse “bags” the baby manually, pumping a kind of bladder thing with her hand to get it to breathe a little longer.

Gail is pale though definitely not grey. She must have a transfusion soon. She is nearly 4.4 pounds and her weight gain has been good, which is why she can’t generate enough iron of her own accord. I went to the blood transfusion centre in Hillbrow to give blood for Gail. I lay on a greasy stretcher next to a tramp that had come in from the winter wind to exchange his blood for a hot cup of tea and plate of biscuits. I hope they do not mix up our blood bags…

11 June
The baby in the next incubator has gone.

12 June
There is a black Perspex line that drips my own blood slowly back into my daughter.

13 June
Gail is glowing like a rose.

14 June
Four pounds 6 ounces—two whole pounds up on her birth weight. Yesss!

20 June
I am a raving lunatic, screeching indignation. This f***ing stupid hospital employs retarded morons! A fool of a woman used regular elastoplast when changing the naso-gastric tube instead of the special dermatologically sensitive stuff. When they ripped the tape off yesterday, they ripped off the top layer of Gail’s cheek. I am howling in outrage at her discomfort. I want to take her home now! I am desperate to feed her without the agitation of the paediatric ward. They say when she reaches 5 pounds and is taking enough from the breast she can go home. In the meantime I better calm down, they say, or I will sour all the milk.

I dreamed I gave birth to quads at 24 weeks. They each weighed a pound. I knew they couldn’t all live and I’d be lucky if one of them wasn’t brain damaged. I walked from baby to baby trying to remember their faces, waiting for them to die, to bleed, to shudder in fits of immature neurology. I had milk for only one baby and I wanted to know which one to give it to.

I woke, my breasts were full, they tingled with the letdown reflex, and my pyjamas were suddenly soaked. I knew Gail was hungry and went straight to her.

When I arrived in the ward, I heard a peculiar noise I had never heard before. I looked in the bassinet to reassure myself that it was not rats squeaking in her crib. My God! Gail was screaming for me—she wanted her mother.

She latched and tugged. I wept for joy. It will not be long before we go home.

 


 

After writing mindnumbing publicity for the deeply disturbed South African Police Service, Liesl Jobson has returned to the primary school classroom at Sacred Heart College in Observatory, Johannesburg. After the daily singing of 14 nursery rhymes, 16 hymns, and 25 rounds, she gathers the claves, tambourines, and maracas and collapses into a heap of exhausted bewilderment. She is also participating in the MA in Creative Writing at the University of the Witwatersrand. Her work has appeared in Lit Pot, Exquisite Corpse, Gator Springs Gazette, and other fine e-zines.

 


 

Gail plays the cello with spider fingers. She is knitting a scarf that measures 3.5 meters in four shades of purple, has taught our cockatiel to whistle “Getting to Know You,” and has written a cookbook for parrot lovers entitled “Birdie Treats.” It would appear that no lasting damage was suffered by her early birth, and, at 11-going-on-21, it would seem she is approaching adolescence prematurely too.

 

Gail, age 11

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