When he was eighteen months old, Stephen was captivated by a nursery rhyme. He wanted me to read “Humpty Dumpty” to him every night. We had three different picture-books of the nursery rhyme and often he had all of them spread open on his bedroom floor. Hearing and seeing “Humpty Dumpty” was not enough—he needed to absorb it into his body. As I read, he ran his fingers over the pictures of the brick walls Humpty precariously perched upon. He touched the king’s men who gathered to unsuccessfully rehabilitate the broken egg. And then he would stand back and flap his hands, stiffly and with utter concentration. I would no sooner finish one “Humpty Dumpty” reading when he’d demand another.
One night, after hearing “Humpty Dumpty” for the umpteenth time, he closed the largest of the three books. I expected him to ask for another reading, but he was silent. Then he closed the other two books and sat on the carpet with his back against his changing table.
Though he could not articulate it further, I understood: he had been falling a lot. Whether it was more than any other child who had been walking for only seven months, I dared not speculate. Each day brought a new scrape on his elbow, a new bruise on his knee. He was big for his age, registering in the 98th percentile for both height and weight and though otherwise healthy, his bigness meant that when he fell, he fell harder and heavier than 98 percent of other children.
He might have been suffering through his first existential moment, wondering if he too would not be able to be put back together again. My heart went out to him, my son, for I too knew what it felt like to be broken.
The night before Stephen was born, I cooked up a batch of DeCecco linguine and ladled portions of white clam sauce over it while Alison, my wife, rested on the living room sofa and watched a cable news channel. Stephen was two weeks late. Alison had been given a dose of pitocin, a synthetic hormone used since 1909 to induce labor, that afternoon. We fully expected a normal, healthy child would be delivered to us the next day.
I set the dining room table with fine china, dimmed the lights, and lit candles around the room before filling our glasses with Pellegrino mineral water. The windows looked out onto our shady backyard, where I could imagine kicking soccer balls and playing games of hide-and-seek with our child in the years to come. It hadn’t dawned on me at the time that our household was set up for quiet contemplation and long, leisurely meals. Oil paintings and Japanese woodcuts hung on our walls. Upholstered arm chairs were selected specifically for the comfort they afforded while reading. The fragile table lamps that sat atop our mahogany tables would all be broken or chipped in the coming years, the tables themselves scratched and gouged. We had spent tens of thousands of dollars decorating our Arlington brick colonial and on that night, while we exchanged pleasantries over a simple meal of linguine and clam sauce, we were enjoying the house that we knew for the last time.
After dinner, we strolled through the neighborhood. The DC metropolitan region was in the middle of a heat wave, breaking record temperatures that dated back to the McKinley Administration. Heat radiated off the sidewalks but we took pleasure in looking at the flowers and gardens that were blooming around us.
We went to evening mass at St. Agnes Catholic Church. This was in the years before the church’s widespread pedophilia scandals became public knowledge—scandals that would largely cause my faith to diminish. At the time, I found the liturgy of the church deeply moving, so moving that I often cried during mass. In all my time as a practicing Catholic, I had not prayed for anything as much as for guidance on the question of whether to have children. We led a comfortable life, Alison and I, for in Washington, it is possible for even callow people to be well-compensated, and it was hard to imagine sacrificing our comforts in order to raise a child. We subscribed to the National Symphony Orchestra, two theater companies, and numerous museums and cultural organizations. We gave money to worthy but hopeless political causes—that is how we demonstrated political commitment: a few pen strokes on a blank check fulfilled, we thought, our social obligations. We held season tickets to D.C. United soccer games. We ate out five nights a week and when we stayed in, we cooked elaborate meals with expensive ingredients— Muscovy duck, exotic fresh mushrooms, and cheeses that had to be specially-ordered. I was the type of cook who used a stop-watch. When a recipe said to sauté shallots for two minutes, I made sure that they were sautéed for exactly two minutes. And yet I had the epicure’s lament that, no matter how silky the deglazed blueberry sauce might be on a plate of pan-seared foie gras, my life was fundamentally empty.
At mass that night, we were quiet and prayerful, preparing ourselves for wonder yet also steeling ourselves in case of tragedy. Like a surprising number of fathers-to-be that I talked to, my biggest fear was that my wife would die during childbirth. Men were going into birthing rooms with a sense of foreboding. We had read too many Frankenstein narratives. In our quest to engineer joy, we expected catastrophe. Alison told me again that she was frightened by the possibility of a C-section, which her obstetrician vowed to perform if the pitocin did not work its magic. I told her not to worry, that I sensed things would work out, but inwardly I was thinking about the risks of infection and the complications that were inherent in every invasive surgery.
It was at moments like this, confronting doom, that we needed the dim lights of a cavernous but empty church, the padded comfort of the kneelers as we prayed after communion, and the familiarities of the call-and-response liturgy. Now, writing this years later, I remember stepping out of the church after mass, Alison on my arm and perhaps receiving the well-wishes from the few other people who had been sitting on the pews with us. We would have heard the bird sounds of dusk and perhaps the chirrups of crickets as we walked across the black asphalt parking lot to the sidewalk that would take us home.
Stephen was thirty months when his preschool teachers advised having an occupational therapist evaluate him. His fine and gross motor skills, they said, were not developing normally. He could not manipulate crayons and scissors as deftly as his peers. And he was still falling down a lot and flapping his hands whenever he was over-stimulated.
Alison scheduled the appointment with the therapist they suggested. Before Stephen’s birth, she’d been a policy analyst for the American Academy of Actuaries, but as soon as he was born she decided to quit her job and devote herself full-time to his upbringing. Such was her immediate love for our child. Because of the sixty hour weeks that my job demanded, I didn’t have many opportunities to see him at preschool or watch him play with other children his age, but I could not believe that he was in any way deficient. Such was the blindness of my love for him.
Hours after Stephen’s evaluation, I set the dinner table while Alison finished preparing the food. I can no longer remember what we ate that night but am reasonably certain that Stephen would have had macaroni-and-cheese. Even now, nine years later, macaroni-and-cheese is one of the few foods that he really savors. Mouth texture meant a lot to him—he could not tolerate hard foods or overly gooey foods, but soft foods (and particularly soft foods of the cheesy variety) he let pass through his lips.
“He failed the Sit’n Spin test,” Alison said.
I had no idea what she was talking about.
“He couldn’t operate a Sit’n Spin.” Alison was near to tears. She brought a paper napkin to her eyes. The Sit’n Spin was apparently a brightly colored Hasbro toy; as its name suggests, children sit on the toy and spin themselves silly. Stephen had probably never encountered the toy before in his life. During their appointment, the therapist set one down in front of him. “He didn’t even touch it.”
“So? What does that mean?”
“She thinks he might be autistic.”
“What’s a Sit’n Spin?”
“He didn’t even touch it,” Alison said again. She put her hands over her face and sighed. “His lack of curiosity, she said, was telling.”
By this point in the dinner, Stephen would have been midway through his first bowl of Mac-n-cheese and oblivious to our conversation. Because he could not yet operate a fork with any consistency, he tended to eat with his hands. Cheese sauce would have been smeared over half his face. We kept a roll of paper towels on the table but had a hard time keeping up with the messes he made. I could not get a clear picture in my head of what a Sit’n Spin might look like but the idea that trained professionals would use it as a diagnostic device to render such a judgment struck me as preposterous.
“He doesn’t play with other children,” Alison said, sniffling, the pain in her voice betraying how much it hurt her to say these things. “He doesn’t make eye contact like other children. He doesn’t converse.”
“He talks just fine,” I said. “Don’t you, Stephen?”
Stephen lifted his head out of his macaroni-and-cheese bowl and grunted.
But the truth was, Stephen’s verbal communication skills were… different, relying more on the intonations and physical gestures which accompanied his words rather than the words themselves. Stephen’s play strategies were different, too. At the playground, he’d sit in the sandbox and dredge his hands through the sand. He prized the tactile sensation of the sand against his fingers and would sit literally for hours sifting through the sand. When other kids invited him to play with their Tonka trucks, Stephen would get out of the sandbox and go spread his hands over the wood chips that were on the ground around the swing sets. If he couldn’t play with the wood chips, he would just stand under the shade of a giant oak and flap his hands.
I viewed his differences as strengths, rather than weaknesses that had to be overcome through intensive therapies. But more than anything, I yearned to prove that he was normal.
The next night, I stopped off at a toy store and bought a Sit’n Spin. At home, I assembled it in the living room. The cat, aptly named Bashful for his skittish ways, was sitting in front of the fireplace. Alison was preparing dinner and I could smell onions and mushrooms sizzling. After screwing in the final screw, I pressed a button on the Sit’n’Spin. Children’s songs playing through a speaker concealed somewhere within the toy. Bashful, spooked by the noise, bolted for cover under our blue Hepplewhite sofa, causing Stephen to laugh.
“Look what I’ve got for you,” I said to him.
Stephen picked up the cat’s plastic mouse and squeezed it, again laughing. Even before he learned to talk, he laughed at the silliest things, so much so that Alison and I took to calling him Laughing Boy. I remember holding him in my arms and walking through the house flipping the light switches on and off. Each time the lights came on, he’d laugh. In my mind, I imagined he was discovering causality—flip a switch and lights come on!—and that his laughter represented a kind of intellectual joy at this discovery.
“Not that,” I said, taking the mouse from his hands. I steered him closer to the Sit’n Spin. “Don’t you want to play on it?”
He stared at the Sit’n Spin as if it were a functionless abstract sculpture.
“C’mon,” I said, pleading. “Don’t you want to play on it?”
Stephen shook his head.
Irrationality knows no limits. A Sit’n Spin was not a proper tool for diagnosing autism—even I knew that—yet I was convinced that if I could just teach Stephen how to properly play with it, I could free him from whatever condition might be preying on him. I would drag the toy out of the closet many times over the next weeks, pleading with him to use it. On the rare occasions when I could coax him to sit on the device, he’d act as if he were in pain. He would not spin on the Sit’n Spin.
Many specialists would evaluate Stephen, testing him on equipment far more elaborate than could be bought in a toy store. Their diagnosis—pervasive development disorder coupled with acute sensory integration disorder—was essentially the same as what the occupational therapist had concluded. I still brought out the Sit’n’Spin at night. Eventually, he came to dread me coming at home at night. He’d stay in his room, or run to Alison for protection. As soon as I’d open the front door, he’d ask, “Daddy, you’re not going to make Stephen play, are you?”
We imagined the days Alison would spend in the hospital after the birth to be a form of quarantine, severe and cut off from all the normal comforts of home. Her obligatory suitcase was stuffed with things to make her stay more endurable: extra pairs of slippers and nightgowns, toiletries, and spare pillows. To this, I added a box of Godiva chocolates. In the early morning hours of June 9, 1999, I tossed this suitcase into the trunk and we drove to the hospital, crossing the Potomac at the Key Bridge and veering onto the high-banked turns of the Whitehurst Freeway. A weak, yellow light issued from the street lamps. The streets around the hospital were tree-lined and pleasant. Better yet, they hosted a number of well-reviewed restaurants where I imagined myself ducking out for a meal while Alison was cooped up in the maternity ward.
Arriving at the hospital, we were informed that three babies had already been ushered into this world that day. At that moment, however, no one was in labor. There was calm. Nurses gathered at the front counter and watched a morning newscast while passing around a box of oatmeal cookies.
We were soon shown to a birthing room, which had lustrous glazed wood flooring and comfortable leather chairs for me to sit on. The hospital’s philosophy was that a stress-free environment was essential for healthy childbirth. The room was equipped with a television, stereo system, and a Jacuzzi to help relax birthing mothers. It would have been a fantastic hotel suite had not there been medical equipment cluttering the area around the bed.
I adjusted the knobs on the stereo system to tune in 103.5 FM WGMS, Washington’s classical music station that we fell asleep to on most nights. A number of popular studies, now largely disproven, had suggested that pre-natal exposure to Mozart would improve a child’s intelligence. We knew of women who attached headphones around their pregnant bellies to deliver doses of Eine Kleine Nachtmusik and movements from the late symphonies, but we were not that ridiculous. At my worst, I merely hummed a few bars from Don Giovanni but mostly, because I prize literature more than music, I read to our baby-to-be. Alison, dressed in a pair of aquamarine velour pajamas, would recline on our mahogany sleigh bed, her head propped up on tasseled pillows, and I would crack open The Great Gatsby and read aloud the epic grandeur of boats beating on against the current, and the transforming power that a single green dock light can have when viewed at night from across a watery bay.
I had been writing a short story at the time, something loosely based on the last years of Willem de Kooning, and while Alison changed into a flannel robe and read on the hospital bed, I pulled the manuscript out of the manila folder than I had brought along and began working on it. The abstract expressionist was once said to have “the fastest lines” of any painter living in New York, yet what interested me were the painter’s last years. A victim of Alzheimer’s, his paintings became softer, mellower. A sense of the serene had overtaken his life, a transformation that I yearned for myself. He painted with wider brushes that made wider lines, took frequent naps, and said things like, “Sometimes I’m afraid of yellow.”
“Are you feeling anything yet?” I asked.
Alison shook her head. “No.”
“Don’t go making yourself too comfortable,” the nurse said. She was tall and with an athletic build, someone who seemed capable of dashing from room to room as crises demanded. “As soon as the baby’s born, you’ll be going to a room in the maternity ward.”
Then she asked, “Are you excited? Are you ready?”
Nearly everyone, from the doctors and nurses to the cafeteria woman who explained Alison’s meal options while at the hospital, asked that same question: “Are you ready?” A transformation came over people once they stepped into our room. Bubbling with enthusiasm, they asked what we hoped to name the baby, whether grandparents were in town. Even our obstetrician, a normally taciturn woman who spoke in hushed tones, strode into the room with a smile. She asked, “Are you ready?”
But we were not ready. Alison spread her legs, allowing the obstetrician to examine her. The previous day’s pitocin had not worked—she had not yet begun dilating—so nurses hooked Alison up to an IV laced with even more pitocin. For me, relaxing on a comfortable chair, it almost felt like playing hooky from my real-world job responsibilities. Alison, hooked up to the IV, was reading A Walk In the Woods, Bill Bryson’s memoir of hiking the Appalachian Trail—something we had talked vaguely of doing ourselves at one time but never did—and I was writing a story and it seemed like we could be like this forever in our pampered hotel suite of a hospital room.
At a certain point, our obstetrician wanted to show us something on the fetal monitor. Alison’s contractions had finally begun, registering as stump-like blips on the monitor. The baby’s heartbeat charted on the monitor as a wavy line. After every contraction, the wavy line dipped a notch. This was not good, the obstetrician said. She asked if we might want to have a C-section, “just in case.”
Just in case.
What does that mean?
We weren’t offered a definition but it was obvious: if the baby’s heartbeat continued to decline, its life might be threatened. Yet our obstetrician did not seem overly concerned; nor did she impress upon us a dire need to perform an immediate C-section. We were obliquely talking about precaution but despite its dips, the baby’s heartbeat was still comfortably in the healthy range. That much, the doctor assured us.
I have replayed this moment in my mind hundreds of times in the last dozen-plus years. Within Catholic theology, there is the notion of sins of omission—meaning that we are just as culpable for the good acts we fail to do as for wrong acts that we actually perform. Had I exercised prudence and caution, I could have convinced Alison that we ought to have gone ahead with it.
Instead, I waffled.
“Let’s just wait and see how things develop,” I told the obstetrician, employing Alison’s fear of a C-section as the justification against the procedure…
… when really what I meant was that I wanted to forestall the inevitable just so I could remain comfortable a bit longer in this pampered hotel suite of a hospital room.
I sank back into my comfortable chair, picked up my pen, and resumed writing my damn de Kooning story, a story that would never ever be published because, like so many of my early attempts at story writing, it was a piece of crap. Unfortunately, I had forgotten my thesaurus, something I found indispensable when writing back then. Ten minutes later, a nurse turned to me with a puzzled expression and shook her head when I asked if she might be able to find me one.
Hours later, our obstetrician looked at the monitor with a new urgency. It happened so quickly, the plummeting of Stephen’s heartbeat. This time, there was no hesitation. Orderlies raced Alison out in a wheelchair to a prep area, where they’d administer an epidural to dull the pain of an emergency Cesarean. I was told to gather our things. Someone, a nurse, would fetch me in 15 minutes so I could be in the operating theater with her for the C-section.
Although I didn’t realize it at the time, pitocin inductions increase the risk of fetal distress. The contraction patterns, although roughly matching those preceding natural births, can be more forceful. Increased pressure is exerted on the fetus, which can compress the umbilical cord, cutting down the child’s oxygen supply. Perhaps because of these reasons, some studies suggest pitocin-induced babies are more at risk of being autistic.
It was now early afternoon and I hadn’t eaten lunch. Nor was there time to wander over to one of the well-reviewed restraints nearby for a leisurely zuppa di pesce. I felt strangely alone. I sat at the corner of the bed, crossing and re-crossing my legs, and it dawned on me for the first time that the day was not about me. Alison’s book was lying on what had been her pillow and I flipped through its pages briefly. Now that she was about to give birth, she’d have no more need for the oversized v-necked maternity tee shirts and black leggings that I packed into the suitcase. Four months into the pregnancy, her feet swelled tremendously and she had to buy new shoes, new sneakers. These too would soon be relegated to the back of her closet, for everyone had assured us that her feet would shrink back to their normal size once the baby was born.
Many minutes passed, and no one came to fetch me.
I wandered into the hallway. The nurses’ station was untended, the television tuned to one of those trashy afternoon talk shows on which spouses trade accusations of infidelity and bankrupting sex and gambling addictions. The hallway was maze-like, dimly lit and, except for that television, eerily quiet. Stumbling around, trying to locate the operating theater, I felt as if I might be the only person in the hospital.
Roving down a corridor, suitcase in hand, I was confronted with two nurses shouting at each other. Something, I gathered quickly, had gone wrong on their watch. I didn’t recognize either nurse, but they must have recognized me because as soon as the first one tilted her head toward me, they fell silent.
The doors to the operating theater were right next to them. Behind those doors, I heard doctors barking at each other. Nearly every other word seemed to be, “Stat!”
“You’re the father, right?” one of the nurses asked. Surgical masks obscured their faces and it was hard to say for certain which one spoke.
“Is everything all right?” I asked.
“You better go in,” said the nurse who had been yelling at the other. She pushed the door to the operating room open with her elbow. The nurses wore gray scrubs and latex gloves, their hair bunched up under elasticized skull caps made of the same gray material as their scrubs. They even wore booties around their shoes made of that gray material, yet without even the precaution of washing my hands I was told to go inside that operating room.
I had always imagined operating rooms to be vast, cavernous spaces but this room seemed enormously small, a cramped ceramic-tiled cave crammed with medical personnel and medical equipment. Alison lay on a stainless steel table in the center of that room. She had already been cut open. A white cloth-like partition was installed over her abdomen so that she wouldn’t have to look at herself.
Our obstetrician looked up at me from the other side of that partition. Blood speckled her gray scrubs and pale latex gloves. “We had to start without you,” she said.
The obstetrician pointed to a spot somewhere near the incision. “Suction.”
An assistant leaned over the obstetrician’s shoulder and angled a length of flexible tubing at that spot. The tubing might have been the width of a pencil and there was the briefest of slurping sounds before the tubing was removed.
Nurses told me that the baby’s heartbeat had deteriorated so rapidly that Alison was rushed into the theater before her epidural could take effect. She was fully conscious, though an anesthesiologist sat on one side of her and had her breathe in gases from a mask. In one hand, he held a timing device that looked like the stopwatch I used when cooking. Every so often I could hear him counting to himself, marking the breaths Alison took from that mask.
Color drained from Alison’s face. Because of how I’d been rushed into the operating theater, I assumed her life was in jeopardy. She seemed older, frailer. Her lips were incredibly pale, dry, the skin appearing to crack. A nurse rubbed her forehead with a sea sponge, which soaked up her perspiration. Although she hadn’t eaten for many hours, she vomited frequently over the next twenty minutes. Another nurse shoved a kidney-shaped basin into my hands to catch what she threw up.
“Is the baby out yet?” Alison asked.
I glanced over the partition just as the obstetrician stuck her hands into the opening she had created in my wife. Stainless steel clamps held down flaps of her skin. Alison’s stomach (or some other dark brown organ) had been pushed to one side. I must have appeared queasy; someone, possibly the obstetrician, told me, “You don’t have to look.”
A moment later, the obstetrician said that the umbilical cord was wrapped around Stephen’s neck. She pulled him out of the womb. He seemed lifeless. The obstetrician wiped a white membranous substance off his shoulders. The atmosphere in that cramped operating theater became tenser. Stephen’s skin was blue.
“Tell me what’s going on,” Alison said.
The obstetrician said something that I couldn’t understand and I squeezed Alison’s hand and then the obstetrician said the same thing again, this time louder. She was holding our baby with both hands. “Stat! Stat!”
One of the nurses inserted a piece of hosing into Stephen’s mouth and down his throat, pumping a rubber bulb that was at the other end of the hose. The pumping seemed frantic, furious. A moment later, relief came over the nurse’s face. She pulled the hosing from Stephen’s mouth. “He’s breathing.”
Stephen wailed. And squeaked. Unlike most babies, Stephen didn’t cry but made a squeaking sound when upset. When I heard it, my heart leapt ecstatic. Never had I experienced such a sudden shift of emotions. The knowledge that someone’s life had been in danger—Alison or the baby’s— had been with me ever since I saw the two nurses yelling at each other, but now I saw that everyone was going to live. The blue that tinged Stephen’s skin dissipated with each new breath. He moved his arms, balling his hands into fists and bringing them to his eyes as if to wipe away tears.
“Where is he?” Alison asked. Lying on the operating table, she couldn’t see how the nurses dried him off on plush towels and swaddled him in a blue blanket. Already the obstetrician had snipped the umbilical cord. Stephen squeaked again. The sound was like something a child’s toy might make when squeezed, and unless I watched him do it, it would not have occurred to me that he was responsible for that sound. Alison strained to raise her head to see him, but the anesthesiologist pushed his gas mask on her once more.
“Where is he?” Alison asked, in a voice that I could barely hear through her gas mask. “Get him for me.”
One of the nurses stepped around me, carrying Stephen. The way she wrapped him in a knit cap and that blue swaddling blanket, tight and with the ends of the blanket tucked in, reminded me of a mummy. The nurse bent to her knees and let Alison see the baby. Stephen’s eyes had been closed but when Alison pressed her cheek to his face, his eyes flickered open. He had the most incredibly long eyelashes. Tears came to Alison and when I saw those tears, tears came to me as well. Out of absent-mindedness, I let go of the stainless steel basin and it crashed to the floor, startling our anesthesiologist. We looked at each other for a moment, the anesthesiologist and I, and then he looked at his stopwatch and resumed counting.
I thought we were in the clear.