Part Seven: The Waiting
The rest of the pregnancy was hard on my body, harder than the others. I was thirty-four, and five babies in eight years had taken their toll. I had high blood pressure in the third trimester and had to go on modified bed rest at thirty-four weeks. Aaron took over everything at home: school drop-offs, soccer practices, dinners, baths, bedtime stories.
He was wonderful. He really was. But he talked about the baby constantly. He’d lie in bed with his hand on my belly and talk to him. Hey, buddy. It’s Dad. We’re gonna go fishing at the cabin. We’re gonna watch the Lions lose every Sunday. I’m gonna teach you to swing a hammer.
The girls listened. They always listened.
One night in my eighth month, I came downstairs for a glass of water at eleven o’clock and found Hazel sitting at the top of the stairs in her nightgown, hugging her knees. Below us, in the living room, Aaron was on the phone with his father, and his voice carried up the stairwell clear as a bell.
“I know, Dad,” he was saying. “I can’t wait either. Finally, right? After four tries.” He laughed. “I’ll bring him to the cabin the first weekend he can travel. You and me and him, Dad. Three Bowman men.”
I sat down on the step next to Hazel. She was crying silently, the way Aaron cries.
“What’s wrong, baby?” I whispered.
She wiped her nose on her sleeve. “Four tries,” she whispered. “That’s us. We’re the tries.”
I didn’t know what to say to her. I held her on the stairs until she fell asleep against me, and then I carried her back to bed, all fifty-two pounds of her, my enormous belly bumping the doorframe. Then I lay awake until three in the morning, trying to figure out how to tell my husband that our oldest daughter thought she was a failed attempt.
I never found the right words. I kept meaning to. Then the baby came early.
Part Eight: The Delivery
My water broke at thirty-seven weeks, on a Tuesday morning in late October, while I was standing in the kitchen packing four lunch boxes. Labor was long and exhausting, sixteen hours at Butterworth Hospital in Grand Rapids, the same hospital where I work, in a delivery room on the fourth floor with a window that looked out on the gray Grand River and the trees along the bank going red and orange.
Aaron’s mother took the girls. Gerald came to the hospital and sat in the waiting room with a cup of coffee and a newspaper he never opened. I’d never seen him at a single one of my deliveries before.
At 9:41 that night, after sixteen hours, the doctor announced that we’d welcomed a perfectly healthy baby boy. Seven pounds, eleven ounces. Twenty and a half inches long. A full head of black hair.
He came out crying, loud and angry, his little fists balled up, his face bright red.
I’ve never seen Aaron look so happy. He was practically glowing. He’d been holding my hand through the whole delivery, and when the doctor held up the baby, Aaron let go of my hand and put both of his over his mouth. His eyes filled. He laughed and cried at the same time.
“A boy,” he said. “Mer. Look at him. Look at him.”
The nurse wiped the baby down and checked him over quickly, and his Apgar scores were good, an eight and a nine. She wrapped him in a striped hospital blanket and put a little blue knit hat on his head. Then she turned around and carefully placed our newborn son in Aaron’s arms.
I watched them together. Aaron, six-foot-one, in his wrinkled flannel shirt with his reading glasses pushed up on his head. Our son, tiny and red-faced, swaddled in the striped blanket, his little mouth working as he settled down and stopped crying.
I expected Aaron to cry or laugh or say something about finally getting his wish. I expected him to say, Hi, buddy. I’m your dad. I expected him to say the name we’d picked out. I even expected him to turn toward the door and shout down the hall to his father in the waiting room.
But he didn’t.
Part Nine: The Words
Instead, he stared at our baby’s tiny face, and his smile slowly faded.
I saw it happen. One moment he was glowing. The next, something passed over his face like a shadow crossing a field. His eyes narrowed. He leaned closer. He tilted the baby toward the light from the window.
He went very still. His jaw tightened. His hands, holding our son, started to shake.
He didn’t look happy at all.
Then he looked at me. His face was white, completely white.
He opened his mouth, and the words that came out made my stomach drop.
“Meredith,” he said. “He looks like Danny.”
For one horrible second, I didn’t understand. I thought he meant the black hair, the Bowman nose. I thought it was sentimental, a man seeing his lost brother in his new son. I started to say something soft, something like Oh, honey.
Then Aaron said the rest.
“His lips,” he said. His voice was cracking. “Mer, look at his lips. They’re blue.”
Part Ten: Blue
I pushed myself up on the hospital bed, sixteen hours of labor and every muscle screaming, and I looked.
At first I didn’t see it. The room was bright, and the baby was red from crying, and he was wearing that little blue knit hat that made everything look bluish around his face. I almost said Aaron, it’s just the hat.
Then the baby yawned. His mouth opened and closed, and I saw it.
His lips weren’t pink. They were a dusky, grayish color, faintly blue at the edges. The skin around his mouth was pale. And his little fingernails, peeking out of the striped blanket, had a faint purplish tinge.
I’m a hospital pharmacist. I’ve been one for eleven years. I’ve worked in the NICU. I’ve mixed medications for babies the size of my hand. I know what that color means.
It’s called cyanosis. It means the baby isn’t getting enough oxygen in his blood.
“Nurse,” I said. My voice came out strange and flat. “Can you check his oxygen saturation, please? Now?”
The nurse was a young woman named Kayla, maybe twenty-five, and she’d been cleaning up the delivery tray. She looked up, surprised. Then she looked at the baby’s face, and I watched her expression change.
She didn’t argue. She took the baby out of Aaron’s arms and laid him on the warmer. She clipped a tiny pulse oximeter sensor around his right hand and another around his foot.
The number came up on the monitor.
SpO2: 79%.
A healthy newborn should be in the high nineties. Kayla pressed the call button on the wall, and her voice was calm and fast at the same time.
“I need a NICU team to Delivery Four,” she said. “Newborn, cyanotic, sats seventy-nine on room air.”
Aaron was standing in the middle of the room with his empty arms still curved the way they’d been when he was holding his son. He was staring at the warmer. He was shaking. I reached out from the bed and grabbed his hand.
“Aaron,” I said. “Look at me. This isn’t Danny. We’re in a hospital. You noticed. You noticed right away.”
He didn’t answer. He just held on to my hand like it was the only thing keeping him from falling through the floor.
Part Eleven: The NICU
The NICU team was there in under two minutes: a neonatologist, two nurses, and a respiratory therapist. They surrounded the warmer, and I couldn’t see our son anymore, just their backs and their hands moving fast.
They put him on oxygen. His numbers barely moved. The neonatologist listened to his chest with a tiny stethoscope for a long time. Then she said something to one of the nurses that I couldn’t hear, and the nurse left the room at a run.
Two minutes later, a technician wheeled in a portable ultrasound machine.
The neonatologist was a woman in her fifties named Dr. Anjali Rao. I knew her a little from work. She sat down beside the warmer with the ultrasound wand and pressed it gently against our son’s chest, and she studied the screen for a long time.
Then she turned around and looked at us.
“Mr. and Mrs. Bowman,” she said gently. “Your son has a congenital heart defect. It’s called transposition of the great arteries.”
She explained it slowly, the way you explain things to parents who are in shock.
The two main arteries coming out of our son’s heart were connected backward. The blood that should go to his lungs to pick up oxygen was going to his body instead, and the blood that should go to his body was going back to his lungs. Two separate loops that barely mixed.
“Before birth,” Dr. Rao said, “it doesn’t matter, because the mother’s blood provides the oxygen. After birth, babies with this condition can look completely normal for a few hours or even a day or two, while a small natural opening in the heart stays open and lets a little blood mix.” She looked at Aaron. “Then that opening starts to close. And the baby turns blue.”
Aaron made a sound. A small, broken sound.
“Can you fix it?” I asked.
Dr. Rao nodded. “Yes,” she said. “It’s very serious, but it’s very fixable. We’ll start medicine right away to keep that opening from closing. Tonight, the cardiology team will probably do a procedure to make a bigger opening, to buy him time. And in the next week or two, he’ll have surgery, an arterial switch. The surgeons will put the arteries where they belong.”
“What are the odds?” I asked. I’m a pharmacist. I need numbers.
“With surgery,” Dr. Rao said, “most babies with this condition grow up and live completely normal lives. They run, they play sports, they grow up.” She paused. “Without it, most don’t survive the first month.”
Part Twelve: “You Saw It”
They took our son to the NICU at 10:23 that night, forty-two minutes after he was born. He went in a clear plastic incubator, with tubes and wires and a nurse squeezing a little oxygen bag, down the hallway toward the elevators.
Aaron walked beside the incubator the whole way, with his hand pressed flat against the plastic.
I couldn’t go. They wouldn’t let me out of bed yet. I lay there in the delivery room with my body empty and aching, staring at the door.
Then Dr. Rao came back. She’d gone with the baby and come back alone. She pulled up a chair beside my bed and sat down.
“I wanted to tell you something,” she said. “Your son’s oxygen saturation was seventy-nine percent when the nurse checked it. If he’d been born four hours earlier, he probably would have been in the high eighties or low nineties, still looking pink. If he’d been born at home, or discharged in a day or two, there’s a real chance nobody would have noticed until it was very late.”
She looked at me. “Who noticed?”
“My husband,” I said. My voice broke. “He was holding him for the first time. He saw his lips.”
Dr. Rao nodded slowly. “Most fathers,” she said, “are looking at their baby’s eyes or nose or hair in that first moment. They’re looking for themselves.” She paused. “Your husband was looking at his lips. That’s not luck. Do you know why he’d do that?”
I put my hand over my mouth. “He had a little brother,” I said. “Who died when Aaron was seven. The same way, I think. A heart defect. Nobody caught it.” I could barely get the words out. “Aaron saw his lips turn blue on the couch at the cabin. He told his mother. She said it was the cold.”
Dr. Rao didn’t say anything for a long time. Then she said, very gently, “Then your husband has been waiting twenty-nine years to see that again and be believed.”
Part Thirteen: Gerald
I found out later what happened in the waiting room.
Gerald had been sitting there for sixteen hours with his cup of coffee and his unopened newspaper. When the NICU team ran past the waiting room door, he looked up. When the incubator came down the hallway with tubes and wires and a nurse squeezing an oxygen bag, he stood up. When he saw his son walking beside it with his hand pressed against the plastic and tears running down his face, Gerald Bowman, sixty-eight years old, dropped his coffee cup on the waiting room floor.
Aaron stopped in the hallway outside the NICU doors. He turned and looked at his father. They stood there for a long moment, two big Bowman men, the old one gray and the young one shaking.
“Dad,” Aaron said. “It’s his heart.”
Gerald’s face went gray.
“His lips were blue, Dad,” Aaron said. His voice cracked open. “Like Danny’s. I saw it. I saw it the second they gave him to me.”
Gerald didn’t say anything for a long time. Then he did something that Aaron told me later he hadn’t done since February of 1997, the night Danny died. He put his arms around his son. Right there in the hallway outside the NICU, with nurses walking past and the elevator dinging, Gerald held Aaron while they both cried.
“I’m sorry,” Gerald kept saying. “I’m sorry, son. I’m so sorry.”
“For what, Dad?”
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