Her twins were coming too early. Nothing would stop them, not the terbutaline, not the magnesium sulfate. The woman was on fire with the drugs, burning up from within, heat blistering from every pore in her body. Something heavy pressed against her lungs. She panted, inhaling air that felt thin, as if she were at a high, unforgiving altitude.
Surely, she thought, she was to blame. She should have taken leave from work sooner, confined herself to the couch. She shouldn’t have allowed herself half cups of coffee every morning. And why had she walked up that steep hill to the street fair last weekend?
The fetal monitor charting her contractions and the babies’ heart rates bleeped and bleeped. Bile clawed its way up her throat. She reached for the plastic bowl on the metal tray attached to her bed. Why was a bowl for vomit molded like a kidney? Wasn’t there something terribly wrong with this design in a hospital environment?
The woman was an artist though she made her living designing packaging. She noticed shapes and patterns, even now, maybe especially now, as she tried to distract herself from the pain.
Another contraction seized her abdomen. She couldn’t remember if they’d given her pain medication; she wasn’t certain what was dripping down the IV line.
Red numbers on the digital clock read 1:58 AM. The woman rolled to her back, the effort frighteningly difficult. Her sheets were wet with sweat. One of the babies kicked. A good sign.
She grabbed the ice bucket, rubbed a few chips against her neck. The ice melted and pooled in the hollow between her clavicle, and she concentrated on only that, those tiny drops of coldness blotting out the intense heat of her body.
She closed her eyes. The tiny puddle at her neck grew into the wide, clear lake near her grandfather’s cabin in the Smoky Mountains. She lay in her grandfather’s green wooden boat, drifting in a patch of shade. Her babies, a girl and a boy, apple-cheeked, fat and healthy, lay swaddled in her arms.
The boat was tied to the trunk of a willow tree. Its tendrils kissed her. The sound of lapping water and the lemony scent of water lilies comforted her. If she could swim in that lake water now, she thought, she would be restored, ready for what lay ahead.
But it was no use. The lake of her dreams shrank in the dim light of the hospital room to a dark pond of cave water where her unborn babies swam with fish smaller than minnows, fish with missing eyes and unnaturally transparent skin.
Not yet, she whispered. Her husband had been sent home several hours earlier. He was likely asleep, twelve miles and two bridges away.
Her baby shower was two weeks away. The cribs weren’t up. They had no car seats, no baby clothes, no bottles. They hadn’t even decided on baby names.
The fetal monitor bleeped and bleeped. The sound reverberated in her ears until it became a continuous screeching, an emergency broadcast radio signal. Thirty-two weeks wasn’t long enough. Their lungs were too fragile, sticky and unformed. She’d had only two shots of steroids. Would they possibly be able to breathe on their own?
Her firstborn babies. Their lives would begin with such a struggle. With tubes stuffed down their throats and in their bellies, with needles scarring their delicate skin, with bleeping and buzzing and white-coated strangers and glass boxes for cradles, with maternal love choked with fear.
Light from the hallway snuck into her room as the door opened wider. Her obstetrician, a redhead with a French accent, walked into her room. Behind her followed a nurse wheeling medical equipment and a man with his head wrapped in a turban. No one turned on a light. Their faces appeared in shadows.
How are you feeling? her obstetrician asked.
What was she to answer? The nurse grasped the fetal monitor’s wide tan belt stretched across the woman’s stomach and peeled it off.
It’s going to be alright, she said. The woman turned her face away so the nurse wouldn’t see her panic. The clock read 2:16.
They needed to do an amniocentesis, her obstetrician said. Her membrane might have ruptured and caused an infection. If so, they would have to deliver right away. She turned to the man in the turban and introduced him as a neonatologist.
Neonatology. The word felt foreign and cold, like the IV fluid dripping down her arm. She’d only skimmed the part about premature babies in the book about what to expect. She’d been certain this would never happen, no chance that her twins would be born with bleeding brains, leaky intestines, frail lungs, or imperfect hearts.
How much will they weigh?
That’s hard to say, the neonatologist said. Maybe three and half pounds each. He crossed his arms and gave her a professional, unpromising smile.
The math didn’t add up. Seven pounds. One baby, not two. The nurse squirted a sticky glob on the woman’s stomach and her obstetrician placed a cold instrument against it. On the black screen the head of one baby appeared then the other, white and ghostly.
Her obstetrician asked her to raise her knees and spread them. She used a pen-sized flashlight to look between the woman’s legs. Could she see all the way into the cave water?
She was too dilated, her obstetrician said. No time for an amnio.
Her babies were coming now. The clock’s red digits read 2:29. Her heart raced and beat erratically. In her fevered imagination she was sure it had swollen to the size of a beach ball and that her babies were bouncing against it her chest, chanting ready or not, ready or not. She to tapped her stomach in an effort to calm them, perhaps reassure herself. Then two orderlies arrived, slid her onto a gurney, and pushed her out into the hospital corridor’s blinding light.