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Wednesday, April 27, 2016


Dear Josie,

Post-Traumatic Teacher Stress Disorder.  I've decided it's a thing. 

Today was the "ABI" lab.  Students were to compute their Ankle Brachial Index.  That is, the test used to measure the severity of peripheral artery disease.   Basically, they had to find their ankle pulse. 

I'm sure it's simple enough for most, but for me this lab requires a pep talk.  The mental (or actual) shot of whiskey the night before and a healthy glass of wine the night after.

Why?  Because in order to determine one's ankle brachial index, the use of a fetal Doppler is necessary.

This means that today, there were roughly twenty four students searching their ankle pulse, and roughly twenty four static sounds resonating between my classroom walls, which suddenly seemed very small.

Let's be clear, I hate that sound.  I hate that sound more than any other sound that could potentially exist.  Ever. 

It's the sound that is there when a heartbeat isn't. When I hear this sound I see the tension in her face as she searches for you, for any proof of you, and she finds this sound instead.  It's the sound of fear and hope and anticipation and confirmation.  It's the sound that plays louder in my nightmares than any other. 

During the pregnancy after you died, my fetal Doppler basically served as a limb.  I felt paralyzed without it.   Every morning it was the first thing I'd reach for; the last sound in my ears every night.  In my third trimester it was my Doppler and me every hour, before and after every meal.   Just in case an impromptu blood sugar spike had caused a problem.  Just in case he had left me since breakfast.

If I wasn't using it I was missing it.  There were times I'd be driving and it would feel like too long, so I'd pull over, recline the seat and search as cars passed me on the shoulder.  No place felt safe and no occasion was exempt.  At the SHARE Angel Ball where your father and I attended as honorary ambassadors, roughly 25% of my time was spent in the bathroom stall.  Just listening.  That Doppler went everywhere with me, in work totes next to graded papers and stuffed into hoodie pockets and bulging from the shiniest of clutches.  To weddings and movie theaters and doctors appointments.  Towards the end I would lay back and the nurse would ask me where, and I would point to the spot I had heard him moments before, in the parking lot. 

When my Doppler began to break due to overuse, I emailed the manufacturer and attempted to explain (in the calmest way possible) why I needed another.  Their response was prompt and logical, asking if I'd tried turning it off and then on again, and if I needed new batteries but that ultimately,  I would need to ship mine first in order to obtain another. This meant 8-10 days with no Doppler.  Upon reading said response I called your father.  Then I sat down on the sidewalk outside the post office, and cried for twenty minutes. 

At my very last appointment prior to the induction, my doctor noticed a rash.  The skin on the lower right side of my abdomen was peeling, actually PEELING from over exposure to the gel and its static-y counterpart.   And all we could do was laugh.  Laugh and cry, and agree that it was time. 

This limb of mine was the first thing to go after your brother was born.  How I'd relished in the release its amputation would bring; how I'd envisioned smashing it "Office Space" style and then burning its remains.  Realistically, this encounter looked more like a stoic mic drop.  On an otherwise normal afternoon, I found myself staring into our kitchen trash can.  After a few minutes I let go of the cold white plastic with one hand, holding tightly to my baby with the other. 

As far as me and Dopplers go, things will always be complicated.  It was the Doppler that told me, for certain, you were dead.  It was the Doppler that told me every day and often every hour, that your brother wasn't.  I will always feel a tightening in its presence, but it will always hold the potential for the sweetest of sounds. 

Imagine my surprise this week, when a student had trouble finding her partner's pulse and asked for help.  I didn't cry or hyperventilate or run out of the room.  Calmly I sat next to her, demonstrated the proper angling, the proper gel-age, finding mine in less than five seconds. 

Because although I struggle with many, many things since you died,  I will slay a fetal Doppler all day.   



Monday, April 25, 2016

On Fish Funerals.

Dear Josie,

Gilligan blew up my TimeHop today.

In my elective course we talk of brain injury pretty regularly.  First semester, nearly a month is devoted to the different regions and all they control.  Next comes action potentials and nerve damage and neuroplasticity.  Class discussions are centered around various neurological disorders and injury and recovery, and your uncle always stops by to speak. 

Last week was the third anniversary of his traumatic brain injury.  Three years have passed since he was found beneath some overpass in the rain; since I received the call that woke me in the night.  Three years since the beginning of that year, the year which shall not be named, because there is no name for that year. 

I mentioned the significance of this day to my classes.  

"Ms. LaFata!"  exclaimed a rather enthusiastic member of my second hour.  "You've been through some STUFF, though."

And she's right.  I have. 

One night in 2013, I fell asleep in a world where brothers' brains and babies' hearts were off limits.  When I awoke the next morning in a very different one, everything was fair game. 

On April 10  I would watch my brother cling to life.  With the help of loud machines and skilled surgeons' hands, he would survive the night.  The next morning he would lose a portion of his frontal lobe forever, and we would live bedside for weeks, wondering if he'd ever speak or dance or swallow again.  Two months later we found out you were coming, and eight months after that you were dead. 

There was shock and hope and love.  And love and hope and shock.  It was a whirlwind to rock all whirlwinds.  It was the most tumultuous, most draining, most altering year of my life. 

Sometimes I think about the person I was before that year.   Sometimes it feels like all of the horrific, heart stopping, vomit-inducing phone calls were condensed and then made and received in those 365 days.  Sometimes it feels like I entered that year a different person entirely, that the current "me" is the result of some hand turning on some massive spin cycle.  And 'round I went and out I came, dizzy and shaking and wet.  A mere suggestion of the threads that went in.  Darker.  Faded.  Stretched. 

Is it any wonder I clung to the Doppler all those months?  Why all of the "This time it will works" and the "What are the chances?" and the "You're so closes!" did me no good.  I had learned that one tragedy does not exclude another; the weight of the target on my back.

In the days before your little brother's induction I was a zombie.  At any moment I could be found wandering the house in the same fuzzy gray sweatpants, staring at clocks and listening to heartbeats, sometimes for hours.  My hands atop my protruding belly and my gaze averted slightly, always, to the door.  Only instead of "brains" I was mumbling something else.  It was baby.  One that cried and took breaths and clasped tiny hands around fingers.  One that you get to take home.

The night before he was born I had a panic attack, which was nothing new.  Around midnight I convinced myself that something was wrong, and I drove myself to the hospital for the eleventh time in two months.  It was 24 hours before my scheduled induction, but that wasn't soon enough.   I was sure he wouldn't make it here.  I was certain my body would kill him too.

They checked me out and sent me home, and when I entered the house at two am there was Gilligan.  The fish your older brother had won three weeks earlier, face up and very dead, in the round little bowl on my kitchen table. 

Immediately I became hysterical.  I woke your father, attempted to convince him that this was some sort of sign.  I begged  him to drive to the nearest 24 hour pet store, (does such a place exist?), to break in and steal another fish so we could pretend it hadn't happened.  So your brother wouldn't have to hear that one more damn thing had died.

I texted your aunt and your grandmother, desperate for answers.  I wanted some old wives tale, some ancient Greek myth.  Any indication that this was clearly a sign and that I should head to the nearest maternity ward for constant 24 hour monitoring until the baby arrived.  I was going on four days of no sleep and nine months of no sanity.  I was so convinced and I was so, so very scared. 

Instead of the confirmation I so desperately sought, your grandmother responded quite simply:   "Nora, sometimes fish die." 

I think that's the hardest part now.  Living in the after of 2013.  Living in a world alongside the knowledge that bad doesn't exclude you from more bad.  Learning to lower the gloves when you'd prefer they remain raised.  Always anticipating the ring in the night.  Always packing. 

It's hard to live here like that.   I'm trying, but it's hard to teach the bereaved brain that sometimes, it's just a fever.  Sometimes midnight phone calls are pocket dials.  Sometimes,  fish die. 



Wednesday, April 20, 2016

On Death Moving In

Dear Josie,

The other day, your brother was arguing with a friend.  Which one was taller.  Your brother lost.  
As Kindergarteners often do, his friend began to gloat.  "Seeee? I told you I was taller!"

Not to be outdone, your brother loudly replied, "Oh yeah?  Well I have a sister in Heaven and you don't!"

I laughed.  Because even though it wasn't funny, it was funny. 

Later I took him aside and explained that the competition involving who has more sisters in heaven, is no game one hopes to win.

It's difficult to explain death to a child.   After you died we called his pediatrician.  I can remember driving home from the hospital, listening to the confusion in your father's voice as the cars passed us in the left lane.  "What do we tell him?  I mean, he'll never...what do we SAY?"

We gave it our best shot, attempting to fill his innocent eyes with the minimal amount of platitudes.  We didn't want to scare him but we didn't want to lie.  We weren't at peace with what happened.  We were going to be okay (were we?) but we were very, very sad.  You would always be a part of our family but you were never coming home. 

I remember his eyes shifting to the wall, briefly somewhere we couldn't see.  A muffled "Oh," was his only response.  And then he got up from the bed and he walked away from us.  Three years old and ten years older.

I think it's logical to fear death, in the literal sense.  I think there are very few people who truly don't,  and I'm certainly not one of them.  I wear seatbelts and helmets and I cook the meatballs through.  I am keenly aware  (to my own social and marital detriment at times) that death can happen at any moment.  How it can come in, seemingly from the abyss and touch you, grabbing hold of the ones you love in an otherwise unremarkable instant.  I am aware of how death can change everything, abruptly and finally and many, many times without one's consent.  You taught me that.  You also taught me something else.

So much of this life is a sadness I could never do justice with words.  A perpetual longing.  A lacking without an ending.  Forever after the knockout.  Forever bracing for the blow. 

But there is a type of growth that can happen after loss.  It's a gradual growth, like a tumor.  Because sometimes you're sure it might kill you.  But there are other times where its presence makes you feel more alive.  There are moments now where I feel such a joy.  Brief, fleeing episodes I can never predict, only feel. A happiness and a gratitude so intense that it steals my breath and leaves me lighter; leaves me higher than before you died.  And in these moments I can only look down and smile, and know that it's from you.  You gave me that. 

And it doesn't make anything worth it.  It doesn't serve as a reason or a resolution.  It doesn't make it okay that you died.  This gland I'd gladly give back without question, for your breath on my skin.  For your hands in theirs on your wedding day. 

But they do give me hope, these moments.  Hope for moments that grow to minutes, and minutes to years.  Hope that death can become a part of you, in such a way that the person you are isn't worse for having touched it.  Hope to fall to pieces time and again, and still trust in the joy around the bend.