May 5, 2019

Julius: The Story of a Premature Birth

The first hint that something was going wrong with Zoraida’s pregnancy came on the morning of Thursday, May 20, 2004. I got out of bed early to attend to our eighteen-month-old son, Marcus, who had woken up coughing. A few minutes later, Zoraida emerged from our bedroom. “I’m soaked,” she said, clutching at her pajamas. She called her obstetrician, and I got Marcus, who was still coughing, ready to see the pediatrician. At the time, we were both more concerned about Marcus’s condition than Zoraida’s. She’d just had her five-month checkup, at which she’d been told that everything was fine. We even had a series of smudgy gray closeups of Julius’s head and organs, like photographs of a poltergeist, to prove it. Marcus, on the other hand, had suffered from asthma symptoms for much of April, and the heavy spring pollen was giving him trouble. We hailed a cab and stopped first at NewYork-Presbyterian Morgan Stanley Children’s Hospital, where Zoraida had been instructed to go. Then Marcus and I went on to the pediatrician’s office, on the East Side.

Marcus’s ears and lungs were clear, and he was having no difficulty breathing. It was a cold; that was all. The pediatrician gave us a sample of Benadryl and sent us home. However, back at our apartment, in Inwood, there was a voice message from Zoraida telling me to come to the triage area of the Children’s Hospital. “It’s not good news,” she said. “The doctor will explain.” I feared that Zoraida would have to spend the next three months on bed rest. Marcus and I went back downstairs and took our second cab ride to the hospital.

NewYork-Presbyterian is like a city within a city. It occupies a half-dozen blocks around Broadway and Fort Washington Avenue, south of the George Washington Bridge. The streets are full of doctors, medical students, nurses, and E.M.S. workers. The Children’s Hospital, where Zoraida was waiting for me, sits on the corner of 165th Street and Broadway. It is a new building, made of sand-colored stone and shimmering glass. That morning, the ground-floor atrium was hosting a health fair for kids. Flocks of grade-schoolers were being shepherded into the building to join the carnival of noise in the atrium. Marcus and I made our way through the din to the main desk, where I was informed that I could not proceed with a toddler. That was a blow. Why wouldn’t they let Marcus in? Then I remembered the word “triage” in Zoraida’s message. Emergency rooms were no place for children. They were also no place for pregnant women who were doing just fine.

I called Zoraida’s sister, Wilma, who lived nearby, to see if she could look after Marcus, who, by then, had succumbed to the Benadryl and was asleep in his stroller. I told Wilma to meet me at Coogan’s, an Irish saloon on Broadway and 169th Street. While Marcus dozed, I sat at the bar, sipped a pint of Guinness, and ate a sandwich. The place had just opened and, except for the bartender, I was alone with my thoughts. I tried to prepare myself for the worst. I actually said that to myself: “Be prepared for the worst.” But what did that mean? That we’d lose the baby? As long as my sister-in-law didn’t show up, I wouldn’t have to find out.

Eventually, Wilma came to collect Marcus, and I walked back to the hospital and went up to the tenth floor. There I was directed to a wide, windowless door that led to the triage ward, a clean, quiet corridor with a nurse’s station at the end. A nurse looked up from her computer screen and pointed me to one of the half-open doors. Behind the door was a sun-filled room where my wife was sitting up in bed.

“I’m three centimetres dilated,” she said. Her face contorted as she tried not to cry. “He’s coming out. I’m sorry, Jon. There’s nothing we can do.”

She explained, and then the obstetrician came in and explained it again. Zoraida’s cervix had started to open. Now that it had begun dilating, there was no going back. The amniotic sac had been exposed, and there was a serious risk of infection to the mother and the fetus. Julius was too premature to survive outside the womb.

For some time, I sat on the bed, holding my wife and absorbing the news. Ridiculously, a scene from the movie “Titanic,” which had been released during our first year together, and which Zoraida had only gone to see with me against her will, kept replaying in my mind. Late in the movie, after the ship has struck the iceberg, Kate Winslet encounters the Titanic’s designer on the stairs. He looks at her and says, “In an hour or so, all this will be at the bottom of the Atlantic.” I started weeping.

The obstetrician returned some time later to explain our options. Each was worse than the one before. The first option was to wait, to see if Julius might stay inside Zoraida until he reached a more viable age. He was twenty-two weeks and three days old. At that time, the earliest a premature baby could be born with some expectation of survival was twenty-four weeks. Even then, Julius’s chances would be slim, and there was the likelihood of severe brain damage. It wasn’t until twenty-six weeks that a premature child might be expected to live with a good chance of normal development. We’d fallen a month short. The doctor cautioned us again that waiting might result in infection to the mother and the child, and, given that Zoraida was three centimetres dilated, the possibility that we would make it through the weekend—never mind the next eleven days—was small, indeed.

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