A Fake Man in the NICU

by Elison Alcovendaz

The first time I held Emmy, I was in Bay 101 in the Neonatal Intensive Care Unit (NICU) at Kaiser Roseville, more scared than I've ever been. The NICU occupies most of the basement of the Women and Children's Center, and as such, upon first impression, felt strangely heavy and dark. The bay held six babies, all of whom were in incubators decorated with colorful name tags. They had spelled her name Amelia instead of Emilia, but I had followed her from the operating room where Patty had her emergency c-section, so at least one of the thousand anxieties I'd possessed before Emmy's birth - babies somehow being switched at birth - was relieved. She did not yet have the GPS ankle bracelet, but she did have a plastic one with a bar code and medical record number that matched the bracelet on my arm. This, and for a while it felt only this, identified Emmy as my daughter, me as her father. 

Allow me a confession: when we first started trying, I wanted a boy. After the miscarriages, that quickly changed (all I wanted then was a healthy baby), but in the beginning, I knew I wanted to raise a son to be the man I always wanted to be but knew I never would become. Someone who: didn't cry so easily at the stupidest of movies, knew how to use a power tool, didn't shy away from confrontation, was comfortable in nature, would not avoid swimming pools for a decade because they were embarrassed to take off their shirt in front of people, was assertive, was physically strong, was self-reliant, was willing to take risks, was not someone who was ruled by their feelings.

When Patty and I first started dating, one of the things she said attracted her was the way I walked into a room. Confident, smiling, making eye contact. I didn't tell her that was something that, to this day, I have to fake. I learned it back in middle school, all false bravado when walking onto the basketball court to show everyone in the gym that I wasn't scared though I very much was. I faked that walk, that way of holding my head high, all the way to adulthood. In a sense, it was the way I faked being what I thought a man was supposed to be. And in the NICU, I felt like that fake man again. 

Emmy was six weeks early and needed to initially be fed by IV. Patty was still in the OR, so I was by myself. I couldn't watch as the nurses tried to insert the needle into Emmy's wrist and, when that didn't work, into her other wrist and, when that didn't work, into her inner forearm. I couldn't listen to her crying. I couldn't look at the wires attached to her tiny chest or, eventually, the cannula hooked up to her nose to help her to breathe. I sat in an uncomfortable rocker beside the incubator, dressed in a Star Wars sweater that made me too warm for the room, able only to focus on Emmy for seconds at a time until I'd be overcome with so much fear I had to look elsewhere. What I saw were other babies, most of them much younger and smaller than Emmy, many of whom weighed as much as your standard hardcover book. Everywhere I looked reminded me that impermanence is a universal constant.

The nurses, all of whom were extraordinary helpful, empathetic, and otherwise just damn good at their jobs, quietly updated their charts and monitored their babies while I sat there for those first two hours. Being in the basement, cell phone reception was terrible. Patty had asked me to follow Emmy to the NICU shortly after the birth, but I couldn't shake the fact that I'd left my wife alone in the OR needing two pints of blood, her abdomen cut open. What kind of husband did that make me? What kind of man? I frantically texted my mom, Patty's mom. My mom said she was okay, but that wasn't enough. I needed more. I needed to see her. But if I left little Emmy there, what kind of father would I be? What kind of man?

"I have a stupid question," I asked the nurse.

"There are no stupid questions," she said.

"Right. How long do the fathers normally stay here?"

"It depends. I've seen fathers leave after two minutes and I've seen some stay here all night. Are you going to go up?"

"I think so. Yeah. Is that okay?"

I went upstairs, and as soon as I stepped into the elevator, the relief that overcame me was quickly swallowed by a wave of guilt. The truth was, I didn't have the inner strength or, in my head, the manhood, to sit there and watch Emmy look so vulnerable. Our journey to this point had been one of "failures" - miscarriages, hospitalizations, hemorrhages, transfusions, rare pregnancy complications - and I had been taught to expect the worst (even now, writing that sentence scares the shit out of me). And I just couldn't watch something bad happen. I needed to see Patty. I needed to make sure that at least one of them was going to be okay.

But when I got upstairs, the first thing I saw was not Patty's face, but the blood. Lots of blood. Unbelievable amounts of blood (at least to me). Earlier, when I saw Emmy being pulled out of her body, I saw Patty's intestines, and that feeling could not compare to the sudden dizziness I felt now. What did this mean? Is everything okay? I latched onto the face of the nurse and managed to ask if this was normal. She said yes. My mind cleared and I finally looked at Patty. 

"How is she?" she asked.

"Fine," I said, then correcting myself, "Great."

She smiled, the pink all removed from her face. She reached for my hand. Her fingers were cold but taut around mine, and we stayed like that for a few moments while we talked. Then she asked me to go back downstairs to be with our daughter. 

 Baby's ankle bracelet.

 Baby's ankle bracelet.

***

The second time I held Emmy, she stopped breathing. Up until that point, the doctors and nurses were amazed how well she was doing. I cradled her in both arms, and in the middle of sucking on a green pacifier, her body went completely limp, arms falling to her sides, her face ghostly. Red lights flashed from the monitor and the alarm clanged throughout the bay. Patty sat in a wheelchair next to me, drugged up and tired, but I couldn't look at her. I opened my mouth to yell for help, but a nurse came around the curtain calmly, put Emmy on her shoulder, and massaged and patted her back until Emmy started breathing again and the alarms shut off. 

I don't want to say what I thought had happened, but in those 20 seconds, I thought it might've been the absolute worst thing. I just knew I had done something wrong. I must've held her at the wrong angle or hadn't appropriately put the pacifier in her mouth. The doctors would explain that Emmy was having her A's, B's, and D's or, in NICU speak, Apnea, Bradycardia, and Desaturation. In other words, due to the immaturity of her brain stem, Emmy would stop breathing, her heart rate would drop to dangerous levels, and so would her oxygen levels. It was common in younger preemies, less so in older ones like Emmy. She would be in the NICU until she could go without a similar episode for five straight days. 

That night, I came down from our room upstairs to bring a syringe of milk Patty had expressed down to the NICU for Emmy. In the elevator, I ran into another dad from a NICU class I had taken earlier that day. He had multiple syringes in his hand and said, with a big smile on his face, that he was going to bottle-feed his daughter for the first time. I learned later that this was his second kid, which might've explained some of his obvious confidence. I had only intended on dropping Patty's milk off for the nurse to feed but I lied and told him I was going to feed my daughter for the first time, too.

"Dad life," he said, laughing.

When I arrived at the NICU, the nurse placed the syringe in the refrigerator and advised me they would have to reinsert the IV in a new place and did I want to stay? "No," I thought, but said "sure" instead. After failing again at the wrists, during which Emmy shrieked in ways that still shake me to this day, they called in a specialist who was adept at working with mini preemie veins. It took her 20 minutes to get it in. The entire time, I sat glued to my chair, telling myself I had to look, I had to listen. If I wanted to be a real father someday, this is the type of thing I'd have to do. Sit there and watch my baby get poked over and over again. 

Over the next few days, we would spend more than half our time in the NICU. I would occasionally change her diaper and sometimes watch over her, but I couldn't hold her. Instead, I watched Patty grit through her own immense pain and fatigue and be the mother I always knew she would be. Instead of doing what a real father might have done, I willingly became a gofer. I went to the cafeteria when Patty needed food. I went to get her water. I greeted our visitors. I went home to get clothes. And each time, I felt that same lack of manhood, that same acidic mixture of relief and guilt; relief to get out of that claustrophobic place, guilt from feeling relief at leaving my wife and baby, even if it was only for a few moments at a time.

***

The third time I held Emmy, it was Father's Day. The nurses gave me a card, a cookie, and a cute laminated paper with Emmy's footprints on it. The other fathers received similar treasures. Emmy had already been cleared of her D's, but was still having her A's and B's. She no longer did it in her sleep, which was great, but she still had them when feeding. She would choke on the milk or formula, lose her breath and drop her heart rate, go limp and pale, but her oxygen levels remained steady. This was progress. This meant that soon, we could go home.

After sleeping in hospital recliners and windowsills built for someone much smaller than me for nearly two weeks, the idea of going home and sleeping in our bed sounded like heaven. But it also meant that we wouldn't have the comfort of the nurses or even the monitors which, while scary, always gave me comfort to know when someone should intervene in her A and B episodes. I asked every nurse who looked at me about monitors we could use at home. They all said with the number of false alarms, they caused more problems than they were worth and advised against them. When we roomed in at the NICU (they let you stay in a "hotel" room there to be with your baby off the monitors before you go home), we slept with the lights on to make sure we could see her breathing. When I wasn't standing over her, I lay in the scratchy bed and researched monitors on websites. I scoured Amazon and mom blogs for reviews. I didn't care that, the next day, the doctor laughed when I asked him the same question. He said what they all said - just watch your baby. Patty had become an expert at knowing Emmy's cues and stimulating her back from breathlessness; I, on the other hand, was glad to mostly be a spectator. Patty and I had decided, however, that later that night, I would feed her again.

Before the feeding, I went out to the waiting room to catch a breather. There was one other person in there, another dad whose baby had just been admitted a couple of days before. He had a brand new Golden State Warriors "NBA Champions" tee shirt on and sweatpants two sizes too large. Like me, he hadn't shaved in awhile. I'd seen him a few times, but he never looked interested in talking, so I was surprised when, as I walked by, he made eye contact and nodded his head as though he wanted me to stop. 

"How's it going?" he asked.

"I guess I shouldn't complain," I said. I'd overheard the nurses saying that his baby boy had been born at 29 weeks and was probably looking at a three month NICU stay. For a moment, it always made me feel better to know Emmy was doing better than the others, but then the guilt at making it a comparison would quickly take over. Eventually, I just hoped we all got out, healthy and alive.

"I know what you mean. What's your baby's name?"

"Emmy. Yours?"

"Logan," he said. 

He stayed silent for a few moments. He looked at his watch and I looked at the door. 

"Happy Father's Day," he said.

"You, too."

Later that night, the feeding went fine, mostly because I kept pulling the bottle of her mouth every five seconds so she wouldn't go limp on me again. Patty remained patient with me the entire time. She talked about what a great team we were. She told me she was grateful for me. The other dad was there, too, rubber gloves on his hands. The only way he could touch his baby was through holes in the closed incubator, and there I was, my baby in my arms, thinking about the man I was supposed to be. 

***

Father's Day NICU

The last time I held Emmy in the NICU was the day of her car seat challenge. Before being discharged, babies born before 35 weeks must prove they can sit in their car seat for an hour with no A's, B's, or D's. The nurse would also need to verify the car seat had been installed correctly into your car. I had long boasted that I would put the car seat in myself, but for a week I avoided it. I didn't want to jinx Emmy coming home, but mostly, I didn't want to get it wrong.

The voice of the stereotypical man in my head said this is something I should be able to do myself, something I wanted to do myself. But after seeing Emmy in the NICU, I felt the best thing I could do was to do absolutely nothing myself. So I made an appointment at a local fire station in Roseville that taught people how to properly install a car seat.

It was 108 degrees outside, and as I pulled into the back of the fire station, I swear I could see the steam rising from the asphalt. A fireman named James waved at me and told me where to park the car.

"She came early," I said, as though this explained why I hadn't already installed it myself. 

"How early?" he asked.

"Six weeks. I thought I had more time. Thanks for letting me come in today."

"It's no problem," he said.

James was tall, built, and wore a pressed fireman's uniform. Despite the heat, he barely broke a sweat, and he had the focused gaze of someone who is used to solving problems. When other firemen passed by, they nodded at James with deference and respect. It was clear that, despite being on car seat duty, he had a leadership role at the station. 

For nearly all my adult life, I've always compared myself to such men. The "man's man." People who know me and my parents know I'm more like my mother - a thinker and a feeler. My dad is a man's man, someone who knows how to fix a car, who is not afraid to climb on top of a roof, the kind of man who, when he's around, you always feel safe. This isn't to say he isn't a thinker or a feeler, too; he is, but he isn't ruled by them the way I am. He isn't afraid of things. If faced with a fire, I'm sure he'd run in right beside James to save whoever's inside. And with all of that, he was always there. I always knew I was loved.

The installation took 45 minutes. James showed me the latch vs. the seat belt methods. We went over safety hazards. We even talked about the Sacramento Kings and fantasy football. When I climbed in to the backseat to pull the seat belt as tight as possible through the car seat, sweat dripping from my forehead, he encouraged me, even when I did it wrong. When we were finally done, he shook my hand and looked me dead in the eye. I was sure I knew what kind of man he was, and I wondered what he thought of me.

***

Since we've come home, I hold Emmy all the time now. Look, you don't have to tell me that my version of masculinity and manhood is wrong. I know it is. Patty lets me know all the time how wrong I am. And I know it comes from traditional social standards, from (as shown in the age of Trump) a long history of connection between manhood and power. And I'm ashamed of it. I'm ashamed at having wanted a boy. I'm ashamed at wanting a son to fulfill the sporting dreams I never achieved and double ashamed that I would put such pressure on a child that hadn't even been born yet and triple ashamed for not intuitively thinking a girl could do the same. 

When I hold Emmy and look at her, I wonder how I could've wanted anything else. Even at six pounds, she is everything. But since she has arrived, in addition to the love and joy and fear, this thing about manhood has once again shoved its way to the forefront of my mind. If I'm not the man I want to be, how can I be the father I want to be? What kind of man will she see in me? 

There's no way to know the answer to that yet, and I know that that's okay. For now, it's enough that she's here. She's here.