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The second week

At the psycho-social meeting, when the twins were ten days old, I learned that Daniel had chronic lung disease and a small cyst on the brain. Nobody knew how serious this might be. Lucy was doing well: she was now on a prong, a less radical form of ventilation.

That day I watched Daniel. He had been through a crisis.

He has a ventilator to his mouth. He is wearing a vest and looks more comfortable. He is lying on his back. His feet are free of bandaging and his legs are straight. His right arm is out to the side. His left arm bends up, the hand with heavy bandaging around it. His eyes are closed.

He is very still and is breathing gently. His eyes move under his lids as if they would open but they do not. He mouths the plastic of the ventilator. His right fingers move very slightly.

His head moves very slightly. His right fingers open and he mouths slightly. His fingers move and his thumb goes to his forefinger. His tongue goes out to touch the plastic. He moves his head, his hands, his feet and then rests. He is very still. The nurse says that he is comfortable now, his chest drain is out. It must have hurt him. He moves his feet slightly, mouths and then his feet jerk. He stops moving and is very still. (When he is still I find it difficult to imagine his experience). Then he stretches in rather a sensual way. His feet jerk and he stretches.

As I watched, I thought I could see a kind of dance emerging—or was it a conversation? It was very tentative but one part of his body moved and another part seemed to answer. Forefinger came to thumb, tongue to plastic. Perhaps he was making some connections. And the nurse was able to think about his experience.

I moved on to Lucy.

She has a frown and her face is rather crumpled around the prong which goes into her nose.

She is lying on her tummy and she is now wearing a vest. Her face is to the right; her right arm is down and her left arm is up. A blanket covers her to her waist. Her left hand flexes.

She opens her mouth and I do not know if it is a yawn or a cry. She closes her mouth and then leaves it slackly open. Her left fingers move and her mouth moves around the tubes. Her left fingers move again and then she is very still. She gives a shuddery breath. Her mouth moves on the tubes. Her eyebrows flicker. Her eyelids try to open but do not. Her eyebrows go up again and again. She is mouthing. Her mouth draws back very slightly and she repeats this.

She jerks. She moves her right hand and her breathing becomes more laboured. She is very still. The knuckles of her right hand move against the sheet and she stretches out her thumb.

Her mouth moves, followed by a very slight movement of her right hand. A little mouthing.

Her eyebrows raise and her eyes open very briefly. They close; open; close; and she is still. Her right hand moves. Her eyelids go up and her eyes open. I am stunned by the blue. The fingers of her right hand splay open, close, open and then rest against the sheet. Lucy opens her eyes and looks around. She closes them. She splays open her fingers and seems to nestle back into herself. Her right eye opens, then both eyes, then they both close. They open again. I wish that her mother was here to greet her.

I thought that Lucy was making a connection between her mouth and her right hand, particularly her thumb. Again I was stunned by her beauty when she opened her eyes and I saw their blue. I felt that she was in some kind of transitional space—opening out to the world and closing back into herself—outwards and backwards. She opened her eyes to see what was out there and nestled back into herself. This was very serious work for Lucy and I wished that her mother had been there at that moment to greet her. As I wondered about that transitional space, I thought of the great beauty of those architectural transitional spaces, the balconies and loggias of Renaissance Italy, and of the kind of excitement they can inspire. This, I think, is connected to a sense of expectancy: one stands on the loggia longing to see the approach of the loved one. This seemed to be a moment of such hope for Lucy.

On day sixteen I met the Smith parents again, this time on the unit. Mrs Smith was having problems about her room on the postnatal ward which was needed for another woman whose baby had died. A compromise was suggested: Mrs Smith should have it for one more night and then be given a room in the nurses' home. She said that she had not minded giving up her room to this woman, although the woman had eventually decided to go home.

What she minded was that they had told her in the morning when she knew that Daniel was going to have his prong put back in and wanted to come down and sort him out. The nurses had said that she could do that but they might pack her things up while she was with him.

She did not want them to do that: some of her things were very personal. So she packed them away herself, and when she got downstairs the doctor was already working on Daniel. The nurses could not give her that hour and she was very upset with them. She repeated this many times.

The parents went on to talk about the weekend:

The weekend had been bad. Father was worried about there not being enough staff: what would happen if all the babies went into emergency at once? A very sick baby had come in. Everyone seemed to be working on it, even the nurse who should have been looking after the twins. ... It really was not safe with so few nurses and Lucy had stopped breathing. Mother had stimulated her and got her breathing again but what would have happened if they had not been there? ... Father said that he wanted to be reasonable but he also wanted the best care for the babies ... . He repeated that he liked it here on the unit; in a funny way it felt like home.

It was a relief from outside where no-one really understood what they were going through.

He felt quite snappy at work ... . He talked about wanting to slap someone's face. I said that perhaps it was rather surprising to him to be having murderous feelings. He looked very shocked and said, "Not murderous.” But Mother interrupted and said, "Yes, murderous!” She had felt very nasty feelings about the woman whose baby had died, that the nurses should have helped her because she had live babies ... . We made another appointment, but they went on talking. Mother brought up people's comments about what she must have done to bring on the birth prematurely, and her anger and guilt about that.

It seemed that both parents were finding it hard to find a space to bear all they were going through. For mother, this got centred on her room and for father on his place of work. They were both overloaded with emotional work and had very little privacy to get on with it. Although father found it hard to leave the unit this did give him some space whereas mother was stuck in the unit and perhaps felt more in danger of claustrophobia. The unit seemed like a good place but sometimes the resources were not adequate. There was some reality to this. The unit was clearly understaffed and any observant parent could note this. Additionally, they had a worry about their own capacity to deal with so much anxiety and uncertainty, plus the impact of having twins was hitting them, adding to their anxiety about resources.

 
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