Being & Becoming: A Williams Syndrome “Mom-oir” Part 5(c)
PART 5(c): THE FATE WHO HOLDS THE SCISSORS
The operation will be an outpatient procedure. As the youngest patient of the day Brendan is scheduled first, to reduce the stress of no food or drink after midnight the night before the surgery. Dr. T. has explained what will happen. The actual procedure will take about an hour. The baby will be put under general anesthesia. A small incision will be made and the split in the fascia will be stitched with dissolving stitches. In the process, Brendan will acquire a normal naval. I request an innie. The doctor chuckles, though I detect or maybe imagine a tinge of disapproval at the apparent triviality of this cosmetic detail in light of the seriousness of surgery.
It’s not that I lack appreciation of the gravity of putting a frail four-month-old infant with a history of cardiac problems under general anesthesia. It’s that in order to function with any degree of maternal efficiency, I have to wrestle my concern and the potential for panic into submission. I have to sit on it with the weight of a Sumo champ so it doesn’t hamper my ability to act — to do what must be done, whatever that might be, should the need arise. Sometimes this results in the random stupid question or comment.
We check in early at the outpatient clinic, having completed all the paperwork in advance. It’s not a long wait before a nurse comes to take Brendan from us. By this time, I have already shrink-wrapped my emotions and any stray thoughts they might engender into a straight-jacket package. I move my awareness to a room down the hall in my brain, where all is quiet, in the present, an inner waiting room. I can still sense the unruly feelings squirming for release. Shushh, I send them the silent message.
There is a feeling of being encased within a machine while waiting in a hospital. There are the sounds: the white noise composed of the electrical drone of equipment at varying pitches; the squeak of rubber soles on polished linoleum; the murmur of voices; the occasional erratic punctuation of a gurney wheel squealing, the disembodied voice on the PA relaying some hospital code attached to a doctor’s name. There are the odors: ink-and-paper of magazines, the waft of coffee from an invisible pot, people’s idiosyncratic perfumes and aromas, some masking an odor of illness, all blended by the anchoring scent of disinfectant.
Aside from the emergency room, the hospital feels like an environment that hums with controlled order, regardless of the human physiological chaos unfolding within it. The professionals are the directors, you are (if like me) the unschooled improviser, trying to perform properly. You can only wait, and during the waiting period when time seems suspended like a motionless pendulum, try not to think.
After an hour and a half by clock time, Dr. T., in his turquoise scrubs with his mask hanging by its elastic around his neck, comes out. He’s smiling reassuringly, slightly absently it seems to me, as if a part of his mind is already surging forward to the next case. But he tells us all went beautifully, no problems, nothing unexpected, Brendan’s in recovery, and the nurse will be out to fetch us in ten or fifteen minutes, as soon as the baby wakes up a little more. More waiting, and though the clock has resumed ticking, the patina of dread has dimmed substantially.
A nurse in a pastel print jacket, white slacks, and white clogs comes to escort us to the outpatient recovery room. It’s a large room with several cubicles partitioned by thick oyster-hued drapes and a nurses’ station. In contrast to an emergency room, the urgency is muted, the pace sedated. There’s a pale-yellow glow from the walls and the overhead fluorescent light panels cast a glaring clarity on the polished metal of IV stands, gurneys, the frames of molded plastic chairs. The soundscape is composed of quiet voices, high-pitched beeps of monitors, various gurgles. Some moans. It is not a dedicated pediatric unit.
The nurse escorts us to the corner cubicle where Brendan lies on his back, limp. His tiny shoulders are visible above a warm woven white cotton blanket. An IV tube runs to a taped spot — on his ankle? His arm? I can’t remember which, but I remember wondering how they managed to thread the needle into his tiny veins.
“We’ve woken him up, but he’ll be in and out of it as the anesthesia wears off,” the nurse tells us. “He did beautifully.”
There’s that word again — beautifully. I’m not sure exactly what it signifies. I stand next to the gurney, with its metal crib sides up, touch his cheek softly with the back of a finger. He’s very warm, very dry. Charles stands behind me. The nurse pulls the curtain partially closed around us, and pads away. We watch. Brendan’s eyelids flicker and I catch a quick glimpse of disoriented agony. He writhes weakly, whimpers, drifts off again. I touch his shoulder. After a time, a fairly short time, a sudden deep red flush infuses his pallor.
What is happening here?
“Get the nurse!”
Charles is off, back quickly with our nurse. She checks the baby closely, surely, checks the IV level, then turns to us calmly, reassuringly. The dark red rash is fading.
“It’s all right,” she tells us. “That’s normal. It’s called an “atropine flush, part of the anesthesia. It’ll go away in a few minutes.”
Her voice is casual, as if this is routine, though she takes her stethoscope and puts it to Brendan’s chest. Prepared to grasp any assurance that things are fine, I accept her nod, and let her walk away.
There was no Google in 1987. I could not pull out my cell phone and look up “atropine.”
But thirteen years later almost to the day, after five more surgeries, all performed under general anesthesia, I look atropine up on the Internet. It’s a drug often given prior to anesthesia to dry up mucous secretions so the lungs won’t collect them while the patient is out. There are medical caveats, extreme ones, it seems to me, effects on the heart rate, on blood pressure, the nervous system, the pupils of the eye, as well as specific pediatric dangers. But I also find a reference on an online botanical site, under Deadly Nightshade: Atropa Belladonna. The word POISON is pixelated beneath it in big red letters.
“Its deadly character is due to the presence of an alkaloid, Atropine.”
Oh.
There’s more: The plant is named after Atropos, one of the three Fate sisters of Greek mythology, the one who holds the scissors to cut the thread of life. The article goes on to detail historical accounts of the substance’s usage, among them Macbeth’s purported drugging of invading Danes during truce talks so he could subsequently slay the anesthetized soldiers in their tents, and the use of a cousin plant, Atropa Mandragora (Mandrake root) in the potion that Juliet drank to simulate death.
I am very glad I didn’t know any of this back in any of the recovery rooms. *
Brendan’s eyes are glazed, filled with bewilderment and pain when he opens them. He strains to be released from this twilight nightmarish sleep, whimpers as sensation returns and he feels the pain from the scalpel’s insult to his body. He tries to cry, but it clearly hurts too much. When the bag of hydrating IV fluid is empty, the nurse detaches it. I hold him, try to keep him still, try to infuse whatever mother’s comfort I can muster into him through my touch. After a while, he nurses a little. He doesn’t spit up. One good sign. After another while, his diaper is wet, the signal that he’s rehydrated, his plumbing is working, and we can go home and move on.
Hopefully.
* Time-travel thirty-six years to 2023. Our whole family is so grateful for the superb medical care Brendan has received over the past three-and-a-half decades. We are also so grateful for the much-beloved organization called the Williams Syndrome Association, through which access to information on all things Williams syndrome, including anesthesia for patients with WS, can be readily accessed:
