A Life Beyond Reason Page 2

  She turned out to be smart and funny, and, I learned, her favorite color was periwinkle. She was the type of person who insisted on rearranging the luggage in the trunk of the car after I’d already packed it. She had grown up in Canoga Park, a city in the San Fernando Valley, and that meant she had once been a “Valley Girl.” But at the tail end of her sentences there was no residue of the valley’s legendary upspeak.

  Over the next year I learned that Ilene’s background was middle class. Her mother was Charlotte Orzoff; her father, Fred Chazan. Their ancestors had come to the United States in the first two decades of the twentieth century. The Orzoffs settled in Chicago after escaping from Tiraspol, a city in what is present-day Moldova, during the tsarist pogroms of 1903–1906. The relatives on her father’s side, the Freiders and Chazans, fled from Vyshnivets in Ukraine in 1920. Following the Bolshevik Revolution, the White Russian army had carried out pogroms, from which her family had escaped. Four of her Freider relatives who remained behind—Sonia, Rachel, Yentl, and their mother, Hannah—would perish several decades later in the Holocaust. The Freiders and Chazans who came to America settled in Omaha before moving on to Santa Monica. Eventually Fred and his father (Fred’s mother had died by then) settled at Venice Beach. Fred served in the military in Alaska right after World War II. Members of the Orzoff and Chazan families set up a mail correspondence between Fred and Charlotte, and after he completed his service the two met, married, and settled in Canoga Park, where they had two children.

  Charlotte died when Ilene was nine years old of a kidney disease that today is nonfatal. She was only thirty-nine. Up until her mother’s death, Ilene had been raised as a conservative Jew, but afterward her father stopped going to the synagogue, and this ended her religious upbringing. After graduating from UC Santa Barbara, she moved to San Francisco where she worked as a food server in restaurants such as Max’s Diner and Dante’s on Pier 39. She began studying to become a physical therapist, and in the fall of 1987 she flew “back east,” as many westerners say, for graduate school interviews. It was while sitting in a glassed-in patio café in Quincy Market in Boston that she saw her first snow flurries. When I met her, she had recently graduated from Boston University with a master’s in physical therapy and worked at the prestigious Loma Prieta Medical Center.

  When we became engaged, Ilene had to call all of her Jewish relatives to tell them that she was marrying a man named Chris. It would have been a little easier if my name had been Moshe. We were married on the morning of August 1, 1992. Our ceremony took place before friends and family in a lovely garden under an azure sky. Steve Woodhams was my best man. Our Song, one that Ilene and I definitely did not have played at our wedding, was R.E.M.’s “Losing My Religion.” No one at our nuptials but us would have understood why a couple so in love would have chosen this to be Our Song.

  For the next few years Ilene and I lived the dream, taking evening strolls on Baker Beach and Saturday morning hikes on Mount Tamalpais, with weekend getaways to Carmel, Point Reyes, and Big Sur and two-week vacations to Lassen Volcanic National Park. Everywhere we went, we traveled with music, listening to cassette mixtapes. We were optimistic believers. Ilene believed in the good that science and medicine would bring. And I believed in the Enlightenment, the ideals of which had become my religion. That movement had laid the foundation of medicine and science and would allow humankind to control its destiny.

  Our respective families also became smaller. The last time my father, Arvil, took unaided steps was on our wedding day. He died two years later. My mother, Fran, had passed away twelve years earlier. Ilene’s father, who was well at the time of the ceremony, died of a stroke three years afterward. Each of us had only one sibling, both of them brothers, so we now were members of remarkably small families.

  I’d been slow to warm to the idea of having our own family. I was not interested in what I had considered in my youth to be the false consciousness of family values. At one time, I’d been convinced that parental love for children was nothing more than bourgeois sentimentality or a primitive response mechanism. In high school, we called the girls who wanted to become mothers “baby makers.” Moving to San Francisco as an adult, I commonly heard procreating heterosexual couples referred to as “breeders.” I harbored a similar sort of antipathy to child-rearing. Individuals have a right to not have children if they didn’t want them, I would think (and this is still my position).

  When I was younger and people, such as my dad, suggested that I start a family, I’d think, I’m no fool. But he contradicted his own advice when another time he said, “If you want to accomplish anything in life, keep the kids off your knee.” To be frank, I didn’t like children. I didn’t see any point to having them. I thought they were boring. They would ruin my life. You would have to pry my male independence from my cold, dead hands. All of which is to say, I was about as interested in having a child as I was in having a tumor.

  In my callow confidence, I completely believed in my own judgment. Long before meeting Ilene, I had moved to San Francisco from Palo Alto because I thought that, beyond my hometown being rich in squirrels, absolutely nothing of any importance was happening there. I also had a number of pet idiosyncrasies. I found the phrase spiritual journey annoying (stories of spiritual journeys were packed with profundities without substance), hated films that were sentimental tearjerkers (you couldn’t buy me with sob stories), gravitated to alternative music (I only liked love songs that were ironic), and preferred living in a community where the sarcasm was clever and the pop cultural references frequent. I found that community in San Francisco before it became too expensive to live there. We in that community believed that people who didn’t conduct their lives in the light of reason were, in my vocabulary at the time, “unspeakably stupid.” Why couldn’t people act rationally? We were constantly examining and reexamining our lives because we all more or less implicitly agreed with Socrates that “the unexamined life is not worth living.”

  But then I met and married Ilene, and the idea of being a dad began to grow on me. I decided I would do it ironically, which is to say playfully, with a jaded urban hipster’s state of mind. I recall telling my buddy Steve, “I’m going to be a parent, but on my own terms.” Perhaps I sensed it was time to move on from the Peter Pan phase. Regardless, in the middle of 1998 a home test strip reported positive, and becoming a father seemed to portend a flourishing world, a world of fullness. Fullness meant a lawn and flowers in the front yard, a white picket fence with a gate, and robins in the trees, a vision I’d glimpsed in David Lynch’s Blue Velvet. Because we were living in a cramped San Francisco apartment, it was ironic that I had come to imagine fullness as a cool late-nineties upgrade of the “Gee, Wally” wholesomeness of the 1950s TV sitcom Leave It to Beaver. We were awaiting the arrival of Theodore Cleaver, Version 2.0, a child of the new millennium. Would this Beav emerge from the womb with tattoos and piercings?

  Ilene fell in love with the baby from the moment she knew it was coming. It took me much longer to get to the same emotional place. I could have used another year without a baby. A line from the song “7” by Catfish and the Bottlemen comes to mind, one to the effect that I would love him but would need another year without him to get things done. In fact, I could have used another two or three. I had great things to accomplish. Specifically, I wanted to be the next Stephen Greenblatt, an internationally recognized American Shakespearean scholar, literary historian, and Pulitzer Prize–winning author. Or at least I aspired to be someone like him, someone who would shake up my field of study, British Enlightenment literature.

  The choice for the hospital came down to two. California Pacific Medical Center, known locally as CPMC, a facility close to home, served the local community. Annually it performed three times more deliveries than did its chief rival, Loma Prieta. It was primarily in the business of birthing babies, and its name might as well have been Babies-R-Us. Outside of San Francisco, though, no one would have heard of it.

  Loma P
rieta was the other option. Ilene felt comfortable there because it was her place of employment. But more importantly it was an internationally acclaimed teaching hospital, universally recognized for excellence, employing the best and the brightest, one to which wealthy people from all over traveled to receive the best medical care. Few if any hospitals were more respected by health professionals than Loma Prieta. This was supposed to be one of the best hospitals on the planet. But perhaps this was the issue: the problem lay less with the hospital and more with the planet.

  Our first glimpse of the boy was on a screen. Afterward we were handed a photo like an old-fashioned Polaroid print: a fuzzy black-and-white sonogram. The scene it captured resembled something you might see on the Weather Channel: a westward-moving hurricane just beginning to form off the west coast of Africa or near the Cape Verde islands. In the upper left corner appeared the date: 31 – JUL – 98. In the upper right the words LPMC PRENATAL DIAGNOSIS and immediately below PT: CHAZAN ILENE, SONO.

  Knowing it would be a boy, I began to dream about the things we would do. We would backpack in the High Sierras, where, camping in the wilderness, we’d drink in an ocean of stars while sitting beside a fire. We’d go to baseball games at AT&T Park, where I’d teach him to root for the Giants and against the archrival Dodgers, the way my dad had done with my older brother Jesse and me back when the team played in Candlestick Park. Maybe the boy would be a nerdy, geeky hipster like his dad, and when he was older he’d introduce me to new concepts or take me to see an independent film being screened for the first time or a cool new band to keep me up to date. Whoever he would turn out to be, and whatever it was he would enjoy, and whoever he would love, he was so going to be magnificent!

  Ilene and I took all of the measures expected of enlightened parents-to-be living in a technocratic society. In preparation for this birth, we underwent genetic testing before conceiving, and Ilene had an amniocentesis early in the gestation period. All of the test results pointed to healthy development. Having read What to Expect When You’re Expecting, Ilene stopped drinking coffee and alcohol, which she had never done much of anyway. Prior to and during the pregnancy she didn’t take any medications, and before becoming pregnant she had followed the recommendation of taking folic acid supplements.

  Our Inner Richmond apartment was very small—only six hundred square feet, but, with the San Francisco rental situation being what it was, we couldn’t think about moving. The dot-com bubble was seriously bulging. We went about assembling baby supplies. Ilene’s cousins Linda and Wes in Antioch lent us the crib that they had used for their kids. We placed a new changing table against one wall in our bedroom and purchased a bassinette. Friends threw a baby shower. We created a birth plan expressing our dream of how the birth should go.

  The baby’s due date arrived, February 20, 1999, a Saturday. By Monday, the baby had not come, but the medical staff with whom Ilene interacted never deemed her pregnancy to be high-risk, so we weren’t worried. To pass the time, we attended a matinee screening of Terrence Malick’s war movie The Thin Red Line at a theater in the Marina District. During the closing credits, Ilene sensed for the first time that the baby was not as active as it had been. In fact she felt no fetal activity at all and immediately suspected that something was wrong. After the movie she went to the office of her OB-GYN next to Loma Prieta, where the fetus underwent tests. Her OB-GYN was part of an all-woman practice. The nurse said the results didn’t look good, the numbers were low and very worrisome, and so she told her to go up to the fifteenth floor of Loma Prieta. There a young male resident physician repeated the tests, carrying them out hurriedly. Ilene told me afterward that he seemed tired.

  “Your baby is fine,” he said when he was finished.

  On Monday, March 1, ten days after Ilene’s due date, the test results again were “not good.” The numbers were troubling.

  Yet the nurse conducting the tests said reassuringly, “Your baby is fine.”

  “Are you certain?” said Ilene.

  “Absolutely.”

  “I think there’s something wrong.”

  “Come back in two days and Dr. Klothoberg will oversee your induction unless you go into labor before then. All expectant moms worry too much. Everything will be all right. Come back in two days. We’ll get that baby out.”

  On Wednesday, March 3, dawn awakened us to a day of great expectation. The sky was clear, the air was a crisp fifty degrees, and a gentle wind was blowing in from the west. Our world was radiant with sunshine. A good day to have a baby! Ilene and I assembled our things, drove across town, and parked our Toyota Camry high on a steep hill behind the hospital, curbing the front tires. After walking down the hill, at the main entrance of Loma Prieta Medical Center, we stopped. We were going to hatch a dragon egg. With great anticipation of the dragon adventure ahead, we hugged, kissed, and approached hospital glass doors so dark they seemed black. All that we could see as we walked up to them were our own reflections.

  March 3 rolled into March 4. Joanne came and went, came and went. The doctors and nurses changed shifts, with Dr. John Klothoberg going off duty and Dr. Sandra Latchesik coming on as the attending physician. She was a slender white woman of medium height, maybe in her mid-forties, with very short, dark blond hair, large cheeks, wire-rimmed glasses, and blue eyes. Joining her was Dr. Lisette Atropski, who was younger, slightly shorter, with long, dark brown, flowing hair, tortoise-shell glasses, and a broad smile. She also was white. Atropski would be the physician who would be with us the most throughout the labor. She was warmer and more relaxed than Latchesik, but she also was diffident and spoke softly. So deferential was she that at first I mistook her for a nurse.

  Dr. Latchesik, by contrast, was dominant, epitomizing complete self-possession and control. She was all business. Her area of expertise was perinatology, a subspecialty of obstetrics concerned with complicated, high-risk pregnancies. Every inch the expert, she made an almost imperceptible nod whenever she said something authoritatively, which was frequently. Standing with her back straight, wearing her starched white lab coat, she would assert something boldly and almost simultaneously nod, as if agreeing with herself.

  As the attending physician, Latchesik was responsible for whatever the resident, Dr. Atropski, did. The attending popped in every few hours but would only stay a moment. She was a whirlwind. “She’s not the most demonstrative of women,” Ilene had said after her first prenatal appointment several months earlier. On a later occasion Ilene had characterized her as “an academic medical diva.” I assumed this meant that Dr. Latchesik was one of the best and the brightest, and I didn’t give this assessment a second thought.

  One crew of nurses cycled off and another came on. A short African American woman in her mid-thirties became our main labor and delivery nurse. Busing in all the way from Sacramento, ninety miles away, she worked per diem, on a day-to-day basis. We never caught her name. As she went about her business, Ilene and I, and sometimes Joanne, watched the show beyond the big windows, the slowly shifting shadows of the tall downtown buildings. A little past midday on the second day a severe pressure pain began developing in Ilene’s lower pelvis.

  “I’m sure something is wrong,” Ilene said. “It feels as if the baby’s stuck, like it’s impacted against my pelvic bone.”

  “Everything is going well,” said Dr. Atropski. “That baby will be out in no time.”

  Ilene managed to take a few steps, but then the per diem nurse approached in a panic and hurried her back into bed—the electronic fetal monitor (EFM) indicated that the baby’s heart rate was dropping. Joanne quipped, “Moonwalk aborted!” After settling Ilene back into bed, the per diem nurse insisted that everything was fine. She turned to the EFM, which was methodically churning out a stream of narrow paper, gathered up a stretch of it, and held it up. “This is where the baby’s heart rate went down,” she said, pointing, “and this is where the heart rate came back up.”

  Around 2:10 a.m. on Friday, Joanne temporarily left to
retrieve something from her nearby apartment. Throughout the night and early morning, the pain in Ilene’s lower pelvis intensified despite the epidural. She also had developed a fever, but at least dreaded preeclampsia was not an issue. It was 2:55 a.m. when the per diem nurse said to a second nurse, a young blond woman, tall and willowy, “The baby’s heart rate is low.” The two discussed whether the EFM was picking up the mother’s heartbeat or the fetus’s. Dr. Atropski joined in this quiet discussion and speculated that a problem was occurring with the EFM, not the baby.

  “Must be Mom’s,” the resident said of the fetal heart rate. She then stepped out the door for about thirty seconds. The per diem nurse wasn’t convinced. She seemed perplexed and asked the blond nurse again if the reading could have been the baby’s. The blond nurse didn’t answer. The per diem nurse then said, “These vitals are not reassuring. I don’t believe the baby’s heart rate should be this low. It’s in the eighties.”

  “Must be Mom’s,” the blond nurse replied, repeating what Dr. Atropski had said. She spoke matter-of-factly.

  “That doesn’t seem right,” the per diem nurse said. But then she dropped the matter when Dr. Atropski stepped back in and reiterated that the heart rate must have been the mother’s. Atropski considered it a nonissue.

  Joanne returned shortly after 3 a.m. Ilene was maximally dilated. Dr. Latchesik stepped into the room for a minute, a brisk encounter. Dr. Atropski told her then that a problem was occurring with the EFM. Latchesik didn’t respond to this statement, and the resident physician didn’t repeat herself. The attending physician obviously was in a hurry. Hours earlier, Joanne had dubbed her Dr. Dash Smoke because she’d been rushing in and out so much. Before dashing out, Latchesik suddenly shouted, “We’re going to have a baby!” The exclamation seemed so out of character that I did a double take. Then she was gone.