*This is the story from Nathan’s perspective, as I experienced the time spoken of here*
Very late Sunday night, Bethany began to have pain sharp enough that she couldn’t sleep. It didn’t feel like it was coming really regular, so she had questions about whether it might be contractions. But mysterious pains have been a part of our life now for the past eight weeks in our journey with Hannah and Bethany on hospital bedrest, so we tried not to fret too much. The pains would not go away though. Finally, Bethany called her nurse in and they put her on the contraction monitor. That nurse monitored and said she didn’t see anything. But the next shift nurse that came on the shift change works a lot in labor and delivery, and said she definitely had seen a pattern. We were troubled. We wanted labor to wait, and buy Hannah another couple weeks!
We had a diagnostic ultrasound at 9:30 in the morning, and we wheeled Bethany down for the test. From the very first image, Dr. Smith told us that Hannah’s head was WAAAY low and that she wanted Bethany checked right away when she went back to the room. We wheeled back upstairs with hearts pounding, and waited. The doctor came in, examined Bethany, and dropped the news on us, “You’re four centimeters dilated and I can see Hannah’s head.” Bethany just emotionally fell apart at that point. All those weeks of waiting and hoping that she would not go into labor had taken a huge toll. Her reserves were completely dry. We were at the destination of Bethany’s pregnancy, whether we were prepared or not.
Bethany was promptly wheeled over to labor and delivery to watch and wait for how things would progress. At periodic intervals, Dr. Smith or our wonderful nurse Donna would check on Hannah’s progress. After receiving an epidural and being placed on other IV medicines to protect Hannah in her delivery, Bethany progressed very quickly. We began to grow worried that the medical team wouldn’t be there in time. Dr. Smith came in and prepared for the delivery, and there was a brief moment, a calm before the storm, when it was just Bethany, me, Donna, and Dr. Smith. Then all of a sudden staff started pouring through the doorway and the room became a sea of blue scrubs.
After four big pushes, Bethany birthed Hannah at 4:56 pm. She came out so small and so purple, and the team of nurses and doctors immediately brought Hannah to the other side of the room, where they worked to resuscitate her. They immediately put tubes down her throat for breathing, and the first one wasn’t where they wanted it, so they had to pull it out and put another one in.
The minutes crept by with Hannah not responding to their work. It was the most terrifying, most traumatic time of my life. As I stood off to the side of the team of people working on Hannah, I felt utterly helpless. Utterly, utterly helpless. I’ve learned in those times of my life that I need to draw on the resource I have of great help in crisis: prayer with the Creator of the universe and our friend. And as I stood there, holding my breath and trying to whisper out prayers, our nurse Donna came over behind me and wrapped her arm around me and held me the entire time they worked on Hannah. Her touch anchored me when I felt like I was endlessly drifting. Her hand held my side and wouldn’t let go. As I told her afterwards, she was “God with skin on for me” during this experience.
One of the measures they use to determine the viability of a child is something they call an Apgar number, which varies from 1-10. The 10 means the baby is strong and vigorous, with a 0 meaning lifeless. After the first five minutes, Hannah was a 1. After the second five minutes, Hannah was a 1. After the third five minutes, she was a 3. And after twenty minutes, she was a 5, at which point they decided she had enough of a chance to take her to the Intensive Care Unit (ICU).
I kissed Bethany and followed Hannah as they took her to the ICU. As they transferred Hannah over from the bed into the isolette bed in the ICU, I again found myself standing by the side in what seemed like a beehive of activity. It seemed like chaos, but everyone clearly had a role and were functioning in it very well; except me. So again I in desperation fell into the pattern of prayer; speaking what I could and letting my emotions do the rest. Hannah’s blood pressure was perilously low, and they decided to go to one of the last resorts they use, which was an epinephrine drip. Hannah’s blood oxygen saturation was very, very low as well. They like it to be near 100, and she was in the low 60s, with a bit of variability up to the low 70s and down to the 50s. That low number meant that oxygen likely wasn’t getting to the organs in need; most especially the brain. And the medical professionals told me Hannah’s lungs were very, very, very small and weren’t big enough to support her. They expressed great doubt that her lungs would be able to grow enough to be able to progress, and even worse, her lungs weren’t absorbing the oxygen the machine was pushing in. The respirator was maxed out at 100% oxygen, the epinephrine was maxed out at the furthest point they felt comfortable, and she was limping along with very, very low blood pressure and very, very low oxygen saturation levels. The prognosis was not good. The nurse practitioner told me they wanted the respirator to be down to 40% oxygen output or below, and that a prolonged period of time on 100% oxygen with such low blood saturation levels would over time become counter-productive.
I had several responses that kept cycling through me in those first few hours. In my better moments, I had two big questions for God based on what God shared with us last Wednesday. I said in those times, “God, are you going to save Hannah, turn things around in a big, miraculous way? Or are you going to do this in a slow incremental way upwards, with your love and healing communicated through touch and care?” In my lesser moments I just begged for something, anything to happen. I kept saying, “God, be our salvation. Please, PLEASE PLEASE PLEASE do what you said you would. Your integrity is at stake as a God who does what you say you will. If she dies, I will look like a fool and you will look powerless, and there are people following this story who will have varying responses. What about the people whose spirituality has been awakened by our story, God? Do you want that crushed? Shattered? Is that what you want? Stand up and be counted! Be the powerful God you claim to be!”
The rest of the evening I spent shuttling back and forth between Bethany (who was still in labor and delivery waiting to deliver her placenta), our friends the Rains’ and Erin and Robert who were committed to being a praying presence, and the ICU. Bethany’s mom had driven down from Michigan and did the shuttling work as well. After over two hours, the medical staff determined Bethany wasn’t going to deliver the placenta, and they prepared her to have a surgical procedure to remove it, which took place at about 7:30. She was very much in shock and emotionally struggling, as the last sight of Hannah she saw was Hannah being wheeled out to the ICU. About two hours after her surgery and over four hours after the birth, Bethany was able to be taken down to the ICU to see Hannah for the first time. This was very, very hard for her. In addition to Hannah’s vitals being so low, her face was very bruised from being the first part of her that moved down the birth canal. We sat with Hannah. The medical staff switched Hannah to a different ventilator called an “oscillator” that breathes in and out for the baby, and Hannah’s vitals crept up just a tiny bit. After awhile, I left Bethany with her mother in the ICU to go out and eat with the folks in the waiting room.
Later, we moved Bethany upstairs to the 13th floor where she would be staying. Her pain had increased significantly from her epidural, and they gave her a strong dose of pain medication. I shuttled back downstairs to report back and to pray with our friends. We had a very meaningful, heartfelt time of prayer there together. After we said our goodbyes and they headed home, I went back upstairs and Bethany and I tried to process where we were at; to listen to one another and talk out what we were feeling. We both were deeply struggling, both with Hannah’s appearance because of the bruising, and with what seemed to be zero progress in her vital signs. We both felt completely exhausted as well.
Shortly after 12, we all (Bethany, Dorene, myself) decided to come back down to the ICU. We each struggled with how to be present in the situation. Bethany especially was very groggy and completely spent from the journey of the last 24 hours. As we sat there, Hannah’s vitals stayed so very low, and the nurse practitioner told us several times, “Her lungs are so so small, and they’re just not absorbing the oxygen.” The situation was very dire, and then it turned much worse.
At about two o’clock am, when being administered a pain medication to sedate her, Hannah’s vitals plunged down even further. This started another rush of activity from the staff. They shut down the pain medication drip, and decided in desperation they would switch back to the first ventilator. During this rush of activity, the nurse practitioner came to us and had the first very serious death conversation. She told us, “We’re switching her over to the first ventilator, but we’re not sure if she’ll make it in the transition. Would you like to hold her? We don’t want to have Hannah’s last moments just be spent with us trying to work on her.” This new situation sent me spinning out of equilibrium. It’s enough to try to be present with a sick and seemingly dying baby, but what we had heard last Wednesday of the promise of her survival presented a crushing, arduous situation. “WHAT IS GOING ON?!?!?!” everything within me shouted in desperation. The two questions of “God, how are you going to save Hannah?” together with needing to be present with the reality of a dying child spun through my head over and over and over again.
As we dealt with this new reality, a short breath of fresh air blew in. In the transition between ventilators, as nurses took over the regulation of breath for Hannah, all her vital signs shot upwards. Her blood pressure went above the target minimum, her oxygen saturation levels sat in the mid 90s; all while her heart rate remained solid as it generally had. These were numbers we had not yet seen. Even more, they were numbers we were never even remotely close to. I looked at Bethany in astonishment. “This could be our miracle, Bethany!” I said. I asked the nurse practitioner what was happening. She didn’t have an explanation other than to say that the nurses were just doing what the ventilator was doing. She reiterated that this wasn’t a game-changer, though, and she ended up being right. After Hannah was transferred back to the first ventilator, she held her numbers for a bit, and they regressed back down to perilously low again.
A doctor came and had a serious conversation with us similar to, but more crushing than the nurse practitioner. She told us that we had now entered into another phase where Hannah’s consistently low oxygen saturation meant her organs were at great risk, and the longer the oxygen stayed at such a low point, the more her organs would deteriorate. They had done everything, they were maxed out, and had no other options. Essentially, she was presenting us with the “life” issue in its most heartwrenching form. Is a respect for life shown by desperately hanging on to a machine keeping someone “alive” when the other signs show a body incapable of progress? Or is a respect for life shown by doing everything you can, and acknowledging that the most compassionate and courageous thing you can do sometimes is to stop and to let the person pass with respect and honor? We felt increasingly crushed in an irresolvable dilemma. On top of the life issue was this belief we maintained against all present signs that God had spoken and said He would save Hannah. I knew that faith sometimes leads us to “foolish” decisions in others’ eyes, but should not lead us to decisions completely out of touch with reality.
I walked to the other side of the ICU with emotions and questions raging inside of me. “Is this it, God?” I screamed on the inside. “Is this a big cosmic joke? Are you just playing with us? Wednesday was you, there is no other explanation. I would have to be insane to explain that all away. But now we’re here. Where are you?” Everything I prayed came out in a torrent; all the tension, all the struggle, all the pure anger I felt at the situation. My words in this time were much saltier than what I wrote, but you don’t need to hear that. I just felt like my soul was howling with a pain I couldn’t hold back. I came back from my quiet scream session with God, talked with Bethany, saw the desperate desire to cling to life in Dorene’s eyes, and approached the doctor.
“How long can a child go along with such low oxygen saturation without destroying the possibility of the other organs functioning?” I asked.
“We don’t really know,” she said. “But we’re in desperate territory right now.” She then asked, begged really, for Bethany and I to sign a “do-not-resuscitate” paper, making the case against chest compressions and a line into Hannah’s chest that would simply make her last minutes extremely painful before death. We complied and signed the document, and decided we would neither take her off the respirator nor keep her on.
In an act of complete desperation, we asked to have Hannah removed from the isolette bed for us to hold her still attached to the respirator. We felt death was imminent and were emotionally and spiritually devastated, but Hannah needed to be held no matter what. Our nurse Patrick swaddled Hannah in blankets as we moved Bethany up in a chair to the bedside, and Patrick handed Hannah to Bethany to hold. I scooted up a chair behind Bethany, and I held Hannah’s head while Bethany held her hand. We began to weep, to sing, to pray, and to speak to Hannah. Bethany kept saying over and over, “God, be who you are. Be strong and mighty for us.” We sang Tom Wuest’s song with lyrics, “Your song will go with us, your wings will cover us, hope thou in God my child…all through the night.”
And, against all reason, as we wept and prayed, Hannah’s vitals began to climb, and climb, and climb, until her oxygen saturation levels went up to the 90s and her blood pressure stabilized above their target for her. After about twenty minutes, the doctor (mystified by this change, and gaining a small shred of hope) came to us and said, “The only option we have left is to get to the 12 hour mark, and we can give her more surfactant in her lungs. She might respond well, and she might crash. But that’s all we have.”
We nodded, and realized we needed to get Hannah to 5 am. That gave us a target to work towards, and so we moved forward. Bethany was utterly exhausted and only had the ability to hold Hannah and keep calling God to be God. I entered into an interesting form of prayer as Hannah’s vitals rode down into valleys and back up again. As her oxygen saturation levels would begin to drop, I would pray for specific numbers from God. If her “sats” were at 74, I would pray for 75, saying, “God, let’s get to 75. Let’s get there, God.” And when Hannah bumped back up to 75, I would say, “Thank you, God! Now let’s get to 76. Can we get to 76?” And we rode this rollercoaster ride of her vital signs. Again, against all odds though, with our medical team out of options, Hannah kept returning upward after valleys. Several times, she spiked her “sats” at 97 and 98%, and they began to turn the oxygen down, first to 98%, and then to 96%. We held at 96% for a long time.
I want to stop and say that Bethany is my hero. After all that she had been through, with significant pain from her epidural in her back, she held Hannah from the moment we were able to hold her until 4:15 and it became too much for her to handle, and she needed to go upstairs for more medication and rest. She has been a model of perseverance for me to follow. She has chosen to be courageous all through the extended hospital rest, and this situation did not change her witness at all. She stuck it out beyond the point where she had nothing left.
We carefully placed Hannah into my arms, and I took over the task of prayer, speaking God’s words over her, singing, and weeping for her. I got to tell her that God had created her in His image, that God had created her with great joy, that God rejoices over her now, dances with her and sings to her, and that her life is worth it. I got to repeat that time and again, picturing God holding her close and dancing around in circles, with her giggling and knowing she is at home.
At 4:35, Patrick noticed that Hannah’s core temperature was beginning to drop, so he politely told me that we needed to get her back in the isolette. I did so reluctantly because of her response to touch. So we put her back in the bed. I moved the chair back away from Patrick so he could get her settled in. I asked the question again, “Is this God’s miracle?” We had already experienced the dramatic, unexplained turnaround. All the medical team had no explanation for it. We all were astonished. But would it last? Could she get to twelve hours, the first big milestone?
As I sat there with a great degree of struggle over what might happen next, the Scriptural passage of the Garden of Gethsemane came to mind for me with Jesus saying to his disciples, “Could you not watch and pray for even one hour? Watch and pray.” I didn’t know whether to interpret that as a command from God or an encouragement to keep going from God. Either way, the result needed to be the same. I felt I needed to be present and praying until Hannah’s “sat” numbers got up to the 90s and stayed there. So I committed to following this course.
At 5:15, Patrick administered hydrocortisone to help her blood pressure, and at 5:30 Patrick and the respiratory therapist administered the surfactant. This was a few minutes of fear and trembling, as I remembered the words of the doctor that the surfactant could make Hannah go one way or another. With great thankfulness, I saw that both medications gave more of a degree of stability to Hannah’s vital signs.
From that time on until 7:30, Hannah’s numbers did less of a roller-coaster, but did ride up and down. I engaged in the “auctioneer” kind of prayer again, and if it hadn’t been as deep of a crisis time, I think I might have had fun with it. It was exhilarating to see the numbers go up; and my gratefulness at each tick up gave me more courage and more energy to keep going. At around 7:30, I found myself nodding off, coming to and trying to keep praying, then nodding off again, then back. Each time I awoke from nodding off, I noticed Hannah’s numbers working their way upwards until she held steady at 92 for a good long time. I felt released to go upstairs, and so I went up to Bethany’s room. She had been so amped up with adrenaline and pain and emotional struggle that she hadn’t been able to sleep at all. Dorene was there too. They were both grateful to hear the news about Hannah, and we were able to celebrate, in a really really tired kind of way.
So, to sum up our experience from those first 12 hours, we got to see some of the best premature infant care possible, and we got to experience the hand of God in a miraculous way. Without the work of the very competent staff of Good Samaritan at the delivery, Hannah would not have survived the transition. I weave my view of their role into God’s promise to us by being thankful for how human wisdom and creative abilities play a role in bringing about what God accomplishes. The ventilator, the medications, and the wisdom and loving hands of the nurses played an essential role, and continue to. But there remained a point, and it was HUGE, where human wisdom and creative capacities could take Hannah no further. It was in that moment, where all seemed lost, that God stepped in and carried Hannah; carried us all. So we got the answers to my two big questions. In response to the first, “God, are you going to do this in a big, miraculous way?” God answered with a resounding, shattering “YES!!!!” delivered with joy and power. And in response to the second, “God, are you going to do this in a slow, incremental way, with love and care communicated through touch and attention?” God answered with a comforting “Yes!” delivered through the wonderful staff of Good Samaritan. Our experience reminds me of the verse in Psalm 86 where “righteousness and peace kiss each other.” For us, “medical science and God’s unique power kissed each other” on Hannah’s first night, and for that, we are truly grateful.