[In the spring of 2009, Mark Nordahl and his wife Veronica Moreno were eagerly awaiting the birth of their first child, Emma. They attended prenatal classes, read books, had excellent medical care. Everything was going as expected. Then, as sometimes happens, life threw them a curve ball, a dangerous and fast one. Here, in his own words, Mark shares his first 24 hours as a father, an experience that makes every Father’s Day especially poignant for him. Happy Father’s Day to all the loving and dedicated fathers out there.]

March 18, 2009 (Nine Days After Due Date)

About 1:30 am Veronica has two strong contractions, but then no more. She had been having contractions all week, so we decide to wait.

About 4:00 am Veronica’s water breaks and it is very brown. We both think this isn’t right, but at least for me, I had never thought to ask whether the “water” really looks like water. After getting her into the bathroom, I call the hospital to tell them we’re coming in. Veronica’s parents came from out of town to stay with us until the birth and help out for a bit afterward, so I walk downstairs to the spare bedroom, wake them up and call my mom to let her know, too. I’m surprised at how calm I am, but we took all the prenatal classes, I know what I have to do. As long as I know that, I’m okay.

We drive to the hospital and get Veronica admitted. The nurses do what they do and everything goes along normally. We mention the possibility of meconium, and the nurse confirms that there was a little. [Meconium is a fancy name for an infant’s first stool; it can sometimes happen in the womb and be dangerous if aspirated into the baby’s lungs.]

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IV line in Emma’s tiny hand.

The on-call doctor comes in to examine Veronica. She’s having trouble monitoring the baby, so they attach a little monitor to my daughter Emma’s head in utero to track her heartbeat. Then we wait.

At around 7:00 am there’s a shift change, so we get a new nurse and doctor. This doctor checks Veronica and at about 7:45 am explains that she’s only two cm dilated and with her water already broken, it’s probably a good time to consider a cesarean (C-section) birth. Around 8:00 am they bring release forms for Veronica to sign for a C-section. I watch Veronica take the papers, then suddenly one of the nurses says something about the baby’s heartbeat and all hell breaks loose.

No Time to Lose

The next thing I know, a nurse is holding my arm and we’re running down the hallway trying to keep up with Veronica’s bed. They take her into the operating room and have me put on the sterile clothes (booties, jumpsuit, mask, gloves, & shower cap) before going in. The nurse leads me into the room through a second door. I remember thinking that all Veronica can see are people’s eyes, and I don’t know how she is going to know which set are mine.

The nurse takes me over to Veronica. There is a sheet at her chest; with my head down beside hers, I can’t see beyond it. Veronica says, “Mark, watch our baby be born!” I’m afraid I’ll see them cutting her and pass out or something, so I slowly peek up just enough so I can see the doctor’s hands. At that moment they pull Emma out.

Emma looks right at me. I remember seeing her eyes first. They’re all black and she has this look of drowsiness about her as if someone woke her from a deep sleep.

The next thing I notice is how pale and pink she is. I think this is a good sign since I don’t see much meconium.

They take her over to a table and as I expect towel her off and suck the gunk out of her mouth. Then it starts to not seem right.

She doesn’t cry, not for a long time (or what seems to me to be a long time). And once she does, they don’t bring her over to Veronica. All of our prenatal classes showed that as soon as possible they put the baby on mom, clean or not, but they aren’t doing that.

Then, when Emma finally does cry, I see her chest rise, rise, rise, then force a single exhaling cry. Then rise, rise, rise and force a single exhaling cry. My first thought is that her chest doesn’t look right to me. My next thought is, why are they still not bringing her over to Veronica?

I stay close to Veronica’s face and just kept telling her how beautiful Emma is and how great she did. Over and over again I tell her because I don’t want her to know the panic I’m feeling or to panic herself and it’s the only thing I can think to do.

At some point one of the nurses calls me over to take a picture of Emma on the scale for the official weight. I just bought a new camera and instead of taking a single picture, I accidentally take a ten second video. By the time I notice, they have already whisked Emma away and into an incubator.

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Emma in the Seattle Children’s NICU attached to the ECMO machine.

Hanging by a Thread

A nurse grabs me and says, “Dad, you go with your daughter.” I think I say goodbye to Veronica but I am not sure. Down the hall and into the elevators we go, ending up in the NICU (neonatal intensive care unit), last room on the left.

They put Emma on a little bed/table and let me stand at the foot of it with doctors and nurses on each side. They’re working on her breathing and trying to figure out what’s wrong with her. I’m watching from the first row, then more staff came in and I’m shouldered to the second row, then more staff and I’m in the third row, then more and I end up sitting on the daybed in the back of the room while all these people are crowded around Emma.

With each step I take back, the gathering staff gets more frantic. I remember seeing gloves and other stuff being thrown to the ground instead of the trash in the rush to get more. I also remember looking over at the door, where there are several nurses just staring at the scene and thinking, “Why aren’t they doing something?”

I’m not sure how long this goes on (seems like a long time to me) when eventually one of the nurses notices me, asks me if I’m the father and takes me under her wing. She sits down next to me and tells me Emma is very sick and they’re doing everything they can for her. She then asks if I want to step out into the hall. She leads me out and has me take off the surgery jumpsuit. (I didn’t even realize I still had it on, and I think now that is why they ignored me up until this point, they thought I was staff.)

The nurse gets me a cup of water and a chair to sit on near the door. Things are still frantic in the room and I’m feeling angry because the doctors are asking for things and the nurses have to run to other rooms to raid the equipment and get supplies. I think, “What kind of hospital is this if they don’t have the supplies needed to do their job?”

The doctor finally comes out (again, I have no idea of time) and sits down with me. I’m told that Emma is very sick and they really aren’t sure exactly what’s wrong with her. They know about the meconium, they know she has a hole in one lung and it is collapsed. But they don’t know why her blood volume is so low. He tells me he thinks she might have a heart defect, but he can’t be sure. He says he thinks they have her stabilized for the moment and he’s going to consult with some colleagues to decide what to do next. He adds that I probably should get my wife to the NICU as soon as possible, which I took to mean he doesn’t hold out much hope for Emma.

Keeping Family in the Loop

Throughout this, I keep asking the nurse how my wife is. Nobody can tell me until Veronica’s nurse actually comes up to the NICU to get the status of Emma. She tells me Veronica is back in her room recovering. I need to see her. The nurse leads me back down to Veronica’s room. I remember focusing on each and every picture on the wall on my way out, so I would be able to remember how to get back.

We get downstairs and as I’m walking down the hall I see my brother Gene and Veronica’s father Hector in the waiting area. Gene looks at me and I panic, wondering what do I say, what do I do? Veronica’s room is before the waiting area so I go straight in without saying anything. I see her in the bed; she looks so tired. I break. I collapse onto her and ball my eyes out. It feels so good to be in her arms, it’s the only place in the world that I feel I can let my guard down and release. Once I’m able to talk again, I tell Veronica all I know. Eventually a nurse comes in and says, “Dad, the doctor says you should come back upstairs right now.”

That is the most painful walk I have or ever will take. I’m thinking Emma is gone or going, I think they want me there to be with her at the end.

When I get there, the doctor explains that there is nothing more they can do for her here, that she’s going to be taken to Seattle Children’s Hospital. The ambulance and transport team are already on their way.

He explains what he knows and what he thinks. It’s this doctor who first utters the word “ECMO” to me, explaining it stands for extracorporeal membrane oxygenation, a type of life support. He tells me that he trained under the doctor that will be in charge of Emma at Seattle Children’s and that he’s a great doctor.

An Unexpected Journey

When the doctor asks if I have any questions, the only ones I can think of are “Can I go with her?” and “Can Veronica see her before she goes?” No one knew the answer to either question. They aren’t going to allow me to drive, so if I can’t ride with Emma, Gene will take me.

As for Veronica seeing Emma before we leave, I quickly turn that question into a demand. I could not have Emma leave that hospital without meeting her mother. If they didn’t meet, and Emma didn’t make it, I would never forgive myself for not giving Veronica that moment. I repeat my demand to anyone to who will listen. Nurses ask, “Can I get you anything, a glass of water?” and I reply “I want my wife here.” The doctor asks, “Do you have any questions?” I reply, “Can you get my wife up here?”

When the transport team arrives, it’s quickly confirmed that I can ride in the ambulance, in the front seat. The crew introduce themselves, tell me what they’re doing and ask if I have any questions. I explain that my wife is downstairs recovering and, on the way out, can we bring Emma by Veronica’s room? I remember the looks on their faces saying “no way” but they say, “We’ll see what we can do.”

Not long after that a nurse comes to tell me that they’re getting Veronica into a wheelchair and she’ll be there soon. And she is.

I’m sitting in a chair just outside Emma’s room when I first see Veronica in the wheelchair coming down the hall. What mixed emotions. I’m elated that she’s here. I’m worried that it’s too soon after her operation to be mobile. I’m devastated at the thought of her seeing our baby for the first time in this way.

She is strong. No tears, asks level-headed questions, taking in the situation, making sure she understands what is happening. A rock (or maybe it’s the anesthesia).

The one thing she asks that I hadn’t even thought of is, “Can I touch her?” So, finally, for the first time, together, we touch our baby.

Then the transport team goes back to work. They have pretty much taken over the room and are getting the little incubator cart ready for Emma. We wait outside the room and watch, another wait that seems like forever.

While waiting, it dawns on me that I’ll be leaving the hospital and have no idea how or when I’ll be back. My coat and backpack are downstairs in Veronica’s room. I’m afraid to leave to go get them; I don’t want to be left behind, but I also don’t want them to wait for me and lose minutes that Emma might need.

Veronica talks me into going to get my things. I walk until I’m out of her sight, then run the rest of the way. I’ve never had a longer elevator ride in my life.

Arriving in Veronica’s room, I see both of our moms still waiting. I quickly explain what’s happening, grab my coat and backpack and run back upstairs.

Once there, the ambulance driver introduces himself to me and says to stick with him, he’ll take care of me. A hospital social worker also introduces herself to us and tells me that I will be meeting another social worker named Katie at Children’s and she will help me with anything I need.

I tell Veronica I think I’ll be back, but I don’t know. A kiss and a hug and off I go.

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Emma stands in front of the special ambulances that transported her to Seattle Children’s in 2009. Photo courtesy Mark Nordahl 2018.

Once again, I find myself following. We go downstairs and I’m surprised to see that we’re going down the main hall, out the main exit to the ambulance and not some back way. I notice random people in the hall and the looks on their faces as we pass. I wonder how the ambulance crew can walk so fast with so much equipment.

I get into the ambulance and buckle up. The driver explains that to get there as fast as possible, he’ll be using the siren and they’ll radio ahead to make sure two bridges remain closed to normal traffic until we get past them.

The driver gives me a bottle of water. I’m not thirsty, but I take it anyway, thinking the last thing I want to do is to forget to take care of myself. The drive itself is strange; the thoughts running though my head are strange. Would we pass anyone I recognize? Would I see anyone I knew out fishing on Lake Washington as we went over the bridge? Why do cars wait until the very last second to get out of the way? How many other new dads have sat in this seat? How will I get back to Veronica?

Settling in at Children’s, But for How Long?

Once at Seattle Children’s Hospital, the driver hands me off to the woman at the front desk of the NICU. She explains that they’re getting Emma settled and I would be able to see her soon. She gives me a temporary badge, takes my info and hands me off to Katie the social worker. Katie is great, and it really helps that the social worker at the first hospital told me her name and that she would be waiting for me. I’m dropped into this new environment and she is the most familiar person here, all because I remember her name from an hour before.

Katie asks if I’ve eaten, gets me some crackers and peanut butter and sets me up with a sleeping room. She explains that I can’t stay in the room with Emma but have 24-hour access to her. I’m so far gone at this point (either shock or exhaustion, I’m not sure), that she leads me to the sleeping room, shows me the showers, lockers, and bedding supplies on the way, and even makes the bed for me while I stand there, not knowing what to do next.

Katie gives me her card and shows me the number to call for the NICU, saying it would take about 30 minutes to get Emma settled. She suggests I lie down for a little while, and leaves

For the first time since Emma’s birth, I’m alone. It’s quiet. I have no idea what to do. I think I should cry, but no tears come. I sit there and stare at the door, for I don’t know how long. I decide to eat the crackers and peanut butter and drink the water, then try to take a nap.

I realize I’m cold, cold to the bone. I put on my coat and hat and cover myself with all the blankets, but I’m still shivering cold. I try to sleep, but can’t, and remember the showers. I go into one of the shower rooms, lock the door and turn the water on as hot as I can stand. I sit on the shower floor under the hot water and curl up in a ball as tight as I can.  I think, “Now is a good time to cry” but again, nothing. I’ve never felt so lost, alone, and small in my life. I think I might have dosed off a bit, I’m not sure. Eventually I get up, get dried off and dressed, and go to the NICU.

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Mark touches and talks to Emma in Seattle Children’s NICU.

Being with Emma

Seeing Emma in the Seattle Children’s NICU, I know instantly I’m not leaving the hospital until Emma does, however long that is. Emma is lying on her back, arms and legs spread with only a diaper on her. There are so many machines, tubes and wires, and a breathing tube in her mouth, taped to her face. The oscillator is thumping (it sounds like a helicopter on the roof), and there’s the hiss of the oxygen. She is so small and though I know she’s being taken care of by the people most qualified to do so, and they are doing all they can, I also know she has no one there just to be there for her, to hold her, to talk to her. No, I can’t leave.

The NICU nurses are great. They tell me I can sit with her, answer my questions when I have them, and work around me. They tell me she can hear me and feel my touch, so I give her my finger to grasp, hold her hand and talk to her.

During Veronica’s pregnancy, our nightly routine was for me to talk to the baby while putting oil on Veronica’s belly (for stretch marks). From the books I read, the baby could hear me and identify my voice, so I kept talking.

It dawns on me that I have a book in my backpack, so I get it and spend the rest of the day reading to Emma. I read until I realize I’m reading the same line two and three times in a row. The chair I’m sitting on is tall (because the table Emma is on is standing height) and I’m feeling dizzy so I figure I better get some sleep. (Weeks later, the nurse from that night said she was watching me, and said I told her I was feeling “woozy” and going to go take a nap.)

That night I wake up at 2:00 am, 3:00 am, and 4:00 am, wanting to get up but physically unable to do so. I do get up at 5:00 am and am down at Emma’s bedside for the rest of the day.

*********************

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Veronica holding Emma at Seattle Children’s.

In the month that followed, Emma spent three weeks in the NICU, six days of it on ECMO and 32 days total at Seattle Children’s Hospital. She was about two weeks old before we actually got to hold her and see her whole face, without intubation.

The diagnosis we were given was that there had been some kind of trauma within the womb which caused the meconium, the brown color when Veronica’s water broke. When Emma took those first breaths the meconium would allow her to inhale, but not exhale, causing holes in both of her lungs. But there was something else going on. Emma had to have two blood transfusions before leaving for Children’s Hospital and when Veronica’s blood was tested after the birth, 20% of the blood in her bloodstream was Emma’s type, so Emma had been bleeding into the womb for some time. We never learned exactly what happened to cause Emma’s issues.

Shortly after we took Emma home, we went back to the hospital where she was born and the doctor who delivered Emma gave us hugs, seemed very upset and made the comment, “This never should have happened to you.” We were told that the case was being reviewed. Later we learned that Veronica’s original maternity doctor no longer worked at that hospital. Emma was born nine days late; Veronica was not feeling herself the day before Emma was born. Maybe something was missed, maybe not. Looking back, maybe we should have dug into it, but we made it through, our family was whole, we were tired, and we just wanted to be “normal.”

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Emma visiting NICU nurses on her ninth birthday.

Looking back on that day and the following month through pictures and memories nine years later, it is almost like looking in on someone else’s experience. Though healed, we all three still have scars from it. Emma’s are on her neck where the two tubes were inserted to remove the blood from her body, run it through the ECMO machine to oxygenate it, then bring it back into her body, allowing her lungs to be shut down in order to heal. The kids at school ask about the scars, and Emma is just starting to figure out for herself how she answers those questions. The scars for me and Veronica are certain triggers, like the smell of Purell which we had to use each time we entered or exited both the NICU and Emma’s room. Running into someone near Seattle Children’s Hospital (at a store, or restaurant) and seeing the hospital ID badge hanging from the orange “Parent Caregiver” lanyard, the same type that we had to wear for those 32 days, still causes me to pause for a split second and remember.

Emma turned nine years old this spring. Each year for her birthday we bring treats to the NICU at Seattle Children’s Hospital, say hi to the nurses, give and receive hugs and take pictures. It is a reminder to them why they do what they do; they need that when there’s been loss. It is also a reminder to us that there are angels among us, that we are strong and can handle more than we ever thought possible. And it teaches Emma where she came from, how tough she is, how she fought and beat the odds, and how special she is.

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Emma, ready for anything. Photo courtesy Mark Nordahl.

Emma is a strong, smart, caring, outgoing kid. I have never seen her back down from any challenge. She sets her own goals and when she does, she doesn’t stop until she accomplishes them no matter how many bumps and bruises she gets along the way.

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Emma and Mark in 2014. Photo courtesy Mark Nordahl.

 

 

 

 

 

 

 

The best parenting advice I ever received came from the doctor who was in charge of Emma’s care in the NICU. On the day Emma was discharged to go home, the doctor said, “She is strong, she has proven that to you. Don’t make her prove she can do things. Instead, believe she can do them and make her prove she can’t.”

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[Cover photo is a portion of Emma’s 2017 Father’s Day drawing for her dad, Mark Nordahl.]

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