Showing posts with label heartache. Show all posts
Showing posts with label heartache. Show all posts

5.07.2020

collective breath

On the way to Woody's, walking hand in hand with Calvin and Smellie, a friend approached on the other side of the street riding his bicycle. We shouted above a passing car or two, then he peddled across and stopped a safe distance in front of us. After chatting a bit, I asked how he and his family were doing.

"Oh, we're struggling," he said in a resigned tone.

My heart sunk.

"Yes, everyone is struggling in their own way," I replied.

He smiled, put his head down to find his peddle and nodded. We said fond goodbyes as he rode off.

When Calvin, Smellie and I reached Woody's house, I called him on the phone. When he picked up, and from opposite sides of his window, we complained about the biting wind, and I told him about my conversation with the neighbor. Woody's silence made me think he agreed that life is strange and difficult right now.

I've been thinking about the tens of millions of unemployed Americans struggling to make ends meet. While I believe we need to continue to shelter in place to mitigate the stress on the healthcare system, I'm sympathetic to the need for hurting people to get back to work. So, too, I've been lamenting those who are sick and suffering and who have lost loved ones to this insane virus. I've been missing seeing friends, gathering around a table to share food and drink and to shoot the shit from across a table. I miss the college students terribly; their absence is palpable and I know it has been hard on them to be away this semester. I feel things have been particularly devastating to doctors, nurses and teachers, especially those with young families.

Strolling home from Woody's house, Calvin turned to me for a hug, and while I embraced him I took a deep, collective breath for everyone.

3.01.2019

ninety seconds

Blood pools on my son's pillow as he bites the side of his tongue. His feet shake. His wrists knock. His guts buckle. Ninety seconds, the seizure takes.

In bed next to him, I scoop him up. A pint-sized teenager, he's getting bigger. Must be over sixty pounds by now. The top of his auburn crown very nearly reaches my jaw. But crawling on the kitchen floor and splashing in the tub, he looks quite small. I can still sit him on my knee and cradle him in my arms.

What is lost in ninety seconds of seizing? Time? Brain cells? Emotional and physical elasticity? A year of life? Precious sleep? Dreams? The ability to block the path of the next seizure?

A friend described the making of neuropathways in the brain as centuries-old rivers etching ever deeper ravines into the landscape. I once was told this is what happens each time someone seizes. Neurons carving passages. Repeated patterns becoming habits. Electric currents snaking along paths of least resistance. Firing synapses conducting dreadful symphonies in the brain. Spasming sinews yanking muscle and bone.

What is lost in ninety seconds of seizing? Breaths? Heartbeats? Potential? Joy? Peace? A bit of memory? Sanity? Grace? Hope? Well-being?

What is lost from thousands of these seizures, each ninety seconds?


Photos by Michael Kolster, Christy Shake and Ann Anderson. Drawings by Peter Bruun.

10.03.2018

too good to be true

"Godammit!" I cried, whipping the covers off and scrambling to our seizing child. It was the first of two grand mals Calvin suffered on either side of midnight last night.

I had been expecting a seizure for a couple of days, having seen many harbingers on Sunday, and more on Monday—my child's warm skin, his hyperactivity, mania, rashy butt, insane fingering, agitation, eye poking, jaw jutting, bumpy face. But yesterday after school Calvin was a dream. He walked well and waited patiently at the grocery store, ate a good dinner, sat happily in my lap giggling as I tickled him, played with his toys for a bit, went to sleep fairly easily with a huge smile on his face.

Calvin's good behavior was an inadvertent gift for Michael's birthday, a day my husband has never liked much. He prefers, in most ways, for his birthday to be a day like any other—no pomp, no fuss, no gifts, no attention. Instead, he made one of his favorite meals—stovetop spareribs braised in onions, white wine and serrano pepper aside creamy mashed potatoes and impossibly thin asparagus. After we ate, I brought out the mint chocolate Oreo ice cream cake I had made while Calvin was at school. Although we are both tired and overextended, it was turning out to be one of his better birthdays.

Regrettably, however, epilepsy has a way of ruining things—sleep, meals, celebrations, plans, hopes, dreams. Considering Calvin's good nature yesterday, the first seizure was somewhat of a shock; the second one, though half-expected because of the earliness of the first, a complete letdown. I told Michael that I had had a fleeting thought earlier that Calvin's good day might be too good to be true. I was right.

The three of us have been mostly awake since 1:30 this morning dealing with a wired child who doesn't appear to be out of the woods. After the second seizure, and for reasons I can never be sure of, Calvin spent several restless hours alternating between lying down and hugging me and sitting up with a rapid and pounding heart, clammy hands, trembling feet, and arms so crooked and fingers working so madly against each other you'd think he could spark a flame. Now he is in the jumper stomping, eye poking, fingering, clenching his teeth, and covering his ears, foamy drool bubbling down his chin.

Days like these nearly break me into little pieces. But there are things that save me from completely falling apart—writing, trying to focus on the knowledge that this too will end, gazing outside at the trees and shrubs turning orange, rose and yellow in the autumn sun, and listening to music hoping my son isn't winding up into another one. And gratitude. Gratitude for other things nearly too good to be true—a warm house, a fine, handsome, creative, talented, thoughtful, smart, prolific and loving husband, wine on the table, food in our bellies, electricity, hot water, indoor plumbing, art on the walls, dry basements, light-filled spaces, cozy fires, dear friends and family, enough clothes, enough money, decent health care and schools, reliable cars, leftover ribs, and mint chocolate Oreo ice cream cake in the freezer.

8.18.2018

fortieth morning

Stepping outside behind Nellie, mug of coffee in my hand, I thought to myself, I shouldn't go outside until Michael's done in the bathroom. Still, I went, leaving Calvin unattended in his jumper, if only for a moment.

In the soggy garden, mosquitoes flitted around my head. Limbs were dripping with last night's rain. The earth was shrouded in mist, birds and crickets chirping. Partway through my stroll I heard Michael shout for me. I knew what was wrong, so I sprinted across the lawn, slopping coffee into my rubber boots as I did.

Entering the house I called, "What kind?"

"Grand mal," Michael answered, just as I saw him struggling to yank our convulsing boy from the jumper, his crooked limbs tangled in its straps.

I ran to the fridge and grabbed a ready-made partial syringe of Palmetto Harmony CBD cannabis oil to give to Calvin once the seizure stopped, aiming to prevent further ones. I thought about giving it rectally, a method its maker had suggested to stop seizures or clusters of them, owing to the cavity's rapid absorption.

The seizure was typical in every way except that its onset was while Calvin was conscious, which has only happened three times in the past four-and-a-half years since introducing a homemade THCA cannabis oil; all other grand mal seizures since then have occurred while he's been sleeping.

Today is the fortieth morning since Calvin's last grand mal, one of his longest stints ever between convulsive fits. I'd seen a few harbingers of an imminent one yesterday—rashy butt, eye poking, some grousing, intense hugging, fingers in his mouth and in mine as if trying to tell me something. While changing his first diaper this morning, I noticed his right eye turning inwards more than usual, then I watched both of his eyes panning back and forth. I made a mental note, thinking he might be heading toward a partial complex seizure, the kind which are more common not long after he wakes up.

Though it's uncommon for Calvin to suffer a grand mal after he's woken, I'm not that surprised. Seems ever since Calvin's epilepsy diagnosis twelve years ago, the seizures have a way of migrating away from higher doses of medication. We've been giving him his CBD oil—the medicine to which I attribute this very long stint free from grand mals—just at night. I've read that CBD's half-life is nine hours, so it makes sense the seizures might start appearing in the daytime.

After Calvin came out of the fit, I slowly squirted in half his nighttime dose of CBD—10 mgs. Tomorrow, I may start giving him small doses of it—0.25 mls equal to 5 mgs CBD—every morning to see if we can control his a.m. seizures.

In the wake of this morning's grand mal, our boy has suffered two partial complex seizures. After the first one, I gave him a small dose of THCA by squirting it into his mouth. After the second, I gave him the same dose, though rectally, something I've never done with cannabis oil. The seizure stopped immediately.

Our boy is resting now. I hope with all my heart he doesn't have any more today. They are no fun to watch. It is hard to feel so powerless in their midst.

And just as I was editing this post, Calvin woke from a nap to a third partial complex seizure. He rubbed his eyes and began to tremble. His lips and face went pale, his breathing shallowed. I gave him half a milliliter of CBD oil rectally. The seizure stopped immediately. He is already asleep again. I hesitate giving him any more medicine because it is within the realm of possibility too much will cause him to have the fits. But my gut says epilepsy is the culprit, and perhaps, too, the ugly remnants of benzos—now gone—that for years were in his system.

5.22.2018

poor little messed-up child

Minutes ago, Calvin had his third grand mal seizure within sixteen hours. It was the first daytime grand mal in months, if not far longer. He had one just after falling asleep last night and then woke to another at four-thirty a.m. He's been crying all morning, his source of misery assumed though unknown. The only thing I feel okay about is that this third seizure occurred while he was napping rather than while he was awake, something the THCA cannabis oil seems to have prevented for years. It would seem he is getting sick again, having just recovered from a nasty cold that is going around.

He is in bed right now. I write this while sitting on top of his changing table with the shade drawn, listening to Baby Mozart, and wonder if he is going through a growth spurt and has outgrown his Keppra dose. I wonder if he needs extra THCA at night. I wonder if now is the time to try the CBDA cannabis oil that was made with him in mind. I wonder if he is still suffering from benzodiazepine withdrawal.

I'm grateful that Calvin's partial complex seizures have virtually disappeared these past couple of months, but it seems as though some of them have been replaced with grand mals; Calvin has had six or seven grand mal seizures in each of the past two months or so. Most folks will tell you that a single seizure is one too many.

For several years I've dreaded Calvin turning fourteen; I know too many parents who have lost children with epilepsy around that age—parents of Kevin, Matthew, Tyler, Kellie, Cyndimae. I wonder if Calvin might be the next to expire, the result of pneumonia, a prolonged seizure or perhaps SUDEP: Sudden Unexplained Death in Epilepsy.

For now, though, I'll hold Calvin's face in my hands, his body in my arms. I'll sop him up since we can never know what tomorrow might bring. I'll hold my breath and hope he doesn't have any more seizures for awhile. But I remain afraid, watchful, exhausted, despondent. My sweet impish boy. My poor little messed-up child.

5.10.2018

vistas

a hummingbird pokes its nose into the throat of a purple rhododendron. spring has sprung. calvin has a may cold. he seized this morning in my arms. screamed. stiffened. convulsed. i slathered lavender oil on his toes and souls. squirted cannabis oil in his mouth when it was over.

skies are white. pine fronds roll in the wind. it looks cold outside. my back is slightly better today, having recently done a number on it transplanting a large shrub that is really a tree. things are finally getting green.

college students amble by at ungodly hours. drunken, some of them. they are through with their classes. my son will never be one of them. he can't even push a doorbell on his own. at night he bangs his head so hard on the padded side of his bed i wonder if he could give himself a concussion. wonder if his brain could be any worse than it already is. he's my sweet, drooly boy. my insufferable son. my enigmatic child.

there's that back twinge again. i hope it doesn't seize up on me.

from the base of a spruce a gray squirrel ogles me through a warped window. an animal more capable than my son. until it gets run over by a truck.

dirty water shimmers in a sunflower-shaped birdbath. so much to be grateful for. so much to lament. going nowhere fast. somewhere, light bends through a half-full vase. the world looks different through discrete lenses. we ought to constantly seek other vistas.

the artist, song, his moves and frames replay in my head. genius. yes. for some, this is america. will misguided whites ever wake up? attempt understanding? make reparations? change? what is with people? still. these days. so lacking in humanity. such ample conceit, contempt, fear, denial, deceit, greed.

perspective. sitting here inside on a now-beautiful day. san francisco both a distant memory and a dream to one day behold again. i'll be back for you. your endless friendly faces, spectacular parks, beaches, vistas, cozy alcoves.

here now. wind still blowing. bees buzzing. child stomping. song repeating. back breaking. heart aching. is there a difference? limited existence simultaneously rich. looking through different lenses. seeking unfamiliar vistas and faces.

Photo by Michael Kolster

11.02.2017

everything you wanted to know about benzodiazepines but were afraid to ask

. . . and, or, your or your child's doctor didn't tell you or know about in the first place.

Below are some outtakes from the Ashton Manual, a critical guide—a bible, really—for current and potential benzo users to peruse, study, familiarize and perhaps memorize.


Calvin is in his fourth year of weaning his second benzodiazepine. He is down to less than one milligram per day from a high of thirty-five—an enormous dose for a pint-sized child. The first benzo, clonazepam, was prescribed when he was just three years old. Had I known then what I know now, I would have flatly refused his neurologist's suggestion to put Calvin on it, particularly while simultaneously starting him on two other drugs. Alas, as neurologists seem to do, the doctor downplayed its side effects, neglected to inform me of the body's tendency for rapid habituation to it, and assured me it was meant as a bridge drug to be used for only a few weeks. It took another benzo, clobazam, to safely come off of it two years later. Calvin has been on clobazam for the good part of a decade. Again, had I known then what I know now. Sigh.

Paradoxical Stimulant Effects
Benzodiazepines occasionally cause paradoxical excitement with increased anxiety, insomnia, nightmares, hypnogogic hallucinations at sleep onset, irritability, hyperactive or aggressive behaviour, and exacerbation of seizures in epileptics. Increased aggression, hostility, and impulsivity occur in some subjects and may result in attacks of rage and violent behavior. 

Less dramatic increases in irritability and argumentativeness are much more common and often remarked on both by patients on long-term benzodiazepines and by their families.

Impairment of Memory
Benzodiazepines have long been known to induce anterograde amnesia. 

Tolerance
Tolerance can develop to all the actions of benzodiazepines, although at variable rates and to different degrees. Tolerance to hypnotic effects develops rapidly: sleep latency, stage 2 sleep, slow wave sleep, dreaming, and intrasleep awakenings all tend to return to pretreatment levels after a few weeks of regular hypnotic use.

Tolerance to anxiolytic effects seems to develop more slowly, but there is little evidence that benzodiazepines retain their effectiveness after 4 months of regular treatment, and clinical observations suggest that long-term benzodiazepine use over the years does little to control, and may even aggravate, anxiety states.


Structural Brain Damage
The question of whether prolonged benzodiazepine use can cause structural brain damage remains unanswered. It remains possible that subtle, perhaps reversible, structural changes may underlie the neuropsychological impairments shown in long-term benzodiazepine users.

Withdrawal Symptoms
Abrupt withdrawal from high doses can cause a severe reaction, including convulsions and psychotic episodes. Withdrawal symptoms from therapeutic doses are mainly those of anxiety, both psychological and somatic, but certain symptoms such as sensory hypersensitivity and perceptual distortion may be especially prominent, and depression may sometimes be a prominent feature.

Long-term benzodiazepine use is associated with more severe adverse effects, including memory impairment, depression, tolerance, and dependence.

Mechanisms of Withdrawal Reactions
Drug withdrawal reactions in general tend to consist of a mirror image of the drugs' initial effects. In the case of benzodiazepines, sudden cessation after chronic use may result in dreamless sleep being replaced by insomnia and nightmares; muscle relaxation by increased tension and muscle spasms; tranquillity by anxiety and panic; anticonvulsant effects by epileptic seizures. These reactions are caused by the abrupt exposure of adaptations that have occurred in the nervous system in response to the chronic presence of the drug. Rapid removal of the drug opens the floodgates, resulting in rebound overactivity of all the systems which have been damped down by the benzodiazepine and are now no longer opposed. Nearly all the excitatory mechanisms in the nervous system go into overdrive and, until new adaptations to the drug-free state develop, the brain and peripheral nervous system are in a hyperexcitable state, and extremely vulnerable to stress.


Psychological Symptoms of Withdrawal
Excitability (jumpiness, restlessness), insomnia, nightmares, other sleep disturbances, increased anxiety, panic attack, agoraphobia, social phobia, perceptual distortions, depersonalization, derealization, hallucinations, misperceptions, depression, obsessions, paranoid thoughts, rage, aggression, irritability, poor memory and concentration, intrusive memories, craving.

Physical Symptoms of Withdrawal
Headache, pain/stiffness (limbs, back, neck, teeth, jaw), tingling, numbness, altered sensation (limbs, face, trunk), weakness ("jelly-legs"), fatigue, influenza-like symptoms, muscle twitches, jerks, tics, "electric shocks," tremor, dizziness, light-headedness, poor balance, blurred/double vision, sore or dry eyes, tinnitus, hypersensitivity (light, sound, touch, taste, smell), gastrointestinal symptoms (nausea, vomiting, diarrhea,,constipation, pain, distension, difficulty swallowing), appetite/weight change, dry mouth, metallic taste, unusual smell, flushing/sweating/palpitations, overbreathing, urinary difficulties/menstrual difficulties, skin rashes, itching, seizures.


Photo by Michael Kolster

9.11.2017

faith of my father

Originally published in The Sun magazine, August 2014
Barbecues with friends are supposed to be fun. Kids are meant to be running around barefoot, playing tag or whacking croquet balls across freshly cut lawns while the adults lounge on the deck with sweaty drinks and salty chips. Everyone is relaxed, enjoying the opiate of burning coals and the serenity of cumulous clouds drifting by.
But not this one. The gin and tonic my friend Kellie had given me as I’d reclined in a bay window did little now to ease my worry over my listless two-year-old boy. Calvin slouched limply in my arms in the late-afternoon heat, the cicadas’ buzz splitting the muggy air. Suddenly the color drained from his face, and his mouth twisted into a grimace, as if he’d eaten something rotten. As the seizure took hold of his brain, his body stiffened into a plank, and his glassy blue eyes rolled back into his head.
“Here it comes!” I called, and Kellie and my husband, Michael, came running.
Guests who were inside quickly ushered their kids out. “Daddy, what’s the matter?” I heard one child ask from the other side of the screen door. I have no idea what the father told his child or if he even knew what was happening.
“Call 911!” I said. Calvin began convulsing, his eyes fluttering, his lips smacking with each new spasm. We turned him on his side and pulled down his diaper. I grabbed the vial of rectal Valium from the pouch in his stroller, cracked off the cap, and carefully inserted the tip into my child’s rectum. Onetwothree, I silently counted as I depressed the syringe, injecting enough benzodiazepine to knock a full-grown man out cold.
By the time the ambulance arrived, Calvin had started to come out of it. The medics surrounded us, shielding us from the view of the concerned party guests. I recognized one of the EMTs from a previous 911 call, but I didn’t acknowledge him. I was fixated on my boy’s catatonic gaze. After looking Calvin over, the larger of the two men gathered him up and carried him to the ambulance. I climbed into the back and reclined on the gurney. The medic placed Calvin in my lap, loosely buckled a seat belt across my legs, and fit an oxygen mask over my son’s mouth and nose. Michael followed in our car.
As the driver pulled away, I watched the barbecue party disappear around the bend in the rutted gravel lane, the parents and kids standing in the yard, a mother resting her hands on her child’s shoulders.

When Calvin had been diagnosed with epilepsy three months earlier, I’d simply added it to the long list of neurological conditions he’d had since birth: ventriculomegaly, ocular and cerebral visual impairments, hypothyroidism, global hypotonia, global developmental delay. (So much for “As long as he has ten fingers and ten toes . . .”) I’d always figured epilepsy was a relatively benign condition. What could be harder, I thought, than getting down on your hands and knees for hours each day, teaching your infant to crawl by supporting his trunk and moving his limbs one by one? What could be harder than enduring two years of colic: seeing your child writhe in pain and hearing him scream for much of the day without being able to soothe him? What could be harder than knowing your child might never walk or talk or read or write or live life independently? At that time I had no idea the answer to those questions was “Epilepsy.”

The summer before we were married, Michael and I vacationed in Brazil. We traveled north along the coast to Salvador de Bahia, where we visited the Church of Nosso Senhor do Bonfim. We had already started trying to conceive a child. It was hot as we climbed the stairs to the stucco church. In a back room plastic limb —hollow arms, legs, and heads—were suspended from the ceiling. Some had been tagged with ribbons; others had stickers bearing the names of the ill, the wounded, the dying. The talismans had been hung by loved ones hoping for a miracle. Pocket-sized photographs of the suffering people were tacked to the walls, a sea of snapshots, their edges curling in the moist heat. I looked up, eyeing the bottoms of feet, the tips of fingers, the plastic heads, and I pondered the faith these supplicants had in a God who seemed to answer some prayers but not others.
Later we sat on the steps of the church under the Brazilian sun, and Michael tied a sky-blue ribbon—a Fita do Bonfim—around my wrist and knotted it three times. As he tied each knot, he told me to make a wish, as was the custom. We’d heard that the ribbons had been blessed by parish priests, and though we had both long since abandoned religion, we liked the symbolism: a wish knotted tightly, so that when the bracelet finally frayed and came off, the wish would come true. With the first knot I wished for a happy marriage. With the second I wished to become pregnant. And, as Michael tied the last knot, I closed my eyes and wished for my child to be healthy.

Calvin had a second seizure in the ambulance. Once we arrived at the hospital, they wheeled us into the brightly lit emergency department, with its shiny lino­leum floors and khaki curtains hanging from tracks in the ceiling. Nurses transferred Calvin to the hospital bed, laid him on his side, and draped a blanket over his body. I told them that Calvin’s behavior seemed odd; that usually, after the administration of Valium, he’d fall asleep, but this time his eyes remained open and fixed, with none of their familiar jerking and roving. His countenance worried me. Though he wasn’t convulsing, I feared that he was seizing again, silently. The doctors and nurses encouraged me not to fret. Michael sat next to Calvin’s bed and held his hand while I called my brother and cried into the phone, licking salty tears from the corners of my mouth. My brother’s voice trembled at the news, and I knew he was crying, too.

Until the death of my father in my thirties, I’d skated around the edges of other people’s tragedies: a high-school friend whose own father had died in a car accident; another whose sister had succumbed to leukemia; a childhood teammate who was killed in a plane crash, along with his father, the day before his twenty-third birthday; my best friend from middle school, who, as a young woman, had a stillborn daughter. Other friends and acquaintances had endured the drawn-out illnesses and loss of parents, siblings, children. None of the survivors spoke to me of how they coped with their grief, nor did I ask.
When I was fourteen, my friend’s two-year-old sister nearly drowned in the family’s backyard swimming pool. Her mother fished her out and resuscitated her before the medics arrived. No one knew how long the child had been facedown in the water. My family lived just two houses away, and I was about to mow the lawn when the mother’s eerie howling echoed into my backyard. A little while later my father came outside to tell me of the accident, and we stood there, shocked, his hand on my shoulder.
The toddler remained in a coma for nearly a week. My friend told me that her mother had prayed to God to save her daughter, offering to give up cigarettes in exchange for a miracle. Though I understood the mother’s desperation as much as any teenager could, and though I’d been raised Catholic, I couldn’t understand a God who would allow this to happen. It just didn’t make sense to me that this child, this mother, this family should suffer so.
The girl survived, but she sustained brain damage. After that incident any faith I might’ve had in the God of Scripture began falling away like dead leaves from a tree.

The attending emergency-room physician arrived, and I listed Calvin’s various diagnoses and suggested that it might be wise to give him an IV, in case he lacked fluids or in the event that he might suffer another seizure and need more medication. I asked for their most skilled IV technician, explaining that Calvin’s veins were particularly difficult to find because of his low muscle tone and layers of baby fat. He had a history of being stuck with needles scores of times in his arms, wrists, and ankles without any luck. The doctor insisted that the nurse assigned to Calvin just happened to be their best, but when she wouldn’t meet my gaze, I knew she wasn’t. And although she tried valiantly, she failed. Then Calvin slipped into another seizure, beginning with the faintest twitching, imperceptible to the others, who continued to doubt my observations. Minutes later another, more skilled, IVtechnician arrived and confidently took over. She tried for ten minutes, sleeves pushed up past her elbows, while Calvin’s convulsions intensified until they racked his body. But she, too, couldn’t hit a vein. Michael and I could do nothing but stand by helplessly with our hands on our boy.

As a child I attended Catholic parochial school and went to Mass most Sundays. I’d sit in the pew among my five older siblings, gazing into dusty rays of sunlight or through the stained-glass windows to the trees and the sky beyond. The silence between recitations from the altar was punctuated by hollow coughs, babies’ cries, and the creak of the wooden kneelers. I tried in vain not to laugh when my siblings whispered jokes in my ear. During hymns our giggles were drowned out by the monotonous drone from the mouths of well-dressed couples seated beside obedient teens, fidgeting toddlers, and infants in frills and bonnets.
I was curious to know what went through the minds of these sober parishioners who sat picking at the lint on their trousers or smoothing an errant crease. Were they thinking about lunch or dreaming of the sweetheart they’d once kissed in the woods behind the school? Maybe some of them were silently annoyed by the tie they had to wear or the itch that begged to be scratched beneath their pleated skirt. Or perhaps they were lamenting the sins they’d committed and would have to confess inside a dark closet to avoid eternity in hell. I’d done so myself, reluctantly admitting to an unfamiliar priest behind a lattice that I’d mistreated a friend or cursed at my mother—though I hadn’t divulged what I’d done between my legs that had felt so good, so right.
During the homily I never felt anything but the hard slab of wood on which I sat, the tile floor beneath my feet, and the desire to be released. I’d think about everything else I could be doing on a Sunday morning, like sleeping in, reading the comics, or climbing trees. I’d look up at my dad, sitting motionless with his austere expression, and try to guess what he might be thinking about. His mind didn’t seem to be on the liturgy. Sometimes his gaze, like mine, would wander to the sky and the trees outside the window.

Michael and I leaned over our seizing boy and offered soothing words of encouragement: “Come on, Calvin. You can do it. Everything’s going to be OK.” But after twenty-five minutes all I could think was that brain damage had likely begun to occur and that my only child’s vital organs might soon begin to shut down.
At that point a pediatrician entered. I gave her a quick summary, and she sat down to try to thread the butterfly needle into my son’s tiny vein while he spasmed. She had as much trouble as the nurses. Finally her needle punctured a vessel, and a bolus of the anticonvulsant Fosphenytoin leaked into Calvin’s bloodstream. I wondered if it burned, if Calvin’s seizing brain had some awareness of the foreign liquor commingling with his blood. I put my hand to his forehead, which felt clammy, and I waited for something to change.

I never once heard my dad utter a word about God save during the grace he recited by rote each night before dinner. The way the words tumbled from his mouth in a garbled strand of syllables made me think he was as skeptical as I was that some deity was calling the shots from on high. Nothing he ever said or did indicated any piousness. If anything, Dad’s faith seemed rooted in the splendor and majesty of nature: the trees, the rocks, the animals, the stars, us. I saw it in his love of gardening, his passion for being out in the sun, his way with animals, how he held my hand and taught me to make a blade of grass sing between my thumbs. I’d watch him sometimes as he regarded a body of water, or mused on passing clouds while lying next to me on a blanket, or searched the night sky for falling stars. I learned from him the sacredness of the natural world. I appreciated its balance, its plain and honest beauty, even its unpredictability, which at least expressed no judgment or dogma.

The seizure raged for another twenty minutes. As I leaned on the edge of the hospital bed next to Calvin, I wished I could feel his pain for him. The emergency medications appeared to have failed my boy. His fingers, toes, and lips were the color of plums, his oxygen-deprived skin ashen. His body still spasmed in rhythmic bursts. In my research on epilepsy I had read that the longer a seizure lasts, the harder it is to stop, like a runaway train speeding downhill. It seemed we had no choice but to watch our boy crash right before our eyes. The only solace was in hoping he was unaware of what was happening to him. He’s going to die now, I thought, and I felt sure my husband was thinking the same. Trying to blot out the presence of the medical professionals, who by now had stopped trying to save Calvin, we wrapped our arms around him and told him we loved him and that he was going to be OK. We stroked his arms and legs, brushed his wispy blond locks from his face. When I kissed his neck, I realized it might be the last time I’d press my lips against his warm flesh.

When he was sixty-five, my father had a bone-marrow sample extracted from his hip and biopsied. My mother told me that he’d had no anesthesia before the doctor had bored a hole into his pelvis, and that my father had come out of the room with a sickly pallor, drenched in sweat. For years they treated the cancer they found with regular bouts of chemotherapy, which sapped his vigor and stifled his appetite until he was a six-foot-four rack of bones. I watched this father of mine—this fine athlete, this track-and-field champion—wither and tremble. When I held his hand in the weeks before his death, it felt as thin-skinned as his ninety-five-year-old mother’s. He and I didn’t talk about the cancer, or death, or what he believed might happen after he died. It seemed of little consequence during the moments we shared. We just sat in relative silence, and I rubbed his back, and he held my hand.
After he died, my mother gave me a jar of his ashes. I rolled the glass around in my hand, held it up to my ear and shook its contents: tiny pieces of bone and grit. I unscrewed the cap and sprinkled some ashes into the palm of my hand, pushed them around with my finger as if writing in sand. Then I touched the center of the pile with my tongue. It tasted like chalk. Ashes to ashes, dust to dust, I thought, and I smiled at the irony: the one piece of Scripture I could finally embrace.
Months later I scattered some of those ashes in a wooded glen on the side of a mountain, and the rest I tossed into the wind beside the sea. It made perfect sense for my father to become part of the universe in this way.

Had I not been in a state of shock, convinced that my only child was dying—my beloved boy who had never been without pain of some sort, who had never developed the words to tell us how much he was hurting—I might have thought unkindly about some of the things people had said to me over the years. I might have recalled the times that family, friends, and even complete strangers, upon hearing about Calvin’s terrible deficits, had said, “There’s a reason for every­thing,” or, “The Lord works in mysterious ways,” or, “God doesn’t give you anything you can’t handle.” And then I might have thought about what I had wanted to say to them: “What reason could there be for a terrified two-year-old boy to have a too-big tube shoved down his trachea without anesthesia, withdrawn bloodied, then reinserted, all while he screams in pain?” Or “If God doesn’t give us anything we can’t handle, then why do some people kill themselves?” And then I’d imagine the plethora of other ignorant platitudes that float inside people’s heads about kids like Calvin and parents like Michael and me. Or perhaps I’d have thought of the comment that my best friend’s Catholic aunt had made to her when her daughter was stillborn: “The saddest part is that she’ll go to hell, since she wasn’t baptized.”
But I didn’t think about those things. I also didn’t think about my Fita do Bonfim bracelet, which years earlier had worn thin and broken, along with the promise of a healthy child. I didn’t think about the plastic limbs adorned with people’s written pleas to God to save their legs, their lungs, their hearts, their brains. No doubt some of the portraits neatly tacked to the walls of that Brazilian church belonged to people with epilepsy.
No, all I thought about was my Calvin and his little birdlike chest, his silky skin, his slender fingers. I meditated on the smell of his hair, the sensation of my lips on his neck, where I might have felt a faint pulse, though I couldn’t be sure. I just thought about kissing my boy, perhaps kissing him goodbye.
And then, after having burned for at least forty-five minutes, the seizure stopped.
By that time a pediatric intensive-care team had arrived to transfer Calvin to the Maine Medical Center, where difficult cases like his were handled. So we were loaded into the ambulance as twilight deepened. The barbecued meats and vegetables that our party hosts had brought to the emergency room, complete with cutlery and cloth napkins, had become shriveled and cold. In the dim ambulance we began making the thirty-five-mile drive. I lay with my son in my lap again, the needle in his wrist bandaged in place, a tube down his throat, a glowing red oxygen-saturation monitor stuck on his toe, and I wondered if he’d ever wake up, if I’d ever again see him smile and feel his soft hands on my face.

Dozens of hospital stays later, Calvin is ten years old—bigger, yet still so much like a baby. He remains in diapers. He can’t read a book, can’t speak a word or walk all by himself. He can’t believe or disbelieve in God. He still has seizures, despite taking huge amounts of medications to thwart them. But he’s here now, and, as my father and I used to do, Calvin and I live in the present moment, breathing the fragrant air, feeling the sun warm our backs, touching the trees and grass, and smelling the lilacs and peonies. We hold hands, embrace, rub each other’s heads, listen to the birds and the wind in the trees. Together, we exist.
When I was about Calvin’s age, my father used to come to my bedroom to say good night. I would complain about aches in my legs. “Those are growing pains,” he’d explain. Then he’d take one shin at a time in his large, strong hands, and he’d firmly press and massage the muscles like a trainer. Afterward he’d scoop me up like a bundle of kindling, slide me under the covers, kiss me good night, and say, “You know I love you, don’tcha, kid?” As he left, he’d pull the door shut behind him until only a thin slice of light shone through the crack. There were no bedtime prayers, no blessings, no mention of angels in heaven—it was just my dad and I and the clouds drifting across the moon and stars outside my bedroom window.

Me and my Dad, 1965

7.09.2017

toxic heartache

As I begin writing this I am weeping—weeping for my child who I may have, in some sense, unwittingly poisoned with P5P, aka coenzymated vitamin B6.

Late last week, a nurse phoned to give me some results of a routine blood draw Calvin had done. He had given a total of seven or so vials of blood to test his thyroid function plus a customary metabolic panel, complete blood count, manganese, magnesium, copper, ferritin, D and B vitamins. Initial results came back normal with the exception of a low white blood cell count, indicating he might have a virus contributing to his recent spate of grand mal seizures.

Friday, however, she called back with some alarming results: Calvin's vitamin B6, a test which I'd requested for the first time and as somewhat of a fluke, was 144. Because the reference range for a child his age is a mere 3 to 35, the covering pediatrician suggested I immediately discontinue Calvin's B6 supplement. The nurse went on to inform me that vitamin B6 toxicity can result in things like flushing, tachycardia (rapid heart beat) and headache, all of which I've witnessed recurrently in Calvin.

For at least a year and a half I've been giving Calvin the B6 supplement, which was recommended to me by a functional medicine specialist, and signed off, reluctantly, by his pediatrician. The supplement, if I remember correctly, was meant to boost Calvin's immune system and perhaps to facilitate the production of GABA, which Calvin's brain is craving during his protracted benzodiazepine withdrawal. I was advised to initiate him on 50 milligrams per day, then at some point later I increased it to 100 milligrams daily when Calvin's seizures worsened. No one advised me to check his B6 blood level so, foolishly, I never had; I should have known better. Somehow, for whatever reason and perhaps subconsciously, this time I did.

After hanging up the phone, a million thoughts went through my head:

could his tachycardia and flushing be due to B6 rather than from seizures? could his tachycardia trigger seizures? could his tachycardia weaken his heart? has he had a persistent headache all these years due to B6 toxicity? are the symptoms i usually attribute to benzodiazepine withdrawal actually due to B6 toxicity? why didn't i research B6, its dose limits, its contraindications, its toxic side effects—like i have for years for all of his other meds—before giving it to Calvin? how could i be so reckless?

Just before writing this I went online to research B6 toxicity. I learned that Calvin's dose, according to his age, should be roughly one milligram per day; he was getting fifty to one-hundred times that for well over a year! I also learned that vitamin B6 toxicity can result in abnormal heart rhythms, decreased muscle tone, drowsiness or sedation, feeling of tingling on the skin, headache, heartburn, loss of appetite, nausea, rash, stomach discomfort or pain, sun sensitivity, and vomiting. 

I wondered if some of Calvin's finger snapping, and leg and arm rubbing are due to B6 toxicity. I went on to read that B6 toxicity can cause one to have muscle pain or trouble with walking, can interfere with one's proprioception, and can induce seizures. Is this why Calvin is stubborn and so often wants to drop down while walking? It can also interfere with the way that the body processes certain herbs and supplements which utilize the liver's cytochrome P450 enzyme system (e.g. cannabis, as does the benzodiazepine clobazam) and that, as a result, the levels of these may be altered in the blood or may alter the effects that they have on the body's P450 system. Having gained knowledge of cytochrome P450 during my research on cannabis over four years ago, had I investigated B6, I would have easily come across these factors—details that the functional medicine specialist and the pediatrician likely weren't aware of—and, with little doubt, I would have objected to giving the supplement to Calvin.

Since beginning this post, my tears have dried, having taken Calvin with me for a morning stroll through the garden. He was mostly compliant and seemed happy to be outdoors on this sunny morning, the birds chirping and flitting around us, roses and day lilies flaunting their brilliance. I sit here now wondering—hoping—that the discontinuation of Calvin's B6 supplement will result in the disappearance of any pain, tingling or weakness he's been suffering, and perhaps even result in the decrease of seizures. I also wonder how its absence will affect the levels of cannabis and benzodiazepine in his blood and how that might present in terms of seizure control, behavior and other side effects. It may prove impossible to know for certain.

My main fear and cause for great heartache, however, is that I've poisoned my child to the extent that the effects of B6 toxicity might be irreversible. He suffers so very much from one moment to the next and it pains me to think—in the absence of most of parenthood's joys that were spirited away two weeks before Calvin's birth along with much of the white matter in his brain—that the child I do have has been further damaged by the substances we've given him in some blind attempt to make things better.

Glimpse of a good moment: Calvin with Gma Kolster and Abby

8.30.2016

a good thing i did

If not for my son’s half-dozen ridiculously manic frenzies, the windy drive north was uneventful. Rather than face each of his outbursts with frustration and impatience, which my sleep-deprived self is often prone to do, I resorted to embracing and kissing him instead.

It was a good thing that I did.

Our day at the fair was a decent one, not that Calvin pet the animals or giggled at the goat’s bleat or marveled at the midway or ate cotton candy from a paper stick; he did none of those things. But he did walk well, a bit, and seemed content in the borrowed stroller, and ate his cut-up bites of lunch and took his meds. Above us, low clouds at times obscured a harsh sun, and gusts of wind cooled our necks and kicked up dust at our feet.

The past eight days—besides a steady increase in eye-poking and these brief, hysterical spells—have been good ones for my son; he's been happy, content, had mostly restful nights and has been walking stronger on his previously-broken foot. I wonder if this somewhat calm, seizure-free stretch is because we briefly paused the taper in his benzodiazepine.

At the fair, while I gave Calvin his noontime meds, chasing each pill with a sip of juice, his eyes rolled back and fluttered several times in what looked like some sort of tiny seizures, perhaps the petit mal type. And on the way back to the car, Calvin did what I call his zombie walk, cooperatively and quietly strolling along in his dad's hand with a pale, blank expression on his face. I remarked to Michael that I’d seen this kind of thing the day before grand mal seizures.

At two-thirty a.m. the seizure hit, too early to give Calvin his morning dose of benzo to head off a subsequent fit, so we gave him the Diastat—rectal Valium—and watched each spasm slowly subside, watched our boy finally catch his breath. Fearing he’d expire in the night, I crawled in with him, though not knowing what I’d do if his breathing stopped or if I’d even wake up if it did.

For an hour I laid awake, eyes closed, while Calvin slept, my mind wandering. I thought of the college kids returning to town, their voices echoing happily down our street. I recalled our recent dinner with Henry and Hector, Michael’s former students whom I've grown quite fond of, and the bottle of bourbon they brought us as a gift. I wondered how Beth, Calvin’s former nurse, is doing in St. Thomas. I worried about Calvin entering Jr. High. I relived the day’s phone conversations with my siblings, thought about the tear running down my cheek while missing Mom, missing life before Calvin, missing sleep. I lamented things like the dying shrub, these weeks without rain, the smug, so-called Christian meme posted on a friend’s social media page asserting that people like me, good folks who don't believe in the god of Scripture, are doomed to eternal damnation. I bristled at the cad named Trump and all that he stands for, grieved the injustices in this nation—misogyny, bigotry, classism, racism. I mourned my losses and those of struggling families fleeing war torn places, and those exposed to earthquakes and viruses, heat waves and floods.

Finally, I drifted off to sleep and dreamt of my childhood friend, Gary, who in my dream was riding a bus with me when a detached door flew off and struck him hard in the head. He started to bleed and seize. I woke in a distressed state, my diminutive tween slowly rousing beside me in the bed, and I embraced him and kissed him.

It was a good thing I did.

Photo by Michael Kolster

8.20.2016

day seven hundred twenty

one: the number of days since Calvin's last partial seizure.
four: the number of days since Calvin's last grand mal seizure.
five: the number of consecutive days Calvin has had seizures this week.
seven hundred twenty: the number of days since Calvin's last conscious-onset grand mal seizure (one that starts when he is awake, not sleeping.)

As inevitable as I have always thought this day would be, it is still sobering to know that he broke that nice long stretch this morning.

Tomorrow we start back to day one.

1.14.2015

two peas in a pod

Tuesday 7:00 a.m.

I’m sitting here in Newark airport sipping coffee during my three-and-a-half hour layover after having taken the red-eye from San Diego. Michael’s phone call came in just before seven a.m., startling me out of a dead sleep that I managed to get with the help of some ear plugs, the puffy jacket Macauley gave me and two padded airport seats facing each other. Calvin had done the dreaded thing and vomited his morning seizure meds, so Michael had redosed them. A few minutes later Michael called telling me he vomited again.

At the exact moment my eighty-five-year-old mother had been ramping up to have another panic attack at home in San Diego, shortly before I kissed her goodbye, my ten-year-old son Calvin was having a seizure back in Maine. Mom managed to dodge the bullet. Calvin was not so fortunate and had a second seizure several hours later, then a third and possibly others.

Back in San Diego I had learned that my mom’s panic episodes have been occurring more frequently, perhaps the result of what we think was a November stroke, perhaps simply because that’s how Alzheimer’s rolls. During these events Mom hyperventilates, seems overly confused about where she is and disturbingly cognizant of her fears. I'm told they happen when she’s had too much stimulation: lots of activity, looking at photos from her past or at pictures on the computer—perhaps even Skypeing. They are heartbreaking to witness. Yesterday, I’d taken her to the park twice for a change of scenery, to get her blood and lungs moving and to keep her body in the best shape possible to avoid a fall. And, since we can’t leave her alone in the car anymore, I’d also taken her into a convenience store to pick up a few supplies. My visit, in and of itself, might have been enough to trigger an attack.

Calvin's seizures are triggered whenever he gets sick, even the common cold can induce them. With the help of two cannabis oils—one CBD, the other THCA—we’d managed to keep the seizures at bay for twenty-one days even though he’s been sick with one virus or another since before the holidays. But his little brain and body finally succumbed to the winter assault, and he crashed last night.

Tuesday Noon

Finally arriving home just before noon, having been shuttled from the airport by Lucretia and her husband and after being smothered with kisses from a very excited Nellie, I enter Calvin’s room just as he is waking. Michael, who is there sitting in the dark with the shades pulled, gives me a warm welcome. He tells me Calvin has been waking, crying, vomiting and falling back to sleep every fifteen minutes since morning. I turn to Calvin and see his eyes rolling up into what looks like a complex partial seizure. Fearing it will turn into a grand mal, and this being at least the third in a cluster, we lift him out of bed and onto his changing table where I give him the Diastat rectal Valium. Slowly, the color seeps back into his lips and pale face, his eyes relax and just before he falls back to sleep I give him his afternoon seizure meds in a spoonful of yogurt. This time, he keeps them down.

It's not quite 10:00 a.m. in San Diego, so Mom is still asleep. She sleeps a lot lately, probably because of all that ramping up mania, like Calvin before a seizure. I slip in next to Calvin as he sleeps and I remain there much of the day while Michael cleans up and walks Nellie in the bitter cold. When I kiss Calvin's head I realize it's the same way my mother kisses me, and I think of how similar they've become. They're like two peas in a pod, I think, my mother and my son, snuggled securely into their little husks of lives—small, sweet, green and alive.

Calvin and Mom, February 2005

10.03.2014

patch of light

At one-thirty in the morning I open my eyes to see Nellie sitting at my bedside with her furry muzzle resting on the mattress. I pat her head and as Michael goes to let her out for a mid-night pee—something we haven’t had to do in the month we’ve had her—I wonder if she might be trying to tell me that Calvin is going to have a seizure. I look in on Calvin and find him sleeping as soundly as I’ve ever seen, which makes me nervous, but I’m so tired I have no trouble falling back to sleep.

It’s four-thirty. I hear my boy gurgle and gasp. “Here it is,” I say to Michael, who quickly joins me at Calvin’s bedside, helps me unfasten the netted canopy, unlatch and lower the safety panel. Calvin’s hands are grey and clammy and his eyes are roving as if he’s blind. Because I don’t want him to have a second seizure, I fetch the cannabis oil, draw up the golden liquid squeezing several drops between his parted lips, pausing every few drops allowing him to swallow.

We change his diaper, which is soaked, then I crawl into bed next to him and Michael turns the light out. Besides a patch of light on Calvin’s back wall the room appears black to my unadjusted eyes and I can hear Nellie breathing on the floor next to the bed. She has never slept there before.

From Calvin’s room I can hear the downstairs clock chime every half hour. Calvin shakes and shivers for over thirty minutes, finally easing into calm, rhythmic breathing. I turn my back on him to get comfortable and, for a moment, he goes silent, still. I wonder if he has stopped breathing or if his heart has stopped, or both. It happens to people with epilepsy. They die in their sleep. For a second I consider whether I should turn to check on him or whether I should just let him be. He suffers so much, I think, and I imagine releasing him, imagine my life without Calvin, which could be so liberating yet so dark. But then he takes a big breath and yawns, and I know he is still with me, my little patch of light amidst the blackness of the hours.

photo by Michael Kolster

5.07.2014

double whammy

I don’t even know how to start or what to say except that I am weary of writing about seizures and it would appear that I’ll likely forgo writing about them long before they stop.

Calvin was hit with a double whammy early Monday morning. I heard the first one at 3:30 a.m., heard that unmistakable gasp when the seizure releases its grip on his lungs. At his bedside I watched his wide-open eyes search for nothing. I considered giving him an extra dose of cannabis oil even though the seizure was over, thinking he might have another, but I regrettably ignored the niggling voice telling me that I should. Never ignore the niggling voice.

After two hours of fitful, post-ictal sleep, as I feared, he woke to another. This time, I ran downstairs, got the vial from the refrigerator, went back up, dropped five beads of cannabis oil under his bottom lip and rubbed it into his gums. Almost immediately he gasped for air, the seizure seeming to come to its end earlier than usual, and before his hands turned blue. He slept soundly for another couple of hours, waking only for his other morning meds.

Michael and I decided to continue increasing his cannabis oil dose, which had been about 0.5 mg per pound of his body weight. We think we could go as high as 2 mg per pound, though just like pharmaceuticals, it will depend upon emerging side effects—if any—and efficacy. If, on a higher dose of my homemade THCa cannabis oil, Calvin’s seizures don’t seem to be diminishing, then I plan to start him on a high CBD cannabis oil, the kind that many children in Colorado seem to be benefiting from. There are enough high CBD strains available in Maine now that, if I wanted to, I could grow my own and/or make my own oil again. But I’ve found a source for growing, extracting and tincturing who is ready to jump when I say the word, which, to say the least, eases my worry some. I just hope that, when the time comes, he can jump high.

My worry is that Calvin is simply one of those people—thirty percent or more of those with epilepsy—whose seizures will quit for nothing. But maybe, just maybe, a little double whammy of THCa and CBD will kick the shit out of his epilepsy once and for all.

11.16.2013

unutterable

I turned silences and nights into words.
What was unutterable, I wrote down.
I made the whirling world stand still.

—Arthur Rimbaud, from A Season in Hell

photo by Michael Kolster

10.17.2013

time after time

My kind friend Tim sent me this version of a Cyndi Lauper song and said:

had me thinking of you and Calvin. Keep up the fine work.

As I listened to the beautiful words that, indeed, made me think of being with Calvin, I couldn't stop from crying.

9.24.2013

sobbing

Sobbing, I worry, not so much anymore about the widening gap between what is and what could have been, but of the electrical storms that race through my boy’s brain and body and of the drugs that do the same.

I used to fret about his failure to thrive, his relative blindness, his flaccid tone, his missing white matter, his reflux, his colic, his inability to calm.

Then my angst turned to his protracted development, his hypothyroidism, his trouble rolling over and holding his head up, the fact that he couldn’t crawl or walk or talk by the age of two.

But now, and since then, the weight my psyche bears is centered in the seizures and in the drugs meant to thwart them. Because it’s not as simple as one might expect. The seizures loom around every corner. The drugs change him, make him hyper or listless, manic or zombie, hungry or indifferent, constipated or loose. They make him dizzy and weak and restless and irritable and headachy and probably nauseous. Take them away and he’s a different kid. Take them away and he suffers withdrawal. Take them away and he seizes. Take them away and he loses skills he worked for months to achieve.

Sobbing, I worry constantly over my nine-year-old boy who is wordless and weak, imbalanced and precarious, wants something but can’t say what, in pain and discomfort but can’t tell us why, can only cry or whine while we search frantically for what hurts.

Sobbing, I wonder how things can go on like this. Sobbing, I worry, and though I wish things were different and I wonder what happened, I try not to ask, why me?

photo by Michael Kolster

8.20.2013

pH probe

The kid, in my estimation of late, has been pretty damn happy. We've gone down—then immediately back up—on one of his seizure meds in a fit of indecision. Last night we reduced a different one, the one that has never shown any obvious efficacy, so why keep him on it?

It feels good to wallow in Calvin's good mood and impish grin, in his giggles and hugs, in his relative seizure-free stint of twenty days. But tomorrow morning I dread. We must take him to the hospital in Portland, leaving the house before seven, arriving for an eight o'clock appointment to get a nasal-gastric tube thread through his nose and into his gut without anesthesia and on an empty stomach. He's getting a pH probe to see, once and for all, if he has been suffering reflux.

I remember when Calvin was only a few weeks old, having to witness a similar procedure every few days while in the hospital. He was being partly nourished with my pumped breast milk through a nasal-gastric tube, since his weak little suck couldn't get enough on its own. Kathy, a nurse with neonatal intensive care unit experience, performed the task as I watched intently to see how she measured and marked the tube for proper insertion. One day, Kathy wasn't at work and the g-tube needed changing. Another, less experienced nurse showed up to do the job. I helped her restrain Calvin, who was just shy of six pounds, while she measured and marked the tube. I'd seen that she'd done it differently than Kathy, and as she thread it through Calvin's tiny nostril he began to gag and scream and tremble. "You're putting it in too far!" I cried, strands of tears and snot streaming from my face onto Calvin. "You measured it wrong!" and the nurse removed the tube as Calvin sputtered, shrieked and turned bright red.

Later, Kathy came in on her day off to replace the tube correctly. She did so for the remainder of the time that we stayed in the hospital until we took Calvin home when he was seven weeks old and had finally mastered the art of nursing. We'll never forget Kathy for her kindness and compassion.

So, I dread tomorrow morning. But perhaps Calvin will pass with flying colors like he did during the anesthesia for his MRI, for his necessary circumcision at the age of two and for his eye surgery when he was five. Perhaps he will impress us with his resilience like he did for the countless, scary, unpleasant, protracted EEG lead applications and removals, his painful and frequent blood draws and IVs with their needles and splints and the restraint needed for all. Perhaps Calvin will quickly forget about the tube taped to his cheek that goes up his nose and down the back of his throat that he'll have to endure for 24 hours, and maybe he'll manage, like my kid sometimes does, to be a damn happy kid nevertheless.

Calvin with his nasal-gastric tube at 20 days old