There Will Be Three

The day sticks in my head because of what Kimberly and I each brought home. I had carried a rip-roaring headache from work; she, a pregnancy test. Headaches are common here; pregnancy tests…not so much. Of course, she mentions it in the offhanded fashion of someone who has to make a phone call before dinner; “I need to take a test.” My throbbing head searched for the adjectives to make this a complete sentence. Test….what kind of test? First time in my life I had test anxiety for a test that wasn’t even mine. Then, I realized it sort of was mine. She explained her missed period, we did the math and she went to pee. Emerging a few minutes later wearing a smile I’d never seen, she said “You have the magic stuff”. Thus we began the long journey of parenthood.

The next few weeks were pretty normal. Of course, she had to give up some things like alcohol (no big deal), Advil (a little worse) and caffeine (now it’s getting serious). Kimberly went through the misery of finding a new OB, which is an experience I don’t think most men really appreciate. Speaking strictly as a husband, I know I’d like to limit the number of people with that kind of knowledge of my wife, so I can only imagine how it must be to actively recruit another person, likely as not a man, to mess around in your business. What’s worse, it took more than one try to find a good doctor with a good office. But she did and is very pleased with her new physician.

After the search came the patient wait until the first appointment, which was scheduled for what was estimated as her 10^th week. We had originally been told that this visit would be mostly about collecting information and history, blood & urine and establishing a due date, so I didn’t go. Knowing her appointment was at 2:45, I waited patiently at work for the call letting me know everything went OK. The call I actually got at about 3:30 was a little more cryptic:

“Hey, I’m still at the doctor’s office”

“Oh. Is everything OK?”

“Yeah. Can you meet me for dinner when I’m done here?”

“Yes. You sure everything is alright?”

“Oh, yes. Everything is good. It’s just taking a little longer”

With that and an agreement on dinner, we hung up. Fifteen minutes later she called back.

“Hey, can you come home now?” I knew it….something was wrong.

“Yes, what for?”

“They did an ultrasound today. I want to show you the pictures”

“Ok. I’ll come now.”

On the way home, I was finally wrapping my head around the idea of having a baby. I’d known since we took the test that we were going to be parents, but with only a urine-soaked stick as the talisman of our impending parenthood, you can understand how the idea was still a little abstract to me. But driving down the interstate, the thought of holding my baby very soon started coming home, and I smiled all the way to the front door. As I got out of the car, Kimberly stood at the door rushing me along. I walked in and, without even a kiss; she pulled me by the hand to the computer where she had loaded the CD from the doctor’s office. The first picture on the screen was a simple baby ultrasound; nothing particularly special about it except that it was my baby and the picture was titled “Berrier Twins”

Twins? That better mean there are two pictures.

That isn’t what it means. It is only by the grace of God that my head didn’t twist off my neck, seeing how I spun it between her and the screen non-stop for at least five minutes, alternately saying “What?!” and “Oh God!”. I spent the next half hour or so staring at one of eleven pictures of two non-descript little blobs that had, with hands too tiny to see with the naked eye, turned my life completely upside down.

This had, as you might guess, changed everything. Kimberly’s age combined with twins now made her high-risk; setting in motion a whole new set of doctor visits. This meant more ultrasounds, more tests and more ways she had to take care of herself to make sure she and the babies stayed healthy. And, let’s not forget…we’re now having babIES… two of everything.

And, we started telling everyone. This is by far the funniest part. We broke the news to most everyone in the same way. “Hey, we’re pregnant” At this point, everyone said congratulations or something like that. Many even anticipated what we’d say when we revealed we had news. Then, we’d chase it, “With twins”. Laughter, almost across the board. People actually found it amusing that we were having two babies. And, I have to admit; once I regained consciousness I did too. After that, though, it was really kind of cool to think about having twins. I found it took considerably less time to absorb the idea of two babies than it did to accept the arrival of one.

In the meantime, I started a new job at one of the bigger hospitals in our part of the world. The orientation process required me to spend some time in different areas of the hospital, including the Neonatal Intensive Care Unit (NICU). I had a little anxiety about an being an expectant father of twins in a place with so much misery, but I figured I could learn a lot, so I’d make the best of it. What I found out rather quickly was that a lot of twins end up there just because they tend to be born a little early and need time to “feed and grown” as one of the nurses put it. Some weren’t all that sick; others were tiny, barely a pound and fighting for every ounce. As we rounded, my preceptor refused to tell me one story, saying instead that I really didn’t need to hear about it. “The story”, as it turns out, was about a twin in the unit (less than 600 grams) whose sister was born into a toilet at 24 weeks and didn’t make it. She was right…I didn’t need to hear about it. I left the NICU honestly not caring if we had a boy or girl, only that whatever it was, it was healthy.

The next countdown was to Kimberly’s next ultrasound on July 17. I was again unable to join her but got home shortly before she did. I met her at the door and quipped “There are three, aren’t there?” She said “No, we’re back to one healthy baby.” I didn’t know before then that I could fit both feet in my mouth at the same time.

As you can see in the picture, baby # 2 never developed past the 10^th week; a common occurrence known as a “vanishing twin”. But the remaining baby was growing fast and well, making it very hard for us to be sad. I think Kimberly said it best with “we have as many babies as we’re supposed to have”; and that’s alright with me.

Most recently, we visited a genetic counselor for additional screening. Mainly they were looking for chromosomal abnormalities like Down’s syndrome. We still don’t know the sex, but the testing went fine and we’re happy to say that Baby Berrier is right where s/he should be. The pictures are incredible, but they really don’t do justice to the live ultrasound and the cartwheels the baby was doing while we watched.

Thanks again for all the congratulations as we begin our roller-coaster ride of parenthood. Keep watching here for more news and updates with the weekly blog, and as always, thanks for reading.

Do good things with the week to come, learn something new and be safe.

Things that go bump in the night...

Principal Vernon (Paul Gleason)talks in “The Breakfast Club” about “the thought that wakes me up in the middle of the night”; and that’s what I’d like to hear for this week’s blog. What scares you? I’m not talking about spiders or snakes or Democrats…I mean the real stuff. I’m just going to ask and see if anybody has the guts to answer. To be fair, I’ll start with mine.

Most everyone knows that my wife and I are expecting (if you didn’t know…surprise!). What many of you don’t know is that we are no longer having twins. At the doctor this week we found that the second baby did not develop. The first baby is growing like a champ, though, so we are still very excited and can’t wait to meet him or her. Everyone tells me I’ll fall in love with the baby as soon as it is born, and I’m so anxious to feel that, but therein also lies my fear…to love something so much when so much can still go wrong. I’m afraid that my body could not withstand having that much love torn out of me.

So there….I’ve taken the first step, so let’s see if you’ll follow. Post a comment here or on the MySpace page. If you’d rather keep it private, send me an email. Thanks for playing along.

Do good things with the week to come, learn something new and be safe.

The Unfallen Sky.

There is probably no greater self-proclamation of professional prowess among paramedics than the mastery of airway management—specifically endotracheal intubation. One of the greatest compliments you could pay a medic is to say he could “tube anyone” and mean it. By the same token, nothing will tear at the fabric of his confidence faster than failing to intubate, even once. Even outside their own ranks; everyone has an opinion of EMS and their ability or failure to pass a tube. Whether it’s the wide-eyed EMT student who latches onto intubation as a lifelong dream, or the grouchy ER nurse who swears that all the paramedics want to do is to intubate people…even though they aren’t any good at it. What escapes almost everyone, including paramedics themselves, is the irrefutable link between this relatively simple skill and the confidence it takes to perform it.

Despite what the grizzled EMS veterans will say, intubation is a fairly easy procedure that, if anything, we have complicated by insisting that we can do it anywhere and trying to prove it. The fact is that a mediocre instructor could teach an eight year-old how to intubate and most of the other paramedic skills in a weekend (A student recently told me “that would be one cool eight year-old”). What makes intubation so prized and contested is the guaranteed acuity of the situation that necessitates it. In the EMS realm, if someone needs a tube, it is because they die without it. Enter the confidence factor.

Because EMS is such an egocentric profession, confidence among the practitioners is usually a given. But, the confidence inherent to the practice of intubation is necessary, because without it the battle is lost before it begins. It is important that you believe you can intubate every single patient that needs it in order to be successful. You won’t get them all, but you must believe you will or you won’t get any.

I remembered this nearly too late this week. During orientation at my new job, I rotated through the operating room to grease the rusty gears of my own intubation skills. From the start I was paired with an incredible nurse anesthetist who gave me all the room I needed to stand after a very long time of sitting by the sidelines. The first patient we saw was a big guy…no neck and a huge tongue. At this point, I hadn’t told anyone that this would be my first tube in a long, long time. Somehow, as I was putting the laryngoscope together didn’t seem like the right time. Drugs were pushed, the patient slept and I went to work.

Money.

Within seconds, I saw the cords, passed the tube and found my long-forgotten swagger. I hung around for a few minutes before excusing myself to search for the next victory in a day that was now certain to be full of them. However, crossing the threshold of the room left me with the uneasy feeling that things were going too well, too soon.

My next patient was with the same anesthetist, and it looked like a cake walk. During the pre-anesthesia screening, we decided together that this patient, a jolly man in his 60’s had an easy airway. Short teeth, big mouth and a solid chin—no problem. Same as before, everything went smoothly until I put the scope in his mouth and saw…nothing.
Well, nothing but tongue and epiglottis. The biggest epiglottis in history. Seriously…somebody call Guinness. I looked some more, being mindful of teeth that were short and stubby in the holding room but had somehow grown in the sterile air of the OR to the size of grave markers. The patient’s oxygen saturation began to fall, taking with it my confidence, and the anesthetist asked “Want me to have a look”? Please.

I took a little pleasure in seeing him struggle for about 4 seconds before placing the tube, but the damage was done. I stuck around for the duration of the surgery, partially to watch the procedure but mostly to give my wounded ego time to heal.

As we walked from the recovery room back to the OR, I admitted to the anesthetist that my confidence had been shaken. He casually remarked “You won’t get them all” and lead me to our next patient which he handed over to me without a second thought.

Allen Neuharth, the founder of USA Today, once wrote “I quit being afraid when my first venture failed and the sky didn't fall down. “ I was reminded of those words throughout the rest of my day in the OR, which was perfect both in intubations and experience. I left feeling on top of the world, not only because I had done well, but because I recognized the value of doing badly. And between “well” and “badly” is confidence, because without the confidence in success, there can be nothing learned from failure.

Too often, people mistake confidence for arrogance. And, while there is an abundance of the latter in modern EMS, most of the accused are guilty only of believing that they are the best hope for the survival of every patient they treat. The difference between confidence and arrogance is the humility of knowing your own fallibility. None of us can save them all, but it’s the guts to try that sets the best apart from those happy with being good enough.

Anyone who is good at what they do gets that way by believing they can be great, and accepting that they must be human.

Three shining examples of confidence and conviction made news this week with their passing.

Jesse Helms, ever a stalwart of conservative values in the 20th Century died on the 4th of July. Like him or not, you could always count on Jesse to tell it like it was, or at least like it was in his mind. The only upside to Helms’s death is that, should the liberal Barack Obama win the White House, we will be able to power Raleigh, NC from the static electricity generated by Jesse spinning in his grave.

Also from the right side of the aisle passed this week Tony Snow, conservative commentator and former spokesperson for the Bush administration. Once again, whether or not you agreed with him or not, Snow’s candor won over people from both sides of the fence. Ed Henry, the very reporter from CNN told by Snow at a press conference to “zip it”, wrote that he believed “life is too short to get yourself all worked up about one tense exchange, one awkward moment or one misstep.” We should all be so wise.

Finally, Dr. Michael Debakey, THE pioneer of cardiac surgery died at the age of 99. Ironically, he owed the last few years of his life to a life-saving aortic surgery that he himself developed several decades ago. Early in his career (he graduated from medical school in 1932) he commented that “If a patient came in with a heart attack, it was up to God.” Dr. Debakey was never satisfied with that, and spent his career of more than six decades giving the Almighty the best help he could. He performed over 60,000 surgeries, developed hundreds of medical devices and listed celebrities and heads of state among his patient list, though never giving special treatment. “Once you incise the skin”, he said, “you find they are all very similar.” Without question, no one will say that about you, Doc.

No big news to report this week about mother and babies. All is well. We have appointments in the next couple of weeks, so I hope to post new pictures soon.

Do good things with the week to come, learn something new and be safe.

Of Inconveniences Rightly Considered...

Thinkers have made much of adventure in the histories of man, nearly always winding the greatest of tales along the paths cut by Odysseus, Washington and their like. It is often said that the history books are written by the winners, usually in ink brought back from foreign lands reached by roads of the most glorious enterprise. This sort of adventure was universally to some greater end; whether it was to reclaim a conquered land, a stolen bride or the unalienable rights of man, the victory speeches of these adventurers never included the line “Just because I could” That, my friends, is entirely a product of the 20^th century.

Modern adventurers; wealthy, aristocratic brigands trekking the earth on corporate sponsored trips to climb the unclimbable and swim the unswimable, are a bastardization of the term typical of what we have become in the last hundred years—lazy. Adventure today is thought of more in cable TV terms: that which can be lived by someone else reality-show fashion to be viewed at our leisure. What this pre-packaged definition disregards is the true prevalence of adventure in our lives. G.K. Chesterton opined that “an adventure is only an inconvenience rightly considered. An inconvenience is only an adventure wrongly considered.” Truthfully, the real adventure in life comes not from seeking high places or deep oceans, but from the imperfections of life itself. The experiences of the lesser endowed of wealth but greater of spirit, cast forth with only the clothes on their back in search of something needed, not coveted. They seek no glory, only their due. Often, the most honest payment they expect is the knowledge that the right thing was done through their part in a job that should have been routine, but fate cast as anything but.

Tolkien writes in The Lord of the Rings, “Remember what Bilbo used to say: ‘It’s a dangerous business going out your door’”. Few among us realize that we are cutting our own path and the most ordinary of stops along the way can lead to a bad end. A hard reminder of this came last Sunday with the news of the mid-air collision of two medical helicopters in Arizona. 2008 has already been a very deadly year for the air medical industry only at its midpoint; each report of disaster reminding us of the fragile nature of even the stoutest among us. But it should also serve to remind us that our story is waiting outside and there is no use hiding indoors hoping it will go away. Fate is patient and demanding, and when she desires our participation she will fling open the doors and seize us into our greatest day. Helen Keller wrote that “avoiding danger is no safer in the long run than outright exposure.” Translated: none of us will get out alive, so you may as well live.

We should never seek to glorify those fallen in pursuit of life; their achievements speak more loudly than any fruitless words of ours. Rather, we should embrace the spirit that pours from their stories, drink it up and use it to refresh our own waning sense of adventure. So many times we get out of bed lonely or despaired, only hoping to get through the day when, all around us lives the chance to make the day…that day, remembered through us.

So far this year, sixteen people have died in air medical crashes, putting 2008 on pace to surpass a very grisly record. This should give us in the business pause to consider how to reverse this trend and augment our own personal vigilance. But it should also empower us to live—to step out of our door and see where we are swept off to.

Later in The Lord of the Rings, Tolkien writes “But I expect they had lots of chances, like us, of turning back, only they didn’t. And, if they had, we shouldn’t know, because they’d have been forgotten” Artificial adventurers are barely remembered after their photo is taken atop the peak they paid to climb; but the folks in the tales that really matter, they endure in ways that don’t allow us to forget.

Please visit the condolence book for the victims of the recent crash and read updated news here.

Speaking of adventures I won’t forget, my wife and I found out this week that we’re going to be parents…of twins. Words truly cannot express the emotions I’m feeling at this news, and I thank everyone for your congratulations and well-wishes. Check back here weekly for updates about the coming 100% increase in the occupancy of our home.

Of a lesser variety of adventure, I’ll be starting my new job this week. While the recent tragedies have made me think hard about my chosen path, I’m very excited at the prospect of this new beginning. I will be posting much about this as well, so stay tuned.

Do good things with the week to come, learn something new and be safe.

All These Years

How long is a year, really? Logically speaking, the question answers itself. A year is a year. 365 days, 52 weeks, a trip around the sun; a year. But a year measured in life passes very differently for each of us. As example, newlyweds may describe their first year as a blur of new sex; while a couple ten years past nuptials will see each of those years marked with more enduring and less volatile tides. Or, a year in prison measured against one spent in luxury will stretch a thousand times past, each miserable day a year of its own.

Yet, the question remains. How long is the year? For most, the answer comes the morning after you went to bed as a 12 year-old and woke at 50. It is when waiting to live your life that life happens and, if you aren’t careful, passes by you. Each year passed towards the unknown end of your days is shorter through no fault of the sun’s, but of wasted life itself. Unheeded advice, untasted fruit and experiences untaken and left on the table all chip away from the robust flesh of living, leaving only brittle bones. The old are fond of saying that youth is wasted on the young, not because they begrudge the youth of time, but rather because they have so little to lose besides another day of life they are no longer willing to waste.

In your years, you can do much or little…such is the prerogative of each. But what you do must be measured against all the others in your life and reconciled with what you hoped to do. Each year is its own debt paid; for, whatever you do with it, you’ve traded that time in your life for it and can never get it back.

I’ve wasted much in my life. Money, love, effort…and precious time. I have awoke from a dreamless sleep of many years months to find that they were gone and I was left with nothing to show but trinkets and crumbs. Lamenting lost time is as useless as losing the time itself, but it is the curse of Eden to regret, and I have certainly done my share. The past year; however, has not been wasted in the least.

The past year has been marked by growth and change; both my own and that at least partially influenced by my counsel. So much has happened; things begun, things finished and those delicious things that live and grow still at its end. Mostly though, it’s been about things accomplished. I’ve rarely….no, never had a year in which I felt like I got so much done. Looking back, I wish for other things, projects, to be completed, but that is more than balanced by what I did finish. Of course, none of this happened in a vacuum, so I would be remiss if I did not acknowledge what I did through others or those who embraced my visions and carried them to fruition. They are the true measure of my year, and I will always hold them special and sacred.

Stephen King writes in Eyes of the Dragon, “I think that real friendship always makes us feel such sweet gratitude, because the world almost always seems like a very hard desert, and the flowers that grow there seem to grow against such high odds.” So, true as it is that I’ve written the ending to a happy and fruitful chapter in my story, it is pleasing to know that this one will never truly end. Good works endure, good memories fade without vanishing, and the love of friends only multiplies with years beyond the forge.

So, how long is a year? If lived well, it can last your whole life.

Many people on both sides of the fence would gasp in horror at the mention of Tim Russert and George Carlin in the same breath, but at a time when we mark the passing of these iconic personalities within weeks of one another, I have to smile at what Heaven must be like today. While they held rather different audiences in daylight, Russert and Carlin both made careers from asking really hard questions that the unwashed didn’t even know they wanted answered until put before us. They took no prisoners, took no bullshit and absolutely refused to take no for an answer…at least not without one more try. Pop culture and politics is forever changed with their passing, and I miss them already for their wisdom and the rarity of their type.

Do good things with the week to come, learn something new and be safe.