On the second trimester (or baby chronicles: Part Two)

May 11, 2018
12weeks 1day gestation

We’re out. People know. I get to tell preceptors in open settings that Mackenzi is pregnant. And I get to see their reactions.

Not much else has changed. I go about my rotations and my day-in-day-out nonsense. I joke with friends that already knew. Every once in a while, someone will congratulate me.

Mackenzi’s morning sickness has seemed to settle. There are good days and there are bad days. Overall, she seems to be adjusting well to the changes. She is starting to show. I notice less fatigue in her, but that might be the end of inpatient pediatrics glow.

Talking about the pregnancy always makes her shine. It seems like a potent medicine against the nausea and fatigue. Get her talking about the baby and the incoming burpy ball of cuteness and her entire affect changes. She smiles, she blushes, and she gets a few inches taller.

I hope this continues, that thinking about our future with the baby will keep us present and filled with joy. Especially when the baby arrives and they don’t want to sleep or eat. And as a result, we won’t get to do either.

May 24, 2018
14w0d gestation

Just casually noted a bulls-eye rash on Andre’s arm. He’ll go for a round of doxy from the urgent care. Him, I’m not too worried about. Mackenzi, with the recollection that Lyme Disease is a vertically transmitted disease, more so. Mother to child transmission makes Lyme a ToRCHeS infection, in caution-worthy company like syphilis, rubella, and herpes.

This places daily activities into perspective. Ticks checks used to be a let’s-be-careful kind of thing. Now that we have a confirmed case of Lyme in our backyard, tick checks are important.

So many considerations during pregnancy and the first few years of this little one’s life. Board questions will come to life as either concerns or realities. Sometimes, I wish I didn’t know so much.

May 29, 2018
14w5d gestation

On nights. While I don’t mind the three days of night shift terribly, I did find myself feeling anxious to leave. I spent the night studying, but couldn’t pin-point why I was so antsy.

When I came home this morning, I realized why. I just wanted to see Mackenzi. To hold her in bed and lay with our noisy, wheezy dog.

I’ve been transitioning more and more into a homebody, ever since I had someone at home to whom I can return. Moving forward into intern year and the overall madness of residency, I’ll have to keep this in mind.

I want to leave so that I can spend time with my growing family. I need to stay because of clinical responsibilities. I have to sacrifice one for the other.

At least for now.

June 9 2018
16w2d gestation

We had a long week. Shelf on Friday, then Step 2 CS on Wednesday in Philly, then three days of Balint training. And we barely get a weekend before we dive straight into two weeks of SELECT 8a-5p.

We’re pretty worn down. It feels like a preview into long, tiring days of residency, where we barely have enough energy to keep the boat afloat: flip the laundry, wash the dishes, fold the laundry, put dishes away, walk the dog, feed the humans, go to bed.

How will baby fit into this routine? How much will baby change the fatigue? Add to the fatigue?

It’s hard to tell and it’s a frightening proposition. Coming back from the Balint training on Thursday, I felt that I had nothing to give. I needed to go outside by myself, to charge my battery just enough to complete the necessary tasks listed above.

I can do that when it’s just me, Mackenzi, and Honey. Can I do that with baby? Am I afforded that luxury of a few minutes alone?

July 6, 2018
20w1d gestation

The past few weeks have been incredibly stressful and draining. I did, however, make baby a point of focus and love. During the slog of Prologue, I would ask close friends if they had said hello to baby today, while grasping Mackenzi’s belly. Then I’d encourage them to do the same, or at least directly interact with the gestating baby.

This would usually get a strong reaction in both the greeter and Mackenzi. Finally, I’d walk away as they have a totally different direction of conversation than before. A fun way to turn love into a bit of chaos.

After Prologue, the study cave has been good to us. We are able to spend a lot of time with each other. Mackenzi is the only human I’ve really interacted with for the past two weeks and I am not yet sick of her. A good sign for things to come.

While preparing for Step 2 CK isn’t quite a walk in the park, it is a chance for us to relax and unwind a bit at home. We no longer need to wake up at 6a to go to clinic all day and then return home to catch up and vent about something that happened.

We get to walk our dog multiple times a day, snuggle with her as we take a mid-day nap for a study break, and bother her when we don’t want to study anymore. I get to kiss Mackenzi’s growing belly whenever I want. I get to feed her now that she can keep food down.

She’s showing so much. To my eyes, at least. And I know she has so much more room for growth. I wonder if the average person would think she’s showing.

We’ve grown so close again these past few days of dedicated step prep. Our housemate will return tomorrow and the dynamic will change once again. But at least we had this small window of time alone together to recharge. He will leave again in a few months and return when baby has arrived. More times of adjustment ahead.

The ultrasound is next week.

I’m looking forward to the appointment. It will feel so real. Maybe we’ll find out if there are internal or external genitalia. We will go by feel.

We have a classmate whose wife delivered at 24wks. That’s in one month, for us. So early, such a wild disruption to the parents’ lives, including the extended hospital stay in the NICU well before the planned delivery.

We are entering a weird window soon, where the baby could arrive literally any day and probably end up alright. A sixteen week-long window of imagining the worst and preparing for the best. Maybe an eighteen year-long window.

July 12, 2018
21w0d gestation

I feel more connected to baby.

The ultrasound on Monday gave us great news. Baby is healthy and growing well. And baby is a boy.

The ultrasound tech was quick and kind. She played along when we told her that we are medical students and that we wanted to see if we could tell the baby’s sexual organs without her assistance. She proceeded to bring the probe to baby’s pelvis and asked us what we thought: we could see his gochu clear as day.

Next to the tech stood a fourth year med student completing her away rotation here at LVHN. She reminded me of my ultrasound day, peering over the tech’s shoulder and melting into the background of the clinical encounter. We all decided collectively to not talk about fourth year or medical school, and to allow us to just be happy expecting parents.

During the exam, however, baby did not want to cooperate. He kept his head pressing against Mackenzi’s bladder, feet up high kicking into her guts. The tech and the physician both spent a good bit of time trying to reposition Mackenzi on this side or that in an attempt to get a profile shot of baby. He kept his hands and arms in front of his face, burrowing deeper into mother’s bladder.

This early on, I wonder what this will reflect on his future personality. Will he have introverted tendencies like I do? Will he be a snuggler?

I remember being a child, anywhere from five to ten years old, stricken with a case of acute otitis media and deciding the only thing I could do is crawl under my parents bed and scream and cry. I remember my mother trying to coax me out of my burrowed hiding place and myself refusing, probably kicking at her reaching arms.

When we found out that this baby is a boy and that he was hiding from us, I knew that we would not get any cooperation from him during this encounter. I knew with that revelation that he’d be a stubborn turd, at least on occasion.

He’ll have that in common with his dad.

July 15, 2018
21w3d gestation

I have been enjoying the bedtime routine of touching baby. Mackenzi notes how much he likes to wiggle when we lay down to sleep. I place my arm broadly over her gravid belly, such that I make contact from my forearm to hand, ready to feel for any movement.

The practice is difficult and requires a large portion of my attention. I have to keep track of her breathing and her heartbeat. When I have these rhythms in mind, then any extra movement from the belly is likely baby.

Sometimes that movement is obvious: a little kick straight into my hand. Sometimes, less so, more like a distant ripple across a pond. I find my attention wandering and relaxing, especially as my body prepares to sleep. When Mackenzi asks if I felt him move, I have to admit that I couldn’t tell between her breath and her abdominal pulse. A good practice for staying present with both my partner and my child.

Telling loved ones about the sexual characteristics of baby is a wonderful experience. It is like telling them that Mackenzi is pregnant all over again. There is joy and hugs all around.

My son is healthy. My partner is healthy. I am happy.

August 4, 2018
24w2d gestation

Yesterday, we had the 24week check-up. So routine: a quick doppler to check for fetal heart rate, a lab slip for third trimester labs, and a handshake out the door. Soon, we’ll be planning the birth.

This morning, we had a difficult conversation. A discussion we had been putting off for a while. End of life planning.

I think the reason to finally sit down and run through various scenarios is the impending third trimester. Delivery serves as an easy state-shift: things will be different on the other side. Delivery also serves as a reason to discuss possibilities: placental abruption, fetal distress, maternal seizures, and all the other ways in which our essential biological function can go awry.

As medical students, we know that these things can happen. As mortal beings, we need to plan around some of these low-probability/high-impact events. We limited the planning to things that could happen to us in the next five or so years: through the delivery and the early childhood of this baby. We can talk about old age when we get there.

It was a hard and draining conversation. We started at the hardest point, imagining that I died, or that Mackenzi died. What if both of us die and baby is left an orphan? Car accident is the most likely traumatic cause of injury.

Then we moved into the gray area of such events. What about intubation or blood products? What if things don’t look good but are not immediately fatal? How long should we keep the other on life support?

Easy to ask the questions, hard to know the answers, and even harder to act on those answers when called upon to do so.

I had just finished When Breath Becomes Air a few days ago. I tried to imagine being a new father, on the other side of delivery, with the knowledge that I am actively dying. A terrifying and clarifying thought.

And so, here are some of my wishes for you, my child.

If I die before you can remember me, I hope that Mackenzi finds another partner for both herself and for you. I know she loves to cuddle at night after a long day and she should not deny herself this earthly pleasure because of my absence. I want you to have a two-parent household, one in which you can learn different skills from one parent and other perspectives from the other.

I just ask that you are raised in a weird manner, distinctly different from your peers, in a way that I would approve if I had the means to do so. I might not be around to raise you, but I hope that my genetic thumbprint and my love for your mother leave a lasting impression on you and your outlook on life.

I love you without holding you and that will not change in the future.

Long Form Sundays

On Death Podcast

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