THE WORK OF LOVE | Amanda Ruth
The room is dark, I am lying on a cramped twin bed, and it is the best moment of my day. I am cuddling my son as part of his bedtime routine, despite the fact he is embarrassingly much too old to still have his mother hug him to sleep. His entire body weight is on me, a comforting presence. I wonder how much time I have until he gets too heavy for me to hold this way. He tightens his grip, squeezing me with all the force he can manage.
“Mommy!!” he pauses, dissolves into giggles. “I’m charging you!”
It is a game he recently started, pretending that his hugs have the power to fuel my energy reserves. I play along. He does not realize how this is much truer than a game for me.
I hug him back. The moment should have been pure bliss, but instead, my mind throws me an unwelcome recall. This is my week of ICU service, and that morning I’d watched a toddler pass away in his mom’s arms. Her love and protection were no match against cancer. As I hold my child, supposedly safe in my embrace, I could not help but wonder if that toddler’s mom had this exact moment I am sharing with my son. That final hug before everything went wrong.
My son burrows under the covers, still giggling, and I can’t help but think, is this the last time we get to be this happy?
***
Going into pediatric critical care, I thought I knew the price the field demanded of me. I heard warnings of years of grueling training, permanently working nights and weekends, the emotional toll the unit exacts. I forged ahead and committed to the training. I went to debriefings, learned burnout prevention strategies, developed a self-care routine, all a set of psychic armor forged through years of witnessing families lose their children.
Then I became a mother. They placed my son on my chest, so new that parts of his body still bore the evidence of his entry into this world, and I was never the same. The love I felt was overwhelming, vaster than my grasp, and perfectly devastating. For weeks, I gazed at him, convinced I would wake up and he would be gone because something this perfect could only be a mirage. His simple existence was an unfathomable joy, and all of a sudden, I was terrified. Because the other price I pay for doing what I do, one for which I was unprepared, is admitting that the armor never existed for the parents.
I remember when I first learned about the just world hypothesis. It was the articulation of every deep yearning I had, that if I worked hard enough, was good enough, I would be safe. More than ever, I wanted it to be true. Yet for years, I have watched parents work so hard to get everything right. They told me about the organic food, the natural supplements, about the carefully selected schools and enrichment activities. Only to witness their bright teenagers succumb to a brain aneurysm. To septic shock. To a freak sports accident. No amount of accumulated parental goodness is failproof insulation against tragedy. There is a reason why the theory is also called the just world fallacy. This world is not just, and people do not get what they deserve.
The truth is any control I have over my son’s health and safety is illusory. I am ultimately powerless to protect him against the big things. I think parents know this, in the secret caves of their hearts, even if they do not admit it. Some burdens are too ugly to drag out into the daylight. Unlike most parents, working in the ICU means I give up even this gossamer of comfort. It means living with the knife sharp terror of my own vulnerability.
***
Coming back into the unit after maternity leave was one of the hardest things I have ever done. Half delirious with the exhaustion of new motherhood, I was slow in finding my footing. My perspective was thrown, my reaction time delayed. Nevertheless, I gradually adjusted to this new reality. I was doing well enough.
Until one night a few months in, when we admitted a baby boy. The patient needed an arterial line, so I started prepping. Fleetingly, I noticed that he was the same age and size as my own baby. I strapped his tiny arm to the cushioned board and grabbed his plump wrist to sterilize it. That was as far as I got. Abruptly, it was not my patient’s hand I was holding, but my son’s. Those perfect little fingers curled against his palm were the same fingers I kiss. To mar this smooth skin with a needle, boring through tissue to find the thread of an artery was unthinkable.
I do not remember how I left the room. What I do remember is my NP taking over for me, smoothly finishing the procedure. Afterwards, we sat together in our workroom. She was the veteran, having been in critical care and a mom far longer than I had, her children already teenagers. She told me it gets better. That I’d get used to it.
All these years later, I am not sure I agree. It does not get better. Yet it is true that I have gotten more used to it, this feeling that I walk around with my softest parts detached from me, constantly exposed to threats.
***
My son’s breathing is regular, his mouth slightly open in his sleep. His head is on my shoulder, although his limbs are sprawled every which way. My love for him still feels overwhelming sometimes, especially when I think about the myriad of ways he could be taken from me.
But now, I am wise enough to know it was never about performing more goodness, or grasping for more control. There was never safety to be bought. The question was always: Do I choose the work of love, knowing the depth of the pain that could come? Could I love something I could not control?
I slowly extricate myself from the warmth of my son. As I start to leave, my gaze is caught on his face, perfectly beloved. Like countless parents before me, I am not sure if I ever had a choice after all.
Amanda Ruth practices pediatric critical care in Texas Children's Hospital and co-directs the medical humanities program. While originally from Indonesia, she is still trying to acclimatize to the Houston heat. In her spare time, she reads as much sci-fi/fantasy as she can and is happily working through the extensive local food scene with her husband and two sons.