Sometimes you can’t make it on your own

Prescript: This blog is not about Cross Country, at least not directly, but it is about my life and as such Coaching and Running are interwoven throughout the narrative.  I am hopeful that (among others) many of my current and former athletes and their families will read this.   A team value we’ve always upheld is that through challenge and tribulation comes a sense of purpose, even in situations where the outcome was not what we’d hoped.  The past few months of my life have put that premise to the ultimate test.  While the experiences I’ve had are unique to my family, I hope my reflections on those experiences contain some insights others may find valuable.

 

At 19 weeks, we thought we lost them.  On Saturday, July 22nd, I returned home from a run with my friend and coaching colleague John Sipple to discover the car of Sarah McCabe, wife of Girl’s Cross Country coach Mark, sitting in our driveway.  This seemed odd.  Though, Sarah had recently babysat for us (the McCabe’s live a short five minutes away) I had not expected to see her visiting on a sunny weekend morning.  I paced up our walkway wondering what brought her to our place and was met at the door by my wife Megan, who told me in a calm and steady voice: “Sarah is here to babysit Clio.  We need to go to the hospital.  I think my water broke.”  My heart dropped.  We were still weeks away from viability.

At the hospital, we were ushered into a delivery room, and the Doctors ordered some tests to determine our status.  The wait for those results were among the worst moments I can ever remember feeling.  When the Doctor came in to report that the test came back negative, relief washed over us and I came to a new realization: the only thing better than learning of good news is learning of the absence of bad news.  Nonetheless, that day will forever be etched into my memory as the day I learned what it must feel like to be met with unexpected tragic news.

Two days later, we visited our Maternal-Fetal-Medicine specialist for one of the twice weekly ultrasounds they had recommended for us, given the complications we’d experienced from early on in the pregnancy.  These regular checks were intended to pick up possible early signs of Twin-to-Twin Transfusion syndrome, a disease impacting about 10-15% of identical twin pregnancies, wherein blood from one twin is shunted to the other.  The best known treatment for TTTS is laser ablation surgery, where the blood vessels are separated so as to stop the transfer from happening.  This was the appointment where signs looked ominous enough for our Doctor to recommend we travel to Houston for consultation with specialists followed possibly by surgery.

The next day, I attended summer running, and gave a speech to the team.  The juniors and seniors would be leaving the next day for our annual team-building trip in Kenosha, and for the first time ever, I would not be able to join them.  I told a story about my first coaching job in Lamoni, Iowa, a tiny rural farm town with a high school student body of just over 100.  I took over a Track team that had not won a conference title in 30 years.  My first year, we finished 5th.  My second year, we finished 2nd, less than ten points behind the winner.  That second year, the team started experiencing success they’d never had before.  We won a meet for the first time.  It was a few days after that first victory that I had to let the guys know I would not be returning to Lamoni the following year as I’d been accepted to Graduate school at University of Iowa.   My message to them was simple: you now know what you are capable of, and you will be successful without me.  Sure enough, the next year they won the conference title by over 50 points.

I relayed this story to the present group to convey a similar point: they had within them everything they would need to be competitive.  Still, my voice cracked as I concluded, “…so, I won’t be able to come to Kenosha with you.  I have to go to Houston.  It’s the best chance my little girls have.”

The next day, the Cross Country team traveled north, while Megan and I flew in the opposite direction.  A month before the city faced the deluge from Hurricane Harvey, we arrived in Houston and met with Doctors from the Children’s Hospital.  But, they opted not to perform the surgery.  The disease had not progressed far enough to warrant an invasive surgical procedure.  It seemed we dodged another bullet.  The surgery would remain an option up until 26 weeks, after which time if signs of TTTS reappeared the only option would be to deliver the babies, as the surgery carries too great a risk in the third trimester.

Summer break ended, school started.  I was no longer able to attend each and every ultrasound appointment, owing to work obligations.  However, I requested a half day to be with Megan for our 26-week appointment on September 1st, since we’d be getting an update on the growth of the twins (these are scheduled for every two weeks).  Though we’d come to expect the unexpected, we were once again thrown off balance by learning that the TTTS was beginning to reverse, with the twin that had previously been receiving blood now in the donor role.  Our Doctor told us this could mean delivery could happen soon – perhaps within a few weeks – and ordered Megan to get steroid shots to prepare for that eventuality (the steroids help aid lung development of the babies).

So, on Saturday September 3rd I cheered on the Red Devils at our home Cross Country invite in the morning and then went off to Hinsdale Hospital later that afternoon to accompany Megan while she got her first of two shots, the other coming 24 hours later.

We spent a relatively relaxed labor day enjoying beautiful weather and the company of my brother, sister-in-law and niece.  The following day, Tuesday, September 5th, began as an ordinary day.  I went to school, taught my classes, headed off to practice.  I knew Megan had a 3:30 appointment with the Doctor for an ultrasound, and that more than the upcoming dual meet against Glenbard West occupied the majority of my thoughts during the run.  Upon returning back to campus after a six-mile loop, I took a detour down to the locker room to check my phone before rejoining the team in the weight room.  Megan had left a voicemail.  The words echo still: “The Doctor says it’s time.”  Adrenaline and fear rushed through my body.  We knew prematurity was a possibility, but only a week earlier things had seemed to be leveling out, and the hope of making it past 30 weeks seemed not just possible but likely.  In the third trimester, every single day matters, and this was way earlier than we wanted.  It meant our girls would face longer odds.  At that moment, I was terrified of what could happen just during the delivery itself.

I found Coach Westphal and relayed the news, told him I’d be out for a while and would update him when I could.  Rushed home.  Packed a bag.  Headed back to the hospital.  I met Megan and she told me surgery was scheduled for 7:00pm, as soon as the second neonatologist arrived.  Megan’s sister Liz was with her, as was our daughter Clio, who, though unable to understand exactly what was happening nonetheless sensed a great change was taking place.

What happened next I’ve recorded already, publishing a facebook post about it on September 6th.  While I know some readers of this blog are connected to me through that social network, others are not, and so here I will defer to the account I published there:

 

Yesterday was a momentous day in our lives. Alexis Rose Lawrence was born at 7:42pm weighing 1 pound 6 ounces. Beatrix Reid was born one minute later weighing 1 pound 10 ounces. Their birth came earlier than we had hoped (26 weeks, 4 days), but based on our Doctor’s advice, this was the best possible course of action.

These precious girls are tiny and, as with all preemies, there are a lot of risks and challenges ahead, but so far the Doctors seem pleased with their progress. We have been told to expect ups and downs, and we know we have a long road ahead.

The beautiful irony in all of this is that yesterday Megan and Liz got the results back from the DNA test they recently took to find out, finally, if they were fraternal (as they’d always thought) or identical, and the results showed a 99.9% chance they are identical. So on the day Megan learned she was an identical twin (as, most of you know, am I) she gave birth to identical twins.

Please keep Alexis and Beatrix in your thoughts and prayers as they adjust to life outside of the womb.

 

Megan and I spent four days in the hospital as she recovered from her c-section, and in that period we made the journey down the hallway from the maternity ward to the Neonatal Intensive Care Unit (NICU) roughly a dozen times.  It began to sink in how radically and irrevocably our lives had just changed, both in the short term and long.  Both babies had safely been delivered, so that hurdle had been cleared, but a new set of worries now lay before us: would our girls be OK?  To see them is to understand how incredibly tiny they are – the smallest living humans I have ever seen in my life.  To envision them as even the size of Clio when she was born – 5 pound, 14 ounces – is hard to conceive at this moment.

In addition to worrying about Alexis and Beatrix’s health, we had also to consider our own.  Megan would be recovering from surgery, must get up every three hours to pump, and faces the challenge of spending time with the twins while also caring for Clio.  I would need to find the strength to balance my work as a teacher and coach with my commitments to caring for Megan and Clio along with making daily visits to the NICU and striving to get enough rest to sustain that schedule for months. I make no claims of exhibiting courage.  You deal with a trial like this the way you deal with being thrown off a cliff.  I am still afraid to even touch our babies, fearing I’ll accidentally knock a tube or IV (Megan is doing much better, already helping out with changing diapers, taking temperatures, and holding Alexis and Beatrix).  Coming back to work in some ways feels like the easy way out – a way to keep my mind occupied on the world of teaching social studies and away from the fears that would otherwise occupy my mental space (certainly the set rhythms of the school week are a welcome contrast to the unsettling and unpredictable world of the NICU).

My weekday now looks like this: After a restless night of sleep where I get up around 2:30am to help Megan get her supplies for pumping, I wake up at 6:00am: shower and grab my lunch, wake up Clio and get her breakfast, drop her off at daycare on my way to school.  I teach and coach as I always have, though I now leave Cross Country practice earlier than I otherwise would prefer thanks to the invaluable compassion and understanding exhibited by Coaches Westphal, Kupres, and Snee – all of whom have picked up my slack over the past weeks.  I arrive home and get updates from my wife, try to play for an hour or so with Clio, then do a few chores (wash the dishes, make lunch, get my clothes and coffee ready for the next day) before drawing Clio’s bath around 8:00.  A few bedtime stories later, we lie her in her crib, and once she drifts off to sleep and our babysitter arrives, we make our now familiar 15 minute drive down Plainfield and County Line roads to Hinsdale Adventist Hospital, park, and take the elevator to the fourth floor where the labor and delivery rooms, maternity ward, and NICU are all located.

Upon arrival, the first thing you do is wash your hands.  We then walk to the southwest corner of the 1st of 3 rooms where Alexis and Beatrix lie in their incubators, tubes and IVs attached, developing in an environment that is the closest humans could come to simulating a womb.  We greet the nurses, lift the blankets draped over the incubators to simulate night, and say hello to our girls.  A typical visit includes an update from the nurse (or Doctor if he/she is there), helping with the ‘assessment’ (taking of temperature, changing of diaper, getting weighed) and giving the girls a swab with a little bit of mom’s milk.  On a really good day, Megan will get to hold Alexis or Beatrix to her chest for an hour – a practice known in the NICU as kangaroo care, which research suggests improves the baby’s health and aids in mother-child bonding.  On a tougher visit, alarms will sound almost continually, notifying the nurses that our babies aren’t getting enough oxygen, or had a dip in their heart rate, or are too cold.  On one early visit, before I learned how to interpret these alarms, I broke into tears on my way out.  I’d felt like I was in a war zone – that each alarm was a bomb going off, and after two hours of near constant beeps, my composure was shattered.   I am always anxious when I arrive (as I was during the pregnancy phase, before every ultrasound), but usually now after a few minutes go by I begin to relax a bit more.  While my emotional state these past few weeks has tended towards fear and worry for the health of Alexis and Beatrix, this has been substantially counterbalanced by feelings of gratitude: for the amazing amount of support we have been offered, for the good fortune of living close to the NICU, for the professionalism, expertise, and compassion of the nurses and Doctors who tend to Alexis and Beatrix.

The girls have had their challenges.  Both sustained infections during their second week of life; both still need help breathing.  Alexis has had to get medication for her heart, while Beatrix has had trouble gaining weight.  Two weeks after birth, both remain weeks away from weighing even two pounds.  But, their vital signs are good, the nurses and doctors assure us their progress is typical for babies of their size, and every day that goes by brings good news, as it represents another day of growth and another day for their internal systems to develop.

The Doctors do not – and, ethically cannot, make any guarantees.  As we keep being reminded, ‘you are not out of the woods.’  My greatest fear remains that Alexis and Beatrix will not survive.  I suppose, though, that this fear will never go away: not after we are discharged from the NICU, not after the girls are old enough to talk and walk, not after they begin school, nor even if they become responsible and successful adults with their own families.  I know this because I know my parents continue to worry about me.  I know from teaching for 15 years how much parents worry about their own children.  And this is, of course, the reality of love.  You cannot have love without fear and worry.  So, here, the comparisons to Cross Country (indeed team sports in general) are apt.  To be fully invested in something is to accept the hardship, frustrations, and disappointments that will invariably accompany any endeavor for which you are ‘all in’ (it is only the athletes who are NOT fully committed who avoid these challenges; but for them, glory will never be the prize).  The greater you care about something, the more you expose yourself to hurt.  But consider that equation in reverse.

The past few months have marked the hardest period of my life, but, as of this writing, my worst fears have not materialized, and it remains possible that September 5th, while the scariest day of my life, may also prove the best.  It’s been a profoundly life-changing experience, to say the least.  While sitting next to Megan in the NICU as she cradles one of our daughters to her chest, while running, while lying in bed at night, I’ve had plenty of time to reflect.  Below are some additional scattered thoughts to share:

 

-This challenge has reinforced how incredibly fortunate and privileged I truly am.  The question is not: why did this happen to us?  It is rather: how is it possible we’ve been so fortunate to have both girls still living and with a chance to do well?  Had this birth happened 30 years ago, it is doubtful either girl would be alive.  If it had happened in many other places in the world, the same would be true.  That we happen to live so close to excellent doctors and hospitals, that we are surrounded by people who have the means and desire to help us, that we have the insurance to cover what would otherwise be insurmountable costs – all of this is good fortune far beyond the norm.

-NICU Doctors and nurses have the most important job in the world.  Period.  Sometimes as a teacher I am lauded for choosing education as a vocation.  Teaching is important.  Not as important as what my NICU nurses do.  I once had a conversation with a man who argued that entrepreneurs were the drivers’ of America.  I respect entrepreneurs.  I don’t think they are more important than the people who work in the NICU.  NICU workers tend to literally the most vulnerable humans in existence.  They make entire lives possible.  I never previously had any clue what a NICU looked like or what employees of the NICU do.  I now understand how special a person you must be to choose to work in the NICU as your life’s’ work.

-Health care is as much art as science.  There is no prescription.  Each individual, even identical twins, is different, and has unique needs.  I’ve participated in conversations with Doctors as they’ve weighed the pros and cons of different treatment options.  In the field of health care, people take a much more collaborative approach than in other professions.  Our girls are seen by 6 main neonatologists who are in constant conversation with each other about what they are seeing and what they think the best way forward might be.  Each of these Doctors has their own network of professionals who they are in communication with, bouncing ideas off each other and inquiring about different fields of research.  They have the wisdom and experience to make educated decisions about what to do, but they can never be sure how these decisions will actually play out, since each one of us reacts differently.  Thus, it is a constant feedback loop of trying out different treatments, adjusting, and finding the best path.  Wean the oxygen a bit, and see how this impacts the heart rate.  Too much weaning?  Go back up.  Readjust the tubing.  Monitor weight.  See how much the babies are urinating.  Check their white blood cell count.  All of these markers help the doctors assess the health of our babies and inform their decision on what to do next.

I find this inspiring.  I think it is a useful model to think about coaching.  What if for each athlete we could create a network of professionals who were in constant communication about that athlete, charting a plan for them that is adjusted regularly based upon different metrics such as resting heart rate, hours of sleep, body temperature, and self-reports about physical and emotional well-being?  It’s not really possible with 100 guys on the team, but if nothing else, this experience reminds me of the importance of seeing the whole athlete and consulting with others who might see the athlete in different contexts.

-When you encounter true struggle for the first time, you learn that there are people you know who have depths of compassion that you never previously knew about.  I have discovered that I have people in my life that I did not know as well as I thought.  I never fully appreciated how amazing these people are.  The kindness others have shown to my family is beyond any I’ve ever shared with others, and makes me want to do a better job of thinking beyond myself and not being shy about giving help to people when they need it, even when they are too tired or overwhelmed to ask.  Relatedly, I’ve become more compassionate myself.  I can see strengths in people I hadn’t previously recognized.  Robert Callan is a senior on our Cross Country team.  I have had both him and his twin sister Grace as students in my East Asian Studies course.  Both were conscientious, polite, responsible and kind.  Robert is not among our faster runners.  His PR for the 1600 Sophomore year of track was 6:34.  As a junior, he improved his time to 6:04.  This year, our goal is to help him break 5:30.  Here is the amazing part: Robert’s mother gave birth to him at 24 weeks and 3 days.  He weighed barely over a pound.  One of the biggest challenges premature babies face is lung-development.  And yet, now Robert is training to be an Eagle Scout, headed to college next year, and a faster runner than 95% of his high school classmates (only a handful of non-Cross Country runners could plausibly claim to run faster).  He and his sister are living miracles, and I never appreciated that until now.

-Do your job well, honor your commitments, share your passion.  Do this because it is a fulfilling way to live life.  But a very unexpected and amazing consequence of living this way has been that during this past few weeks when my family has never had a greater need for support, we’ve discovered a huge network of people stepping in to lift us up and carry us through the challenges we’ve faced.  So many people have been there for us – our immediate and extended families, my work colleagues, the families of current and former runners, friends from all different phases of our lives-  sending well wishes, bringing food, caring for Clio while we visit the NICU.  It has genuinely been awe-inspiring, humbling, and overwhelming to accept so much help from so many caring, kind, thoughtful individuals.  To all of you, words are insufficient to express the depth of our gratitude.

We who teach, who coach, who parent, who are students – all of us have benefited from the work and care of others.  Every individual is unique and beautiful and has inherent value; but each of us as individuals cannot flourish without families, networks, teams and institutions designed to nurture us – each of those in their own way an incubator promoting growth.  God willing, Alexis and Beatrix will grow up and eventually attend school at Hinsdale South.  When they are old enough to understand, I hope I am able to convey to them how many different people are invested in their well-being and growth, how wide their network of support, how much we should be grateful for each new day.  It is a lesson I am only now fully comprehending.

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5 thoughts on “Sometimes you can’t make it on your own

  1. As a mom of two I know what it is like to have an immense amount of worry over even the slightest chance that something may be wrong so I can’t even imagine what you guys are feeling. I held back tears while reading your description of what visits are like.. I was petrified after having a single abnormal stress test… Prayers to you and your family for the strength of the babies and strength of you all!

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  2. Noah, I am reading this in Chapel Hill, NC, where I am visiting my sister Christy. What a beautiful gift you have in your writing – thank you for this post! Our Chris was a preemie, and Cayley will be a NICU nurse at the end of this year when she graduates from Michigan – it really will be a rewarding and hard career! You are right in that you have a virtual ARMY praying for your family and so many who truly love you all and care for you. Can’t wait to join in the help when we’re back. Sending love to you all!

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  3. Thank you for sharing your heartfelt and most intimate experience; you have touched my heart deeply and I hope your beautiful daughters, Alexis and Beatrix will find new strength and wellness in their beings each day. Sending love and support to you and your family.

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  4. That was beautifully written, Noah. I hope it provides some comfort to hear that my very good friends delivered twins at 21 weeks, and it while it was pretty scary for several weeks, those two little fighters started kindergarten earlier this month. And they ride bikes, and play soccer, and swim. They have an incredibly normal life. Wishing for the same for you, Megan, and Clio.

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