Cesarean
Kim Groninga
The patient was taken back to the operating room where epidural anesthesia was found to be adequate. The patient was placed in the dorsal supine position with a leftward tilt, prepped and draped in the normal sterile fashion, and good fetal heart tones were noted until abdominal prep.
There are moments in my personal history at which I am afraid to look. Take the day before we moved into our current home. During our final walk-through, Carly sat in a sand box under a two-hundred-pound 4x4 that was merely balancing on the A-frame around her. The current owners, no doubt immersed in the hundred small tasks of moving out, failed to recognize the danger of an unattended, half-assembled swing set. If I look over my shoulder, I’ll imagine us not noticing in time and, instead of Tim snatching her up in a bundle, I’ll see the falling beam and Carly’s small face turning upward to meet its weight. I’ll see a neighborhood we had not yet met gathering around our crumpled two-year-old being loaded into an ambulance. I’ll see my purse drop into the yard, my body lean and run. Or—if I look back—I’m afraid I’ll see that, in high school orchestra, when Brett Shollenbarger, a senior, climbed out the back window as a prank during rehearsal and fell through, it was his throat the glass sliced open instead of his face. As I see him in my memory catching overflowing blood in his cupped hands, I will also see death, face to staggering face. If I look back, I’m certain the timeline will re-open, and crucial moments will ricochet wildly in wholly different directions. Like the riptide we originally avoided slipping back in and yanking Carly and her uncle Brian into the ocean off the empty beach. If I turn around, I’ll discover the real me screaming for her from the shore.
Epidural anesthesia was found to be adequate, and a Pfannenstiel skin incision was made and carried down through the underlying fascia. The fascia was dissected off the rectus muscles inferiorly and superiorly. The rectus muscles were separated in the midline, and the peritoneum was entered superiorly and bluntly with extension and with good visualization of the bladder. A bladder blade was inserted, the vesicouterine peritoneum was grasped with pickups, and an incision was made and extended laterally.
Celestial Blue — a name I dreamt of bestowing upon my daughter. Little C–, I will tell you about your grandfather: He wore a blue collar to work — a black one home. His doctors wore masks. I dream them, but I don’t remember. In another dream, I am stretched bank to bank across a great, blue river in a dark, metallic mist — infant girl to tingling hands to clenched teeth to locked knees to grandfather she’ll never meet. I wake to those same doctors tugging her from my splayed body, working with blades behind a screen. I try to tell them to wait. A gloved hand holds me down with a mask. Below, water — so clear I can see its infinite deep.
A bladder flap was created digitally. A bladder blade was reinserted, and a transverse hysterotomy was made with a scalpel and extended bluntly. The bladder blade was removed, and the baby’s head was delivered. The baby was DeLee suctioned in womb. The body was delivered; the cord clamped and cut; and the baby was handed to awaiting Family Practice physicians. Cord gases were sent.
I worry about things in envelopes. I seal, open, re-seal, and re-open them to check their contents. I waste tens of dollars in stamps every year because some of the envelopes get ruined. I worry, too, about things in closets: shirts losing their balance and slipping from their hangers first one shoulder then quickly the other; dresses hung too close together to find plumb. I worry about house fires and the deep end of the pool and forgetting how to sleep and the speed with which pavement flies underneath moving cars. I worry about dreams — about how quickly a closet full of tiny pink clothes can become a closet full of ghosts.
The placenta was allowed to deliver spontaneously. The uterus was exteriorized, cleared of all clots and debris. The hysterotomy was repaired in a running, locked fashion with O-Vicryl. Good hemostasis was achieved using O-popoffs. The gutters were then cleared of all debris, and good hemostasis was noted. The fascia was closed in a running fashion and the subcutaneous tissue was closed using interrupted sutures — both with O-Vicryl. The skin was closed with 4-O Dexon in a running fashion after good hemostasis noted of subcutaneous tissue. The patient tolerated the procedure well.
Tim saves Carly’s baby teeth. He keeps the little rattlers in a plastic trinket box where they knock around bumping their red roots together. He plans to use them to save her life someday. Instead of saving the future, I save the past: a photograph of her and me and the snowman whose head we made so big the neighbor guy had to put it on for us; recordings of her singing a made-up father’s day song; her four-year-old handprint in the sidewalk.
Sponge, lap, and needle counts were correct x 2. Dr. Williamson was present for the entire procedure. The patient was stable and taken to the recovery room.
Kim Groninga, "Other Things that Grow" (Final Thursday Press, 2010), teaches at the University of Northern Iowa. Her poetry and nonfiction have appeared in Atticus Review, North American Review, Mid American Poetry Review, and elsewhere. She lives with her husband and two rescue dogs and loves wildflowers, farm animals, and theatre.