Daddy gets a guilt trip.

Daddy gets a guilt trip.

Daddy gets a guilt trip.

Notes on fatherhood.
April 6 2007 2:46 PM

The Hospital

Daddy gets a guilt trip.

This article is part of an ongoing series by Michael Lewis about the birth of his third child. Click here to read the other entries in the series. Michael Lewis first began his "Dad Again" column after the birth of his second daughter, Dixie, in 2002. Click hereto read about that delivery.

Walker on a gurney waiting for an ambulance. Click image to expand.
Walker on a gurney waiting for an ambulance

I'd driven an hour from home to give a talk, and was up on a stage with my cell phone off, when Tabitha left three messages. In the first, she said Walker was having trouble breathing and so she was taking him to the doctor; in the second, she was on her way from the doctor's office to the emergency room; in the third, she was on the emergency-room pay phone, either crying or trying not to cry. "He has RSV," she said, mysteriously, and added that he was strapped to a gurney and waiting for an ambulance to take him to a place that handled infants with RSV, whatever that was. Her cell phones wouldn't work there, she'd been told, and there was no number on which I could reach her.

And so I found myself doing 85 across the San Mateo Bridge, toting up in my mind how little I'd done in my son's 11 weeks on earth to keep him alive. Seventy-six nights and I'd spent zero in the same room with him, unless you counted the night of his birth, and the few times I stayed up until midnight to feed him a bottle of pumped breast milk before handing him over to his mother. Eating was another thing he'd done almost entirely without me: eight times a day, or more than 600 daddyless meals in total. His diaper needed changing about as often as he ate, yet I'd done that seven times, and remembered each event. He slept 16 hours a day, leaving eight in which he needed to be tended. Roughly three of those went to feeding and another to bathing and changing clothes—two more of his activities I'd managed to avoid entirely. That left him just four hours a day of what might be called discretionary leisure, or about 300 hours total, of which I'd occupied no more than 30.

Walker getting chest X-rays 
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Walker getting chest X-rays
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Those were the raw stats: They shocked even me. No matter how you spun them, they suggested a truly awesome paternal neglect. (Seven out of 600 diapers!) It had to be some kind of record, at least in the modern era of fatherhood. The achievement was probably in some small part due to what might be politely called an attitude problem. When asked to take the baby, even for just a few minutes, I instantly become a corporate executive sentenced to a long jail term. I race around the house cleaning up my affairs, wondering what needs to be done before I'm removed from society. But the larger part of my neglect arose from changes in the structure of our family life, brought about by the addition of a third child. Once a collectivist farm, we now had more in common with a manufacturing enterprise, beginning with a ruthlessly efficient division of labor. Mama took care of the baby; Daddy took care of everyone else, or paid other people to do it for him. Family productivity remained stable and, amazingly, Mama didn't complain about the arrangement. Many times in the past 11 weeks, I expected to be chastised for doing so little but instead found myself appreciated for doing anything at all. On those rare occasions, I was no longer a father doing his duty but an assembly line worker who has rushed down the conveyor belt to rescue a fellow worker who has fallen behind. A company hero. Worker of the month.

Walker with tubes in his left foot and wires taped to his chest 
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Walker with tubes in his left foot and wires taped to his chest

On this afternoon, the assembly line finally ground to a halt, its gears gummed up with paternal guilt. It took 90 minutes to get home, drop the girls with our endlessly generous neighbors, and speed back to the hospital. There I find Walker with two tubes up his nose, another in his left foot, and wires taped to his chest. Dried blood stains the blanket by his feet, where nurses have tried and failed to insert an IV drip. He looks bad, but his mother looks worse. She hasn't slept properly in months, and she's spent the last five hours watching this baby she's been caring for poked and prodded with needles and strapped down on gurneys. Four different people had offered her four different explanations of RSV, but the hardest piece of information she'd come away with was that she should expect Walker to be in the hospital for at least a week. "Don't worry," she says, reading my mind. "I'll spend the nights with him."

Tabitha and Walker
Tabitha and Walker

Thirty minutes later the door closes behind her, and she's gone. It's just him and me, for the first time, really. Except for his sad little wheezing sounds and the beeping of the machine that measures the amount of oxygen in his blood, the room is silent.

RSV, it turns out, stands for Respiratory Syncytial Virus. From the point of view of Berkeley's infants, it might as well be the bubonic plague. The hospital floor has 28 beds, and 25 of them are occupied by infants with RSV, who share one other trait in common: older siblings in school. School-aged children are the rats of our time. After a day of happily swapping germs with their peers, my children apparently returned home with what probably felt to them like a mild cold, and kissed their baby brother—who promptly lost his ability to breathe. There's little that medicine can do for him except attach him to a machine that measures the oxygen in his blood, and, if he's about to suffocate, attach him to an artificial respirator.

Walker in his hospital room 
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Walker in his hospital room
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My job as his attendant is to decide when he's about to suffocate. Over his bed is a black box that blinks bright red digits, like a radar gun. One hundred is a perfect score. Under 90 and the box starts to beep, and I'm meant to call a nurse to suction the mucus from his nose and mouth. For an hour or so, his number is a reassuring 94, but then it plummets, and I call a nurse. Twenty minutes later it happens again, and then again and again. It's about six at night when at length he is finally able to breathe properly, and falls asleep. That's when the phone rings. I didn't even know there was a phone, but there it is, howling, right beside his ear. He wakes up and begins to cry. I pick it up. It's a woman who says she's from the hospital's "financial counseling department." The department has checked our health insurance, she says, and discovered that we have a $100 deductible.

"So?" I say. Walker's now trying to holler. Only he has no voice, so the cries emerge as tiny gasps.

"How do you want to pay?" she asks.

"Just send it to me," I say.

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"We typically collect before you leave the hospital," she says.

"Can't you just stick it in the mail?" I ask.

"I'll send over by courier," she says.

Walker's nurse Kim 
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Walker's nurse Kim

Forty minutes later the patient is soothed and sleeping again when in charges a nurse. "Where's Mama?" she asks, loudly. Walker wakes up and begins to cry. The nurse tsks tsks around him until he is inconsolable and then finally says, "There should be more fathers like you." "There are!" I want to say, but before I can, she's gone, and I'm working to get him back to sleep.

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Thirty minutes later the courier bangs on the door, with the bill, waking him all over again. And so it goes, for the next 24 hours. Bill collectors, nurses, doctors, interns, floor cleaners, linen changers: As soon as he's recovered from one of their visits and fallen back to sleep, another bursts into the room and disturbs him all over again. Each time he wakes, he cries, and each time he cries, he generates mucus, and each time he generates mucus, he begins to wheeze and his radar-gun readings plummet. The odd thing about this is that the doctors all admit that there is nothing they can do for him. He's in the hospital only so he can be near an artificial respirator. But the hospital seems only to increase the likelihood that he'll need an artificial respirator. Such is the state of our health-care system: They keep you from dying, but somehow leave you feeling you're getting the raw end of the deal. Asking politely for peace and quiet does no good; the nurses change every four minutes, and the new one never has any idea what the old one did or didn't do. After the 15th time he's awakened, I decide that it's time for a show of paternal authority. I make a sign:

PLEASE DO NOT DISTURB.
I'M SLEEPING.
THANK YOU.
WALKER.

The "Please do not disturb" sign 
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The "Please do not disturb" sign

I tape it to one side of the door, and drag the chair that doubles as a bed against the other, so that no can enter without climbing over it, and me. Then I hunker down, like some Montana survivalist, and wait for the enemy. The first assault comes about 10 o'clock that night: a new nurse.

"Can I help you?" I say curtly.

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"I just want to look at him."

"Why?"

"We're supposed to," she says—which is to say that even she knows she serves no good purpose other than to collect evidence for any future lawsuit.

"Nope," I say.

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And she leaves!

Walker with oxygen tubes
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Walker with oxygen tubes

I repel several more assaults until, finally, word must spread that there's a total asshole guarding the little boy in Room 5426, because we find ourselves well and truly alone. I change his diapers and feed him and suction the mucus from his nose. I notice for the first time that he has my hands and feet. I study the little heart-shaped birthmark on the back of his head. I discover that if I hold him to my chest and hum against the back of his neck, he falls right to sleep. Tabitha comes and offers to take over, but the truth is I don't want to leave: He feels like my jurisdiction. After every new child, I learn the same lesson, grudgingly: If you want to feel the way you're meant to feel about the new baby, you need to do the grunt work. It's only in caring for a thing that you become attached to it.

And he gets better, and better. On the third day, he's hitting 100 on the radar gun, and seems almost himself. At 6 o'clock that morning, an intern—a student who is there for no reason other than to satisfy his curiosity—catches me off guard in the bathroom. But I hear a stir. I bound out to discover this child-doctor bent over my son, preparing to apply cold metal to sleeping flesh.

"What do you think you're doing?" I snap at him.

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"Can I listen to his breathing?" he asks. He's not even a doctor. He's a tourist.

"No!" I boom, Shrek-like. I haven't slept in two days and I'm in no mood. Still, it comes out a more menacing sound than I intended. The poor kid actually trots out the door. Then I look down at Walker and, unless I'm mistaken, he's laughing. He's got tubes coming out of every orifice, and he's having a ball. We're just two guys in a foxhole, defending ourselves against repeated, ceaseless assaults from the hospital staff.

"How you doin', buddy?" I say.

Getting better 
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Getting better

"Coo!" he says, and smiles. It's a big sloppy grin. It's then that the doctor arrives, with good news. She points to the black box over his head—his number flashes between 94 and 96—and says, "He's the strongest on the floor." My first thought: There are 24 other kids with the same thing and they're all more likely to die than he is, and … since no one ever heard of 25 kids dying in a children's hospital … he's not going to die. My second thought: He's winning the RSV tourney! I look down at him, proudly. He smiles again. I'm hooked.