Every six weeks, Jack gets to visit his namesake, Dr. Jack Rychik, for his regular cardiology appointment. On Tuesday, I had the privilege of escorting the Munch (solo this time) back to the mothership: the Cardiac Center at Children’s Hospital of Philadelphia.
This visit happened to occur in the immediate aftermath of an especially rowdy nor’easter that dumped nine inches of snow on metro Philly, knocked down more trees than Paul Bunyan, and — to understate the matter — made travel especially difficult.
Even under normal circumstances, these appointments are grueling. They entail a 4-5 hour gauntlet of mini-appraisals: weigh-in, evaluation, blood-pressure monitoring, EKG, echocardiogram, and then final consultation with the great man himself.
First hurdle is driving into University City, which is to transportation what messages in bottles are to mail delivery.
Then there’s navigating the byzantine maze of CHOP’s parking infrastructure, which was evidently designed by a committee of blind schizophrenics. The last logistical caper is the main hospital itself, which is laid out sort of like Willy Wonka’s factory, except without the delightful spectacles and delicious treats.
The time in between appointments is punctuated by endless strollering down anonymous corridors and skull-numbing bouts of loafing with the rest of les miserables in the putridly-lit cardiology department waiting room on the third floor.
Good thing Jack isn’t a serial melodramatist and hopeless complainer like his old man. Kid’s a pretty tough nut, in fact.
Some grim context that also needs to be mentioned: these visits invariably require blowing through Jack’s nap schedule like a wall of wet toilet paper. This time, we were due to check in at the hospital when Jack would ordinarily be going down for his second nap.
Now, I might assume everyone could appreciate why that’s a huge frigging problem, but in case not, here’s my quick (I mean, for me) dadsplanation:
When I’m tired (I mean like Arctic expedition tired), I can be, I’ll admit, kind of an asshole. (My wife will no doubt opine in the comments section below). And by that I mean more of an asshole than one might think I am ordinarily. Point is, it’s a grey area. And in that wretched state I try to avoid humanity to the furthest extent possible.
When babies get that tired, they freak out and start wailing hysterically and punching you in the face. They go outside and smash all the windows in your car with a tire iron, and then they come back inside and take all your milk and juice out of the fridge and dump it down the sink. It’s ugly.
When babies get tired and hungry, lights out. They’ll reach out from behind and murder you as you’re driving them to see their cardiologist, right before they explode like a smashed pumpkin.
12:40 PM. With that unsavory scenario in mind, I tank the Munch up before we head out to traverse the craggy roadways of West Philly on our way to the hospital. Check-in is at 1:30 PM. As the car chatters and lurches and pounds its way toward our destination, I strike up a conversation with Jack to take my mind off of the inevitable repair bill and the torrent of dollars that will be fleeing our checking account.
“So, Munchie, do you know how you got your name?”
I glance at the rear-view mirror. I can see Jack’s cherubic face in his headrest mirror. He doesn’t reply. Such a polite young man.
“Well,” I begin, “your mother and I hadn’t been able to agree on a name for you. She has a thing for Australian rugby player-types, and she wanted to name you Aidan or Lachlan or Connor or something like that.”
“ ‘Nix,’ I’d said. ‘We’re not naming him after one of your Kiwi boyfriends.’ ”
Cue recriminations, cognitive distortions, invective, silence.
(The actual conversations were playful, but Jack insists on having his stories punched up a bit).
Anyway, on this particular night, as we were sitting in the living room gazing at our spouse-ignoring devices, I had an idea (it does happen).
I looked up and said, “Why don’t we name him Jack?”
“Huh.” She didn’t hate it. In fact, she was intrigued. “Why Jack?”
“After Dr. Spray,” I replied.
Dr. Spray is the head of CHOP’s cardiothoracic surgery team, and a bona fide international celebrity as far as pediatric cardiothoracic surgeons go. A number of the CHOP moms on our heart babies Facebook page swore on a stack of parenting books that it was Dr. Spray or bust for them. If he wasn’t available when they were scheduled for surgery, well then they’d just keep their babies carbon frozen like Han Solo until he was available.
We’d actually been able to book Dr. Spray to do Jack’s first procedure (we have a connection at the airport). But Jack decided to arrive three weeks early, when Dr. Spray was presenting at a conference (or maybe he was playing golf at Augusta and that’s just what they told us). Damn kids.
“Hmm,” Mom replied. “ ‘Jack.’ Interesting.”
“Could be good luck,” I said. “Maybe Dr. Spray’ll do something extra celebrity-like if he knows he’s operating on another Jack.”
She marinated on that for a few moments, placed her hands on her belly and closed her eyes. She looked up.
“I like it,” she said. “He feels like a ‘Jack.’ ”
“Fantastic. Knocked that out.”
We went back to doing our thing.
Ten minutes later, I looked up again. “Shit.”
“I just remembered. Dr. Spray’s name isn’t Jack. It’s Tom.”
“I was thinking of Dr. Rychik.”
“Really?” She looked perplexed. “I thought his name was Tom.”
I pause after the payoff so the Munch can chuckle, applaud, burp.
Nothing. I glance at the rear-view mirror. Jack is asleep.
Not for long. It’s 1:15 PM. Traffic flow alternates between jailbreak and parade speed, detours abound, and we’re running late. Punctuality is not a reciprocal thing with medical professionals. They will make you wait even if you’re on time, but if you’re late you get the gong.
We’re about seven or eight blocks from the hospital, which even in normal weather means nothing in University City. It could take you five minutes or fifty. However, the nor’easter has, if possible, gunked up city traffic beyond its normally sclerotic pace.
Google Maps isn’t much help in a situation like this. Municipal crews are arriving in real-time to clear away storm debris and snarling traffic in the process as soon as they arrive. One moment, a road is yellow and your ETA is 12 minutes. The next moment, you stop at a red light, sip some styrofoam coffee, and glance at your phone. The road is now blood red and your ETA is whenever the Browns win the Super Bowl.
My previous impression had been that outside of its park space, the City of Philadelphia was largely treeless. Or perhaps arborially underprivileged. Wrong. Turns out there are plenty of trees in the city. Or at least there were. On Tuesday, most of them were blocking its roadways.
At this moment, a large oak — probably planted by Benjamin Franklin, from the size of it — is blocking Spruce Street. A city crew is busy chewing away at the big tree. The racket wakes Jack up. We need to get around this obstruction, stat.
“Time to get Knight Rider, Munchie,” I tell Jack as I hook a left on 42nd.
Children and cars present a dilemma. On the one hand, you’re obliged to be extra-cautious with kids in the car. On the other hand, kids are the main reason you’re liable to be running late for something in the first place.
But they don’t heart me for nothing, folks. I am safe and expedient and I successfully skirt the law. From 42nd, I bank a right on Locust, and punch it through a yellowish light at 41st. At 40th and Locust, I make an if-you-say-so right at a no turn on red, get some fantastic luck at the next light and sail left to get back onto Spruce.
“Excellent driving, Michael,” I say to the totally impassive Jack.
1:21 PM. We’re in a three-car lineup waiting for a ticket to get into the underground garage at the main hospital.
The uniformed attendant is a large, garrulous man, as Philly as Dalessandro’s cheese steak. His Eagles ski cap looks Ron Jaworski-era. He’s talking in an animated manner to the driver of a burgundy SUV with New York plates. I crack the window. He seems to be giving the driver directions.
“Shit,” I mutter. Sounds like they’re re-routing cars away from the main garage.
The SUV leaves the roundabout back onto Civic Center Blvd., and after talking to the attendant, the car in front of me does the same.
This ain’t good, I think. Something’s up.
“How you doin’, buddy?” the attendant asks me.
“Not bad. We’re here for my son’s appointment. Cardiac Center, third floor.”
“So, what I told those two is that the garage is packed, from what they’re telling me. Flu season. I’m telling people to go down and use the Wood Garage. But it’s up to you.”
“If you don’t care, I’m willing to take my chances.”
“Fine with me. Good luck.” He hands me a ticket and the gate lifts.
It’s a gamble, but I figure we have nothing to lose. They’ve sent search parties after people who parked in the Wood Garage. Plus, I’ve convinced myself that I know a few secret spots down there.
Didn’t need ‘em. The garage was more full than usual, but we found a space within five minutes, and were checking in on the third floor by 1:33 PM. Fortunately, three minutes won’t get you sent to Palookaville.
2:01 PM. First up is weigh-in and blood-pressure. Jack is by now looking ragged. His pink-rimmed eyes are vacant as Gloria, the RN taking his blood pressure, makes a series of rapid clicking sounds with her mouth, snaps her fingers and rattles her ID lanyard to get Jack’s attention. I’m not sure why she wants his attention, but she does, and her animal-trainer methods aren’t getting it.
Then she puts her hands on her hips, and says with a coquettish pout, “What’s the matter, Jack? You don’t like Gloria?”
It’s like she’s flipped a switch. The Munch produces a huge smile and turns his head to the side. He looks back at Gloria, grins wolfishly at her, and coyly fingers his mouth.
“Uh oh,” I say. “Now you did it.”
“I can see that,” Gloria says. She turns to Jack. “Oooh, you’re trouble.”
2:43 PM. Blood pressure looks good, so we’re on to EKG. Jack is now fully roused, looking around for the next contestant to flirt with. That would be Catherine, the EKG tech. She doesn’t stand a chance. By the time we’re done, she’s so smitten I almost expect her to ask if she can babysit.
The EKG is the first test in this battery you can’t get results for when it’s done. You can ask, but the tech will tell you, plausibly, that the results are “interpretative.” That means it’s the doctor’s job to tell you what the results mean, and the tech’ll get a righteous ass-chewing if they tell you what they think.
The doctor will tell you what they think the results mean, eventually, but it’s only one piece of an infinitely complex puzzle whose shape will never cease changing. So you’re better off not thinking about it too much. Or at least I am.
3:47 PM. We spend about 40 minutes in the waiting room before we’re called in for the main event: the echocardiogram. It’s late-afternoon. Jack had a second wind of sorts, but his sails are down.
So are mine, but for different reasons. The burden of not knowing about your heart baby — the way you know within the guardrails of probability about your regular kids — bears down enormously on parents.
The weight is constant and it is cumulative, the way that water pressure increases the deeper you sink. These children might look fine, and then the parents get terrible news. Or they might look fine and be fine. Or they might look like hell, but it turns out to be a simple fix. Rainbows appear, unicorns prance through your front yard. You never know.
And you never will. You get used to not knowing, in as much as human beings get used to damn near anything. But not knowing is a heavy load nonetheless, and it is unrelenting, and there is no one in the world to help you carry it — not even the other parent. Maybe the only one who can help you is your baby, because babies exist in the eternal present, which is where you need to stay in order to survive.
The sonographer leads us into the echo room, and as I wheel Jack’s car seat stroller into a corner, I’m fumbling around in the commando bag for Big Blue, Jack’s favorite pacifier. The last time I did this with Jack, he was grumbly as hell. That time, the evidently-childless sonographer wanted to give him a sugar pop to calm him down. This time, I’m prepared.
I give him Big Blue, lay him on the exam table and unzip his onesie. The long scar on his chest glistens in the low, raking light. As the sonographer prepares her equipment, Jack munches quietly on his pacifier and I fall back into a chair next to the exam table.
The echo room is dark and peaceful, strangely removed from the world. The steady hum and whirr of the lab equipment fills the space. It feels like a womb. A bright X-ray lamp on the far wall even simulates the opening of a birth canal. The Munch falls asleep on the exam table, and at this rate I’m not far behind him.
The sonographer slathers aquasonic gel on Jack’s chest and begins probing the contours of his heart with a round-headed wand. Colored pools appear on the screen. Each color represents the velocity and direction of blood flow from different chambers of Jack’s heart. Jack periodically startles awake and then he drifts back to sleep as the sonographer turns knobs, moves the wand, adjusts sliders, taps keys on her keyboard. After about ten minutes of this, I’m in a trance.
The exam takes a little over thirty minutes. The sonographer stands and quietly says that she’s going to bring the doctor in, that he might want to take more pictures, she doesn’t know.
I’m alarmed. There’s something about the way in which she says it, her vagueness, that I don’t like. I think she’s seen something.
She closes the door behind her and leaves me and Jack alone in this dark, somnolent recess of the hospital. Jack is awake again, sleepy but still munching quietly on Big Blue.
I scoot my chair forward and gently trace my fingers along the crown of his head. “How are you doing, Munchie?”
He stares at me, blinks, munches.
“I’m okay, I guess, thanks for asking. I’ll be honest, though, right now I really wish that this was it. The last stop. I wish this was like, I don’t know, graduation or something, like one last visit to the doctor before you’re cleared for life and we never have to come back here.
Munch, munch, munch. Blink.
“I know. That’s not the way it works. We’ll be coming back here for the rest of your life, and that’s if we’re lucky. You’re a sweet baby, and I appreciate your patience. I’m just talking like this because I’m a little worn out, and I don’t have the gas to make small talk right now. Plus, you don’t understand me anyway.”
Jack smiles. Over the hum and whirr, the sounds of a ten-ton galactic poop reverberate in the darkened lab.
4:39 PM. Jack and I are waiting for Dr. Rychik in one of the exam rooms. It has a large window overlooking the street. Jack and I are watching traffic.
“Hello, hello, Jack and Dad,” we hear behind us. “How are you all doing?”
We turn to greet Dr. Rychik. My response is something friendly and wry.
Dr. Rychik says something baby-oriented to Jack. Jack looks at him like he’s the windowless side of a mud hut.
“He’s a little worn out,” I explain.
“I can imagine,” Dr. Rychik replies. “Let’s wrap this up, then.”
Dr. Rychik examines Jack on the exam table, and then we sit. Dr. Rychik pulls up some windows on the computer screen.
“Jack looks good,” Dr. Rychik announces.
I brighten up. “Oh. The sonographer made it seem like she saw something you’d want to look at.”
Dr. Rychik frowns and waves that away. “No, that’s just standard procedure. To check with the attending cardiologist. Everything looked good to me.”
“Oh.” So a misunderstanding. An hour of mind-wandering gloom because I don’t understand their SOP.
“Anyway,” Dr. Rychik continues, “We’d like him to be bigger, but he’s growing. The VSD is still there, but it’s not growing.”
Best outcome is that if the intramural VSD that emerged after his second operation stays the same size, as Jack grows then it will get smaller in relative terms. Dr. Rychik asks how he’s been at home.
I shrug. “Tell you the truth, he seems like a normal baby to me.”
Dr. Rychik nods. “To me, as well.”
I tell Dr. Rychik about Jack’s play-date with the folks from the cardiac kids developmental follow-up unit. Dr. Rychik asks how that went.
“Pretty well,” I say. “They gave him a B.”
“That’s what I would give him,” Dr. Rychik says. “Maybe B-minus.”
We tee-up for six weeks hence, and Dr. Rychik asks me if I have any questions before we leave. We’re probably both thinking about beating rush-hour.
“Just one,” I reply. It’s from mom. “How long can he cry?”
Dr. Rychik peers at me quizzically, and then the lightbulb turns on. “You mean with regard to sleep training.”
I nod. “Just curious. Important to know the healthy parameters.”
“Of course.” Apparently it’s the most common question Dr. Rychik gets from parents. That doesn’t surprise me. “The answer is that this child can cry as long as he wants.”
I nod. “That was my intuition, but I have a Humanities degree, so …”
Dr. Rychik grins. “What do you do?”
“I’m a writer,” I announce, to the imagined blare of courtly trumpets. “And I’m at home with this turkey and his brother.”
Dr. Rychik tilts his head appraisingly. “No kidding.”
“No kidding. In fact, I’ve just started a blog to chronicle our misadventures. It’s called ‘We Heart Dad.’ ” I nod at Jack and give Dr. Rychik an obvious wink. “Get it?”
Dr. Rychik grins. “I get it. Clever.”
I shrug. “My wife came up with it. I’m just the muscle in the operation.”
Dr. Rychik chuckles. “You know, one time, when ours were little ones, I offered to babysit them so my wife could do something, I forget what. Go out of town, or something.” He waves off any nagging predilection in the back of his mind to recall what it was his wife wanted to do.
“I thought I was being nice,” he continues. “She gave me a flat stare and said, ‘Jack. You can’t babysit your own kids.’ ”
No, you cannot. Game, set, and match to Ms. Rychik.