CHAPTER THIRTY-SEVEN - DECISIONS
PART ONE
WEDNESDAY, OCTOBER 1, 2008
MAC'S ROOM
BETHESDA NAVAL MEDICAL CENTER
BETHESDA, MD
1045
Harm strolled to his wife's room feeling good, well, as good as a sleep-deprived new father could feel.
Reaching her room, Harm pushed open the door and walked inside to find Mac sniffling as if she were crying or had been.
He admonished himself as he moved to his wife's side. 'Why hadn't he gone to the NICU first to check on the health of his baby girl? Then he'd have been prepared to find her this way.'
"Mac, what is it?" he asked nervously, having realized that not only could she be in this state because she'd been told that something was wrong with their baby, but that she could have bad news to tell him about her own health, as well.
"My baby hates me," Mac announced before she began to cry harder.
Though Harm was sure that, for whatever reason his wife believed that to be true, he didn't believe that to be the case, and he found himself breathing a little easier now that he knew that Mac hadn't had to hear the doctor give her bad news without him being there to support her.
Harm, having made it to her bedside, but fearful of hurting her if he put his arms around her to comfort her, wrapped his hand around the one of hers that didn't have the IV in the way.
"I'm sure that she doesn't hate you. She's only two days old. She hasn't lived long enough to learn to hate anyone. So, why would you say that she hates you?" he asked.
"Okay, then she doesn't like me. Is that better?" Mac snapped at him, looking down at their hands.
Harm knew by the way that she was eyeing his hand that she was pondering pulling her hand from his, so he needed to say something to make her change her mind since he needed the contact, too. It made him feel like he was doing something to help.
"Why wouldn't she like her mother? She's a wonderful woman," he said sweetly, hoping that she'd take it as the compliment that he'd intended and not think that he was being condescending.
"I don't know, but she doesn't," Mac said, looking at him.
Her sobs had reduced to just tears streaming down her face.
Knowing that something must have happened to make his wife feel the way that she did, Harm made a request. "Tell me what happened to make you feel that way."
"After you left, I went to visit her. Though, as you know, I've been pumping my breast milk for her, last night they gave me the chance to nurse her for the first time, but she wouldn't even latch on, and I tried early this morning and a little while ago, too, but she doesn't want me…three tries, three failures. She hates me," Mac explained, starting to cry again.
Harm dropped a kiss into Mac's hair while contemplating in which direction he wanted to go when he spoke.
Not wanting the room to remain silent for too long, he quickly reached a decision about what to say.
"If she's anything like her father, I think that it's far more likely that you and she had only a failure to communicate and that she loves her mother as much as I do," Harm said lovingly.
"I don't think that's it," Mac said tearfully. "After my third try, the NICU nurse said that babies born prematurely often don't develop the sucking reflex at the rate that either the doctors or their parents would like to see, and at two days old, it might be too soon to expect her to be able to nurse. She also said that I shouldn't worry because she hasn't taken to a bottle yet, either, so I just needed to keep trying until she got the hang of it." Mac sniffled, a sign that she was bringing her emotions back under control.
"The nurse probably sees this kind of thing a lot working in the NICU. So, though I'm sure that it's difficult and frustrating for you, the nurse is probably right. You just need to give our girl a little more time to figure out what she's supposed to do."
Mac tears were finally gone, for which Harm was grateful since it meant that she was feeling better and able to think clearly again.
"I guess that makes you right," Mac said with a tired smile.
"How am I right?" Harm asked, confused, since to him, her statement was coming out of the blue.
"Right that she and I had a misunderstanding…she must think that I'm frustrated with her for not knowing what she should do when I'm not. I'm just worried that I won't be able to take her home when I'm released if she isn't able to nurse yet."
"Did the nurse give you any idea of how often you should try to breast-feed her?" Harm asked.
"She suggested that, since we were both so upset from the last try in particular, I don't try to feed her every feeding time, perhaps every other one, or even take the rest of today off and try in the morning. If they get her to suck from a bottle in the nursery before then, they'll tell me so that I can see if she'll accept the breast before she gets used to sucking from a bottle nipple, which takes less effort."
"She's getting your milk, so even if she has to be bottle-fed, she'll be getting the health benefits of being breast-fed," Harm commented, trying to focus Mac on the positive.
"I know, and if I have to accept that I'm doing all that I can, I will ... but I don't want to settle. I was able to breast-feed Matthew and I want to have that bonding time with my little girl, too." Mac inhaled sharply. "Now, before I start to cry about it again, let's talk about something else. Tell me how your meeting with the SecNav went this morning when you told him how the coin toss came out."
"I didn't tell him how I came to my decision," Harm said with a chuckle. "I just told him that I appreciated his patience and that, after careful consideration, I had decided that I was honored to know that I'm being considered for the position and, whether I'm appointed JAG or not, I don't think that it's the right time for me to retire and that I'd be proud to serve my country in whatever capacity my skills are useful to the Navy."
"I'm sure that he was impressed by your words."
"I don't know if he was impressed since he didn't really comment directly on my decision. He just said that the meeting to make the final selection was set to begin on Friday at 1000 and would last until they'd made a decision."
"They're going to work through the weekend?" Mac questioned with surprise.
"It seems that six weeks before the Presidential election is a bad time to have one of the top positions in the military open. So the SecNav told me that, if they don't reach an agreement on Friday, they'll be meeting over the weekend and that there'll be a new JAG appointed before Monday when the position is officially vacated by Cresswell, who's starting his terminal leave."
"Well, I hope that they make the right decision and select you as the next JAG," Mac said with pride.
THURSDAY, OCTOBER 2, 2008
BETHESDA NAVAL MEDICAL CENTER
BETHESDA, MD
0820
Harm felt like he'd gone ten rounds in a fight. He was beaten down both physically and mentally from trying to spend as much time as possible at the hospital with his wife and premature daughter and still be a presence at home for his other four young children.
Harm was sleeping a couple of hours at a time here and there, but his naps were only enough to rest his tired eyes and get him through until he was able to take another one. They weren't the recuperative sleep that his mind and body needed.
Though Mac had been doing her best to take the suggested break from trying to breast-feed her baby girl after yesterday morning's failed attempt, she'd grown impatient and had had Harm accompany her to the NICU to try again before he'd left last night.
Minutes after he'd arrived this morning, Mac had tried again, and though their daughter had latched on this time, since she hadn't suckled, Mac had viewed it as another unsuccessful attempt and had been reduced to tears again.
Unable to do more than hold Mac's hand while she cried it out, Harm was feeling completely helpless to make things better for his wife.
With Mac having cried herself to sleep, Harm wanted to see his baby girl.
As he plodded towards the NICU, Harm let out a sigh. He didn't know what he was going to say, but he felt that it was time to have his first father to daughter lecture, and it was going to be about how she was upsetting her mother.
With the double doors of the NICU in sight, Harm shook his head in disbelief that he'd been seriously considering what to say to his newborn daughter to get her to comply with his wishes and nurse from her mother.
He quickly surmised that the only reasonable explanation for doing such a thing was that he was cracking under the pressure of recent events.
It would be completely understandable, he thought, given that, in the past week he'd had a crazy man stalking his family, his daughter had decided to make an early arrival, Mac had nearly died after her delivery, he'd been trying to decide if he was going to retire and, if that weren't enough, tomorrow was the day that the committee was supposed to vote on who to appoint as the next JAG.
So much rested on their decision. For instance, would a move be in his family's future, too?
Yes, that had to be it. He was suffering from stress overload and, combined with his lack of sleep, it was giving him delusions about being able to reason with his three-day-old daughter.
NICU
0807
It hadn't been three full days yet, but Harm could already go through the necessary precautions of scrubbing up and putting on a sterile gown before entering the NICU with the ease of someone who'd been doing it for months.
Even though Harm had the routine down, he was hopeful that he wouldn't have to perform the time-consuming actions for much longer since, just yesterday, his baby girl had been doing so well that she'd been moved from an Isolette to an open bed. It was more of a plastic tray than a bed, really. However, whatever it was called, it was much easier for him to scoop up his daughter and hold her several times a day without disturbing her monitoring wires.
Harm entered the nursery unit, and his ears were filled with the sound of his daughter crying, wailing at the top of her lungs.
It was amazing to Harm that, in only the accumulated few hours that he'd spent in here with his baby since her birth, he could already tell her cry from the other babies' cries.
Today, a nurse, one whom he'd seen several times over the course of the last few days, was standing over his daughter.
Since Harm had just entered the room, he had no way of knowing if something was wrong with his daughter or if the nurse was there only for the sake of trying to soothe her upset little patient.
Worried that it could be the first, Harm drew a deep breath, bracing himself to hear bad news, offered the nurse a tired smile and then turned his attention to his crying baby.
"What's the matter with daddy's girl?" Harm asked as he began to stroke her cheek with his bent index finger.
"I'm afraid that her being upset is my fault." Harm looked up in the direction from where the voice had come and saw Sarah's pediatrician standing a few feet away. "I woke her while conducting my exam."
"How's my baby girl doing?" Harm asked nervously.
Given his wife's tear-filled morning, he was hoping to have good news about their baby when Mac woke up.
With her father's soothing touch, Sarah Patricia Rabb's cries ceased, restoring the NICU to a quieter place where Harm and the doctor could talk without having to raise their voices to hear over his daughter's wails.
"She's doing very well. In fact, so well that she doesn't need all this extra monitoring and, as soon as I can consult your wife's doctor about her condition, I'll make a decision about whether to release your daughter from the NICU to the regular care nursery or to in-room care."
"She's doing that well?" Harm questioned, a little surprised, given the problems with her nursing.
"I know that she probably gave you a scare that first day when she was having trouble maintaining her body temperature, but I assure you that that's behind her, and she's been doing so well that she no longer needs the NICU."
"Are you sure? Since she isn't eating, I mean."
The doctor couldn't stop the corners of her mouth from turning up to form a slight smile at the concern of this father for his little girl.
"I understand your concern. However, though she isn't nursing, she isn't going hungry. They're feeding her here, and if I opt for in-room care, she can be taken to the regular nursery for feedings temporarily. As far as the long term goes, if no progress has been made in the next day or two, we'll be teaching you and your wife how to feed her at home in the same manner that we've been doing here."
"So she doesn't have to be eating in a traditional way for her to be released from the hospital?" Harm asked, holding his breath in anticipation of the answer. This could be the information that would ease Mac's anxiety over the failed attempts to breast-feed their baby.
"It would be ideal if Sarah were feeding from the breast or a bottle, but there are other acceptable methods for delivering nourishment such as the syringe-style feeder with a tiny tube attached that fits against the roof of her mouth, thus rendering a sucking reflex unnecessary. She needs to know only how to swallow, and she's been doing that for the nurses."
Harm let out the breath that he'd been holding. He just knew that the fact that their daughter's issue with nursing wasn't going to keep her from being released from the hospital was going to make Mac feel a lot better, at least less worried that their baby wouldn't be able to go home with her.
"Since Sarah showed signs of improving by latching on this morning, I'm not sure that we're even going to have to worry about alternative methods. That's why I hope that your wife's doctor tells me that she's recovered sufficiently to be able to care for her baby in-room, even if for only part of the day. I believe that reuniting mother and child as quickly as possible will allow them to bond, and the bond that they create during that time will allow their natural instincts to kick in and solve the feeding problem," the pediatrician explained.
"Is there anything that I can do to help them?" Harm asked.
The doctor looked down at the newborn who'd been soothed to sleep by her father's touch.
"You seem to have good instincts, so keep doing what you're doing, but if you have any other questions, don't hesitate to call me. Now, if you'll excuse me, I'll see if I can get in touch with your wife's doctor to see about getting this little one into the care of her parents as soon as possible."
Harm offered the doctor a tired smile.
The doctor smiled in return before stating, "Once I know if Sarah will be moving to the regular nursery or into your wife's room, I'll let you know, but, in the meantime, you can continue to visit her here."
Harm nodded in acknowledgment and offered a "Thank you" in gratitude as he stared down at his daughter.
She was sure that his attention was so focused on his daughter that she could've walked away without a word, and he wouldn't have noticed that she'd left, but the doctor replied, "You're welcome."
MAC'S ROOM
BETHESDA NAVAL MEDICAL CENTER
BETHESDA, MD
1245
Had the failed attempt to nurse her baby this morning been the first or second try, the nurse's words of 'she latched on, that's progress' would have eased Mac's mind about the situation. However, being the fifth or sixth or maybe even the seventh try - she was trying not to count - Mac was starting to feel that her baby girl was going to have to stay in the hospital much longer than anyone had originally thought, which was starting to wear on her belief that her tiny little girl was going to be okay.
Having gotten some rest after her emotionally draining morning, Mac had awakened from her nap with a husband about to burst at the seams with news about their baby girl.
Harm's news that their daughter was doing so well that a release from the NICU was in the works lifted Mac's spirits about the health of her baby. However, with the failed attempt to nurse her baby this morning still weighing heavily on her mind, Mac was left feeling useless and unsure that she was the best person to care for the newborn, causing her to have doubts about the possible placement of Sarah in her room.
When her lunch had arrived in her room forty minutes ago, Mac had been able to convince Harm to leave to go eat a decent meal. However, he'd agreed a little too easily, so she suspected that he knew that she really wanted just to be alone with her thoughts for a bit, and that though he'd left her room, he probably hadn't left the hospital.
Though she had many things on her mind, most of her thoughts were about how she felt about the possibility that her baby was going to be moving into her room some time today.
Mac was slowly able to push aside the feeling that her tiny girl would starve to death if left in her care, wanting to believe that having her daughter close would do as the pediatrician had told Harm - that once she and her daughter had had some time together to bond, the nursing would come naturally. However, a new, practical worry began to creep into her thoughts.
Still feeling a little weak and in some pain from her surgery, she wondered if having little Sarah in her room full-time would be physically too much for her.
Mac was ready to dismiss her concern about being able to change diapers and such, knowing that Harm would be there if she needed help or needed some time to rest until it came to her that keeping him here with them full-time wouldn't be fair to the children who they had at home.
Consumed with her thoughts, Mac hadn't eaten much and, given the time when her door began to open, she assumed that it was a hospital volunteer coming in to remove her lunch tray.
"Hey," Harm said, sticking just his head into Mac's room so as not to reveal the bag that he had in his hand.
Eyeing her still almost full lunch tray, he added, "Do you need more time to finish your lunch?"
"No, I'm finished," Mac replied, wondering why he wasn't coming into the room.
"You didn't eat anything," Harm said with concern.
"I'm not hungry," Mac informed him, bracing herself for a speech about either screwing up her blood sugar or on needing to keep up her strength after having had a baby and surgery.
"I can't really blame you for that. Hospital food makes you crave my meatless meatloaf, doesn't it?" Harm joked, pushing the door open enough so that he could lift the brown paper bag into view, the logo of which he had facing him so that Mac couldn't see it and might get the idea that he'd brought her some of his infamous dish from home.
"Harm, I'm already in the hospital, so please tell me that you didn't bring me… " Before she could finish, Harm entered the room grinning, and she knew that he was teasing her.
"No, I didn't, but I did bring you..." Harm said before placing down a fast-food cup next to her lunch tray.
Mac's eyes lit up, and a smile began to spread across her face when she saw the familiar logo on the side of the cup.
"...a chocolate shake and…" he said while placing the bag that he'd been holding in his other hand next to the cup. "...a Beltway Burger, but if you aren't hungry…" He let his voice trail off as he saw her hand already making its way to the chocolate shake.
"I didn't think that you'd leave the hospital," Mac stated as she wrapped her hand around the cup and began to pull it towards her.
"I wasn't going to, but then I went to see little Sarah and decided that you needed something special to eat to celebrate," Harm said, taking great pleasure in seeing the contented look on Mac's face from her first taste of the shake. "Since it was you, I thought that this would fit the bill."
"Celebrate what?" Mac said after releasing the straw from her lips.
"Our baby getting out of the NICU," Harm informed Mac proudly.
Mac was immediately less interested in her shake and more interested in the information that Harm had about their baby girl's move.
"When are they moving her?" Mac asked excitedly.
"They've already moved her. I walked her to the nursery myself before I went to get your burger."
Mac didn't know how the change in location would affect her schedule for visiting her baby, so, lifting her cup, she asked, "Now that she's in the regular nursery, did you ask when I can go in to see her?"
After asking her question, Mac took the straw between her lips, and Harm noticed that what had seemed to be joy at getting the treat now seemed to be a source of comfort for her.
"I didn't have to ask because they told me. She should be here any minute," he replied, avoiding the sensitive topic of breast-feeding by not admitting to Mac that the nurses had been instructed to take care of Sarah's next feeding before bringing her to Mac's room.
"She's being released to in-room care?" Mac questioned in disbelief.
"Your doctor said that, though you certainly aren't ready to be released, you are recovered enough to care for Sarah in-room for part of the day. So I suggest that you eat up. You're going to need your strength."
Mac suddenly had her appetite back and reached for the bag on her bed table.
1302
Less than five minutes had passed since Mac had finished the last bite of her burger and sucked down the last of her shake when a nurse pushed open the door and said, "We have someone here to see you."
The nurse had barely gotten the words out of her mouth before another nurse pushed the little hospital bassinet into the room.
After checking the identification bracelets of mother and baby and being doubled-checked by the other nurse, the nurse who'd announced little Sarah's arrival spoke to them for a few minutes about the doctor's instructions about what being in-room part-time meant, and after reassuring the couple that Baby Sarah was doing well and that they were just a nurses' call button away, the two nurses left the room to allow the parents and child to get better acquainted.
As soon as the nurses had left the room, Mac started to get out of bed, saying, "I want to move to the chair to be closer to mybaby."
As Harm offered Mac his assistance to help her relocate to the chair, he wondered why, all of a sudden, little Sarah was her baby.
Once in the chair and as comfortable as her post-surgery condition would allow, Mac's eyes became fixed on her tiny newborn daughter, and her hand reached out and pushed down the edge of the blanket so that she could see her baby's entire face as she spoke lovingly, "Hello, baby girl." Not taking her eyes off of little Sarah, she said to Harm, "She looks so sweet."
"She's beautiful like her mother," Harm whispered with his eyes fixed on his wife and baby girl.
"I don't want to wake her, but I want to hold her," Mac said softly.
"I don't think that she'd mind. To minimize you moving around until you've healed a bit more, if you'll sit back and get comfortable, I'll hand her to you," Harm offered.
"Since the bed can be adjusted with just the touch of a button to make me more comfortable if I get tired of sitting in one position, maybe I should be on the bed to hold her."
"If you think that it'll work better, let's get you back into bed," Harm replied, already moving to offer his assistance.
1317
Harm was sitting in the chair next to Mac's bed.
He was happy to be watching his wife hold their baby girl since, for the first time in three days, the smile on Mac's face reached her eyes.
"You know that you're going to have to let me hold our little doll every once in a while," Harm said meekly, not really wanting to separate the two of them, but more as a means to remind Mac that she was his child, too.
Without looking up from the child in her arms, Mac said, "Are you sure about her name? We haven't turned in Sarah Patricia as the name for her birth certificate yet, but since it has to be filed within five days of her birth, we don't have much time left to decide."
"Her name may not have been legally recorded yet, but Sarah Patricia is what we've told the family. My mother is already calling her namesake Patty, so do you think that it's wise to change her name now?"
"I wasn't suggesting that we change both of her names. I'm just thinking that three Sarah Rabbs in the same family will be too much."
"Changing her name would reduce the number of Sarah Rabbs who I know by one..." Harm said, mulling over the suggestion as if it were a clue that he was trying to process in a case on which he was working. "... but I kind of think that Sarah suits her. She's pretty and she has my heart like her mother. Then there's her resemblance, at least personality-wise, to my grandmother, who's always early for everything and is a very strong woman."
"So, you weren't naming her after only me?" Mac asked, turning her head to look at him for the first time since she'd begun to hold their baby.
A deer-caught-in-headlights look came over Harm's face because he wasn't sure what kind of reaction that he'd get from his wife if he told her the truth, that he really hadn't put much thought into the name, but rather the name had just slipped from his lips when he'd looked at his daughter for the first time. It had been only after he'd given it some thought about why he'd said it that he'd come up with possible reasons that it had been the first name that he'd uttered, especially since it had been one of the first names that they'd eliminated from his list.
A smile started to appear on Mac's face as she realized that her question had put her husband in a tough situation because, if he'd named their daughter after only his grandmother, he wouldn't want to confess that information to her.
To let her husband off the hook, Mac spoke again.
"Maybe, as a compromise, we could give her your grandmother's middle name and, if you really want to name her after me, too, then we could use my middle name, and Patricia could have two middle names."
"I don't know, Mac. The name just seems right to me, but if you really want to change it ..." His voice trailed off.
Though the baby in her arms was in a different generation than her namesakes, since the other two women were still living, Mac really thought that three Sarahs was too many in one family. However, since she'd told Harm that he could pick their daughter's name, he had to be in complete agreement with her, or their baby's name would remain Sarah Patricia Rabb.
Mac didn't think that she was going to win the 'name change' dispute, but in hopes that he'd change his mind if he gave it some thought, Mac had one last thing to try before she gave up on the idea completely.
"Well, I'm a little tired. Why don't you hold her for a while and talk the name change idea over with her? When I wake up, we'll see if the two of you have a final decision for me," Mac suggested.
Mac couldn't help but notice the broad grin that came across Harm's face at the mention of him taking a turn at holding their daughter.
"Sure, you get some rest. We'll be here when you wake up," Harm replied.
"If they come to take her to the nursery and I'm not awake, you wake me so that I can say goodbye, okay?" Mac requested as Harm began to lift the sleeping newborn from her arms.
With his daughter settled against his chest, Harm sat quietly with her until Mac had drifted off to sleep.
With her mother sleeping, it was time to talk over the proposed name change with his baby girl so that a decision could be reached before the deadline to submit the paperwork to record her birth.