Story Behind the Book

It's day three in the Neonatal Intensive Care Unit in Albany, NY. I'm sitting vigil over my daughter, who is lying in a clear plastic pod under McDonald's french fry lights, looking like something between a very delicate alien and a tiny baby. She was born six weeks prematurely, weighing only 2 pounds.

We haven't named her yet because we're waiting for her blood tests to come back, which will tell us if her miniscule body is saturated with infection, or not. My placenta was so infected it reached the umbilical cord, preventing most nutrients from passing on to her. The likelihood of her coming out clean is slim. I've already learned the most important saying in here, in NICU land: If they survive the first week, they'll live.

I'm 35, this is my first child, and I didn't grow up babysitting or fawning over children. An investigative writer by training and DNA, I was following police cars on my 10-speed bike by the time I was 9 years old. I could make that Schwinn fly to find out who was in trouble and why. Then I'd write it down on spiral notebook paper, with the headline BREAKING NEWS!, and deliver it to everyone's mailbox in my suburban Washington, D.C. neighborhood.

I tried charging a nickel for my police beat stories, all with a compelling local angle - the neighbors were paying that much for Ginger Stewart's crappy lemonade - but no one wanted to pay except my Dad, so I gave it away. He wanted me to try designing a good logo for my newspaper, typing it instead of using pen, and charging 10 cents, but I just wanted to get back on my bike and chase more sirens.

I sit here fidgeting, wondering how the other women in here - and they are all women, precious few daddies show up - know what to do. They seem so prepared, reading parenting, scrapbooking, fashion and weight loss magazines. One by one, they cheerfully go into the pumping room to put on what I refer to as the cow gear, come out a half hour later and daintily sit back down. They ask informed questions about nursing bras and chat about which diet might work to get the pregnancy fat off.

For me, getting the motherhood instincts revved up is like fighting with an alternator in an old car on a cold winter morning.

I hold up the front page of The New York Times, plaster it to the side of my little one's pod and tell my daughter: "This man is a criminal. That's cri-mi-nal. He's a war monger because he can't craft a better economy and he's competing with his father. The worst part? Everyone knows he's a criminal, but no one wants to change their ways. It's like that with most criminals, and most things, honestly - global warming, pollution, waste, cruelty. It's not like we don't know what the ills are in our society. We know. There's no mystery who the bad guys are. We just don't want to look. We worry about the wrong things - blame everyone except ourselves for having flaws, push away righteous, demanding people - because if we look at the truth, we have to change. People would rather die than change, so we let things rot rather than give up luxuries."

Breathless, I lean back, look up. I sense a bunch of eyes that have just gone back to magazines. It should be noted that the other women in here don't seem interested in talking to me. I want to explain that I'm not always like this, perhaps I'm a little hormonal. But no one wants to hear it.

Well, one young mother does talk to me: The teenage drug addict who leaves every half hour to smoke. We talk politics; she's very smart really, just had no one growing up. And she takes having a 2-pound baby in stride, in a way no one else does. Everyone else in here is hiding in magazines. She sings, fusses in her baby's pod, brings in cute decorations for it. In fact, she will end up teaching me one of the most important things I'll learn in the NICU: For preemies, the clothes that fit best are doll clothes you can buy at Toys R Us. She explained that the biggest manufacturer of clothes in America is Mattel. "It's Barbie. They make more clothes because of her than any other reason."

I like the drug addict, and even her boyfriend. He's the only man who shows up every day after work. If I make it to day 10 in here, I know I'll be dying to bum cigarettes from them.

Here comes the creepy morning-rounds doctor that won't look me in the eye. It's not just me, he doesn't look at anyone. My husband and I brace ourselves.

The blood test came back negative. No blood transfusion necessary, no infection, she just needs to put on weight. She was starving inside me, and was smart enough to pull the rip cord and get the hell out where I could feed her. And she did it just in time; if she had stayed in any longer, she would have been infected and died.

I cry a relief so deep, and unfamiliar, that I wouldn't have been able to imagine it before; the absence of pain equaling pure joy. I ask to hold her. I'm not allowed to hold her for more than a few minutes at a time because she can't retain heat yet. Once in my arms, or hands more like it, I swear my precious tiny girl turns her head up toward me, and she knows she's all right, too.

Apparently that makes her hungry. Her eyes aren't even open, yet she reaches up and rips the feeding tube out of her nose. Alarms sound. The nurses move in with lightning speed. But I hold her protectively and ask if I can try nursing her; she obviously doesn't like eating out of her nose. While trying to pry her away from me, they inform me, the idiot, that developmentally the sucking ability doesn't kick in for another week.

I stare at them, holding on tighter. When my father was 17, he escaped from Communist Bulgaria through the Turkish underground after my capitalist grandfather was thrown in jail. My mother was throwing hand grenades in the Israeli army when she was 18. These aren't genes for the fainthearted.

"Okay, Little You, did you hear that?" I say. "If you don't want to eat through your nose - and ew, I don't blame you - then you have to eat here." I place her in front of my nipple and push it at her teeny mouth. The nurses stand, hands on hips, clearly wondering if they should call in whatever shrink is on duty.

She opens her little almond shaped eyes, whose lids aren't fully formed yet, and we hold each other's gaze, or so I imagine. Then she latches on and starts eating. I look up and smile at the nurses, and now they don't seem that interested in talking to me, either.

They have more important business anyway, which is to try and talk one of the other mothers out of doing the O-ring diet, where they surgically insert some sort of ring around your stomach so you can't eat too much. Her name is Stephanie and she claims she is a vegetarian, has no idea why she has always struggled with weight, and now with the baby it's just too much to battle. The nurses describe the details of the surgical procedure, in an effort to daunt her, but it's not working. Her daughter, who weighs one pound -no, that's not a typo - isn't doing that well. Her monitors keep beeping. Stephanie keeps patting the pod as if it will make the monitors stop, her eyes fixed on the nurses, hoping they'll find a cure for her flab.

It's day four and I'm exhausted. I don't know why it never clicked in my lizard brain that feeding a newborn means being awake every three hours, even in the middle of the night. Now, when you have a preemie newborn, it means pumping in the middle of the night at home, alone, without your baby, because they won't let you sleep in the NICU.

I wake up with a start, in a horrible cold sweat, at 4 a.m. I call the NICU, and sure enough, she's awake and crying, crying for me. I go to the hospital, an hour drive from my home in Woodstock, in the dark.

I get there and she stops crying. I hold her for a few minutes, feed her. I love her more than anything in the world and suddenly I just want to take her home, even though I'm terrified. When she's back in her little pod, I sit slumped next to her, holding her tiny hand through a portal in the side of her pod.

When it starts to get near 8 a.m., the tired mothers start filing in, their women's magazines in hand, and take their own stations, slumped next to their own pods.

And then, in my sleep-deprived stupor, an idea pops into my head. The NICU should be set up with cots next to these pods, so I could hold Matilda's hand all night, even when I can't hold her. We named her Matilda last night, which means battle warrior.

As people drink coffee and wake up, the conversation invariably goes to dieting and fashion. Today, they've added plastic surgery to the mix. It's not just the same old body issues, it's worse now. I swear we're all worse. Absurdly, I suppose, I sit here hoping Matilda can't hear this obsessive talk, because now that I have a little girl, I feel a ferocious protectiveness. I don't want her growing up with the same self-loathing body issues we all grew up with.

Here we all are, grown women with life experience, traumatized by births gone wrong, and all we can obsess about is being fat. I'm not outside of it, either. No one is impervious to her environment. I may make fun of it, but deep inside I'm listening, wondering if I will get back into my favorite jeans, ignoring my own frustration that my husband finds it too upsetting to be here anymore. And now that he knows Matilda will survive, in some way, he can rationalize going back to work full time, even though he doesn't have to.

As the morning drones on, I hit a wall of exhaustion. My idea to sleep in here spins a little, getting broader as I try to escape the oppressive energy of our collective obsessions, hobbies and visiting relatives, who invariably make the mothers more anxious, not less. Now I'm listening to women's sisters and mothers compare weight loss dilemmas. Ah, family legacies.

Here's an anthropological observation: The NICU brings out the worst in family dynamics, competition, shame and blame. And when the families of origin leave, quiet shame resumes, a breathing undercurrent to the metronome of magazine pages going flip flip flip.

I scootch my chair over a little, so its back is to the latest conversation about eating habits, trying to shield Matilda. She is sleeping. She's only awake every couple of hours for a few minutes. I stare deeply at her innocence, until she blurs and my idea takes focus:

What if we could have one big pod we share with our babies. And for the women whose babies can't/won't/don't nurse, what if they could sleep, blessed sleep, in a medically induced comatose state, uninterrupted by beeping monitors, crises, and family woes, until they get out of the hospital. The nurses could do formula feedings every couple of hours.

And if we were in the pod with them, we'd be attached but not constantly bringing in germs from the outside world. We'd have a joined womb effect-living out their pregnancy term with them, as close to enveloping them as possible.

By lunchtime, I'm giggling, looking at the women, flipping through their magazines, shaking their heads, dog-earing pages of clothes they wonder if they'll ever fit in again. With a NICU coma, mothers could lose significant weight by the time their babies are released.

Then I remember something. My mother was obsessed with Elizabeth Taylor when I was growing up. She adored her because my mother struggled with weight, and it comforted her to know that someone so glamorous and famous and gorgeous and smart struggled as well. One day, right after Elizabeth Taylor separated from Sen. John Warner, my mother was reading from some magazine, shaking her head, saying what a shame it was, poor woman:

"She really believes that each marriage is forever."

I don't look up from the newspaper. My mother's devotion to celebrities was a cause of much teenage embarrassment for me.

She starts laughing. "See, I'm not the only one!"

I look up. "Okay, you're not the only one what?"

"Listen to this. She checked herself into a Beverly Hills rehabilitation clinic, poor thing. And then she tried to talk the doctor into putting her into a coma so she could lose weight. She says: ‘You have to, I can't stop eating if I'm awake!'"

Slapping the table, my mother stands up to get more coffee and a cookie. "Only in America. People have gone completely mad." She says it, but she's not really judgmental. The whole point is that she's comforted by a country that can afford to think about such things.

Matilda is sleeping deeply and there's an hour to go before I have to wake her up to feed her, so I take my laptop and try to find out if Elizabeth Taylor ever went into a coma to lose weight. I find out nothing, but I do see the creepy doctor in the hospital cafeteria, so I plop myself down next to him, at his table, most uninvited.

He has a patient file lying open on the table. One of the babies needs surgery, and there's a highlighted note that the mother took antidepressants during pregnancy. I'm so nosy I can read very well upside down. He doesn't close the file when I sit down. In fact, he leaves these patient files out in the open in the NICU all the time, and it's common practice at the nurse's station, too. I've asked him about the privacy policy before, but he never gives me a real answer.

One of the games I play here, mostly to keep myself busy, is to try to think of something compelling to say so Dr. Creepy will look me in the eye. Nothing has worked so far. Not even when I told him that upon checking into the hospital - three centimeters dilated, rushed in by ambulance paramedics, seized by doctors desperate to stop the labor - I told my husband to purposely spell my name wrong on the forms. He spelled it Rivkeh instead of Rivka so I could track where the hospital sells my name and personal data. I told the doctor that within 24 hours, we started receiving junk mail at home, addressed to Rivkeh, with offers for maternity clothes, diet programs, and baby gear. He squirmed a little at that one, but never looked up.

Today, I'm hoping I've found the trigger: "Hi! Could you medically induce a coma for someone if they wanted to go to sleep for two weeks to lose weight?"

Dr. Creepy looks up. Gotcha! An hour later, he not only tells me how it could be done, but now that he thinks about it, you wouldn't even need to risk infection with an I-V. You could use a simple nasal catheter.

I thank him, take my laptop back to the NICU, and spend the next five weeks sitting next to my preemie for 15 hours a day writing the first draft of my novel, TWO WEEKS UNDER. I pester Dr. Creepy in the cafeteria most days with questions, until one day he does something completely new.

Unprovoked, he looks up, smiles, and asks: "Will you mention me in your story?"

"Mention? You've inspired a character!"

He beams with pride. And when he smiles, he looks like a morph between Ted Bundy and Oliver North.