Our Aural History

aural historyWhen two of my newborn babies spent time in the hospital due to serious medical problems, one of the many things that distressed me was all the noise surrounding them.  I wanted them to be introduced to the world differently. I wanted to wrap them in the sounds of home — voices of people who loved them, clatter of dishes at dinnertime, wind in the trees, lullabies sung, books read aloud. Instead there were loud beeping devices, intrusive announcements, squeaking wheels on equipment carts. They heard all sorts of strangers’ voices too, often while those strangers (for the very best reasons) imposed discomfort or pain. When they came home, both times, I noticed the sounds around them more than I normally would just because it was such a blessed relief.

My concern wasn’t overblown. In utero, a baby hears a symphony of prenatal sound that includes the mother’s heartbeat, breathing, and movement.  The baby’s auditory system is fully developed by the sixth month of pregnancy and what sounds it hears is a particularly big deal from that time until it reaches six months of age. Here’s what one medical journal has to say:

The period from 25 weeks’ gestation to 5 to 6 months of age is most critical to the development of the neurosensory part of the auditory system. This is the time when the hair cells of the cochlea, the axons of the auditory nerve, and the neurons of the temporal lobe auditory cortex are tuned to receive signals of specific frequencies and intensities. Unlike the visual system, the auditory system requires outside auditory stimulation. This needs to include speech, music, and meaningful sounds from the environment.

The preterm as well as the term infant cannot recognize or discriminate meaningful sounds with background noise levels greater than 60 dB. The more intense the background noise, especially low frequency, the fewer specific frequencies (pitch) can be heard and used to tune the hair cells of the cochlea. Continuous exposure to loud background noise in the NICU or home will interfere with auditory development and especially frequency discrimination. The initial stimulation of the auditory system (speech and music) needs to occur in utero or in the NICU to develop tonotopic columns in the auditory cortex and to have the critical tuning of the hair cells of the cochlea occur. The control of outside noise, the exposure to meaningful speech sounds and music, and the protection of sleep and sleep cycles, especially rapid eye movement sleep, are essential for healthy auditory development.

Hearing is also said to be the last sense to leave us at the end of life, as indicated by electroencephalograms of people in their last hours. (Oftentimes music can reach unconscious and dying people when other stimuli cannot.)

Sound has a way of sinking into us, linking with sensation and emotion to form lasting memories. When I read about refugees forced from their homes by war or famine or rising seas,  my sorrow for them (and my admiration for their courage) leads me to think about what sensory experiences they can never fully recapture from their homelands. Keeping one’s own language, foods, and faith alive is vital but I wonder if hunger for the unique sounds left behind ever goes away.

We carry aural memories with us forever. I suspect sounds from early childhood are rooted the most deeply. Here are some of the happiest I can remember.

  • A summer of locusts, the sound cresting and falling like waves.
  • The screen door’s awwaak as it opened and my mother’s voice from somewhere in the house calling “don’t slam it!”
  • The shriek of a swing hung on chains as I swung on my belly watching ants scurry below. 
  • My father whistling as he tinkered with some project.
  • News on the radio my mother listened to for a few minutes each morning, all of it inane chatter to me except for ads that lodged in my memory like this one
  • Planes taking off from nearby Cleveland Hopkins Airport,  curving overhead like toys even though adults insisted they were big enough to hold actual people inside (pffft!)
  • Music my father listened to as he graded papers — classical, pop, big band.
  • The creak of our old rocking chair.
  • The indescribable security of lying in bed hearing my parent’s muffled voices. 

Imagine sounds from 100 years ago in the place you are now. Perhaps horses on stone-paved streets, vendors hawking their wares from open carts as they traveled through town, afternoon paperboys calling out the latest headlines, church bells tolling the hours, the whistle of steam engines passing in the distance, children playing outdoors everywhere.

Or maybe imagine sounds 100 years in the future, if you can.

What sounds surrounded you as a baby? Your children in infancy? What aural memories make up who you are today?

A Sandwich Made of Kindness

how to help a parent whose child is hospitalized

CC by 2.0 Kyle Simourd

Waiting for medical test results is itself a stress test. I play mental games, especially the one where I won’t let myself check the time even though I’m also cheating by checking the time. I keep busy with small tasks. Mostly I try to smother dread by piling on layer after layer of positive thoughts.

This is what I was doing the day we took our firstborn baby for an upper GI. Benjamin was a bright-eyed delight, so enthralling to his new parents that we’d watch him sleep while commenting like giddy sportscasters at his every facial expression.  But as weeks went by, we realized he was sick and getting sicker. He’d nurse contentedly but the milk didn’t stay down. Sometimes immediately, sometimes not for almost an hour, he’d struggle as if in pain until he vomited the milk back up in forceful plumes. By the time he was two and a half weeks old he was nursing almost continually, desperate to keep something in his stomach.

Doctors, nurses, friends who were parents, and our own parents all said he was fine. We were told we were overreacting as first-time parents tend to do. We were assured that he was allergic to breastmilk or that he wasn’t being burped correctly or that he needed rice cereal to settle his stomach.  We were told he had reflux or colic. The usual refrain was, “He’ll grow out of it.”

Being me, I researched every possibility for our baby’s symptoms. One that stood out was pyloric stenosis. This is a narrowing of the pylorus, the lower part of the stomach through which food passes to enter the small intestine. The opening continues to narrow as the disease progresses, eventually preventing the baby from getting any nutrition at all. Our doctor said that diagnosis was unlikely with a “big, strapping boy” like ours, and not to worry. My mother, an RN, showed me pictures of babies diagnosed with the disease. They looked like famine victims, not at all like my baby.

By the time he was four weeks old Benjamin’s weight had stalled. The doctor said if we insisted, he could schedule an upper GI, but he was sure the baby was just fine. I ordered John Gofman’s Radiation and Human Health from the library and was horrified to read that the earlier a child is exposed to x-rays, the greater his lifetime risk of cancer. That didn’t make the decision easier.

I also read more about pyloric stenosis. Like some kind of Biblical plague, it’s most likely to occur in firstborn male babies. It also runs in families. I remembered hearing that the first son in my father’s family had died in infancy.  (My grandmother blamed herself and refused to nurse her subsequent children. The formula she used caused my poor father to have eczema so severe that the doctor ordered her to spare his skin the pressure of being picked up, that instead he should have his arms tied to his crib all day so he couldn’t scratch. I’d like to reach through time and throttle that doctor.)

After putting it off for a few days, my husband and I were sure we saw desperation in our nearly five week old son’s eyes. We took him for the test. Then we waited. And waited.

Finally the doctor called with the results. He told us to take our baby directly to the hospital for emergency surgery. Benjamin had the blocked digestive tract indicative of advanced pyloric stenosis.

When we got there our baby was deemed so severely dehydrated that it was too dangerous to take him to surgery right away. After many attempts to insert an IV, each second a screaming misery for our child, Benjamin ended up with a line running into his head. Worse, I wasn’t allowed to nurse him in case surgery was scheduled soon, so he screamed with hunger as well. Hours passed and the surgeon didn’t show up to examine him or talk to us.

I was frantic, knowing that my baby had been starving and yet I wasn’t able to feed him. One nurse assured me that the glucose drip was as good for the baby as mother’s milk. Another nurse, seeing that we were holding him rather than letting him wail in the crib, told us “I don’t have much use for pick-me-up-shut-me-up kids.” That explained the largely ignored toddler in the next crib who cried mournfully, so traumatized that he barely paused his crying when we tried talking to him and playing with him.

Hours dragged by and the surgeon still hadn’t arrived.  I went to the nurses’ desk and said as politely as I could that if the surgeon didn’t speak to us in the next half hour I would nurse my inconsolable baby on the way to another hospital.

That did it. A sleepy-voiced surgeon roused himself to call, saying with annoyance that he’d operate in the morning.  And he did. The stenosis was repaired and our baby faced a few more days of hospitalization  to recover.

My husband and I, first time parents at 22 and 24 years old, were so focused on our baby’s health that we were barely aware of our own stress. We had already decided to live on one salary. Our budget had space for homemade meals and quiet pleasures like taking a walk. It didn’t have space for my husband to take off more than the day before and day of our baby’s surgery. It didn’t have space for parking fees in the hospital lot. It didn’t have space for meals in the hospital cafeteria.

I stayed at the hospital with Benjamin as he recovered. Nurses snuck me cans of apple juice and crackers. They brought me pillows so I could lie back in the chair holding my baby. They looked at my bedraggled state and hinted that I could go home to shower. I was still not allowed to nurse until my baby had healed, a source of misery for both of us.  And I suffered over every procedure I could hear being performed on crying children up and down the halls.  Every beeping monitor and rattling cart jangled at what was left of my nerves.

Plenty of people offered to help. I was entrenched in such moment-to-moment care that had no idea what help I needed. My husband was there every spare hour, other than that no one came to visit.

Then one afternoon my husband’s Aunt Grace showed up.  Despite our affection for her we rarely got to see her. She was and still is a private person who is a busy volunteer and active grandmother. Just seeing her familiar face was a blessed relief. She said she wasn’t going to stay long, she just wanted to hold the baby for a bit to give me a break. I hadn’t imagined such a break, but passing him over let me take what felt like the first deep breath in a long while.

Then she gave me a white bag. When I smelled it I realized I’d been hungry for days. Ravenous, actually.  I pulled out a warm foil-wrapped sandwich with deep gratitude. As I unwrapped it my hope flagged. I’d been a whole food vegetarian for years, yet here was a white roll with roast beef and mayonnaise  — a trifecta of What Laura Doesn’t Eat.

I didn’t want to seem unappreciative. Maybe I could wrap it back in the foil and pretend I’d eat it later. I looked at her holding my baby on her shoulder, her cheek against his cheek.  She looked back with such deep kindness that I bit into that sandwich, wiped the goo from my lips, and took another bite.

I could practically feel every cell in my body embrace those nutrients.  Never before or since have I eaten something so powerful. That sandwich tasted like love.

~

Life is full of tests that have no assured results. A big one is how to help someone in crisis. If you’re not sure what to do, take it from Aunt Grace. Show up. Hold whoever needs holding. And bring a sandwich.