Berkeley writer Monica Wesolowska recently published the memoir Holding Silvan: A Brief Life (Hawthorne Books, 2013), which explores the love and ethics behind forgoing medical intervention for her newborn son. Wesolowska has published her work in many literary journals and anthologies including Best New American Voices 2000, My Little Red Book, Beach: Stories from the Sand and Sea, The Carolina Quarterly, Quarter After Eight, and online at Literary Mama. A former fellow at the Fine Arts Work Center in Provincetown, she has taught fiction writing at the University of California Extension for over a decade. She lives in Berkeley with her family. Here, the opening chapter:

BIRTH

IN THE MORNING, THE PHONE NEXT TO MY HOSPITAL BED RINGS. Stepping from the shower, my skin scrubbed of the sweat and blood of yesterday’s triumphant labor, I slip past David to pull on my old robe and head for the phone. I’m not worried. I’m expecting another friend, a relative, more words of congratulation to match my sudden pleasure in my baby—a healthy, full-term boy who waits for me in the nursery—but the woman on the other end of the line is a stranger.

“Hello, darling,” the stranger says in a husky, soothing voice. She is calling from another hospital. She says she needs to clear up some confusion about the spelling of my name before the transfer. I, too, am confused. When I tell the stranger that I don’t understand, that I am about to go down the hall to collect my baby because it’s time to nurse, she says, “I’m so sorry to be the one to tell you, darling.”

With these vague but tender words, the ecstatic glow of motherhood that has surrounded me since Silvan’s birth begins to fade.

An ambulance waits; the transfer is happening any minute. Wrapped still in my dirty robe with its stiff patch of dried blood in back, I open the bathroom door and try to convey the stranger’s words to David hidden in the steam. Though David has told me his worries about Silvan since the birth, I’ve dismissed them all as mere symptoms of new fatherhood. “Wait for me,” he says turning off the water, but there is no way.

If I could, I would fly to my son.

IN THE NURSERY, five people stand around Silvan’s bed. Five people. This is the baby’s “transport team” as someone puts it—two people to wheel the bed, one to drive, two more “just in case.” In case of what? In the night, when the resident had taken Silvan from me because he would not stop crying—little mewls like a kitten, little peeps like a bird—she only wanted me to sleep. She’d promised to bring him back when it was time to nurse. Even when she returned a few hours later to tell me they needed to keep Silvan for “observation,” I hadn’t begun to worry. I was too tired, too happy. I’d roused myself to go down to the nursery to see what they were worried about—cute little fist curls they called seizures. I’d held Silvan until I thought I’d pass out, then returned to bed without him. Nine months of hope is a hard habit to break. Besides, even if they were right in the night, he is totally calm now, sleeping peacefully. At last, he has stopped crying. Surely this is a good sign?

“It’s the phenobarbital,” they say.

I would stay beside his bed until they’ve wheeled him off to the ambulance, but a nurse comes in. She’s been searching for me, racing around coordinating my discharge. She needs me back in my room for an exam by a midwife. There’s paperwork to do, a birth certificate to apply for, breast pumping to do. She’s helpful but unpleasant. “Do you want to be discharged now or not? Because I have all my ducks in a row.”

Back in our room, my mother has arrived; David’s father and stepmother, too. I call out to them how cute the baby is—“just like David”—as they are ushered into the hall. The midwife spreads my legs. The breast pump arrives and I insert one breast into each cup, sign a birth certificate, agree to a home visit from a nurse and who knows what else, while the breast pump makes its thump and suck. Hospital staff tells me not to be embarrassed, they’ve seen it all before. David is searching the room for our possessions, which he stuffs into clear plastic bags provided by the hospital. The only thing he can’t find is the charger for his cellphone. It seems a small detail, too small to mention, but the symbolism is clear: soon we will become almost impossible to reach.

“HELLO MOM. HELLO DAD.” Shelley, the husky-voiced receptionist who’d called earlier, welcomes us to her hospital.

I am slow-moving but not in pain. Back at the other hospital, the last thing I’d done was put on my shoes and my mother had praised me for being able to stand on one foot so soon after birth—as if she herself is not equipped with such maternal strength. But maybe the recovery of my body matters as much to her as it does to me: it seems that this is the least I deserve, a body that can recover swiftly enough to care for a baby who must have been damaged while inside of me. For even though everything about my pregnancy and labor and delivery had seemed blessed, something has obviously gone wrong.

Shelley comes around her desk to hug us.

We are entering her world, the world of the Neonatal Intensive Care Unit, the dreaded NICU, a world where parents must dress in hospital scrubs to hold their children. Shelley shows us the routine: remove watch and jewelry, push sleeves above elbow, remove sponge and nail-pick from its plastic package, turn on water by whacking the metal knee pedal, get soap by depressing the squishy foot pedal, scrub, scrub, scrub thirty seconds each side, all the way up to the elbow.

On the whiteboard behind Shelley’s desk, I’m shocked to see my last name listed, proof that parenthood is not going the way I had imagined. Baby Boy Wesolowska, the whiteboard says, though our son’s name is Silvan Jerome Fisher.

DR. A is a strapping man, almost-handsome, with steady, almost-kind eyes. Almost, I say, because he is not my baby and my baby is everything in the world right now. Anything else can only be almost. Dr. A speaks to us clearly and intelligently as Silvan’s neonatologist. We stand by the side of Silvan’s bassinette. Unlike many of the babies in bassinettes around him, Silvan is plump and whole. Still he looks odd, lying by himself under a heat lamp.

Dr. A speaks with optimism but with an honesty that admits the unknown. His first diagnosis is best-case. “We have no evidence so far of anything but what we call subdural hematoma, a blood clot under the skull.” He says this happens sometimes during labor. After all, he reminds me that I pushed for several hours to get the baby around my pubic bone. Pushing for several hours is not uncommon with a first baby, but it’s not ideal. He holds up his hands to show us the plates of a baby’s head, and how they are still mobile, moving like continents. They are supposed to be this way, but sometimes when they crunch together in the birth canal they cause bleeding which leaves clots. These clots will shrink with time.

“This may cause seizures for him later in life, or it may not.”

With motherly pride, I assume it will not. And if it does, well, people live with seizures. My father, after whom Silvan has taken his middle name Jerome, had two seizures in his twenties. Though the seizures alarmed and embarrassed him, he went on to marry, have four children and a significant career.

And yet, as I hear the news, I feel faint. I say, “I have to sit.” And then I add, “It’s not because of what you’re saying.” Already, I know it’s important for this man to know that he can speak to me straight, that I don’t need to be coddled. I like honesty. But I do feel sick, woozy, and nauseated. Perhaps it’s a postpartum hot flash. “I just gave birth,” I remind him, apologetic, as someone wheels a stool my way.

THE NURSES TAKE over for a while. One brings me a little square of flannel.

“Tuck this inside your bra or somewhere close to your skin and wear it for a day, then bring it back. We’ll put it by your baby’s nose so he can smell you while you’re not here. That will comfort him.”

Another brings me bottles and shows me a room where I can pump milk.

“I know he can’t nurse right now, but when he’s better, we’ll start with the first bottles and go on from there so he doesn’t miss anything. That will also keep your own milk supply up and ready for him.”

I am stunned by their solicitude. Prior to his birth, friends promoted home births to me. Hospitals, they told me, were sterile, stressful places that ignored the wisdom of a mother’s body. At home, they seemed to think, nothing ever went wrong. But I liked my obstetrician, trusted her to trust me to give birth naturally. And I’d succeeded. For sixteen hours, I’d imagined ocean waves arriving and receding, getting high on my own endorphins as my body moved through novel pain, and then I’d pushed the baby out…but instead of being alert and drug-free, he’d been limp and silent. The triumph of that natural labor is now separating from the outcome as if the two events are unrelated. If this happened to him in a hospital, I tell myself, it could have happened anywhere. At least I’m not facing the blame for having risked a home birth; at least they’re treating me well, as if I am necessary and important, as if I am his mother. Because I am his mother, even if he is not in my arms.

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Upcoming readings: Sunday, Oct. 13, 6 p.m., “Lit on the Lake: A Plunge into the East Bay’s Literary Depths,” Lake Chalet, Gondola Room, 1520 Lakeside Drive, Oakland, litquake.org; Wednesday, Nov. 20, 7:30 p.m., Pegasus Books Downtown, 2349 Shattuck Ave., Berkeley, (510) 649-1320 or pegasusbookstore.com. For more info: monicawesolowska.com.

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Copyright c 2013 by Monica Wesolowska. Excerpted from her just-published memoir, Holding Silvan: A Brief Life, published by Hawthorne Books. All rights reserved. Reprinted by arrangement with Mary Evans Inc. All copyright remains the sole property of Monica Wesolowska and all rights other than one-time reprint rights are reserved by the author.