Bedside Manner

We’re a few hours in when something starts to go wrong with the epidural. Not all at once, but a creeping awareness of sensation starts to tug at my attention as I lie there and look at the trees outside, and read, and make small talk with my husband.

At first, I ignore it. But then I start to get nervous.

“I can wiggle my left toes,” I say, not really to anyone. Observationally.

And a few minutes later, as I watch a contraction rise and fall on the monitor next to the bed, “I felt that one.”

And a few minutes after that, “Do I have the kind of epidural that wears off?”

This gets the team’s attention.

No, the nurse assures me, it’s a continuous drip, and if you need more at any time, you can hit this button—and don’t worry about overdosing yourself, because you can hit the button as many times as you want and it’ll only give you the amount of medicine you need.

I hit the button, and wait the requisite fifteen minutes, and then ask again—should I be able to feel pain?

The anesthesiologist is busy. There are ten c-sections going on today (ten!), and he is in high demand, shuttling from room to room. Earlier, I could hear the woman in the next room working through contractions, moaning and crying, for what seemed like a long, long time. They are not easy sounds to ignore, despite my husband’s and my efforts to studiously ignore each other through the increasing volume. Surely they are not easily ignored by a doctor whose charge is to relieve the body from its own sensation—but perhaps professionalism is its own insulation. Perhaps pain, and all of its sights and sounds, becomes routine to those who see it all day, every day. As I look at my left knee bouncing under the sheet, I feel those sounds coming for me, creeping closer with each minute that ticks by on the wall clock I can’t stop staring at.

I vaguely recall the sounds, the pain, hazy in the memory of my daughter’s arrival six years ago. The feeling of a sound taking control of your diaphragm, working its way up your throat and out into the world. Against your will, but more than that. Against your own awareness. I had an epidural that time too, after the surprise of labor pains had me hyperventilating, my face and hands gone numb and tingly. This time around, when I’d heard about the anesthesiologist’s busy day, I’d asked for it early, while the pain was still not even pain, just increasing discomfort. I can ride out discomfort, but I am afraid of pain. I am afraid of my own ability to get through this. My inability. I am grateful for modern medicine. I am grateful for the anesthesiologist. I am grateful for the nurse’s assertion that I really am getting the pain-killing medication through my spine, even though it seems not to be going everywhere it needs to go. I am grateful grateful grateful, but gratitude alone is not going to dull the sensation of this child’s arrival into the world.

They tell me that sometimes the epidural can distribute itself unevenly. I imagine medicine seeping into my limbs, pooling in the crevices and curves of my right side, but leaving the left side dry. While we wait for the anesthesiologist to return from one of the c-sections, the nurses turn me fully onto one side. I’m lying on a sheet covered with an absorbent disposable pad, like a puppy who hasn’t been housebroken, and to move me, someone has to heft each side of the sheet to rotate my giant, useless weight. It is embarrassing, though my usual sense of modesty has been leaking away all day, like air from a lightly punctured balloon. Receding, like my cervix is supposed to be doing under medication. They’re both stubborn, though—mind and body.

The pain doesn’t decrease, and my left side feels like it’s in high-relief, in stark contrast with my numbed right. I shuttle my eyes back and forth from the wall clock to my right and the monitors to the left, where the line of each contraction is wiggling its way up and down a continuously unfolding bar chart, digitally displayed as well as printed on a narrow sheaf of paper. It looks like a lie detector test, which is strangely validating: yes, I am telling the truth, it hurts. At first, when the line trends upwards, I turn my head away from the monitor to watch time tick by on the clock. They’re not long, each contraction a few tedious minutes, and then there’s a welcome pause, a brief nothingness of another few minutes, each a delicious relief. I anticipate and covet each break. The anesthesiologist will be here in twenty minutes, the nurses tell me, and I find myself quickly calculating how many contractions, how many tiny trials that will be. Math, in the face of pain! Truly, bringing a child into the world is full of unexpected wonders.

At some point, they rotate me onto my back again, and my husband offers to squeeze my hips, something we did the first time around, during our daughter’s endless birth—a way to relieve the pain of the contractions, even just a little. He has to perch on the side of the bed, one hand on each side of me, and he looks panicked and awkward, poised over me with his arms wide like a guest trying to corral a spilled drink on their host’s wooden table, flinging his arms into its path while waiting for someone else to grab the paper towels. It helps, a little, though I’m trying not to stare into his face too directly because he looks as stricken as I feel. It might be another twenty minutes, they tell me eventually. I’m not watching the wall clock now, but closing my eyes each time the line ticks upwards.

I had not prepared for this. It feels foolish and inane to admit, but I had counted on the dulling power of the epidural. Why didn’t I watch some YouTube videos about breathing techniques? Practice meditation? Practice anything?

I used to do yoga. Not well, but regularly. There was an instructor I liked at my chain-store gym, her classes the reason I kept my membership for as long as I did. She was good at describing how your body should move and feel through each pose, somehow making phrases like “knit your ribs together” make sense. She seemed normal, approachable—so unlike the giant photographs of artificially smiling, sweat-less athletes plastered on the walls of the gym. She arrived in the group fitness room like one of us, a civilian, her authority inconspicuous as she padded between mats to her place at the front of the room, apologizing for the lack of parking and stuffing her winter socks into her boots, just like the rest of us. She was so real, so perfectly human—positive and proud when our triangle poses were correctly angled, kind and generous when we couldn’t pull off crow pose. She was a good teacher.

Under her guidance, breathing had started to make sense to me, to feel powerful and consistent, rather than an obstacle to be moved around, held, avoided. Then she paused in her teaching to have her own children, then we moved away from that gym and I canceled my membership, then the pandemic. I tried to look her up, but I only knew her first name, and never was able to track her down. Why wasn’t I more persistent? Why didn’t I keep practicing, even with someone else, even through Zoom?

Yoga breathing feels distant to me now, but I pull a thread of memory back to those classes and start trying to breathe through the pain. I close my eyes, try to feel the warmth of the breath in the back of my throat, find the teacher’s voice in the basement of my consciousness to guide me through. I forget the clock. The doctor is never coming, these hip squeezes will never be enough, it’s all going to last forever. All I can do is breathe. I drag the air in and out of my mouth, scraping it over my teeth. My mind is a blank, nothing in my thoughts but my breath. I can see the remembrance of light on the inside of my eyelids. I am deep inside myself every three to five minutes now, pressing the side of my face hard into the flabby hospital pillow with each contraction, a vision of that old group fitness room glowing in my mind’s eye.

Someone is touching my arm.

I open my eyes to see the newest nurse hovering over my left side—she just came on service an hour or so ago, right before this pain started. She looks so young; she could be the older sister of one of my students, too old for Civics class but almost too young for the rest of the world. She is very gently rubbing my forearm as she watches the terrible crescendo of a contraction on the monitor. She doesn’t say anything or even look at me, and her touch is so soft. A claw-less bird. An alighting. This touch feels so important, so much stronger even than my husband’s desperate grasp on my waist. It feels so different from the careful, efficient prodding of medical support; so distinct from the calmly professional hands that have been checking monitors, positioning the IV, taking blood pressure. It feels like kindness.

*

Two months earlier, I forced forty-one high school seniors to come to school on a Saturday morning to take a three-hour practice AP test. The incentives were fairly weak: fast-food breakfast, a grade that would count as their final exam so they would know early, in April, what they needed to work on before the year started to wrap up in May to finish with the grade they wanted. Many of these students I had taught for two years. They groaned and scowled, and almost every single one of them showed up on the appointed day. I felt so tenderly towards them.

Mostly they arrived early. They helped me carry the boxes of donuts and coffee from my car, walking slowly with me as I waddled along, pregnant and sweating, taking the long way through the neighboring building’s grounds, because the parking lot gate was stuck. I’d brought flashcards, but many of them had made their own. Their conversation buzzed through the library as I turned on lights, organized test packets—warmly quizzing each other about the twenty-seven amendments, laughing about mnemonic devices for landmark Supreme Court cases. A handful arrived at the last possible moment, texting their friends to have someone run down and open the door for them before the test began. And then, packets distributed, phones collected, they sat and struggled in thick silence, as I watched them.

I was wearing the only shoes that still fit me, and they squeaked a little when I walked, so I tried to sit as much as I could, staring searchingly around the room to monitor the students’ progress as I graded essays and checked the time.

At a far table, I noticed a boy slumped over his test. At first I thought he was just concentrating, really in it, face close to the page, but eventually I got up and squeaked over and saw that his eyes were closed. This had happened before—this student was bright and curious, but kept late hours and fell asleep in class easily if we were not in active discussion. He still tended to do well in class—I had made that tired joke several times about learning through osmosis when he fell asleep head-down in his notes.

I like to think I’m a pretty understanding teacher. I know not everyone finds history and government to be as fascinating as I do. I know my students hold down many jobs outside school hours (sometimes, maddeningly, overlapping with school hours), and many have to work because their families need them to. I know many sign up for the AP class because their friends are in it, their social circle more compelling than the dangled possibility of college credit. I know sometimes even with the windows open and the fluorescent lights turned off, the classroom—the school, the life in which we find ourselves—is stultifying. But it can be hard not to take it personally when a kid falls asleep in your class. And this morning, I had brought coffee! Sugar! Flashcards and good vibes!

A decade ago, during my first year as a teacher, I monitored a study hall. Our directive was to keep students silently on task for sixty minutes. They were not to talk to each other; they were not to sleep. I would sit, seating chart in hand, and bark students’ names across the quiet cafeteria, growling warnings to those who whispered or nodded off; and then calmly issue detentions to repeat offenders. My colleagues and I traded exasperated smiles as our charges glowered in submission. I did not make myself popular among students, though I probably did make myself known. I remember feeling drunk with power. I remember feeling like I was doing my job.

We have probably all seen a frustrated teacher bang a hand on a desk, or maybe even drop a heavy book to the floor—the noise of it enough to startle a room, let alone a single, dozing teenager. The violence of it enough to shock anyone to attention. And we can perhaps imagine the justification: this is the job. Teachers are there to prepare young people for a sometimes cruel and painful world. It is serious work. This can be the thinking of the powerful, as well as the professional—it can be a seductive, and sedative, rationale.

I paused next to where this sleepy student was sitting on that morning in April. His eyes were closed, face muscles perfectly relaxed, his expression smooth and neutral in sleep. Very few spaces had been bubbled in on his answer sheet—his fatigue had come on strong and suddenly, it seemed. His hand was still curled around a yellow number two pencil.

How many hours had we spent in class, discussing the importance of this day? How could he not be more prepared?

I touched his arm. Just for a moment.

When he looked up at me, I hoped my smile said, You’ve got this. And I’ve got you.

We nodded at each other, and he got right back to the test.

*

The anesthesiologist finally arrives, all apologies, syringe at the ready to provide temporary relief with hard drugs, fentanyl, and while I’m surprised by this—evil undertones of the opioid epidemic chiming through my mind—I also welcome it. I’m desperate. He checks the epidural, I’m rotated yet again to my other side, and now I’m so drained that all shame at my immensity, my immobility, has evaporated.

The drugs do their work, and after passing through a brief sleep, I’m roused again. The midwife asks if I want to have a baby: it’s time, my body is finally ready. Though how can it be? How will I be able to push? The epidural has been distributed evenly and with the extra medication my body has become its own uncanny valley, folded where it seems to matter most, my hips hinged right where I lose sensation. I am myself from the waist up, while below my navel another woman’s legs are being wrestled into the stirrups. Where is the rest of her? What is wrong with her? Her flesh feels warm and foreign under my hand, as I try to hold a knee steady—it’s like holding a wax figure with a concrete core. The nurse who had stroked my arm through the contraction pain earlier is struggling with my other leg.

Later, after the exertion of pushing and the excitement of holding the new baby, sticky and pale but so sweet and strong and lovely already, the same nurse helps me to the bathroom, my right foot uselessly dragging as we yank it forward, the epidural is still so strong. We are caught in something between a foxtrot and a wrestling match, the two of us against my stubborn, exhausted body, and all I am able to think of is her light touch on my forearm, even as she steadies me with iron in her grip, as I lower myself to sit.

*

When my son is four days old, the AP scores are released. I scroll through them on my phone, one-handed as I steady him to nurse in the half-light of the early morning. The numbers unfurl awkwardly, not formatted for a small screen, and I smudge my thumb back and forth, up and down, to read everything.

The baby’s tiny fist is curled against my skin, covering my heart.

I read the names and numbers, feel relief welling within me. Tenderness.

I jiggle my baby against my left knee, flex my toes.

My student, the sleepy one, the one whose arm I touched to wake him on that April morning, has passed his test.

And I have passed mine.

-Andrea Cavedo

Andrea Cavedo's writing has appeared in the (now-defunct) online publications Gapers Block and Hungry Mag. She has taught history and government to high schoolers for the last decade, and lives just outside Chicago with her family.