Friday, February 4, 2011


Last night, I was reading a book our office just received called The Happy Lawyer: Making a Good Life in the Law. Since I am currently struggling mightily with exactly how to do this, I was interested to see what the authors had to say. I skipped around and started with the chapter “Happiness: A Primer,” which basically reviews what scientific research, particularly neuroscience, has to say about happiness.

Well, you’d think by now that I would know to stop at “neuroscience.” But I didn’t. I don’t even think a red light went on. I just kept reading innocently enough.

Until I reached a section about the three different “brains” and the functions of each. I didn’t get past the first paragraph. All because of one simple sentence:

“The brainstem controls heartbeat, respiration, body temperature, and other essential functions.”

In an instant, I was transported right back to those wretched three days in the PICU. I was right there by Hudson’s bedside when the nurses would disconnect her ventilator tube momentarily to change its position or clean something out or moisten her gums and lips with ointment. During those 10 seconds or so, I stared as Hudson’s chest just lay flat, unmoving, no breaths going in or out. And then they would put the vent back on, and her chest would start rising and falling again, in an all-too-regular rhythm.

In eleven short words, I was right back there by Hudson’s bedside on Wednesday morning when the PICU nurse asked me, “Does she feel cool to you?” Cool? Why would she feel cool? I touched her forehead and her tummy and she didn’t feel particularly cool to me. They took her temperature and it was below 90 degrees. (I remember thinking what kind of mother was I that I hadn’t noticed this?) They went to work immediately trying to raise it. The nurse tried to fish out the ibuprofen suppository she’d just given Hudson within the last 30 minutes. They covered her with a warming blanket, which looked like a big, clear, pool float. It was very hard to keep in one place and made it difficult to lie down and snuggle with her. They insulated her IV tubes with warmers so that the fluids they were pumping into her would help raise her temperature quickly. They put her on a continuous temperature monitor so they could keep track. About an hour before this, the neurologists had done some reflex tests and gotten no responses, but those results were completely invalid since Hudson was probably hypothermic at the time. While this momentarily gave me some hope, I quickly realized that the fact that her brain was apparently not even doing a most basic function of maintaining her body temperature was independently a very bad sign.

In one tiny sentence, I was right back there in the armchair by Hudson’s bed on Thursday afternoon as the nurses gingerly moved her into my lap and arms so that I could hold her on that last day. Her blood pressure kept dropping, making the monitor sound off ominously, until the nurses realized that one of the joints on her central line was cracked, so the medicine that was controlling her blood pressure was unstable. It was then that the attending physician asked us if we wanted them to take any extreme measures to prevent her from crashing if her body had decided it was time to stop. We said no.

“The brainstem controls heartbeat, respiration, body temperature, and other essential functions.” I read that one sentence and immediately, my own heart started racing as I remembered how Hudson’s brainstem slowly ceased doing any of those things. I got up from where I was reading, went downstairs to the room where Hudson’s memorial table is, and there, with the light off, I just let myself be back in that place. I was there for several minutes, crying and taking deep breaths in the dark, just letting it be. And then I felt better.

I have wondered many times about whether I have been experiencing some form of PTSD since our stay in the PICU and Hudson’s resulting death. I’ve certainly read articles about parents who spent time in the ICU with their children suffering from PTSD (and that was in cases where the child did not ultimately die). I don’t know enough about the condition to say so one way or the other. The main symptom of PTSD I have experienced is this repeated reliving of the worst moments of those awful days. And while I have certainly experienced some other symptoms of PTSD, none have been so dramatic or affecting as these flashbacks, and none have been truly incapacitating.

What I can say, though, is that even as recently as a few months ago, the flashbacks I had last night would have sent me into a downward spiral that might have lasted for several days. I wouldn’t have stopped crying after a few minutes. I would have crawled into bed and been up half the night continuing to relive those moments over and over again in my head until I succumbed to a fitful sleep. This time, the worst of it was over within several minutes and the only lingering after-effect was yet another anxiety dream (this one involving Bess repeatedly running into the street even as I called to her over and over again—even though it was Bess in the dream, it was definitely a dream about Hudson). Otherwise, I slept relatively well, woke up feeling okay, and have managed to make it through writing this post without falling apart again.

I realize that I’ve written about some of the moments included in this post several times already. I guess I am only just now grasping the real power of telling my story over and over again. I don’t know if the flashbacks themselves will ever go away, but over time, their quality has changed, their grip on me has lessened. And for that, I am incredibly grateful.


  1. I'm sure you probably do have some form of PTSD. I think it would be hard not to after all that you experienced. And I'm sorry that those experiences keep replaying themselves for you, and that they seem to pop up without notice. I know that must be really hard. Thinking of you, and Ed and Hudson and Jackson too. xoxo

  2. I agree. PTSD seems like an obvious human response to such a devastating loss. There is much research done on the effects of parental loss in children-I am not familiar with such research on the effects of the loss of a child on the parents, although it's probably out there.
    Mandy, to see the grip lessened, even just a little, must be relief.
    With you every step (up and down) and thinking of you often,

  3. I agree that it would be amazing if you did not have some PTSD after what you went through. And it is very different from the grief, in my (very different and not really comparable) experience. They complicate each other but for me, at least, they are pretty independent.

    My experience is not really comparable because the PTSD for me is mostly related to what happened to me in the ICU after I lost my baby, but to give you an example: these days, when I read a story about a stillbirth or neonatal loss, the sympathetic grief is pretty overwhelming and probably predictable. But this entry led to a very different reaction: I panicked. I wanted to stop reading (and in fact I did, I went and paced around my living room for a while), my heart raced. I didn't cry (even though I am not sure when I've read anything sadder) but I may have a nightmare tonight.

    I find the word "trigger" really appropriate for this reaction. The grief doesn't need to be triggered; it's always there, and some things just bring it to the surface, or make me feel a particularly acute sadness on someone else's behalf. But the panic and fear from my ICU experience is really different. Most of the time it's not there, it's not something I think about, until I do, and then I'm right back there, and I am terrified all over again. (This time without the benefit of being mostly unconscious.)

    I did not find therapy to be very helpful with this, but I think others have had different experiences. I did not have a very good therapist.

    I wish your triggers were not so easy to stumble over.

  4. I agree with the others here - I think it would be amazing if you didn't have some level of PTSD after your devastating loss. You continue to amaze me, however, with your strength and resilience. (((hugs))) Mariann

  5. I agree as well... PTSD would be as 'normal' as can be after the most unimaginable loss..
    some days I don't know how you do it Mandy. I don't know how many of us do it.

  6. You do sound like you have some of the symptoms, namely dreams and flashbacks as well as "triggers." PTSD is considered a very normal psychological reaction to extreme grief, but there are people who can help you work through it if you haven't approached a doctor or therapist about this already. If you are willing to do so, it might be helpful.

  7. Mandy, like so many others, I have read every post and with every word, I not only bear witness and miss sweet Hudson, I am awed by your ability to lean into the pain and allow it to transform you. I am so grateful I answered "yes" to your post of "coffee and conversation" for new moms; because with it, I entered a world of love more profound than any of us could ever have known. Thank you for allowing us to stand with you. We surround you always...Renee P.

  8. Mandy, I'm so sorry you have to relive the trauma of your experience, but I'm glad you are finding that the process of sharing your story has lessened the power the flashbacks have over you. I know that the first week after Naveen was stillborn, I kept replaying my labor and his birth over and over again in my mind, reliving the trauma. Finally I wrote down what happened, and when I worked up the courage I shared it and that helped lessened the grip of the flashbacks on me. So I hope you can keep telling your story here and to a really good therapist and to whom ever else will listen. Like you, I don't think my flashbacks will ever go away (they are part of my memories of Naveen, and part of his story, so in a big way I don't want them to - even though they are painful), but I do have hope that they don't have to be overpowering. I wish you didn't have to face these battles, but I have so admiration for the way you keep surving. Love to you.

  9. Oh, this stuff is so hard. But the fact that you can see your reactions gradually lessening I think is a good sign that you are adapting and being reflective about it, even though it is awful to go through.

    The 'replaying' of a scene over and over again sounds pretty familiar to me. For me it is the immediate aftermath of the accident, and then the first hours at the hospital. Beth's description of the 'trigger' effect is spot on.

    Take care xxh

  10. Mandy,
    PTSD is probably playing a role in the flashbacks and the intruding images. There are minefields everywhere and a sentence in a book can and did send you back to a traumatic place. The mind also protects until we're ready to revisit certain images and memories. I'm learning that for myself. It's so very hard but breath by breath we keep going.

  11. There hsa been a lot more research done recently about sudden death of a loved one is more than just grief but more closely resembles PTSD. I believe it, that has been my experience.

    I think in someways though,your brain needs the flashbacks. It needs to relive the moments until it understands what happens, until it believes it is real, until you can fully comprehend what has happened.

    I am glad they are getting shorter and more managable.