Iowa City, a different chapter

We leave for Iowa City late in the afternoon.       Cowboy Dave needed to watch the majority of a football game, enough to know which team would be headed to the Superbowl. We arrive in this college town, home to the University of Iowa and Hospitals, a sprawling campus surrounded by corn fields. My son Jim and Sara, the woman who shares his life, are both interviewing for positions at the University. We are the official nannies for their children as they mix and mingle with the academics.

In 1977 Jim had been diagnosed with what the doctors thought was a heart murmur.  He was six months old.  Dr. Scott, my pediatrician with a really bad hair piece said, we know something is wrong, we just don't know what it is. So began our relationship with the University. Year after year we showed up for appointments waiting for the doctors to figure out what was going on in this little boy's chest. There was a medical van that came to Dubuque every few months that checked children with cardiac conditions, but Jim was required to go directly to the University.  That always bothered me.

When Jim was eight years old he and his brother and sister and I would take long walks picking violets, stalking grasshoppers.  Little Jim would require lots of rest stops, frequently sitting on the curb or sprawled out on the grass.  He's the baby, I told myself,  he needs more rest.

That summer the doctors decided to do a complicated test. They injected dye into a vein in his groin and the dye would circulate and show a moving x-ray of Jim's heart.  They practically burst into the waiting room where we huddled with our coffee cups.  I thought, hooray, it's all right.   We know what's wrong, they crowed, and we can fix it.

Jim had a hole in his heart and blood was leaking.  Half of his heart was enlarged due to the muscle needing to work harder to supply the lungs with blood.  Open heart surgery would be necessary.  Could we wait another year, I asked, he is so young. No, too quickly came the answer, the younger they are, the faster they heal. What would happen if he did not have the surgery?  He would begin having small heart attacks as a teenager and then death in his early 20's.

We returned to the University. Jim was prepped and a tray was wheeled in holding IV equipment for the anesthetic.  Stop, the surgical nurse hurries in.  Jim's doctor had injured his back while playing golf.  How totally comically predictable is this, I said.  There would be no surgery today.  Back to Dubuque with Jim and me in the back seat singing funny little songs and my ex-husband with his new wife simmering in the front.

I want a different doctor, I said, and back to Iowa City we went.  Our new guy was Japanese and I had difficulty understanding his conversation.  But I could feel the intelligence radiating from his person and he picked up Jim's toy transformer model and in a few deft moves had the thing figured out. This is our man, I thought.

I talk with the social worker and she recommends a support group.  I decide not and then find a woman in my office with a little girl who needed the same surgery at the age of three.  I seek her out and ask, what was it like?  Imagine the worst, she says,  and then realize it will be worse than that.

The day of his surgery my little boy with pink cheeks and bright eyes is rolled into the operating room.  What returns is a still little body with yellow waxy flesh, the respirator pumping his chest up and down mechanically, greasy eye lids closed tightly.  They are mainlining morphine every four hours, no questions. This small boy is  surrounded by numerous machines tended by people in white coats.  Don't mind us, one technician quips. I stopped paying attention to you guys a long time ago, I thought.

Back at the Ronald McDonald House I walk out on my small deck and rage at the moon.   A few days ago Jim had risen  from his home town bed and found me in the kitchen smoking a cigarette.  Mom, he said, shadows under his eyes, I don't know any other kid who needed to have this done. I know, I said, the world is not a fair place.  He shrugs and goes back to bed, his shoulders bowed by the weight of the situation.

Jim's surgery was longer than the expected eight hours due to a lingering cold.  I spent the time curled on a couch in the waiting room hating everyone who had healthy children. After 2 1/2 days he was discharged from intensive care and I am able to sleep in his room. There was a young man in the other bed, fifteen years of age, a farm kid with a shock of red hair, and he had a malignant tumor removed from his leg.  His parents had talked with him in the early evening, his father planted corn every spring and his mother was a social worker with the school system.  I will quit my job and take care of you , she said.  No, Mom, don't do that, he replied, quietly weeping, you love your job.  The boy was receiving his first chemo treatment that night and back in the eighties, chemo was rough stuff.  All night  he vomited, poor boy, until he was only capable of dry retching.  In the morning, he apologized  knowing he had kept me awake.  I think my heart broke at this point. I often wonder what happened to that boy.

Jim came home and the doctors were right. I had a difficult time keeping him still.  The wire they used to fuse his chest  together would eventually be absorbed into the bone and even an airline metal detector would not find it. A white ropey scar remains where his chest had been pried apart.

My former husband came on the fourth day following surgery and I returned home to check on my two older children.  Jim peered at me with an old man's eyes, not wanting me to leave.  As I rose from my seat a social worker appeared and took Jim's hand.  Come, she said, let's check out the operating rooms. Jim says this is when he decided to become a doctor.  Interesting, don't you think.