Title: A Gap in the Tapestry
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Byline: As told to Debbie Shapiro
I stared at the piece of paper in my hands. The square-shaped bigger than life head, the small body, the tiny hands and feet, replete with fingers and toes — a normal ultrasound for a ten-week-old fetus. The technician wished me "B'shaah tovah" as she handed the print to me with a big smile. And although I smiled back at her, inside, I cringed in pain.
The story really began over ten years before, when, without any connection to a pregnancy, I developed massive bilateral pulmonary emboli, a life threatening condition where both lungs became clogged with hundreds of blood clots, any one of which could prove fatal. I spent over a month in the hospital, almost blind thanks to a clot lodged in an eye muscle, and too weak to even sit up in bed. Despite the doctors' dire prognosis, I survived and returned to my vibrant self; the doctors called me a walking miracle. Less than a year and a half later, I married my husband, and in the next several years, b'chasdei Hashem, I succeeded in delivering three healthy babies without complications.
So when, shortly after realizing that I was expecting our fourth child, I developed enormous blood clots that covered the bottom half of both legs — hard, finger-size swellings that were extremely painful — I immediately called my gynecologist. He, of course, instructed me to head straight to the nearest emergency room.
At the hospital, the doctors were barely able to hide their shock. They had never seen anything like this before. The head of the internal medicine department was called in and I was placed on a heparin pump and instructed not to get off the bed. By now, however, the pain had become so intense that standing was not even a possibility.
Over the next week, it seemed as if every specialist who had anything to do with the hospital came to look at my legs and give an opinion. Although the blood clots were extremely painful, they were not dangerous. They were, however, a sign that something about my pregnancy hormones was causing my blood to clot, and although the problem was presently contained to my superficial veins, if a clot were to develop in one of the larger, deeper veins, there would be a real danger that pieces could break off and fly up into my lungs, brain or heart and kill me.
The morning of the ultrasound, the heads of the department had entered my room and, with extremely grave expressions on their faces, questioned me as to exactly how far along I was in my pregnancy. Before leaving the room, they instructed the nurse to send me for an ultrasound to confirm my calculations.
I intuitively understood that the doctors were going to recommend that I terminate this pregnancy, that I abort this precious life that I held within me. I immediately phoned my husband and asked him to discuss my condition with our rav, Rav Moshe Halberstam, zt"l. "Please make sure the rav understands," I said, "that I am willing to do whatever is necessary to have this baby — even if it means spending the next six months in bed. But I am also aware of the dangers, and if he paskens otherwise, I will accept it wholeheartedly."
I began giving myself a silent mussar schmooze. Of course I knew that my life takes precedence over that of my unborn child's, and that as a G-d fearing woman it is my obligation to follow the Rav's instructions. Obedience to daas Torah is a measure of one's yiras Shamayim. My seichal understood that if the Rav were to instruct me to abort the baby, then that was what I would have to do; it would be just as min haShamayim as if it were to happen naturally, and therefore I must never allow myself to feel guilt for terminating a potential life in such a case.
But still, I questioned how I would be able to live with myself afterwards, and I was angry at myself for allowing my emotions to contradict my intellect. It was difficult for me to bridge the vast distance between my brain — my intellectual understanding — and my heart — my emotional reactions.
As I fingered the picture of my unborn baby, I felt the tears well in my eyes. I wanted to place the picture in a safe place, so that in the future I could look back and remember this precious little neshamah that I was carrying so close to my heart. But I realized that I was being foolish and forced myself to crush the paper into a tiny ball and throw it into the nearest trashcan.
Back in my room, an acquaintance stopped in to visit me and, in a rush of emotion, I told her what was going on. "My husband is speaking with the Rav now," I concluded.
Her reaction floored me. Instead of urging me to listen to daas Torah, she gave me a whole drashah on "emunah and bitachon," stating that the mere fact that I had asked such a shaylah showed a lack of emunah. Instead, she argued, I should simply place my trust in Hashem that He will keep me healthy and help me to deliver a healthy baby. As I listened to her passionate speech, I kept on repeating to myself that it was the voice of my yetzer hara speaking. Oh, how I wanted to believe her, to just have "emunah" and trust that everything would work out. But I also knew that true emunah is bowing my will to daas Torah — asking a shaylah and obeying the Rav's psak.
While my friend was still in the midst of delivering her speech (and I was quietly telling myself not to listen to her), four doctors entered my room and requested that she leave. Even before she had a chance to close the door behind her, one of the doctors said, "Your life is in danger. We have no choice but to terminate the pregnancy."
When I told them that my husband was presently discussing the situation with Rav Halberstam, zt"l, the head of the department left the room to phone the Rav. Less than twenty minutes later, an orderly brought me to the doctor's private office, where Rav Halberstam was waiting on the phone to speak with me.
The Rav asked what I thought about the whole situation. I responded that as things stood now, I was in a lot of pain but not really in danger; but that I did realize that if the condition were to spread to my deep veins, it could be life-threatening. "I'll do whatever is necessary to save this pregnancy," I continued. "But I also realize that if the Rav paskens otherwise, then that, too, is min Hashamayim." With those last words, I felt the tears trickling down my cheek.
The rav explained that although his first concern was for my life and according to the information the doctors gave him, I would probably have to abort the baby, he wanted to discuss the situation with a specialist in the United States
Baruch Hashem, I did not have the nisayon of terminating the pregnancy. The specialist felt that there was no immediate danger to my life. He felt that I should return home on what was then a new, experimental medication: low-molecular weight heparin. He instructed me that other than taking a one-hour brisk walk each day, I was to remain flat on my back with my feet elevated above heart level. In my hyper-coagulative state, standing or sitting, which causes the blood to pool, could cause me to form new blood clots. Brisk walking, on the other hand, increases the blood flow and prevents new blood clots from forming.
The next few months were spent in bed — except for my daily one-hour brisk walk. Seminary girls came each afternoon to help with the children and housework, organizations sent in readymade meals, and I tried my best to walk where no one would see me! It was extremely embarrassing to be on the receiving end of so much chessed and then be seen looking the picture of good health as I power-walked around the neighborhood. I truly hoped that if anyone noticed me they would judge me favorably.
Then, in my sixth month of pregnancy, the unthinkable happened. I developed a DVT (deep vein thrombosa), a blood clot in one of my main veins. There was a real danger that a piece of the clot could break off and travel into my lungs, a potentially life-threatening condition, and I was immediately hospitalized.
I spent the next six weeks in the high-risk pregnancy ward, flat on my back, receiving intravenous heparin. Although my life was in danger, the pregnancy was completely normal. Finally, just a few days before Purim, the doctors decided that the situation was stable and sent me home with instructions to remain in bed with my feet elevated above heart level until it was time to deliver the baby.
I was so excited to return home to my family. Neighbors had sent over a beautiful Purim seudah, the house was immaculate, and it was wonderful to finally sleep in my own bed! But despite the euphoria, something didn't seem right. It took a while until I realized what it was — I wasn't feeling my baby.
I was petrified, but I kept on telling myself that I must be overreacting. After all, before I was discharged from the hospital, I had gone for an ultrasound and monitor, and everything had appeared perfect. I tried to convince myself that it was nothing more than the excitement of returning home.
But when I still didn’t feel the baby by the next day, I returned to the hospital to make sure that everything really was all right. The nurse listened to the heartbeat and reassured me that the baby sounded fine. I was ready to return home, grateful that my fears were nothing more than a figment of my imagination, but according to hospital protocol I couldn't be released without an ultrasound.
It took several hours until I was finally called me in for the ultrasound. At first, the technician reassured me that everything looked fine, but that she couldn't discharge me until the baby made some movement. After waiting ten minutes, she gave me a few cubes of chocolate to eat, but still, nothing. Then she placed a loud, buzzing machine next to my stomach — again, nothing. Finally, she called in a senior doctor.
After that, everything happened very fast. I remember being transferred to a hospital bed, and that there were several people standing around me — helping me into a hospital gown, placing a monitor around me, inserting an intravenous line into my arm. On the monitor, the line for the baby's heart was completely flat. Yes, the heart was beating, but it was a steady 160, without wavering up or down, a sign of severe fetal distress. Without warning, I suddenly felt a painful stinging sensation in my upper arm. "We just gave you a shot to help the baby's lung's develop," the nurse explained.
Someone handed me a form to sign, agreeing to an emergency C-section. Within minutes an anesthesiologist appeared to administer an epidural anesthetic. Stunned and petrified, I was rushed through the long hospital corridors and into the operating room.
All I remember of the operating room was that it was freezing cold. I couldn't stop shaking as the doctors began the surgery to remove my child. Just before the final incision, the anesthesiologist administered something to put me to sleep, and the next thing I remember was waking up in a large room surrounded by many beeping machines, with my husband at my side. He looked exhausted and worried.
"How's the baby?" was my first question.
He didn't know.
"Is it a boy? A girl?" I continued.
"A girl." His voice was flat.
"Did you get a chance see her?" I asked.
He told me that he had managed to catch a peek of our newborn baby girl as they whisked her away to the PICU. "She was on a respirator," he said quietly. "She looked very, very sick."
"Please find out how she's doing."
My husband went to the nurse's station. From my bed, I watched as he spoke to the woman at the desk and then slowly return to my side "She said that she'll call the PICU and get back to us as soon as she has some information," he said.
Sometime later, the nurse appeared at my bedside. She had a box of tissues in her hands. I knew what she was going to say. Yet, even as she said the words, "Your baby passed away a few minutes ago," I felt a searing, wrenching pain, it was as if I was being physically torn in half. I was overwhelmed with a sense of emptiness, of loss, and no words could comfort me.
It's funny how, at times like this, everything we've ever learned about emunah comes rushing back to us, an anchor to keep us from falling into the depths. "I know that this was min Hashamayim," I kept on repeating to my husband, "and I know that this baby had to come down to this world for a tikkun, and that, b'ezras Hashem, after 120 years I'll be together with this baby in the Next World. But still, although I know that everything that happens is for the good, the pain was excruciating; it was beyond anything I have ever experienced." And I wished — oh, how I wished — that I could have seen my daughter at least one time before she was taken away from me, had some fleeting memory of the precious little neshamalah that I had given birth to.
Even as I lay there, feeling the enormous waves of pain wash over me, I was amazed at another emotion that kept bubbling to the surface: gratitude. I was so grateful that I had been able to carry this baby to the eighth month, and that I had merited to give her the gift of life, even if it was only for a few short hours. "It was all worth it," I said. "Everything, the months in bed, the pain, the surgery, to enable this neshamah to do her tikkun." Even as I said these words, I was amazed at my own capacity to feel such contradicting emotions.
That baby was my youngest child. Although this story happened almost eighteen years ago, the pain — the black hole of emptiness — still exists. It will never disappear. Eighteen years ago, it was raw and fresh. It overwhelmed me, filling up my entire being and dominating my life. Today, it's a small gap in a rich tapestry, barely noticeable, definitely not a blemish, but an integral part of the entire picture, providing another dimension of texture and depth.
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