If a Tree Falls (19 page)

IN THE CHILL OF EARLY MORNING, Juliet’s first birthday, Bill and I settled Sophia, still in her pajamas, into my parents’ hotel room down the hall from ours. Then we bundled Juliet in her fleece coat and crossed the busy Boston street to Children’s Hospital. I clutched Juliet tightly as we walked, shielding her from the wind as I could not shield her from the risks of the operation she was about to undergo. In the pre-op room at 6 a.m., she was one of at least fifteen babies facing surgery.

Awake most of the previous night, watching Juliet sleep, all I could think was
: she is intact.
The sounds reverberating in my ears—the rumble of the ice machine, the shuffling of feet down the hall, the hum of the heater—why were they so important? Juliet understood the world as well as any one year old, and she was happy, bonded to us, related. How crazy were we to have a surgeon invade
her head, drill into her tiny skull, weave an electrode array around the curls of her cochlea—all to bring her into the hearing world?

Diminished by my uncertainties, it was all I could do to follow the directions of the nurses. I put on scrubs so that I could carry Juliet into the operating room and hold her as they administered the anesthesia. As I put the blue mask over my mouth in preparation, Juliet, her playful eyes sparkling, yanked the mask off in a peek-a-boo game.

In the operating room, I held Juliet tight, warm against me, as the doctors briskly shoved a black rubber mask against her face. Her muffled gasps were swallowed up, her fight dissolving as she went limp in my arms. Quickly, the doctors took her and ushered me out of the room. Bill was waiting for me as I weaved my way, flushed and dazed, to the end of the hallway.

The surgery could take up to five hours. As we searched for an empty cluster of chairs in the waiting area, we recognized a mother and daughter from a pre-op appointment two weeks earlier. I looked on as Bill engaged the daughter, played Pacman with her. I filled with admiration for Bill, for his kindness toward this worried little girl—her twin brother was in surgery—but it only punctuated my loneliness.

I called Sophia on my cell phone. She was watching cartoons. I told her I’d call again when Juliet was out of surgery.

“She’ll have a big bandage on her head?”

“Yes, like in the pictures I showed you.”

“Because they’re making a cut in her head?”

“Yes.”

“Will it hurt?”

From Sophia’s tone, I half suspected that she hoped it would.

“I need to go now, Sophia. Have fun with Grandma and Grandpa. I love you.”

I hunkered into a seat, and I started to open a skein of wool. I was going to use my hands, crochet a scarf, allow the rhythm of my movements to calm my bursting head. Somehow, though, my opening of the skein yielded an immense tangle of wool. I looked at Bill, now sitting beside me, reading the newspaper. I asked him if he would help me unravel the mess of knots and he said “No,” he couldn’t bear to, it would unravel
him
. Next to him, but alone, I sat for the next several hours, trying to untangle the wool, my eyes burning.

The attending nurse cheerily updated us with: “they’re still drilling” (into Juliet’s skull, that is) at the forty-five
minute mark, at the one and a half hour mark, and unbelievably, at the two hour and fifteen minute mark. I couldn’t help overhearing conversations about cancerous tumors and heart defects. Another mother, sitting a few seats away, burst into tears.

Sometime during the fourth hour, I looked down and noticed that my wedding ring was not on my finger; it must have slipped off. I searched the waiting room, then I searched the bathroom, the cafeteria, everywhere I had been that morning. How could it be lost? I rummaged through my bag, then dumped the entire contents onto the chair next to me. My ring was nowhere among the papers about implants, the sticky notes with friends’ cell phone numbers, my wallet, random coins, paper clips, and the sparkles fallen from Sophia’s barrettes. With quaking fingers, I squeezed my hand into the narrow inside zipper pocket. There, my fingers twisted tight around the cool braided gold. I put the ring on, reassembled my bag, stowed the skein of wool, and pressed my back into the chair for the remainder of the wait.

From down the hall, I saw the surgeon loping toward us. His blue scrub mask was pushed back on his forehead, and he was grinning a toothy smile. Bill and I had liked him since our first consultation. He told us that his own son had needed ear surgery as an infant—a surgery that
he’d had to sit out. Now he came to lean against the arm of a nearby chair, his legs stretched out in front of him.

“The surgery was extremely successful. We were able to thread the electrode array very high up along the curvature of Juliet’s cochlea. She is going to have access to all channels. We tested the implant mechanism and it’s working. When the surgery wound heals, in about a month, the audiologist will program her external processor. I’d like to see Juliet in about three weeks.”

I was elated, and suddenly embarrassed that in the same time it took the surgeon to give Juliet a cochlear implant, all I accomplished was unraveling a skein of wool.

In the recovery room, Juliet’s head was bandaged thickly, her face swollen, her eyebrows pressed low. Asleep, she looked agitated, like a boxer in a fight. She awoke in a fury, screaming and punching, a detoxifying maniac as the anesthesia worked its way out of her body. I gathered her up but the weight of her bandage threw us both off-balance. She nearly flipped out of my arms, she was so top-heavy. I jostled her into a cradle position, careful not to stretch the many tubes and wires connecting her to monitors. Juliet raged inconsolably, then suddenly, abruptly, fell asleep.
Twenty minutes later she awoke again in a fit, her arms and legs flailing, then she tumbled back to sleep. I held her through the night, through countless ragings and sleeps, cramped in the hospital crib-cage meant only for her. In the early dawn, I perceived the smooshed and crooked beginnings of a smile. Juliet stood herself up, lifted her blanket to cover her face, and resumed our earlier game of peek-a-boo.

A month after the surgery, we drove back to the hospital so that the audiologist could “turn on” Juliet’s sound. An external processor would be programmed by computer, first very softly, then later with gradual increases in volume. Like a dimmer switch on lights, it was important to be gradual with Juliet, so that she would
like
sound, since she could take her processor off (and stop hearing) if she didn’t. Before we got into the car to go, the phone rang. It was Jan, from Clarke.

“Are you ready?”

“ I don’t know,” I said.

“You should be prepared for Juliet to cry. Lots of babies cry.”

“I know.”

“Or she might become agitated.”

“OK.”

“ I just want you to know, Juliet is not going to respond today the way you want her to. What you want is for her to hear her first sound, turn to you, and say: thank you so much!”

In fact, Juliet’s reaction to sound was far more wondrous. In the cochlear implant mapping room, its door marked with a child’s geometric drawing of a cochlea, Bill and I wrapped our arms around Juliet as the audiologist programmed the external processor on the computer. The external processor consisted of an earpiece, shaped like a behind-the-ear hearing aid, with one wire attaching to a magnetic disk the size of a quarter and another wire attaching to a small box with a control panel. Juliet’s earpiece was blue, like Sophia’s hearing aids, and now the audiologist attached a snazzy pink stripe to its top. The magnetic disc was brown, and it glommed onto Juliet’s head like a magnet onto a refrigerator:
glup.

The audiologist instructed us to be completely silent. She turned the system “on,” then handed Juliet a drum and a stick. Juliet whacked the drum, then jumped back like a startled animal at the sound of the boom. She searched our faces with wide questioning eyes. She beat the drum again. Boom! Then, with a wild thrust of her head, Juliet laughed.

Juliet used the drum stick to beat other things: the audiologist’s pant leg made almost no sound, the metal file cabinet made a loud clanging boom, the wood chair back sounded different from the thick wood table top. Juliet, at thirteen months, was a scientist, studying and experimenting with sound.

According to the audiologist, all sounds would come in as beeps and blips at first. It would take months before the neural pathways between Juliet’s auditory nerve and her brain would be forged and able to translate the input into meaningful sound. Months before “moo” could be distinguished from “quack” and pinned on its rightful farm speaker. And months before Juliet would turn at the calling of her name. But Juliet’s excitement carried us through. At home, she was thrilled to hear the sizzle of an egg in the frying pan, the rush of water through the faucet. She prompted us to sing songs, to “moo” and to “quack,” to turn on music, to attend to the many noises we ordinarily delegated to the background and ignored.

We poured milk into Rice Krispies cereal, and we bent our heads low to the bowl.
Snap! Crackle! Pop!
We jingled bicycle bells:
Jing, Jing!
Rang doorbells:
Ding Dong!
Honked horns:
Beep Beep!
We placed and received calls on our toy phone:
Rrrring Rrrring Rrrring!
We bought and sold stuffed animals with our toy cash register:
Ring; Bonk
(the money
drawer sliding open). We played “Jungle”—
Roar!
—and “ Farm”—
Cockadoodledoo!
We sounded off harmonicas, drums, recorders, a kazoo. A whoopy cushion.

Juliet reawakened us all again to the wonder of hearing. Her joy chased away our worries that our decision was selfish or presumptuous. Even if it was these things, it was not
wrong
. Juliet reveled in sound.

We hunkered into our work. And we hunkered into our wait. Who knew what Juliet was processing? Or what she might sound like when she had heard enough to venture into speech? I thought often of that computer simulation I’d heard: that croaky sentence, “ I like to play tennis.” Was Juliet’s hearing really like that? For a week, when I had laryngitis, I was especially curious. Perhaps through an implant, my raspy voice was inverted, so I finally sounded like my usual self?

Each morning, we put on Juliet’s implant processor. I also stuck a high-volume hearing aid into her non-implanted ear. Set at highest volume, the hearing aid might give her access to some sounds—most likely low frequency sounds and sound patterns. If it worked at all, she’d hear these through the normal hearing process, rather than the
implant’s electronic one. Juliet objected to the aid, but I persisted in putting it in. Through her fits, I rasped in my best Demi-Darth-Gulch voice. Any chance to round out Juliet’s auditory experience was worth it.

Bill made us breakfast—the girls liked his “crispy” scrambled eggs—and then went upstairs to work. He was telecommuting now, working in our attic for a national child advocacy organization based in Seattle. Sophia put on her own hearing aids, and got ready for preschool. Then, I whisked Sophia and Juliet down the block in our double stroller to Sophia’s school. Once Sophia was settled into her classroom—having shown us her paper weavings, her popsicle stick fairies, her plastic cup of grass on the windowsill—Juliet and I ambled our way home, missing Sophia already. Back inside, to keep things cheery, I chased Juliet around our house. “I’m going to get you, Juliet,” I yelled. And with exaggerated, booming steps, I ran after her, as she scuttled ahead of me, squealing.