“Do you know if he was sick at all? Were there any problems with the pregnancy or delivery or after?” I asked her.

“No. It was tough for them to get pregnant, but when they finally did, everything went well. She was never sick. The delivery went well. They were out of the hospital in two days. The baby had a perfect checkup visit. Everything was perfect.” She stared at me. “How does this happen?” she asked, shaking her head.

I took a breath. “It’s so hard to say. Sometimes it’s an underlying medical problem a baby is born with. It’s nobody’s fault. It’s just one of those things in nature. Other times, we never have any diagnosable reason for why it happens. Again, I am truly sorry.”

“Thank you, thank you,” she said, before lowering her head and walking back over to her daughter.

Dr. Thomas asked to speak to me. I took the phone and, at the request of the family, informed her of what had happened. She told me the story of the difficult conception. She recounted how happy the parents had been to be pregnant. They were such a cute, hardworking couple, she said. She told me she had known the young woman since she was sixteen years old, and now here it was, sixteen years later, and she was delivering her first baby. Everything had gone like clockwork. Her voice cracked as we said our good-byes and acknowledged that it had been a very hard night.

As I ticked the pertinent boxes on the death note and hospital chart, my mind began to wander, but I had to keep redirecting my energy to the work. I sent off an email to the medical director requesting smaller pediatric blades in the event of future neonatal codes, one more discussion point for the next staff meeting. I heard Pam muttering to the tech that I should have been able to intubate the child, that there had been no equipment problem; the issue had been me. The tech responded that it didn’t really make a difference, since there had been no bringing the dead infant back to life. I heard Deb say that we really should have proper pediatric equipment and that Pam shouldn’t be criticizing me so harshly.

I spoke to the medical examiner on call, then notified Organ Donation that this, like any neonatal death, would be a medical examiner case, so not a candidate for organ donation. Ultimately, the family left, and Baby Tally was wrapped snugly in his white blanket and rolled away to the morgue.

One by one, the hours passed.

Finally, my shift ended and I found myself at home as the sun rose. I drank a glass of red wine, chased it with chamomile tea and a Benadryl, and fell into a shallow sleep. Hours later, I awoke feeling heavy and with one thought: I had failed the baby. It was two hours before night shift number two this week.

I knew that my mother would be off work by now. I picked up the phone to call, to tell her of my failure while I prepared my dinner. I stood over my new yellow soup pot from Williams-Sonoma—the pot was part of my strategy to buy fancy cookware to encourage me to cook, to get on with life. Much like the monthly auto-renew membership to my yoga studio, this strategy, of investing financially in something that would force me to participate in life, always worked. I couldn’t stare at my pricey pots, pans, and high-speed blender without feeling sufficient guilt over not making use of them regularly.

As the soup simmered, I choked on a flood of tears. In that moment, I realized that in all my years of training, I had never really cried. During my residency, when people were brought into the emergency room beaten and stabbed and later died in my arms, I didn’t cry. At family conferences, when I had to inform wives that I’d had to put their husbands on ventilators and had no idea whether those men would ever breathe on their own again, there were no tears.

And when I had been a desperate girl, a child without a childhood, praying to the crescent moon at midnight that my family might survive, that I might survive, I didn’t cry. The pain might have scorched my throat, my eyes might have misted up, but I never truly let myself feel the burn, never lowered the floodgates. My divorce only months before had shattered me in ways I had never imagined, but even then, I hadn’t fully allowed myself the luxury of a stream of tears. There wasn’t time. I had to get through it; I had to push past it to survive and excel. Now here, after graduations, after my divorce, between night shifts, between the cracks in the crumbling stories I had told myself of what my life should look like by now, there was an opening for reflection.

The truth was I had never cared about “marriage.” I was never a girl who thought there was anything special about the title of “wife.” Both its historical roots (women used as property) and the state defining legitimate versus illegitimate love to bolster both the patriarchy and the heteronormativity on which it depends had stained the institution in my eyes. Instead, I valued a spiritual union, which is something that can never be bestowed by anybody besides the two souls in the relationship. Sure, traditional marriage made sense from a business perspective, if the conditions of that business were best served by such a contract.

When I was young, I didn’t dream of being a mother. Most people I knew of chose a partner with the same level of meaningful intention as Ken marrying Barbie, then reproduced reflexively like cattle, so, in my estimation, the mere acts of coupling and multiplying never conferred any singular importance or achievement to neither humans nor the one-celled organisms who can do this too. I figured motherhood would happen for me one day in the future, when I got around to it. It wasn’t something I needed to do, but I took for granted that I would. I suppose I took it for granted in the same way I assumed that I would encounter the partner with whom it would make sense to share my life—settling was not an option.

I stood stirring my soup of the day, a rustic chicken stew with quinoa, chickpeas, and a selection of veggies, allowing rivers of salt to flow down my face. With each turn of the spoon in the pot, I remembered what it was I actually missed: a healthy, soulful connection to another person. And now that the option of having a family seemed to have evaporated, I grieved that I’d lost the chance to do childhood and spiritual marriage right, the way I had never known them for myself.

During our call that day, I told my mother about Baby Tally. I recounted how he had looked like Eli and the baby I didn’t have. I told her that this new city was far lonelier than I had ever imagined possible. But worst of all was that I might never get to raise a child the way a child should be raised, to provide her with the love and shelter she deserved.

My mother responded reflexively the way many mothers feel they have to. She told me that the baby’s death hadn’t been my fault, that none of it was my fault. She ended with a statement as certain as fact that of course I would have the family I wanted one day. She spoke as if time weren’t a factor, as if the future held limitless possibilities for me—whatever I wanted.

But I knew better. I knew that days morph into years, which turn into decades that don’t promise particular outcomes. In the same way, no matter how “perfect,” a soul can take its leave from earth in twelve days or twelve years without so much as a hint.

It’s human nature to want to bind ourselves to the parts of life we hold dear whether those parts are actual people, events, items, or dreams. We want to fasten them to us so they’re safe and near us forever. But this type of binding frays and tears until, even when we fight the awareness, we’re forced to see how illusory the reliance on permanence is. What we have, in all its glory, to hug and hold, to caress and learn, to feel and grow, is simply right here and right now. If we are lucky, the bond holds in the moment—and the experience of it shines and breathes and expands. Then our story can change in an instant, and we may never be given the gift of why.

I didn’t have an answer. Baby Tally’s family didn’t have an answer. We had all been broken in that moment—broken open by shock and grief and anger and fear. I didn’t know how or when, but this opening could lead to healing. After all, only an empty vessel can be filled by grace; but to get there, we had to help each other rise while we shed the same tears. We had to get up and start again.

FOUR

    Erik: Violent Behavior Alert