SKIN

I was born on Easter Sunday, almost five decades ago. And as the day of my birth fast approaches, I’m reminded of a recent and unforgettable birthday when one of my then eleven year old twin boys, Alex, went to hospital to have a circumcision. He’d been enduring infections over the past three or four months, and after many treatments with no result, surgery was unavoidable. I joked that I’d be the only mother lucky enough to get a foreskin for her birthday.

Two days before the operation, however, I started to feel anxious. ‘It’s only a circumcision,’ I was told when conveying my fears. ‘It’s not like the surgery he had back then. He’ll be fine.’

“Back then” was when Alex was three and a half, and before that, when he was three weeks old. Both traumatic, pain-filled, leaving us with a legacy of physical and emotional scars.

And now, here I am again with my son in pre-op, waiting to go into theatre, fighting the memory of his last hospital experience eight long years ago. Compared to the foot reconstruction surgery he endured back then, apparently a circumcision is 'no big deal'. Besides, he's fine. Chirpy, in fact. I'm the one who's not fine. I focus on breathing slowly and turn my head away from him when I feel tears sting the corner of my eyes. I have to stay strong and I don’t want him to see me crumbling. I don’t want to frighten him.

The day has been long. We’ve been here six hours already. Alex’s twin brother, Sam, is in the waiting area – they wouldn’t let him in here with us. Now and again I leave Alex and go and make contact with Sam. ‘Shouldn’t be much longer, Sammy,’ I tell him, and then rush back to Alex.

Eventually, a nurse wheels us into to the operating theatre.

‘Hey look, Al: it’s just like ER!’ Alex knows my penchant for the weekly soapie that my daughter and I watch with great fervour.

The medical team are kid-friendly, joking with Alex and making light of all that’s about to happen. I’m standing next him, holding his free hand as they begin to inject a large syringe of white gunk into his arm. It hurts him, and as he begins to cry there’s a look of audacity on his face – you said I wouldn’t feel anything! I hold his hand tighter. ‘It’s okay, sweetheart.’

And then he’s gone. Mid-cry, his head flops to the side as his life force is snapped away. I’m suddenly afraid. He’s not my Alex any more. He’s not my sleeping, content, Alex, the one I kiss goodnight, the one whose head I’ve tenderly stroked as he sleeps. That Alex has suddenly gone.

I’m hurried from the room and I can’t stop the tears. The nurse reassures me he’ll be okay. I feel embarrassed about being such a worrisome mother, for exposing my cracks.

‘I’m okay. It’s just that last time he had surgery, it was a terrible experience, that’s all,’ I explain.

‘It’s only a circumcision. He’ll be fine.’

Before I go through the swinging doors to Sam, I wipe away the evidence of fear. He’s bored and he wishes he’d stayed at home – being lugged around to his step-brothers’ footy practise sessions – than come in here for hours on end. I feel bad for him that it’s all taking so long.

There’s no phone signal in the waiting area, so to make a call I need to go into the stair-well and up two flights of stairs to get outside. I feel the pull of my anaesthetised son get stronger, the further away I get. I keep the door ajar with my foot. The phone signal is strong out here.

My phone beeps a multitude of messages from concerned relatives, which I don’t have time to respond to, but I send one to my husband, telling him we’d be home in a few hours. I also send the twins’ father a message, telling him where we are and that we’ll be late getting to the ward, but to come and look for us as soon as he gets here.

I go back down the stair-well, back into the waiting area and back to a bored and hungry Sam. Forty minutes passes, which seems like a long time, as I was told it was only a fifteen minute procedure, maximum.

‘Is that Alex?’ Sam suddenly asks, looking up from his electronic cyber-dog game.

I strain to listen through the swinging doors that open and shut momentarily. I hear a muffled wail, but am not sure if it’s Alex. It can’t be. After all, it’s only a circumcision, I remind myself. I imagine my little boy still sleeping, maybe waking, groggy, but in no pain. The image calms me, but I pace close to the door, all the same.

The cries do sound familiar, but perhaps it’s as familiar as when a child in a crowded place calls out ‘Mum!’ and all mothers turn around, thinking it’s their own child’s voice they hear. It’s a universal cry – everybody’s child is our own.

The post-op door suddenly swings open and a nurse almost runs into me.

‘Are you Alex’s mum?’ She looks worried, hurried.

‘Yes. Is he okay?’

‘He’s in a bit of distress. I think you should come.’

I look back at Sam. He stands up to come with me.

‘You have to stay there, sweetheart. I won’t be long. It is Alex crying.’

I leave Sam and rush in. Alex is lying on his back, screaming, ‘It hurts! It hurts! Oooww! It hurts!’ and gripping the side of the gurney with one hand while his other knuckle-white fist smashes against the rail. The nurse shields his bloody penis as he then begins to manically scratch at the air, wanting to hold where it hurts.

I hold his wild hand, and stroke his head, tell him that I’m here and we’ll stop it hurting. I’m not even sure he hears me, but I’m certain he knows it’s me, even though his eyes are closed tight, like he’s stuck in a bad dream and can’t wake up.

‘What’s going on? Why’s he in so much pain?’ I look around wildly at concerned faces, and indifference from other medical staff who are tending their own quiet, recovering patients. It’s all so unreal. One doctor is laughing as another recounts a subject she’s undertaking in ethics; others are hunched over clip-boards, oblivious to our cocoon of hysteria. There’s an elderly man with a nasal tube, lying on a gurney, assuring the nurse he’s okay and quite comfortable thanks; monitors are beeping, bed rails are clanging. And my boy is screaming.

I’m fast spinning out as my attempts to soothe him are futile. I’m aware that Sam is just outside and can also hear his brother’s screams. My husband is at footy practise with his kids. My daughter is at work. Alex’s father is probably in traffic somewhere. I’m alone in a sea of faces and my son is screaming and I can’t help him.

‘They don’t think the penile block worked’, the nurse who brought me in says. ‘It’s supposed to stop this kind of pain and trauma when they come out of the general. Especially after a circumcision.’

I’m flabbergasted and furious, but I have to stay calm for Alex’s sake. ‘Hold my hand, sweetheart. Squeeze it as hard as you can. We’re going to make you feel better very soon. The doctor’s coming. Hold on. Hold on.’

I try to keep my voice calm, but I too, want to scream ‘What can we do? What’s being done?’ I ask her. She tells me they’re getting him some codeine, but it takes a while to get it signed off. ‘We’re also waiting for the anaesthesiologist. The surgeon and other doctors have gone – Alex was last to be operated on.’ Her tone is concerned, her eyes empathic. She’s with me in this. I realise she looks familiar, but I can’t place the face.

‘His twin brother is in the waiting room. He’ll be worried.’ I want to tear myself in two and be with them both. The nurse sends someone out to make sure Sam’s okay. She comes back. He’s fine, she tells me. I’m not reassured, but there’s nothing else I can do. I look at my little boy in his gaping white gown, his scarlet penis swollen and bursting with black stitches, his thighs and groin painted in antiseptic yellow-brown. I can’t leave him. Sam will have to wait.

Another nurse, walking fast and carrying a syringe of syrup, comes over to us.

‘Here you go, matey. Take this and it will make you feel better’, he tells Alex as he squirts the liquid into his mouth. His demeanour is caring, but futile, given my son’s distress. Alex desperately gulps the medicine. For a second his wails stop, then start again.

‘How long will it take to kick in? Will it help? Can’t we get him something stronger, quicker?’ I need to know when this will end.

The helplessness that surrounds us is treacle-like, weighted and oppressive. Nobody can do anything until the anaesthesiologist can be summoned.

I realise how isolated I am in this. There is no father here. No grandparent. The waiting room is full of families supporting other parents, waiting in anticipation and concern for the person who’s being operated on. But it’s just me here. My husband has his own children to look after and the twins’ father couldn’t afford not to work and take the time off to be here. Sam came under sufferance, but it’s the best I could do on my own.

As I hold Alex’s hand, telling him how many minutes have passed and how long it will be until the medicine helps, with a flash, I recall an image I recently saw on television of an Afghani mother holding her dying son’s hand - her naked anguish, his unbearable pain, and the futility of hope for help that would never arrive. I don’t feel any better knowing her outcome will be different to mine, but I do feel connected to her grief somehow.

Then I remember the ‘one in ten’ statistic that the anaesthesiologist had rambled off during his pre-op consultation. It didn’t mean anything to me then, just as the statistic of the one in a million chance of Alex dying during the general anaesthetic didn’t. But it did now. It means the whole damn deal sucks and that Alex doesn’t deserve to be a statistic. He’s had his share of trauma in his mere eleven years and he doesn’t need any more.

Twenty minutes later, and still no respite, a middle-aged, white-gowned doctor arrives and swiftly injects something into Alex’s IV.

‘What’s that?’ I ask. And who the hell are you and what took you so long? There was no introduction, no bedside manner from this man. It was all business.

‘It’s a sedative. We’re going to give him a spinal block and we need him still.’

Alex’s crying gradually becomes a whimper as he drifts into semiconsciousness. The fierce grip of his hand in mine slowly evaporates, yet I still hold on.

‘Do you want to stay for this?’ the familiar-looking nurse asks me gently, as I watch them roll my son onto his side and paint his back with antiseptic. I suddenly remember who she reminds me of: the woman on Biggest Loser, the pretty one. Stupid thought to have at this moment, but there it is anyway.

‘Should I? Can I? I don’t want to leave him.’ Which son needs me most right now? Who will feel my absence more acutely? ‘I don’t know what I should do,’ I tell her. Wanting to stay, wanting to go.

She touches my arm. Such a simple gesture, but the touch of reassurance I need. ‘I’ll hold his hand. He’ll be fine. I’ll look after him. He’s barely awake anyway.’ And then as an afterthought, ‘But you can stay if you want to.’

‘If you stay and you feel faint, sit on the floor,’ the doctor snapped. I don’t intend to faint, but I don’t want to see Alex hurting any more. I have to choose: Sam is on the other side of the swinging doors and scared; Alex is semiconscious and the nurse said she’d watch over him. I trust her that she will.

I decide to go to my other son. ‘I’m going to make sure Sam’s okay, sweetheart,’ I whisper to Alex, stroking his hair. ‘But I won’t be far away and I’ll be straight back, okay?’ He gives a small, quiet nod. Knowing he can hear me somewhere in the fog of his descent, gives me relief, but makes the decision to leave harder. Before I change my mind, I kiss the top of his head and go. Unstoppable tears flow, stronger and faster the closer I get to the exit door.

Sam rushes to me, crying, and holds me tight as I sob and tell him about his brother.

‘He’ll be okay, but I need you to be taken care of so I can take care of Alex.’ I look around, frantically. ‘Where’s Dad? Is he here yet?’ Sam shakes his head. Surely he’d be here by now?

The room full of waiting parents look at me with collective sympathy but also relief that it’s my child and not theirs, in crisis. I ask one of the admin staff if I can use their phone to call my husband. Fortunately her compassion overrides office policy, and she dials the number for me.

As soon as I hear his voice, I come undone, losing the moment of calm I had summoned, and become more inconsolable with each word. My husband, forever the pragmatist, reminds me he’s at footy training with his kids and that as soon as it’s finished he’ll come in and pick up Sam.

I discover a small bar of hope on my mobile phone. I hold it up high in the corner of the waiting room and send Alex’s father a message telling him what has happened and where we are, hoping he’ll come quickly and help me take care of our boys. I leave Sam and again and go back to Alex.

An hour later, and it’s all over. The spinal block has taken effect; Alex is still groggy and drifting in and out of sleep, but at least his pain has eased. I hold his hand and tell him it’s going to be okay and that his dad will be here soon. Better be here soon.

As he’s being wheeled back to the ward, a father whose teenage son has also just had surgery walks alongside me.

‘Doesn’t matter how old they are, you’d always take their pain for them, wouldn’t ya?’ he says, his watery eyes belying the gruffness of his tone. It’s a question that doesn’t need an answer.
We arrive back at the ward. Alex’s father is sitting on the chair next to the bed, casually flipping through a magazine.

‘How’d it go?’ he asks, ignorant of what has happened to his son. Apparently his mobile phone has been turned off for the past few hours. Hospital policy. I envied – despised, even – his oblivion.

Fifteen minutes later my husband arrives with a cheery ‘gidday’. And why shouldn’t he be jolly? Alex is the calmest and most alert he’s been for hours. He looks fine, sounds fine, is fine. For now. Heaven only knows how he’ll be when the spinal block wears off.

As quickly as he arrived, my husband leaves with Sam, needing to get back to the other kids who are home alone. And not long after that, my ex-husband also leaves. His wife needs hay-fever medication and if he stays any longer he’ll miss the pharmacy. God forbid.

And so now it’s just my beautiful boy and I, alone together again. I go to get the car while a nurse helps him into a wheelchair and meets me at the hospital entrance. My brave, strong, youngest twin by two minutes leaves the hospital, one foreskin less, and one nightmare experience more; and me, with one birthday I’d rather forget.

Together we make the tender journey home.