Blue Baby

By Joseph LoGuidice

Madelyn Muro has no choice but to enter the world a fighter – her dying heart will have it no other way. Maddy needs an immediate surgery on a heart no bigger than a walnut in order to get through her first week of life, and will have to endure several more just to grind her way to a sidelined adolescence. She has Arthur, the backbone of the Muro’s, and her manic-depressive mother, Sandy, to guard her. And there is Junior, a prototypical older brother who camouflages his sensitivities. The family is there, and so are the desires of a teenage girl. But unless Maddy survives a decisive surgery, she will not live to scratch the surface of her dreams. While tethered to machines that keep her alive, Maddy needs the power of fate to align itself. And she needs her dark gift.
Henry Crimson is seventeen and motherless, and he loves three things: his adoring kid sister, Beth, his girlfriend, Nikki, and cars. Fast cars. His father, Sam, a bitter alcoholic, dismisses Henry, and life for that matter. Sam tells Henry he will never be remembered for anything, teaching Henry that words can be daggers to the soul. Defensive yet caring, Henry is desperate to be counted for something – something good, and his vintage BMW may be his doorway to significance.
In a world of countless and seemingly independent parts, Blue Baby draws upon the themes of oneness, and the razor’s edge of life and death. Through Maddy and Henry, we see that we are the ethereal and fateful parts of something greater than what can be seen and touched. We see the diffused life under our lives.

• Language: English
• Publisher: Joseph LoGuidice
• Release date: Nov 15, 2014
• ISBN: 9781311467928

Joseph LoGuidice

Joseph LoGuidice first wrote Blue Baby as a short story that the online literary journal, Toasted Cheese, published in 2010. His favorite pastimes are golfing and worrying about not worrying so much. He is currently working on his third novel and lives with his wife and two children in Westchester County, New York.

Book preview

Prologue

There’s no such thing as a good night for a trip to the emergency room, especially after you just brought your newborn home. Nine hours after leaving the softness of newborn pediatrics, Arthur and Sandy Muro raced back to the hospital. Their baby, Maddy, had turned blue.

"There’s something wrong, really really wrong," Sandy was nearly hysterical, but there was nothing Arthur could do. He was taken up, stuffing Arthur Jr. into his car seat. Besides, Sandy refused to let go of Maddy. She said that if her infant daughter died, she would die in her arms.

Arthur weaved around cars and blew red lights, hand on the horn all the way. You’ve, we’ve got to hold it together, Sandy. Lord God, sick baby, and maybe a sick wife again. He pressed the accelerator as the hospital lights came into view, and swung the car into the emergency parking area.

Arthur parted the automatic doors with Junior on his shoulder and Sandy clutching Maddy to her chest right behind him. The first thing he saw was a greasy-headed teen in a yellow blood-stained tank top. There was a fat woman with labored breathing and two young men with no apparent issues, and many others. He scanned a room packed with ailing bodies and addled minds. He hated them all.

They approached the desk of a frazzled nurse. I have insurance, I can’t deal with paperwork, Arthur said.

What’s wrong? The nurse said.

We left this hospital with this baby today and now she’s very sick.

What’s wrong with her? The nurse rose from the chair to peer at Maddy.

She’s blue, Sandy screamed. My baby is fucking blue!

The emergency room and its murmurings halted. The sound of the eleven o’clock news hung in the air. The nurse looked at a female doctor who stopped in the hall. The doctor walked over to Sandy, took one look at Maddy and said, Call pediatrics, stat. Maddy was taken away. Arthur held Sandy with both arms in the waiting area. Her cheek was warm against his chest, her eyes closed but twitching. Arthur closed his eyes, too.

Life had been fine up to this point. Sandy’s pregnancy with Maddy had been smooth, and Artie Jr. was a stomping, healthy two-year old. They had good jobs, money, and a nice home in Sleepy Hollow, New York. All that seemed left for Arthur and Sandy was to thwart a second ambush of post-partum depression, and with enough game planning, anything was possible. Things could be made to order in his orderly world.

Tonight proved just how much of a lie that was.

Arthur wriggled his right foot and tried to keep his eyes closed because that felt like praying and maybe praying would help. And maybe the blueness was nothing, just gas or something.

Arthur shook his head at this thought. Gas, how stupid. How could gas cause Maddy to turn blue? Blue was something else entirely. Blue was death’s shadow before death reached the door.

The female doctor was back. Arthur’s heart jumped. Sandy dug her nails into his arm.

We have to transport Maddy to the children’s hospital at Westchester Medical. It’s her heart. We’re not sure what ailment exactly, but please go and be with her.

Her heart? Sandy said. Is she dying?

She’s struggling to breathe, and she needs a pediatric facility. That’s really all we know right now. Please be with her before we transport.

You’re saying it like she’s going to die, Arthur said.

This is a critical time.

A nurse buzzed them into pediatric intensive care, and led them through a corridor. Arthur glanced into the rooms, each one occupied by a child or a young teen. Maddy was in a section on the far end of the wing, segregated from other sick babies by a curtain.

Oh God, she’s been intubated, Sandy said. Maddy lay in her tiny bed with a tube down her throat, tubes in her nose, heart monitor patches on her chest. Sandy knelt down, and touched the palm of Maddy’s hand. Maddy didn’t react the way she had only a half day earlier. Arthur reached down, and with his fingertip applied light pressure to the backs of Maddy’s fingers causing them to close, thus connecting father to child and child to mother.

They’re coming for her, Arthur said.

• • •

Arthur and Sandy checked in at the children’s hospital a half hour ahead of the transport they weren’t allowed to ride in, and waited for word of Maddy’s arrival. They sat on plush, red chairs on blue carpeting. It felt like an expensive hotel.

"What is wrong with our baby? How could they not know over there? How could they not know? Sandy had thrust that question into the air a dozen times in the car. They should know with all those things, those machines. They’re doctors."

We’re lucky this——

Lucky? That word doesn’t apply to anything.

Arthur took a slow breath and let it out through his nose. That this place is here, Sandy. Some kids have to fly when they’re sick, or they don’t make it at all.

We haven’t made it yet, she said.

Drawings by children hung on the walls of the seating area where the lighting was yellow and warm. Crayons and colored pencils depicted cheery, haphazard suns, boxlike cars, dogs, cats, stick people, and giant blades of grass with flowers that smiled. Letters of unequal size spelled Mommy, Daddy, and names of siblings and pets. This was not the white, sterile environment of the adult emergency room where people looked tired and desperate. The idea of hope prevailed here. Quiet hope. Arthur clung to that.

A youngish cardiologist entered the waiting area. It had been almost an hour since Arthur and Sandy were told Maddy had arrived. Arthur stood up and took the doctor’s hand. The doctor was tall, dark hair, very thin. He sat next to them.

Mr. and Mrs. Muro, I’m Dr. Rappaport, the cardiologist working with Maddy. You’re going to have a lot to absorb in a short amount of time so I’ll try and be as clear as I can and answer all of your questions. Madelyn has what’s called hypoplastic left heart syndrome, HLHS for short.

What is that? Sandy said.

The left side of Madelyn’s heart is underdeveloped, and she’s not getting enough oxygenated blood pumped back into her body. That’s why she’s blue and too tired to feed.

Will it develop? Arthur said. Her heart? Is it something that will get stronger if we keep her here for a while?"

Dr. Rappaport frowned and shook his head. I’m afraid it doesn’t work like that. Her heart is failing, but——

She’s dying? Sandy said, tears running down her face, nails digging into Arthur’s arm.

"Her heart is failing, but there are options."

Let’s have them, Arthur said.

Okay. Dr. Rappaport leaned forward and placed his fingertips together. Madelyn’s left ventricle and aorta are too small. The ventricle pumps blood to the aorta and the aorta delivers it to the body. There is an operation called the Norwood procedure that would allow for Madelyn’s right ventricle, the healthy one, to become the sole pumping system. It would be the first of three surgeries.

Three? Sandy said.

Yes. The second will happen in three to sixth months in most cases, and the third in two to four years. All with the goal of relieving the heart’s workload.

And the other options? Arthur said.

Well, a heart transplant is an option, but that would require several factors to come together in regards to a donor, and we may not have the time.

And? Arthur said.

Compassionate care.

Arthur shook his head. Not an option.

What? Sandy said. What does that mean?

To just take Madelyn home, Arthur said.

To what—-die? Sandy said. Fuck that.

I agree. Dr. Rappaport said. That used to be the only option, but now things are different. These kids have a chance.

Maddy, she’ll make it through till we get to surgery? Arthur said.

She’ll be sedated until that time, and given drugs to keep the ductus arteriosis open – that’s a passageway for blood flow that would normally close in a very short time.

Sandy held a hand to her face and shook her head. What was that word? Ductus….

Arteriosis. You’re going to learn a whole new language. We’ll take it one word at a time.

Dr. Rappaport got up as did Arthur. They shook hands. And you can go see Madelyn right now if you like.

Sandy never got up from the chair. Maddy, she said with a blank stare. We call her Maddy.

Dr. Rappaport nodded. Maddy it is.

• • •

Arthur and Sandy lived at Maddy’s bedside in the Cardiac Intensive Care Unit after the Norwood surgery. It was the only room that mattered for them aside from their bedroom where they tried for some rest. And Junior, who was now passed between in-laws on both sides, slept with his parents; something they never allowed before. It helped, but only the heaviest fatigue dissolved the vision of Maddy tethered to wires, plastic and steel.

The CICU is where they learned to endure the gravity of a man-sized scar that had no business on a baby. Maddy now had one that split her chest like a red river through the breastbone, and beneath the surface of the river a temporarily repaired heart no larger than her closed infantile fist. There were pacer wires in her heart, oxygen tubes in her nose, arterial lines in the belly, and IV lines. All of this revolved around a scar that would not be trumped by technology and its various tentacles.

God, will we ever have her home? Sandy said, her hands on the bedrail.

It will be some weeks yet, Arthur answered. But yes, we will.

Maddy lay with her legs forming a little diamond, knees bent, heels touching, and her arms resting wide. And the scar pulled in the eyes, demanding onlookers pay homage to her struggle. The scar was a symbol, forever a doorway into Maddy.

One

Maddy walked the aisles of CVS Pharmacy while waiting for her prescriptions. Hearts were everywhere, from candy and cards to the hearts stuffed animals held, all shaped with the symmetrically rounded tops that connected at a narrow pointed tip. Most were of the deep red color that Maddy imagined whenever the doctors had to open up her chest. There was a fluffy white bear holding a heart that read I Love You. There were dogs and cats and even frogs holding these hearts. But the bear seemed to be holding his out to Maddy, as if she could just take it, bring it to the doctors and tell them to use it. Dumb bear.

Are they ready yet?

Maddy turned around to see Arthur standing in the aisle reading a Daily News. He stood just less than six feet and no longer towered over her the way she remembered. Glasses, dark hair with grey, trimmed neat. He had an air of Gregory Peck about him.

No, Maddy said. I never called it in.

Arthur looked up from his paper. Oh.

Maddy perused the spot that provided a calming innocence to her as a child, the candy aisle. This was where Sandy, her mother, had taken her to buy Valentine’s candy to bring to kindergarten. Maddy was just learning to read, so Sandy bought the little candy hearts with the messages on them to trade with her classmates. They were pink, lavender and yellow, and they read, I LOVE YOU, and BE MINE. It was beautifully simple for a child to grasp; hearts were shaped like this and they said things on them.

Mommy, what does my heart say on it?

Courageous, honey. Your heart says courageous.

Courageous was anyone who had to wait for a prescription to be filled at CVS. Maddy left the candy aisle and sat on a bench next to Arthur who was still reading his paper.

What’s the news?

Same as yesterday, just tweaked a little, he said, not looking up.

How are the stocks doing?

It’s Sunday, so they’re doing whatever they did on Friday.

Oh, well how’d they do on Friday?

Almost what they did on Thursday, just tweaked a little.

Maddy leaned back, snapped her gum and stared at the ceiling. What’s it say about Madelyn Muro not calling in her refills before hand?

What it always says. Arthur shook his paper and continued to read. She’ll never learn."

Bet they didn’t tweak that, she said.

"No, they didn’t."

Sometimes she just couldn’t call in the damn refills. Blood thinners, beta blockers, vasodilators, Maddy could build a small cabin with the brown plastic bottles had she saved them. Each bottle had her name on it, so anyone would know whose home it was. If the visitor were a doctor, he’d know the life she’d lived, too. To most kids, those bottles