My Beautiful Memory

By David Rowan

Alexandra Rowan earned a double major degree in creative writing and communications. Shortly after her graduation in 2013 she died suddenly and without warning because of her use of hormone-based birth control. This book is a testament to her life, written by her father, David. My Beautiful Memory examines her life and death, and describes the difficult journey that her parents had to undertake following their loss. It concludes with an examination of the US drug industry’s influence over the regulation of these drugs that kill over one thousand women each year. Alexandra was a young woman with a love of many things, but her chief passion was writing. Latter parts of the book are written in her own words.

• Language: English
• Publisher: John Hunt Publishing
• Release date: Jan 25, 2019
• ISBN: 9781785357657

David Rowan

David Rowan is a retired oil and gas executive. Originally from the UK, he gained US Citizenship immediately prior to the tragic events of 9/11. He is the author of the biography, My Beautiful Memory, that honors his daughter, Alex, who died tragically at age twenty-three. Following her death, David and his wife established a foundation that, in conjunction with the University of Houston, funds an annual creative writing festival and offers writing-related scholarships and internships. Dave and his wife live in Houston, Texas.

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Preface

I did not intend to become a member of an exclusive club that you would not wish on your worst enemy, the Club of Parents Who Have Lost Their Children. I did not intend to become an activist, fighting against the injustices of our American medical and drug lobbies. I planned to enjoy a comfortable retirement, quietly fading away with my wife while we watched our lovely daughter Alexandra grow and thrive.

However, in October of 2013, all our plans changed forever: Alex, our only child, died suddenly and without warning. This horrible event has forever altered my life and that of my wife. Everything from that terrible day forward has been completely different from my expectations beforehand, and I began a journey that took me through the darkest times of my life, a journey that continues to this day. Where, when, or if it will ever end, I don’t know, but I do know that I have no choice but to travel down a sad and grim road.

When I began writing this book I thought that perhaps it might be some sort of catharsis for me, that it might liberate me, or at least ease my sorrow. But it hasn’t. Some of the work brought back joyous memories; some of it revealed things I hadn’t known before, and some was terribly depressing to relive, but always, the writing drove home one simple, unavoidable and painful truth: My daughter is dead and she isn’t coming back.

She didn’t have to die, and the more I learn about the cause of her death and the insidious, commonly available drugs that killed her, the more this statement rings true—she didn’t have to die! I hope that others need not tread my path in their future. I hope that these words will make young women or their parents stop and think. It may almost be a cliché to say it, but if just one death is avoided by reading this book, then it will all have been worthwhile.

Finally, I promised Alex that her writings would be published, and some of her work is presented here. It was her lifelong desire to become a published author, and her work is good enough, but this ambition was curtailed by her unnecessary demise. No matter; if she is out there somewhere, she’ll know that at last she has achieved her goal.

Chapter 1

August 1990—Birth

The London summer of 1990 was exceptional; for many weeks temperatures had soared into the 80s. Most Brits, after their first flush of excitement about actually having a summer, were now back into their usual mode of moaning about the weather. Another Scorching Day, No End in Sight shouted newspaper headlines. For Roz, in her second trimester, the heat simply added to the misery of a difficult pregnancy. Lying in bed on the top floor of an old hospital with no air-conditioning, her enforced bed-rest was a taxing proposition and she sweated out the days with her fellow bedmates, staring out across the dirty slate rooftops of the city center.

Although the initial stages of her pregnancy had seemed normal, as time progressed Roz’s blood pressure had gradually increased. At first the doctor had simply advised rest. When this had no effect, full bed-rest was ordered. But it was all to no end, and finally she’d been admitted to University College Hospital (UCH), an imposing Victorian red-brick complex just off the top end of Tottenham Court Road. Roz knew that this was the right place to be: As a medical secretary in Houston (and in England before we’d moved to the States), on our arrival in London she’d done research into the many hospitals near our flat and had concluded that UCH was by far the best in terms of prenatal care. She’d even sought out a position there, interviewed successfully, and ended up working at the place. She had thus got to know the ins and outs of its operation; who were the good doctors, who were the not-so-good, the cranky ward sisters and the kind ones. The hospital was an old building with many floors and definitely no air-conditioning in most of its wards. So here she now lay with the other mums-to-be, like rows of beached whales lying on their beds glistening in the heat, all windows opened, table fans whirring, waiting for the contractions to start.

Throughout her weeks of confinement there, my ritual was to climb the stairs each evening and hang out with her for as long as I was allowed. My routine was: board the sweaty, smelly, and crowded Tube near my office at Barbican; ride four stops on the Metropolitan, District and Circle line; exit at Great Portland Street and walk five minutes to the hospital entrance. After my visiting time with Roz ended, I would then make a 45-minute walk up through Camden to our place in Kentish Town, usually stopping off for fish and chips or a kebab on the way. The next day, repeat, and so on. It was a tedious routine, but we’d both embarked on our quest for a family with eyes wide open, and we considered our efforts to be worthwhile.

At the age of 39, Roz was relatively old for her first pregnancy, but was in generally good health. Neither of us had anticipated any major problems, although maybe Roz subconsciously did when she researched and selected UCH? Her rising blood pressure was a mystery to us, but not to the doctors: We had never heard of pre-eclampsia, but here it was, putting Roz on full hospital bed-rest. The causes of this sickness are essentially unknown, but the problem affects around 1 in 20 pregnancies, usually showing up in the second trimester and continuing for some time after birth. It was worrying for us both, but not overly so; we simply dealt with it and continued to look forward to our baby.

So, the days and weeks passed, me with my routine, Roz with her boring and sweaty confinement. Meanwhile, her BP numbers quietly continued their inexorable rise to danger-point.

Despite the hot weather, I’d been sleeping well, even though our apartment lacked air-conditioning: The long walk home every night and the couple of pints I usually drank along the way all helped get me off quickly once in bed. Following our move from Houston we had bought a two-bedroom ground-floor place on Torriano Avenue in a corner of Kentish Town close to where it merges with Tufnell Park. This area of London is old and working class. There were no leafy gardens and stuccoed mansions for us, just rows of terraced houses that had, for the most part, been converted into flats. Our mid-terrace place was nothing special, but it was all we could afford in the sky-high real estate environment of central London. We occupied the ground-floor garden flat, while the upper two floors had been made into a self-contained three-bedroomed apartment. It was a nice enough place, close to both work and Hampstead Heath, and within walking distance of most of central London. One enjoyable quirk of our home was that it had once been owned by Tom Bell, an English actor best known for being one of the many ‘Doctor Who’s’ on the BBC. We sometimes received breathless fan-mail for him from as far away as Japan. Living and working in the city, we had both learned not to rely on public transport of any kind, and although I had a car, driving was next to impossible. To be more specific, driving was possible, parking was impossible: Whenever we managed to get a spot close to the flat we were always reluctant to go anywhere in the car again and thus lose our sacred parking place. I therefore walked to as many places as possible, including the hospital, resorting to the Tube only when the distance was too great, or when I was especially short of time.

During our time in Torriano Avenue, we’d both gotten used to hearing our noisy, horrible upstairs neighbor clumping around. Consequently, I could normally ignore random noises and sleep on right through them. This particular night, however, I was eventually roused by a constant banging on the front door. I awoke with vague memories of repeated ringing noises that I’d apparently managed to ignore, but this banging wouldn’t go away. I got up and stumbled half-asleep to the front door, expecting to find some drunken friend of our neighbor, or even Dominic himself who had perhaps somehow managed to lose his front door key. Instead, I was greeted by two policemen.

You Mr Rowan? one inquired. This was odd, but I guess I was too sleepy to figure out what was happening, so I answered in a noncommittal way, suspicious of their presence so late at my front door.

Maybe … why?

Well, if you are, you need to get down to University College Hospital as quickly as possible. Your wife is in labor and they’ve taken her into theater. The hospital tried calling you several times, but no one answered the phone. Aha, the ringing noises!

Err, thanks so much, I’ll get down there right now, I said sheepishly, feeling like an idiot for being so cagey with them. They gave me long-suffering looks and turned around to leave.

Good luck, mate, said one as they got into their police car and drove away. It was just about 1:30 a.m. on Tuesday, August 21st, 1990.

With such an emergency in progress I had no thought of preserving our precious parking space, but quickly dressed and jumped straight into the Volvo to head for the hospital. At that time of night the drive was brief. What was a 45-minute walk was a 10-minute drive. I didn’t even bother to worry about parking illegally; I really needed to get inside—if the hospital had sent police to get me, things could not be good. This obviously wasn’t going to be a normal birth; Roz was only at 30 weeks, far too soon to deliver. God knows what I was thinking as I ran up the steps and into the hospital entrance. I turned left and pushed through heavy oak swing doors towards the maternity wing.

As I rushed down the corridor, a team of nurses and doctors came the other way. They were pushing a strange platform-on-wheels type of contraption. The trolley had several intravenous (IV) bags on poles, big lamps shining down onto the platform, and all kinds of beeping monitors and other equipment. In the middle of this paraphernalia was a small bundle of white sheets with wires and IV lines disappearing into them.

You’re not Mr Rowan by any chance, are you? asked one of the nurses. When I answered in the affirmative, she said, Well, here’s your new daughter. We’re just taking her to the neonatal intensive care unit. They’ll be able to take much better care of her there.

I looked down at the bundle of linen. There, almost buried in the sheets, was a tiny, tiny baby, wires and tubes all over, around, in and on her. She had a large clear plastic pipe coming out of her mouth, her head was covered in some sort of knitted woolen bonnet, and one of her arms was taped to a small wooden board that allowed a hair-thin IV line to safely enter her veins. This was not a baby-looking baby: She was thin, with no fat anywhere, her skin like pinkish-brown translucent parchment. Each leg was the size of one of my fingers, her arms even thinner. She wasn’t moving much or making any sound. This was my daughter, and she was beautiful. Although she didn’t have the name yet, here before me was Alex, 2 pounds 9 ounces of miracle. I followed the team to the neonatal unit.

I suppose that most folk would imagine the neonatal unit in a hospital to be a quiet place, low-lit, even contemplative, with only babies’ cries to punctuate the silence as diligent nurses quietly got on with their job. That certainly would have been my uninformed mental image before walking through the doors. Not so: The intensive care unit (ICU) portion of the neonatal unit of UCH was a noisy, brightly lit hive of activity. The noises didn’t come from the premmies, but from all the monitors and other equipment attached to them that were constantly alarming and being silenced. Nurses and doctors bustled about everywhere. The ratio of staff to patients was high, maybe even one to one, certainly one doctor and nurse for every two or three babies. Talk between the staff was constant, which was comforting because the nurses especially seemed to be taking great pains to advise doctors and parents of every development or issue that arose. In fact, the only quiet adults in the room were the babies’ parents, who sat or stood silently around the incubators staring down worriedly at the new life before them. It was all a bit of a daze for me and I wasn’t taking much in. The nurse who had spoken to me earlier in the corridor approached.

Mr Rowan, we need to get your daughter into a proper incubator and hooked up so we can start treatment. She has the usual premature infant’s immature lungs so we’ll be feeding her oxygen, and we will need to get a good line into her so we can hydrate and feed her. Perhaps you can go and visit your wife while we get on with our work?

God, Roz! I’d forgotten all about her in my focus on the baby. Oh, right. Where is she? I asked.

She’s up in Intensive Care on Floor Two. Just say who you are and they’ll let you right in.

Oh great, wife and daughter both in ICU; this was not good. OK, thanks. I’ll go on up, I said, but as I was about to leave I was told to wait just a second. The nurse retrieved a polaroid camera from a cupboard and took two pictures of tiny Alex wrapped up among all her sheets, wires and tubes. She still wasn’t moving about much.

Here you are, you can show these to your wife, the nurse said smilingly as she handed over the photos.

I went up to ICU and was taken immediately to Roz. She was in a bed, also with all kinds of drips and monitors hooked up to her. She looked both pale and peaky at the same time. She was pretty out of it, but after a short while became aware of my presence.

Is it all right? she asked weakly. I took out the pictures and held them up for her.

The baby’s fine, I said, not wanting to worry her. Look, here’s some photos—she’s a she, not an it.

Roz stared woozily at the two polaroids. Oh God! Has she got everything? she asked. At first I couldn’t understand the meaning of her question. However, after I took a second look at one of the pictures I noticed that, the way Alex was lying, it almost looked like she had only one arm!

She is perfect, I assured her, and she’s being well taken care of downstairs, so don’t worry, you concentrate on getting better.

Roz faded off into a drug-induced sleep while I held her hand. I arose and asked around to try and find out what could have happened that would end up with both wife and child in ICU. Apparently things had initially been going as per usual that day. When I had left at about 8:30 that evening, Roz’s blood pressure, although still slowly on the rise, was within acceptable limits. However, later in the night her BP had suddenly spiked, an event that is fairly typical of pre-eclampsia. When a patient’s blood pressure suddenly goes off the charts like this (300+), the inevitable consequence is kidney failure. The doctors therefore had no choice; they had to deliver the baby early in order to save the mother. It was a calculated risk. At 30 weeks gestation, there was apparently a 90 percent chance of the baby’s survival, whereas leaving Roz with sky-high BP values meant a serious risk of kidney failure or death for both mother and child. It was a simple decision. Roz had been quickly prepped for an emergency caesarian. By chance, I had arrived immediately after the delivery, although if I’d been a lighter sleeper I could have got there in time to see Roz before she went into theater.

So, I had a wife with possibly damaged kidneys, whose blood pressure was still dangerously high, and a daughter with multiple premature delivery issues who had a 1 in 10 chance of dying. Who the hell do I spend my time with? Thus began my yo-yo life of bouncing between ICUs.

Work was out of the question. I spent my waking time at the hospital, splitting it about two-thirds with the baby, one-third with Roz. After a couple of days Roz improved enough to be moved out of ICU, though she remained in hospital. This was an important step for her, as it finally allowed her to meet our tiny daughter, who still lay in the intensive care unit of the neonatal department.

Alex was needing lots of oxygen to breathe due to the immaturity of her lungs. When babies are born at full term, their lungs are lubricated by a juice (surfactant), the production of which is stimulated by the birth process. This makes the lung membranes flexible and capable of the necessary expansion and contraction that is breathing. Not so with a premmie, whose lungs are stiff like cardboard, and are thus unable to supply the required volumes of air to breathe: This is why Alex needed all the oxygen.

As we soon learned, it was very fortunate that Alex could tolerate the vital IV supplying her with fluids and drugs. Imagine an adult’s vein and how difficult it sometimes is to find one—when donating blood, for example. Now imagine how small the vein of a baby is. Now imagine how small it is when the baby is ten weeks premature. We quickly learned how important it was to have a good line into a baby. The hospital team was all too aware of the need for successful IVs; certain members of staff had been trained exclusively to perform the unbelievably difficult task of finding veins the size of a human hair and running in a line. ‘Trained’ is probably not the correct word; it is more of an art that some staff could do and others couldn’t. Without this oh-so-important supply line, a baby quickly deteriorates. We saw nurses and doctors despair when they couldn’t get the needed drugs and fluids into a tiny body because of unreliable IVs. These poor children would then die slowly in front of their parents, the nurses, and us. It was always heartbreaking, and a somber reminder of the fragility of newborn premature infants.

One of the scariest moments for us during those first weeks with Alex didn’t come from any medical issue, however; it was the day when the nurses said that we would need to bathe our daughter! I still have a vivid memory of nervously holding her above a small plastic tub containing a couple of inches of warm water. She was tiny, barely bigger than my hand, and still covered in wires, tubes, and sensors. We took off her miniature nappy, and I slowly lowered her down into the water, terrified that I might drop her or rip out some of the lines. Poor Alex looked worried herself, as if she was just as scared of being dropped as I was of dropping her. We managed to pull off the job without incident though, and got her safely back into her incubator. Just as when the nurse had taken polaroid pictures for me on the night of Alex’s birth, we learned that this whole bathing thing was simply a way of getting us to bond with our baby and to humanize this little bundle of skin and bones. It was standard procedure for all parents on the neonatal unit, and it soon became a part of our routine, no longer a scary task. We both became completely devoted to our feisty little Alex, who liked to cry long and loud whenever something was not to her liking, much to the amusement of the staff, who often noted that she was the best crier in the unit.

Why Alex? Like any prospective parents, during the pregnancy we’d discussed lots of different possibilities for names. We chose not to know the sex of the baby beforehand, and eventually landed on a unisex-type of name—Alexander if a boy, Alexandra if a girl. Maybe this was laziness, but I loved the name for a couple of reasons. Firstly, a friend I’d got to know in London whom I greatly admired was called Alex Szygovsky. He was a wonderful musician, super-nice guy and a good laugh to hang around with. Secondly, although perhaps bizarrely, Alex is the name of one of my favorite movie characters, the amoral teenage gang leader from A Clockwork Orange. This might seem an odd person to name your child after—Alex in the wonderful Anthony Burgess book and Stanley Kubrick film appears to be a horrible delinquent. Well, I can only advise you to read the book and watch the movie again, and you’ll find that the story is a black comedy, full of surprises. Our daughter was full of surprise too, in her own way, and we both agreed that Alex was the perfect name, and so little Alex was Alex.

By the time of that first bath, Alex’s eyes had opened right on cue per the doctors’ prediction. There has been enough research into neonates that most biological milestones are well defined. Doctors would literally tell us, She should open her eyes on Thursday, and voilà, it would magically happen. The link between vision and blood oxygen levels is also well understood. One of the sensors glued to Alex’s tiny body measured blood oxygen level: If it got too high, then there was a high risk of permanent damage to her eyes. If too low, then brain damage sets in. This was one of the many monitors’ functions; when oxygen levels got out of pre-set boundaries, an alarm would sound and the nurses would adjust the oxygen flow. The noise of these alarms going off was constant in the critical care unit and added to the generally frenetic atmosphere. We got so used to seeing the nurses adjusting the oxygen flow that we often ended up making the adjustments ourselves.

During the initial period following her birth, everyone became anxious to get some of Roz’s breast milk into Alex in order to provide not only nutrients, but also the immunological benefits that come from natural feeding. Just as with predicting the day Alex’s eyes opened, it was the same with her sucking reflex; the doctors knew that trying to breastfeed before a certain level of the baby’s development would be hopeless, as the baby simply wouldn’t know what to do. On the predicted day, we were told that she’d now have the sucking reflex and would thus be able to breastfeed, and indeed she did. Unfortunately, breastfeeding was not successful, so Roz began to express her milk for subsequent bottle feeding.

I eventually discovered how these doctors could so accurately forecast a baby’s development. It was because they had a ‘User’s Manual’ for them! We found this out during a particularly distressing period of our time at UCH: One day, we were introduced to a new nurse working in critical care. We began chatting with her, and mentioned our concern over the fact that Alex was still in need of a lot of oxygen. Oh, that’s because she has a hole in her heart, she cheerfully advised. But don’t worry, they can do open-heart surgery to fix it if they have to.

WHAT?!

We immediately sought out the head doctor on shift and were ushered into his office. He was out dealing with some emergency, so while waiting I nosed around the room, and that’s when I discovered a thick tome of a book called Care of the Neonate. This was the baby’s user manual—it provided masses of information on every possible aspect of premature infants’ care and treatment. I studied it intently for about ten minutes until the doctor finally came in. With my engineer’s background, it was strangely comforting to know that there was a ‘baby manual’; clearly all the possible issues that Alex might have to deal with had been dealt with before. In my uninformed head I imagined the doctor simply flipping through the pages of this book anytime a problem came up, finding the answer, and trotting off to implement the book’s recommendations. Simple!

The doctor sat down and we immediately began bombarding him with questions about the terrifying prospect of operating on a tiny premature heart. He gently explained that all babies are born with a hole in their heart because, while in the womb, there is no need to pump blood—the mother’s heart does this job for the baby. At birth, the opening between the ventricles closes up naturally, but of course in premmies it isn’t so straightforward, and sometimes closure doesn’t occur. However, as with knowing when eyes open, or when the sucking reflex starts, there is a well-defined timetable for the heart hole to close up.

Be patient, he advised. The chances of having to operate are very low.

We both left his office feeling better, although obviously still worried. During our meeting with the doctor he’d asked why we’d suddenly become so concerned. We told him about our conversation with the new nurse: We didn’t see her in the unit again. Alex’s heart fixed itself on cue during the following week.

After several weeks we were finally told that Alex was sufficiently stable that she could be moved out of critical care and into the general neonatal area. Fantastic news! We felt that somehow we’d reached a big milestone, and that the risk of losing her had diminished. Prior to this moment, we hadn’t talked to people about her condition but took things very much one day at a time, never thinking beyond the next 24 hours. It always seemed like two steps forward, one step back with her progress, as with all the other tiny members of the critical care unit. During our weeks at the hospital there had been lots of happy news, as we saw babies leave with their beaming parents, but we’d also seen so much pain and heartbreak as babies faded away and died. For example, one couple had a little boy who was not very premature and who seemed in good condition with a healthy weight, but he contracted a series of infections over the course of his weeks in the unit and sadly died. Then there was another baby who had been in the unit for over a year; he just wouldn’t thrive and although he looked like a big bruiser of a lad, he needed to be in an incubator all the time, with a constant flow of oxygen. Then there was Poppy; she was a little girl born at 27 weeks around the same time as Alex. We became friendly with her mum and spent lots of time together. Poppy was really small, with quite severe cerebral palsy among other problems. Her mother was totally devoted to her care, although the father had walked out on his family soon after Poppy’s birth, unable to handle the whole situation. Just as with us, Poppy’s mum took things one day at a time, choosing not to look ahead but dealing only with the issues at hand. Planning ahead was almost like tempting fate, but finally Alex was well enough to be moved into a less critical part of the hospital, and our relief was palpable.

The day she was to be moved, I had to go into work for a team luncheon that signified the successful conclusion to one of my projects (I had returned to work a few weeks prior). I was elated about Alex’s improvement and began telling anyone who asked about her condition that she was getting better. The luncheon, with around a dozen of us, was held in a wine bar close to my office, and it passed liquidly into an afternoon of high jinks and wine. It was like I had been crammed inside a pressure cooker for weeks and weeks and now someone was venting it, relieving the pressure. The relief lifted my mood and, for a few hours, all stress and strain fell away. At around five o’clock I finally staggered my way to the Tube station and on to the hospital, very, very happy and very, very drunk.

Here you go, Mr Rowan, time for Alex to take her bath, the nurse said as she handed me Alex. Roz was already there, waiting for me to show up.

Don’t let me near her! I giggled, pulling back from the proffered baby. I’m legless! The nurse laughed—she’d obviously dealt with this situation before—and calmly handed Alex over to Roz.

In her new surroundings Alex had fewer wires and lines in her and was in a more conventional cot instead of an incubator. Things were looking up. On that happy evening I staggered home to Kentish Town, zig-zagging all the way.

The months passed. Roz was now out of hospital and I was back at work full-time. Alex slowly improved, gaining weight at a snail’s pace. We’d been advised that a decent weight was the key element in allowing her to be discharged, but with her starting out at well under 3 pounds, it was obvious that she wouldn’t be leaving anytime soon. By now her oxygen needs had reduced and, instead of a tube directly into her nostrils, there was a simple oxygen line with a conical end funnel that was placed near enough to her mouth to supply the gas needed to keep her blood oxygen levels healthy. Other paraphernalia had diminished too, with fewer monitors and sensors. It was a slow but positive progression, and it was obvious that Alex was much more comfortable with her new situation: She was still feisty, but more at ease when being handled, even smiling and taking interest in her surroundings, much more so than just a few weeks before. Our long daily visits continued to include the usual bathing and feeding rituals. I felt that she was gaining a real personality, rather than being just a sick premmie. She still was vocal about anything that didn’t suit her, but that just added to her character, and I didn’t mind it a bit. Poppy’s mum shared similar thoughts about her daughter; we all felt more upbeat about life and the future.

All the babies in the unit were still very much of a premature appearance—no fat kids here. Interestingly, whenever our close-knit clan of neonatal unit parents would see full-term babies, we all thought that they looked pudgy and odd, not like our lean little girls and boys. But weight gain remained the big issue in getting out of the unit—that and the elimination of Alex’s dependence upon oxygen. The doctors actually told us at one point that, if all else was satisfactory, then Alex could be discharged and go home with an oxygen tank. Roz and I were both really uncomfortable with this idea; we did not at all like the prospect of having to care for a baby who was tied to a tank. By now, after our months in the unit, Alex’s oxygen needs were minimal, but whenever nurses tried to turn off the supply, within a minute or so, the alarm would go off, and they’d have to reinstate the gas. It was now over three months since her birth and these last hurdles to discharge her from the unit were beginning to frustrate everyone. One evening, the doctor sat down with us.

I think Alex is faking it, he said. I think her lungs are good and that she’s just being lazy about breathing, so with your permission, I’d like to turn off the oxygen and see what happens.

After exchanging worried looks, we both replied We’re up for it if you are, knowing that the doctor wouldn’t permit any serious consequences if things didn’t work out.

He turned off the oxygen supply valve on the wall, and removed the supply tube and funnel from the cot. We all watched quietly and tensely as her blood saturation level began to drop: 94% … 91% … 88% … 84%. Alex didn’t seem distressed at all, but sure enough the alarms began to sound as they detected that she was not getting enough oxygen. After a stressful couple of minutes the monitor went as low as 80%, but then an amazing thing happened: Alex’s chest began to heave up and down more strongly than before, although she still seemed comfortable enough. Saturation numbers slowly began to rise and after another couple of minutes, there she was, breathing on her own, no oxygen supply, and with healthy saturation levels!

You little madam, Roz said happily as we all congratulated each other and said Good girl—well done to Alex.

She never needed the gas again. Now it was simply a matter of getting her weight up. Once again the doctors surprised us. The broad rule of thumb is that a baby should have doubled its weight before being allowed to leave the hospital. Alex is getting close to 6 pounds, so I think we can begin planning for her release. This was amazing! By now it was getting close to Christmas and we had resigned ourselves to having a UCH Xmas, but perhaps she’d be home for the holiday?

One important step on the ‘road to freedom’ is for parents to spend a full night with their baby. This is primarily a way of making parents more comfortable about being away from the inherent safety net of the neonatal unit, but it’s also so that hospital staff can check up on the competence and coping-skills of the father and mother. I can well imagine some parents being totally overwhelmed and terrified at the prospect of caring for their baby without the nurses and doctors being there to help. We were both nervous about this milestone event, but also