Before I Let You Go(6)
I doubt Annie knows what “NAS” stands for, but I know: neonatal abstinence syndrome. It’s a cruel start to life—all of the physical symptoms of opiate withdrawal, crammed and compressed into a tiny newborn’s body. I saw a few cases during the obstetrics rotation of residency. I watched those little babies shake and scream for hours on end, until they’d sweated through their clothing and vomited up every drop of milk in their stomachs. We treat NAS in much the same way that we treat heroin withdrawals—with gradually decreasing doses of opiates—but it’s a very difficult condition to manage. There’s nothing worse in the world than watching a brand-new baby writhe in an agony that could have been avoided.
I’m about to welcome a new niece or nephew who will have one of the worst possible starts to life. There is only one upside to this situation: most NAS babies come through the awful early weeks relatively unscathed. Long-term outcomes are usually good, as long as the baby goes home to a stable environment. I stare at Annie, sitting in the front seat quietly weeping, and wonder if there is any chance of that happening in this case. What kind of upbringing can she offer this baby? And who else is there to support this child? Where is the father? Is my sister’s entire support network me?
When we reach the hospital, Sam parks in his staff parking spot and turns to me.
“I’m going to get Annie a wheelchair. Can you please wait with her?”
When Sam leaves the car, Annie finally speaks.
“I’ve really fucked things up this time, haven’t I?”
“You need to stay calm, Annie.”
“I tried, Lexie, I promise you.”
“Does Mom know about the baby?” I ask. Annie shakes her head. “Can I tell her? Or do you want to? We can call her in the morning.”
“No, I don’t want to worry her—I’ll get clean first, then we can call her . . . I just need to get my shit together . . .”
Annie’s voice is starting to wobble, and I realize this isn’t the time to have this conversation, so I let the subject drop. We sit in silence for a while, other than the lingering echoes of her sporadic sobs.
“Sam seems nice,” she says eventually.
“Sam is wonderful.” I look out the window to see him approaching us with the wheelchair. “Wait here a second?”
Before she can respond, I slide out and shut the door behind myself. Sam parks the wheelchair beside Annie’s door and stares at me over the roof of the car.
“Are you okay?” Sam asks me. His eyes are bloodshot and there are already bags hanging beneath them. He won’t be operating today, which means that five or six patients will have to wait for their surgery. Sam is a general surgeon; these were unlikely to be lifesaving or critical surgeries, but it’s still a huge inconvenience. The patients will now have to wait weeks or months for their operations to be rescheduled.
This is what happens whenever Annie reenters my life—things fall to bits, and she’s always oblivious to how the effects flow on and on beyond her. It’s remarkable how one person’s presence can disrupt every little thing that is ordinarily secure. I know it’s too late to go somewhere else, but I can’t hold back my reluctance to proceed.
“We shouldn’t have come here, Sam,” I say quietly, keeping my voice low so that Annie will not overhear us. “We should have gone over to Montgomery Public. You don’t understand what happens when she’s around—she’s chaos personified. It’s just too risky for her to be in your hospital.”
“If she’s here, she’ll be treated well. The nursing staff will give her extra attention, and there’s a high-risk obstetrician I trust implicitly—her name is Eliza Rogers, and I’m going to call her in the morning to ask her to care for Annie personally. Trust me, Lexie, this is for the best. Plus, your clinic is only a few blocks away, and our place is only a twenty-minute drive. She’s going to need us.”
“Annie doesn’t just come into your life and pass through it. She takes prisoners and leaves a trail of destruction.”
“Well, whatever happens—we’ll handle it together, right?” I hesitate again, and Sam raises his eyebrows at me. “Look—we’re just going to have to talk about this later. She needs treatment now.”
He’s right, and I know it. I force my thoughts away as I help Annie into the wheelchair. For better or worse, she’s here now. Sam navigates the wheelchair through a maze of brightly lit hallways, and he’s nearing the ward when I finally glance at my sister. I find her staring at the floor, her jaw set hard. Guilt rises as I wonder if she’d heard my conversation with Sam over the roof of the car.
“Are you okay?” I ask her quietly, and she slowly raises her eyes to me and says, “Have I ever been okay, Lexie?”
I don’t know how to answer, but while I’m fumbling for words, we arrive at the maternity ward. Things begin to move quickly; Annie is sent to give a urine sample and then taken to a private room. A monitoring unit is fitted to her belly, and after several failed attempts by a nurse, the consultant manages to fix an IV into Annie’s arm. No one mentions her collapsed veins or the pockmarked scars along her inner elbow. No one says aloud what I know they are thinking—what I’m thinking, although I hate myself for it.
Filthy drug addict.
We are medical professionals. We know addiction is a disease. We know how hard it is to beat, and how hard it is to access treatment around here. Between meth and narcotics, there’s an epidemic of addiction in this state and there aren’t enough rehab centers. Then there’s her pregnancy, which would disqualify her from treatment at all but a handful of rehab centers in the entire country. Annie represents an impossible mix of circumstances that the rehab industry just isn’t equipped to deal with. I know this, her doctors know it, her nurses know it.