What I Want You to Know About the Air We Breathe

We walk up the stairs to the second floor of the hospital and stop in front of the door to the ICU. A nurse hands us a clipboard with a small card fastened to it. We walk over to a bench near the elevators where we sit as I fill out the basic details. You are quiet and nervous as you take in the scene, observing the other families milling around near us.

It only takes me a few seconds to enter what needs to be completed on the form. We rise and return the clipboard, and the nurse points us to a short line at the end of the hallway. You hold my hand and I give yours a squeeze as we walk together to the station as directed. Once it is our turn, we hand over the form and your insurance card.

“How tall are you?” the nurse asks you with what I imagine is a smile under her mask. Your nerves have the best of you, though, so I answer for you. She then looks at you and asks if you’re going to grow up to be as tall as me. You just shrug, your anxiety not at all eased by this small talk. She hands back our cards and directs us to the next stop.

We come at last to a windowless room. We peer in and see several families gathered there. Directly in front of us is a mother with her two daughters, both a little older than you. Next to them is a father and his son, who is sitting shirtless and starting to cry. The father bends down and tells him it’s okay to be scared, as the boy continues to grow more anxious.

I look down at you and see that you are focused on the young boy. “Do you remember when you used to be that afraid of getting a shot?” I ask you. You shrug again. “Well, you’re probably still feeling pretty nervous. That’s fine, buddy. I get nervous before shots, too. Just remember to breathe, and it will be over before you know it.”

The mother and the daughters leave, and it is your turn. You sit up in the tall chair and, unprompted, roll up your sleeve. The nurse preparing the shot comments on how brave you are. Another nurse working at a computer station a few feet away asks if I give my consent. I do. The first nurse swabs your arm and pokes you with expert efficiency. It is over before you even have time to think about it hurting; before you even have time to remember to breathe.

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When we were driving to the hospital earlier, you told me you didn’t like going there because that’s where your mom was before she came home on hospice care. I told you I understood and felt the same. That I don’t like going to the hospital either, because of all the memories I have there.

What I didn’t tell you then was that the worst night of my life—even worse than the night your mom died—was the night that she spent in the ICU, right near where we came up the stairs for your shot. I remember sitting on the same bench where we filled out your vaccination card, waiting for permission to enter the ICU and come be with your mom.

Earlier that afternoon, she had undergone an endoscopy. It was supposed to be quick and diagnostic, a way of determining the source of some internal bleeding with the hopes that it could be resolved and she could be sent home to see you and the rest of our family. I kissed her goodbye on her way out and then sat in her hospital room playing games on my phone as the minutes turned to hours and I tried to avoid thinking about all the reasons this straightforward procedure was taking so long. Eventually a doctor came in and told me that your mom had not tolerated the procedure well, and that they had to intubate her to perform it. After the procedure was finished, they extubated her, but her breathing was not strong, so they were forced to reintubate her and transfer her to the ICU for observation.

I nodded along as the doctor relayed all of this, trying my best to comprehend what he was saying, and to process the implications of what he was telling me. Was she about to die? Was there any chance she would make it home to see you? How aware was she of all that was going on?

With shaking hands, I gathered my belongings and your mom’s, and went to wait by the ICU. I sat on the bench by the elevator and pulled out my phone to play more mindless games.

I wondered what “intubation” would look like. Since the time of Covid-19, I had heard a lot about intubation, but it remained such a strange word. To me, it always sounded like “incubation,” conjuring up images of chicks poking through their eggs under a warming lamp.

What struck me first when I was finally allowed in to see your mom was how miserable she looked. The tube shoved down her throat was taped to her mouth to prevent it from coming back up. Her wrists were strapped to her bed to prevent them from jerking up to somehow remove the tube or other wires and lines attached to her body. Her eyes were half open and glazed over. She was already heavily medicated but I could tell by the way that she was jerking with each breath that she was still in pain.

I immediately texted her doctor, who had generously given me her work cell number, and asked if she could make sure your mom got more pain medication. She sent in the orders for heavy doses of Dilaudid. Finally, the additional medication was administered, and your mom’s movements began to calm.

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Before everything had gone haywire, I promised your mom I would make sure she wasn’t in pain throughout the process. Seeing her in such distress, I knew that if she died here in the ICU, scared and in pain, I would never forgive myself for breaking my promise. It didn’t matter that I couldn’t have predicted this turn of events. I would have carried the guilt of this night to my own grave.

As the machines clicked rhythmically and air was forced in and out of your mom’s lungs, I sent an email out to our friends and family to update them on all that had happened. I encouraged them to text me if they wanted me to say anything to your mom, hoping the love of our community would help her pull through. Then I read the texts to her as they started pouring in.

At around ten, a nurse came into the room and told me I was not allowed to spend the night in the ICU. I knew better than to push my luck, after all the exceptions to Covid-19 protocols that I had been granted, so reluctantly I kissed your mom goodbye on her forehead and left, hoping that I would see her alive the next morning.

I came home that night, afraid and exhausted. I told you that your mom was going to die soon, knowing it was important to be honest with you and concerned we wouldn’t have a chance to speak in the morning before I left again for the hospital. We both cried in my bed until we fell asleep.

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Somehow, your mom survived the night, and her lungs began showing better function. By the time I arrived back in the ICU early the next morning, the doctors and nurses were beginning to wean her off the pain medication so they could extubate her again.

As your mom began to gain consciousness and the effects of the Dilaudid began to wear off, her eyes found mine. She appeared anxious and annoyed. She waved her hand, and I somehow knew she was trying to tell me to make it all go away. I tried to tell her that she was alright, that the tube was going to be removed soon, but she only seemed to grow more frustrated as the time crept by.

Once the tube was finally removed and her voice started to come back to her, and once the doctors were satisfied her lungs would be able to perform as required, we began to discuss next steps. She said she never wanted to have anything like that happen again. The fear, the loss of control, the pain, the confusion. She was ready to end her treatment and go home to die with dignity.

I informed her doctor, who came in to hear it directly from your mom’s own mouth. They began the process of transferring her to home hospice care, but it would require one more night in the hospital before everything could be arranged.

Your mom was moved out of the ICU to another room for the night. We spent the day mostly laughing and enjoying each other’s company, but occasionally the gravity of everything would crash down on us. Your mom would think about you and start to cry. I paced the room, or nervously bounced my knees when I sat. Late in the afternoon, I found some beef jerky to snack on, suddenly realizing how long it had been since I last ate, and your mom snapped at me because the smell of the jerky made her nauseous.

I felt pressure that night to make sure your mom survived at least another day so she could see you and the rest of our family that was gathered at our house. Her breathing had become more apneic as she slept; long periods of silence between breaths would cause me to worry that she would not breathe again. I held her hand as she slept, squeezing whenever the silence would stretch out too long in hopes it might help her body remember to breathe.

That night, my friends from college held a vigil for us from their homes. They divided up the night into blocks of time, with each one staying awake during a stretch to pray for your mom, to text me kind words of encouragement, to tell me they were playing some of my favorite songs on guitar in their garage, to be there with us from afar. They were keeping me from giving up. Squeezing my hand, in a way.

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I didn’t tell you all these things as we went for your Covid-19 vaccination shot. It’s too much to say to you at your age. And, anyway, your vaccination is such a cause for celebration, even if it does make you a little sad being here at the hospital.

Of course, not everyone shares the same hope in these vaccinations. I don’t know how aware you are of the divided world you’re growing up in, or if it will still be so divided by the time you read this. So I’m not sure if you understand, or will understand, how even this simple shot seems to be a wedge dividing people into two distinct groups. How tribalistic a world we inhabit, with camps clearly marked by the colors of their hats, the slogans on their shirts, or even the colors of the stripes on their American flags.

But here we are. Divided. Often unwilling to listen to one another. Convinced the other side is brainwashed by the polarized and polarizing media they consume.

I try not to think about all that division. Instead, I think about your mom in that ICU: intubated, scared, in pain. If a shot in the arm can help keep you from going through that type of experience from this strange disease, even by a small bit, well, it’s a no-brainer to me.

But it’s about more than just us. This virus travels through the very air we breathe. That which sustains us, one of the few things it seems like we all still share. It’s a little ironic, then, that one of the ways we take care of one another now is by limiting the reach of our breath. We wear masks. We stand farther apart. We avoid gathering in groups.

And now we take shots meant to help our bodies fight off the virus and the worst of its effects. To protect ourselves, and to keep one another from being intubated in the ICU. To keep strangers from having to wonder if a loved one will make it through the night.

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Three weeks later, we come back to the hospital for your second shot. You aren’t as anxious this time, and I am less rattled as we walk past the doors to the ICU. Once again you roll up your sleeve without prompting and the nurse quickly administers the injection. And just like that, you are fully vaccinated against Covid-19, for now at least.

As we walk out the hospital, you take my hand and give it a squeeze. You tell me you are happy you got the vaccine. You say that you are taking care of other people, and that makes you feel good.

I squeeze your hand back and tell you how proud I am of you for thinking of others, and I smile under my mask. Behind the fabric, I exhale a breath that it feels like I have been holding in for the better part of the last two years.

Then I inhale deeply and notice, even from under the mask, that the air we all breathe is beginning to feel a little cleaner every day.