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Routine Procedure

“We are doing the right thing,” I say.

Are we doing the right thing?

My husband nods. “Better to do it now. She probably won’t even remember it.” The lines etched into his forehead are unconvincing.

Hundreds of thousands of children—millions, maybe—have their tonsils out every year. It’s as common as getting a filling at the dentist. A rite of passage. But hundreds of thousands of children are not my own two-year-old daughter Emerie, toddling along in happy ignorance as we follow the nurse through the sterile, echoing corridors to the pre-op room.

In the room, there is the usual battery of vitals and questions: blood pressure, temperature, has she eaten anything since last night? I change Emerie into a hospital gown covered with dancing teddy bears. It swallows her like a tent.

The nurse is running down the procedural checklist with the empathy of a drill sergeant while I entertain Emerie with a few cotton balls and a tongue depressor.

“First, I’ll administer a little valium to make her drowsy.” Check.

“Then one of the surgical nurses will take her to the operating room.” Check.

“They’ll put a little mask over her nose and mouth and she’ll fall asleep.” Check.

“The whole procedure shouldn’t take more than a half hour.” Check.

My brain registers the fact that this information is supposed to be reassuring.

“What about the IV?” I ask. “They won’t put it in until after she’s asleep, right?”

“Sure,” says the drill sergeant nurse. She hands me a little measuring cup with the Valium, and although I am tempted to toss it back myself, I put it to Emerie’s lips and she drinks it down without complaint.

The nurse exits through a swinging door that leads into the surgical corridor. The clock ticks. The fluorescent light hums. Emerie giggles. I cringe with guilt.

At first we thought the snoring was funny. You could hear her from any room in the house. Even as a baby, her sleepy chortling could match that of any grown man. And even though she was my third child, I didn’t know that I was supposed to be worried. I fall into the camp of motherhood that doesn’t make a big deal out of runny noses or fevers or falling off bikes. Childhood, I think, is fraught with events that can be cured with a few Tylenol or a princess Band-Aid. Snoring is apparently not one of those things.

I didn’t know this until the night I was in her bedroom putting away laundry after she had fallen asleep, clumsily rummaging through the closet for an empty clothes hanger. As I listened with half an ear for the rhythmic in-and-out gurgle that told me she was still sleeping, the room fell silent. I froze, peeking over my shoulder, sure that I woken her. In the faint light that trickled in from the hallway, I could see that her eyes were still closed, that her mouth was still propped open—but more importantly, that she was not breathing.

The tiniest bit of panic knotted in my throat. I stood for a moment, willing her chest to move. By the time I dropped the clothes and reached her bed to shake her awake, she gave a great, heaving gasp and promptly resumed her snoring. I sat in a red plastic chair by her bed and watched her repeat the performance multiple times in the span of ten minutes. The snoring didn’t worry me. But not breathing certainly did.

“That’s it? Don’t you need to take an X-ray or something?”

We have been in the office of a highly recommended pediatric Ear, Nose, and Throat specialist for less than five minutes. He listened politely as I described Emerie’s episodes of sleep apnea, took a quick look in her mouth, and promptly declared that she needed a tonsillectomy.

“Not necessary. Her tonsils are huge,” he says. “Much larger than they should be. And probably her adenoids, too. I’d recommend removing those while we’re in there.”

I have a sudden memory of the Brady Bunch episode in which Cindy has her tonsils out and the doctor discovers that Mrs. Brady needs hers out too. I decide not to mention that I am one of the few children born in the 70s who still has a full set of tonsils intact. And I have a gut feeling that a two-year-old in pain will not be as easily placated with ice cream as five-year-old Cindy Brady.

The doctor answers our questions patiently, describes the procedure in detail, reassures us that tonsillectomies are the most common surgical procedure for children and that he has performed hundreds without complication.

It is all very matter-of-fact. Paperwork is filled out, a date is set. I read everything I can find about tonsillectomies. I join discussion groups online and other mothers tell me I am doing the right thing, without question. I am prepared.

Or not.

In the pre-op room, the valium is starting to take effect. Emerie wobbles as if her head suddenly weighs too much. She looks at her hands curiously, then at me; climbs into my lap and rubs the corner of her favorite blanket on her cheek. She is drifting away.

The surgery door swings open and a man who identifies himself as a surgical resident arrives to take my daughter. Hesitantly, I bundle her up with her blanket and place her in his arms. As she exits through the swinging door, her eyes lock onto mine with the sudden clarity that I will not be going with her.

Something sick and liquid fills my stomach. This is the part I was completely unprepared for: the part where you entrust the life of your baby into the hands of someone you’ve only just met. The part where you can’t hold their hand when they’re scared. The part where your own heart is splayed open on the table, the first of many moments in which your child will feel abandoned by you.

We sit for a moment, the silence of Emerie’s absence growing bigger. Slowly, I begin to gather her pajamas, her coat, the book she brought from the car. I blink back tears because it’s silly to make a fuss over such an ordinary thing as a tonsillectomy.

And then I hear her cry from somewhere down the hall. Not a scream of pain or panic; just a muffled, drowsy protest in the few seconds before the anesthesia does its work and she sleeps.

I lose it. Completely.

My husband is caught off guard by the sobs erupting from the woman who never cries; the one who is always calm and rational and in control. He wraps his arms around me and I soak the shoulder of his shirt with my helplessness.

An hour later, I am dozing in the vinyl recliner of a brightly lit room in the children’s unit. Emerie is sleeping deeply on my chest, her tiny arm stretched up around my neck. At least temporarily, she has either forgiven me or forgotten that I was the one who allowed her pain. I wonder what she will remember of her surgery, if she will have dreams with white walls and stainless steel and strangers hovering over her.

I tuck the brown curls behind her ear so I can see her face. Her breath smells like metal and blood. For the first time I am very conscious of how quiet the room is. Emerie’s little chest rises and falls rhythmically, deeply. But she is most definitely not snoring.

I’ve been holding my own breath for an hour.

I breathe a little sigh of relief.

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