Saturday, November 26, 2011

A Meditation on Infant Mortality

The standard figure given for infant mortality in the Middle Ages is thirty percent, although some historians' numbers go as high as fifty. Thirty children out of every hundred, dying before their first birthday--a staggering amount of tiny graves.

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At the beginning of this week, I was intending to do a Thanksgiving Day post about my son Adam, giving thanks that he has had no complications since his surgeries for biliary atresia in January. But on  Monday night, as my husband and I sat bleary-eyed in the emergency room at Doernbecher Children's Hospital, we realized that he was having his first complication.

He had registered a low grade fever off and on for the past five days and been exceptionally fussy. Maybe he's teething, I thought. (Isn't that every mother's rationale for unexplainable baby behavior?) Then, on Monday afternoon, I changed his diaper and discovered that his stool was white--an indication that his bile ducts might no longer be working. His doctors suggested taking him to the lab to get some blood work done. And so, instead of running to the grocery store to get eggnog, and allspice, and Thanksgiving Day hors d'oeuvres, we zipped down to the doctor's office and had Adam's blood drawn. It would take a day or more to get the results. I was worried, but David reminded me that there was nothing to be worried about...yet.

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by Giotto
One popular misconception about the Middle Ages is that since so many of their children were certain to die, medieval parents refused to become attached to their offspring. In her article "The Medieval Child: An Unknown Phenomenon?", Sophie Oosterwijk refutes this notion. She points to the popularity of the Madonna and Child paintings, a clear representation of an affectionate mother. She also provides a wealth of other evidence that medieval parents were "fond of their children," despite the likelihood that they would lose "at least some of them to diseases or accidents."
Miracle reports and other types of documents attest to the lengths to which parents were prepared to go to obtain healing, rescue or salvation for their children, as well as to their grief when their efforts proved futile. The popularity of the theme of the Massacre of the Holy Innocents and its vivid depiction in medieval art and drama also suggest that medieval people viewed child death with anything but indifference.
It was not uncommon for a woman to bear ten children. It was not uncommon for nearly half of them to die in infancy. It was uncommon for the woman to feel no sorrow for their passing. She was still a mother, after all, and though she lived in a hard place and a hard time, that did not make her heart a heart of stone.

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When Adam's fever spiked to above 100 degrees that night, I called the advice nurse. After reviewing his file with the doctor on call at Doernbecher, they instructed me to bring him in to the emergency room. "It could be nothing, or it could be really bad. With his history, we don't want to take any chances." 

The blood work we had done earlier was upgraded to "stat." We arrived at Doernbecher and waited in the emergency room for several hours for the blood work to be completed. When the lab delivered the results, the liver numbers were way higher than normal, giving evidence of a possible liver infection. The next step was an ultrasound to see if there was some sort of blockage in Adam's bile ducts. The ultrasound was inconclusive. Meanwhile, Adam's fever began to go down. While the doctors conferred into the wee hours of the night about whether they should admit Adam or send him home, David tried to get our scared and screaming boy to go to sleep. Every time he closed his eyes, another doctor or nurse would come in to poke and prod him into resuming his screams.

I sat in the recliner, too exhausted, too uncomfortable, and too anxious to sleep. Were his bile ducts really blocked? Was the surgery that had seemed so successful no longer working?

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Edward I and wife Eleanor
Oosterwijk gives this anecdote about King Edward I of England:
One example of the supposedly indifferent attitude of medieval parents towards their children is the chronicle description of Edward I's reaction while on crusade at hearing the news of the deaths of first his son John and then of his father, king Henry III of England. According to the chronicler, Edward grieved far more for his 64-year-old father than for his five-year-old son and, when asked to explain the reason, he replied that the loss of a child is easier to bear as one may have many more children, but that the loss of a father is irremediable. This has often been taken as the typical medieval response to the death of a child; indeed, Edward himself was due to experience such losses all too often, for only six of the (probably) fourteen children he had by his first wife Eleanor of Castile reached adulthood. 
However, what has often been overlooked is the fact that Edward's reaction, instead of being typical, was in fact seen as unusual even if proper and devout; the episode illustrates surprise at his behaviour both on the part of Charles of Anjou, who asked him to explain it, and on the part of the chronicler, who considered it significant enough to record. Although it may have been exemplary of Edward to mourn so much more for the death of his aged father (which actually made him the new king) than for his own little son, it seems at the same time to have been considered far from normal.

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The doctors decided to put Adam on antibiotics in case his liver was infected. He would spend the night at the hospital and undergo more imaging in the morning to locate the assumed blockage. I drove home at 3am, hoping that my seven-months-pregnant body could get a few hours of sleep. David stayed at the hospital to deal with more doctors and more disruptions to Adam's sleep.

The Psalmist says that "weeping may endure for a night, but joy cometh in the morning." And so it happened for us. By the time I got back to the hospital at 9am, Adam's fever had disappeared. The white bowel movement proved to be an anomaly. The head GI doctor told us that if there was some sort of sludge blocking his bile duct, it seemed to have gone away. Whatever had sent his liver numbers up in the lab tests was probably just a minor infection. They released us from the hospital at noon that day and we went home to sleep, sleep, sleep.

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by Masaccio
Oosterwijk says:
Medieval reality might have been a far cry from our own twentieth-century idea of childhood as a joyous and carefree phase of life -- in itself rather a modern Western idealization-- but the medieval popularity of the Virgin and Child could only have worked if people recognized its fundamental truth: the bond of affection between mother and child. 
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At the beginning of this week, I was intending to do a Thanksgiving Day post about my son Adam, giving thanks that he has had no complications since his surgeries for biliary atresia in January. At the end of this week, I can finally make my Thanksgiving Day post, and praise God that Adam's adventure at the hospital was short-lived and far less serious than it could have been.

The standard figure given for infant mortality in the Middle Ages is thirty percent. The infant mortality rate in today's United States is currently less than one percent. It is a blessed thing to be a mother in this country and in this century. It is truly a thing for which we can give thanks.

8 comments:

  1. Amen. And for that reason alone I would never choose to live in a previous century. So glad that Adam is doing better!

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  2. Rosanne I remember nights like that in the hospital. They are not fun but thank goodness you made it out with nothing major wrong. They both are beautiful boys and just think because of what you went through as a family you all will have such a strong unbreakable bond. Congrats on the new pregnancy too....thoughts of a girl? xoxoxo

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  3. Thanks for the congrats, Lizzy. Looks like this next baby's going to be a boy too. :-) At least they'll all enjoy playing together....

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  4. This is a brilliant and very moving post. I am glad your son's crisis was not more serious. I am glad also that you highlight some of the evidence that Mothers have always been mothers (some care deeply about their children and did so 500, 600, 800 years ago, and some, sadly, do not). It might interest you to know that Henry III (Edward's dad)lost his youngest daughter Katherine (who was handicapped) and grieved so that those around him feared for his life. He paid a priest to say mass for her soul everyday for the rest of his life.

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  5. I'm so glad to hear he's doing better, Roseanne. This was such a lovely and touching post. Thank you, also, for sharing and giving us a deeper look at the emotional side of the medieval family.

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  6. Thanks for the kind comments, all! And Sophie, thanks for sharing the touching anecdote about Henry III. Sounds just like what a father today might do (minus the masses, of course).

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  7. What a moving and well-written piece, Rose. Very absorbing and very real for those of us who love that boy greatly. Praise God for His goodness to us all in Adam's little life.

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