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02/21/2007

I think I broke my leg while writing this post

Charlie has had his final developmental assessment.  The pediatrician examined him, toted up his scores, and said, "I'm comfortable discharging him."  Because of my turbulent gynecological history, it unnerves me to hear "comfortable" and "discharge" used in the same sentence, but in this case I didn't mind.  In this case, I was relieved.

It's not quite accurate to say Charlie's caught up.  This seems to be a common yardstick for preemie development, the idea that eventually they will be indistinguishable from their chronological peers, but it's a bit misleading.  It's not that a child truly catches up, like a businesslike Myrna Loy catching up to William Powell in The Thin Man by crisply asking the barman to bring her five more martinis — "Line them right up here."  It's that by a certain age, the range of normal development has broadened enough that most children, preemie or full-term, fall comfortably within those parameters.

And Charlie falls comfortably.  Well, he falls a lot, anyway.  At 24 months adjusted, he remains behind in gross motor development, operating at the level of an 18-month-old.  The doctor has seen enough to rule out the possibility that this is caused by any injury or neurological abnormality.  It could be an uncomplicated consequence of his prematurity, or it could be hereditary.  "As children, how were the two of you at athletics?" the doctor asked Paul and me.  "Poor," I said firmly.  He laughed and said, "Wow, that wasn't even one of the choices.  I was going to ask if you were average or below average."  "Poor," I repeated, with added emphasis, resisting the urge to illustrate by falling out of my chair, dropping an easy fly, and breaking my collarbone with a sickening audible snap. 

The doctor gave Charlie a ball to see if he would throw it.  No dice.  The doctor then took the ball and tossed it to me, to see if Charlie would get the idea.  Predictably, I fumbled it, stumbling over a croquet wicket, breaking the doctor's jaw with a clumsy swoosh of my jai alai cesta, and severing the jugular of the crooked French judge with the jagged toe pick of my skate.  "I...see," the doctor said, through the splinters of what used to be his mandible.  "Wow.  You weren't kidding."

Given the two strikes against him — heredity and prematurity — the doctor is of the opinion that Charlie's general lack of coordination might persist.  "If it does," he said, "he may need support when he becomes interested in games and sports."  Hey, no problem there: I'll be more than happy to teach him my moves.

He needs no additional support for his fine motor skills.  While we watched, Charlie adeptly retrieved raisin, eventually built a tower of seven cubes ("That's the yellow cube...and the green cube...and the other green cube...CRASH!"), and took apart then reassembled a Patek Philippe without swallowing all that many pieces.  I was so proud I accidentally brained Paul with my mashie niblick, then hooked my own ear with my fly fishing lure.

It is in language development that Charlie really shines, coming in at 30 months.  All through our visit he was casually littering the room with seven- and eight-word sentences.  (Predictably, I tripped over one as we left the office, bruising my tailbone and losing the Super Bowl in the last three critical seconds of the game.)  He demonstrated knowledge of prepositions.  He pointed at things.  He identified colors.  He named animals.  There was one touch-and-go moment when he pointed to a picture of a man and said, "Lady," but I'll give him a pass on that because, Jesus, you should see my haircut.  Let's just say I don't need a swim cap when I get myself hopelessly entangled in the lane ropes during the 200-meter butterfly.

It got just a little bit dicey after he'd named all the animals ("Cat.  Dog.  Horse.  Bird.  Lady."  "What?"  "...Mmmmman!") and was asked a bit more about each.  "Which one meows?"  Easy.  "Which one barks?"  Nailed it.  "Which one flies in the sky?"

Nothing.  And you know why?  I have never, not once in his life, told him that a bird flies in the sky.  A bird says tweet, a bird builds a nest, a bird has feathers and a beak, a bird lays eggs, a bird feeds regurgitated worms to its young, but somehow I've glossed over that flying thing.  Yet another indication of my complete disregard for the physical in favor of the cerebral.  As he was failing to answer the question, I tried to smack my forehead in self-reproach, but instead I merely fell off my bicycle, causing the entire peloton to snarl itself up in an impenetrable knot of metal and aerodynamically shaved flesh.

And then the doctor asked Charlie, "Which of these animals gallops?"  Look, doctor, in our house a horse says neigh.  Period.  End of discussion.  But Charlie rose to the challenge, answering, "Actually, doctor, it's patently obvious that the horse in question — Equus caballus — is traveling in a leisurely canter.  Note the number of hooves concurrently striking the ground: one two freefourfivesixseveneight!"  Or he stared blankly.  You know, whatever.

We will continue to follow his gross motor progress, working with a local physical therapist, but the doctor feels that what Charlie needs most is practice and time rather than intensive therapy.  So we'll work with him.  We'll clue him in on what birds and horses do.  (It's going to blow his tiny mind.)  And we'll encourage him to run, kick, throw, catch, and tumble.  But I think we're all agreed that it's best if I don't help.  It's all I can do to click "Save" on this post without ending up in traction.

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