A high-tech grasp of the obvious

No kidding: Premature babies 'feel true pain', says a report of a new paper in the Journal of Neuroscience. They don't just flinch and tense their bodies and scrunch up their tiny faces and yell as loud as their underdeveloped lungs will let them. Now we know, thanks to a series of brain scans done on preemies, that parts of the brain later associated with high-level sensory processing light up when you stick a preemie's heel.

None of this surprises anyone who's, say, spent six weeks in a NICU, but what got to me was the unacknowledged technical tour de force involved in measuring the brain activity of babies down to 25 weeks without freaking the local research ethics committee right out. Preemies are, uh, delicate. When Charlie was born, you could look at him wrong and half a dozen alarms would go off. He'd desat when you turned the lights on.

The J. Neuroscience web site isn't giving me any damn help at all, so my imagination is running wild. First I think they must have used an MRI — visions of baby inserted into enormous magnet with LOUD, CLANKING moving parts. Baby, whose life depends on the metallic needles, probes, patches and wires inserted into or covering its body, inserted into enormous magnet. Hmmm, maybe not. You can also measure brain activity with PET scans — baby whose life is hanging by a thread shot up with radioactive glucose for the sake of science and inserted into enormous (but nonmagnetic and possibly nonclanking) machine. Um.

EEG? I've had a couple of those. Dozens of electrodes pasted onto baby's skull, while the researcher explains, "Kid, we need you to remain calm and unruffled while we glue all these patches to your head, but as soon as the nurse sticks your heel it's OK to register discomfort."

I'm clearly missing a brain-scan method or twelve here — anyone out there know the answer? It amazes me that gizmos have advanced to the point where you can safely do this kind of research on such fragile little blobs, and kinda awes me that the parents of these kids were willing to give consent to something that wouldn't help their babies a bit but might somehow make life in the NICU more comfortable for someone else's very sick baby.

UPDATE 315pm: A kind reader has sent a copy of the article, in which very reassuring things are said about how the infants were treated. There is also a picture of a photogenic 33-weeker being probed. The sensors, aka "optodes", are not very big at all, and apparently monitor blood flow (which translates to brain activity) right below wherever they're placed. So they're essentially the hyper-evolved cyborg cousins of a pulse-ox clip. Much simpler than I'd thoughtt, and a good thing too.

03:47 PM in Paul scrawl | Permalink | Comments (33)


Every now and then one of our friends or family members comments on how nice it is for Julie that I help her with Charlie. I smile and remind myself that beating them about the head and shoulders with a spare newel post would only cause trouble. It's not just that such comments rekindle, ignite and fan with blast bellows my fear of being an inadequate parent. It's that they make me want to find some way to prove them wrong.

And I really hate keeping score. Well, yeah, partly because I think I'd come off a poor second. But if I didn't, what difference would it make?

Just how would you do it anyway? Any decent judging system for Xtreme Charlie would make the new figure skating rules look like Go Fish. I start imagining something like this:

  • Major eruptions from top or bottom: 10 points plus
    • 1 point for every item of Charlie's clothing tagged.
    • 2 points for every item of parent's clothing tagged.
    • 3 point bonus if you have to shower.
    • No points for Charlie's socks.
  • Minor eruptions, bodily or emotional: 2 points.
  • Meals: 2 points
    • 1 point off for good behavior
    • 2-point bonus if he gets the lid off the sippy cup.
    • 1 point for food in hair and ears
  • Bath: 1 point
    • 1 point bonus if he cries throughout
    • 1/2 point off if he says "Buh-bul" more than three times.
  • General care: 1 point per hour
    • 1/2 point off if he sneaks up and tickles your stomach
    • 1 point bonus if he's a pill.

Then there would be the saintliness points for singing sweetly to Charlie during a bonus round, and some kind of style credit for singing on key...

Around here we pretty much limit the tallies to  "I caught the last three diaper blowouts, you get this one" or "You took him to daycare, I'll pick him up." (Julie: bath and med/bottle setup. Paul: pajamas and bedtime bottle delivery).

The other week, while Charlie was blessedly sleeping off a couple hours of his (and Julie's) most recent encounter with a random stomach bug, Julie commented, much to my surprise, that I do more for the boy than she does. I told her that I always felt just the opposite. I think this is one of the many good things about both having lived on our own for years before moving in together. If you're used to doing an entire household's worth of chore singlehanded, it feels a little like slacking to do any less.

12:53 PM in Paul scrawl | Permalink | Comments (35)


The 7.5 percent solution

Drugtube_2 Charlie has always been pretty cooperative about taking his medicine, at least since it stopped being delivered by needle and tube. And he's taken a lot of it: antacids, antibiotics, painkillers, inhalants...

He sits quietly sucking his bottle and breathing from his nebulizer. He opens his mouth obediently for a hit of Motrin. But there's only one drug he's really addicted to. He's started serious teething again, and when he so much as glimpses that little pink-and-purple tube of benzocaine from across the room he lets out a shout and points avidly in its direction. No gentleman junkie here: be quick with his fix or he'll climb you.

All the books will tell you that topical anesthetics aren't that useful, that they wash away in a few minutes and make the rest of your baby's mouth feel funny. Charlie can't read, so Charlie doesn't care. He gives a little coo of deliverance as he opens his mouth for gelid relief. Sometimes he wants both sides, usually just one. As soon as he feels the numbing rush he loses interest in the little tube and goes back to playing or talking or chewing on his spatula.

Every now and then I feel a brief puritanical qualm about dosing Charlie with this stuff on demand, relieving his pain whenever he asks for it instead of teaching him to suck it up and grit his teeth like a man. What if benzocaine turns out to be a gateway drug to the harder stuff, like acetominaphen or ibuprofen? But then I come to my senses. He's already taking the hard stuff. And none of his six and a half teeth even meet. He couldn't grit them even if he wanted to.

There is one place where I intend to keep him from new thrillseeking concoctions, and that's in the kitchen. His newfound love of pesto alla Genovese, for example, I will not abide. He's cutting into my share.

11:58 AM in Paul scrawl | Permalink | Comments (42)


The very messy bunny

I really should have known this already: if Charlie visits a household with other children, he's going to need a new set of clothes by the time he comes back. Julie has been taking a short break from our vacation, and before heading for Oregon I decided we should visit a few friends from my dashing bicoastal days. First up, D., whom I've known since college, now with a 6-year-old, a 3-year-old and the first dog Charlie hasn't absolutely loved on sight (he must have been jetlagged).

And a sandbox. Throwing sand up in the air is apparently the funniest thing a 20-month-old can do, handily edging out peekaboo with someone almost his own size, and well ahead of trying to uproot ornamental plants. Charlie's clothes looked right out of Lawrence of Arabia by the time he was done (only with festive polka dots), and it took close on half an hour to rinse most of the grains out of his hair. He came home in a fetching ensemble of nearly-new overalls and tee shirt.

My other friends have no sandbox, only gazillions of wooden blocks -- including some from G.'s childhood -- a bunch of plastic dinosaurs and a bowl of cherries on the kitchen table. So far, so good. And Charlie is remembering the names of both of their boys. He's walking half a dozen steps at a time. I'm basking in the compliments and holding an almost adult conversation about robots and integrated circuits. Maybe I'll get Charlie out of this with only a few fruit stains.

Then he spots the watering can out on the deck. "Wuh!" he cries imperiously. (Sometimes I think his language skills could be a little less advanced, thank you, especially when I take him down from a nice long ride on my shoulders and he immediately responds, "Up! Sho'!") Anyway, there is nothing for it but to start filling watering cans and watch him pour them on himself. With occasional breaks to mix up some mud and rub his pants into it.

"Oh, I can just wring his clothes out," I say bravely. But no, upstairs is apparently a trove of cardboard boxes labeled by child and year. Out come pants, a shirt, a windbreaker, a cap that turns out to be just a little too small, more overalls... "Please! take them," says my friend B. I do, and better yet, this time I even remember to collect all of his cups, plates and utensils before taking him out to the car.

On the way back to the hotel, Charlie hugs his hand-me-down rabbit while demanding crackers at every traffic light. Then he stands proudly on the sofa so that he can smile, growl, wave his hand and play peekaboo with the baby in the mirror. And I bless the luck that has put our room directly across the hall from the laundry. And given me friends who put up with me even as they welcome Charlie.

02:13 AM in Paul scrawl | Permalink | Comments (19)


More water please

September in New England means cool weather. As our neighbors shut down their pool for the season, we drain and hide our little aquatic play table (somehow the idea of Charlie soaking himself and us to the skin with 55-degree water — that's minus nine celsius for you metric folks — just wasn't attractive). So the last time Charlie went out on the deck, he picked up his lonely, left-behind watering can, carried it over to his high-and-dry Godzilla doll, and spoke the title of this post.

Every time I hear Charlie pick up a new word or phrase, I'm astounded not just by him, but by the amazing complexity of language and the the near-miraculous way that kids manage to pick it up  and to make sense of the hash that is adult conversation. Sometimes we put his shoes on, sometimes we put on his shoes. He likes to take a nap, we like to take a picture of him. He takes a ride in a car.  Dogs bark. Trees have bark. Trees are made of wood. Would Charlie like a cracker? It won't be our turn to turn until the light turns green.

Sometimes I'm surprised he doesn't start screaming in frustration: "Use the same damn words when you're saying the same thing! Use different words when you mean something different! This morning you gave me 'some' milk with breakfast, now you're giving me 'a cup of' milk, and it's the same thing. First you tell me you're making a bite of food, then you tell me 'Don't bite people' -- can't you make up your enormous effing minds?!"

But instead he, like pretty much every other toddler on the planet, just sucks up new words as if he were a huge semantic sponge. Watermelon. Farmer's Market. Hippopotamus. (Then he tosses them back at us in nearly unrecognizable variations. If only I'd paid more attention to those tables of vowel and consonant shifts back in Linguistics 110, I'd know immediately that feces benekeh means fleece blanket.)  I know that Charlie is the descendant of thousands of generations of primates whose lives and reproductive success depended on learning the language of the adults around them, but even so, watching the process close up is fascinating and humbling.

Just not humbling enough to make me fill up his watering can.

08:27 PM in Paul scrawl | Permalink | Comments (38)


How soon they grow up

It started with three little words: "Oh, my gosh." There are plenty of exclamations Julie and I use (and mostly try not to use around Charlie), but that's not one of them. When he started talking about caps and peddlers, we could not deny the awful truth: his daycare has books we don't have at home, and his teachers read them to him.

Then he started asking us to help him do somersaults. What will they teach him next?

We try to get him to open up to us about his life, just like they tell parents in those public service announcements, but he's already mastered the art of inscrutability.

"What did you do at daycare today, Charlie?"
"Did you go outside?"
"What books did you read?"
"Charlie had a poopy diaper."
"Did you read a book about caps?"
"Charlie had a diaper change. Charlie has a fresh diaper. Sprayed the diaper table wiffa sprrrrray bottle."

OK, I guess that counts as telling us at least a little bit about his day. But it's not enough. I want to know who his friends are, whether he's hanging out with the wrong element in the nap room, what dastardly schemes he and his wee pals are hatching. ("Look your parents in the eye and smile when you kick hell out of the table leg at dinner," they tell each other — Charlie could never have  thought of that on his own, could he?)

Of course if he really is as fast-talking as the pediatrician seems to think, maybe he'll be the one that other parents worry about their kids associating with. He'll have a little 3-foot-high posse, all trailing identical stuffed Ernie dolls and all exuding a whiffy atmosphere of menace as they politely tell their parents, "Dad will get out of Charlie's rocking chair now."

09:09 PM in Paul scrawl | Permalink | Comments (20)


No, I would not like to cut the cord

Not even a symbolic snip of the last few inches. I was instructed to put on scrubs and booties and mask and a silly hat, and not to touch anything that might be sterile. Okay, a newly-extracted baby covered in blood and goo and other stuff probably isn't sterile but I still prefer to practice my cutting skills on things that aren't yelling at the top of their healthy little lungs about how effing cold and bright it is out here.

Not that any of you were waiting with bated breath or anything: Baby not-Natalie arrived a little before noon; he and Julie are doing fine. And darn the maternity unit for not having wireless. (But if they did, not a baby in the place would sleep for the clacking of keyboards.) More when more of us are awake.

10:36 PM in Paul scrawl | Permalink | Comments (415)