...there were hydrocephalic babies. Except not all were still babies. Some were much older. One, whom I got to know well, was my age: 16.
It was not uncommon for kids in my small town of Cambridge, MN, to work part-time at the Cambridge State School and Hospital. The town had 3000 people, CSSH had about as many, about half of them severely or profoundly disabled. Many of these had severe birth anomalies, hydrcephaly, microcephaly, severe chromosomal abnormalities. These patients, often abandoned by their families, wound up at places like CSSH.
I worked at CSSH in food service throughout high school, and later, on vacations from college, as a psychiatric aide. If you are squeamish, please go on to another diary.
My first assignment at CSSH was to the Infirmary. Sick people from the "Cottages" (where most lived) came there, and the most profoundly incapacitated were cared for there, in the "Baby Ward." The Baby Ward housed the most severely disabled patients in the institution, some with skulls and brains that had failed to grow properly. But the ones I remember were those with hydrocephalus, meaning "water on the brain." There is a build-up of cerebral-spinal fluid in the core of the brain which forces the brain and skull outward.
There were babies on the Baby Ward whose heads were massive. The head of the largest was about two feet in diameter (I do mean diameter, not circumference). Their heads were flattened on one side, or compressed on both from lying in their cribs. Many had bedsores on their heads. Their bodies were underdeveloped from lack of activity.
Each evening I would wheel in a large steam cart with pureed meat, vegetables and desert. Then the women I thought of as "the farm ladies" would feed them. One by one, the two or three farm ladies would lift each baby out of their cribs and cradle them in their strong, ample arms as they fed them the pureed food. Just like little babies, they would spit the food out a couple times before they would get it down. The farm ladies did not like it when the kitchen sent spinach. They would talk and chuckle among themselves and were gentle but capable in caring for the babies.
Every few days I would visit the babies. Most were unresponsive, but a couple of them would clasp my finger when I offered it. One, a boy (whose name I intended to remember, but have forgotten), would look at me and seemed to recognize me. He would wiggle and do a little smile. The ticket at the head of his crib told me he too was born in 1951. I knew if he had not had this accident in development, that we would have had many things in common. Selecting him out gave me a way of thinking about the large issues, of life, health, chance, quality of living, segregation of the unwanted, abandonment, poor women's lives, fate, death, God. The Sisters from the Convent of Saint Benedict who taught us Catechism every other Saturday had visited CSSH and taught us that All lives have value. My best friend, who was a wonderful artist, painted a mural of happy animals on the longest wall of the unit. She put her soul into it, to brighten their lives. It also brightened mine. I went to visit the one-who-was-like-me when I was leaving for college. A year or so later, when I returned to visit, he was gone.
I have told the Story of the Babies to each of my children. I remember them. But I have never claimed to have the answers to all the questions they raised for me.
*****
Today, CSSH is gone, torn down and replaced with a prison.
How did this happen? Medical technology (especially ultrasound), advances in gynecological practice, and progressive changes in 'right to choose' laws have made hydrocephalus something that can be detected and 'treated'; or alternatively, such pregnancies can be terminated. The most common treatment for hydrocephalus involves early detection and the implantation of a shunt to allow for the CSF to drain properly and not build up in the brain. Surgical intervention before the baby is born is still experimental. If the condition is detected early enough (before 20 weeks), the pregnancy may be terminated (yes, Virginia, ultrasounds are done for reasons other than to see if there is a peepee there). If the parents choose to continue the pregnancy, radiologic monitoring can determine how quickly the condition is progressing. The doctors and patient will decide when the baby can be safely delivered. This may involve an early c-section, followed by an immediate shunt procedure.
But sometimes things don't go right. The hydrocephalus may progress quickly. Not all forms of hydrocephalus are the same. Some forms coexist with other serious brain deformities. And in all too many cases, lack of early prenatal care leads to late diagnosis with fewer good options - with the potential for serious harm to the mother. In such cases, late term abortion options (including "partial-birth abortion") offer an alternative. Indeed, such conditions are among the reasons late-term abortion can be considered medically - and morally - justifiable.
*****
My experiences at CSSH were not the end of my encounters with the realities of reproductive medicine. For several years, in the early 1980s, I also worked for the Obstetrics Department of an acclaimed teaching hospital in an area with the second highest rate of infant mortality in the United States, setting up an electronic medical record system. I have collected (including interviews) and/or reviewed information on thousands of poor and young pregnant women who were referred to our hospital. It was not uncommon for these women to have had no prenatal care until well into their pregnancies. Among the patients seen in our Young Mothers Clinic, there were 14, 13, and 12 year olds. The younger they were, the more likely they were to have been impregnated by a relative. Many were uninsured (we got them signed up with Medicaid), some had not known they were pregnant, a few did not know how they had gotten pregnant; one girl I remember had become pregnant before she had even had her first period.
The notion that late term abortion is a procedure that currently undergoes no more medical or moral scrutiny than a facelift -- something that people have done while on vacation or on a whim -- is a fantasy by the very kind of people who get facelifts. Or by those who are removed from these realities by their wealth or their moral blindness. Or by those who, as with so many other things, blame the "other," the poor, the victim, or the desperate. And most clearly, by those who have never said, with anguish and compassion, "There, but for the Grace of God, go I."