Dear Will #1

A diversion from my usual content into something more personal.

Earlier this year my wife and I learned that we were expecting. I am sharing this letter to my son as a pregnancy announcement.

Dear Will,

Yesterday your mom and I learned that you’re about six weeks old and have a heart rate of 115. You have a heart rate.

Your mom told me I should write down some stories about our lives, and I thought it was a good idea. In particular, I thought it might help us to explain, one day, why you spent so much time at a veterinary hospital, why there was a playpen and a crib in a doctor’s office, why there were times when your mom and dad had to be somewhere else, and why dad couldn’t always afford to do everything for you he thought you deserved.

The patient who inspired this is a puppy named Otis. Otis is a golden retriever, a little younger than our Tank. Otis had eaten a something and had been vomiting for about a week when he went to the emergency room. They diagnosed a foreign body, what we’d later find to be a washrag. But Otis’ owners couldn’t afford the surgery at the emergency center, so they called me and I agreed to do it at a lower cost.¹

Otis’ owner would tell me that I had restored her faith. She said that she’d prayed so hard and God had answered. I smiled and said I was only trying to save the puppy, not anybody’s immortal soul. A brush off of what I imagine was a compliment. It wasn’t a deity that made the difference that day, it was us mere mortals. There was no laying on of hands, no miracles, no sainthoods to be doled out. It was just a few people trying to do the right thing. The owner, the ER doctors, and your parents.

My staff had left for the day, so your mom came in to help me, as she had so many times before. More than one date had been cut short or a vacation postponed because I couldn’t save a life alone. Your mom, as I’m sure you’ll have noticed by the time you’re old enough to read this, is always there for me. For everyone she loves, in fact. She’s the best person I know. The best one I’ve ever met. And, as always, she agreed to come in to help me without a moment’s hesitation.

Once the surgery was underway, I found the obstruction and exteriorized the intestine. The obstructed bit of the intestine was in bad shape, so I tried to gently push the object along to a healthier spot in order to remove it. The intestines were so friable that they just tore; not completely, but enough. I knew that this meant that the surgery had just gone from “enterotomy” to “resection and anastomosis.” Instead of making a small incision in the bowel and closing it, I’d be removing several inches of bowel entirely and sewing the remaining ends back together. I was tempted to call your Uncle Albert for help, but it was Charlotte’s birthday so I left him alone. It did give me confidence to know that if I needed his help, I would call him and could count on him to come.

I didn’t wait. I asked your mom to watch the patient, tore off my gown and gloves, and left the OR to pull a textbook off the shelf. I flipped to the page (440, I think) on intestinal surgery and flipped a few more to find the diagram and description of the resection and anastomosis. I'd only attempted the surgery once before in the last nine years and, even though the last time was on a much sicker patient, the dog hadn't made it.

But Otis needed it done. So I read the pages, set the open textbook on the cart outside the OR, and scrubbed back into the surgery. Your mom, of course, knew exactly what this meant. She had been through enough of these emergencies to know that, since I’d never cracked the textbook during a procedure before, it was of consequence that I did so today. She understood the extreme risk and challenge, and she never uttered a word of doubt. Her confidence meant the world to me.²

Skipping the sticky, squishy, smelly details, I did the R&A on Otis and texted a picture of it to Uncle Albert, who assured me that it looked great. I finished the exploration and closed up the abdomen. The R&A can fail for several days after the surgery, so I was still sweating a bit for the next week or so, but Otis did fine. He'd scarf his meal and meds the next morning and never look back. 

When I told your older brother about it, I left out the part about having never done the procedure successfully, but he said he didn't know how I did it, and that he'd never be able to handle the pressure. I think he may have been being nice, but it made me think. I replied that the pressure was never a consideration; the pressure was simply not factored into the calculation of it. The puppy would've died if we hadn't done anything, a family would've lost their dog. Those things might sometimes come about because I wasn't a good enough doctor, but it would never be because I wasn't brave enough. My skill will always falter before my courage.

Once the family and the ER docs called me, I bore a responsibility to try to help. Not to succeed, but to try. Denying them help didn't absolve me of responsibility. Success and failure were the binary outcomes and failure meant a dead puppy. My fear, anxiety, pressure, and whatever else had no bearing. How I felt simply did not matter, but what I did would matter a great deal.³ It might be called courage or bravery, but it was just doing the work when, at that moment, we were the only ones who would help. Sometimes you'll see me or your mom with an apparent lack of emotion, appearing fearless or unbothered or untroubled by a stressful problem we face. It isn't the absence of bad emotions you see, it's just that we overcome the doubt with resolve.

We got a good outcome. Otis made it. And there have been many before and since. Splenectomies and enterotomies and cystotomies and on and on and on, Will. We don’t win them all, but we win most. Sometimes all it takes to save a life is to have the courage to try.

I never really started keeping track of these until your mom suggested I do so, and I found out you had a heart rate. I wanted to tell you about it because I hope to spend my life inspiring the same sort of courage in you that my dad, my mom, and your mom have inspired in me. I don't know how to teach it, I just hope to give you the opportunity to witness its importance. Because you weren't named only for Norman ancestors or for your great-grandfather and grandfather and father, Will, you were also named for the verb and the noun. Will is the expression of faculty and purpose, control deliberately exerted, intention, desire, wish, the expression of inevitable and future tense, of ability or capacity, of habit, of expectation. The means by which grit is manifested, courage is demonstrated, and all is accomplished is Will.

As I write this, Otis’ owner still hasn't paid the entirety of their bill, even the discounted one; but their dog is alive and happy, and he has, like this sentence, a semicolon.⁴ Sometimes we are the last line of defense between a happy puppy and a dead one. Because of that unfortunate but occasional reality and our sense of responsibility, the world in which you will be brought up is full of animals, of chaos, of duty, and, I hope you'll see, of courage. Doing surgeries for less than the maximum possible price is one of the reasons why I never made as much money as I could have. Doing surgeries nobody else will do is why your mom and I won't be omnipresent. Sometimes, and I promise it will be only sometimes, we'll need to save a life before we put you to bed.⁵ It's why you had a playpen beneath the image of a man holding back Death. It's why there was a crib down the hall from an X-ray machine. It's why you can sleep despite dogs barking and monitors chirping.⁶ It's why you will have grown up in a place where we spend our days happily resolute in trying to better and save the lives of animals.

I love you already.

Love, 

Dad

1. I don’t mention the “fraction of the cost” bit to shame the ER doctors. They’re bound fast because it’s just so difficult and expensive to run an emergency hospital. My costs are lower. I like to believe they’re happy when I say “yes” to being able to help.

2. She’d later point out that I never turned around to look at the textbook for the rest of the surgery.

3. Your mother is the same, only she has no training in medicine or years of experience to bolster her confidence. She is simply resolved to do the right thing.

4. The first of what I intend to be a great many “dad jokes.”

5. I can’t wait until you’re old enough to help.

6. I hope.