Power

I thought I would feel hopeful in a crisis

But when my partner had an emergency C-section, I felt something else.
Power

I thought I would feel hopeful in a crisis

But when my partner had an emergency C-section, I felt something else.

A few months ago, when my partner Edie was around seven months pregnant, we started watching a TV show called Bodies. First aired on the BBC in 2004, Bodies was the breakthrough creation of the writer Jed Mercurio, whose later series Line of Duty and Bodyguard have been huge hits in the UK — the sort of shows that are increasingly rare these days, where every episode feels like a week-by-week national event. Apparently someone at the BBC realized they were missing a trick by sitting on a bunch of half-forgotten old Mercurio content now that he's become the hottest property in British television drama, so they threw all of Bodies up online. For obvious reasons, Edie and I were spending a lot of time every evening sitting together watching TV, and we'd been enjoying Mercurio’s dramas for a sort of campy, pulpy thrill, so we decided to give Bodies a go, without really knowing what it was about.

Bodies is about an incompetent surgeon who keeps on getting promoted and protected by the hospital authorities because his research on ovarian cancer guarantees a lot of prestige and money. And this particular surgeon, would you believe it, works in a maternity ward. On a certain level, a more inappropriate drama to watch when you're anticipating the birth of your first child couldn’t possibly have been conceived. In every episode, pregnant women filter into the show’s South Central Infirmary ready to give birth, only for Dr. Roger Hurley to bluster and panic and make the wrong call every time, as babies are stillborn and uteri are lost to infection. In the pilot episode a grieving father, his partner in a coma, is handed the floppy, silent corpse of his 28-week-old fetal son, and asked if he would like to give him a name for the purposes of the paperwork that the midwives now need to fill out. He says they would have named him Daniel.

As we worked our way through the series we initially thought: Why are we watching this? Why are we doing this to ourselves? This is hurting us more than it is entertaining. This is not the behavior of rational human beings. But something kept bringing us back — catharsis maybe? — and, over time, the spectacle of all this interminable incompetence and disaster became almost comforting, like picking a scab. The show is obviously sensationalistic, but medically it is at least somewhat accurate — Mercurio himself was a hospital doctor before he became a TV writer. It became educational: we learned about conditions we might not otherwise have come across, like uterine rupture and placental abruption. Over time, we started to get a sense of when a mother or baby in a particular episode was going to die, and when someone was going to find a way of overruling Hurley and helping a patient pull through.

One thing we learned for certain was that if you're a character on the TV show Bodies, and they take you for an emergency caesarean section, your baby is likely to live. With a C-section, the doctors always seemed to know what they were doing — much more, at any rate, than when they were attempting a vaginal delivery. A lot of the time, upon delivery, the baby would need to be revived with a little air-pump thing they have standing by in the operating room, but after a few goes with the machine they would usually start to cry and be fine. (Indeed, the only real problem with the C-sections is that through the show, the hospital administrators are trying to honor a government target aimed at keeping the number they perform down; Hurley, who likes to please the administrators, is therefore often fatally reluctant to approve them).

But what does it feel like, I would think, projecting on to the fretting partners forced to look on, horribly passive, as crisis erupted across their loved ones’ birth canal, what does it feel like to have the two people you love most in the world suddenly carted away from you, as a team of doctors and nurses respond quick-forceful to the signs being given them by a machine, which tell them that your child is in distress, which tell them that they can't wait, they have to get the baby out right now?

What does it feel like when the disaster is happening? What does it feel like when everything you love and have hoped for is at stake?

At around 5 a.m. on July 22, I found out. Or, at any rate, I suppose I did. Everything happened so fast, to be honest I'm still absorbing it; I don't have complete access to the memory. My fear I guess is that looking back on it, knowing that things turned out as they did, I'm going to end up doing the moment some dishonor.

Edie’s water had broken at 3 a.m. the previous day, but her contractions had not been coming on with any regularity. When she was admitted to hospital at 9 p.m. that evening, it was effectively to have her labor induced, which had technically been starting but not. Our son was situated very low in her birth canal, but her cervix had hardly dilated. We had wanted to use one of the hospital’s quite-nice birthing suites, where Edie would have had a midwife-led delivery without too much medical intervention, but the baby's heart rate was dipping slightly with every contraction, so we were placed in a slightly less nice room with more medical oversight instead.

Edie was given an epidural to help with the pain, and then put on an oxytocin drip to help induce more regular contractions. For around half an hour or so, we thought that everything was ticking over pretty nicely, that she would go into labor properly any minute, that we just had to wait and get through this and we’d meet our son at the end. But then his heart rate completely crashed.

In this moment, I didn't ask the universe for anything. I didn't see what the point would be.

Doctors and nurses rushed in to our birthing room, tipping Edie to her side (which is something they do in case the baby is being strangled by their own umbilical cord), desperately checking the heart monitor's screen. Numbers blazed wildly: 101, 78, 148, then just some dots. “Okay,” said one doctor, who we'd been introduced to earlier and told was charge of the ward that night. “Let's get her to theatre.” “I love you,” I said, knowing I would be forced to wait behind, as they took her away for an emergency C-section. Then I rushed to the toilet, to vomit out of fear.

It is in moments like this, according to the philosopher Beatrice Han-Pile, who runs the “Ethics of Powerlessness” project at the University of Essex, that a feeling of hope paradigmatically arises. “Hope constitutively involves a (pre-) reflective experience of powerlessness,” she writes us in a 2017 paper entitled “Hope, Powerlessness, and Agency.” “Hopers feel unable to bring about the desired outcome by the sole exercise of their agency.” People in general don't “hope” they will be able to, for instance, raise their arm to drink a cup of tea — they simply know they can. If I said I was “hopeful” of raising my arm, you would know there was something wrong (perhaps my arm had recently been injured). If you asked me if I was going to return the book you'd lent me and I said “I hope so,” you'd feel a bit put out.

One example Han-Pile focuses on is that of “a loved one surviving a difficult surgical procedure”:

“If we hope for something over which we believe we have no control at all, such as a loved one surviving a difficult surgical procedure carried out by someone else, this experience of powerlessness is radical and reflective: we are both convinced and aware that there is nothing that we could do to bring about the desired outcome. By contrast, if we hope for something over which we believe we have some, but not total, control (such as winning a race), our experience of powerlessness is relative and may remain pre-reflective: we feel that there are intentions we can form (such as training harder) but that the resulting actions would not suffice on their own to bring about the desired outcome.”

When Edie was wheeled away by the doctors to the operating room, I obviously dearly wanted, more than I have ever wanted anything else, for everything to turn out alright. But I couldn’t feel hopeful — despite everything one might assume about such moments of crisis, hope would have seemed completely inappropriate. In fact, contra Han-Pile, it was precisely my powerlessness that made hope so inaccessible to me.

To have been hopeful would have implied my involvement — the belief, correct or otherwise, that I at least had control over something, in some aspect of the situation (later in the same paper, she gives prayer as an example of an activity a powerless-but-hopeful person might undertake — but, while those who pray might admit their personal powerlessness, they do at least appear to be assuming that it is in their power to request some form of divine intervention). But at this point, I was essentially ballast: I didn't even know if I would be allowed to see the C-section take place.

I was told that if the baby’s heart rate picked up, they could administer anaesthetic through the epidural and Edie would be awake during the procedure, and I could scrub up, if I wanted, and sit by her and see it too. But if, when they got there, the baby’s heart rate was still down, they would have to administer a general anaesthetic to get him out without any delay, and I would have to wait outside while Edie, unconscious, had a most likely lifeless fetus cut out of her.

In this moment, I didn’t ask the universe for anything. I didn't see what the point would be. I knew I couldn't influence the outcome in any way. I just wanted it to all be over, to know how this all turned out — to know if I got to live in a world where I could hold my son and form a loving new family with his mother, or if my life would always, now, be tinged with sadness — that I would always have loved someone I never even got to see before he died. I didn’t even try to imagine a positive outcome; if I did anything at all, it was to simply will time on. I was the opposite of hopeful. I was flatly, and blankly, resigned.

When I saw my son for the first time, he was purply-red and screaming, emerging from the depths of Edie’s abdomen with his cord hanging gray and meaty from his navel. He looked healthy and huge; one of the midwives immediately proclaimed that she had never seen feet so big on a newborn (we later measured them — they’re almost two centimeters larger than the feet of the average newborn). He cried and sucked the air, begging to be fed by licking his hand. The doctors seemed faintly astonished. I don’t know if they were telling us this just to reassure us, but apparently babies born by emergency C-section are almost never this alert. “I knew it, he just likes the drama,” said our anaesthetist. I was asked if I would like to cut the cord. I don't know how much of the next few hours I can accurately piece together. I was high on joy and relief. He was out, I could hold him. We were a family.

But what had helped me through all this was not hope. More than anything else, what had stopped me from losing my mind across all the peaks and troughs of emotion associated with my son’s birth was a certain useful fiction that had been given to me by watching Bodies, in which I had witnessed — whether accurately or what — the scope of everything that can apparently go wrong. Thus when I was in the operating room waiting for my son to be born I had a general idea of what everything was, saw the doctor waiting by with the little instrument to revive him, etc. I knew what the procedure entailed; I knew that despite everything, it was the safest way to ensure a positive outcome.

When disaster rises to meet us, perhaps we don't need hope — or perhaps better, perhaps hope is just not for these sorts of moments (I don't just mean the disaster of a pregnancy possibly ending in stillbirth, but also something like the effects of climate change — the young environmental activist Greta Thunberg, for instance, has publicly argued against the efficacy of hope in fighting climate change). What we need is something not progressive or prospective but simply blank and automatic: an index of adverse consequences, organized from “worst possible” to “most likely, given everything.” Not to wallow in despair but to brace ourselves; to use to prepare, if need be, to have our worlds torn apart. When one is rendered powerless, for whatever reason, that is really something to cling on to.

One week later, my son sleeps beside me in his Moses basket, the bass of GZA’s Liquid Swords rising up around him from the floor. He is peaceful and beautiful, but when I hold him in my arms I just think: you are so fragile. He is feeding well, and has noticeably packed on weight since his birth. He is lively and alert, but he could just as easily have never been. Life and death came close early on for this one. I'm not sure what that means, if anything. Just that I’m grateful he exists.

Tom Whyman, a contributing writer at The Outline, is a writer and philosopher from the UK.