Saturday, 1st July 2005.

Afterbirth (part I)

12:27 a.m.

The evening Joshua was born, Emily was moved onto the observation ward - a slightly lopsided set of rooms that seemed to have no hub or central area, perhaps indicative of its status as a transitionary unit. She was given a bed near the end of the ward, next to a corridor that ran to the supply cupboard. A middle-aged midwife with a clear knowledge of breastfeeding technique but a general lack of bedside manner arrived, and tried to fasten the baby (quite literally) for feeding.

One thing we learned quite quickly about the John Radcliffe was that if you want anything they'll usually oblige, but you generally have to ask, and often two or three times. This might sound obvious and whiny, and perhaps it is. It's also a little unsurprising that a hospital that big is filled with people who don't seem to know what's going on. It's less a question of incompetence and more about miscommunication. The brown paper folders that house patient notes become indispensable guides for the staff, as doctors and nurses and midwives and consultants change shifts with clockwork regularity and the only clue as to what's been going on is in the steadily accumulating paperwork.

What's worse, differences of opinion or mix-ups can lead to misdiagnosis. We found out about this quite early on, when it became apparent that Joshua was suffering from jaundice. This is nothing to worry about - and Sue, our paediatrician, decided that they would put some lights on him. This involved shoving a flat piece of fabric up the back of his vest and leaving it there: the fabric was attached to a tube, which was attached to an electrical device that would make the fabric glow a mysterious blue-green through his vest. He looked like a radioactive alien baby, or a modified Nova with a neon strip that had been worked on by chavs.

This was fine, although it made moving him a little tricky. Later on Tuesday evening, after Sue had gone off duty, another paediatrician ascertained that a stronger dosage was needed. Joshua was moved to a nursery that contained a large UV overhead light and a padded cushion large enough to hold a baby, not unlike an open sunbed, and Emily went with him, rehoused in a bed that was adjacent to the side room. The nursery was unduly hot and not terribly pleasant, but we realised it was for the best, although neither mother nor son got much sleep that night. When I arrived the next afternoon she told me that when Sue had started her new shift she had said that she would not have recommended the stronger treatment: it was either a difference of opinion between consultants, or (more likely) the second paediatrician had examined the count for jaundice and used the lower threshold that applies to babies less than a day old as a guide, rather than taking into account the fact that Joshua was a little older than this.

So he'd spent a night in there for no really good reason, other than a clerical error. It was irritating, particularly as Emily lost her window seat in the process, but there seemed to be no harm done - although Josh spent most of Wednesday feeling rather dehydrated as a result. I was annoyed but put it down to the sheer incompetence I have come to expect from the NHS - a very nihilistic attitude to take, but the alternative is to get cross, and I'm not really the compensation culture type.

I've found that the staff tend to be overly cautious: I think it's a fear of lawsuits, "or perhaps", as Uloma was saying this morning, "they actually care about the babies". Emily is regularly inundated with offers of painkillers, and questions about her urine, as well as how the baby is feeding. This can grate after a while but on the other hand it's good to know that expert medical care is available if needed. I'd had reservations about the John Radcliffe - I still do - but I have to admit that they've looked after both of them, even if they ask the same questions a hundred times a day.

Joshua himself has ceased to be a ball of wrinkled flesh and is now starting to become a personality: his first trick was to open his eyes and stare very hard in what looked like disgruntled bewilderment, the sort of look a pensioner gives to the two small children who disturbed his nap. He worked out very quickly that if he has his eyes open he can see things, and seeing things is good, even if his field of vision is limited to only twelve inches at the moment. Certainly he seems none the worse for the ordeal of labour. My new theory, as I'll tell anyone who'll listen (which means that Emily's heard it at least a dozen times already) is that there's a reason why our memories don't start until about three: everything before then is pretty traumatic, one way or the other.

Joshua is starting to work out that a lot of the people in blue tunics who approach his cot are actually coming over to stick needles in him or contort his arms and legs into awkward positions while they check for medical progress. It's at this point that he wails: Emily, who recently read The Baby Whisperer, is beginning to work out what his different cries mean. A repeated "Wah! Wah! Wah!" means general distress, while a high-pitched dog whistle noise generally means trapped wind. We delight in small things: strange, speech-like noises, prolonged eye contact, and that moment the other evening when, as I placed a finger in his mouth for him to suck, he reached out and placed his tiny fist into my palm. One of those father-son moments that you can't predict and can't really write down.

All the immediate family have visited - Mr and Mrs Knight, of course, came the day he was born, and then "popped in to say goodbye" the following morning before promptly settling down for a two-hour bedside chat. My parents followed later in the day. Miriam was also supposed to come on Tuesday, but she took several wrong turnings before travelling the wrong way up the M11, and then realising (as she reached the end of the thirty mile stretch she'd been forced to travel to reach the next junction) that she'd left the key to her petrol cap at home, and that she only had enough fuel to get back to the house. She came Wednesday, along with Matthew and a still-vomiting Katherine, while my brother popped in yesterday. "This is your uncle Mark. He's the footballer."

Josh is on a five-day antibiotics programme, administered twice daily from the special care unit. Em has to take him down for the four a.m. dosage, so I've been doing it in the afternoons. We finish Sunday, which is the expected release day for both of them, assuming there are no further complications. Certainly taking a trip down to that unit is enough to make you take stock of a few things: the first time I entered I was let in by a doctor who promptly strode off down the corridor to the other end of the unit without a word. Not knowing what to do or where to go I followed him, only to have Sue drag me back - a familiar face in an unfamiliar context.

I have a thing about needles, so while they did the heel prick I stood outside the treatment room and examined the pictures on the walls: a full staff chart, with actor portrait-style photos running in conjunction with the list of names. I noted that one midwife was called Smitha Baby, a name you really couldn't make up. After a while I got bored and moved onto the photos of the special care children: the bulbous, misshapen heads of the handicapped, the ageless look of Down's, the tubes that hang from the nose, given along with gestation dates and progress charts. But it's the quietness of the place that gets you - room after room of incubators, each supporting babies who demanded constant attention without even realising it, while the doctors and nurses dash back and forth in comparative silence, amidst the beeps and hums of heart monitors and refrigerator fans, trying to work miracles. It made me feel very fortunate.