When I used to be 5 years previous, my dad and mom determined they may now not watch the nightly information. Or slightly, they may now not watch it if I used to be in earshot. The coverage of the attack at the Munich Olympics had precipitated me to have such an intense worry of being killed by gorillas that I couldn’t sleep. No matter what number of occasions my dad and mom defined the distinction between terrorist guerrillas and primate gorillas –and that there have been no gorillas in Michigan anyway – I remained sleepless with fear late into the evening for weeks. My dad and mom ultimately gave up and subscribed to the afternoon paper in addition to the morning 1.
The drawback isn’t just that I’m a champion worrier. It’s that I courtroom fear – I search it out, I invite it into my residence, by no means remembering how exhausting it’s too dislodge it from its comfy chair by the fireplace. I watch true-crime documentaries once I’m alone. I Google photographs of black widow spider bites. I do know the statistics about paracetamol overdoses. I’ve memorised the seashores with harmful riptides. I’ve put in a carbon monoxide detector in each home I’ve ever lived in. And once I acquired pregnant with my first youngster, I purchased What to Expect When You’re Expecting – and the chapter titled What Can Go Wrong was the 1 I learn first.
Retained placenta; umbilical twine prolapse; foetal arrhythmia; toxoplasmosis; preeclampsia; placental abruption; gestational diabetes; cytomegalovirus: I examine all of them, and realized the warning indicators. Perhaps to different ladies, these issues stay obscure, shadowy threats throughout being pregnant, however to me they have been exhausting, clear, rapid risks. When my obstetrician instructed me that mine was a wonderfully regular being pregnant, the very very first thing I mentioned was: “Are you sure?”
And but I used to be stunned when catastrophe struck. The belongings you fear about aren’t alleged to occur – that’s what fear does. It’s a preventative. And my catastrophe occurred shortly, with out fanfare or drama. One 2nd, I used to be a pleasant, regular, completely happy pregnant married lady of 32, strolling throughout my bed room to my desk whereas my husband made lunch downstairs. And then the nice and cozy fluid gushed out of me, soaking my clothes and leaving slightly moist spot on the pale inexperienced carpet.
I yanked down my denims and pants, anticipating blood, however there was solely wetness. I knew it was very doubtless that my waters had damaged, however I used to be barely 26 weeks pregnant. It didn’t appear attainable. I stepped out of my garments and went to the highest of the steps to name my husband. He stood on the touchdown together with his arms all sticky from making hamburgers, and I instructed him what had occurred. We mentioned it for a surprisingly very long time. Was it actually so dangerous? How a lot fluid? Maybe a cup? Was there blood? Was the child nonetheless kicking? Should I name my physician? Yes, we determined.
I wrapped a towel round my waist and known as my obstetrician. He was a person in his late 50s with a perpetual hangdog expression, and because of this, my husband and I known as him “Doggie B”. I cherished Doggie B. Nothing ever stunned him, nothing ever alarmed him. I couldn’t image him giving me dangerous information, and since I couldn’t think about it, I felt it wouldn’t occur.
“I want you to meet me at the hospital,” Doggie B mentioned. “Go to the maternity ward. And I want you at Georgetown Hospital where they have the neonatal unit.”
I placed on contemporary pants and denims and my husband and I drove to the hospital. It was 29 January 2000, and an ice storm was simply starting. Something occurred to me on the best way to the hospital: my thoughts cut up in 2. One 1/2 was satisfied that that this journey was pointless, that, in fact, my water hadn’t damaged, that I used to be simply tremendous. The different 1/2 was simply as positive my waters had damaged and that I’d virtually actually go into labour and provides start to a child too younger to stay. The 2 halves of my thoughts rotated inside my head just like the lights of a lighthouse, the anxious half flashing after which disappearing, changed by the calm 1.
At the hospital, a health care provider who appeared identical to Andie MacDowell carried out a pelvic examination and took vaginal swabs. A nitrate take a look at was performed on one of many swabs for the presence of amniotic fluid. (Its presence would have meant membranes containing the child had ruptured – 3 months prematurely – and would more than likely trigger me to go, disastrously, into labour.) The different swab was for despatched off to the lab to examine for the presence of arborisation, in any other case often called ferning, as a result of amniotic fluid produces a fragile, leafy sample beneath the microscope. Both exams have been destructive, though they have been working a repeat simply in case. I started to really feel slightly ridiculous.
The Andie MacDowell physician instructed us that there was no proof that I used to be leaking amniotic fluid, however that they have been going to confess me, she mentioned, “on the strength of my story”.
The power of my story! I used to be appalled. I’m a author – in fact I instructed a robust story. Maybe I didn’t have to be right here, I instructed my husband, as nurses wheeled my gurney into a personal room. Maybe I ought to simply inform an equally robust story about how nothing was mistaken and go residence.
The physician got here again. “I just saw the ferns,” she mentioned. “You have definitely ruptured. We’ll try to delay labour as long as possible.”
“Three months?” I requested.
“Yes, that’s the hope,” she mentioned.
I wouldn’t have been so scared if it weren’t for the look on her face.
Nurses got here into my room and started to bustle round me whereas the physician defined that my situation was known as preterm untimely rupture of membranes, or pPROM. The 2 most harmful (and commonest) issues of pPROM are excessive pre-term start and chorioamnionitis, a bacterial an infection of the foetal membranes. Both are devastating for the foetus. I reached for my husband’s hand.
The nurses put me “in Trendelenburg”, which means my hospital mattress was tilted in order that my head was 20 levels decrease than my toes. (I assumed it was some lengthy German phrase that meant “head below feet on the side of a mountain”.) A nurse wrapped a foetal monitor to my stomach with a thick strap, explaining that it may very well be learn from the nurses’ station, and they might know instantly if I started having contractions. Another nurse slid a pair of puffy compression leggings on to my legs. They inflated and deflated each different minute with a whooshing sound. It was like having Darth Vader respiration at my bedside. I used to be instructed to lie on my facet so as to not put strain on my vena cava, which might decrease the child’s oxygen provide. Yet one other nurse poked a needle into my arm to begin a line for intravenous antibiotics.
The physician gave me a shot of steroids to assist develop the child’s lungs, in case the child would shortly be needing these lungs to breathe. “Aren’t steroids counter-indicated in pregnancy?” I requested.
“Yes, but it’s more dangerous to go without,” she mentioned.
Doggie B known as the hospital to remain that he couldn’t make it in due to the ice storm. In his absence, the physician ordered the nurses to offer me a shot of terbutaline, a drugs that may delay preterm labour for as much as 48 hours.
“Please,” I begged. “I don’t want any more shots. I’m not in labour. This could be so bad for the baby.”
From the second I realized I used to be pregnant, I had divided the world into issues that have been OK for the child, and issues that have been dangerous for the child. The first group included rice, poached rooster and yoga, The 2nd group included alcohol, secondhand smoke, deli meat, smoked seafood, uncooked eggs, smooth cheese, pâté, caffeine, unwashed greens, weight-reduction plan soda, eggnog, x-rays, aspirin, ibuprofen, antihistamines, nasal decongestants, cough syrup, librium, valium, sleeping capsules, castor oil, vitamin A dietary supplements, paint fumes, insect repellent, acupuncture, cats, hair dye, altitude, saunas, reptiles, tick bites, microwaves, electrical blankets, rollercoasters, bikini waxes, stiletto heels, scorching canine and faucet water. I trusted nobody however myself and Doggie B to classify objects, and definitely not a health care provider I had met 10 minutes earlier than.
They gave me the terbutaline anyway. It made me dizzy and chilly, although it makes most individuals scorching. They piled extra blankets on high of me. My arms shook uncontrollably.
The neonatologist got here to speak to us. He had thick glasses and he talked in percentages. It was clear that he was not fascinated about providing consolation; he was there to convey data. He instructed us that for infants born at 26 weeks, the survival price is 50%. Of the surviving 1/2, one-third had main disabilities, and are more likely to be depending on caregivers for ever. It was widespread for them to have respiration issues, cardiac problems, mind bleeds, cerebral palsy. Brain injury, deafness, blindness. Another 1/3 had extra reasonable disabilities: spastic muscular tissues, important listening to loss, impaired imaginative and prescient with out blindness. The closing 1/3 (one of the best we may hope for, apparently) had milder studying disabilities, anemia and digestive issues.
I watched him dispassionately, probably not listening. He was so stereotypically nerdy that I couldn’t recover from it. Why was he telling us all this scary shit anyway? I wasn’t going to enter labour. The child wasn’t going to be born but. Why couldn’t anybody perceive that?
The first evening was longer than I’d have believed attainable. Visiting hours ended and the nurses chased my husband out. He drove residence on streets that crackled and shifted with ice. I used to be not allowed to face, and even sit. I used to be served a dinner that I used to be too nervous to eat. And I realized about bedpans. Peeing into one thing the scale and form of a casserole dish whereas mendacity in mattress together with your head angled towards the ground is messy and awkward.
But that isn’t the worst factor about bedpans. The worst factor is the opposite individuals concerned. Having to ask somebody to deliver you a bedpan, having to make dialog with that individual whilst you use it, having to apologise as a result of your intention is slightly off and now there’s a moist spot on the sheets, having to ask that individual to wipe you, having to ask her to wipe you once more since you nonetheless really feel damp and sticky, having to thank the individual, and also you do actually thank her, you’re so grateful, it’s simply that 2 hours in the past you have been an upright individual with slightly dignity, and now you’re not.
The hospital lowered the lights within the corridor, identical to on a transatlantic flight. Nurses glided by on squeaky sneakers. I lay on my facet and gripped the steel railing of my mattress. The lighthouse in my thoughts revolved, and for 1 instantaneous the room was flooded with chilly, vivid, white worry for the child. Then it was gone. Certainty that the child wouldn’t be born early stole over me, and I gathered that certainty shut. I lay awake and watched the sleet falling exterior my window. It occurred to me that I couldn’t see the bottom.
Doggie B got here to see me the subsequent day.
“Can you believe this?” I mentioned to him. “Me, your most paranoid patient!”
He didn’t trouble to disclaim that I used to be his most paranoid affected person. When he spoke, his voice was delicate and unconcerned. He mentioned that I’d stay on mattress relaxation, and until an infection pressured us to behave sooner, he would ship the child at 33 weeks, when the best threat was over.
I didn’t need to have the child at 33 weeks. I wished to have the child at 40 weeks, like everybody else. I knew the dangers. But I had additionally been instructed the dangers of preterm an infection: a child born with mind injury, cardiac defects, limb abnormalities, microcephaly, hydrocephalus, paralysis, bone lesions, eye lesions – or probably no stay child in any respect. I refused to weigh the dangers; I’d merely not go into labour, nor would I develop an an infection. That was all there was to it.
I frowned at Doggie B. “Why 33 weeks? Why not go to May 10?” That was my due date.
He shrugged. “OK, May 10.”
He was a a lot better liar than the Andie MacDowell physician.
After Doggie B left, the nerdy neonatology physician got here to my room once more. He wished me to go right down to the neonatal intensive care unit (NICU). “You need to see what a preemie looks like,” he mentioned, pushing his glasses up his nostril. “You need to prepare yourself.”
The Andie MacDowell physician was there, too. “A three-pound baby takes some getting used to,” she mentioned. “You don’t want to see one for the first time in the delivery room.”
To each of them, I turned a deaf ear and a sullen face. I used to be not going into labour. I used to be not going to go to the NICU and nobody may make me. Conversation was lower brief when one other nurse got here in and instructed me that my monitor had confirmed slight “disturbances”, and gave me one other shot of terbutaline.
“I can’t believe terbutaline makes you cold,” this nurse mentioned as she took blankets from the blanket-warmer and I shivered beneath them. Out within the corridor I heard her say to somebody: “That one is so contrary.”
I may see – remotely – that each one these docs and nurses knew one thing I didn’t. I came upon a lot later that what they knew have been the chances. Fifty per cent of girls with pPROM go into labour inside 48 hours, and 95% ship inside 1 week of rupture. Four of the remaining 5% ship inside 2 weeks. One p.c of girls with pPROM expertise spontaneous resealment of the membranes and go on to hold the child to time period.
One per cent.
“Do you knit or crochet?” one of many nurses requested me early on. “Lots of bed rest patients find that helps them pass the time.” “No, I read and I write,” I answered, pretentiously. And untruthfully, as a result of I’ve at all times watched a substantial amount of TV.
I couldn’t write as a result of I couldn’t sit up. I additionally couldn’t write as a result of if I targeted an excessive amount of on my state of affairs, the lighthouse in my thoughts would revolve and the anxious, scared a part of me would rush out, gibbering with alarm, baying, screaming, howling that the child was going to be born too quickly, the child was coming now, the child was going to die. How may I write with that occurring?
I had a headache from being in Trendelenburg. I couldn’t bear in mind what it was prefer to look somebody within the eye, so lengthy had I now spent gazing up at everybody from thigh-level. When I ate, it was 1 wobbly, precarious forkful at time. After some time, I simply gave up and if I couldn’t eat it with my fingers, I didn’t eat in any respect. I drank via a straw, till all the things tasted the identical: just like the plastic of the straws.
I couldn’t write, so as an alternative I learn. Constantly. Ceaselessly. I needed to maintain the e-book open in entrance of me sideways, like somebody gripping a big steering wheel. My husband introduced me books and I stacked them on my overbed desk, and as I learn every e-book, I held the subsequent e-book in my free hand, with my finger marking the beginning of the primary chapter in order that as quickly I completed 1 e-book, I may instantly begin one other. I will need to have learn dozens of books whereas I used to be in hospital, and I can solely bear in mind certainly one of them.
Only 1 e-book held my curiosity. I instructed my husband precisely the place to seek out it on the bookshelf close to my desk and he introduced it to me: Steven Callahan’s Adrift, a memoir of the 76 days in 1982 throughout which Callahan had survived in an inflatable life raft after his sailboat sank. I had fallen in love with the e-book when it was first printed, in 1986. It looks as if an odd alternative of studying for a teenage woman, particularly 1 as studious and non-athletic and seasickness-prone as I used to be. But I’ve at all times been drawn to survival tales: they dovetail properly with my persistent worry of disasters.
Callahan spent greater than 2 months in a rubber raft in the course of the Atlantic, spearing fish to eat uncooked, utilizing photo voltaic stills to distil water, and making countless, determined makeshift repairs to his patched and leaking vessel. I had learn Adrift many occasions over time, however now I learn it once more, and was impressed by his struggling and ingenuity in a brand new approach. I used to be in a hospital mattress the place nurses introduced me meals thrice a day, and I slept in a mattress on clear sheets and was in no hazard of drowning. I may do that. I may.
You don’t sleep in hospital. You can’t sleep. Too many individuals coming and going. A nurse comes each 4 hours to examine your vitals: temperature, pulse price, blood strain, child’s heartbeat. Another nurse is available in each 2 hours to ensure you are doing all of your kick-counts. Meals come thrice a day, plus a night-time snack for pregnant ladies, which suggests 4 occasions somebody comes into your room to ship a meal, and 4 extra occasions somebody comes again to gather the tray. A nurse comes each time it’s good to use the bedpan. An orderly comes each morning to take you for an ultrasound. Your obstetrician comes by day by day to examine on you, and also you don’t need to miss his go to, as a result of he’s the one 1 who tells you what you need to hear – no, there’s no signal of an infection; sure, I’m positive you’ll carry to time period. The hospital chaplain stops by as soon as a day. She was a mousy lady with a perpetually scared expression. It’s not look on a hospital chaplain.
So that’s greater than 30 individuals coming to your room and interrupting your sleep. And then there’s the bodily a part of it. If you’re confined to mattress, after you lie in your facet for just a few days, it begins to really feel as in case your hip sockets are lined with steel shavings, as if the sheets are lined with shattered glass. Before lengthy, crimson, tough, scaly patches the scale of saucers seem in your hips and your shoulders – the beginnings of bedsores. The compression leggings chafe your thighs.
You overlook the way to sleep. The line between waking and sleeping was as clear and sharp as the road down the center of a street, however after 2 weeks, that line has blurred and is sort of invisible. You stagger backwards and forwards throughout it like a shambling drunk, till there isn’t any extra sleeping and waking; there may be simply this dim, boring, soupy consciousness. Your actuality shrivels down into 1 lengthy, hazy, beige-tiled tunnel. You used to fret, however it has gone past that now. Worry was inside you, however now you’re inside it. Worry is a dome that has descended over you and trapped you. This is your life now. This is your world.
Every day about 10am, an orderly arrived with a gurney and I fastidiously scooted on to it after which the orderly pushed the gurney via the hospital halls to the prenatal division.
Two weeks had passed by, and I hadn’t gone into labour. This appeared to shock everybody however me and Doggie B, who started, cautiously, to talk of resealment. The nerdy physician got here by and gave me a complete bunch of latest statistics about what the child’s probabilities have been at 28 weeks, at 30 weeks. He didn’t transcend 30 weeks, although. They eliminated my IV. Everyone talked about one thing known as “BP” as if they have been talking of the Rapture. (“Bathroom Privileges.”) The ambiance in my room grew to become positively springlike, regardless of the snow exterior.
Doggie B mentioned step one could be for me to rise up and take a bathe. A bathe! Nothing may have been extra tempting. He gave me a date. Now it was one thing to stay up for. I had my husband herald a bottle of my favorite shampoo and a bar of coconut cleaning soap. The day lastly got here. A nurse eliminated my circulation leggings. I sat up slowly and swung my toes to the ground. The nurse took my arm and helped me to face. I stood there, swaying. Amniotic fluid poured out of me and splashed to the ground. The nurse let go of my arm in shock. I lay again down and turned my face to the wall.
It took me some time to regain my unusual equilibrium, particularly contemplating that the docs now suspected I had been leaking repeatedly for the reason that first rupture. Rupture of the membranes is taken into account “prolonged” (and subsequently harmful) when greater than 24 hours passes between the rupture and the onset of labour. My waters had damaged greater than 300 hours in the past. The threat of sepsis was very excessive.
But nonetheless, 2 days – perhaps 3 – and the stubbornly optimistic facet of my character fought its method to the forefront and re-planted its battle flag. The Andie McDowell physician wrote in my chart: “Patient needs to understand that resealment is highly unlikely at this time and that preterm birth is almost a certainty.” Yeah, nicely, that’s what she thought. This child was not coming early. I merely wouldn’t enable it.
Another week in mattress glided by. Every every so often, that they had me get up, and each time I leaked amniotic fluid. But nonetheless I didn’t go into labour. Nor did I’ve a fever or stomach ache, the 2 biggest indicators of an infection. Life as I now knew it went on.
After I had been on mattress relaxation within the hospital for 25 days, there got here a time once I stood up and no fluid gushed out of me to splatter on the ground. The nurse and I checked out one another in amazement. “Go take a shower, quick!” she mentioned. “I’ll change the sheets on your bed.”
It was not the gradual, luxurious bathe I had dreamed of, however I can let you know this: it was fairly fucking good. They didn’t enable me off the bed once more that day, however I used to be lastly taken out of Trendelenburg. I stood up the subsequent day and once more there was no leak. I took one other bathe.
When Doggie B got here to see me subsequent, I used to be sitting in a chair to greet him, radiant, each my satisfaction and my stomach monumental.
I had performed it. I had resealed. I used to be within the 1%.
Doggie B wished to ship me residence. I fought him. I had been within the hospital for nearly a month at this level, and I used to be just about institutionalised. Go residence? Without the foetal monitor? With no nurses to hear for the child’s heartbeat each 4 hours? No day by day ultrasound? Uh-uh. He was loopy if he thought I may deal with that a lot accountability. I instructed him that I wanted to be within the hospital close to the NICU. I pointed to my chart the place it mentioned “Severe Risk Pregnancy” in large scary letters. Doggie B stood agency. He discharged me and my husband drove me residence.
Steven Callahan writes of seeing the primary meals after his rescue – a cake of chipped coconut topped with a dot of crimson sugar – and the way he checked out it in surprise and thought: “Red!” That was precisely how I felt once I noticed my home once more. Green! Blue! Lilac! My hospital room had been unrelentingly beige.
I used to be nonetheless on virtually whole mattress relaxation, allowed up for 15 minutes twice a day. A bathe within the morning and dinner at evening. Out of the hospital, the lighthouse in my thoughts revolved quicker and quicker, unchecked by the nurses’ reassurance. I counted continuously how typically the child kicked, and took my temperature 5 occasions a day. The amniotic sac had resealed, however the rupture had been extraordinarily extended, vastly rising the possibilities of an an infection reaching the child. Even feeling the child’s actions couldn’t quell my fear. Doggie B’s receptionist realized to place me straight via to him once I known as.
Time floor slowly by. My husband introduced me breakfast within the morning earlier than he left for work. Our housekeeper introduced me lunch. My husband introduced me dinner and we ate on the card desk he had arrange within the nook of our bed room. Then I crawled again into mattress and anxious till I fell asleep, awakened, and began one other day. That was my routine, and I by no means diverse from it. I don’t imply I by no means diverse from it considerably; I imply I by no means diverse from it in any respect.
Thirty-one weeks. Thirty-two weeks. Thirty-three. Still I didn’t go into labour. I lay in mattress and stroked my stomach with my fingertips. Thirty-four weeks. Thirty-five. March ended and April started. A blizzard of cherry blossoms changed the snow exterior my bed room window. Thirty-six weeks. Thirty-seven weeks. I now not watched TV or pretended to learn books. I knew nothing however my stomach and the countless ready. Time had softened and stretched like taffy, pulling itself into lengthy, gooey ribbons. Thirty-eight weeks. Thirty-nine. I used to be sure that the child could be born on 21 April, the identical day Steven Callahan was rescued. But 21 April got here and went. And then in the future I acquired as much as take my morning bathe and felt the slightest trickle of fluid run down my leg. My waters had damaged for the final time.
Our son was born 12 hours later at Sibley Hospital in Washington DC. We named him Angus. And so my life modified once more in one other minute, one other 2nd. The 2 halves of my thoughts fused again collectively. I went from severe-risk being pregnant to wholesome new mom. I used to be completely unprepared. For so lengthy the purpose had been to remain pregnant – I had virtually forgotten child was the top end result. I knew nothing about newborns, nothing about breastfeeding or burping or vaccinations. The nurses needed to present me all the things. One them mentioned, in a cautious voice: “I’ve heard about you, I think.” I may inform that no matter she had heard was, at finest, a combined overview. “Didn’t you rupture very early and do a lot of bed rest over at Georgetown?”
I felt a cussed thump of satisfaction. “Thirty days at Georgetown. Eighty-eight days altogether.”
“Wow,” she mentioned. “I bet you never want to see a hospital again.”
I didn’t know the way to inform her that nearly the alternative was true. It wasn’t simply that I knew about hospitals now, and knew I may survive an extended keep in a single. I used to be a special individual from the 1 who had been admitted all these weeks and months in the past: a tried individual, a modified individual. Very few experiences remodel your view of the world and your self, however mattress relaxation did that for me. I had overwhelmed almost unthinkable odds. All the issues I’ve at all times meant to repair about myself however had by no means acquired round to – my stubbornness, my hypochondria, my rigid nature – had turned out to not want fixing. Had, actually, turned out to be survival expertise.
Twenty-four hours glided by, and I cried as a result of I by no means wished Angus to get any older. The inconceivable had occurred: time had accelerated.
Six months later, I organized to talk to Steven Callahan by cellphone. I instructed him how a lot his e-book had meant to me, how a lot he had impressed me. We found that we had each been obsessive about numbers, with calculating and re-calculating the times of our progress. I instructed him that my ordeal had altered me in some basic approach, that generally I even missed the mind-bending, terrifying drive of it. He agreed.
“Sometimes I feel a loss,” he mentioned, “in terms of the fact that few if any experiences I will ever have again can equal the intensity and importance of that one. You try to mine the precious elements of the experience, but they slip away from you, and that’s another loss. You try to appreciate this enormous gift you’ve been given, but eventually you just get on with it.”
The valuable components of my expertise have been fading, too. I took my rest room privileges as a right now. I slept on my again once more. I went for walks. I anxious about site visitors jams and deadlines and love handles, identical to a traditional individual. I acquired on with it.
Angus is 17 now, taller than me, taller than my husband. He has the beginnings of a moustache and a voice as deep as James Earl Jones’s. He is aware of the way to do laundry, and make spaghetti. He can take the Metro by himself, and he realized to drive this summer season. It’s attainable he watches porn on the web. (It’s extraordinarily attainable.) I’ve new fears and worries, about youngsters. The vivid, icy terror of the hospital is behind me, however it has taken a very long time.
One day, when Angus was about 3 years previous, I cleaned out a closet and unexpectedly discovered the plastic water pitcher that had been by my hospital mattress. In an instantaneous, the lighthouse in my head revolved, and all the things went white and chilly. I used to be sure that the child was at risk – so sure that I needed to run to the lavatory and vomit. I don’t know why this stunned me, or why I assumed I’d be totally different, resistant to the after-effects of my ordeal. All survivors have scars.
Katherine Heiny from theguardian.com