A Saturday at SickKids During COVID-19

As I lifted my son Felix up over my shoulder for his standard burping stint after our midnight feed last Friday evening, he started to cough. I paused: normally he would burp, maybe spit, and the limit have some milk dripping out of his nostril. But he didn’t cough. I listened to him after placing him back in his bassinet, worrying there was something off. His breathing rattled raucous. I barely slept. A few hours later, at our 3:00 am feed, he coughed again. I alerted my husband that I worried something was wrong. We waited until morning. Normally, Felix is massively alert from about 9:00 am to 10:30 am. He plays Japanese war history with his father as I make breakfast for the two of us. But on Saturday he was lethargic. We tried to rouse him, but he stayed asleep. I called our midwife, called the family doctor’s office, called the resident on call at the hospital. By the time they responded, we had made a decision to bring him to the emergency room. He didn’t open his eyes while I put on his blue bear suit on the changing table, to keep him warm in the cold April wind outside. It was all I could do to stop my own tears, to maintain composure as the fear set in.

I projected a future state where all I had of him were the few pictures I’d put up on Facebook. Where all we were given was 5.5 weeks. Where all that would remain would be the memories of how active his breathing became when he concentrated, of the way he laid his head on his hands to sleep on my chest after a feed. I cried over this feared future and realized just how deeply I love him.

The parking lot at the hospital was surprisingly empty. Back during our prenatal visits in January and February we had to fight for parking spots, adding an additional 15 minutes travel time to make sure we were on time. We skipped the parking fee to save time and walked as quickly as possible to the hospital entrance. In front of the normal revolving door stood two temporary entrances: one for patients and visitors and one for staff. We walked through the first. The light changed from sun to dark. A few masked hospital attendants were seated at a greeting table. Upon seeing a small infant wrapped in my arms, hearing my cry that our son wouldn’t rouse, they rushed us to a screening from in the ER. We sanitized our hands and put on face masks. Walked through the bottom foyer spotted with a few people, some ordering coffee from Second Cup, some sitting like sentinels in masks monitoring the surroundings. We moved fast. Walked to a nursing station where four of five nurses looked at my son. “He’s still pink,” they said. “That’s a good sign. But we can’t care for him here. You should take him across the street to SickKids.”

We turned. Back through the corridor and across the street. I did everything I could to keep his head warm from the wind. Mihnea, my partner, reminded me it was more important to keep his airways open at this time. Our pupils resettled again as we entered the SickKids entrance. My glasses fogged from the humidity rising from my mouth through the mask. “I can’t see anything,” I said to Mihnea. He took off my glasses and wiped them as I walked to the line to register our son for care. The attendant asked me three screening questions and checked boxes on a form: Have you traveled to a foreign country in the last 14 days? Do you have any of the following respiratory symptoms? “Only one support person is allowed in with the child.” I told Mihnea it was me. He said he would try to get water-only baby wipes while we were in the hospital. I barely said goodbye, rushing to get my son care.

They put a hospital band around his tiny wrist and again comforted me that things couldn’t be dire because his color was still ok. I described his symptoms, answered another screening questionnaire about my own respiratory symptoms. And we were escorted down the hall into room number 7, waiting for the nurse and doctor to arrive.

The nurse came first. He was calm as they took his vitals, lethargic from the illness. Heart and breathing were normal. No audible congestion in the lungs. No fever. We stripped him naked and weighed him: 4.69 kilos, or 10 pounds 5.4 ounces. He’d grown a ton since his weight dropped to 6 pounds 8 ounces during the early-day dip in the hospital, fed only on colostrum from breasts getting practice with breastfeeding. The nurse asked if I’d like to turn the overhead light down. “Sure,” I said, settling into the dim darkness, obsessively scanning the white bars of the hospital crib as I held my son in my arms waiting for the doctor to arrive. I asked if they had diapers and wipes, as he needed to be changed. No wipes, but they did offer 2 size 1 diapers. They were scented: I cringed, as I only allow my son to wear diapers that are pure. But there was no choice. We wiped him with a paper towel and little water, leaving some residue on his bum. Again, this wasn’t the time for me to fuss.

The doctor came shortly thereafter. An Indian woman who exuded wisdom, practice, and care. She asked questions, listened to the rasp in Felix’s breathing as I rocked him, waited a little until she could hear a cough. Was encouraged that his vital signs were ok, and requested that I stay in the hospital through a couple of feeds to monitor how things progress. “It’s tricky with little ones,” she said. “If you’re worried, we’re worried. Symptoms progress rapidly in one or the other direction, so let’s watch him and see what happens.”

“Ok,” I responded, laconic. “Do you have any food or water for me while I wait?” I am meticulous about my hydration and nutrition while breastfeeding my son. Drink liters of water per day. Eat incredibly well.

“I can bring you a cup of water and a nutrigrain bar. If you need a proper meal, we can see to that later.”

She returned with a small styrofoam cup filled with tap water, 2 nutrigrain bars (one blueberry and one mixed berries), and 2 packets of shortbread cookies. I asked if she could watch Felix while I went to the bathroom. She offered to hold him, cradling him against the yellow gown over her chest.

She passed him to me and closed the curtain behind her as she left. I downed the 6 ounces of water from the styrofoam cup and plugged in my cell phone. And I sat in a hunter green plastic chair, holding my son. They’d removed the comfy nursing chairs because they are harder to sterilize during COVID.

Hours passed. I looked at the white bars on the hospital crib. Paced around the room to relieve my aching back. Held my son. Was bothered by the sickly smell of the scented diaper. Spoke to Mihnea and my parents on the phone. Responded to a few texts I’d been meaning to respond to, mentioning to an old friend that we were in the ER. Nothing to read. Nothing to eat. I was in my pyjamas, as I didn’t make time to change before we left: grey Quantas airline sweatpants my mother got on a trip back in the 1990s, the drawstring still in the pants under tatters of revealed seams; Mihnea’s grey Burberry shirt with four buttons near the collar, undone so I could feed; no bra; hiking boots; a grey sweatshirt stained with spit up and leaking breast milk I took off and laid on the green plastic chair next to me so Felix wouldn’t get wet. We didn’t have any extra outfits for him. Nothing. I needed to keep him dry.

Eventually, he ate. It was a tired feed, lacking his normal vigor. He sneezed and coughed, but didn’t pull off. I took videos of his sounds to show the doctor.

She returned to check in a few times and eventually we did another examination. And, fortunately, he stirred. “Look at his eyes!,” she exclaimed. “He is beautiful. Strange that the first images he’ll form will be of people will be with masks.”

She was encouraged by his energy, but offered a COVID swab. I accepted. The nurse came in with what looked like a small white sword, the size of a cocktail umbrella. While Felix had roused a little, he was still drowsy so more tolerant of sticking a swab up his nose than he normally would be. I embraced him. She stuck it up the right nostril. He cried a little, but not too badly. She stuck it up the left. And that was it. “Can I hurt him?” I asked. “No,” she replied. “You’ll have results in 2-4 days.”

Because Felix was showing signs of improvement, the doctor felt comfortable discharging us around 5:00 pm, about 5 hours after we arrived. She diagnosed him with a viral respiratory infection and gave instructions on waiting for the COVID test result. Made a virtual check-in with a pediatrician the following day. “Are there any concerns I can help address?” she asked.

“My biggest worry is that I will lose my son,” I replied.

“We’ll act on him before that happens. Put him on an IV or oxygen support. What matters is that if you’re worried, we are worried. Symptoms with little ones progress quickly, and you know better than anyone if he is behaving differently from normal. Look out for signs of breathing distress, fever, dehydration, vomiting. But some congestion is ok. Good luck!”

I dressed Felix back in his big, warm, blue bear suit. Mihnea came and picked us up, holding Felix closely to his chest as we greeted us at the entrance where he’d left us that morning.

We drove home, vigilant. We ate dinner, vigilant. We slept next to him in our bed, vigilant. We fed him, vigilant.

He got better. Quickly.

We got a call within 20 hours informing us that his COVID test results were negative, but that, given the potential for a false negative, he should still be isolated for 3-4 days. We wouldn’t have brought him for a walk in the cold anyway. Homebound, vigilant.

The experience upended us. We learned to cherish his wails, as they signaled vigor and life. To cherish the frustrations of being tired as he still doesn’t sleep more than 3 hours at a time at night (but it’s getting better and better!). To cherish his clear breathing. To cherish the raw fact of his existence. To cherish that he is our son. We always did, but we do now more than ever.

There is no science to newborn care. It’s a matter of intuition. States change in a matter of hours, and a parent is tasked with watching severity, not duration. I wanted guidelines, measurements, answers. There were none. Just the amazing burden of responsibility to know another deeply, to know Felix inside out and backwards and know when it could be time to bring him back to the hospital for additional care.

It’s as I mentioned in my last post: a recipe for misery is to compare your child with statistical development milestones. Parenting is about depth of knowledge, the depth of knowing one little person in every aspect of their being. I have deepened my knowledge of the rate and cadence of his breathing. Of his body temperature. Of his moods. Of the hint of redness that appears around his eyes when he is sick. Of the wetness of his tears and the inside of his mouth. Of the way his hands move when he is curious and when he is scared. Of the feelings that emerge in the bath, on the bed, on his play mat. He is my world now. Our world. The only way to care for a sick newborn is to pay close attention to who he is and how he is. And to know when he’s not himself.

I will hold deep inside me a token of unconditional love in the backache I felt sitting in the dark against a plastic green chair in a hospital room on a Saturday afternoon. There was no question I would do otherwise, as I will when, inevitably, the next worry comes our way.

The featured image is of my son Felix this Saturday morning. I can see the illness in the little tear grazing the bottom of his eye, the depth and sadness in his plea. He couldn’t voice his pain, couldn’t tell us what was coming. All we could do was listen.

Quarantined with a Newborn

Time to write is sparse and passes with a 10-pound being breathing warmly on my chest. Too sparse to bother with hypotaxis and refined style. As such, I present but a list of the things I’ve learned in the past 5 weeks since my son Felix was born. Some of these lessons feel universal; others are undoubtedly conditioned by the particulars of the world in March and April, 2020, this bizarre counterworld of the Coronavirus quarantine.

Reflections

It is a bad idea to get a dog before having a baby. Daft and pacified by pregnancy hormones, I thought that would bring joy earlier this year. Visions of my domestic paradise. Thank god my partner was wise enough to think otherwise.

Footed onesie pajamas should have zippers. It’s ludicrous that they make pajamas with snaps. Way too hard to get onto a newborn who screams crying when changed in the early weeks of his life. Every new mother should know this.

Birthdays with a newborn during quarantine are humble, just like any other day. The highlight of my birthday was a walk alone with my partner while my parents watched the baby. We ate chicken soup for dinner because my partner had stomach issues to heal. A birthday with a newborn indexes the complete toppling of priorities from self to other: it’s for him that I want presents now. No need for anything else.

Towards the end of my pregnancy I discovered that touch is a more fundamental medium of communication than language. Now, in the first month of my son’s ex-utero life, I’ve learned the importance of music and movement. I have sung and danced more in 5 weeks than in the last 5 years or more. Perhaps than in my entire life. I sing Felix to sleep after a 3:00 am feed, rocking back and forth to Tchaikovsky’s Sleeping Beauty to ease the spit up that prevents his sleep. I improvise melodies, finding a Phillip Glass- or Max Richter-like motif I can repeat over and over and over in harmony with my rocking squats to calm my son. He loves Bach, Mozart, Gould playing Bach, Sokolov playing Bach, Sokolov playing Schubert. He heard his father play piano every morning in my womb for nine months, and it is his home.

You learn how to do nothing. You watch him feed, watch how his eyes look out into space with a keen curiosity as he coos. Watch how his hands gradually open up as his stomach fills. You learn to accept that tasks won’t get done. You’ll start to assemble his play gym and he’ll wake up crying and you have to stop and leave the task partially complete and attend to it later. Your friend Marion mentioned that you have to love the process, not the outcome. That outcomes-focused thinking, the drive of hitting OKRs that drives life in business, is toxic to the unruly spirit who has no need for goals. He needs love, care, unconditional attention. Your sense of accomplishment is overhauled, replaced with the solid awareness that he is gaining weight well, thriving, healthy as can be. That it would be devastating if it were otherwise.

And yet, you also learn how to prioritize better and differently than before. You fit a load of laundry into your morning routine, taking advantage of the few spare minutes while your partner cares for your child. You make the transitions fast: out for a run now, don’t bother with the fussing, if you don’t go, you won’t get it in. You settle for short distances, as your postpartum body is still healing. You feel a sense of accomplishment when you realize you can do the laundry and cook a wholesome meal and even write a blog post with your baby.

You see the beauty in the little things, effortlessly seeping into the holiness of everyday life that somehow felt like play acting before, somehow felt like something to strive towards and that is now a given, a ground you walk on. The heat of shower water over your shoulders, as your back muscles release from the new strain. The light reflecting off the painting in the piano room, that’s been there evening after evening but only noticed now that your son gazes upon it from his 4Moms swing during dinner time. The magenta inlay in the painting Bruce Jefferson gave that hangs in the nursing room, which you discovered watching your son watch it. The etching of the tree branches against the evening sky. The feel of the wind on your cheeks. The taste of carrot juice in the morning. The fluffiness of the duvet when you get in for the third time in one night. The details of the world sing. There is no longer a world outside distracting you from noticing them.

The baby loves to look at the new world. His eyes are keen and curious. He loves to look at the rafters that line the ceiling in the basement. Loves to look at the back porch after dinner. It’s the best way to soothe him at the cusp of the witching hour.

One way for a new mother to make herself miserable and strip the joy from raising a newborn is to read the internet and compare her child’s development to what’s expected at certain ages. She starts to see her child against the backdrop of a statistical norm, blinds herself from seeing him, uniquely, seeing the wonders of his personal journey and development. Fatigue cuts the integral into a derivative: each green poop, each subtle variation from the perfectly healthy baby catalyzes massive anxiety. But wait a few hours and the pendulum shifts back to normal. And if I stay off the damn internet, I see him for who he is, grow with him, respond to what he’s telling me rather than imposing external methods and guidelines onto him. For we are one, both one and not one, a unit that emerges from our interaction. He is calmer when he senses authentic interaction between my partner and me. He feels it’s right. We supervene on one another. Therein lies the joy.

Beauty is not the same as joy. There are moments of sublime beauty as I observe the curvature of his closed eyes, the color of his skin, olive like his father’s, against my chest. My son, for me, is more a bundle of beauty than of joy. There are joyful moments but not when I force Mom voice upon him to get to a smile faster. Our joy cannot be feigned.

Fatigue is not depression. It can feel that way, but it’s just fatigue. It plays nasty tricks upon the mind and has a funny way of making us regress back to the most shameful inlets of our selves. But it’s just fatigue.

The body adapts more easily to punctuated sleep cycles than I ever expected. Feed for 30 minutes, keep him upright for 20 minutes, fighting off sleep, slowly, slowly, transfer him to his bassinet, wait, deep breath, hoping he’ll stay asleep, hop into bed, wake up in 45 minutes, 60 minutes, 90 minutes, 120 minutes, longer stretches as nights advance, feed again. And the key is to just lie there and let the images wash over the mind and let sleep come. For it comes. It has no choice.

Face masks strip us of emotional entanglement with other beings, a core emotional and spiritual dimension of our humanity. When a new mother gets a runny nose in normal times, she may wash her hands more frequently and make sure she sneezes into tissues, but only a few are paranoid enough to put on a face mask. But the age of COVID-19 wants otherwise. Having a sore throat and runny nose is means for panic, panic, fear something could happen to him, even if infants are reputed to be more immune. But it is torture to wear a face mask while breastfeeding, as the mother is deprived of her ability to look upon her son. All she sees is blue, a blue curtain blocking their connection. He cries, and she cannot console him. She cannot read his cues. She is isolated, apart. The dilemma is heartbreaking. But time helps wash away the pain.

6 feet doesn’t feel like enough on walks. 9 feet. Walking in the middle of the road, nearly getting hit by cars, to avoid runners and walkers and dogs. Fear and anxiety lace time outside, time that would otherwise capture the joy of seeing him at ease in the fresh air, hearing the coos from the carrier on my chest, on my partner’s chest. Someday. Someday we will go for long walks and love the sun and greet people without fear they will harm us or we will harm them.

The underpinning social mechanisms of different companies are revealing themselves clearly, showing differences that weren’t as apparent before COVID. Netflix, Amazon, and Zoom are tuned for an isolated, separated society. Facebook too, absent the advertising business model. These companies thrive on distance, thrive on people staying at home away from one another. WeWork, AirBnB, Uber, the sharing economy companies, represent a fundamentally different concept of social engagement, one where people share spaces, share belongings, come together across the digital divide. Is the distributed, isolated world enabled only by companies like Amazon the political infrastructure of our future world? Will the nation as political unifier surrender to this new kind space? Will we somehow come back to normal or will the civilization my son grows up in look different from that I grew up in, from 1984 to 2020? What can I do to influence his world? What should I do? For now, our world is small, contained, insular. A sleeping boy on my chest as I write, listening to Glenn Gould, the master isolationist, playing Mozart piano sonatas.

The featured image of me and my son Felix. We looked more or less like this while I wrote this post.

Touch and the Self

Touch is the most basic, the most non-conceptual form of communication that we have. In touch there are no language barriers; anything that can walk, fly, creep, crawl, or swim already speaks it. - Ina May Gaskin, Spiritual Midwifery

Sometimes we come into knowledge through curiosity. Sometimes through imposed convention, as with skills learned during a course of study. Other times knowledge comes into us through experience. We don’t seek. The experience happens to us, puzzling us, challenging our assumptions, inciting us to think about subject we wouldn’t have otherwise thought much about. That this knowledge comes upon us without our seeking enforces a sense that it must be important. Often it lies dormant, waiting to come to life. [1]

I have never thought deeply about how and what we communicate through touch. I’ve certainly felt the grounding power of certain yoga teachers’ hands as they rubbed my temples and forehead during savasana. I’ve been attuned to how the pressure of a hug from a girlfriend in high school signaled genuine affection or a distancing disgust, the falseness of their gesture signaled through limp hands just barely grazing a fall jacket. When placing my hand on the shoulder of someone who reports to me at work, preparing to share positive feedback on a particular behavior, I’ve consciously modulated the pressure of my hand from gentle to firm, both so as not to startle them away from their computer and to reinforce the instance of feedback. Most of my thinking about communication, however, has hovered in the realm of representation and epistemology, trapped within the tradition that Richard Rorty calls the Mirror of Nature, where we work to train the mind to make accurate representations of the external world. Spending the last five years working in machine learning has largely reinforced this stance: I was curious to understand how learned mathematical models correlated features in images with output labels that name things, curious to understand the meaning-making methods of machines, and what these meaning-making methods might reveal about our own language and communication.

And then I got pregnant. And my son Felix grew inside me, continues to grow inside me, inching closer to his birth day (38 weeks and counting). And while, like many contemporary mothers-to-be, I initially watched to see if he responded differently to different kinds of music, moving more to the Bach Italian Concerto or a song by Churches or Grimes, while I was initially interested in how he would learn the unique intonations of his mother and father’s voice, my experience of interacting with Felix changed my focus from sound to touch. My unborn son and I communicate with our hands and feet. The surest way to inspire him to move is to rub my abdomen. The only way he can tell me to change a position he doesn’t like is to punch me as hard as he can. Expecting mothers rub their bellies for a reason: it’s an instinctual means of communicating, transforming one’s own body into the baby’s back, practicing the gentle, circular motions that will calm the baby outside the womb. Somehow it took the medical field until 2015 to conduct a study concluding that babies respond more to a mother’s touch than her voice. I can’t help but see this is the blindspot of a culture that considers touch a second-class sense, valued lower than the ocular or even auricular.

But as research in artificial intelligence and robotics progresses, touch may reclaim a higher rank in the hierarchy of the senses. Brute force deep learning (brute force meaning throwing tons of data at an algorithm and training using gradient descent) has made great strides on vision, language, and time series prediction tasks over the past ten years, threatening established professional hierarchies that compensate work like accounting, law, or banking higher than professions like nursing or teaching (as bedside manner and emotional intelligence is way more complex than repetitive calculation). We still, however, have work to do to make robots that gracefully move through the physical world, let alone do something that seems as easy as pouring milk into our morning cereal or tying our shoes. Haptics (the subfield of technology focused on creating touch using motion, vibration, or force) researcher Katherine Kuchenbecker puts it well in Adam Gopnik’s 2016 New Yorker article about touch:

Haptic intelligence is vital to human intelligence…we’re just so smart with it that we don’t know it yet. It’s actually much harder to make a chess piece move correctly-to pick up the piece and move it across the board and put it down properly-than it is to make the right chess move…Machines are good at finding the next move, but moving in the world still baffles them. 

And there’s more intelligence to touch than just picking things up and moving them in space. Touch encodes social meaning and hierarchy. It can communicate emotions like desire and love when words aren’t enough to express feelings. It can heal and hurt. Perhaps it’s so hard to describe and model haptic intelligence because it develops so early that it’s hard for us to get underneath it and describe it, hard to recover the process of discovery. Let’s try.

Touch: Space, Time, and the Relational Self

Touch is the only sense that is reflexive.[2] Sure, we can see our hands as we type and smell our armpits and taste the salt in our sweat and hear how strange our voice sounds on a recording, but there’s a distance between the body part doing the sensing and the body part/fluid being sensed. Only with touch can we place the pad of our right pointer finger on the pad of our left pointer finger and wonder which finger is touching (active) and which finger is being touched (passive). The same goes if we touch our forearm or belly button or the right quadricep just above the knee, we’re just so habituated to our hands being the tool that touches that we assume the finger is active and the other body part is passive.

Condillac’s statue in the Traité des Sensations has always reminded me of the myth of Pygmalion, who falls in love with a statue he creates (inspiring what would become My Fair Lady). Here’s Rodin’s take on the myth.

In his 1754 Traité des sensations[3], the French Enlightenment philosopher Étienne Bonnot de Condillac went so far as to claim that the reflexivity of touch is the foundation of the self. Condillac was still hampered by the remnants of a Cartesian metaphysics that considered there to be two separate substances: physical material (including our bodies) and mental material (minds and souls). But he was also steeped in the Enlightenment Empiricism tradition that wanted to ground knowledge about the world through the senses (toppling the inheritance of a priori truths we are born with). The combination of his substance dualism (mind versus body) and sensory empiricism results in a fascinating passage in the Traité where a statue, lacking all senses except touch, comes to discover that different parts of her body belong to the same contiguous self. The crux of Condillac’s challenge starts with his remark that corporeal sensations can be so intertwined with our sense of self that they are more like “manners of being of the soul” than sensations localized in a particular body part. The statue needs more to recognize the elision between her corporeal and mental self. So Condillac goes on to say that solid objects cannot occupy the same space: “impenetrability is a property of all bodies; many cannot occupy the same space; each excludes the others from the space it occupies.” When two parts of the body come in contact with one another, they hit resistance because they cannot occupy the same spot. The statue would therefore notice that the finger and the belly are two, different, mutually exclusive parts of space. At the same time, however, she’d sense that she was present in both the finger and the belly. For Condillac, it’s this the combination of difference and sameness that constitutes the self-reflexive sense of self. And this sensation will only be reinforced when she then touches something outside herself and notices that it doesn’t touch back.

For Condillac touch unifies the self in space. But touch can also unify the self in time. When I struggled sleep as a child, my mother would stroke my hair to calm me down and help me find sleep. The movement of her hand from temple to crown had a particular speed and pressure that my brain encoded as palliative. When I receive a similar touch today, the response is deep, instant, so deep it transcends time and brings back the security I felt as a child. But not merely security: the transition from anxiety to security, where the abrupt change in state is even more powerful. Mihnea, father to the unborn child growing inside me, knew this touch before we met. I didn’t need to ask him, didn’t need to provide feedback on how he might improve it better to soothe me. It was in him, as if it were he who was present when I couldn’t sleep as child. And not in some sick Freudian way — I don’t love him because he harkens memories of my mother. It’s rather that, early in our relationship, I felt shocked into love for him because his touch was so familiar, as if he had been there with me throughout my life. The wormhole his hand opened wasn’t quite Proustian. It wasn’t a portal to bring back scenes form childhood that lay dormant, ready to be relived (or, as Proust specifies, created, rather than recovered). It was more like a black hole, collapsing my life into the density of Mihnea’s touch, telling me he would father our children and know how to help them sleep when they were anxious.

There’s an implicit assumption guiding the accounts of Condillac and Mihnea’s touch: that, to use Adam Gopnik’s words, “we are alive in relation to some imagined inner self, the homunculus in our heads.” But touch becomes even more interesting when it helps us understand “consciousness itself as ‘exteriorized’, [where] we are alive in relation to others…[where] our experience of our bodies-the things they feel, the moves they make, and the textures and people they touch-is our primary experience of our minds.” Here Gopnik describes the thinking of Greater Good Science Center founding director Dacher Keltner, who (I think, based upon the little I know…) disagrees the Kantian tradition that morality is grounded in reason and self-imposed laws and instead grounds morality in the touch that begins with the skin-to-skin contact between mother and child.

A cursory introduction to psychologist Dacher Keltner’s thinking about touch.

I think the magic here lies in how responsive touch can or even must be to be effective communication. Touch seems to be grounded on experimentation and feedback. We imagine what the person we are about to touch will sense when we place our hand upon their arm, perhaps even test the pressure and speed of our movements on our own forearms before trying it out on them. And then we respond, adapt, feel how their arms encounter our fingers and palms, watch how their eyes betray what any emotions our touch elicits in them, listen for barely audible sounds that indicate pleasure or security or contentment or desire or disgust. Touch seems to require more attention to the response of the other than verbal communication. We might (albeit often incorrectly) presume we’ve transmitted a message or communicated some thought to others when we say something to them. It’s better when we watch how they respond, whether they have captured what we mean to say, but so often we’re more focused on ourselves than the other to whom we seek to communicate. This solipsism doesn’t pass with touch. Our hands have to listen. And when they do, the effect can be electric. The one being touched feels attended to in a way that can go beyond verbal and cognitive understanding. Here’s how Ina May Gaskin described an encounter with a master of touch, a capuchin monkey:

She took hold of my finger in her hand-it was a slender, long-fingered hand, hairy on the back with a smooth black palm-and I had never been touched like that before. Her touch was incredibly alive and electric…I knew that my hand, and everyone else’s too, was potentially that powerful and sensitive, but that most people think so much and are so unconscious of their whole range of sensory perceptors and receptors that their touch feels blank compared to what it would feel like if their awareness was one hundred percent. I call this “original touch” because it’s something that everybody as a brand new baby, it’s part of the tool kit…Many of us lose our “original touch” as we interact with our fellow beings in fast or shallow manner. 

Gaskin goes even further than Keltner in considering touch to be the foundation of morality. For her, touch is the midwife’s equivalent of the monk’s mind, and the midwife should take spiritual vows and abide by spiritual practices to “keep herself in a state of grace” required to tap into the holiness of birth. In either case, touch topples an interior, homunculus notion of self. The power lies in giving ourselves over to our senses, being attuned to others and their senses. Being as present as a capuchin monkey.

Haptics: Extending the Boundaries of the Self

This focus on presence, of getting back to our mammalian roots, may strike some readers as parochial. We’re past that, have evolved into the age of digital communication, where, like the disembodied Samantha from Spike Jonze’s Her, we can entertain intellectual orgies with thousands of machine minds instantaneously, no longer burdened by the shackles of a self confined to a material body in space. The haptics research community considers our current communication predicament to be paradoxical, where the very systems designed to bring us closer together end up leaving us empty, fragmented, distracted, and in need of the naturalness of touch. So Karon Maclean (primary author), a prominent researcher in the field:

Today’s technology has created a paradox for human communication. Slicing through the barrier of physical distances, it brings us closer together-but at the same time, it insulates us from the real world to an extent that physicality has come to feel unnatural…Instant messaging, emails, cell phones, and shared remote environments help to establish a fast, always-on link among communities and between individuals…On the other hand, technology dilutes our connection with the tangible material world. Typing on a computer keyboard is not as natural as writing with a nice pen. Talking to a loved one over the phone does not replace a warm hug. 

An image summarizing Karon Maclean et al’s research interests in haptic intelligence, from their article “Building a Haptic Language: Communication Through Touch”

Grounding research in concrete case studies centered around the persona of a traveling sales woman named Tamara, Maclean and her co-authors go on to describe a few potential systems that can communicate emotions, states of being, and communicative intention through touch. One example uses a series of quickening vibrations on a mobile phone to mimic an anxious heart rate, signaling to Tamara that something is wrong with her son. Tamara can use this as an advanced warning to check her text messages and learn that her 5-year-old son is in the hospital after cutting himself on a rusty nail. In another example, Tamara sends a vibrating signal to a mansplaining colleague who won’t let her get a word in edgewise. The physical signals don’t require the same social awkwardness that would be required to cut off a colleague with a speech act, but end up leading to more collaborative professional communication.

Maclean is but one researcher among many working on creating sensations of touch at a distance. My personal favorite is long-distance Swedish massage to feel more closely connected with a partner. Students in Katherine Kuchenbecker’s research lab at the Max Planck Institute have published many papers over the last couple of years focusing on generating a remote sense of touch for robot-assisted surgery, to make the process feel more present and real for a human surgeon operating at a distance. Other areas of focus for haptics research are on prosthetics. Gopnik’s article is a good place for layman interested in the topic to start. I found the most interesting conclusions from the work to be how sensory input needs to be manipulated to be cognizable as touch. Raw input may just come off as a tingle, a simulated nerve sensation in an artificial limb; it needs modification to become a sensation of pressure or texture. All in all, the field has advanced a long way from the vibrations gaming companies put into hand-held controllers to simulate the experience of an explosion, but it still has a long way to go.

Let’s imagine that, sometime soon, we will have a natural, deep sense of touch at a distance, with the same ease that today we can send slack messages to colleagues working across the globe. Would we feel ubiquitous? Would our consciousness extend beyond the limitations of our physical bodies in a way deeper and more profound that what’s available with the visual and auditory features that govern our digital experience today? Will we be able to recover our “original touch” at a distance, knowing the Jerónimos Monastery in Lisbon more intimately because we can feel the harsh surface of its Lioz pillars, can sense, through the roughness of its texture, the electric remnants of the fossils that gird its core?

I just don’t think anything can replace the sanctity of our presence. The warmth and smell and stickiness of a newborn baby on our skin. The improbable wonder of a body working to defy entropy, if only for the short while of an average human lifespan. This doesn’t mean that the tapping into the technology of touch isn’t worthwhile. But it does mean that we can’t do so at the expense of losing the holiness of a different means of extending beyond the self through the immediate connections to another. At the expense of not learning from the steady rhythm of kicks and squirms that live within me, and will soon come to join us in our breathing world.

Arches from the Jerónimos Monastery in Lisbon. I found myself drawn to touching the Lioz pillars when I was there, and was shocked at the abrasiveness of their texture.

[1] What I’m trying to get at is different from the sociological concept of Verstehen, a kind of deep understanding that emerges from first-person experience. There’s definitely a part of this kind of knowledge that is grounded in having the experience, versus understanding something theoretically or at a distance. But the key is that the discovery of the insight wouldn’t have come to pass without the experience. I am writing this post - I have become so interested in touch - because of the surprising things I’ve come to learn during pregnancy. Without the pregnancy, I’m not sure I would have been interested in this topic.

[2] I think this is accurate, but would welcome if someone showed the contrary.

[3] This is one of my favorite texts in the history of philosophy. I also referenced it in Three Takes on Consciousness.

The featured image is a detail from Bernini’s Rape of Proserpina, housed in the Galleria Borghese in Rome. Bernini was only 23 years old when he completed the work. Proserpina, also known as Persephone, was the daughter of Demeter, the goddess of harvest and agriculture. Hades loved Proserpina, and Zeus permitted him to abduct her down to the underworld. Demeter was so saddened by the disappearance of her daughter that she neglected to care for the land, leading to people’s starvation. Zeus later responds to the hungering people’s pleas by making a new deal with Hades to release Proserpina back to the normal world; before doing so, however, Hades tricks her into eating pomegranates. Having tasted the fruit of the underworld, she is doomed to return there each year, signaling the winter months when the harvest goes limp. The expressiveness of Hades’ fingers digging into Proserpina’s thigh illustrates the complexity of touch: her resistance and fear shout from creases of marble muscles, fat, and skin. And somehow Bernini’s own touch managed to foster the emotionality of myth in marble, to etch it there, capturing the fleeting violence of rape and abduction for eternity.

To My Prenatal Son

You and I are one. Both one body and not one body. Our two hearts beat together, yours relying on the pulse of the chord that nourishes you, gives you oxygen, gives you amniotic food. You eat what I eat. Feel shadows of what I feel. How your brain develops depends on what I feel, as I hint what you will face in the world outside. I work as hard as I can to send you calm, don’t want my anxiety to mistransmit the message. You hear most of what I hear, just not Jóhannson’s Orphée in my ears as I write. Perhaps right now you hear movements in our home I’ve blocked out with my AirPods. You press your head down on my bladder, cephalic anterior. You invert with me when we do downward dog. You have no choice. I am your vehicle, Garuda to Vishnu, Nandi to Shiva, the mouse to Ganesha. Some people call the fetus a parasite. I feel more like I am a vehicle for your being and growth, my existence subordinated to give you life.

This state is temporary. Soon a new relationship will form as mother and child. You will still eat what I eat, through colostrum, then milk, not the fluid that surrounds you. You will still feel shadows of what I feel, no matter how hard I might try to control the states I transmit to you: your limbic system outsmarts your cortex, my cortex. You’ll hear more of what I hear. Sounds won’t be blocked behind the water womb. I’ll hear you for the first time. We’ll change how we communicate with one another. I will watch your eyes for cues, listen to grunts and swallows as you suck. I will watch how your fingers curl on your hands, your toes curl on your feet. You will watch my eyes, vague at first, but there. For now we communicate through touch alone. Because you are still me, I rub my stomach with the same pressure and circular movement I’ll use when I rub your infant back. I rub me as if I am rubbing you. I rub me to settle you down when you kick in frustration after the hiccups start. The hiccups come on slow, a pulse here and there in my belly that eventually settles into a regular cadence. And then you notice it, want it gone, increase the amplitude of your movements to try to get them to stop. We get up from bed together. We walk over to the room where I will nurse you after you’re born. I rub me to rub you, whisper that it will be ok, that they will go soon, that, like teething, this is a positive sign of growth. That growing up hurts. That this is the first of so many hurts and aches, nothing compared to the heartache of the first unrequited love, the rejection that feeds on unmatched desire. And you, too, communicate with me through touch. You punch the living day lights out of the membrane that surrounds your liquid world when I lie on my left side at night, telling me the only way you can that you hate what your vehicle is doing. I respond. Rotate. Settle onto the other side to grant you peace.

And it is not just growing up that hurts. Since you have been me, since those early days of cells dividing from one to two to four to eight to sixteen to all these powers of two cascading into being, days cloudy in my memory, far away now, sensations I have to stretch my memory to recall, how tired I felt walking up the hill that leads to our home, how tired I felt on walks near the Charles River in Boston or the Pacific Ocean in Victoria, when, pitched momentarily into old age, time somersaulted into the future. I had to sit down after a kilometer of movement to catch my breath. The miracle was that I welcomed the morning sickness (which lasted all day, and came more frequently at night) because it was a sign that you were alive. At that time there were no other signs. You didn’t kick yet. You didn’t squirm your fingers on my lower abdomen. I relied on my nausea to know you were safe. I welcomed the discomfort. When it subsided I worried, fretted that perhaps you weren’t viable. Waited anxiously for the sickness to return. It was all I had of you. And my relationship to the pain involved in bringing you to life changed. I suffered effortlessly because it meant you were ok. Abided in it. Practiced the patience I will need after you are born. And now as we prepare for labor I continue this practice. Your father and I invite situations of physical pain. We hold ice cubes in our hands and breathe through the sensation. We squeeze our toes under the weight of our bodies at yoga class and breathe through the sensations. He massages my perineal muscles, stretching muscles and skin that have never been stretched like this before. It burns. Screams with discomfort. And I breathe through it knowing that the work will help us with your birth. Again time somersaults. We are at once totally here, totally present, and present in the awareness of the work we are doing for that future moment. As I work to give you an unmedicated birth, work to feel you come through me into the world, where others can meet you (for I already know you, your father already knows you too, but not the same way I do), the most challenging exercise I face is that your birth may not be as I wish it to be. I may have to adapt, accept, follow medical protocol to ensure we are both safe, both alive through your phase shift, your coming to live in a new way. But for now, your father and I practice modifying my relationship to pain, and deepen our connection to one another through our work.

These visions, these hopes, can be empowering, dangerous, and absurd. Empowering because they can fuse mind and body to make birth beautiful by making birth mammalian. Marie Mongan opens her book on HypnoBirthing with an anecdote of watching a cat give birth to kittens. The cat first finds a dark, safe place, the kind of solitude we look for when having a bowel movement. And in this place of safety her body does its work, seemingly effortlessly although undoubtedly with pain. But upon sensing a threat, be that a dog or some other predator coming near, the birthing work halts. The cat closes up. Gets up. Walks away from the now endangered place and only returns when the signs of danger to her kittens has disappeared. This image resonates deeply. For I too am mammal, you too are mammal. We will need a place of safety to give my body the right cues to enable to uterus to push you into the world, to enable the cervix and pelvic floor muscles to stay relaxed rather than clenching and give you space, to focus the oxygen and blood on my abdomen rather than in my arms and legs so you have what you need to move down the birth canal. My mind can help, help by getting out of the way. Help by encountering the pain and sensations without fear, trusting them, trusting you who know much more about this than I. Dangerous because I cannot suffocate you, now or after you are born, with images of what I want you to become. You will be who you are, rife with eccentricities. You may not be like me. You may not be like your father. Sometimes I fear you will be deaf. I will still love you. As Alison Gopnik says, I will work to be your gardener, not your carpenter. I will create conditions for you to grow as you will, a being like me and unlike me. Will watch with surprise as you move in our space. I will not shape you in a pre-formed image, will not mold you and chisel you according to the formal cause (Aristotle) I’ve prefigured in my mind. No Silicon Valley Tiger Mom horror. I am sure it will pain me if for some reason your development is slower than others. I promise I will accept it with grace and do what I can to help you without loving you any less. As James Carse says, our relationship with one another will be an infinite game, not a finite game. I won’t block us from growing together in surprising ways because I feel I need to embody the role as mother. I will engage with you. Inhabit the world of your imagination, embrace it, welcome it as you teach me to recover poetry from prose. I will ask you why after you ask me why. Our conversation will never end, for at its heart will be the mysteries, the big things we never really understand. We’ll journey here together. Absurd because, as I’ve found in my last weeks working before I prepare for maternity leave, the reality of what the future brings is never what we planned. Situations arise. Challenges come upon us. I thought, at this point, I’d be coasting on the ideal of servant leadership, grappling with the recognition that I am not needed, preparing an organization for my impending departure with calm and grace and beauty. But the future wanted otherwise, as it seeps into my past. I am still working hard, solving hard problems, breathing day by day so my stress levels don’t impact you. Sometimes I feel like I’m in an Ionesco play laughing at what I thought this phase in my pregnancy would be like. In my best moments, I feel empowered. I think of you and how I want to be for you, and carry out my work with as much integrity as possible. I want to be strong for you. I want you to be able to watch your mother after you are born and smile, maybe not to your friends, but to yourself when no one is watching, because you have me as a role model. You have already given me strength. Already helped me become a better version of myself.

Your name is Felix. I wasn’t sure if I wanted to know your gender, but ultimately am grateful that we learned it because it deepened our connection to you, made you more concrete. At first you were just the baby, just it. When writing about you I’d either use they as a gender neutral pronoun or hop between he and she. And then you became he. And then you became you, Felix, not just the baby inside me, not just a baby, but this particular, unique, singular being. Granted as you grow into yourself outside my womb, your gender identity may evolve. That’s fine. Perhaps this is a temporary you.

Others will meet you in just a few weeks’ time. I won’t meet you then. I already know you. I don’t consider the moment of birth as one of your coming into the world. You are here, currently part of me, not visible to others the way they are used to being with others. Your birth is like a phase shift. Like plasma, you will take on a new form. Breathe in a new way. Eat in a new way. Your stomach will grow. You will poop black tar for the first time. You will take in the world in a new way. You will teach me as you take in the world. I will do my best to teach you, but I think I have more to learn from you than you from me. Someday you might read this and feel embarrassed. I get that. I’d feel that way too.

The featured image is of my hand on my belly one week ago. I tried to write this post last week, but found I was revealing certain details I wasn’t comfortable sharing in this public forum. I stopped. I felt the pain of failure and wondered if I’d ever be able to write this post. Since then, I read Knaussgaard’s Spring, a novel where he addresses his 3-month-old daughter in the second person. It inspired me and give me the courage to write this post. The lyrical mode is protective, gives me the ability to reveal depth without disclosing too much of the particular.