As a rule, I’m not one of those readers who flips ahead to the last few pages of an article or book before committing myself to reading it. I like a little mystery in my life.
But that’s exactly what I found myself doing when I started to read Andrea Curtis’ “Small Mercies” after it first appeared in Toronto Life magazine in 2005. I was on a train crowded with commuters, heading home from a day of work, when I found myself in the unusual position of getting choked up after only a couple of pages.
You see, Curtis’ story begins with the realization that, at 32 weeks into a “medically uneventful” pregnancy, she can’t remember the last time she felt her baby kick. From there, the story launches into her trip to the hospital for an emergency C-section and the birth of her 3 1/2-pound son a full five weeks before he could be considered full term.
She recounts the ordeal and seeing her son Ben in the Neonatal Intensive Care Unit for the first time:
… I could make out a reddish-looking infant lying in a nest of rolled blankets inside the box. Fully extended, he would have been about the length of a squirrel, with a big belly and pencil-thin limbs, but at the time he was lying on his side, legs propped up in front in the fetal position. A strip of white tape held transparent plastic prongs in his nostrils, and there were large rectangular splints made of foam taped to his left hand and his right foot to keep IV lines steady. You could see purple bruises on his hands and feet where they’d tried and failed to find a vein. He was wearing only a disposable diaper, but it was so big it covered nearly his entire torso. He had wires attached to his body, tape tabs holding them in what must have been a specific order, though it looked to me like a writhing tangle of mating snakes.
My tiny child looked solitary and foreign, as if he weren’t of this world. I tried to say something appropriate, something motherly, but I had no words.
At this point I flipped ahead to the end of the story. “If this doesn’t have a happy ending,” I thought to myself, “I can’t read this now, or I’m going to lose it right here on the train.”
A compelling narrative and a richly detailed behind-the-scenes look at a NICU would, on its own, be enough to hook any reader. But Curtis doesn’t stop there. She ups the ante by introducing another element to the piece: the question of how much money and effort should be spent on high-risk preemies at a time when fertility treatments and other medical advances have made them increasingly common in North America. As she writes,
…the biggest questions raised by our ability to push the boundaries of biological survivability are moral rather than financial: is it right to keep the tiniest, most at-risk babies alive outside the womb just because we can? And most critically, what are the short- and long-term consequences?
This is where Curtis’ skill as a storyteller shines – how she paces the story and deftly tacks between these two parallel narratives is what makes this piece so good.
After the birth of Curtis’ son, the narrative shifts almost seamlessly back and forth between her experiences during her son’s month in the NICU (and those of the other mothers she meets there) and a clear-eyed examination of the costs, consequences and ethical implications of bringing high-risk preemies to term.
At first, this seems like an impossible argument even to try to articulate, especially alongside a mother’s story about her own high-risk preemie. Why wouldn’t we want to save every baby we can? But Curtis takes a step back from her personal story and approaches the issue in a fair-minded way.
To keep readers engaged, she often ends sections of her personal narrative with a cliffhanger of sorts, such as waiting to learn the results of an ultrasound that will reveal whether her baby has brain damage. Her own experiences also offer jumping-off points for the broader narrative. After she sees her son in the NICU for the first time and is overwhelmed by his state, she shifts from personal concerns into a section about how the health prospects for preemies depend on their age:
In my post-birth haze, it slowly became clear to me that, although all babies born before 37 weeks are technically premature, there is a universe of difference between a baby born at 32 weeks gestation, like Ben, and one at the extreme of viability—widely regarded in Canada as 23 weeks. Everything about them is different: the level of care they require, their prognosis and their treatment.
In other places, Curtis links her parallel narratives with a metaphor. At one point in the story, she describes the isolette that her son lives in – small, clear plastic box filled with wires and tubes and draped with quilts, alive with the hum of machinery. She moves from this description of his physical environment to a section about the atmosphere of the NICU as a whole with the phrase:
It’s more than just humidity that makes the NICU a hot box. The air there is also thick with fear and hope, fraught with tangled questions about the value of life and death.
Beyond presenting a timely and thought-provoking ethical debate, Curtis uses this second narrative thread to provide a larger context to her own story and to give it some breathing room. This is not a cheap device used to prolong the story and ratchet up suspense, although it does those things as well. Instead, it provides readers a much-needed break when Curtis’ fraught story starts to feel overwhelming.
Just when you think you can’t bear to read about one more development with her son – will he test positive for respiratory distress syndrome? Will he ever start gaining weight? – she subtly shifts gears into the second narrative, explaining the marked differences in premature babies’ viability based on their age, the ethical guidelines outlining when babies are too young to be resuscitated, and the long-term health risks associated with being premature, including cerebral palsy and learning and physical disabilities.
The transitions between the two narratives are smooth, and Curtis is judicious about presenting the most relevant and interesting medical research in a way that’s easy to understand. Moreover, she spends just the right amount of time with her second narrative before diving back into the heart of the story and what readers really want to know – the fate of her son and the other preemies we meet along the way.
Beautifully written and emotionally taut, “Small Mercies” is a textbook example of how to pace a story for maximum reader engagement that is sure to keep you glued to the page until the very last word. But take my advice: It may be best to read it in a room by yourself with a box of Kleenex at the ready.
Bruce Gillespie (@bgillesp) is an assistant professor in the journalism program at Wilfrid Laurier University in Brantford, Ont., Canada. He’s also the co-editor of two anthologies of life writing: “Somebody’s Child: Stories About Adoption” and “Nobody’s Father: Life Without Kids.”
For more from this collaboration with Longreads and Alexis Madrigal, see the previous posts in the series. And stay tuned for a new shot of inspiration and insight every week.