July 18, 2016 began as just one more day in a long succession of above 80-degree days in the suburbs west of Boston. Thirsty trees previewed the rusty shades of autumn. Cigar shapes of prematurely curled rhododendron leaves littered my lawn. We needed rain.
At 4:55 that afternoon I was home, busy at the computer on the third floor, when I sensed a change and looked up. The brightness of the sun had vanished. Soft, grey light filled the room. A loud rush of water far beyond the splatter of rain or the gurgle of an open faucet startled me and I jumped up from my desk. For a fraction of a second I thought the pipes in the bathroom had burst.
Then an explosion of sound, as if my daughter Amy had slammed the front door, shaking the house in her sudden anger. But Amy was forty-six and no longer lived at home during the week. More noise. Tremendous cracks. Each one sounded as if an entire tree had split open in a single blow. From the window I could see nothing beyond a silver curtain of cascading water. Light everywhere, but no separate streaks, no brilliant flashes. The riot of noise continued. By now I was on the second floor, hurrying to close an open window. Beyond the pane the row of arborvitae bowed toward the ground in obedience to the demanding wind. Perhaps three minutes had passed?
Next, an abrupt silence. No falling water, no sharp claps of thunder. A bird sang briefly; another responded.
Filled with unease, I continued to the first floor. As I pulled open the front door, I smelled winter. The neighbor’s tall pine rested in the V shaped space between the double trunk of my white birch. The fir tree missed blocking the door by inches. Branches and needles filled the yard. Gradually neighbors appeared in the road, paused, gazed in wonder. I joined the procession.
Upended trees lay across lawns and roads, their giant root balls revealed for all to see. Delicate root fibers dangled in the air—naked and vulnerable. My throat tightened, my stomach felt hollow. The destruction followed a specific path. My side of the street was a wild tangle of downed trees, branches, leaves, roots, and dirt. The opposite side was calm and untouched, all in order, as if the wind had been of two minds. “A rain bomb,” someone said as we walked along the road surveying the disarray.
“No, a wind bomb,” another replied.
* * *
The sudden force of the storm, the hole in my stomach, the tightness in my throat all triggered memories of an incident twenty years earlier. Amy’s twenty-second birthday had been only a week away and in three days she would graduate from her special needs high school program. We were both excited about the party we were planning. I was also filled with an anxiety I tried not to reveal. Despite two years of meetings, research, and visits to various programs, I had not found a good supported-work option or a more independent living situation for her.
I tried to focus on our shopping. While we waited to cross the street Amy reached over for my hand and rested her cheek against my arm. It was the gesture of a younger child. The woman standing nearby caught my eye, smiled, and looked down at Amy. “What a good girl, remembering to hold your mother’s hand.”
Amy nodded. “Yes, she is my mother. We’re having a birthday party!”
Once across the street, Amy stopped and turned to me before heading down the block to CVS. “Mother, if CVS doesn’t have napkins and balloons can we go to the Big Party Store? Please! Please!” She tilted her head and looked up at me, her eyes blue and beseeching. “Don’t say maybe. Say yes!”
I sighed and glanced at my watch. “Amy, we really don’t have time today.” I watched her face for signs of defiance—narrowed eyes, a downturn of her mouth—saw none and continued. “It is a long drive to the Party Store. We need to get home for dinner, right?”
Amy paused, then grinned. “Okay, my mother!” No angry reply, only a happy smile and a bouncing, blond ponytail as she ran ahead toward CVS. “Mother, come on! I will go first. I will find napkins and balloons and cake mix!”
Hurrying to catch up, my body tensed as I thought, oh, no, cake mix? CVS definitely doesn’t have cake mix. By the time I entered the store Amy was asking her favorite clerk about balloons and cake mix. The man smiled, his face puzzled. He knew Amy but could not understand her rapid, excited speech. I nodded toward him to acknowledge his helpfulness. Then turned to Amy. “Amy, let me help you look.”
“No, Mother! I can do it!”
“Well, I don’t think they have cake mix. Let’s just look for balloons and napkins.”
“No! I want cake mix!” Amy’s hands went to her hips. She pivoted toward me. Her voice rose. “Amy needs cake mix now! You don’t know anything!”
The clerk tried to step in. “Amy, your mother is right. We don’t carry cake mix.”
Amy’s eyes darkened, then scrunched up. I moved toward her, on guard, my body tensing. “Get away from me, you ugly mother!” She stamped her foot, clenched her fists. “I hate you motherfucker mother!” Her book bag dropped from her shoulder. Papers and pencils scattered across the floor.
My heart sank. Would I ever get used to Amy’s rapid changes in mood? What more could I do to help her manage her impulses? I tried to remain calm. “Amy, we need to go outside right now.” The clerk backed away. Shoppers turned to look. “Amy did you hear me? Pick up your things and follow me.” I headed for the door as she ran up behind me.
“Don’t you tell me what to do, awful mother!”
Two customers approaching the checkout line stared at me as if to say, “What kind of mother are you? Can’t you control your own child?”
“Ugly, bossy mother! Fuck you! Don’t leave me!”
Now there was alarm in the gazes of others. One asked, “Should I call the police?”
My stomach turned over. “No, I can manage. Thanks.” Amy had been in such a good mood, so happy when I met her as she got off the school van at my office. How had I missed the underlying tension?
I turned toward Amy. “I am leaving. Get your papers and pencils into your bag and come outside.” I glanced at the others with an expression I hoped conveyed an apology and headed for the door without looking back. I could not risk further aggression on Amy’s part. Although slight and looking far less than her twenty-one years, Amy was long past the age when I could simply pick her up and carry her out. If she gripped my arm and twisted it, as she was capable of doing, I would need help to break free. I could only hope she would follow me toward the door.
Behind me I could hear her muttering ‘bad mother, bad mother’ as she grabbed up her things and stamped out after me. But the yelling and nasty language continued, grew louder. She threw her book bag at my feet and ran toward the cross walk. I rushed after her, managed to grab her arm, and pulled her back. I struggled to breathe normally. A policeman stepped in front of us.
“Is this yours, young lady?” He handed Amy her book bag.
The policeman looked at me before turning to Amy. “What’s going on here, ladies?”
“My mother won’t buy me cake mix! I hate her!”
“That’s no way to speak to your mother. Do you know who I am?”
Amy caught her breath, looked over at me, and back toward the officer. “A policeman. And Mr. Policeman, can you tell my mother to stop driving me crazy? Please!”
Usually I laughed at this stock phrase of Amy’s and gave my standard reply. “Well, that’s what mothers do. And you drive me crazy sometimes too, Amy.” But today’s outburst was too serious to smooth over. Amy could have hurt me physically or hit someone with her book bag. She might have run into the street in front of an oncoming car if I had not pulled her back.
The policeman was stern. “No, your mother is trying to take care of you. But I will tell you to stop yelling. I suggest you and your mother both take deep breaths.”
Amy looked down, and reached for my hand. My voice trembled as I tried to gauge her mood. “I’m so sorry.” I paused, but decided I had no choice. I needed his help. “Could you walk with us to our car? I think Amy is calmer now, but the car is across the street and down a block.”
“I can drive you home if that would be safer.”
I cringed. What must he be thinking? Had he been outside CVS and heard the commotion or had someone called 911? Amy’s private meltdowns were one thing. When they occurred in public they left me feeling exposed, shaken and ashamed in my incompetence. And this explosion was one of Amy’s worst. “No, no, that’s fine, I just need to get her settled in the car. We’ll drive around a bit until she regains control of herself.”
* * *
The destruction in the section of town hit by the July 18th microburst was substantial, and it lingered. No one was injured but a car two blocks away was crushed. Electricity was cut off for four hours while the most dangerous of the downed electrical lines were repaired temporarily. For several days town work crews cleared roads and assessed trees, utility poles, and buildings for structural damage. For weeks the sounds of buzz saws and the sharp wood scents of a lumberyard greeted me every morning. All summer and fall the slightest gust of wind covered the ground with leaves dislodged from bushes and tree limbs.
Every weekend as Amy and I did our errands and drove through the neighborhood she commented on the disorder. “Wow, Mom, what happened? What a mess!”
My reply was always the same. “There was a terrible storm, Amy. It was very short, but very bad.”
Each time I gave this reply I recalled one or another of Amy’s outbursts, silently ranking them in order of severity the way weather reporters rank storms. The CVS incident rated an 8 on a 10-point scale. Most were less severe, in the 4 to 6-point range. But one winter she had smashed a second story window—a definite 10 on the Amy-outburst scale. Shards of glass had scattered across the snow under the window where she’d stood pounding on the glass and yelling at me while I shoveled the driveway. She didn’t like the snow and had refused to come with me. But I’d let our discussion about going outside drag on too long. She was more agitated than I realized by the time I decided to leave her alone inside.
The broken glass frightened us both. When I reentered the house she threw her arms around me in tears. We talked about how dangerous her actions had been. “Yes, Mom, very dangerous, not good to break things.”
She was unusually quiet the rest of the day. But the next morning when I reminded her of the broken window and suggested we pick up the glass in the snow together, she could only say, “No! No, you pick it up, you like outside!”
* * *
Microbursts were not officially identified until 1977. Often their rains and winds are still mistaken for tornadoes. But tornadoes can wreak havoc on the ground for long distances. Microbursts rarely cover more than a mile or two. Meteorologists can differentiate between tornadoes and microbursts. But to those affected by either type of storm, the focus is not on the difference, but rather on the danger, the violence, the damage.
* * *
Amy was born six weeks prematurely on June 15, 1970 in Bogota, Colombia. Three days earlier the obstetrician had told me everything was normal and on schedule, my child would be born in six or seven weeks. Her father and I had intended to finish our doctoral research in time to be back at the University of Michigan for her birth. We planned to return to Bogota after receiving our graduate degrees.
The onset of labor was intense and rapid. We reached the maternity clinic only minutes before Amy entered the world.
I’d taken care to eat well. I hadn’t smoked. Most days I’d walked a mile or two. There had been no morning sickness, not even a mild cold. The obstetrician assured me there was nothing more I could have done to prevent Amy’s early birth. “These things happen, Senora, we do not know a cause for everything.”
Amy could not maintain her body temperature. She spent thirty-two days in an incubator. Each day I arrived at noon and stayed for the three hours permitted visitors to the nursery. I gazed at my baby through a glass window and watched as nurses fed her and changed her diaper. I could not hold her. I could not touch her tiny hands or rosebud ears. She could not feel my skin or see my face smiling into hers.
But Amy could breathe on her own. She could suck from the bottle of formula the doctors insisted was better than my breast milk. They were not worried. “Amy will be fine,” they said.
Every night until we brought Amy home over a month later, I woke up covered in sweat, terrorized by dreams that haunted me throughout the day. Where was my baby? Was she frightened? Were the nurses paying close attention? I longed for her body next to mine. Surely she felt a similar need, an equal absence? Our separation felt dangerous—too sudden, too violent.
* * *
Doctors now know that an infant born even two or three weeks prior to full term is at risk for a variety of developmental difficulties. Research in the 1980s and 90s with CT scans and MRI’s revealed how much the brain develops in the last trimester of pregnancy. Every additional day in the womb adds volume to critical brain matter. When an infant is born without a fully developed brain there is danger of neurological damage, the earlier the birth, the greater the danger.
* * *
On July 18th I had not noticed anything unusual prior to the change in light, the rush of water and the thunderous cracks. Had these sudden disruptions been preceded by a few moments of stillness? Were the leaves unruffled by even a trace of a breeze? Perhaps the sky had darkened in the distance? I do not know. I had never been in the path of a microburst, had no experience to alert me.
* * *
By the time Amy had been home from the clinic for a week, I knew immediately when she was overtired, over stimulated, approaching a melt down. Her ears turned red. Soon she would be fussy. Very shortly fussing would turn to tearful cries. Then, moments later, the cries would become angry screams. The chance to intervene was brief. I learned to hold her, to sing softly, to wipe her face with a damp cloth. To escape with her to a quiet place where she could relax and nap. I knew I must do these things before her entire body was awash in rage—face contorted, arms and legs flailing, until finally exhaustion took over and she hiccupped her way to sleep. There seemed to be no cause other than emotional or sensory overload—no infections, no fever, no particular food or allergy—that could account for her blushing ears or the outbursts they signaled. Again the doctors said Amy would be fine as soon as she gained weight and her brain matured.
Once Amy was able to travel, we returned to Ann Arbor. Our lives had turned upside down—sleepless nights and tired days, nerves raw, hidden grievances exposed. We struggled to complete our dissertations and returned to Bogota hanging on to the hope that Amy would outgrow her early difficulties.
* * *
When she was rested and serene, Amy’s eyes followed every moving thing: a fly on the window, a bird overhead, wind ruffling a curtain. She wanted to touch each flower, feel each thing her fingers could reach. She greeted people with smiles, waving her hands and uttering small gurgles of delight.
But Amy was four before she spoke more than five or six words. Her hearing was fine, but she seemed to have trouble remembering sounds and turning them into recognizable words. When she did begin to speak, phrases came slowly and were often garbled. Even now at forty-seven, her syntax is confused, her speech hard to understand at times.
* * *
In addition to the difficulties doctors attributed to her premature birth, Amy was born with a congenital malformation of her right hip socket. For several periods of three to six months between her first and eighth birthdays, she was encased in body casts that started three inches below her armpits and ended at her toes. A U-shaped opening between her legs allowed her to pee and poop. This captivity resulted from repeated surgeries for the hip dysplasia. She learned to pull herself around with her arms. It was an exhausting, frustrating process. Her ears were often red.
The red ears warning signal was there to guide me until, sometime around her fifth birthday, it disappeared. By then I had learned to note the slightest change in my daughter’s gestures, her facial expressions, the tone of her voice. A fractional increase in the timbre of her utterances could signal trouble. When she looked around, her lips tightening, her eyes a bit wider and darker blue than usual, then scrunched up for a second, I was on guard. When she raised her hands and held each side of her head, sometimes first pulling roughly on her braids, I took note. Were her feet twitching back and forth? Were her toes visibly wiggling? Wiggling toes usually signaled happy interest, but just a little too fast could mean frustration.
If I caught these small warning signals soon enough, I could intervene. At first I simply picked her up and carried her to a calmer place. As she grew older, this was no longer possible. I could suggest it was time to read a book or leave the group activity. But I had to make my suggestion at precisely the right moment. An intervention offered too late was apt to trigger the outburst I had hoped to avoid.
* * *
A week or so after the July microburst I ran into a neighbor in the grocery store. We talked about the storm. “I’d been outside in the yard, trimming dead branches, but it was so hot, so still, the breeze had quit entirely. I went inside to cool off,” she said.
“I was working upstairs,” I replied.
“We were both lucky, Susan. A tree fell into my yard only moments after I entered the house.”
My stomach tightened as it had when the first thunderous cracks sounded in my ears. “It might have hit you!”
“Yes, I know. But I’m okay. I’m just glad I sensed something…maybe a shadow? Or the odd moment of stillness?”
* * *
When Amy was young I’d tried to help her father see the warning signs: the red ears, the wiggling toes. I explained the dangers of an overload of exhaustion and frustration caused by too much noise, too many people, or too much activity. He refused to listen. “You can’t know what’s bothering her. Everything’s a mess. She’s always crying. I can’t deal with her!”
By the time Amy’s third birthday approached doctors had begun to take a more negative view of her progress. Some said she might never walk more than a few steps or speak more than a few words. She needed better medical care and education than Bogota offered. When she was four, Amy and I returned to the States. I hoped her father would join us. He did not. We divorced. I found a job and enrolled Amy in a special education program.
Even among those who tried to understand and help Amy, what was usually obvious to me was often invisible to others. To them she was unpredictable, explosive. “She was fine. She was laughing and having fun. Then she shouted and ran off, crying.” Or, “Then she threw her book at me and screamed, I hate you!” Or, “She loves playing with Ashley, but today she flew into a rage and tried to hit her.”
* * *
I searched for more information, possible answers. How could I understand my daughter’s world? How could she understand mine? What more could I do to help her adjust to circumstances that too often seemed to overwhelm her? Various doctors suggested a residential setting, anti-psychotic drugs. Extreme measures from specialists who longed to cure but could not. We tried two of the suggested medications. Amy had nightmares. She ground her teeth and slurred her speech in new ways. I stopped the medications.
Different experts, and eventually small doses of two new medications helped somewhat. Amy’s outbursts are fewer now, milder. She can recover more quickly. And thanks to the persistence and skill of surgeons, teachers, therapists, and dedicated caregivers, Amy walks, albeit with a limp, and talks enthusiastically, resorting to gestures when she cannot find the words she needs. She has gained a sense of pride in her accomplishments and can self-monitor much of the time. Returning from her day program or a shopping trip she goes straight to her room to arrange her books or purchases. She emerges only when she feels calm. But her outbursts often remain a mystery, even to Amy herself. “Amy so sorry. I not mean to throw that nasty, ugly book!”
Sometimes she writes me notes following the format she learned on visits to my office:
You are my pal oh, my mother. Why Amy yell? I so sorry. I very sad. Amy loves so nice mother. She gives hug and kiss.
* * *
Meteorologists continue to study microburst activity and to look for data that will improve their ability to predict these storms more accurately. But the general public has no instruments to read, nothing visible-to-the-eye like a tornado funnel, to signal that a microburst is imminent. For most their arrival is a mystery. Only those who have experienced a microburst sense danger in long strings of sweltering summer days. We have learned to be on guard—alert to the tint of the sky, the feel of the air, the slightest stillness of leaves.
* * *
Research since the 1970s has improved outcomes for premature babies. Today many infants are alive who would not have survived forty years ago. These advances have prompted more research on the causes and prevention of prematurity as well as on treatments following birth. Some researchers are now combining brain scans and MRIs with genetic and molecular data. This work may reveal mother/child-specific information on the warning signs of prematurity and lead to the development of individually calibrated pre and post-birth protocols.
* * *
For now, the terminology for Amy’s problems remains descriptive: non-specific developmental delays, problems with impulse control, difficulty with short-term memory. These labels provide neither explanations nor cures.
I keep searching.