To Induce or Not to Induce

As you may have read below, I've been very impatient for the birth of our first child. Under other circumstances, I might not be but the premature labor pains my wife endured earlier this week got me very excited about our impending arrival. So she and I have been talking, on and off, about the benefits and drawbacks of medically inducing labor.

Benefits: the baby is born on our schedule, we can plan in advance when we can expect to bring the baby home and have the apartment ready in time, and my wife can finally stop carrying 35 extra pounds around.

Drawbacks: we're not thrilled with the idea of tinkering with her body's natural rhythms, labor could prove more painful since the cervix hasn't finished preparing itself for dilation, and as of right now, there's no medical reason for it.

I did a little research and found a very good resource at the Mayo Clinic that discusses the effects of and reasons for inducing labor. From the website:

Your health care provider may recommend inducing labor for various reasons — primarily when there's concern for your health or your baby's health. For example:

• You're one to two weeks beyond your due date, and labor hasn't started naturally.
• Your water has broken, but you're not having contractions.
• There's an infection in your uterus.
• Your baby has stopped growing at the expected pace.
• There's not enough amniotic fluid surrounding the baby.
• Your placenta has begun to deteriorate or separate from the wall of your uterus.
• You have a medical condition that may put you or your baby at risk, such as high blood pressure or diabetes.

Rarely, inducing labor is a matter of practicality. If you live far from the hospital or you have a history of rapid deliveries, a scheduled induction may be best.

There's an important caveat, however. If you've had a prior C-section, you may not be a candidate for labor induction. After a prior C-section, inducing labor increases the risk of uterine rupture. This rare but serious complication — in which the uterus tears open along the scar line from a prior C-section — can cause life-threatening blood loss, infection and brain damage for the baby.

There are, however, several folks methods - like castor oil and spicy foods, which I mentioned in a previous post - that supposedly work. We've largely ignored them, although I never say no to spicy food. Instead, my sweetie has continued to do light exercise and the contractions, although still not very strong, have increased somewhat in intensity and duration.

Since none of the medical reasons apply to us, and since we're taking as naturalistic an approach to her labor as we can, it seems that induction isn't in the cards for now. Once we hit Due Date Plus 10, then we can talk about it.

In the meantime, she and I are sitting out the hours, enjoying our final few days of peace and quiet before our new arrival. I know that someday we're going to look back nostalgically on these last days. Right now, though, that's pretty hard to imagine.

Choosing a Pediatrician

About two months ago, somewhere around Week 30, my sweetie and I started looking for a pediatrician for our child. Throughout the pregnancy and through the labor, our baby's health is the responsibility of my wife's obstetrician. The moment mother and child separate, though, Junior is going to need his or her own doctor.

Choosing a pediatrician is both harder and easier than it sounds. If you already have a child and you're happy with your kid's doctor, you're all set. If your friends and family have a pediatrician or pediatric practice that satisfies them, great... assuming they're taking new patients. For many new parents, though, it's not quite so simple.

In our case, my wife and I each have family all over the place and none with children living nearby. We don't know too many people in our neighborhood with kids - I suspect that'll change soon enough - but, in the meantime, we're more or less on our own in terms of finding a pediatrician.

I should mention here that my wife is the only child of a career soldier who retired at the rank of sergeant major after 26 years of military service. He has a natural inclination towards compulsive organization, a habit the Army did little to correct and much to encourage. And my wife is very much her father's daughter.

One of her first actions was to track down a the names of doctors at the pediatric practice affiliated with her OB and put together a list. Making a list may sound like a lot of work but in this case, it saved us a lot running back and forth for information. It was made easier in our case because we asked the nurse teaching our childbirth class if she had any recommendations. This list became the base of our search.

She printed out the list, noted where they went to medical school, conducted - although, if you know any doctors, you'll probably agree that "endured" is the better word - their residency training, and how long they had been in practice. Once the list was complied, we went over it together. And this where my biases crept into play.

I don't care about my doctor's ethnicity, religion, gender, or sexual orientation. I don't care about those things in my kid's doctor, either. What I do care about is where my doctor went to medical school and where they did their residency training. This may be due to conversations I've had with a former girlfriend - herself a doctor - who never a met a student from a Caribbean medical school who was remotely competent or interactions I've had over the years with friends and classmates who've gone into medical practice. I don't know. What I do know is, I want a doctor who trained in the United States or, failing that, Great Britain or Western Europe. What I don't want is someone who attended medical school in the Caribbean. I'll get into why in a minute.

Say what you will about the present state of the American health care system - and there is a lot to say about it - I would still argue that the United States as a whole consistently produces the best doctors anywhere. I want to stress the words "as a whole." I have no doubt that European, Asian, and Indian medical schools produce some outstanding physicians. In most cases, however, the level of resources available to train doctors is far higher in the U.S. than elsewhere. The result is that, knowing nothing about else about my child's potential caregiver, I'm more comfortable with a U.S.-trained physician than one who was educated overseas. In places like, say, the Caribbean.

Many American students have over the years gone to medical schools in the Caribbean. Despite their idyllic locations, however, places like Ross University and St. George University have lower admissions standards than their U.S. counterparts and lack an academic medical center at which medical students can train. This, to me, is a major strike against them.

Students at these schools typically spend their first two years studying basic science, just like their American counterparts. For their third and fourth years, however, they are scattered to the four winds, sent to hospitals around the U.S. and U.K. in largely piecemeal fashion to get their clinical training while American students typically stay in the same area, rotating through their home medical center and nearby hospital affiliates.

Academic medical centers in the U.S. see a huge variety of cases and have eight- or nine-figure research budgets, giving medical students an exhaustive - in every sense of the word - range of learning experiences. These hospitals typically don't teach students from foreign medical schools, including those based in the Caribbean, concentrating instead on teaching students affiliated with their own medical education programs. Foreign students are consequently forced to take on clinical rotations at hospitals with fewer resources for training and don't see the range of cases that students at a major medical center would encounter. The result is that Caribbean medical students tend to receive a lower quality of basic clinical training, which hampers their ability to land a high-quality residency.

In fact, when it comes time to find a residency, graduates of foreign medical schools are at a distinct disadvantage. Highly competitive specialties tend to have few or no foreign medical graduates at all, with those spots going to the cream of the U.S. crop. Unfair? Perhaps. But medical education is as much about opportunity as anything else. A med school graduate from Harvard or Columbia, or even the University of Arkansas, will have had many more opportunities to engage in a wide range of clinical experiences than a graduate of a school in the Caribbean.

I'll be the first to admit that Caribbean medical schools might not be getting a fair hearing. But as long as recruiters from those schools continue to recruit applicants who couldn't get into American medical schools, they're going to be stuck with a reputation as second-rate, a reputation that will limit their training opportunities and count against them when medical residency directors rank their wish lists of applicants.

The long and short of it, then, is that my wife and I wanted an American-trained pediatrician. Personally, despite everything I've written above, I'd be willing to overlook a Caribbean medical degree if the doctor in question had done his or her residency at a reputable medical center in the U.S. A top-flight residency can make up for most deficiencies in earlier medical training and I'd be comforted knowing that Dr. X passed a rigorous training program. As it happened, though, that was a non-issue.

In fact, most of the pediatricians in our area were educated and did their residencies either in our state or a neighboring state. This isn't surprising. While a neurosurgery or dermatology practice may have a roster of physicians from the best medical schools and residencies in the country, pediatrics is one of the least glamorous - and lowest-paying - medical specialties. And where a Park Avenue or Beverly Hills pediatric group might boast a collection of Johns Hopkins or Stanford M.D.s, this is not the norm in most parts of the country. And that's fine.

Training standards at major academic medical centers are high enough to reassure me that the doctor I choose will be competent to handle 99% of whatever afflicts my child. For the other 1%, I can always see a specialist (assuming my insurance agrees to cover the costs, but that's another post). So as long as the pediatricians we were considering had done their training at a major university hospital, we would be happy.

We narrowed our list down to a small handful of candidates at the local pediatric practice, all educated at state university medical schools, all with residencies within driving distance of our home. Unfortunately, some of the factors we might have used to winnow the list further didn't apply.

All had the FAAP designation following their names, meaning that as Fellows of the American Academy of Pediatrics they were committed undergo regular training to update their skills and knowledge base. So the lack of that couldn't be used to narrow the list.

We asked our OB, herself the mother of 3 school-age kids, if she had any recommendations or reservations, and were told that she'd be comfortable with any of the doctors in that practice. So that didn't help, either.

I also skipped over two doctors who were in their sixties, although it didn't matter much to my wife. While there's a lot to be said for decades of clinical experience, my wife and I didn't want to be in the position of looking for a new doctor again in five years because our current pediatrician retired. We want to build a stable, long-term relationship with someone who knows our child and I thought that an older doctor might call it a career before Junior called it a childhood.

My wife then picked up the phone and tried to schedule brief appointments to meet with the two doctors left on the list. One was available, the other couldn't commit to a time right away. So my wife met with doctor #1, a 40-something man with an approachable demeanor, and came away impressed.

A short while later, she met with doctor #2, who was the head of the practice. Saying that your kid's doctor is the chief of pediatrics at X Hospital may impress at cocktail parties - and if it does, that's kind of sad - but the head of a practice isn't always the best doctor. It's usually the doctor most willing to take on the administrative workload involved in managing the practice, often in return for a larger piece of the practice's income or a reduced clinical or overnight call load. All that paper shuffling takes time away from patient care and I didn't want my kid to have to compete with paperwork for his or her doctor's time.

Like I said, choosing a pediatrician is both harder and easier than it sounds. If you're stuck in the "harder" end of things, there are many good resources available to help. Start by asking your obstetrician or perhaps your primary care doctor for referrals. If you don't have a regular OB or if you prefer to look online, you can warm up at Parents Magazine or Baby Resource. An excellent list of questions for your prospective pediatrician comes from Children's Hospital in Boston. And if you're not happy with the referrals you've gotten locally, you can try the referral service run by the American Academy of Pediatrics.

My wife and I were lucky in that our local pediatricians met our requirements and were available to take new patients. For some, it might be this easy. Others may have a tougher time. The most important point is to not rush into this decision. This is your kid's life on the line. Do your homework and take your time. It's as much for your health as your child's.

Waiting for the Birth

This past Monday, my sweetie started having contractions. We very calmly went to the hospital, only to be told after two hours of monitoring that the labor wasn't progressing and to head back home. That was three days ago. She's still having contractions. We're still waiting.

I'm an elementary school teacher, which means that right now, I'm on vacation. It also means that I've been at home for the past 3 weeks, helping prepare the apartment for our impending arrival. At this point, all of the prep work has been done. The crib is built and mattressed, the car seats are installed, the baby monitor is plugged in, all loose wiring is secure, the changing table is positioned by the crib, even the diaper pail is bagged and ready.

All we need now is the baby.

We don't want to induce, certainly not with the due date still a few days away. Maybe if the baby overshoots the due date by a week, sure. Right now, though, it's way too early. Still, those contractions are driving me to distraction. I know, I know, my sweetie feels them more than I do. And she does. Yet, she's taking this much more calmly than I am.

Right now, she's splitting her time between very light exercise and reading. I'm burning off my nervous energy blogging. I've become very impatient. I want my kid now!

My sweetie has taken to exercising in the apartment partly because it's insanely hot outdoors right now and partly to help speed labor along. We spent part of this afternoon online looking up various ways to progress labor without resorting to medication. There aren't many options.

Some of the stranger ones include the consumption of castor oil - apparently suggested by well-meaning Little Rascals fans unaware that a woman does not in fact excrete her baby - and eating spicy foods.

The one that made the most sense, actually the one that made the only sense, was light exercise. Walking is the simplest and most cost-effective. Lace up your shoes and step outside. Or, if your summer's been as hot as ours, stay indoors and pace back and forth with the TV or radio on for company.

Stair-climbing is another option, assuming you don't push yourself too hard and are in reasonably good shape.

Swimming would be my choice - it takes pressure off the joints while still providing a moderate cardiovascular workout - but my sweetie wanted to stay out of the 105 degree heat index presently outside our window. I can't say I blame her.

So she's walking back and forth, resting, doing a few squats. Me? I'm just sitting here. Waiting.

In more restrained moments, I realize that in a month or two, I'll have moments when I want to send the kid back. I know this. I accept it. I still want my kid now.

I want to know what the baby will look like, feel like, sound like. I want to know if it's a boy or girl.

I want to show my child what the outside world is like, what's waiting, what having two sets of doting grandparents is like.

I want to share my passion for writing, reading, travel, and games with my child. I want to share all those little moments of discovery: how to walk, how to pile blocks, how to speak, which parent is mama and which one is usually confused.

I'll have those moments, and countless others besides. I know this. I do. I'll have more moments than I'll know what to do with.

There's just one small problem. I want to start now.

Infant Intelligence

My baby, although still in the womb, is the smartest baby ever. My evidence? Although my wife is now at term, our baby has apparently decided to stay right where he/she is and avoid the stress of the outside world a while a longer. Genius.

But, seriously, if we're talking about infants, is being "smart" really that big a deal? And if it is that big a deal, does it mean more to the child or the parent? I once noted to an acquaintance that her baby was holding her head up on her own about a month ahead of the developmental average. The acquaintance, a woman with an Ivy League law degree, took it as a complement - to her, not her kid - even though I'd meant it only in a "hey, cool" sort of way.

And while we're at it, how exactly do you measure intelligence in a baby? What constitutes "smart" for a person who thinks feet are for sucking, not for walking?

There are so many hypotheses about the nature of human intelligence it's hard to know where to begin the conversation. There's no universally accepted definition of intelligence, never mind an accepted way to measure, gauge, or assess it. The result is a slumgullion of arguments guaranteed to keep academics squabbling and parents fretting for generations to come.

Here's what we do know in very, perhaps overly, simplified terms: from an undefined moment in utero until the moment it shuts down for good, the brain constantly gathers information. The flow of information causes neurons to connect, interconnect, and multiply (up to a point). Those connections guide behavior and perception, which in turn affect the processing of incoming information, which influences how neurons connect and interconnect, which further guides behavior and perception, and so on.

Just because the information is going in, however, doesn't necessarily mean that it's being processed in any meaningful way. And even if it is processed meaningfully, articulating that meaning may still be impossible.

I could spend the next hour trying to teach a one-year-old how to do algebra. I guarantee that the information is going into his brain through multiple pathways: the eyes, the ears, even the hands if I give him a calculator. But if I then stick an equation in front of him and say, "solve for X," he'll most likely chew on the end of his pencil and then wet himself.

So how do we measure an infant's intelligence?

"Intelligence," if you'll let me provide my own definition, is a measure of the brain's output in response to external and internal stimuli. In other words, intelligence is how the brain responds to certain triggers. And it has its evolutionary advantages. If you're in the woods and a bear starts charging toward you and your brain says, "RUN!!!", you're more likely to pass your genes on to the next generation than if your brain says, "ooo, look, a pretty rock!" In theory, therefore, all you have to do to measure intelligence is measure the brain's responses to selected stimuli. And this is where it gets messy.

Intelligence testing has a long and controversial history going back decades. About 100 years ago, two guys, Alfred Binet and Theodore Simon, drew up the first modern intelligence test while studying mental retardation among French schoolchildren. In 1916, Stanford University psychologist Lewis Terman made some modifications, which led to the test being dubbed the "Stanford-Binet" test. An updated version is still in use today.

The Stanford-Binet has been widely criticized for its generalizability (how well it applies equally to all people) and reliability (how accurately it measures what it claims to measure). Two kids can get identical scores and proceed to go in opposite directions in terms of academic performance. Despite this, it remains the gold standard for intelligence tests. If you've ever taken an IQ test, it was probably a version of the Stanford-Binet.

Another common and highly popular intelligence measure was devised by Havard education professor Howard Gardner. His seminal book, Frames of Mind, lays out what Gardner calls the 8 "multiple intelligences" or MI. Rather than restricting intelligence to a narrowly-defined intellectual exercise, Gardner argues that intelligence is expressed through numerous facets: athletics, music, spatial reasoning, mathematical ability, interpersonal skills, etc. in ways unique to each individual.

Naturally, Gardner, too, has his critics. Opponents have argued that MI is too relativistic to offer any meaningful measure of intelligence and that it could allow teachers an excuse to play to a student's strengths while glossing over his weaknesses, emphasizing music, say, over math. Despite criticisms, however, MI has taken hold in many schools that have adapted Gardner's theory to the practical matter of devising a curriculum. If your children attend school in the United States, I'll take even odds that MI plays at least some part in the curricular structure.

Many other intelligence measures have cropped up over the years, each with its strengths and weaknesses, none of them the Holy Grail, end-all-be-all test that provides once and for all an irrefutable, definitive measure of a particular person's intelligence.

Naturally, that doesn't stop test-makers and theorists from trying. It remains a lucrative business. There's gold in them thar' brains, just waiting for the right test to unearth it.

Parents of young children, of course, tend to be as concerned about what goes into the brain as what it spits back out. The success of the Baby Einstein line of products - which is what inspired this post in the first place - tells me that some parents will go to any lengths to have a "smart" child. And what better way to stack the odds in favor of having a "smart" child than to have a "smart" baby?

And if that's all there is to it, fine. Buy your kids the toys, show them the videos. It can't hurt. Heck, it might even help. If a child knows left from right, how to tie her shoes, and how to read consonant-vowel-consonant words (like "cat" and "dog") by the time she's 4, great. It'll thrill her kindergarten teacher.

I suspect, though, that in many social circles, parents measure their self-worth by way of their children's accomplishments, even if that accomplishment is as mundane as little Johnny holding his head up a month ahead of schedule. And if that's how parents are using Baby Einstein and his copycat spawn, they're missing the point.

It's not about you. It's about your kid.

Yes, we all want our children to be smart. I'll be the first to tell you that I hope my child is intelligent, both in terms of intellectual capacity and the good sense to put that intellect to constructive use. (By the way, Junior, if you're reading this post and it's many years old, close the browser and go finish your homework. Then get back to me.)

Intellect tends to lead to success. The most successful people - by almost any measure - tend to be highly intelligent. George Washington, Enrico Fermi, Mohandas Gandhi, and Michael Jordan are or were very smart. Whatever else you may think of your own local politicians, they, too, are highly intelligent people. I say that because deviousness is, after all, an expression of intelligence.

All of which brings us back to the intelligence of the infant. I could in fact actually have the world's smartest baby, capable of feats that are the stuff Nobel laureates' dreams. Unfortunately, brilliant or not, my baby will be physiologically incapable of expressing that intelligence for quite a while. This means that my baby - and yours - won't be the subject of parental bragging rights anytime soon. Someday, perhaps. But not for a while.

Like I said, I hope my kid is smart. As someone who likes to set high expectations, I'm tempted to say, "my kid will be smart." And maybe my child will be. Heck, maybe my infant will be.

But how will I ever know?

In The Beginning

In the beginning, there were two of us. My sweetie and me. And it was good.

I went to work each day, trying to corral 22 hyperactive third graders and maybe teach them something while my sweetie stayed home by day and taught a class at the local junior college at night. It was a sweet, almost pastoral existence, minus the sheep. But, last October, after waiting for the maternity benefits to kick in on my insurance, we decided to finally try to conceive.

We'd heard all sorts of stories from people who'd tried for months, years, to have a baby before conceiving. Since we were in our early 30s, we assumed we were in for at least several months of vigorous trying. We couldn't wait.

One day, about 3 weeks after we started trying, my wife called me at school while the kids were lining up to go home. She'd just taken a pregnancy test. It came back positive.

I vaguely remember spending several minutes - after the kids had all gone - skipping up and down the hall.

Fast forward nine months. We're now in Week 39 of her pregnancy. So far, so good. The baby is developing normally, my sweetie's weight gain and health are right where they should be, and the apartment is filling up with all the bits and pieces that signal an impending birth. We were, we told ourselves, ready.

Then, last night, she went into labor.

I'm a calm person. I really am. So when my sweetie came out of the bedroom to the living room around 9:30 and said she was having mild contractions, I just nodded and asked if she was okay. She said yes. For the next hour and a half, we monitored her contractions. I hummed Semper Fidelis while timing them and read the same page in William Cohan's House of Cards over and over for about 90 minutes, jumping - calmly - every time she said, "another one's starting."

Of course, I told myself, I wasn't really a ball of nerves. My asthma hadn't kicked in, after all. My inhaler was still on the office desk, untouched, unneeded. My breaths were nice and deep. Calm.

Around 11:00, we decided to head for the hospital. The nurse at our birthing class said that if we weren't sure if the baby was coming or not to go to the hospital anyway, just in case. So we got dressed and got our stuff together. Weeks earlier, we'd packed a gym bag with clothes, a tote with books, CDs, and snacks, and my camera bag. Along with a nursing pillow and a portable radio/CD player, we had everything we needed to spend a few days in Labor and Delivery.

I carried everything but the pillow down to the car, my sweetie on my heels with the pillow in hand. Everything went into the back of the car. We got into the front seats. I started the ignition, pulled out of the parking lot, and started down the road. A minute later, I checked my pocket.

No inhaler.

I carry that thing with me everywhere - work, home, car, plane, walks. I sleep next to it at night. As Milhouse van Houten once said, I need it to live. And I'd left it at home. For a second, I debated whether or not to go back for it. After all, if you're going to have an asthma attack, a hospital is the best place for it. But my sweetie urged me to turn around and go back for it. So I want back and five minutes later, we were once more on the road. A minute later, I checked my watch.

No watch.

It, too, was at home, sitting on the printer where I'd put it after her last contraction.

"Should I turn around for it?" I asked.

My sweetie gritted her teeth. "No."

Fifteen minutes later, we pulled up to the ER. Since we'd already pre-registered, check-in was simple. Fork over my insurance card - which, thank God, I hadn't forgotten - sign a couple of sheets of paper and off we go to the maternity observation room. Since we had no idea where it was, we asked the admissions clerk.

"Go around to the left and you'll see it on your right."

No problem. We went around to the left, walked a little, and saw on our right... the ER. Okay. We passed a man, woman, and 8-year-old boy huddled together on a stretcher and walked up to the main desk.

"My wife is in labor," I pointed to my sweetie, who smiled, hands on her abdomen. "Is this where we go for maternity observation?"

The nurse frowned. "That's upstairs. Second floor. Go back out the way you came, make a right, and take one of the elevators up."

Upstairs? The clerk had forgotten to tell us that part. But that's okay - I was still calm. We went back the way we came, made a right, and took the elevator up to the second floor, where we found the Labor and Delivery unit. We went to the main desk and repeated what we'd said downstairs.

"Observation?" the nurse said. "You have to go downstairs for that."

"But we were sent up here."

"You were?"

"Yes."

"Maternal observation is downstairs," the nurse said, "on the first floor. If you're standing in the elevator and step out, you go left and it's down the hall on your right. The sign is small but it's there."

My sweetie let out a breath. I was still calm. I swear.

We caught the elevator down to the first floor, turned left down an empty hallway, and started looking for the sign. We saw lots of signs. "Anesthesia." "Surgery." "Maintenance." But no "Maternal Observation."

We went back to the elevator and went down a different hallway. "Benefits." "Administration." "Do Not Enter." But no "Maternal Observation." We tried a third hallway. Again, no "Maternal Observation."

It was like a boring Hitchcock movie.

Back at the elevators, we met some of the hospital's maintenance crew. A very nice woman with a power buffer gave us our first useful direction. Maternal Observation isn't on the first floor, she said. It's on the ground floor. The nurse on L&D had neglected that minor detail.

So we went down one more floor, made the left turn out of the elevator, and finally found it halfway down the hall.

By now, we had no idea where in the hospital we were but it was approaching midnight and we didn't care. A very nice nurse set my sweetie up in a curtained-off bed, hooked up the contraction and fetal heart rate monitors, and checked to see how dilated she was. One centimeter, she said. "We'll keep you here a bit. I'll be back to check on you in about an hour."

We watched the contractions on the monitor, gently sloping up and down. From start to finish, they were, my sweetie said, uncomfortable but not painful. Every 3-4 minutes they came, sloping up, peaking, easing down. The only other sounds were the wet, steady whoosh-whoosh of the baby's heart and the murmured goings-on on the other side of the curtain.

My sweetie drifted off to sleep and dozed for nearly an hour. I spent most that time pacing - calmly - and watching ESPN on the wall-mounted flat-screen television. I sat down for a little bit, watching my sweetie's pulse throb gently in her neck, and resisted the urge to kiss her. She deserved to rest.

After some 90 minutes, the nurse reappeared, checked my sweetie's cervix again, and found that it was still 1 centimeter dilated but "very soft." Still, it seemed that baby wouldn't be arriving any time soon.

She gave us our discharge directions - come back if the contractions get stronger, if my sweetie's water breaks, if there's any bleeding or spotting, or if the baby suddenly stops moving - and unhooked my sweetie from the monitor.

Getting out was a lot easier than coming in. It turned out that from the registration desk we had to go left, and then left again. Details, details.

We drove home, disappointed. But we'd at least figured out what was where in the hospital, what we might forget when we leave home, and how we'd react under pressure.

I, for one, would remain calm.