Nurses rolled the babies past Jay in pod-like incubators, ventilator tubes taped to their mouths. He touched the plastic, shaken by how tiny they were. The neonatologist told him the odds of survival at that age were not high; babies that made it were often afflicted with lifelong handicaps such as cerebral palsy. Then again, preemies like this sometimes left their unit after three months with virtually no problems.
Sometime that afternoon, the hospital learned through consultations with Sissy's obstetrician that she was carrying the babies for her brother and his partner. The neonatal intensive care unit (NICU) at Arlington Memorial had never had a pair of gay men as parents. It didn't sit right with some of the staff, and there were whispers in the corridors and at the nurses' station.
"A few people thought it was very, very awkward and were a little grossed out," said Dr. Scott C. Tisdell, a neonatologist whose own gay brother happened to be adopting a child.
The staff was careful, however, not to show any disapproval. And even before Surmay's documents were signed, the hospital treated Chad and David as the rightful parents. When Chad arrived that evening, they snipped the ID bracelet off Jay's wrist and gave it to him.
As they entered the NICU, Jay warned Chad that his first look at his children might be unsettling. Breathing and feeding tubes snaked into their mouths, and lines ran into their hands and umbilical stents. Monitors were taped to their torsos and feet. White cloth patches shielded their eyes from phototherapy lights. Yellow plastic discs protected their ears from noise that could cause their blood pressure to spike.
All Chad could do was smile. His daughter had an adorable ski-slope nose. His son was wiggling his arm. They both had long blond eyelashes, and rounded chins like David.
A nurse told him he could touch them, but not to stroke or rub. For the moment, his sadness and fear were washed away by the instant connection he felt to his children.
David felt the same sensation when he arrived a few hours later. The babies had stabilized, and their color looked better than he expected. He couldn't believe how immediately his emotions were captured by these two tiny beings.
"Oh, my God, I'm a parent," he thought. "It's no longer theoretical."
"Just live," he begged the babies. When you get older, he told them, "you can throw up in my car all you want to. Just live."
Over the next 24 hours, the doctors prepared everyone for the worst. Statistically, nearly half of all babies born before 28 weeks of gestation do not make it. At 24 weeks and four days, the cusp of viability, the twins could be expected to careen from one life-threatening crisis to the next. Conditions could change in a snap, so a good night did not necessarily mean that a good morning would follow.
Because the babies' blood vessels were so thin, the risk of brain hemorrhage was high. Any stimulation to their systems — a change in temperature, say, or even a bout of crying — could cause massive bleeding.
Gastrointestinal problems also were common because their organs were not yet fully functional. Asher's blood-sugar measurements were high, and he was being treated with insulin. The nurses would try to keep the babies sedated and still, hoping they would gain weight.
If they could get through the first 72 hours, the odds would improve. The good news was that this NICU didn't lose many babies, maybe two or three a year.
Sissy's obstetrician spoke to Chad on Saturday morning and said he was baffled. Though twin pregnancies were risky, everything had looked perfect. Infection could cause this kind of rapid labor, but there were no signs of it. He could remember one case like this in 16 years. They would probably never know what happened, he said.
It didn't take long for the hospital staff to conclude that Chad and David were more devoted than many parents who passed through the unit.
They slept in Sissy's room — one in a chair, one on the floor — and kept vigil in the NICU late at night. Chad asked so many questions the staff eventually supplied him with medical texts. They were loving to each other and comforting to Sissy, even under stressful circumstances that drove many couples apart. Both of their mothers had flown in to provide family support.