By Janine Kovac
The nurses at the Newborn Intensive Care Unit (NICU) at Alta Bates Hospital in Berkeley knew who I was before I’d even stepped onto the floor. Not because my boys were born at just 25 weeks’ gestation and were the youngest in the NICU. Not because, at 1 pound 12 ounces and 1 pound 9 ounces, my twins were the smallest in the NICU. The nurses in the NICU knew me because of our Aunt Rita.
“Tell your Aunt Rita ‘thank you’ from us,” nurses said to me, over and over as they stopped me in the hall or came by the twins’ hospital room. “What a wonderful person!”
Aunt Rita remembers birthdays and sends thoughtful gifts for no particular reason. She and her husband host a family reunion every summer at their home in the Midwest. I know that she’s wonderful and fabulous but I couldn’t figure out how these Berkeley nurses knew that, too.
For the first month of the twins’ lives, they were in such critical condition, that each boy had a nurse standing at his bed side around the clock. The nurses showed me how to take my sons’ temperature (which had to be done every four hours), change their diapers (which were smaller than an iPhone) and touch them without over-stimulating their tiny
underdeveloped nervous systems (with one hand resting firmly on the top of the head and the other hand firmly on the soles of their feet—no pats, no strokes, no light brushes).
These were the kind of details I posted in our private blog for family and friends. The day the boys were born I’d recounted brief details of the birth. When Aunt Rita saw the post, she sent a huge edible bouquet to the staff at the NICU. There were stems made of carrot and celery sticks and flower blossoms carved out of pineapples.
“Thank you to the doctors and nurses who are taking care of my nephews,” the card read.
“That bouquet was eaten in about twenty minutes,” one of nurses told me. “Even the kale.”
The metaphors for gratitude belong to a family of “moral accounting” metaphors. We say
we have debt of gratitude or that we pay our thanks. We say, “I owe him a thank-you.” Appreciation is earned. (Incidentally, many of the same metaphors are used for forgiveness: “I owe him an apology.”) Moral accounting metaphors are often subconsciously used in bribe and reward reasoning, and ideas about sacrifice, guilt, punishment, and judgment of others. Gratitude researcher Robert Emmons would have said that Rita’s thank-you was freely given (one of the kinds of gratitude that makes us feel the happiest, for both the “thanker” and those who are thanked).
The unexpected thank-you from Aunt Rita set the tone for our relationship with the doctors and nurses of the Alta Bates NICU, a relationship that my husband and I continue to nurture two years later. The card and thank-you gift did the obvious: it thanked the wonderful staff for the work they do. It was a gentle reminder to express my own gratitude regularly, frequently, and before it was owed. Moreover, the card’s message reminded me that my boys were part of a bigger family. My boys were nephews, cousins, grandchildren, Godsons.
But this is what was so enlightening to me: the card and fruit bouquet set into a motion a cascade of freely given thank-yous. The nurses were tickled—and touched—at this obvious display of thanks at the beginning of the boys’ hospital stay. After all, it was so early. So much could still go wrong. Aunt Rita’s thank you was a vote of confidence in their abilities, like a declaration of optimism. The nurses in turn thanked me profusely—unearned thanks on my part, but I was tickled and touched all the same. Even though the bouquet didn’t come from me, I still got the credit.
Matt and I logged so many hours at the twins’ bedside. Sometimes we just stood there, watching them. Other times we changed their diapers or rested our hands on their little bodies. We’d often sit alongside the nurses and ask questions about this medication or that oxygen setting, writing down answers that usually spawned more questions.
But since I’d walked into the NICU preceded by Aunt Rita’s thank-you gift, we always had something to talk about besides preemies and grim statistical outcomes. At first, our conversations with the nurses centered around edible bouquets and kale, but we also talked about weddings, favorite books, home remodels, and recipes for baked chicken. We talked about anniversary surprises for our spouses and birthday presents for favored nieces. And yes, we swapped stories about favorite aunts.