The fact is that many many Americans still depend on employer-sponsored health insurance, and in some ways, Obamacare has given people more options in terms of these exchanges, but it’s also increased incentives for employers to offer health benefits. For the near future, most are likely to continue doing so. At the same time, as everyone knows, healthcare costs have increased exponentially over the past few decades, just as most companies have become relentlessly focused on cutting labor costs and returning wealth to shareholders and executives. That gives CEOs like Tim Armstrong direct incentives to monitor employees’ personal health. Sometimes, there might be ostensibly legitimate reasons for doing so, such as containing overall costs, but the truth is, in the huge majority of cases, employers have no legitimate business in knowing any individual medical records or expenditures.
There’s no point in offering health benefits if you’re going to point fingers when people actually need to use them. This mentality that it’s somehow the victim’s fault is not only unfair, but it’s completely illogical. To say that anyone can control whether or not they have a premature baby, the fact is that the fundamental purpose of health insurance is covering events that are unpredictable for any individual but completely predictable in the aggregate. If you run a company of 5,000 employees as Tim Armstrong does, you can pretty much bet that, in any given year, someone might have an extremely premature baby. And if you’re running the company in the hopes that that won’t happen, that’s not a very prudent way to safeguard the company’s bottom line.
One motif or omen, as you put it, in the book is your mentioning that, the day you suffered the medical event that led to the premature birth, you wrote about your protagonist suffering a miscarriage. The fiction seemed to inform your reality, to some extent. On the flip side, how will this entire experience shape your future writing?
Even after my daughter came home, and even after her recovery was looking to be miraculous — as much as I hated that word when I first heard it related to my daughter’s birth — I still was haunted by the fear that, at any moment, I could lose her all over again. Just that sense that, one moment, everything was perfect, and the next moment, complete catastrophe with no warning — it’s hard to let go of that fear. Maybe it sounds silly, but I completely thought that I would never be able to go back to the novel that I was writing, because if I was going to write about anything bad happening to the baby in the book, I thought: “How can I know something terrible won’t happen to my daughter in real life?” It wasn’t just my writing. There were a million things I was superstitious about, like the way we used to gloat about how exuberant and full of life our son was. I was always afraid to celebrate anything out loud again because, at any moment, it could all be taken away from you.
But I really feel like my daughter taught me to be fearless in a way. She had no choice but to fight for every breath. She had no idea the odds that were against her, the fear about her future, the fact that, for a lot of the earliest part of her life — and it’s painful to admit — I was afraid to become attached to her because I thought at any moment I might lose her. She really showed me how to live in each moment knowing that you might not get the next one. I think I’ve been able to bring that back to my writing. For me, writing has always been a way to confront the dark mysterious areas of life that you don’t want to experience, but I think that your fiction comes alive when you plunge further into the depths that you’d otherwise like to go. Until my daughter was born, I don’t think I knew just how dark life could get, and how wide the unknown really is.
But I think it’s also taught me so much about love and uncertainty and the inherent fragility of life, and I hope to bring all that into my daily life as a mother and to let go of some of the worries that I think are endemic in modern parenthood: all the focus on the milestones and the benchmarks. Is your kid going to speak perfect Mandarin, or eat like a French kid, or get SAT scores like the Chinese kids are supposed to do? Everyday, I do a gut check. At the end of the day, I remind myself: Are we all safe and sound? Are we all together? I need that reminder just like everyone else. If that’s the case, then things are okay.
Also, there’s something transcendent about the love I think I learned from my daughter. Each moment I hold her, it’s enough, and it has to be its own reward. To this day, when she says things like, “Mom, I see the moon!”, that stills my heart. In writing, you have to go to the darkest places in order to have those moments of transcendence.
You discussed earlier that the book helps you tell the origin story for your daughter. But there are parts of the book that expose some very dark and honest emotions that surround the birth of your daughter. I’m sure there will be a time when your daughter will want to read the book, and some of those passages may not be pleasant to read. How do you hope to frame the story to her? Do you see any challenges in talking to her about the book, and if so, how will you overcome them?
There were many, many moments in the writing — especially when I had to leave her with my husband or a babysitter to go and write the book — that I did feel like I was betraying the deepest darkest secrets between her and me in order to capture the reality that we live through. For me, there was no point in telling her story unless I was going to tell the full truth. I think there are so many platitudes surrounding the talk about premature babies or the way we like to simplify the messy process of bringing new life into the world, in terms of these charts and checklists and images of the perfect baby. For me, what was most beautiful and important about her story was the fact that her journey, in some ways, defied every cliché that you could possibly ascribe to it. But it also confirmed, in some ways, everything that we might want from a feel-good, inspirational story.
I think that ultimately, this question of “How much is a human life ultimately worth?” is a terrifying way to assess someone’s existence. But because of how she was born, that was the question hanging over her from the start. I think that, ultimately, she will understand that every challenge that she faced was part of her journey. I’m the kind of person that hates the word “miracle.” The last thing that I expected was for her story to be this kind of a happy ending, and yet I can’t take that away from her. She earned that label, and I have to give it to her. Right now, she’s two and a half, and she’s just proud of herself for everything that she does on any given day. She’s so proud when she throws a terrible tantrum. She’s proud for stealing a toy or cookie from her big brother. When she saw the cover of the book for the first time, she said, “Hey, that’s me!” She was thrilled! I want her to know everything she overcame to be who she is today.
At the same time, I want to recognize, yes, in many ways, she’s a miracle. People who see her now will have no idea of her history. It took me a long time to let go of the worries about the kind of life she might live or what she might accomplish. I don’t mean in terms of test scores or school admissions. I mean in terms of whether she’d be able to crawl, whether she’d be able to walk, whether she’d be able to feed herself one day. She has sailed through any test like any other two-year-old. But the journey hasn’t been easy for her. Everything that I think ordinary kids can take for granted has been harder for her to reach. But if she didn’t seem so apparently unscathed, I don’t think the value of her life would be any less.
Naguib smiled. “I don’t think so.” Naguib spoke slowly, running his hands through his brilliantine curls, still thinking about it. “I had the experience of responsibility on Tahrir. I was organizing medicine, food, tents—everything. And if I was elected from my part of the city, where there is a big section of slum, it means a high proportion of the people I would be responsible for would be living below the poverty line. How could I sleep at night? That’s way too much responsibility. Whoa.” He put out his hands to rein in an imaginary horse.
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