Thursday, September 6, 2012

Consciousness

It was inevitable that my mom, despite a truly heroic effort, would say something wrong in the aftermath of Balthazar's death.

Mom: (struggling to articulate the enormity of my loss)
"It's a tragedy, Elizabeth. After all, he was almost a real baby."

Me: (too shattered for the meaning of her words to fully register)
"He seemed like a real baby to me."

Other than that, no one has suggested that my loss is less than if Balthazar had been born alive and died minutes later, but of course it is different. He did not receive a birth certificate or a death certificate. We got a "Certificate of Remembrance" which I guess is better than nothing, but what are we remembering if he was not born and he didn't die? I listen to the stories of the parents in the grief group whose babies were critically ill for days or weeks and try to decide if what happened to them is worse. I think it must be, but how would I know?

From the experience of my three pregnancies I've come to believe that life doesn't begin at conception, but neither does it wait for that first breath. So when does it happen? It's a politically loaded question and since I am staunchly pro-choice it's something I've tried, I'm ashamed to admit, to avoid thinking too hard about. Now I'm online Googling "ensoulment".  The places your children take you.

So here's what Wikipedia has to say about ensoulment: beliefs about when it occurs vary widely. In the time of Aristotle the male fetus was considered "ensouled" at 40 days, the female at 90 days. Some cultures believed that life begins at the quickening, between fourteen and twenty weeks. A lot of people cite fetal viability as the moment when a fetus becomes a person, but fetal viability keeps moving backward, saving younger and younger babies, as well as varying from pregnancy to pregnancy.  It's possible now, but not guaranteed, that a fetus at twenty-three weeks can be saved.

Then there are the Stoics, who apparently didn't think you became a full-fledged person with a consciousness until you were fourteen years old.

Where does it all leave Balthazar? Was he "almost" a real baby? Was he a "real" baby? We don't seem to have the language for his in-between place.

Sometimes I search the internet for hours trying without success to find something interesting to read. And then there are days like yesterday, when I found this article about consciousness that seems to speak directly to me. Daniel Bor, author of The Ravenous Brain, believes that the neural pathways between the thalamus and the prefrontal cortex, which are necessary to create what we would consider consciousness, are not in place until around 33 weeks gestation. Before that, he says, a fetus is not conscious in the way that we understand it and does not feel pain. He also mentions in the essay that a fetus in the womb is sedated by chemicals produced by the placenta.

So when Balthazar died, according to Daniel Bor, anyway, he had a consciousness, but he was sedated. That's less painful to imagine than a lot of scenarios. Plenty of people go out that way these days. 

I'm not a neuroscientist so I can't evaluate the science behind the 33 week claim, but it makes intuitive sense to me. It certainly feels right that at 37 weeks and 5 days Balthazar was a person with a consciousness. Right, but horrible, because then he was not a "almost a real baby" but a person who died. But I think that's true.

Or maybe I'm just trying to find evidence of Balthazar's, for lack of a better word, personhood. Maybe it's confirmation bias, me looking for something to prove what I believe in my heart. Maybe I'm just jostling for position on the hierarchy of grief, leaving the parents who lost a child at 32 weeks on the other side of the divide. Will their grief be less because some scientist tells them their fetus was pre-consciousness?

Daniel Bor's research into consciousness has also made him a vegetarian. I'm not ready to follow him there just yet. 


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