I am watching the neon pink heartbeat line race up and down in a perfunctory pattern, the steady beeping of machines providing an irking—and somewhat urgent—backdrop to the screen. I am suddenly reminded of the beautiful sermon I heard delivered by my talented and incredibly wise father-in-law.

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"The beat of a heart," he had said—in his powerful, commanding voice that takes over an entire room of 300-plus congregants—"is constantly moving. I wonder at the notion of a younger, more innocent me in an up-and-down motion. In fact, if the activity monitor shows a flat line, that’s a sure sign that deep trouble is brewing. The pulse of life is exactly what life is; those screens are depicting life as it should be!" He paused to let the message sink in. "Life is over when there is a flat line. If we have nowhere to go, no challenges to bring us up, no hills to surmount, no lows to combat the highs, then what is life?"

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It’s several weeks since that moving speech, and only now do I have time to internalize it. As I sit beside Layla’s bed, waiting for her to wake up from her general anesthetic, there is a hollow feeling of déja vu, one that I haven’t felt in a while. It’s a combination of waking up at 5 a.m., the drive in the dark to the hospital and checking in at the surgical ward. The bracelets snapped around our wrists, the little hospital gown Layla needs to change into, the gathering momentum of the staff as more patients stream in, and the pre-op room fills up with noise and activity. In some ways, it’s all too similar to the surgeries we went through in Boston, now more than five years ago.

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But at the same time, it is entirely different. Layla is a person—a child who is fully aware of what is happening, expressed nervousness for the event, and was sleepy and confused when she was woken up at 5:15. She is old enough to have conversations with the staff, which she does in her typical social and curious manner, interacting with them and trying to process all that is happening around her.

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And as they wheel her off to do the procedure on her middle finger, one of the three affected by ABS, Amniotic Band Syndrome, I am brought back to that pre-op room in Boston where I handed my baby over to an anesthesiologist and watched with a pounding heart as she was whisked away. This procedure today is so much shorter and less invasive than the cleft-palate surgeries she went through as an infant, but the buildup is so similar, it has unnerved me.

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I realize then that there is still some anger (or is it frustration or disappointment) that lingers within me from Layla’s birth. Looking back, I wonder at the notion of a younger, more innocent me—a first-time mother—being handed a baby with a face split between the nose and the mouth and a little, tiny hand with three fingers missing two-thirds of their joints. I remember some of the shock and confusion. I remember trying to navigate those first few weeks.

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I remember, too, speaking to a couple of mothers we were put in touch with—mothers who had birthed children with similar defects—and one conversation still stands out vividly in my mind. Instead of what I thought would be a calming, reassuring conversation, the woman confessed to me that her child born with a cleft was still her “hardest child” five years down the line. She mentioned challenging behaviors he had and although the cleft journey was difficult, the child himself was “not easy.”

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I was annoyed with this piece of information. I wasn’t interested in hearing more negativity associated with my already challenging situation. I also didn’t see how my daughter would be “difficult.” She happened to have a very sweet, positive, excitable nature, and I felt like she was so easy to please, so curious about life and so sociable and interactive.

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The words from that conversation have always lingered at the back of my mind. As Layla grew older, the energetic and excitable personality has turned into a feisty little girl with strong leadership skills and fierce opinions. Her curiosity turned into out-of-the-box thinking and a knack for intelligent questions and deep thoughts. Her love for adventure and fun, coupled with her strong creative streak, means she gets easily distracted in a place like school, and she’d much rather be doing something creative and artistic than sitting at a desk and doing what her teacher tells her to do. And that hasn’t always been easy.

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But as I sit here today, and watch the rise and fall of the heartbeat activity monitor in front of me, and watch Layla’s chest rise and fall along with it, I realize the wisdom of my father-in-law’s words.

This is life.

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This is the ups and downs of the path we all are sent on.One conversation still stands out vividly in my mind The hardships are a must; they mean that we are pushing ourselves, working on ourselves, appreciating the highs when they come after the lows.

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This is the meaning of a healthy heartbeat. The steady pulse on the screen before me. This is my daughter whose amazing energy and constant positive, optimistic character had her smiling from ear to ear in her pre-op bed, not fazed by what was coming and even if she was just a little, refusing to let it get her down.

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This, I want to tell that mother I spoke to six-and-a-half years ago, is still a challenge and maybe always will be, but within that challenge, I see G‑d creating the cure before the “strike.” That vivacious, strong personality that may hold her back in some ways was tailor-made for her and the journey she was planned for. Her strength of character, her extroverted personality, her leadership skills, her creativity, her spunk and her excitement for life means that she will fight for whatever it is she believes in, and she will always get to the places she sets her eyes upon.

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Today was a day of highs and lows. Because that’s life, isn’t it? We celebrate the highs and bow our heads to the lows, and we pray that the lows don’t go lower than what we can handle. Then we look back in hindsight, and we realize that G‑d equipped us with the tools to deal with all those ups and downs. And we thank Him.

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