Manhattan, July 23, 1972.

Diesel exhaust wafted in through a window. I closed it and looked down sixteen stories to six buses with engines running all parked in front of the Dick Cavett Studio across from our apartment building. I felt claustrophobic not having a window open, but the exhaust was too much.

Felice and I were living at 200 Central Park South at the corner of 7th Avenue. Our neighbors were luminaries like Muhammed Ali and Florence Henderson. They had huge apartments with fabulous views of the park. At twenty-five I was doing very well, but not quite that well. We had a small studio at the back of the building with a not so fabulous view of 58th Street.

Most of our furniture was from my bachelor days: a fifty gallon acrylic fish tank; an imported rosewood wall system with matching coffee table, night stands, headboard, and dressers. The newest addition to our furnishings was a small satin-white Danish-modern crib with bright pink and black floral designs on each end. Felice was eight and a half months pregnant.

She had let her hair grow ever since we were married two years before. It reached to the small of her back. I loved the way it hung. She was positively radiant. Her breasts had grown full. They looked wonderful, but as they filled out they also became tender. It had been look but don’t touch for months.

July in Manhattan was stifling hot and muggy. Exhaust from buses and trucks back then made current Manhattan seem as fresh as virgin meadow. Rush hour you could barely see two blocks down 7th Avenue.

Both of us were eager for the big event. We were lying in bed and Felice said, “Here comes another one.”

I felt a raised ridge running down the middle of her belly. It was so hard and tight it was like touching an over-inflated balloon that might pop any second. She’d been having contractions on and off for the last few hours. Her contractions continued through the night. I dropped in and out of sleep. She called her doctor in the morning. He asked her to wait until 1:00pm when his office hours started.

I brought Felice to the doctor’s office on 28th Street by cab. She was the first patient in. The doctor took a quick peek and said, “It’s time. I have a few more patients to see right now. Then we get you off to the hospital. I’d better come with you in the cab.”

Better come with us in the cab? Not what I wanted to hear.

The driver was hesitant to let Felice in the cab, but the doctor assured him everything would be okay. We left for the twenty-five block ride to the hospital.

We made our way up 8th Avenue to 53rd Street in heavy traffic. 53rd was completely jammed. After five minutes without moving, our doctor said we’d better walk the last bit because we were running out of time.

The doctor told us he’d walk ahead to get ready. Felice was fully dilated and ready to deliver and we were walking a city block, a tenth of a mile, to the hospital. Every thirty seconds or so we had to stop so Felice could bend over and manage another contraction. She took all this in stride. I was getting very nervous – VERY nervous.

After what seemed like a three-day hike, we got to the hospital. I took Felice up to Maternity. She sat in a wheelchair and I was sent back downstairs to Admitting for paperwork.

I was told to take a seat. I said, “My wife’s having a baby upstairs and it’d be really nice not to miss it.” No one cared. They had babies all the time. There were forms to be filled out and they told me they’d get to me as soon as they could. The form-meister resumed telling her associate about her trip to Bermuda.

At last I was done. I ran out of Admitting and took the elevator back to Maternity. A nurse gave me a gown and mask. I changed and entered the delivery room.

The lighting was harsh. The room smelled of ether and other nightmares from my own childhood. Felice lay on a delivery table with her knees up. She was pant-breathing like she was trained to do in Lamaze class.

The doctor said don’t push. Pant, pant, pant. The doctor said push. Pant, pant, pant. Felice drew on some inner strength. I was there with the breathing and touch, but in the end this was really something she was doing on her own. I had no contractions, I had no kicking in my belly. I had no sensation of being split apart. I was a passenger on this ride.

She withdrew into herself and sought no external support – didn’t cry out, didn’t whimper or moan. She made no sign at all of looking for someone else to ease her burden. I was amazed at her strength. If I were on that table I’d be screaming my head off. She was the definition of stoic.

A few minutes later, five-pound seven-ounce Joseph popped into the doctor’s hands. The doctor said, “We have a little problem here.” I looked at my son as he drew his first breath and saw that his upper lip and lower nose were missing.

My priority was Felice. There was blood and fluid everywhere. She was exhausted. She was delivering the afterbirth. Instead of handing Joseph to her, the doctor brought him to a cleaning station and put him in a plastic bin.

“Is the baby okay?” Felice asked.

“We have a little problem. He’s a boy, a bit light weight for nearly full term. I give him an APGAR of six out of ten. It looks like he has a bilateral cleft lip and,” the doctor looked inside Joseph’s wide open mouth with a flashlight, “a bilateral cleft palate. I know it doesn’t look so good, but these days we can fix this kind of thing right up. I’ll have our resident plastic surgeon stop by to take a look.”

“Can I see him?” I asked.

“Oh, sure. Nurse, hold him up,” the doctor said.

I was no expert, but it seemed to me that newborns belonged on their mother’s chests. Joseph was in Tupperware on the other side of the room. I held Felice’s hand pretending that everything was as it should be. “You made a baby! Good job.”

Felice was transferred to the recovery room. I got back into my street clothes and made my way to a pay phone.

I called my mother and told her the good news. She was very excited. This was her first grandchild. “Is everyone okay?”

I said, “Everyone’s doing fine. He’s a boy and his name is Joseph, after his grandfather.” My mother sighed.

“Joseph does have a cleft palate,” I added as casually as I could. I heard the phone drop and an anguished scream. My sister came on the line. “What’s wrong?”

“It’s nothing. Don’t worry. Everything’s okay. Put Mom back on.”

I tried to be stern with my mother. I told her, “I’m not upset, so you shouldn’t be either. The doctor says they can fix this right up these days.” I acted unconcerned.

“Then it’s not so bad?” she asked.

“It’ll be fine – don’t worry.”

I was talking to a woman who knew a good deal about the doctors and operations and recovery periods and agony that lay ahead of us. My mother gave birth to a cleft palate child of her own – me.

The feeling of detachment I had during the delivery had intensified into real shock. I was confused. I thought about the surgeries and everything else ahead of us as though Felice had just given birth to me and I was the one who would be operated on. Someone had pressed a reset button and I was going to go through the procedures and hospital stays, the braces and speech therapy and teasing and bullying and isolation all over again.

Early next morning I woke up and headed back to the hospital. Felice was sitting up in bed with a breakfast tray. She looked withdrawn.

“How’re you doing?” I asked.

“It feels like the baby died. They won’t even let me see him,” she said with hopelessness in her voice.

I went to the nurses’ station and told them what Felice just said. “You have to let her have her baby.”

It was as though Joseph had slipped through the cracks. I couldn’t believe it hadn’t occurred to anyone that Felice needed to hold her own baby.

I went back to her room. The nurse brought Joseph in. Felice held him and cuddled him. I stroked them both.

His fingers were so tiny. He didn’t look real. How could a human being start out that small? I was amazed all over again that Felice made something this complicated without even using her hands. What a talented belly.

Felice told me we had an appointment with the hospital’s resident plastic surgeon in the afternoon. She recited a list of things I had to buy so we could take Joseph home: diapers, pins, formula, bottles, nipples, sterilizer. We had planned on a shopping trip in a couple of weeks – but Joseph showed up early.

On the street it occurred to me I had no idea where to buy any of this stuff. I had never bought diapers or formula. I had never been with anyone while they bought diapers. I was on foot in Manhattan. We had no relatives in the city. None of our friends had children. I was on my own in a very big city with an urgent mission.

I went to a small convenience store near our apartment and asked an elderly Hispanic woman at the cash register where I could get baby equipment. She pointed to a display of condoms. I said I needed formula and diapers. She directed me to a store a few blocks away. I thanked her for the clue. If this new place didn’t work out I’d ask there. I’d just keep asking random people until I found a place. It was a plan.

The convenience store lady sent me to the right place. The store had six kinds of everything on Felice’s list. Bottles, nipples, sterilizer, formula. How to choose? Enfamil or Similac, Similac or Enfamil? I stared at the labels. Hopeless. I chose Similac because it was twenty cents a can more expensive. More expensive must be better, right? I had no idea what I was doing and I knew it.

At 2:00 I returned to the hospital for the meeting with the resident plastic surgeon. He looked as if he was in his late twenties. He explained that Joseph had a bilateral cleft palate and lip. I said, “I have a cleft palate and lip. What does ‘bilateral’ mean?”

“On both sides,” he answered. “I’ve never seen a bilateral cleft before, but I think surgery may be required soon. I’ve not worked with cleft palate children at all, but if you’d like, I’d be happy to take Joseph on as my first patient.”

Felice and I were overwhelmed by the complexity and pace of everything. We had critical decisions to make and no basis for making them. I could barely think at all, but this felt really wrong to me. My own childhood surgeries told me that doctors spent years training with experienced specialists to learn the intricate ins and outs of cleft palate treatment. This guy hadn’t worked with cleft palate kids at all – hadn’t even seen a bilateral cleft. He was offering to take Joseph on? This had to be terribly wrong.

I was so confused it didn’t occur to me to get angry at his suggestion. “Thank you very much – we’ll think about it and get back to you.” Later on I wished I had thrown a chair at the bastard.

Before going back to our apartment I stopped in at work. I’d been a missing person for the last two days. It never even occurred to me to call.

I saw Claire, an administrative assistant in her early thirties. She lived by herself in an apartment on the upper East Side. She was meticulous about her appearance. Her hair was always coiffed perfectly, she liked expensive clothes, and had the subtle underdeveloped upper lip that many of us with cleft lips shared. Unlike mine, her scar was barely visible.

Claire looked surprised to see me. “Where have you been? We’ve been looking for you.”

“Felice gave birth yesterday. He’s a boy.” I tried to sound the way a new father should. Instead, my voice was wobbly.

She stared at me and said, “Something’s wrong.”

I was a grown man standing in the middle of a busy office talking to a woman I barely knew. Tears came streaming down my face. “He has a bilateral cleft palate. I have to find a doctor. I don’t know anyone. I don’t know what to do.”

Claire looked at me for a second before what I’d said registered. She took an involuntary breath, like I’d knocked her off balance, and then reached for a pad and pen at the same time she started talking. “I know just who you need to see. His name is Dr. Hogan. He did some work on me. He’s head of the Cleft Palate Clinic at New York University Hospital. He also has the most exclusive cosmetic surgery practice on Park Avenue. I’ll tell him you need to see him. He’s worked with hundreds of kids. He’s the best there is, really.”

I took the note. “We’ll call him first thing tomorrow. Thank you.”

Later that evening I returned to the hospital and told Felice about Claire and Dr. Hogan. She’d been asking doctors at the hospital about where to go and also found out about the NYU Cleft Palate Clinic.

I was with Felice the next morning when a man in a white jacket walked into the room. “I’m Dr. Hogan. Are you Felice?”

Felice and I were both surprised to see him. We’d made no appointment. We didn’t know he was coming.

“I’ve seen Joseph.” There was something reassuring about him. He got right down to business. “He has an extensive bilateral cleft of the palate and lip. It’s as severe as any I’ve seen and I’ve been doing this for thirty years. He’s going to need a series of procedures. First we’ll close up his lip. I know the center section seems to protrude pretty far out now, but we don’t want to remove any tissue or bone because he’s going to need it later as he grows. We’ll operate when he reaches ten pounds. That should be in about a month.”

I felt gratitude welling up inside me. This man knew what he was talking about. He knew what came next. We were no longer in this alone.

“Next we’ll construct a new palate for him by slicing the tissue in his mouth and doubling its size. He doesn’t have much to work with, but I think we can do it. He’ll eventually need some bone grafts to stabilize the center section of his upper jaw. We usually take bone from the hip and pack it around the upper jaw. He belongs in the clinic program. We have specialists who deal with kids like Joseph every day. We’ll take care of his mouth, nose, hearing, speech, teeth, and anything else that crops up. Why don’t you think about it and give me a call if you want me to proceed.”

I looked at Felice. She nodded. I said, “We want you to proceed. Felice has heard good things about the NYU Clinic and Claire thinks you walk on water. What’s next?”

“Take Joseph home. You’re going to need a Breck feeder. You’ll be feeding him every couple of hours around the clock. The nurses will show you how. Check in with his pediatrician regularly. Give me a call as soon as he weighs ten pounds and we’ll schedule the first procedure.”

Dr. Hogan left. I felt a huge relief. I needed a plan – I needed to follow someone’s advice. I believed that Dr. Hogan truly was the best there was. I trusted him completely.

Felice said something amazing. “If Joseph had to have this problem, it’s a good thing he got us as parents.”

Her words came back to me all night long. I drifted in and out of sleep. At about 6:00am her words rang in my head one more time. I suddenly realized I was Joseph’s father – not Joseph himself. Yes, we had a lot to go through. But I would be there to help, to support, to calm fears, to get the best care possible. I wouldn’t be the one having the surgery, helpless, vulnerable, unable to influence the events around me.

For the last three days I’d believed I was Joseph – seeing everything through his eyes, dreading the smells and needle pricks and burning and stinging of endless surgeries. I was Joseph – and I was overwhelmed.

I dressed and felt an indescribable closeness to my new son, an overpowering need to be there for him. I needed him as much as he needed me. He gave me purpose and direction. I knew why I was here. I was Joseph’s Dad.