I’m an economist by profession. In economics we have terms for three different “best” points in a function: maximum, optimum, and “satisficed.”
Maximizing
Maximizing is kind of self-evident. It’s when we work on something until we reach the highest possible level of achievement.
Optimizing
Optimizing is when we reach the level of achievement that makes the most sense given the other things that we’re also working on optimizing at the same time. We stop working on one task when our time could be spent more valuably on a different task. Here’s an example. When we put ten more minutes into polishing a bathroom to perfection, it might mean we have to give up doing a quick pick-up in the living room. Our overall happiness and sense of peace might be greater if we left the bathroom at a level just below perfection. Then we could spend ten minutes on the front room instead of insisting that the bathroom be perfect. That’s the idea anyway.
Satisficing
Satisficing is similar to optimizing. It’s when someone works on improving something until it’s good enough to satisfy them rather than pushing on until it’s maximized. An example is when a small business owner puts in enough work effort to make enough money to just cover her needs. She can satisfice rather than trying to maximize her profits (which might mean giving up treasured family time). We can apply the same principle to any task or project. It’s parallel to the concept of “enough” as a guiding principle.
Decluttering
We can apply optimization to decluttering. It means stopping at the point in each room or category where switching our energy to a different category or room will lead to greater happiness. After a while, effort spent on one category or room reaches a point of diminishing returns. When the same level of effort would generate more happiness if applied to a different task, that’s when it’s time for us to switch.
When I was growing up, my family backpacked together. My first official backpacking trip was in the mountains north of Boise, Idaho, when I was four years old. I carried a can of peaches in a little drab green knapsack (and nothing else) and was pretty proud of that. We spent the night in a big sleeping bag with my whole family, the kids squished between my parents. My memory is of two rectangular car camping bags zipped together, taking up the entire floor of our pup tent.
We didn’t do much family backpacking for quite a few years after that first trip, but when I was a teenager we started up again. Over the next decade, one combination or another of my five immediate family members backpacked into one basin after another in the Uinta mountains in Utah and in the Wind Rivers in Wyoming. We logged hundreds of miles on trails in the two mountain ranges combined. It was a routine summer/fall activity for us. We trained in advance for our trips, hiking many miles to get in shape (sometimes carrying backpacks with jugs of water or encyclopedia volumes in them).
Mom planned out our menus and made fresh beef jerky and baked “Logan” bread and dried fruit in a dehydrator and so on. It was a huge undertaking. Then she methodically organized our meals and snacks in carefully-marked plastic bags. Dad had each of us weigh ourselves, then he distributed the gear and food packages among our packs, reweighing from time to time, trying to keep our starting loads at or below the recommended physical limits for our respective body weights.
Our backpacking trips lasted anything from a few days to as long as a week or two. For our longest trips, we cached food ahead of time at midpoints on our planned routes.
Uintas Highline Trail
In my young adult years, after my two older siblings had moved away, my parents and I still backpacked together. Twice, the three of us (and our Old English sheepdog, Chaucer) backpacked the Uintas Highline trail in Utah from one end of the mountain range to the other; once from east to west (a route covering 85 miles) and once from west to east (a 100-mile trip). We did the east-to-west trip just before I left to serve an 18-month church service mission in South Korea. (2 months of language training in Utah, 16 months of missionary work in Seoul.) The west-to-east trip was just after my return to Utah.
Fairly early in the east-to-west trip, my parents and I spent a morning climbing up a valley to a broad ridgeline west of Chepeta Reservoir. As we climbed to the northwest, the forest thinned out until only scattered small scrubby trees remained. Then there were no trees at all. We couldn’t see much ahead of us other than the higher ridgeline and a few clouds. Along the trail here and there we passed surprisingly large rock cairns, some as tall as me or taller. I wondered whether they had been built by sheepherders. The morning weather was a bit sketchy. Shredded white, misty clouds rose up around us and blew past. It was foggy in places.
As we reached a point at the top of the climb where the highline trail turned slightly southwest, we could see to the north of the mountain range for the first time that day. The view was unsettling. Big cumulonimbus clouds were billowing up from floor of the basin to the north of us. As we hiked westward, the clouds rapidly built into a dark, threatening storm that soon rose above the mountains. It was headed our way.
Trouble
In the High Uintas, there are some basic rules for summer travel: Get up early, get packed, and get going. Storms are going to hit—and they’ll often hit hard with little warning—at any time from noon-ish on. Lightning is the biggest danger, but hail, high winds, and driving rain are typical hazards as well. The daily storms can sometimes be avoided by getting over a pass, or by hitting a summit and then getting back down, early in the day. But there are times when circumstances make high altitude travel during storm hours unavoidable. This was one of those times.
It became apparent that the storm was going to reach us soon. The specific place where we were on the Uintas ridge is a kind of wide plateau where the elevation is about 12,000 feet for a mile or more in any direction. There was nowhere safe to go to in the time we had left.
The three of us decided that we would have to hunker down and ride out the storm up there on the ridge. We took off our backpacks, removing a rolled-up foam sleeping pad and a plastic tarp. We put on our rain gear then leaned the metal-framed backpacks against each other. Then we covered them with black garbage bags that we used as pack covers, tucking in the bottoms of the garbage bags to hopefully keep water out.
Lightning
After we had covered the packs, we moved a ways away from them to get away from the metal. We spread the sleeping pad on the ground and squatted on it in a row, facing north, shoulder to shoulder, and covered up with the tarp just as the storm hit. The wind, rain, and hail blasted us. We hung onto the tarp and to the dog, doing our best to keep as dry as possible while minimizing our contact with the ground. Lightning was popping all around us. I could feel my hair standing up and thought for sure we’d be hit at any second.
The noise was deafening. Over and over blinding lightning flashed around us and the sound of close-up lightning—like a bedsheet being ripped—was followed instantly by the rifle- then crushing cannon-shot KA BOOOM of thunder right on top of us. Hail was pounding and the wind and rain and the storm on the tarp were all so loud, we couldn’t hear each other even when yelling at the tops of our voices even though we were physically touching each other.
I was certain we were going to die. “If lightning hits one of us,” I thought, “it’s going to take out all of us.”
Then an odd thing happened. I thought, “This couldn’t possibly be any worse,” followed immediately by the thought that it would be worse if, in addition to the storm, a sniper were shooting at us right at that moment. A sniper would have definitely made things worse for us in the middle of the storm. And that thought—for some bizarre reason—was comforting to me. I suddenly felt relieved.
(A Word of Apology
Now, in no way at all do I mean to trivialize the complicated trauma associated with actual sniper shootings. I can’t imagine the horror of being a part of, living through, or dying in a sniper shooting, whether in war or otherwise. This was a time well before the U.S. had experienced the shootings that have occurred in recent years. I thought about changing my story to get rid of the sniper part. The idea of a sniper making things worse was central to my experience and my story, however, so I decided to be true to that. I apologize if this re-traumatizes anyone in any way.)
Survival
After what seemed like a very long time, the storm blew over. We stood up in a bit of a daze, shook the water off of the tarp and the sleeping pad. Then we repacked and gathered ourselves enough to get our backpacks back on and continue on our way westward. We had been incredibly fortunate.
*
Late last Monday afternoon, I got into our car and drove away from a medical office building in Bountiful, Utah, lost in a haze of thoughts. For years we’ve struggled with our triplets’ behavior and have sought out many professional opinions and educational support for them. We’ve been in and out of multiple school and medical and psychology offices, trying various types of therapy, counseling, and treatments, looking for answers and trying to find ways to help our kids and ourselves.
After several years of this and having made minimal progress, we were recently able to finally get all three into in-depth neuropsychological testing to find out what their individual specific issues are. Last week, I met for an hour with the triplets’ neuropsychologist and one of her interns to get the results from Miss A’s four hours of testing. During the meeting, as we went over test result after test result, Dr. C (who is great, by the way) explained to me that little Miss A has deeply challenging learning disabilities. Her test results indicate that she has ADHD, an anxiety disorder, a social disorder, and multiple cognitive challenges.
Autism
I also learned that my sweet boy B has been diagnosed as being on the autism spectrum. This came as no real surprise, given B’s behavior over the past four years or so. Still, it put me back on my heels a bit, so to speak. (Today, Ryan and I learned that C, too, has been diagnosed with autism. B and C are identical twins, so it isn’t surprising that their test results are similar. Both boys tested as having cognitive disabilities and attention deficit issues as well.) Two past screenings had missed it, but it seemed obvious to me that B was autistic. Even with that, the official diagnosis is a lot to absorb.
Dr. C said to me, “[A] has a complex set of things she’s dealing with, and she’s the least complicated of your three. You have three one-in-one-hundred kids.”
As I drove home that day last week, thinking through everything Dr. C and her intern had discussed with me, I found myself slipping into an increasingly negative state of mind. “How are we going to get through this? What’s going to happen to my kids? How will this ever be okay?” And then the thought came to me, “At least there isn’t a sniper shooting at us,” and I knew it was going to be okay. The storm will blow over, we’ll get up, we’ll get ourselves pulled together, and we’ll get going again. And it will be okay.
I was pregnant with triplets, it was the afternoon of January 25th, 2012, and at 28 weeks and five days into the pregnancy, a routine solo pregnancy checkup had turned into an emergency.
But let’s back up a bit. Earlier that day I had come in for a normal (normal, at least, for a high-risk triplet pregnancy) maternity appointment at the office of our MFM (maternal-fetal medicine specialist), Dr. Michael Draper. His office was at University Hospital on the east side of the Salt Lake Valley, sandwiched between the Huntsman Cancer Center, up against the Wasatch foothills, and Primary Children’s Hospital just above the University of Utah in Salt Lake City.
Photo credit: University of Utah
Each of my check-ups started with an ultrasound exam. The ultrasound tech had put jelly on my tummy, scooted the transducer around a bit to get things going, and had just barely started taking a look at Ryan’s and my unborn babies when she quickly stood up, wiped off the transducer, excused herself, and went out to get an MD.
She returned with one of the doctors in the practice who took her own look. I don’t recall her name. After just a couple of seconds of looking, she told me that our Baby A—the tiniest and most vulnerable of our unborn triplets—was in trouble. Her amniotic fluid was all gone, and she was getting smashed by babies B and C who sat above her in my uterus. She was having heart decelerations (her heart was threatening to stop beating).
Dr. Draper
That doctor left, and just a few minutes later our own MFM, Dr. Michael Draper, came into the examination room. He said to me,
“We have a name for people like you.”
“What’s that?,” I asked.
“In-patient,” Dr. Draper said and smiled at me.
Then he asked me where Ryan was. At work downtown, I told him.
“You should get him up here,” he said. “You might be delivering these babies this afternoon.”
Yikes!
I sent Ryan a quick text message, and he left his office and hopped onto a bus to head up to the hospital.
By not long after that, after I had been moved across the hall to a room in the labor and delivery department, I was checked into the hospital (mobile check-in…modern technology, right?), had changed into standard hospital attire (big gown, opens in the back, you know the drill), and was lying on a big hospital bed (“on” because I was definitely not IN the bed) with a bunch of wires and monitors attached all over me, some for me and some for the babies.
Ryan arrived and found the labor room where I was. There was some hurried paperwork and we took care of some signatures, but things still seemed fairly calm. Ryan and I had taken a childbirth prep class and had previously toured the labor and delivery department, as well as the neonatal intensive care unit (NICU), so we had at least some idea of what was going on.
While Ryan and I were talking with the nurse, and as other people came and went from the room, Dr. Draper had been monitoring Baby A. He had been listening to her heartbeat with a Doppler monitor and watching her heart on ultrasound at the same time. The head of my bed was somewhat elevated. Dr. Draper had told me that he wasn’t sure whether what looked like Baby A’s decelerations were actually THAT, or whether it might be that the monitor was picking up my own, slower heartbeat.
Someone explained the process Ryan would have to go through to get gowned up so that he could be in the delivery/operating room, should monitoring turn into a C-section. We were chatting in a completely relaxed way with one of the nurses, discussing whether or not I should have my tubes tied as long as I was already opened up, should a C-section end up happening that day.
Everything Changes
But then suddenly everything changed from calm to terrifying.
“That’s it. We have to get her out!”
Dr. Draper quickly reached behind my head, hit the red alarm button on the wall behind me, and slammed the head of the bed down flat (seriously, SLAMMED). He instantly ripped off all of the wires that had been attached to me, shoved away the wheeled monitoring and ultrasound equipment, sending the machines sailing out of the way across the room, and released the brakes on the bed. Then he RACED the bed out of the room and down the hallway into the next-door operating room, the medical people running behind, leaving Ryan standing alone in the labor room.
My heart was pounding and everything was getting fuzzy.
A flurry of activity was already going on in the OR. There were beeps and people attaching things to me and oxygen and people moving around the bed. Almost the instant the bed came to a stop, an anesthesiologist asked me to sit up. I did, and found myself looking straight through a big glass window into the NICU where a sea of masked and gowned people were all looking back at me, three teams of seven people each, each team waiting to receive one of our babies through the window.
I found out later that as soon as Baby A’s scary situation had been found, the NICU had been notified and they had frantically called staffers all over the Salt Lake Valley in order to get enough of them, in all of the right specialties, up to the hospital in time for our triplets’ delivery. Twenty one sets of eyes were looking at me from the spaces between surgical hats and masks. Even today, almost seven years later, I get choked up when I think about that moment. All of those people, waiting to save our tiny babies’ lives. It’s hard to talk about it without crying. Such an overwhelming feeling.
The anesthesiologist put a needle into my spine, injected the anesthetic, and then had me lie back down. The surgical team quickly put up a curtain across me so I couldn’t see my lower body. I also couldn’t see or hear Ryan.
“Where’s Ryan??!” I yelled. Nobody answered. “WHERE’S RYAN???” No response. Everything was happening really fast. There hadn’t been anyone available or enough time to help him gown up.
Dr. Draper ran something across my lower tummy. Three times, in quick succession as the anesthetic took hold, he asked, “Can you feel that?” “Yes.” “Can you feel that?!” “Yes.” “Can you feel that?!” “No,” and instantly Dr. Draper cut me wide open with a big scalpel swipe across my lower abdomen.
Babies Out
In seconds, Baby A was out and had been passed through the window into the NICU. No crying. Then Baby B was pulled out, and I could hear a weak cry as he too was passed through the window into the hands of the team that was waiting for him. Then there was some HARD tugging, and Baby C was out and into the NICU as well, one more tiny cry as he went.
All three babies were delivered within two minutes. It had been less than seven minutes from when Dr. Draper hit the alarm button until all three babies were in the NICU. It had all happened so fast, Ryan hadn’t been able to get gowned up fast enough to get into the operating room before all of the babies were gone.
Ryan did get into the OR in time to see my uterus being sewed up and put back into me. Dr. Draper stitched up the layers of my body where the babies had been pulled out, and then I was wheeled back into the labor room where we had started.
Apgar = 0
A bit later, as I was being monitored to make sure I was doing okay, one of the nurses told us that when Baby A was pulled out her head was smashed flat, she had no heartbeat, she wasn’t breathing, and she was completely blue. Her first Apgar score—a way of describing a newborn’s overall health on a scale from zero to ten—was zero. The NICU team had had to resuscitate her, but thankfully her heart had started beating again and she had started breathing. Her head popped out into a more normal shape (babies’ heads are amazing things), and she pinked up. The nurse told us that Baby A wouldn’t have made it to the next day if we hadn’t found out how bad off she was and delivered her that afternoon.
I later learned that Baby A had suffered from what’s called “intrauterine growth restriction,” or IUGR. Ryan noticed that Baby A’s umbilical cord looked like a thin, curly old-fashioned telephone cord. The boys’ umbilical cords, in contrast, were as thick as Ryan’s thumb. At some point in gestation, babies begin to produce their own amniotic fluid. A’s body apparently hadn’t been getting everything it needed through the defective life support system she was attached to inside of my uterus. She had stopped growing and had stopped producing amniotic fluid. Without enough of fluid to adequately cushion her, she was smashed between her twin brothers and my pelvic bones, putting her into fetal distress.
After they had been stabilized and placed on ventilators, all three babies were moved into the highest-care room in the NICU. I was transferred into the regular maternity ward. The triplets had been born just before staff change, a period of time during which parents are not allowed in the NICU. After staff change, someone came to my room and asked whether I wanted to see my babies. Of course, I wanted to see them! But I couldn’t get out of bed; I couldn’t move my legs right yet, and I was still in a post-surgery haze. So they took the whole bed with me.
NICU Babies
They wheeled my bed out of my room, down the hall, past the labor and delivery ward, and into the NICU. They threaded the bed through a narrow hallway and into the small, dark rooms where the triplets were. Tiny, tiny babies, with tubes and wires all over them, lying in gently-lighted plastic incubators. At birth, Baby C was 3 lbs. 4 oz.; Baby B was 3 lbs. 1 oz.; and tiny Baby A was 1 lb. 5 oz. So small!
I didn’t think about it at the time, but after our babies had been in the NICU for a while I realized that rolling an entire bed into there was not typical. I suspect that they had done that for me so that if one or more of the babies didn’t survive, I would have at least had a chance to see them when they were alive. As it turned out, I was able to see them, hold them, and—eventually—take each of them home from the hospital with me. Not all NICU or preemie parents have that happy outcome, and my heart goes out to them. I can’t imagine anything more heartbreaking. We were very fortunate to have all three make it.
The morning after the triplets were born, Dr. Draper came by my room in the maternity ward to visit for a few minutes with Ryan and me. As we talked, he told us that the nurse in the labor room had been wrong about Baby A. He said he wanted us to know that her survival had been a true miracle. If we hadn’t found out that she was in distress right when we did, and if she hadn’t been delivered right when she was, she would have died.
He said, “She wouldn’t have made it for five more minutes.”
