ATTENDING: beyond the long white coat

View Original

K: Kangarooing and kenosis

What do kangaroos have to do with kenosis?

If you had to guess at a meaning for the verb “to kangaroo” you might go with “to bounce: to travel by leaps and bounds”.  (And—side note—if you look the verb up in the OED online, the definition includes not only “to make a great jump, literal and figurative” but also the hunting of kangaroos!)

Kangaroo with joey. Image from Unsplash.

In the NICU, though, we think of kangarooing as resting in order to grow. 

We use the derived verb “to kangaroo” in the context of kangaroo (mother) care, a process in which a baby is placed—and then rests—skin-to-skin, chest-to-chest, heart-to heart with a parent.  

Most people have seen the resting part of kangarooing: happy relaxed moms and babies cuddling.  We might think of, or even see, the happy relaxed glowing mom/baby cuddling (“oozing oxytocin”) without full awareness of the many careful slow steps it takes to get to that place of rest. 

But that process of setting up, and settling down, is also part of kangarooing.  And although the preparation process might not get as much attention, it’s crucial to reaching the end result of rest and growth.  

In fact, for adults, the mere prospect of undertaking the procedure of moving a baby into kangarooing is daunting.  Before making even the slightest move, every line, tube, and lead needs to be accounted for.  At the very least there is a feeding tube from baby’s nose or mouth into the stomach.  IV lines may be delivering nutrition and medications into  tinier-than-a-toothpick blood vessels.  And baby’s airway might well contain an endotracheal tube smaller than a pencil (say, the size of a sock-knitting needle) without much more wiggle-room than the IV lines. 

Moving all those attached supports, along with baby’s monitoring needs—three cardiorespiratory monitor leads, a pulse oximeter, and a temperature probe– and, of course the baby herself, with mom, into a recliner, and then settling them all securely?  “Daunting” might not even begin to describe it.

Don’t forget that, for the baby’s mom, getting ready to kangaroo involves getting naked from the waist up in a room with strangers—one more experience of exposure in a long cascade of vulnerability—and standing ready to hold the tiny person who, if the world were as it should be, ought still to be hidden inside.  

But let’s think about the baby’s perspective on the undertaking— which is not the same as the adults’!  The baby is not anticipating anything. She hadn’t planned to arrive early and end up in the incubator, let alone in the intensive care unit. She still isn't making any plans. She doesn’t know she’s “on the NICU roller coaster” and she certainly can’t see far enough ahead to anticipate any hills or valleys.  She’s living in the moment, focused on that instant of physiologic survival– so when the adults move her, her reaction is a stress response. Her heart rate goes up. Her oxygen levels drop. She might breathe faster, or she might stop breathing altogether. That’s scary for the adults, but they know that once she settles in safely on her mom, she will not only gradually recover but likely become more stable than before the move. 

Once babies adjust to the change and the movement, their vital signs stabilize and they’re able to go into deep sleep. Over time, kangarooing accrues benefits for premies: the rest and connection improve their prospects for growth, neurological  development, and survival.  

It takes time to feel safe. It takes time to recover from the unexpected, sudden, drastic life changes. And the place of safety and connection is so much better than that of isolation and separation. 


What if we are in the same position as the baby?

What if we “independent adults” have been trying to survive on our own with some artificial life support, not even knowing what we lack? 

We may be feeling hopeless, at odds, incapacitated, feeble, not-enough… unaware that we are in need of His abundant mercy. We so want to hold it all together, and also to find a place and a time to rest—but then we think we need to do that ourselves, and we’re doomed to failure. We are never going to get there by ourselves, no matter how much we try to figure it out under our own power. 

And yet– He has done it. He is for us.

The weight of our sin and our mess weighs us down (Ps 38:4), but also– that is also the weight of His glory, and the lightness of our joy: He bore, and bears, that weight for us. He bears with us, bears us up, and carries us. He dwells with us. He offers us his easy, light yoke of working together: working from His indwelling glory to bear the burden of our infirmities and distress.

Only when we rest in Him are we able to work with him. Only when we realize that He has stalked the gap will we find power and courage to keep stalking it ourselves: taking the risk of drawing near to Him and His terrible glory, in our need and brokenness, and finding His rest in the cleft of the rock– the secret place in which He hides us. Because He is the original Gap-Stalker, who has rent the heavens and come down to our scrabblingly low level—and who has made that “great jump, literal and figurative” in that OED definition of “kangaroo”.



What if there is no kangarooing without kenosis? What if we need to recognize our limitations and admit our vulnerability – and offer our entire naked-baby selves – before we can truly feel safe? What if the truth of His having humbled Himself in love, His inviting us to follow His lead, and His promise to keep and to hold us – is indeed what makes us free?

In Biblical Greek, kenosis refers to the process by which the Second Person of the Trinity emptied Himself –lowered Himself, humbled Himself–to become not only human, but an embryo, a fetus, a newborn, a child. Our God knows far more than we do about kenosis; in fact, He’s the expert. And He invites us to rest in Him–let’s take Him up on the offer and learn kangaroo-kenosis. And remember that learning is a process that takes practice.

We will never be able to humble ourselves as much as He has humbled Himself. He has made, and makes, His strength perfect in weakness.

(Spiritually, then, maybe we do bounce a bit like a kangaroo— in that we go down in order to go up.  See I Peter 5. And one more thing: if you spend any amount of time looking at pictures of kangaroos, you can’t miss noticing that those joeys get bounced around a bit. But they are being held. And that makes all the difference.)

O God of peace, 

Who hast taught us that in returning and rest we shall be saved, in quietness and confidence shall be our strength:

By the might of Thy Spirit lift us, we pray Thee, to Thy presence, where we may be still and know that Thou art God; through Jesus Christ our Lord.  Amen.

 -ACNA Book of Common Prayer, p.78