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Take trash for example. No one ever thinks about their trash. They collect it from their house once or twice a week, set it by the curb, and forget it until the next week. Not us. We lived in an area where there were strict limits on the number of bags you could throw away each week, and we always exceeded those limits—especially when the kids were in diapers. We easily had two bags of trash on an ordinary day, more on birthdays and holidays. By the end of an average week, we’d have four huge cans filled with bags of garbage and diapers.

I remember so many Sundays nights when Jon would be in the garage rationing out what garbage he could put out and what he could hold back for the next week. It was like a game of schoolyard trading where we always got the bad deal. “I’ll trade one bag of dirty diapers for two bags of kitchen refuse that maybe I can compress down into a single bag to put out next week.” But each week, the same problem only got worse.

One solution was to call our neighbor and friend, Miss Beverly. She came over weekly to fold our laundry and was always willing to help us out. She and her husband never used all of their garbage allotment, so Sunday nights Jon would wheel a trash can down a few streets and up a hill to leave it at her house.

I know it seems crazy to worry about trash, but Jon and I spent a lot of time in those days thinking about it. We would fantasize about normal family-sized trash the way other people dream of white picket fences.

During that time, we exceeded our trash quota so often that we left presents on top of the trash cans in hopes the sanitation workers would take everything we put out. Sometimes we left little snacks, baked goods, or candy—anything we had.

But not every problem could be solved logistically; sometimes we just had to make do. For example, some parents worry about their kids watching too much TV; I worried that my kids couldn’t see the TV. We moved an old TV into the babies’ room so they could watch a movie before their nap. But because the TV was small, and the perimeter of the room was filled with cribs, there wasn’t a central location that gave all of the kids a good view of the screen. Several of the kids, Hannah, Leah, and Alexis, especially, couldn’t see it too well. But we had to make do. Again, this was an issue I was sure normal families never faced—but it was another small thing that added to the guilt I felt.

Trash logistics and six little faces trying to view a TV screen aren’t life-shattering issues. But in our family, the most ordinary activities could feel extraordinary. That also meant that unexpected events, like a sick kid, could feel downright harrowing.

Sickness is serious business at our house. Colds and flu don’t just travel through our family; they take up residence in each and every child. But sometimes it’s not just the illness that brings us down. The ancillary things like doctor’s visits, prescription refills, and health professionals who don’t understand our needs further complicate daily life.

Lots of families with kids have stories about how all the kids got sick at once. As a nurse, that part isn’t hard. I’m used to taking care of multiple patients at the same time. For me, the hardest part is trying to get each and every child to the doctor’s office when (and only when) they need to be seen.

In December 2006, five of the six had been coughing for nearly a week. I’m not the kind of mom who runs her child to the doctor for every little sniffle, but their coughs had gone on for a long time and I was particularly worried about Leah. When I put her into her high chair one day, I thought I heard her wheezing. I decided to listen to her chest with my stethoscope, and when I did, I heard crackling and more wheezing.

I called the doctor’s office and asked if Leah could be seen that day.

“Well, we don’t really have any appointments available today.”

“Can you just fit me in between appointments?”

“We don’t usually do it that way.”

Big sister Mady lovingly helping Leah with her breathing treatment