Monday morning I told crews at the ambulance house that, "Someday Nathaniel will have a very two-year-old moment, probably when he is mad at me or wants to get a reaction, and he will pull his trach tube out." At 6: 31 Monday night, he proved me right.

Rich, Peter, Nathaniel, and I went for a walk after dinner and were returning home, coming up the sidewalk between our front door and the street. Peter was ahead of the stroller; Rich and I behind it. Peter looked at Nathaniel playing with his Lightning McQueen matchbox car, then turned to unlock the door. Two hands were on the stroller tray playing with a car. Not angry. Not having a temper tantrum. Nathaniel was waiting happily with a smile on his face. Peter turned the key, pushed the door open, turned back towards Nathaniel and yelled, "He pulled his trach out!"

That fast. Not to make Mom mad. Not to get attention. He put his finger up by his trach, perhaps to itch his neck, hooked his trach tube and it was out.

He was blue in the time it took Rich to undo the waist belt and get him out of the stroller.

He vomited as Rich laid him on the floor. Vomit flowed down his chin and filled his trach stoma.

Peter got the ambu bag. Rich removed the old trach ties hanging from his neck. I got our spare trach that is taped to the wall near his crib. Nathaniel clawed at my arms and hands desperate for help, but unable to know how to make things easier on us. I got a trach in and took over bagging. Rich suctioned and connected a pulse oximeter. Peter called 911. Nathaniel's oxygen levels were not responding quickly.

One loses track of time in moments like these. I hear myself saying, "Deep breaths, son. Take deep breaths. You are going to be ok. Take deep breaths." His eyes were locked on mine as if trust would make the mucus and formula blocking his airway disappear and it become easier to breathe.

Suddenly first responders were there beside me on the floor in my hallway bent over my baby.  Firemen. "You will be the first ones to Nathaniel's house," Tricia had told them at training last month. "He lives right around the corner from you."

We moved Nathaniel so more people could get around him to help. I asked for oxygen and trach ties and suctioning and for someone to hold down his arm that continued to want to grab for my hand holding the trach in his vomit slimy throat. Someone asked for more light. I have no idea if it was family or first responders answering the requests, but hands moved together like they were coming from one body. Like we had trained for this moment.

Nikki appeared at my left. Steve was over her shoulder. Paramedics and firemen who were not just answering a call but whose names I knew. Whose faces I knew. Paramedics and firemen who over the last months have invested time and energy into learning about Nathaniel, watching our routine trach changes, and asking questions about how to help us in an emergency. First responders who just that morning laughed with me that someday he would be very two and pull out his trach. First responders who have Nathaniel's address not only written on a paper in the truck, but on their hearts and knew before dispatch said STAR 10 that the call was our house.

God saved my son's life again Monday night. Not only in the moment of emergency, but in the months leading up to May 11th. He goes before Nathaniel. He placed the idea of the STARS program on someone's heart. He opened the door for first meetings, and training sessions, and for opportunity to build relationship. Because God works through people to bring life to a gasping frantic world. I cried for a fleeting moment when the fireman to my right said, "How about you give Nathaniel to Nikki and let me help you up?" I wanted to let it explode because this was all too much for one day. Training paramedics in the morning and telling my husband and son about it on a walk, and working with all of them to save a two year old that evening. All too much. For a moment I let Nathaniel go and I cried.

And then Nathaniel reached out his arms to me and I swallowed the sob, took him back from Nikki and carried him to the ambulance.

Nathaniel is home sleeping in his bed as I write. He charmed all the emergency room doctors and his favorite ENT and her resident. He coughed up enough vomit that everyone felt comfortable sending him back home. He is a strong boy. We will watch him closely for signs of aspiration pneumonia. I hear him coughing now on the other side of the wall and doubt I will sleep soon. The night nurse has questions about suctioning and O2. It is okay that she needs me. Because more than I need sleep, I need space to be weak. Space to remind myself of God's faithfulness. Space before Nathaniel wakes and needs his mommy again.

Before he is very much a two year-old and pulls out his trach again.