Modern Medicine

About a year ago (I am still too traumatized to look at dates or otherwise dive too deeply into the day), I was rushed to the hospital where they had to do a second D&C to remove the remaining pieces of my poor, broken baby.

My broken heart is another matter. Those pieces are still coming back together.

I want to mark this unfortunate anniversary with a comment on our health care system with regard to OB/GYN care. Miscarriage -- and other unfortunate complications of pregnancies -- is incredibly common, yet there remains a huge disconnect in the way providers address women who present with it. Warning signs are dismissed. News delivered insensitively, even harshly. Hurtful offhanded comments made. The entire (hugely relevant) emotional experience of miscarriage remains largely -- notwithstanding the rare, evolved obstetrician -- ignored.

I have been handed ER discharge forms referencing "fetal parts." Been told it's probably nothing. Given advice about it being meant to be, and told to "just try again." Last year, I called the doctor with a huge warning sign the day before I hemorrhaged at home and bought myself an ambulance ride, and was told to "monitor it" and call on Monday for an ultrasound. I still think about how nice it would have been to avoid one of the most significant traumas of my life by being brought in, calmly told there was remaining tissue and brought to the OR without drama.

And then, perhaps the most significant indignity of all, the one I shake my head at every time it pops in. After the second D&C, they brought my loopy, exhausted, shattered self upstairs to the maternity floor to recover. They put an ice pack in a newborn diaper for me to use. I heard cries through the walls. I had to see that fucking hospital channel that tells you how to take care of the baby you just had, if you were lucky enough to bring it out alive.

Get it together, doctors.

To every girl who has been there, may your own moments have made you a little tougher, a little wiser, a little kinder, a little better. "In the midst of winter, I found there was, within me, an invincible summer." -Albert Camus.

If Only It Were This Easy

I just got an email from Target with this subject line:

Baby Sale at Target

Are babies for sale? Because I am definitely interested, and -- in contrast to the Lilly Pulitzer offering -- I would actually line up for this.

In real life, things are a little tricky. We may have found a surrogate, but every step feels precarious.

Not a Weight Loss Plan I Recommend

One of H's teachers commented this morning at drop-off that I am looking great -- thin, but not too thin. Have I been working out?

Nope. Just lost the dead baby weight.

I said that in my head. Don't worry.

An Involuntary Mission

Here's what kind of everyone needs to know about me. This quest for another baby, this never-ending mission? It's not voluntary. It doesn't feel like an optional choice to me. I have four PGD-screened embryos with the same genetic makeup as H in a freezer right now, and the drive to bring one of them home where he belongs feels as obvious and vital to me as taking in air several times a day.

I get it. I've been at this for a long time. People are sick of hearing about it. I'm sick of hearing about it. I'm sick of talking about my reproductive plans publicly. I didn't ask for this to be my "thing" in life. But it is what it is, and it's part of me, and I need to talk and write about it to understand how to think about it. To keep my prefrontal cortex from malfunctioning. And I need to keep going. I need to try until there are no more options. Because I still -- despite all the evidence to the contrary that's presented itself over the past four years -- I still believe he's out there.

So you don't have to understand or agree with my willingness to put my embryo inside another lady and go broke in the process. But just know that that choice was made for me when five embryos tested healthy in November 2013. 

One Year Later

These are the moments that still break my heart:

It was still cold, snow everywhere, and we bundled up early in the morning to get to the appointment. The three of us. I couldn't find child care so my poor H was along for this terrible ride.

We had just gotten H a booster seat, and before we left he told me he wanted to give his old convertible seat to the baby.

I was still careful, shielding my obviously pregnant belly as I walked across the ice to the car. I was so nervous, and yet ready to have it over with, to know what, if anything, the high AFP meant. I thought they'd find something with the placenta.

On the way to the hospital, Pharrell's "Happy" came on the radio. I loved the song, and hoped that hearing it in that moment wouldn't ruin it forever. At some point my husband changed the station and "Route 66" was on, a song we had all just heard on the soundtrack to the "Cars" movie we'd watched together. One of the last happy moments of the pregnancy.

The ultrasonographer called us back from the waiting room, and as we walked back she asked if I had to use the bathroom. H answered instead: "No, thank you." We all laughed.

H's face as everyone else realized what was happening...so innocent to the horror unfolding. Unaware he had just lost his brother.

Coming back home to the business of it. The calls to doctors and the insurance company. The search for someone who could do the surgery. Essentially being told good luck by my OB's office, whose high-risk doctor, the only one skilled past 13 weeks, was on vacation. Having to slog through all of the moments to come.

Telling H there was no longer a baby.

Standing in the hospital bathroom before going to the OR, saying goodbye, and I'm sorry. Terrified of the pre-surgery warnings, wishing I were with my H, having a fun day in my beloved city.

Realizing how old my second boy would be today. Wishing I knew if he liked oatmeal, or was quick to smile like his brother. Wishing I'd had the chance to be his mama too.

***

Marking a year since the death of your baby is a lonely exercise. There is no way to get others involved without striking them as melodramatic. Once again, I'm the only one who can carry this.

I wish I could tell you that the past year has changed me for the better. That I've somehow been enriched by the epiphany of grief and suffering. There may be some of that, but mostly it's been a matter of making it through days. And on some, I thought I'd break. So there's this: I survived.

It does help that this year's March 18 feels brighter and warmer than last year's. After every winter, a spring.

Sliding Doors

One year ago today, I had my last regular doctor's appointment as someone who thought a baby would come out of it in the end. I just looked at the calendar, at all the appointments typed in with ignorance about what was to come. Is that blissful? I'm not sure.

I remember waiting forever for the OB, who was off seeing other regular pregnant people, maybe delivering a baby. A typical day, and I was another typical patient. Until I wasn't.

She poked around for a while with the doppler, I remember. I was anxious, she was not. She found the heartbeat in her typical casual way, as if it there were never any doubt. As if no one ever had a doubt. Maybe she always finds the heartbeat. Maybe mine was the only one that stopped beating after she found it.

It feels so far away, and yet it also still feels tangibly close, as if I could reach out and shake it up and shuffle it around and let the pieces fall down again, a million pieces put back together the way they were meant to be. I want to be Gwyneth Paltrow and miss the train this time. Maybe that's why I let myself look back at the calendar just now. A bunch of dates are all that's left of it. The closest I'll come.

Love from Unexpected Corners

I went for a mammogram a couple of weeks ago, my first. I'd been thinking for a while that I wished my fertility centers, like CCRM, required them. There is no proven link between fertility treatment and breast cancer; slight elevation in risk instead seems correlated with the mere fact of infertility, especially among those who have not had children. Still, I longed for some reassurance, especially since I've had some strange breast pain (which is typically not associated with cancer) since the pregnancy/the horror of my milk coming in last year.

On the day I went, I was a bit of a basket case. I guess you could say I've developed some sort of PTSD in the wake of this last, supremely awful pregnancy; I am awaiting the falling of another shoe. How do you carry on after years of living beta to beta, the cortisol steadily dripping through your veins creating a perpetual state of alert? If you're like me, you start worrying about twinges and pain. You ask your new gyn for a pelvic ultrasound in addition to the mammo, to investigate that cyst-like pain you have in your pelvis.

I can't emphasize enough the extreme state of unabashed panic I had myself in before this ultrasound. Being on an ultrasound table with a wand between my legs does not lead to good things for me, friends. I was convinced I would get horrendous news, like maybe my ovary had twisted itself into a ball in protest. I had myself worked into quite a dither. On top of it all, it turns out that when you're not pregnant, it is even harder to get any kind of indication of anything from ye olde ultrasound tech. She was Fort Knox. Said I'd have to wait until my doctor got the report...which could be two days. Somehow I convinced her to get the radiologist to send it that day.

Meanwhile, onto the mammogram. This felt like a walk in the park compared to everything else. The test itself, while not something I'd opt to do for fun, was really nothing. The tech showed me my girls on TV. Then I told her to please tell the radiologist that I've had this pain in that one place, and that I had a pregnancy last year. And then, before I knew it, we were sharing sad stories.

Hers was a late-in-life surprise after adoption, which was the best thing she'd ever done. At 12 weeks, she went in for a routine ultrasound and was given the terrible news. She was alone.

I felt acutely vulnerable, half clothed in my cotton robe, shedding tears. Then she said something I desperately needed to hear.

She said, you have two paths you can take. Don't take the bitter path. Don't shut down every time someone announces a baby. I did that for a while, she said, and it was so disingenuous. It wasn't the real me, and it hurt me while not accomplishing anything.

It felt a bit harsh to hear, like the sound of the truth often does. It was as if she could see inside my shadowy heart. She could see where I've been headed lately. It felt a little bit like a judgment, but I needed to be judged.

She's right. I don't want to be that girl. I don't want to resent, covet, begrudge. I was an enthusiastic liver of life before infertility and loss had its way, and I'll be damned if it's going to take some essential part of me in its stormy path.

So thank you, mammogram lady. Thanks for being honest about your story, and for the little correction you dared to pass along.

The ultrasound, by the way, was normal. As was the mammo. Apparently I've got some dense breast tissue up in there, so I have to go back for an ultrasound just to be sure. But apparently that's pretty normal, too.

PS - On this Valentine's Day, I'm spreading the love by encouraging you to get a mammogram, too. My new gyno (more on her, and the experience of a gyno-only, pregger-free waiting room, later) says the risk is now one in seven, with no family history. One in seven, girls. Think of your seven closest friends. And if they're 35-40 or have family history, tell them to get their baselines, too.