An Exclusive Club
Losing something you’ve never had is particularly difficult. Infertility is funny like that. One diagnosis, spoken out loud, robs you of the illusory self you’ve crafted, that of: Woman Who Can Get Pregnant. It’s been two years since I was told I couldn’t conceive naturally. Today, a ballooned-out version of my body is primed for its third round of in-vitro fertilization. As I lie on the table waiting for the doctor to guide embryos into my uterus via ultrasound, he smiles and hands me an 8x10 sheet.
“The first photo of your child,” he says.
I find myself wondering how many times he’s made this declaration. A bold one, considering this procedure is more often a vehicle to disappointment than motherhood. I know he’s peddling hope, perhaps a justification for the exorbitant financial price tag attached to this experience. I gobble it up. This orchestrated maternal moment, however brief, allows me a momentary pass into the club of motherhood. I stare at the photo, two black and white circles surrounded by a crisp ring that harnesses clusters of asymmetrical cells. I wonder who they might be.
I take a photo of myself on the way home from the clinic that day. I’m invariably critical of most photos, but there is something about this one I love. My hair is in a disheveled side braid, my face free from make-up. I´m smiling, like a woman with a secret. It feels like a beginning. I look relaxed, wholesome even, like someone who deserves to be a mom. I’m worthy. This photo is evidence of the good choices I´ve made to get this far. I don’t smoke or drink to excess. I´ve cleaned up my diet and exercise regularly. I even drink almond milk. I’ve paid my dues, and I’m eager for the universe to hold up its end of the bargain. And it does, temporarily. I still look at that photo and think, yes, that looks like a woman you´d want as a mother.
I imagined pregnancy would offer a more legitimate, or at least socially acceptable, outlet for my surplus of love than a couple of embryos. Not to minimize their value. On the contrary, I’ve tended them with the care botanists reserve for their prized orchids: one quarter of a pineapple each day, folic acid, prenatal vitamins, and a plethora of other supplements, slowly ingested despite my aversion to pills, shots that leave bruises, and medicines with a dizzying array of side effects. My sacrifices start early, and I feel pride in my scrappy little fighters who’ve flourished in their petri dish despite the odds. I admire them. We are united in our tenacity. Most mothers don’t get to connect this early, but before they are even in my womb, I’m invested, rooting for them. I believe mothers work to nourish the relationships they have with their babies, and they value these relationships more for the effort. This is one of my theories on motherhood I’ve yet to substantiate. The effort adds value. At least I know this to be true for my embryos.
By design, my husband is spared many of the repercussions of our fertility treatments, so he was keen to be The Medicine Man. From the beginning, he diligently tracked doses, injection times, and medication combinations. Despite several practice runs, that first shot was not what I envisioned. After a cartoonishly elaborate Medicine Mixing Ritual, I’d lain, disinfected, on our bed. I felt small, swallowed up by an impossibly fluffy duvet that, on purchase, my husband had deemed “a tad froo-froo.” He leaned over me, needle gripped, the way one might clamp a knife while pantomiming how serial killers stab their victims. My cool-under-pressure, army-aviator husband was terrified. Puncturing his wife’s skin was not a mission he’d ever envisioned. Minutes of agonizing build up ended abruptly when he plunged the needle into my stomach with the finesse of a spooked horse. The realization he’d punctured my skin caused him to release the syringe in futile protest. The needle remained lodged in my belly, the syringe swinging up and down, its fervor akin to a recently vacated diving board. We both stared at it, briefly mesmerized, before bursting into laughter. During that first round of IVF, we came together, united by our shared obstacles.
I don’t subscribe to the notion that ‘things happen for a reason.’ For the most part, I try to inoculate myself against failure through preparation and hard work. The unpredictability of IVF terrified me, so I prepared the best way I knew how: researched my doctor. He came highly recommended, although I’d heard murmurs his bedside manner was lacking. Trading a few kind words for expertise seemed a reasonable concession, so I booked him. My husband loved his no bull approach. After the first failed round of IVF, he pulled us into his office and robotically broke down the likely causes of failure. He mostly addressed my husband, and they volleyed back and forth, all business. Numbers made sense to my husband, much more so than his increasingly emotional wife. Only when the doctor was explaining the science behind the numbers did he become more animated. Despite approaching middle-age, he took on a boyish quality as he spoke. I could sense my husband took comfort from the succinct exchange of information. The doctor detailed our next protocol and told us to book with his nurse for the following week. We stood, and his attention shifted to his computer screen before we’d left the room. At the time, I’d hoped for more. Not an apology but at least a shared sense of disappointment.
As we walked down the hall, my husband kissed my check and said he’d wait in the car. The air conditioning in the Volvo had been slowly dying. It would take a good ten minutes before the interior was an even remotely tolerable reprieve from the Florida heat. The nurse sat behind the reception’s Plexiglas window. I rapped quietly on the glass despite being the only patient in the waiting room. She looked up and slid it open.
“I’d like to book for next week.” I said.
I’d gotten to know her in the one-sided way particular to medical personnel. Much of our time spent together had involved her probing my most private parts with me naked from the waist down. I’d pegged her as kind, although it’s not initially apparent. She didn’t coddle, but she was invested and insightful. I respected her. She nodded and filled out an appointment card.
As she handed it to me, she touched my wrist briefly and hesitated, “He really does care you know. He just doesn’t know how to show it.”
I met her eyes, and she looked away. The moment had passed. I told her I’d see her next week and headed for the door.
After our second failed IVF, the doctor reduced his fee. His nurse informed me at this point he’s only charging us his costs. I took it as a tangible sign of his caring, the emotion he seemed incapable of conveying in person. Despite my husband’s misgivings, my family stepped in and closed the gap between the limit on our credit card and the remainder of the bill for our third cycle. He conceded. Only because the alternative was worse. We both knew we couldn’t afford another treatment. The weight of our expectations was overbearing. It created fissures where none existed. His refusal to stop at a Dairy Queen one evening prompted a hormone-induced crying jag. He tilted his head and studied me.
“You really need to get a grip,” he said.
Instantly, rage replaced my sadness.
“You´re clueless. You have no idea what these drugs do to me.”
He continued, “You’re smarter than this. You know it’s the drugs, so don’t let them be in charge.”
He shrugged, signaling the conversation was over. I took several deep breaths to slow my pounding heart, scared of how my tongue would cut him if I gave myself permission. When had his pragmatism become insensitivity? I turned and stared out the window, resentment simmering in my chest. In my angst, I confided to my mother, perhaps the only other person on earth who wanted this as much as we did. He leaned on no one. We were both waiting to be on the other side of this, an unspoken understanding we’d reconnect then. At the time, we were surviving.
Ultimately, it’s our third round of IVF that results in pregnancy. I find out exactly fourteen days after taking my photo on the way home from the clinic. For weeks, we bask in the newness, the victory. I marvel at my increased gag reflex as I brush my teeth each morning. My husband rubs my stomach as I fall asleep on his shoulder at night. We’ve made it, and we’re untouchable in our happiness. Then we get the call. The doctor would like to see us. During the drive to the clinic, I stare out the window at the cloudless blue sky. My husband is quiet, his hand clamped on my knee. We are scared to speculate out loud, on the chance voicing our deepest fear will make it so. When we arrive, the nurse is waiting, and the three of us walk towards the doctor’s office. Is it me, or does she seem particularly solemn? She pulls a chair up on his side of the desk, and my husband and I sit across from them. The lines have been drawn. The doctor is uncharacteristically enthusiastic, his discomfort amplifying his neglect of social cues. He delivers the news of my miscarriage with the inappropriate charisma of a television game show host.
“You’re HCG readings have dipped,” he booms. “What do you think that means?” Ever the eager student, I weigh the options carefully. Surely this discussion would be going differently if the news were that bad.
“We need to increase my progesterone?” I hedge. The nurse shifts in her chair. He smiles-as if pleased to have stumped his contestant.
“This is not a viable pregnancy.”
His demeanor implies the conclusion is obvious. He continues, “After three treatment cycles, it’s apparent this is not in the cards for you. You should move on. Your chance of ever getting pregnant is almost nil, even with IVF.”
I look to the nurse, her face a mask of apology, although I’m not sure if it’s for his clumsy delivery or the news itself. I’m stunned. After this appointment, I’m meeting up with my mom to brainstorm baby names over frozen yogurt. How can this be happening? My husband is still. There are no numbers to crunch or plans to devise. He is impotent. The doctor shrugs slightly. I feel the powerful urge to bolt. I must escape this office. There is nothing left to be said. He smiles at us amicably. You win some, you lose some, the smile intones. I stare at him. His expression communicates, “At least we gave it our best shot, Slugger. Look at all the medicine I prescribed. Clearly, I did my part,” as if he is somehow entitled to act like we are a team. We aren’t. He’s lost nothing, and I just lost my most basic ability as a woman. He´d be eating tuna on rye in a few minutes; I´d be retching next to my car holding the door for support.
Somehow, with my husband by my side, I manage to reach the parking lot. I squint against the sun. Everything feels too bright, too loud. For the first time, I notice the garish display of wealth surrounding our ancient Volvo, a variety of Mercedes, Lexus and BMWs peppered with the odd Porsche or Maserati. Apparently, infertility is a battle only the wealthy fight. I watch my husband quietly for a moment, and he watches me. Clearing a strip of dust with my back, I slide down our passenger door and plop to the asphalt. Some distant part of me registers hot pebbles biting the backs of my thighs. Grief wells up and threatens to break my chest wide open. I am being attacked simultaneously from outside and within. I know in this instant my grief has the power to devour me. It threatens to strip me down to nothing and leave me bare. I wail. Guttural sobs and inelegant hiccups punctuate my tears. I cry and scream until my body is limp from the effort. My husband stands beside me, an unobtrusive protector.
“I want a cigarette.” I say.
A habit I´d kicked with great effort fifteen years earlier. He looks at me and nods. He considers smoking a habit no less evil than shooting heroin, so him acquiescing is a welcome acknowledgment of the magnitude of the moment, the loss.
As the days pass, I realize my milestones will be different than other moms. I don’t get to hear the first heartbeat on an ultrasound. I didn’t make it that far. I can only imagine the strong and steady drumbeat emanating from my stomach, a determined, staccato rhythm announcing its intention to the world: I will be. I imagine the first flutter in my stomach, so subtle, I’d doubt its origins, the first real kick, set of hiccups, and glimpse of a grainy, perfect face on an ultrasound. At what point would I not be pregnant? I had always thought of it as such a binary proposition. I imagine my HCG number going down and wait anxiously for my period.
Like many mothers who’ve soldiered through fertility treatments only to suffer early miscarriages, I have different firsts. My encouraging firsts involved needles, and egg retrievals, and phone calls telling me my embryos had survived their third then fifth day on this earth, hunkered down in a petri dish. Then there are the crushing firsts of a prolonged goodbye: first period, first missed ultrasound appointment, first email from an automated service telling me my baby is the size of an olive today, first phone call to family undoing news that was spilled in the naiveté of early excitement. So many firsts.
In the grief hierarchy, I’m perceived by many to be lingering on the bottom rung.
“At least it was a chemical pregnancy,” friends offer- it is understood the word “chemical” means “less significant.”
“Can you imagine how much worse it would be if you were further along?” they’d ask.
No. I can’t. My grief is clearly not imbued with the right amount of gratitude. Not only have I failed to stay pregnant, I’m drowning in sorrow and selfish for the tunnel vision it creates. Friends I’ve always considered compassionate display mind-boggling callousness. In a moment of heartache, I confess to a close friend that I find it hard when our girls’ trips evolve into “Mom talk.” I’m not invited back. How selfish, I imagine them clucking. The audacity to confess such ugly feelings, don’t I understand these mothers have rights too? And the group carries on, oblivious or indifferent to the grief that exists in a nearby, parallel world.
Survival demands I cull my friends list, and my heart breaks a little more. Each day is a fresh tonic of anger, shame, and sorrow, although the ratios shift. My fellow infertiles understand. An unlikely tapestry of colleagues and acquaintances have emerged as my cheerleaders. We bond as we linger over lunch in the breakroom, waiting until others leave so we can spill our most recent triumphs and disappointments. We seek each other out at our book club, each hearing through the grapevine that the other is experiencing something similar. The confessions tumble out quickly. We don’t feel a need to ease into these brutally personal details.
This patchwork tribe of fellow infertiles contains my most fiercely loyal allies. They are my side-by-side warriors. Some days, words are not needed. The grief hierarchy is absent. One person’s disappointment is felt by all. We understand the emotional whiplash of an imagined future being snatched from our grasp. The corners of life turn more sharply in this world. My fellow-warriors aren’t goading me to validate my grief. They are holding me up, so I can gulp some air between the waves that threaten to drown me. My only hope is when their turn comes, I can do the same.
I have not been granted access to the club of motherhood, but I’ve been granted a far more exclusive pass into the Sisterhood of Infertility. It’s not a club I wanted to join, but these are my people. There is no tidy ending for my grief, no higher moral lesson to be gleaned from my infertility, and they understand. Nobody here will tell me this is “God’s plan” or that “things happen for a reason.” I don’t know what comes next, and that needs to be okay. For now, in this sisterhood, I grieve.