Friday, February 09, 2007
By way of disclaimers, this post is not about pleasant or funny stuff. It has to do with pregnancy loss and emotional pain and really gross physical experiences. I know a few of you have had recent losses, or will resonate with other bits and pieces here, and I just wanted to offer a warning... I won't be offended if you skip right on past this post and wait until I feel like bitching about coworkers or wondering who keeps performing the brain transplants on my children.

This time of year is always a little odd to me. The post-holiday hangover has faded, and any new psychological injuries inflicted by certain nameless mothers-in-law have stopped throbbing and started to scar a bit. The last week in January contained my parents' wedding anniversary, now officially not supposed to mean anything anymore because they've been divorced for over a year and my father is planning to move in with his girlfriend within the month and yet somehow it's still a significant date in my head, as well as my father-in-law's birthday, now officially not supposed to mean anything because he died in August and yet still arousing new and tactless behavior on the part of my allegedly grieving mother-in-law (I had Emily call her to offer 6-year-old-style support, and at the end of the conversation, Emily said, "Do you want to talk to my mom?" and within the 2 seconds it took me to get the phone up near my head, she - mother-in-law - had hung up). So early February provides a bit of respite from the high drama and emotional minefields of the previous, oh, six weeks or so.

But in recent years, this time of year has had its own associations, more muted but still less than uplifting. That's 2004's fault. Which, to be fair, is really 2003's fault. October 2003, to be precise.

Up until October 2003, life was unreasonably good. I was in my third year of grad school, working a practicum that I loved, several weeks pregnant, in good physical shape, feeling like I had my life and my career all nicely aligned and planned and playing well together. Hah. In late September, I had been involved in a really stupid car accident - second in line at a light at the end of a highway off-ramp, turning left, and a tractor trailer carrying telephone poles ran the red light and hit the back end of my poor little Saturn. Scared the bejeezus out of me, but didn't physically harm me and the car was drivable, so I checked in at work and then went home for the day, no big deal. Called the doctor just in case, but given my unharmed state and no scary pregnancy-related symptoms, I was told to just take it easy for the rest of the day and then resume whatever normal was for me.

A few days later, I went in for a scheduled ultrasound, should have been around 10 weeks of the pregnancy. I have a habit of getting pregnant unexpectedly - four times on the Pill so far, baby! - so early ultrasounds to determine the viability and dating of the pregnancy are routine. I walked in feeling fine, not a glimmer of nervousness or worry. I already looked pregnant, because in the infinite humor of the Reproductive Gods, you might be able to conceal a first pregnancy for, oh, 7 months or so, but with subsequent pregnancies you look about 3 months pregnant before you're done peeing on the stick. It's like the muscles know what's coming and they just don't even bother hanging on.

I walked out of the ultrasound still feeling fine, but befuddled. Instead of measuring at 10 weeks, the yolk sac was measuring at 5 weeks. And there wasn't, actually, an embryo to measure. But instead of getting the sympathetic head-tilt that might have triggered alarm bells for me, the ultrasound technician was all bouncy and upbeat, talking about how I must have just been off on my dates, no big deal, everything looked great. I could go home, put my feet up, and keep my regular appointment with my doctor in two weeks. No, no, no reason to see the doctor now, immediately after the ultrasound - she could just pass the information along and that would be fine. Buh-bye, now! Have a nice night!

Now, Willem and I are numbers people. He moreso than I, of course, or at least he successfully plays one on his math grad student TV show, but still. Being off by more than a month seemed like an awfully big lapse. And by the time I got home, I realized that I'd had my first positive pregnancy test six weeks before that appointment - more than a week before the five-weeks date the ultrasound tech was offering. Since I don't tend to believe in the predictive value of my own urine, this just seemed wrong. I called the doctor from home, told her the story, and she suggested I come in the next day for bloodwork, just to set my mind at ease.

I'm still not entirely sure how having another person poke me with a needle is supposed to ease my troubled mind, but I'm an agreeable sort (what? shut up! I am TOO!), so I went in. And scheduled follow-up bloodwork for two days later, because the thing about is-she-or-isn't-she bloodwork during pregnancy is that you don't just need the presence of the magical chemical hCG, but you need to know what it's doing. It should be doubling every two days for the first 12 weeks, and then just when you're about to reach toxic levels and start ripping the heads off random strangers just because you can except that you're so tired you won't bother, the placenta takes over and the second trimester glow kicks in.

So it happened that about a week after the car accident, I was back at work, now worried about the pregnancy but having been told by both the perky ultrasound technician and the doctor that while the ultrasound readings seemed unexpected, there was NO evidence of trauma due to physical injury. I was in the third floor chart room of a state mental hospital north of Boston when my cell phone rang; I actually shushed Elissa Ely (google her, she's famous in Boston and a fabulous writer, not to mention a pretty decent psychiatrist, even when working with lowly interns) to take the call. It was my obstetrician.

"I'm so sorry," she said. "We never suspected this. We were so busy looking for bleeding or trauma that we didn't really pick up on the discrepancy in the dates [something something] not developing [something mutter whimper] blighted ovum [don't cry now, have to walk through the locked psych unit to leave, don't cry here] no chance of improvement [oh God oh God oh God] can wait for it to terminate naturally or [no no, you can't say things like that to a pregnant woman, oh, shit, but I'm not pregnant] schedule a procedure [please stop, tell me this is not true, please just stop]..."

Somehow, that conversation ended. Somehow, I left the chart room and navigated through the hallways without any of the patients picking up on my angst; which is astonishing because those with severe mental illness are very, very skilled at recognizing emotional turmoil in others. Somehow, I found myself standing in the doorway to the interns' office, facing five or six people I'd worked with for two months. I started to talk, and choked on my own words. I fled to the bathroom across the hall and bawled, just leaned my face against the stall wall and cried, open mouthed sobbing, eyes streaming and nose running and generally about as undignified, and uncaring, as I have ever been in my life. I have a vague memory of one of my fellow interns, Jillian, coming in and speaking, though I can't remember what she said and I didn't leave the stall for a long time. I have another vague memory of another intern, Giovanni, stopping me in the hallway, saying, "My wife is a doctor [I need to go home] been through this ourselves [how the hell am I going to drive two hours home like this?] if there's anything you need [I need my husband] don't rush back to work..."

I drove home. I called any number of people, just to talk, just to make the minutes pass because it was such a long drive home and I couldn't possibly think about anything else and I needed something to ground me enough to make it home. The first person I called was Carolyn, one of my very closest friends, who, if she hadn't been about 107 months pregnant by then, would have driven me home herself - and probably would have anyway if I was thinking clearly enough not to drive. I called my mom, I called Willem. I don't remember. I know there was a long dead spot, no cell service for about 30 miles, and I turned the radio up so loud it hurt. The last person I called was Jenny, another dear friend, and by then I had burned through the initial adrenaline rush of shock and hurt and was almost flippant. "Hey, Jenny, it's Kate. Just calling to let you know that I can't go out to dinner tonight, I'm not staying in Mass. tonight. Yeah, I'm having a miscarriage instead. Talk to you later!"

And then I waited. For three weeks, I kept going to classes, going to work, and waiting. Kept looking pregnant, kept feeling pregnant, and, except for the fact that I spent a minimum of three hours every day crying, kept acting normal. Just waiting. The doctor had explained, "Eventually, your body will recognize that the pregnancy is not viable and will spontaneously abort, but you can schedule a D&C at any time." At my convenience, you know? Like making a dinner date. Whatever should I wear?

I was waiting for some sign from my body, some agreement with the doctor, some recognition that this pregnancy was not going to happen. It was like a metaphysical game of Chicken: which came first, my body's recognition of reality or my brain's capitulation to the stress and misery? Turns out, my body can outlast my brain by about a week. On October 13 I gave in and scheduled a D&C for the 21st; on the night of the 20th, I started to bleed. I still had the D&C, because the bleeding was light and unenthusiastic and the doctor thought it could take up to a month on its own.

It was a blighted ovum, which in normal-person language means it never became an embryo; sperm and egg met and did their thing and triggered my body to create a yolk sac and get nauseous when I brushed my teeth and go up two bra sizes, but stopped developing long before anything even resembling a tadpole, much less a person, appeared. It was not my first pregnancy loss, but it was far more difficult and painful than the other, which happened when I was 19 and ambivalent and unhealthy.

So that was October, and the next several weeks are fuzzy and indistinct. I do remember going to the Pumpkin Festival in Keene, where we lived at the time, and taking Emily to the nighttime fireworks display, and dancing with her in the street, and finally remembering that here was proof that life wasn't all bad, wasn't all unfair. I remember my mother coming out to take me to the procedure, and getting me home again afterwards. I remember Willem being a little frantic and a little clueless because he had never seen me quite so broken, but also being so good with Emily, and caring for us all, and not saying any of the incredibly stupid and thoughtless things that half the planet feels compelled to say when presented with the topic of "miscarriage."

That was November, too.

And this is quite long enough, so I'm going to post it and go to bed.