The Infertile Maternity-Leave Temp

Part I

Unable to conceive on my own I ended up taking a job scheduling patients at a local hospital. I had two masters’ degrees and was working towards a Ph.D. when the diagnosis of infertility threw me for a loop and derailed me from my original intent—which was to be a college professor and have a fabulous life. I started working at the hospital as a temp—an adequately paid minion’s position in the hierarchy of hospital life that does not require a BA, though one would be preferred so that they know you can talk good. It turns out I talk very good so I was soon promoted to the role of maternity-leave temp. Yes, most sensible well-run organizations stock their human resources departments with a few maternity-leave gal Fridays to pick up the slack when someone goes on leave, or in worst case scenario—bed rest. Just look at the work place, the herds of folks working as mid-level administrative assistants are often breeding up a storm—or getting ready to get married so they can breed up a storm. Or plain and simply wearing big tops to mess with the boss’s head. Most women love these jobs because they get benefits and can support families without too much trouble. In my case, I became the infertile maternity-leave temp as I descended into a childless funk. How could having a baby ever be so hard?

To hell with a career—what I really needed at age 40 was a hospital-desk jockey job—where all efforts are spent on the telephone. Where I didn’t have to be a snappy dresser, where I could dash across the street without a fuss whenever I needed a blood test, or some other round of medical torture. I soon landed with the department of Coagulopathy Studies and voluntarily became the personal bitch to Dr. Eugenia Budd. Dr. Budd, a former oncologist, specializing in blood cancers, had a conversion experience upon giving birth to her first child: As she pushed him out—a healthy baby the result of four IVF attempts—she realized she wanted to work with the living—those who were going to live. In particular, those ladies with little clotting problems that sometimes cause numerous miscarriages. Well wasn’t this just my karma? WTF I thought when the temp agency placed me with her and all the other physicians who study blood, blood and more blood.

This is the story—and not exactly in order, There is a baby, oh yes, a baby girl, eventually, the result of many wishes, an unshakable will, and the contortions of modern medicine, and thankfully the HMO that footed the bill. And thankfully the state of Massachusetts and a savvy lawyer named Susan Crockin who lobbied our state legislature in the 1980s so that treatment for infertility is covered in this state. God bless her pea pickin little heart is all I can say. That or there is a baby that was born somewhere around here, we don't know, to a socially challanged individual who--or there is a lactose intollerant baby from Asia. Here goes—

I am pregnant again.
Five days pregnant, pee-on-the-stick-get-a happy-face pregnant. I am 44 years old. Before the infertile quietly say in their minds, where is my gun so I can shoot her and then myself, let me tell you about last time I was pregnant.

It was after an IVF cycle.
The fifth one. The very last one. My numbers rose. We were ecstatic, my wife and I. Yes, this one’s the deal, we thought, and we eagerly went back to the IVF clinic for that confirmation ultrasound only to find that there were no eggs in the basket. Oh, they were somewhere, likely to have drifted over to the fallopian tubes. But there was no gestational sack to be seen. No heart beat, just the rising numbers in my successive blood tests. On a January day, in a blizzard, the chemotherapy drug Methotrexate was jabbed into my ass. I was dismissed. And for two days I ached as the hopeful lining of my uterus melted away, and along with it, the happy hormones of pregnancy. I was in a biochemical post-partum state, clinging to the arm of my sofa. My wife watching from the other side of the room. Powerless.

I am four months pregnant.
Four months oh-god-could-it-be-true pregnant after a formerly frozen embryo was placed in my womb one hot July day. The day so hot, speeding to the IVF clinic across town. Resolved that whatever happens happens, and I don’t care so badly, but I do because I instinctively know, somehow that it will work. As we pass a used baby-toy store on Route Nine I see a giant ladybug that seems to be both a car and activity set. It is for a baby just starting to walk. I want the giant ladybug for the daughter I want to have. I want to sit it in my living room, like an auspicious sign because I know, I just know. I want it bad, but I say nothing. The car speeds on, the trees shading us. The nurse at the transfer holds my hand. Everything happens so easily, unlike the first 4 IVF attempts where I am still recovering from a trans-abdominal retrieval that feels like major surgery. The embryos go in. We watch them on the screen, they slide right in in a wash of lab-prepared serum. There they are. Perfect, thinking of dividing. We are given a picture. Somehow I know…I know. I am four months pregnant and carrying 2 pizzas and a two-liter of Coke for the workers installing windows at our house. I start to bleed. It feels like the first good trickle of menstruation. Maybe a twinge of a cramp. I lay down on the sofa. I call my doctor. I call out for my wife. We rush to the hospital and are put in triage. There is a line of people to be signed in. I don’t care about the woman who comes in behind me, suffering with the labor of her fourth child. I take the last available chair, sit, put my feet up on the wall and wait. I am angry and I am jealous. I am afraid I will lose this pregnancy. I start to talk to the baby. "Stay. We have so much. Each other and a nice home. A strip of green yard that looks like Ireland. Dogs that bound and play. Cats, and this beautiful city called Boston. A big sandbox called Cape Cod where we will turn you loose to play. Stay with us.

Agony. Let me tell you about agony.
I promised myself three years earlier that it would be easy. Yes. Put a little sperm in there and someone will grow. Just like that. It’s how it is done. Four cycles go by and anxiety sets in. Clomid is added to the regimen and wow. I am pregnant! Easy! I am so pregnant and fertile at 41 that my numbers skyrocket. The Dr. nods her knowing nod when she sees my rising HCG. It could be twins, but we won’t know until ultrasound. But when we get in there, there is no heartbeat. There are two empty sacks. Or are there three or are there four empty sacks? Or are those fibroids. I was blindsided. Blighted ovum. Lights on, no one home. A regular Andromeda Strain in my womb. I didn’t expect to fall apart later in the car, in the hospital-parking ramp. Dilate and Extract? Really? Missed abortion? How dare you call it that, check it off on a form that was printed in 1990 and then copied so many times the printing has blurred. I didn’t miss anything. I didn’t abort, that implies intention! But no matter my words, no matter my wishes, no matter how many times we wave the ultrasound wand, no matter how many times the hospital bills my HMO for tests and more tests. Nothing changes. A day after the Dilation and Extraction I can’t stop crying. My wife talks me into going to the movies. I decide to spend time in the bathroom because I can’t stand the theatre, the script, the everything. Don’t look in the mirror, I tell my self. Don’t look. But I do, and I start shaking, and I erupt with something I can’t explain. A tide of hormones, post partum rushing out, and me chasing them, begging them to stay. Please stay, yet I can’t move the moon overhead, It doesn’t work that way. I would have stayed pregnant forever, just to grow a fist of tissue. But that fist would never be a baby. Never. Six months later I look up the pathology results from my Dilation and Extraction to see what they excised. It was "grey tissue, the remnants of conception." It was cold and clinical. Probably some path-lab flunky writing descriptions late at night while going to medical school. Remnants. No curly blond hair or green eyes. No giggle. I print the pathology report. I hide it in my desk at work. I read it over and over again. Then I can’t stand seeing it and send it through the shredder.

I am seeing a newborn girl held up in the air.
She has an ancient look in her eyes. Like she is saying "What? I was happy there." My wife holds her. I see that look on my daughter and wife’s face for an eternity. I have known this baby forever. Yet in that moment I think, sense that something is terribly wrong.



That I am dying. After 5 days of induced labor the cesarean section was an emergency procedure. I ask later if I walked into the OR. My wife shakes her head, having been through a 5-day ordeal. So many times it seems I have walked into an OR in a Johnny with rubber socks on my feet. Somewhere around that third day something was wrong. I was begging for a c-section. I turned my head and closed my eyes. I will keep them closed until this or I am over. My ankles swelled up. My kidneys failed acutely. I wanted water fiercely. I was furious every time it was refused. I told my wife to shut the fuck up. Water.

I am watching a silver spotted dog fly down the length of the yard.
She spots a Frisbee and with honed skill becomes airborne, connects her mouth to the disk, snatches it out of the sky, lands with the grace of a dropped piano, and returns in a swift loop, insisting on another throw.

I am watching a small brown dog, a terrier with elegant legs that lives to jump. She cartwheels over the grass. She flips blindly in pursuit of the ball. She does a victory lap before placing the ball in my hand and posing like a short stop.

In my heart as I hear it on the monitor with the bongo clip of the infant’s heart rate, I imagine that silver dog galloping in the sheep pasture. Her galloping raises a yellow dust. Let me do this, my wife said just days before. She meant that she had to go be with the dog as they put her down. My beautiful silver problem dog with a Lone Ranger's mask and hemangioma carcinoma. Inoperable. We came home on a Tuesday after work and she could not run. She limped out of the house, her gums white, her toes splayed, looking at me knowingly. Truth is, she had been wheezing on the stairs, moaning in her sleep at the foot of the bed. I had thought she was imitating me at first because we are so in sync. I don’t know why, but this dog came into our home, chose me as her person and pushed the small brown dog out of my arms. There I was eight months pregnant, sitting on the filthy veterinarian’s floor waiting. My beautiful silver dog wasn’t glad to see me, her side shaved and re stitched up like some kind of Frankenstein, unable to lean on me. Already she knew what was in store, though I didn’t. As we parted, all I could think to do was to put three pieces of kibble in her mouth. It was all I had thought to put in my pocket. I slipped it in her mouth, feeling her tongue, and tickling her lips one last time. I love you. And she is glad to be rid of me. Our work together finished. If I could bring that day back, I’d have packed my pockets with sausages and raw green beans and buttered toast crust. All her favorites so she would know.

She went, the baby is to come. The dog, named for the goddess of motherhood is to watch and protect us.

I am getting a call from the nurse eleven days later.
This is after the 4th IVF, after a 3rd IVF was botched. This is after the surgeon got 30 eggs and over half of them were fertilized. This is after 10 were placed back inside me. "I’m sorry, but I don’t have the news you want." Everytime I get this call, every time right before I bleed, it’s as though those embryos are fire works—going up into the sky, exploding in beautiful promise one after another, yet they dissipate, fall, and fade.

This is after the embryologist comes into our blue curtained cubical to announce to the entire world—you have beautiful embryos, BEAUTIFUL! Six of them, ten of them, twelve of them, nine! It’s as though she says it on purpose within earshot of the woman next to us who does not have beautiful embryos—who will be 43 next week and cut off from all future IVF attempts with her own eggs. I know all this because our previous IVF attempts have crossed paths. I see her get up, in her Johnny and rubber hat and walk into the procedure room with as much dignity as she can muster, her graceful husband bringing up the rear. What I heard through the curtain: "Fragmented" "only one" "so very sorry" "Might as well try…"

The waiting room. Or:
The hierarchy of patient folders in the Assisted Reproductive Medicine Suite at a major hospital in Boston: No folder—couple holding hands: there for initial consult, scared, hopeful, or completely innocent of how their lives are about to be hijacked for a few years. Blue folder—novitiate: declared infertile—on to injectable medication and 2 well-timed interuterine inseminations (IUIs) per cycle. Easy-peasy, we will be pregnat in a snap. The red folder—The mother load, the infertile warrior—if there is a spouse, they are not holding hands because the social work department has probably suggested they commence marriage counseling. The very rarely seen shiny green folder—If held by an "older" patient yet hopeful-looking woman, she has probably plunked down somewhere in the ballpark of 30K to become ocyte recipient. Likewise, a shiny green folder held by a young annoyed-looking woman usually means she is being stimulated to donate her eggs. The wait at this hospital—the hospital where I have come to work—is always heinously long. No wonder the college kid is perturbed. Having arrived at 1 pm for a 1:15 appointment it is now 2:30 and counting, and that’s just how it goes. The inhabitants of the waiting room often get to know each other, or they slyly glare at each other, wondering, wondering, just what is her story?

One time so gleeful after an ultrasound on the 11th day of injectable stimulation, my wife hushed me when another woman got into the elevator. She was clutching the telltale red IVF folder to her chest and tears were pouring down her face as we rode to the 3rd floor in silence. "She didn’t have a good ultrasound" my wife said. "I heard them say they were going to cancel her cycle." And we? Well, this was going to be the time we told ourselves because I was growing eggs like a she lobster grows berries.

"I’m sorry, but I don’t have the news you want to hear."

The dogs and I are driving away. We go to a place called the Sheep Pasture. The big dog sticks her ears out the sunroof, her front feet standing on the console and her rump resting on the back seat. The little dog rides shotgun. The pasture is so beautiful you would think it was heaven. We walk and walk, my big dog in unabashed joy, ready to charge off and make friends. I am swollen from all the injectable drugs, and I cry silently, feeling the earth beneath my feet. I cry until I see all the other dog walkers. We converge on a gentle hill top. Twelve dogs weaving in and out amongst each other. 12! Having an impromptu play date, their bodies brushing up against one another in perfect joy. I realize that I would be the mother who would get the calls from the teacher because my dog is so badly behaved. In fact, that’s why we are there, so my problem dog with a healed brain injury can socialize. It cures me some how. The small brown dog—15 pounds—is smaller than the rest. Yet she always gets the ball. Always wins, always does a victory dance. I am proud of her. I cry less that night.

I am put in bed, a dog on either side of me to sleep and guard me after an emergency intubation on the first IVF cycle. There they always sleep. Especially on a sunny day.

I am watching a two-year old girl run full throttle down the length of the yard. Her little legs fly, her perfect little butt cheeks hang out from under her top. Up somewhere by the shed are her panties and shorts. She has made a compromise with us. She will wear the top, but the pants must go. After a full day of encasement at school she feels this is reasonable. Some people have entire out-door kitchens and grills so that they can eat en plein air on a hot day. The more sophisticatedly artistic among us paint en plein air. Our daughter, well, she poops en plein air. It wasn’t our intention to start this habit. What happened is our neighbor brought over a spare hand-me-down potty-chair, and we forgot to take it in the house. Then we realized that the house is very far away when you are two and you have to go NOW! So the potty stayed, and so she sits, from time to time, giving us a wave to let us know she’s all right. Once she has finished she stands up; kicking off all layers on her bottom half. A look of glee fills her eyes and she bolts away. Free at last, free at last; thank god almighty I‘m free at last!

"Maeve, where are your pants?" we ask when she simmers down.
She shrugs, finding her words: "I’m a no."

There was a lady—attractive, long dark hair—looking like a retired fashion model. She seemed so nice. She had the red folder. I still had blue, which means I was still in the IUI phase. I saw her months later at the hospital and I thought—jeesh—still not pregnant? She looked sad and resolved. Then came the time I had graduated to the red folder and I saw the same lady again while we both waited in a waiting room full of Oprah magazines as old as a toddler. Jeesh—still not pregnant, I thought. And it must have been some kind of final meeting because as she left the waiting room, a nurse practitioner called out her name. They came together and embraced, sharing a final intimate moment. And that’s the last time I saw her. I wonder if she adopted, or maybe she was pregnant. It dawned on me then that it doesn’t work for everyone.

Four years and counting and still childless. I might be pregnant again.
Tomorrow, a Saturday I will stop off at my favorite IVF clinic for a blood test on the way to New Hampshire. I have all the symptoms: the feeling like I could cry and the feeling happy and the feeling anxious and the feeling like I could just die all at once. Dr. Eugenia Budd and I are having a chit chat. "You know you don’t have to wait until tomorrow all you have to do is pee on a OPK stick and it will tell you. Ha HA HA! Maybe I shouldn’t have told you that. Oh well, bye!" Of course I have an OPK stick left over from my pre Clomid days. My wife is fast asleep upstairs. I pee on a stick. It is ever so slightly positive. I call Eugenia Budd back on my speed dial. She says "Seeeeeeee?" I go up and nudge the wife to show her. She sits up. "Now I’ll never nap!" she says
"Might as well get used to it".

We stop at the IVF clinic and we know what they are going to tell us later that day when they call.

I am pregnant again.
Four weeks pregnant, but without the ultrasound confirming what we know. I am caught in a rainstorm on Cape Cod so I dart into a clam shack and end up sharing a table with two urban doctors, a husband and wife, who talk a blue streak about their four children. When she asks about my children and I tell her I am in that state of almost pregnant she says "I am rarely wrong, but I am pretty certain it’s a girl."

I can’t stop eating and buying chicken soup at 11 am in the hospital cafeteria. I take too much so that the lid squirts when snapped on the Styrofoam cup. "It’s like a little boy!" I say to Aida, the cashier, who responds, "Yah, but you’re having a girl"

This emboldens me a week later when I climb out of the pool on a hot day, suddenly with cramps, only to discover a brown pool underneath me, and brown rivulets running down my leg. Noooo! It can’t be—it’s going to be a girl—both the psychic doctor and the cashier promised me. A girl, our girl. I go to the locker room, I am hemorrhaging all of a sudden. Big fruit like clots, one with what looks like a beansprout. I am naked wrapped in a towel that bears a widening red stain. "I think I am having a miscarriage," I say to a friend so lucky to be 7 months pregnant at the age of 40. She lays me down on the floor. Cell phones are brought to me. Bottled water administered. I am acutely aware of the glare from an angry looking woman. Does a smirk curl her lip? Has she cursed me, is she the victim of failed IVF or failed romance only to find she can’t bear children, and is therefore vengeful with jealously? Is this the evil eye? I close my eyes. I will walk to the emergency room across the street in my towel. I will stay there all day, past midnight. I will bleed and bleed and bleed and no heart beat, no gestational sack will ever be located by the callous x-ray technician chewing gum.

I describe what happens to Dr. Eugenia Budd, the hematologist and expert of coagulopathy who takes care of pregnant ladies who happen to miscarry a lot. Dr Budd used to be an oncologist but switched her focus on to trying to keep people with blood disorders pregnant. In a nutshell, Dr. Eugenia Budd knows it all. She’s been there personally, done that, and would never shit a shitter.
"That’s not good, sweetie. Sorry, so sorry" and I know that once again it’s a scratch.

"Don’t breathe," says the Dr. at the IVF clinic.
We went in with a song and dance: bleeding in the pool—here’s a frozen clot the size of a grapefruit slice in a zip lock bag. Blah blah blah. D&C I suppose, oh well, its not the first time. I bite my knuckles, I will be so stalwart and brave. They get me up and into the saddle, feet in the stirrups.
"Stop breathing…now."
"Breathe, stop. Hold it hold it."
"Say doc," I say. "Why is it that you keep telling me to stop breathing?" He has the ultrasound wand pushed way up above my cervix inside my vagina. "It’s kind of hurting."
"Don’t breathe," he says.
And I see a look of puzzlement play on my wife’s face.
"But why?"
"Because when you don’t breathe I can see the heart beat."

Someday when my wife gets the car and comes to collect me with our daughter, I will swoop the girl baby into the air, and turn around, watching the hospital towers spin above us. I will blink just to concentrate on the delicious giggle of the baby before she is strapped in her seat and driven home.

More tk--