Primates of Park Avenue

by Martin,Wednesday

  “What do you see down there?” I asked the doctor. I didn’t feel nervous. I had been told to go on bed rest before because I might well have had a miscarriage—most recently a year and a half ago or so, I mused now, my feet pressed against the Minnie Mouse washcloths, if that’s what they were, that covered the stirrups—and everything had been fine. Lily, the calmest mother I knew, had exchanged long, reassuring emails with me about it for days and talked with me on the phone for hours as I cried. I went on bed rest, and we got a home health aide who did Sudoku and made me penne with Bolognese sauce. I watched The Real Housewives of Orange County. I told Lily and Candace about every episode, in great detail, and they listened and laughed and kept me afloat. Everything was fine, the way it had been fine about all the other things—the time I started bleeding bright red in my first pregnancy and the doctor gave me fifty-fifty odds; the time during the birth of my first son when the nurse, watching the baby’s dipping, arcing vital signs during the absurdly long labor, exclaimed to the doctor, “This baby is coming and going, and I don’t like it!”; the problems with my husband’s ex-wife and his daughters as he and I tried to make a life together; the dramas and disasters that seemed to never end. Everything was always fine.

  “You don’t want to know,” my OB sighed from underneath the pink sheet draped primly over my lower half. Now he pushed back in his rolling chair to where I could look at him, and when I began to hoist myself up on my elbow for this conversation, he said, very quietly, “Lie down.”

  Lying flat on your back is a strange way to get bad news—unless the person looms over you or you close your eyes, you’re just staring up at the ceiling and listening. And then, depending on the severity of the badness of the news, you might experience what I had previously thought to be a cliché or a dramatic device—you might find yourself looking down at your own body. A voice was saying “bulging membranes” and “incompetent cervix” and “Her foot is sort of sticking out of your cervix” and I was wondering, How did I get up here, and who is that woman down there who looks so upset? It was as if her whole face were crying—contorted, red, melting into itself. Her roots were pretty dreadful, too.

  When my husband grasped my hand, I slammed back into myself. It was a painful sensation, like bumping your elbow, except your whole body is your elbow, and I felt dazed and flattened somehow as I demanded, croaky-voiced and incredulous, “What?” Now I could see my OB’s face as he said, simply and with a forced calm quietness, “These things usually don’t end well.” He looked pale and tired. I noticed then that I was wringing my hands together, but it felt more like searching for something and trying to rub it away at the same time, and I willed myself to stop.

  “So do you think I’m going to lose the baby?” Now I felt almost serene. Was that the worst thing? Okay. Was he going to tell me something worse? I doubted it. We hadn’t been sure we wanted this baby and at the very last minute we decided that we did, and now we might not have her. But we would. Wouldn’t we? Everything was going to be fine. He mentioned a cervical cerclage, a little stitch or two to hold the cervix shut, and I said that I knew what it was, and told him I had written a story about it for a woman’s magazine once, it had prevented a woman I interviewed from going into preterm labor, and then she hung upside down for a few weeks, and everything was fine.

  It can only have sounded like so much yammering to my doctor, who nodded and repeated that he was sending me to the hospital right now.

  “Like, right now?” He nodded. For how long? my husband asked, squeezing my hand. “Well,”—my obstetrician played for time here, I have to suppose in retrospect, and then he said, slowly and precisely—“it really depends. It could be a long while. Or not.” There was a doctor at the hospital who specialized in high-risk cases, he went on, mentioning this other doctor’s name—oh yes, I loved him, he had done my amnio all three times, he was wonderful, I prattled and chatted—and this doctor might have some other ideas. So go. Go right now? I asked again, aware that I had asked this before but unable to remember the answer. Yes, he said, unsmiling. I got myself ready and he told me he liked my shoes. I told him that they were called skimmers, and that they were for the rain, and that girls have all the fun.

  Once I was admitted, I asked a resident who came in why they hadn’t elevated the feet of my bed. Why was I just lying flat? Wasn’t the point to keep the baby in there? She smiled. “Do you really think it’s a good idea to spend the next eighteen or twenty weeks with your feet up? Come on now.” I stared at her, smiling at me like we were in on the same secret, like we knew the same things. I nodded in confusion, my impulse to agree apparently unaffected by the dim realization that I was agreeing, quite possibly, to a tragedy. For a moment I understood what she was saying, glanced it, and then I ducked away.

  What the hell did she think I thought? I thought there was going to be a way to make this all better. I was waiting to talk to the high-risk OB who had done my amnio every time, the one who was so young and cute and smart that all the mothers and expectant mothers called him Doogie Howser behind his back, and he could fix anything, and he would.

  They were going to do an ultrasound later, hours and hours later, so my husband would go home for a bit. I made a list of things I wanted him to bring back to me when he returned that afternoon. This included makeup and toiletries, a collection of academic papers on women and aggression, and a Henry James novel I had already read four or five times. And I wanted a picture of my sons. Looking at their faces would be like reading Henry James again and again—I knew the outcome, and it was comforting, in spite of the difficulty and sometimes the pain, to trace those same familiar contours over and over with my eye and with my mind. Someone brought me some horribly vivid green Jell-O and I thanked her and asked her to take it away and with an understanding smile, she did. Another doctor came in later and asked me how I was and what I did and when I said I was a writer and researcher she said, “Don’t research this, please. You’ll drive yourself crazy.” I promised not to and then I started to cry and she said something kind like they all did. Gesturing to the photo of my two young sons I had taped up next to my bed—my older son laughing while his baby brother screamed at the top of his lungs, perhaps because his big brother was pinching him off-camera, or perhaps just because—I told her that I already had two kids. If I didn’t I don’t think I could bear this, I said. So it could be worse. She looked at me for a moment and then she said, very quietly, tilting her head to one side, “It could be worse, but it could be better, too,” and she was right.

  “Here’s the baby, here’s the heartbeat,” the ultrasound technician said, unable to meet my eyes. Then she fled, leaving her clipboard and her glasses behind. “I’m going to give it to you straight,” Dr. Doogie Howser said as he walked in, looking at the ultrasound projected on the wall. My beautiful baby in silhouette, floating in her grainy gray shadow world, the mysterious not-knowing, not-known world, the sound of her heartbeat playing loudly, soothingly, reassuringly, like something that will never stop.

  “Okay,” I chirped. It was going to be fine.

  He started to talk, quickly, like someone wanting to be finished, and it was this quality that I noticed before I really heard or took in the words. The upshot was that Daphne was doomed. There was no way. Well, there were extraordinary measures, but the chances that those would save her were heartbreakingly, sickeningly slim. And the risk to me was tremendous. Infection, high blood pressure, death. Daphne was dying inside my body, and simply too premature and too unhealthy to survive outside, even in one of the world’s best NICUs. His voice went on, quiet and quick, urgent, firm, a voice that was reasoned even as it said unreasonable, insane, and impossible things. There isn’t going to be a baby. She wasn’t really waving at you in that ultrasound last week. You didn’t want her and then you changed your mind and now you can’t have her.

  I said No, intending just to cut him off, to say No, wait, what about, to steer him to anot
her way of understanding it, to lead him to the part of the room or the sentence or the idea where Daphne was fine and everything was just fine, to the place where broken things can be salvaged and put back together. But I must have been screaming instead of talking, because the doctor beside him said, “Oh my God,” very softly and put her face in her hands, and then she reached over to turn on the light and the room was garish and antiseptic, and there was no way to hide from anything. No more grainy beautiful shadows, no baby Rorschach to watch, to be lulled by, to follow to another place.

  Sometimes women wanted to have labor induced and then deliver the unviable fetus, the doctor was saying, and some wanted “to let nature take its course” and expel the fetus . . . “Are they crazy?!” I demanded of no one in particular, cutting him off. But Doogie Howser seemed to think I really wanted to know, and he said, “Well, some women find that, for closure, they want to go through the process, and see the—”

  I cut him off again. “How big is she?” I demanded and he said, “We don’t really . . .” but I urgently needed to know this now and I practically shrieked, “How big is she? Tell me how much she weighs!” and so he made an estimate and I began sobbing again, but it was an easy decision, now that I knew. She was someone to me, and I could not wait and let her dwindle away into nothing, it could not be a slow fading goodbye like that for my baby. I noticed now that my husband’s eyes were closed, and he kept them that way for a long time as I stared at him. Daphne was kicking a lot now and when I looked down I noticed how absurdly, extremely pregnant I looked for someone just into her sixth month. Because I am small, and because this was the third baby, I had popped early, and looked much farther along than I was, and it was, in that moment, unbearable to contemplate the huge nothingness that had opened up in the very spot where there had been a body that changed and grew, plans, a newly decorated room, a baby.

  Letting nature take its course, the doctor was saying, could take a few days, and now I knew what people meant when they wrote or said that they felt cornered “like a wild animal.” I was trapped, crouched in a spot that was getting smaller, and I used my words to try to push my way out, but it was hard to talk—the words came out like breaths and gasps, and I was angry at myself for that.

  “She isn’t in pain,” Doogie Howser was saying now, “And you didn’t do anything wrong.” And when I asked him, “How do you know? How do you know it isn’t my fault?” he grimaced and closed his eyes for a moment, and then he opened them and said, “Because I know. I just know it’s not your fault.” Something had pierced his expression, it seemed, as he said it—he was suddenly a person talking to another person, trying to coax her back into the world.

  I stayed alone in the hospital the night before the surgery, insisting that my husband needed to be at home with our children. Since I was in the labor and delivery area of the hospital, I heard babies crying as I slept. I jerked awake again and again, realizing I was in the hospital where I had given birth to my children, thinking I had to get my baby, that it was my little girl who was wailing nearby.

  Dr. Doogie Howser would do the surgery, and he came by the next day in the morning to tell me, somewhat sheepishly, that it was scheduled for 3:00 p.m. He was sorry for the delay, he said, and then he looked at what I was reading and we chatted a little about Henry James. And then I waited, first alone and then with my husband, talking and doing nothing. I couldn’t eat, but I didn’t want to. Daphne was kicking so hard, fluttering so much, that you could see it through the hospital gown I was wearing. The doctors explained that this had to do with the amniotic fluid seeping away. To me, that sounded a lot like she was suffocating. I kept telling her, in my head and aloud, that I was sorry, and that it wouldn’t be long now. At one point I turned to my husband and said, “We’ve had some good times,” something I always say to him when something terrible is happening, and he smiled.

  I thought I was okay as they wheeled me into the OR, which really does look dramatic in the same way it does in television shows when they do those shots from the perspective of the person being wheeled in. I was fine until we got inside, where it was hushed and very somber with bright lights, and everyone in their green scrubs and masks and shower caps, and they started to transfer me from the gurney to the operating table—is that what it is called?—and Daphne fluttered and kicked, and in spite of or because of the fact that they had told me this was happening because nearly all the amniotic fluid was gone and she could not survive, it felt so pathetic that I said something like, Please hurry, I can’t stand it, she’s kicking so much. I noticed a nurse crying—she was wearing a pink surgical mask—and then Doogie Howser was holding my hand and talking to me. He asked me if I had anything surprising, like piercings, that he should know about, and I laughed and we talked about all the surprises he had had along these lines. He kept holding my hand for a long time, which was at once awkward and reassuring, like a date almost, but a date with someone who is about to perform a surgical procedure on your dying baby because she doesn’t have a chance in hell and you can’t sit around and wait to expel her. I asked the anesthesiologist what she was going to give me and she said, “Something to make you go to sleep,” and Doogie Howser rolled his eyes and said, “I don’t think you know what we’re dealing with here. Tell her exactly what you’re giving her and exactly how much.” She did—it was some kind of benzodiazepine, and I remember telling her that I wanted to give me the maximum dosage, so I would be completely out, gone, but to make sure that I didn’t die from anesthesia. And I wanted clean lines, I managed to say as I was going under; I had children and I didn’t need to die of some stupid, entirely preventable infection.

  Afterward my OB was there, and my husband, and we chatted and then Dr. Doogie Howser came in, probably to get a sense of how I was doing. He said hello and asked, “Do you remember what we talked about after the surgery, when you were waking up?” I opened my eyes very wide, feeling alarmed, wondering, searching. I had no idea. “Was it anything we can’t repeat in front of my husband?” I ventured, and everyone laughed except Doogie Howser, and then eventually he left the room and I was left wondering what the hell I had said. What had I said? To this day I wonder what I said; to this day my response to losing Daphne is to wonder what the hell I said to Dr. Doogie Howser in the moment I was swimming out of the blackness. The anxious, nagging worry is a black cord that connects me to him, and to her.

  The doctors had all said “the pregnancy” and “the fetus” when we discussed what was happening and everything that could not be done. The fetus could not be saved. The doctors could not take any steps to prevent this stillbirth of my fetus. It could not be turned back or turned around or stopped. The fetus was unviable. Then, the social worker who came after “the surgery” called her “the baby.” This sharp and sudden semantic shift was presumably intentional. Shut down the mother in your brain so you can have the procedure. Open up the mother in your brain now that she is dead and disposed of, so you can mourn. The way we always have for the forever which we’ve lost our babies. The social worker asked if I wanted a funeral and I said no. The high-risk doctor had already asked, and had told me that if we didn’t, she would have a “hospital burial,” explaining that basically she would be dispensed of as medical waste. “Which she isn’t,” he was quick to add, and I said, “Well, I guess she is,” since we hadn’t been able to donate any stem cells or use her tissues in any other way. Now the social worker asked if I wanted a memorial box. It had a baby hat inside, she explained, and the death certificate, and a little hand and footprint, and I grimaced, I think, feeling that was outrageous somehow, and ridiculous. I imagined what I might do with such a box—shove it into a dark spot high in a closet? Put it in the storage unit? What? We talked about how I felt singled out—who the hell loses the baby just into the sixth month? You feel safe after twelve weeks, who knew? And why?—and she pointed out that all the women in this wing of the hospital had lost their babies during the second or third tr
imester. A whole wing of us, I thought. Something to feel good about.

  Motherhood is carved out of death’s territory as much as it is out of the territory of the living. No one told me that. Not the pediatricians, and not the upbeat magazines like Fit Pregnancy! and New Mom!. But when I turned to anthropology, to the books on my shelf already and the ones I bought in the months after I lost Daphne, trying to understand, I saw this massive true secret, stretched out but never worn out, across what seemed like eons. Nisa’s losses helped me make sense of my own. And now I learned something else, too, the obvious lesson that had never occurred to me: when a baby or a child dies, the world stops. In a small but very real way, a way that cannot be undone or denied, the world ends. And then slowly, over the weeks and months and years, it is the job of everyone who loved that baby or child, who has ever loved any baby or child, to remake the world, to get it to start again. And then again, another job, more work: to somehow find a way to live in a world where something like this can happen. To live with the daily bitter taste and the unfairness. The flat, anguished sensation of having been turned inside out, of being unprotected. The crazed but logical, urgent-feeling need to hide away your littlest one, the one who is left, the obsessive fear that now he or she will be hit by a car or walk into the pool or somehow, anyhow, be extinguished. How long had it been, I wondered day after day, week after week, that women had felt this way, had known this and forgotten and remembered it? It was in us, I knew.