An Excellent Choice

by Emma Brockes

  The fact is, I do love him, a little more each day. I can’t say this too often to L; she gets tearful. I will discover this for myself one day—the profound effect of someone who doesn’t “have” to love one’s baby nonetheless going ahead and doing so. For now, however, it is simply astonishing. I have always had a lazy, negative reaction to adoption; too much hassle; too much heartbreak. Too much pressure to compensate for that primal rejection of the birth parents. I want to be pregnant for the experience of it and I want the child to be biologically mine for reasons of ego and as a link to my mother. But when I look at L’s baby, with whom I have neither a genetic link nor any formal responsibility for, my heart judders to a degree I would never have thought possible. I look at Leila, who was adopted from an orphanage in India and raised in Britain by white people and is such a testament to the limitations of the genetic argument that my dad, who has known her as long as I have, once said, “I wish Leila was my daughter.” (“All right, steady on,” I said.)

  Naïvely, perhaps, the risks inherent in my situation—of loving a baby I have no legal rights to—have never struck me as real, partly, I suspect, because I’m so distracted by the task of getting pregnant and partly because I’ve never considered him mine. It is hard to imagine a scenario in which L, who denies her son nothing, would deny him my love when I pose no threat to her parental rights. If our relationship has, at some level, been constructed to serve our needs as two single parents, then the biggest threat to us now isn’t some fight over the baby, but what happens if I fail to get pregnant.

  * * *

  • • •

  “YOU CAN’T CAUSE a miscarriage from jogging,” says Leila. It’s the following morning. She is lying on an airbed in my living room, surrounded by wardrobe options.

  “I don’t need to dress up, do I?” I’d said when she invited me to come with her to the human rights forum—oh, OK, it was the U.N.—that afternoon.

  “No. But don’t wear your fleece.”

  “I’m not going to wear my fleece. If I stick up my hand, will you take my question about Syria?”

  “Assuming it’s not ‘Where is Syria?’”

  Leila has almost no tolerance for the nonsense around fertility and, in spite of the icy temperatures, suggests we do something to burn off her nerves and give me a feeling of agency, which is to take ourselves out for a run. A few years earlier, I’d spent hundreds of dollars on sneakers and thermal base layers, even doing a race organized by the New York Road Runners club and feeling sufficiently invested to be vain about my time. For my last birthday, Leila got me a personalized message from the guy who makes the Couch to 5K app, which I’d picked up at the airport and made me squeal while boarding a flight to Miami. Since then, I’ve lapsed, but Leila hasn’t. I look out of the window; there is still snow on the ground.

  “Um,” I say. For a moment, the two halves of my new personality—the one that wants to give in to the madness and the rational side—clash. “OK.”

  We run east toward the river, our breath coming out in thin clouds, then carry on all the way to the Brooklyn Bridge. I start out mincing, clenching my uterus to prevent the zygote from joggling out of its seat, but after fifteen minutes I forget and just run. “See?” she says. “It isn’t so bad.”

  It isn’t so bad. I should feel good. I have overcome superstition and done something healthy. For some reason, however, it doesn’t feel like a victory. On my own in the flat later, I consider my frazzled state and can’t help feeling that just this once, I should have asserted my right to be weak, even at the expense of spooking my friend.

  On the other hand, as the end of the month approaches, I am increasingly convinced that good news is on its way and, as a result, am extravagantly casual about my chances. On the phone to my dad I chatter about the curried goat I had for lunch at a restaurant in Midtown and tell him about L’s baby’s hilarious language gaffs. I go on about my nostalgia for Britain, which makes my dad laugh and tell me I’ve been out of the country for too long; the Tories, slashing NHS budgets and flogging off large parts of the capital to foreign billionaires, have turned the place into a mini-America.

  “Any news?” he says tentatively at the end of the call.

  “No!!” I say, with the manic cheer of a hippie about to go mad with an ax. I don’t say, “At thirty-eight? With no drugs? On the second try? Are you insane?” but my tone implies it, expertly setting up an expectation of failure against which my forthcoming victory will be all the more stunning. A few days later, Leila goes home. A few days after that, I get my period. So much for fucking raspberry tea.

  All my warm feelings about adoption, about L’s baby potentially being “enough” and about love being all we need evaporate in a flash. The cold, sharp edge of competition rises to a shriek in my soul. At the very best, at this point, I may turn out to be statistically average. At the very worst, I may prove irredeemably defective. This has nothing to do with wanting a baby. This is about winning and losing. There is only one possible bright side to my failure this month and that is if I had been pregnant, I would have had to rearrange my entire mental landscape to accommodate the possibility that herbal remedies actually work. As it is, I return to the clinic, disappointed by the growing evidence that I’m not exceptional and carrying a cup of Starbucks the size of my head.

  Dr. B makes himself coffee and returns to his seat. His expression is one of mild wryness, as if the human condition were one in which he and I take a mutual but largely dispassionate interest. He recommends Clomid, an oral drug designed to stimulate the ovaries and trick my body into releasing more than one egg the following month, before moving on to discuss the American government’s manipulation of the international money markets.

  My body doesn’t respond to the Clomid, and a month later, I produce a single egg that fails to fertilize. Three failures. Three months. Five thousand dollars and counting.

  There is a photo of me taken around that time that captures the state I am in. It is early February and it is snowing again, the kind of laborious New York snow that looks as if it were falling upward. A photographer from the New York Times has come to my apartment to do a portrait for a piece about family secrets, to which I have contributed some thoughts about my mother. We do a few setups, some in my office, some in the living room in front of the bookcase, where, I realize too late, a book called Dateworthy: Get the Relationship You Want is on prominent display behind my head. “If that ends up in the Times I’m going to fucking kill you,” I say to L, who forced the book on me in the first place. But the photo they end up using is worse, in a way, a classic local newspaper shot of Miserable-Looking Woman Stares Into Camera While Holding Up Photo Of Dead Person. “It’s not that bad,” says L doubtfully when it comes out a few weeks later. But it is. I look utterly dejected.

  “I don’t get the sense that statistically anything out of the ordinary has happened yet,” says Oliver. And while I can see this is true, for once the rationalizations don’t work. It still feels like a personal failure.

  I don’t call Merope, or Kate, my best-friend-from-college, who have two children apiece and neither of whom, I think, can possibly understand. And I don’t tell my dad, whose anxiety hurts me more than my own. Instead, I go online to the infertility forums, those groups and comment threads in which women struggling to get pregnant hang out. I have heard about these from friends and know no good can come of consulting them, but I don’t care. Stoicism hasn’t worked. Now I want to wallow.

  As it turns out, I have no idea what I’m getting into. Page after page of women discussing their reproductive histories going back eight, nine, ten failed cycles, volumes of treatment I didn’t even know it was possible or legal to have. Some have been TTC (trying to conceive) for twelve years, a struggle many of them itemize in an e-mail kicker, so that with every glib posting their entire traumatic backstory republishes. I scroll down in horror; contributors listing every drug they have ta
ken and the dates they found out they weren’t pregnant, or worse, when they conceived and lost the baby. The tone of the postings is one of fake cheer, with a sense of clubby exceptionalism that comes from using the jargon. Having fertility treatment is a little like taking out your first mortgage and getting a buzz from saying things like “marginal interest rate” or “discretionary ARM,” only in this case it’s “gonadotropin,” and “follicle,” and “endometrium,” and “hypoestrogenic.” I had done this myself and considered it harmless. Now, however, I can see how dangerously seductive this superficial expertise is, how it keeps hope alive and confers on each woman a tenuous sense of control. Infinitely sadder is the jolly shorthand—for the results of a pregnancy test, BFN (big fat negative) and BFP (big fat positive); DH for darling husband; all the way down to EWCM, for egg white cervical mucus—that users clearly think communicates cavalier good humor but (is this how I seem to others?) instead just looks flagrantly unhinged.

  No one shows signs of wanting to give up or move on. No one has a prognosis so bad that someone somewhere in the group hasn’t heard of another woman in the same situation who still managed to get pregnant. Rather than wishing one another luck, everyone wishes one another sprinkles of “baby dust,” at which point I get off the site and make myself promise never to go back.

  And so, to anyone reading this who is in the early stages of fertility treatment, I offer some advice: before you get in too deep, write down where your cutoff is, whether that be three rounds of IVF, a fifty-thousand-dollar spend, or a year of trying. Write it in big letters and stick it to your fridge door, along with a printout of your bank statement, a list of everything you love about your life and possibly a copy of your marriage certificate. Write a list of all the acronyms you never want to find yourself using, and the number of jaunty exclamation points beyond which someone needs to reach in and pull you out.

  Better yet, prearrange an intervention from friends and family. Because once you’re in it, all reason will fly out the door. You will buy the raspberry tea. You will eat the pineapple. You will sit in the Fertility Chair at work (and that April, on a trip back to London, I do). You will fall down the rabbit hole into the infertility forums and anyone who questions you will be given the kind of short shrift you give a friend who tries to cut you off after your third martini. Meanwhile, the bar will keep serving you until you throw up.

  Well beyond that point, in fact; until you are taken away in an ambulance, put on a drip and required to sell all your assets to settle the bar tab.

  * * *

  • • •

  SO HERE WE ARE, month four. Time for the heavy artillery. Repronex, Fertinex, Follistim: they sound like gynecological problems that would have interested Freud. In fact, they are brand names belonging to the next stage of fertility drugs. If Clomid, a synthetic drug, works by triggering an overproduction of the body’s own hormones, then these drugs, known collectively as gonadotropins, are identical to the hormones produced in the brain and act directly on the ovaries to increase egg supply. They have a much higher success rate, with higher risks, but if this is explained to me, I don’t hear it. One morning in March, I stand in Dr. B’s office while a nurse unpacks a silver bag onto the table, containing swabs, syringes, needles and a handful of glass bottles, on the side of which is a name that doesn’t immediately betray its usage. Bravelle: it could be a fancy private school or a yoga retreat in upstate New York.

  There are clinics that make patients go in for a five-hour seminar on how to give themselves injections, but not this one. In five minutes flat, the nurse shows me how to load the syringe from the silver-capped bottle, deposit the liquid into the green one, shake to dissolve and load it back into the syringe. “Then change the needle and inject it here,” she says, indicating a triangle below my belly button. I nod, grateful for her matter-of-factness, and figure I can look it all up on the Internet afterward. Then I cross the street to the pharmacy and hand over my prescription.

  “Insurance?” says the pharmacist.

  “Doesn’t cover these drugs.” (You would never in these circumstances say “I don’t have insurance.” You might, at a pinch, say “Self-pay,” which implies resources so vast insurance isn’t an issue. I have heard people do this: talk about expensive procedures they’ve had and then casually let drop that their doctor “doesn’t take insurance.” This means they’re so wealthy, they don’t need health insurance because what’s a trifling ninety thousand dollars between a woman and her back surgeon?)

  The pharmacist looks at me expectantly. I am still so stupid in the ways of the American system, I have no idea what her problem is.

  “That’ll be eighteen hundred dollars,” she says in a voice designed not to carry.

  “You’re fucking joking.” This comes out like a Tourette’s outburst, guttural and spontaneous. The pharmacist blinks behind large spectacles. “Here’s a voucher that will get you two hundred dollars off,” she says and we stand for a moment in silence, looking at each other over the two-dollar items on display at the cash register. Then I hand over my credit card.

  One of the things the nurse has told me is that for psychological reasons, it can be easier to ask someone else to do the injection. “Come round,” says L on the phone that afternoon, “I’ll do it.”

  “You will not.” I once let her cut my hair after she’d watched a video on YouTube and was convinced she knew how to do layers and although, to be fair, it was as good as some $150 haircuts I’ve had, there was something off about the symmetry that I don’t fancy seeing translated into puncture wounds in my belly. If any amateur is going to stab me with a needle, it’ll be me, and that evening, after watching an instructional video put out by the drug company, I lay the paraphernalia out on my desk and immediately run up against the first problem.

  Have you ever actually looked at your abdomen? Where does it start and your torso stop? Or your “side”? How big are the ovaries and where exactly are they? What if I miss the spot and, as with the hero in James and the Giant Peach, throw magic at the wrong thing? Will I blow up my appendix? Or poison my liver? It’s not that I’m squeamish. I could never be a doctor or skin a rabbit, but I don’t run screaming from the sight of blood. And I’m not frightened of the pain. It’s more the prospect of messing it up—of doing the fertility-drug equivalent of Woody Allen sneezing away the cocaine in Annie Hall. This stuff is so expensive that if I cock up a single injection, overdilute it or drop it and shatter the vial, I will have to buy a whole new course of treatment.

  Eventually, after injecting liquid in and out of the syringe multiple times, rewatching the video and satisfying myself that the air bubble is too small to kill me, I settle on a target and stand holding the needle an inch from my belly. Do it. Do it. Do it. Can’t do it. Do it. Can’t do it. DO IT. Can’t do it. For god’s sake do it.

  I carefully lay down the syringe, walk to the kitchen, pull out a packet of frozen peas from the freezer, slam it against my flank and hold it there until the area goes numb. Then I go back to my office and ram the needle in up to the hilt. It doesn’t hurt at all. I am euphoric.

  From then on, I look forward to the injection all day: wiping the lunch crumbs from my desk and disinfecting the surface; laying out the gear; twisting on the big needle, mixing in the liquid, twisting on the little needle, then flicking the syringe and jabbing it in. Nothing about drug use has ever appealed to me, except what I can now see is the power of the ritual. There is something mesmerizing about going through the same drill every day. Sometimes I am heavy-handed with the needle and a dark bead of blood forms on the surface of the skin. Sometimes I get in and out cleanly. Then I deposit the needle in the toxic-waste receptacle given to me by the clinic and swab the area clean, feeling as if I’ve just performed six hours of brain surgery.

  It never crosses my mind to think about what is in the drugs, although I’ve since read that it’s a derivative of urine, specifically, the urine of
postmenopausal women, which contains high levels of the hormones that stimulate egg production. This makes sense, I guess, that the aging female body responds to the dearth of eggs by producing larger and larger amounts of the hormone responsible for producing them. Anyway, at the time I couldn’t be less interested. As with all drugs, I assume it is awful and toxic and that, save for the reason I am taking it, I would be better off not taking it. What can I do? It could be George’s Magic Medicine for all I cared as long as it does its job.

  “You’re responding very well to the drugs,” says Dr. B a couple of weeks later. This sounds like good news, but he looks uneasy. We are in his office after the ultrasound, which has revealed I am on course to produce more eggs in a month than the average woman produces in an entire year. I envisage them stacked up like bombs in a World War II airplane, my poor, laboring ovaries cranking out one after another after another. If a woman is born with a finite number of eggs, and if, like rings on an oak, every egg dropped represents a month of her life, then I have a gynecological age of about ninety-seven at this point.

  “Frankenstein,” I say jokingly and Dr. B looks irritated in the same way a friend of mine did when I asked him how many people he’d had to bribe to get his property business in the Balkans off the ground.

  “Not Frankenstein,” he says and I can see him turning the word over in his mind. “We’ll cut the dosage. But . . .”

  I don’t want to hear it. I’m not interested in the risks. I don’t even know what they are, beyond some vague threat of “overstimulating” the ovaries, which was, I thought, the whole point of the exercise. After the failures of the past few months, all I can hear is that I have responded well; more than well, exceptionally! If you had told me, a year earlier, that a large chunk of my self-esteem would rest on how many eggs my ovaries could be artificially stimulated into producing in a given month, I would have thought you were mad. Now here I am, strutting around feeling great about myself on account of my MASSIVE EGG STASH. Suddenly, I understand why men go in for penis enlargements.