by Emma Brockes
“How’s your jizzing?” says my friend Janice later that week. “I’ve been worrying about it.” We are at the bar at Blue Ribbon Sushi on Columbus Circle, eating bone marrow rice. (“Jizz,” as well as being a slang term for sperm, serves as shorthand for the kind of high-turnover journalism we both work in and to which we occasionally refer as “jism.” Anyway, she meant the other jizzing.) I wince.
“It’s fine,” I say. “No big deal.”
“Is it painful, when they do it?”
“Nope. They just wazz it up your fanjo and off you go.”
I tell her, boastfully, that I have “overresponded” to the drugs and am carrying a ton of eggs around in my midsection, and after laughing, Janice, who is British, shakes her head and says, “This country is insane.”
I hadn’t thought to look at it that way. It’s true that if I was at home, where public health policy recommends only “small doses of fertility drugs” for IUI patients, I would almost certainly not be in the position I’m in. But while I laugh with my friend at the reckless Americans, I’m secretly, almost hysterically, grateful. It might be alarming to have produced a high-bordering-on-insane number of eggs this month, but it is surely preferable to the miserly alternative. If I want a result, these are the breaks. I want a result. I will take my chances.
The following Saturday, I lug my giant egg hoard back to the clinic for the insemination. It is their busiest time of the week and the place is teeming. L and I are, once again, en route to Costco and while she waits for me outside in the car, I sit in the waiting room anxiously watching the clock. Because of the rush, appointments are running way behind schedule, and when I finally get into the treatment room, the atmosphere is so harried and unpleasant that Dr. B rushes in and starts conducting the ultrasound, without raising a single concern about the secret world order.
“I have to ask you,” he says, frowning at the screen. “How do you feel about high-order multiples?” This is the first time I have heard the term.
“What do you mean?”
“Three or more.”
I burst out laughing. “Three or more babies?! I don’t feel good about that.”
“I’m serious.”
“So am I. I don’t feel good about that.”
It may strike you as absurd that I haven’t considered this sooner. But I haven’t. All I have done for a straight fortnight is preen about my egg supply and speculate on how it elevates my chances of getting pregnant this month. In spite of the Christmas card wall, in spite of a million tabloid stories about fertility treatment gone awry, it simply hasn’t occurred to me that the chances of getting too pregnant are part of the deal. This is particularly true when you have IUI. In an IVF cycle, doctors stimulate the ovaries to produce a large number of eggs, then remove them and, after fertilizing them outside of the body, decide how many embryos to transfer back into the woman. In the UK, by law, a maximum of two embryos can be transferred to a women under forty and three to a woman over forty; in the United States, by guideline, up to three embryos for the under forties, and five for the over forties.
With IUI, there is no control over how many eggs fertilize. Once you’ve taken the drugs, all bets are off. This is how Jon and Kate Gosselin got into their situation. Their sextuplets weren’t a result of wanton use of IVF, but of standard IUI, of triggering ovulation in a woman who has produced large numbers of eggs and decides to go ahead with the insemination anyway. Some doctors will cancel a cycle if more than four or five eggs mature in time for ovulation. Others will press ahead, because it’s impossible to tell how many of those eggs are viable. The implications of producing “too many” eggs, and how many are too many, are notoriously difficult to judge.
“It’s up to you,” says the doctor and looks at me. The nurses look at me. Everybody looks at me and waits. For the first time, I feel a twinge of fury. Can they really be raising this for the first time now, at the eleventh hour? For god’s sake I’ve already taken my pants off. And of course I can’t bring myself to do it—to throw away the cycle, waste more than two thousand dollars and start all over again the following month, not to mention face the embarrassment of telling everyone in the room to stand down.
“Go ahead,” I say grimly.
“OK.” He flicks a look at a nurse, who turns to the tray and picks up the catheter. “With this many eggs, you’re going to feel a lot of cramps tomorrow.”
By the time I come out, L has a parking ticket and we fight all the way to Costco. For the next five days I am in a terrible mood. On Thursday night, I dream of blood gushing out of me, and on Friday morning, when I get up to go to the loo, that is exactly what happens. Not just blood, but lumps. I am still bleeding on Sunday, when L and I drive out to Queens on an errand. While she talks to the guy about changing the oil in the car, I stand on the garage forecourt and feel the sky spin above me. I have let myself down. I have let Dr. B down, not just by failing to get pregnant but by failing to keep up my side of the bargain to be rational and not crumble and care. I thought I had this thing down but instead, here I am, malfunctioning at every possible level.
Dr. B is gloomy when I go in to report this on Monday. A pregnancy could potentially survive this kind of blood loss, he says, but it is unlikely, and after giving me a bunch of free samples of a drug designed to strengthen the lining of the womb, he suggests that if I fail to conceive with this many eggs, we can assume the egg quality is compromised. The analogy he makes, unkindly as it feels at the time, is with a “bum coin”: after throwing it a bunch of times and getting the same result, the probability of a new outcome lessons with each throw until it whittles down to zero.
Then he says a word to strike fear into my heart: “escalation.”
“I would try one, or at most two, more cycles of IUI,” says Dr. B.
“Two,” I blurt, finally getting the hang of second-guessing my doctors. It has been only four months. If I was under NHS care, I would potentially have to go through ten—ten!—failed cycles of IUI before being diagnosed with “unexplained infertility” and qualifying for the next stage. I’m not ready to start paying ten thousand dollars a throw for IVF, nor to admit that I have a real problem. Dr. B gives me a small shrug; OK, on your head be it.
The following day, I have a dental appointment and shuffle miserably to the clinic in Park Slope. I love my dentist. It’s the kind of place I used to go as a child, with faded twenty-five-year-old prints of art exhibitions on the wall and an aggressively unglamorous waiting room. As the dentist loads up the anesthetic for the filling, I mumble something about being pregnant.
“What was that?” she says.
“There’s a small possibility I might be pregnant but probably not.” I must go bright red because she stares at me. “OK, well, if there’s even a small chance you’re pregnant, I wouldn’t be happy injecting you.” She puts down the needle, cancels the work and doesn’t charge for the visit. “It can be hard,” she says kindly as I leave the room. On the way out, I go to the loo, stare at my reflection in the chrome surface of the hand-towel dispenser and burst into tears. And there you have it; the worst has happened. I’ve become the woman crying in a public toilet about her ovaries. I go home, type “heavy blood loss + still pregnant” into the infertility forum and give myself up to an afternoon of self-loathing.
* * *
• • •
AT NO POINT, either then or in the days that follow, do I consider throwing in the towel. I have invested too much time and energy to walk away with nothing. L is calm and encouraging and thinks the doctor is too keen to move on, although I suspect there is something noble in his calculation that IVF might save me time and money at this point. Anyway, L’s steadiness is soothing, and for a second I wonder if this is what it is like to let someone else carry half of the load.
There is a single good thing to come out of the month. After you’ve taken fertility drugs, persisting with the delusio
n that raspberry tea makes a difference is like dropping an H-bomb, then sending in a man with a cutlass, and just like that, I let the woo-woo stuff go. I think about advice from the coast guard about what to do if you get caught in a rip tide—overcome the instinct to struggle and give yourself up to the current, so that in due course, with any luck, you will wash up bedraggled but alive on some distant shore. Finally, I understand that no amount of industry on my part will change how this thing turns out. When it comes to functions of the body, there is only blood and luck.
The next day, I am due to fly to Vancouver for work. “I think you should cancel,” says L. I am still bleeding heavily and my insurance is iffy, claiming it won’t cover complications arising from fertility treatment.
“Yeah, but it’s Canada,” I say. “They look after you there.” At five a.m., I go to the airport carrying enough wadding to man a field hospital in Crimea. The bleeding continues steadily over the Midwest and during our descent into Vancouver’s metropolitan area, although I feel better once I get to the hotel and install myself in Starbucks for an afternoon’s work. My eggs might be hurling themselves like lemmings from the cliff. I might be about to throw my life savings down on a bet. But I can still cross a continent and efficiently meet a deadline on the other side. And at least I am getting away from that fucking clinic for a week. Even if it is my choice to be there.
EIGHT
Waiting
THERE IS SOMETHING my mother used to say about what would happen to her if something happened to me. This was, I understood, the only context in which it was OK to give up or fall apart, to be anything less than invincible. “If something happened to you,” she would say blithely, “I would become an alcoholic.” She took a little license with the grammar in that statement, given the amount she drank toward the end of her life. Nonetheless, I understood what she was saying. My mother, graduate of a terrible childhood, a woman who remade herself from scratch in her twenties and whose entire sense of self rested on being the person who doesn’t collapse in the face of calamity, was boasting of her annihilation as a marker of how much she loved me. There was, she meant to imply, nothing bigger in the universe than a mother’s love for her child and no devastation greater than the event of her losing it. Which was all well and good. But what of this: the devastation of losing a child one never had? What of losing the idea of oneself as a mother? What is the appropriate response then?
Here is the paradox and perhaps the cruelest thing about fertility treatment: that the harder I engage in trying to have a child, the more I want one, and the harder it becomes to convince myself of something I once took for granted—that I’ll be absolutely fine if I don’t. The term “baby hunger,” which has always offended me as infantilizing, in a similar category of insult to that of saying women can’t be presidents or prime ministers because they are erratic for five days of the month, is now an accurate description of how I feel. I am manic, ravenous, clawing at the door of motherhood begging to be let in, terrified of what will happen if I’m not.
I have always been able, through a little mental effort, to sell myself on the idea that whatever happens is the very thing I wanted to happen in the first place—I’m not married; I don’t care, I like my own space; I don’t have a banker-size salary; fine, an interesting job is more important than money—but there is nothing I can do with not being able to have children, no story I can tell that will make it OK. Of all the competing types of shame in my system, this is by far the worst, having to admit to myself I have been wrong all these years. I think back to how I scoffed at the older woman in my office, the one who broke rank to lecture me about not waiting too late to have children. I think of all my protestations of what it is to have a meaningful life—that work is the thing, that education is the thing, that travel and culture and friends are the thing, that connection to another adult human being is the thing, all of which, it turns out, and as I have known all along, are, if not secondary, then at the very least weaker delivery systems for the main business of life, if one believes that business to be love. It’s wrong and reductive to value a woman on whether she has children, but in terms of the way I value my own life, the idea of their absence, now that I’m forced to confront it, feels like an extinction-level event.
I am in Vancouver to cover the annual TED conference and, after returning from Starbucks, stand in the chintzy hotel room and taunt myself with the prospect of this being my life for the rest of my life: a string of loosely connected anecdotes leading nowhere and building to nothing. I’ll carry on meeting deadlines in foreign cities, then head out to find junk food. I’ll lie in bed until noon on Sunday mornings, a vast and terrible array of choices before me, none requiring my attention more urgently than the next. I will grow even more petulant about not getting my way, because my own way will be all I have to consider. My life will take on a different shape to that of my friends with children, stripped of all those petty concerns that I know, from my own mother’s death, when nothing hurt more than finding scraps of old notes from her or chipped buttons she had sewn into my clothes, add up to a greater sum than their parts. I will hold myself to account in ways that can only add to my shame, the calculation being, particularly for women, that if you don’t have the baby you wanted, you’d jolly well better have something else to show for it, and nothing short of a Nobel Prize or the best, most passionate relationship will do.
That last one terrifies me. I have never regarded being in a couple as an end in itself, either for form’s sake or because I hate being alone. Even in the early days with L, when I was as in love with her as I’ve been with anyone, it struck me that being with someone is basically a nightmare a lot of the time. I’ve always rather despised women who are never single and boast of how they haven’t dated since they were sixteen because of all their wonderful long-term relationships. What’s wrong with them? I thought. Why is their sense of self so vested in being with somebody else?
Now all of this flies out the window. Without a child, I’ll have to get one of those relationships in which we grow old together and finish off each other’s sentences and start looking as alike as dogs and their owners—certainly not the relationship I have with L, whose priority is her baby and who I am, by any metric, wrong for in about twenty-four different categories. No one, looking at us, would mistake us for the perfect couple, or even for a couple at all half the time. If my relationship is going to make up for not having children, then I’ll have to get back into the dating pool, and of everything, I think, this is the most depressing consideration of all. Have a baby, and I will potentially never have to wash my hair again. Don’t have a baby, and I will have to keep primping and preening and shaving my legs as I get older and my stock withers and dies.
One of the advantages of my job is that it proffers a million opportunities to lose oneself in someone else’s concerns, and just as these thoughts are becoming unbearable, I leave the hotel to head out for the conference. Vancouver is a beautiful city full of wide, light-drenched streets and views across great sheets of water. At the convention center, which overlooks Vancouver harbor, I pick up my huge ID badge and the gift bag allocated to every attendee. (It contains a combination of small luxuries—coconut water and KIND bars—and things you can’t get hold of in the normal run of things, like TED-branded bags and water bottles. I have a collection of ugly items from around the world in this vein, including an EU-branded beach towel from a summit in Thessaloniki, a woolly hat from the NATO gift shop in Kosovo and a pin from a donkey sanctuary in Kashmir, all trinkets that bring back happy memories and remind me to celebrate the day I stopped saying yes to everything.)
TED, as most people know, started out as a modest tech and design forum and exploded over the years into a franchise styled as the world’s greatest minds tackling the world’s hardest problems to a paying audience of the world’s richest arseholes and I have to say, if one must endure the sudden exit from one’s system of two dozen unfertilized eggs, there
are worse places in which to do it. The toilets are clean. There are stunning views over the water. As I wander around the conference hall, Al Gore is never far from my peripheral vision. There are coffee stations and yoga stations and a confectionary stand that doesn’t dispense candy but is committed to “storytelling through chocolate.” On a communal white board, someone has written “ohmygod we are soooo lucky to be here,” and someone else, “a drawing is simply a line going for a walk,” all of which I write down with a view to making fun of later before retiring for an hour to the toilets.
The theme of the conference is, loosely, resilience, and while people might say they attend TED for the wacky serendipity of ideas, really what resilience means in this context is how to maximize one’s performance at work. It’s what links the scientist who, after studying the unique motor abilities of cockroaches, found a way to replicate their movements in robotic form with the guy who dragged a sled to the Antarctic and the woman who developed software to thwart cyberattacks. More broadly, it represents what feels to me like the American style of striving for success without concealing one’s efforts. I remember years ago, Merope calling me on a Monday morning to say she felt guilty for not getting more done on the weekend, to which I said something pious like not everything has to have measurable results. I believed this at the time, and still do, but only because of some weaselly inner logic which argues that the real way to make something happen is to allow for the possibility that it won’t. “The slack line catches the biggest fish,” wrote Thomas McGuane in his memoir of fishing and writing, a principle I believe in with a kind of superstitious fervor: stop trying so hard—or rather, stop appearing to try so hard—and you will get what you want. Allow yourself to fail—or rather, allow it to appear that failure doesn’t faze you—and only then will you prosper.