by Susan Fox
“Many women in their forties have safe pregnancies and healthy babies,” the doctor said quietly. “But with your bipolar disorder, you’ll definitely want to consider all your options.”
“Abortion,” Brooke whispered. She believed in a woman’s right to choose, but she’d never once believed she would face that choice herself, in her forties.
“Yes, that’s one alternative. Along with, of course, having the baby and keeping it, or having the baby and putting it up for adoption. But Brooke”—the doctor leaned forward to clasp Brooke’s hands in hers—“if you continue with the pregnancy, you might need to go off lithium. You’d have to talk to Dr. Allenby about that.”
“Off lithium?” Brooke pulled her hands free and shook her head frantically. “I need lithium to control the bipolar.”
“Medication during pregnancy can have a negative impact on the fetus.”
“I’d be scared to stop taking lithium.” It had been her salvation, and just the thought of doing without it made her heart race.
“You need to talk to Dr. Allenby and think about this. If you decide to terminate, you can of course continue taking lithium and we’ll schedule the procedure.”
A racing heart, a pounding head, she was on the verge of a panic attack. Surely an abortion was the only realistic choice. “I guess we should do that.”
“No, Brooke,” she said sympathetically but firmly, “don’t give me your answer today. You must get all the information and think this through very carefully. I strongly recommend that you discuss it with the father and also your family.”
Brooke tried to imagine phoning Jake with this news, or telling Evan and Jessica. Good Lord, her daughter-in-law was pregnant. How could Brooke be pregnant too?
Dr. Young touched Brooke’s hand. “Talk to Dr. Allenby today. I’m sure he’ll make time to see you.”
Brooke nodded, still unable to believe this was happening. When she’d missed her period, she’d put it down to the recent excitement and stress in her life. She wouldn’t even have mentioned it except she’d been in for her regular physical and the doctor asked about her period.
Thank heavens she was finished for the day at Beauty Is You. Feeling dazed, she walked a couple of blocks from the small office building where Dr. Young worked to the renovated old house where Dr. Allenby lived and ran his practice.
His wife, who also worked as his office manager, greeted her. “Brooke, we weren’t expecting you.” Penetrating gray eyes studied her face from behind red-framed glasses. “You look pale, dear.”
“Can you squeeze me in?” she begged. “Something’s happened.”
“He’ll be free in half an hour. In the meantime, come into the kitchen and have a cup of coffee with me.”
Brooke followed her into the cozy room. Caffeine was a no-no during pregnancy. Besides, it certainly wouldn’t soothe her jangled nerves. “Could I have herbal tea instead?”
“Of course, dear. That’s a much better idea. I’ll have the same myself.”
Mrs. Allenby seemed to sense that Brooke didn’t want to talk. She simply made and poured the tea, then puttered around the kitchen making meatloaf while Brooke sat, sipping tea and trying not to think. Finally, Dr. Allenby came into the room.
“Well, Brooke, this is a surprise. Did you want to see me?”
“Oh yes, please.”
She followed his broad-beamed back into his office and perched nervously on the edge of her usual chair. “I’m pregnant.”
When his eyes widened and his mouth dropped open, she realized she’d never seen him lose his composure before. For some reason, it lifted her spirits. “I’m middle-aged and bipolar, but I’m not dead,” she pointed out. “And I happen to like sex.”
“Well . . . of course.” He stroked his graying beard. “But you never said you were seeing anyone. I thought you’d decided against having a relationship.”
“I did. I have. This isn’t a relationship. Oh, damn!”
“Brooke? I haven’t heard you swear in years.”
“I haven’t been pregnant in years.” She remembered the slogan “God never dumps more on us than we can handle” and didn’t know whether to cry or laugh.
When she began to chuckle, Dr. Allenby joined her. He was a bit of a Santa Clausy kind of man, and when he laughed his rounded belly really did shake. And that made her laugh harder.
After they both calmed down, he said, “Good for you. That’s a healthy reaction. So, you’re pregnant. I take it this wasn’t a deliberate choice?”
She sat back in her chair and told him the whole story, omitting not a detail. He was the only person in the world she’d ever been so frank with. Besides Jake.
When she finished, he said, “So you’re thinking seriously about having an abortion, but you’d like more information before you make up your mind.”
“Dr. Young wouldn’t let me decide today. She said I needed to think about it, and to talk to you.” And to everyone else in her life, she thought wryly, but that was advice she wouldn’t obey.
“There are several issues,” he said, his expression serious now. “One is health, yours and the fetus’s. You know you’re a little old to be having a child, even though you’re in excellent shape. And then there’s your medication. Lithium is one of the safer bipolar medications to take during pregnancy, but there’s some risk of it causing congenital problems in the fetus, such as defects.”
She shuddered. “I’m five weeks pregnant and I’ve been taking lithium all that time.”
“If a problem had already occurred, chances are you’d have miscarried. We’d certainly do an ultrasound around sixteen to eighteen weeks, to assess heart and vertebral body development. And of course, given your age, an amniocentesis is indicated.”
She nodded.
“If you did decide to proceed with the pregnancy, we’d have three choices.”
She leaned forward, listening intently.
“One is to continue the lithium but try reducing the dose and monitor you and the fetus closely. Another is to get you off the lithium and monitor even more closely. You know there are bipolar patients who manage the illness with no medication.”
“We tried that,” she said nervously. “It didn’t work for me.”
“Things change. You’re healthier, more confident, more self-aware now.”
Because of the lithium. “What’s the third option?”
“To try alternative treatments.” He stroked his beard again, reflecting. “Though lithium is one of the safest medications, and pregnancy isn’t the best time to experiment with new treatments.”
“So, that leaves lithium or no lithium. Taking it could hurt the fetus. If I don’t take it . . .” She swallowed hard, thinking of her manias and the black depressions that had made her feel suicidal. Of drinking, to escape the depression. “What’s likely to happen?”
“Possibly nothing. Or possibly a recurrence of symptoms. I’d want to see you every week. You’d need to be particularly diligent about your diet, regular exercise, lots of rest, avoiding stress. You know the symptoms to look for. And if you ran into the slightest problem, we could put you back on lithium. The first trimester is the most critical time for the fetus. But if you did well, we’d try to go the whole pregnancy without medication.”
Brooke lifted her chin and stared him straight in the eyes. “I’m terrified at the idea of going off lithium.”
He gave a sympathetic smile. “It’s done a great job for you. But bear in mind, you’re a different person, Brooke. You’re far healthier and stronger than when you were diagnosed.”
“But I’m bipolar. It’s like being an alcoholic. It doesn’t just go away.”
“And I wouldn’t suggest we take you off lithium indefinitely. We’d put you back on it when the baby is born, because there’s a high rate of symptom recurrence during the postpartum period. No breast feeding, because the lithium gets into your milk.”
He studied her face intently. “There are no guarantees, but I think we
could get you and the fetus through the pregnancy without any serious problems. But that’s only the beginning.”
She swallowed hard. “I know. The child could have bipolar disorder. We talked about that risk when Jessica and Evan were deciding whether to have a baby. And the risk would be higher for me than for him, because I definitely have it and he probably doesn’t.”
“Is there any sign of bipolar disorder on the fetus’s father’s side?”
“I’m sure there isn’t.” Jake would have mentioned it.
“That helps. And remember, we don’t have many solid facts about this condition. A child may inherit the gene but never develop the illness. Environmental factors like loss and abandonment can have a huge influence. And that’s something you can control, to a large degree. Plus, you—or adoptive parents—would be on the lookout for symptoms, and if the child was bipolar, he or she would be diagnosed very early. As you know, medication and therapy can be very effective.”
Adoptive parents, definitely. She couldn’t raise a baby herself; that was far too scary. Yet who’d adopt a baby knowing there was a risk it had bipolar disorder? “Treatment isn’t effective for everyone. You said yourself that I’ve been lucky.”
He nodded.
“I can’t go off lithium. I can’t risk bringing a . . . damaged baby into the world.” And expecting someone to adopt it, to love and care for it no matter what happened.
“You’re saying you want an abortion?”
No! What woman ever wanted an abortion? She just wanted somehow, magically, to not be pregnant. Slowly she said, “You told Evan and Jessica that no child comes with a guarantee.”
He smiled. “That’s the truth. And lots of parents who have hereditary conditions—physical or mental problems—make the conscious decision to have children.”
“I wouldn’t. If it had been a decision, I wouldn’t have done it.”
“But now it’s done. And now it is a decision.”
“If I have the baby and put it up for adoption, what are the chances it would find a good home?”
“I think they’re good. People adopt babies and children with fetal alcohol syndrome, drug addiction.” He leaned over and patted her hand. “This is a lot to take in. Why don’t you come in again tomorrow, after you’ve had some time to think?”
From Dr. Allenby’s, Brooke went home to change, then drove to Boots, knowing Jess and her students would be finished for the day. Usually, she rode with Robin, but sometimes when she was stressed, she took Beanie out on her own. Riding in the country soothed her and helped her sort out problems.
She brought the pinto mare in from pasture, saddled and bridled her, then headed out on a favorite trail.
“What am I going to do?” she said, bending forward to stroke the horse’s warm coat.
She couldn’t have the baby. There was no possible way.
Tomorrow she’d call Dr. Young and ask her to schedule the procedure. No one but she and her doctors would ever know she’d been pregnant.
She felt so alone.
Beanie tossed her head, letting Brooke know she’d like to speed up the pace, and Brooke eased up on the reins and let the horse fall into an easy, ground-eating lope.
No, Brooke wasn’t alone. Being out here on Beanie was a reminder of that. She had family, including the wonderful granddaughter who’d taught her to ride. There was just this one decision she had to make on her own.
For a moment she regretted having met Jake, but then, when she remembered the way he’d touched her, the passion and tenderness in his eyes when they’d made love, she changed her mind. Meeting Jake had been a blessing.
It was only the baby—no, she wouldn’t think of it as a baby, just an unwanted pregnancy—that was a problem. But she’d solve it.
Riding alone in the country made her feel strong, competent, self-sufficient. She might not know the answer right now, but she’d figure it out. Without telling her family, or Jake.
Of course she wouldn’t tell Jake. It was the last news he’d want to hear.
She finished her ride, tended to Beanie, and returned home to make a healthy supper.
After eating, Brooke sat down in the living room, with the country station she’d come to love playing and Sunny beside her, and picked up a book. She remembered sitting this way with Jake.
He’d asked to borrow her Stephanie Plum book so he could finish it. She’d told him to keep it. It was silly to have him mail back a used paperback. It was kind of like pretending they’d stay in touch.
That was one of the things she liked about their relationship. Once they’d decided to trust each other, there had been no pretense or deception between them.
It wasn’t being dishonest if you didn’t tell a lie, just remained silent.
And that, Brooke knew, was a cop-out. At least in her terms. Had playing the Arnold Pitt game got her back into the habit of living her life dishonestly?
Jake might not want to know about her pregnancy, but she had to tell him. For her own peace of mind, her self-respect.
She went into the kitchen to find the paper on which he’d scrawled his contact information. Staring at his bold handwriting, she tried to decide what to say. To imagine how he’d respond.
No, she couldn’t do it by phone. There he’d be, utterly shocked, trying to find words as the silence between them grew. She should give him a chance to digest the news before responding. A chance to not respond at all. After all, she wasn’t asking for his participation or his opinion; she only wanted to be honest with him.
E-mail then. Except it was so informal. It didn’t seem . . . substantial enough for such weighty news. For this, she’d use the good old-fashioned method.
Brooke went to her desk and found a notepad. Dear Jake, she wrote, and then she paused. Everything she could think to say sounded trite, superficial, downright stupid. Finally, she continued:
I really hope all is well with you, and with Jamal as well. I’m healthy and happy, except that today I got some surprising news. You might rather I didn’t tell you, but I don’t think it’s fair to keep secrets from someone I care about. Anyhow, the news is that I’m pregnant.
As the pregnancy was unplanned—and unwanted by both of us—the logical step seems to be to terminate it.
Brooke looked at her words, written neatly in blue ink: the pregnancy;terminate it.
When Jessica had announced her own pregnancy, they’d immediately started talking about the fetus as a baby. But Brooke couldn’t afford to think of her own pregnancy in the same terms.
She bit the end of her pen, then wrote:
This all sounds so cold and matter-of-fact. If you were here, in the living room with me and Sunny, I’d be able to talk to you. We never had any trouble talking. But we had a relationship that we both knew was time-limited, and now that time is past and here I am, writing you with news I know will shock you. Part of me wants to rip up this letter but another part wants to write on and on, to tell you about the garden and how well Jessica is looking and how I’ve seen Karen MacLean a few times and she mentions Jamal with astonishing frequency. But you probably don’t want to know those things, any more than you want to know about my pregnancy.
Anyhow, I will understand completely if you choose not to answer this letter. The past belongs in the past. But please, Jake, because you know me so well, understand that I wrote because I had to, because honesty is so important to me. Not because I wanted to hurt or upset you, nor because I want anything more from you than the wonderful gifts you’ve already given me.
She reread her words. Some phrases sounded like the real her, and others were so formal and stuffy. She could try again but doubted she’d do any better.
The only part about the letter that was easy was how to sign it. She wrote, Love, Brooke. Then she folded the paper and addressed the envelope.
As Brooke prepared for bed, she automatically reached for the bottle of lithium and unscrewed the cap. She shook a pill out into her hand and gazed at it for a long
time. Eventually, she put it back in the bottle. Missing one wouldn’t do any harm. She should at least sleep on her decision overnight.
Jamal and Jake, in street disguises, entered the seedy bar in a run-down area of Winnipeg. Since Jamal had become a sergeant he didn’t do much street-level U/C work, but this assignment needed a black male and he’d said he’d do it if he could work with Jake.
They sauntered up to the bar. Jake ordered a beer and Jamal got tomato juice with bitters. They chose a table midway across the room, where they could keep an eye on all the action.
The Black Devils were a new gang, and Winnipeg wanted to bust them before they got a foothold. Rumor had it that the gang was using this bar as a headquarters for dealing drugs to kids from the local high school and college.
“Don’t recognize any members of the gang,” Jamal said quietly.
Jake shook his head. “Those kids playing pool in the back corner look kinda squirrelly, like they’re maybe hoping to make a buy.”
“We’ll hang out a while,” Jamal said. He took a swallow of his drink. “One hell of a job for an alcoholic.”
“You need any motivation to stay sober, just take a look over there.” Jake cocked his head toward a scruffy old guy who could barely get his glass to his mouth, even though he’d wrapped both shaking hands around it.
Jamal looked, and shuddered. “Hard to believe that’s the route I was headed on.”
“Harder to believe Brooke was doing it too,” Jake murmured.
“Amen. That’s one hell of a lady.”
“Yeah.” Jake thought for the millionth time of what she had said. She loved him. At first her declaration had scared the shit out of him, but now it made him feel warm inside. No matter how rotten the world might treat him, there was one special woman who loved him. Hell, not that he knew anything about love, but maybe he loved her too.
“There you go, all mushy faced again,” Jamal teased.
“Don’t tell me you haven’t been thinking about Karen MacLean. The two of you seemed to be getting on pretty well that night you left Brooke’s so early. Almost makes a guy think . . .” He deliberately let his voice trail off.