The Choice

by Bernadette Bohan

  This was his standard answer. Pregnancy might kick-start the cancer again. Cancer could kill me. Having another baby could tear my family apart. I knew he would shake his head and intone the same deadpan response each time I saw him, but each time I knew I would have to ask him the same question. I was obeying an inner compulsion sharper than hunger; stronger than desire. My head told me I was foolish to imagine I could have another child, yet my heart longed for a baby.

  For seven years I never gave up hoping that one day he’d ‘give me permission’. I prayed that there would be some new scientific discovery – some new drug perhaps – that would enable me to carry a child to term without making myself sick or losing the baby. I was desperate for someone with a PhD to claim that pregnancy never triggered the growth of cancer cells. Or I needed a test to prove that my kind of cancer was caused by something entirely different.

  I think it is something that anyone who has lost a baby will understand, that yearning to fill the empty place the unknown baby should have filled. How I wondered about that lost child: who it would have looked like, how it would have been with three children running around. I came from a large family – it was a natural thing for me to expect a big family for myself. I liked to think of him or her as my special guardian angel who had been with me for such a short time, giving me hope and comfort in the dark days of fear as I waited for the diagnosis, then quietly taking its leave of me to allow me, eventually, to be healed. Some people believe that children choose their parents – that they are souls that come to us to fulfil a need in us as much as in them. I don’t know about this, but I did believe that it was all part of God’s purpose, and who was I to question it?

  Not that I was obsessed, you understand. I wasn’t depressed, I wasn’t crazy, I wasn’t about to rob another woman of her child if I saw it in a pram in the supermarket. I felt nothing approaching the way friends of mine who have been trying unsuccessfully for a baby for many years feel. In the same way that I had learned to live with cancer, accept it, and take what good I could from the experience, I learned to live with this loss. The void would always be there, and the space I had set aside in my heart for another child was simply a fact of life. I took out all of Sarah’s pretty little baby and toddler clothes which I had carefully packed away for a younger sibling. I held them to my cheek and inhaled what was left of her babyhood, mourning my lost third child who would never wear them. Then I washed and ironed them and gave them away. Toys and books that were gathering dust, never to be held by the chubby little fingers of a child of mine again – they all went too. After all, how could I jeopardize the life that I had fought so hard to keep? No, I knew I had to move forward, embrace life with outstretched arms and enjoy what I was so fortunate to have been given. Ger was happy as we were, and was anxious for me not to worry about having another baby. ‘Look, love, put it out of your mind – it’s not going to happen. Don’t rock the boat.’ I knew this was right, and sometimes I would give myself little pep talks: ‘Come on Bernie now, get a grip. You’re doing fine. Your kids are doing fine. You don’t need another child.’ I reluctantly accepted that it was not to be. But the want never disappeared.

  So I got on with living my life, as women do. With so much going on in the house with my young children I couldn’t mope around, and besides I’m a real doer – I hate sitting around doing nothing.

  In May 1994 we had four weddings to go to: one was a family wedding and the others were colleagues of Ger’s. Each weekend there would be another long drive, another traditional Irish knees-up where we had great craic, as they say. A good laugh, a great time. I always enjoy weddings – they are so full of life – and I suppose I must have been extra-relaxed after one of these occasions. I remember seeing all the small kids running around and I held the baby of a friend while she got up and danced. The little thing looked into my eyes and gave a big toothless grin, and my heart melted. The need for another child wasn’t vague and formless any more, it was an ache I couldn’t assuage. I had a strong feeling that somewhere out there was a child waiting in the wings for me to be its mother. That night I chose to embrace my destiny.

  I wasn’t on the Pill as I had had cancer, so we followed what I call the ‘temperature’ method of natural family planning. This system enables you to become attuned to your own time of ovulation – the few days around which you are most likely to become pregnant and should avoid intercourse. When Ger took me in his arms that night I murmured to him that I hadn’t taken my temperature that day, and I knew it was around the middle of the month. ‘I really want a baby,’ I remember saying softly, and he simply replied, ‘Let’s not get into that now, love.’

  A few weeks later we were in Cork for a couple of days’ holiday with the children. We did a little sightseeing and swimming – it was a lovely break. When the kids were busy one afternoon on the beach I decided it was time to tell Ger my period was late. ‘You’ve been late before, haven’t you?’ he asked, without missing a beat. That was true; a few days here and there never bothered me. This was different though – this was more than a few days. We sat holding hands looking out at the choppy sea, contemplating the enormity of the prospect. Neither of us really believed it could be happening.

  A few days later I sat in the bathroom at home with a pregnancy test. It was one of those Plus and Minus kits, where a plus sign equals baby and a minus sign equals no baby. My heart was in my mouth. I was excited and fearful at the same time. As I stared at it, slowly but surely a small cross appeared. I was pregnant. The little cross seemed like a tiny sign of hope. ‘What God takes away he gives back in His own good time’ – my mother’s words came back to me. I sat there for a long time.

  I didn’t know whether to laugh or cry. Part of me was elated – I had done it! We had been given the chance to have another child! But part of me was imploding with dread. The cancer. It might bring the cancer back. My oncologist would be furious. I imagined the progesterone coursing through my body, doing its job of thickening the lining of my womb and providing a nourishing place for my baby to grow, but at the same time being the evil poison that might somehow trigger the unnatural cell division that causes cancerous tumours to grow. This sweet promise of life that simultaneously held the threat of death.

  When Ger came home that evening he had hardly put his things down before asking the question: ‘So – plus or minus, Bernie? Was it plus or minus?’ We were talking in code and the children looked up in surprise. Were we discussing a maths test or something? ‘Plus!’ I grinned, unable to conceal my delight. ‘It’s a plus!’

  ‘Oh my God,’ said Ger, wide-eyed and managing a smile, ‘this is going to change our lives.’ That had to be the understatement of the decade, I thought.

  We didn’t tell Sarah for a while, but Richard found out by accident a few days later. He was off school the day I went to see the GP in order to have the pregnancy officially confirmed with a urine test, so that was that secret well and truly out in the open. I took him off to a coffee shop for lunch and the little lad could not contain his excitement – he could hardly sit still. Leaping ahead as children do, he kept exclaiming, ‘A brother! Mum, I’ll be able to show him how to play football!’ I couldn’t dampen his childish enthusiasm, but I did try to explain that because mummy had been sick things might not always go to plan. ‘Steady, son, I lost a baby once before, you know. Don’t get carried away now.’

  Dear God, please don’t let me lose this baby, I prayed, please don’t take it away from us. I had to hang on to it, I had to stay well.

  While my family wanted to celebrate, my doctor made an appointment for me to see the oncologist as soon as possible.

  He looked up at me when I entered his surgery. Because it was an unscheduled appointment he knew that there could only be two reasons for my appearance. Either the cancer was back, or I was pregnant. Or both. He looked at the file on his desk containing the referral letter from my GP. Wordlessly he motioned me to lie on the couch. This felt totally different from my normal
appointments. No friendly banter, no routine questions and answers. It was only a couple of months since he had given me, for the enth time, his ‘don’t even think of getting pregnant’ spiel. Yet I was desperate for a word of reassurance, something to make me believe it was all going to be OK. He checked me for any signs that the cancer was ‘presenting’. Nothing. ‘You’re fine.’

  At the moment.

  I waited for him to rail at me for my temerity in getting pregnant, but he just looked unbearably weary. He wasn’t going to tell me to get rid of the baby; he knew well enough how much I wanted it. Instead, he said brusquely but not unkindly, ‘You’re back in the system now. You’ll be in and out of here throughout your pregnancy.’

  So I was a ‘cancer patient’ again. I had been doing all right – well, even – and now I wasn’t.

  He put his hand on my shoulder as I rose to leave. ‘Poor Bernadette,’ he murmured.

  Chapter Ten

  ‘A Little Miracle’

  My heart sank as I left the hospital. Like any woman who wants a child, I had been rejoicing in my pregnancy, despite the nagging worry. Now the oncologist had struck fear into my heart. Here I was, defiantly, stupidly pregnant, after so many warnings to put all thoughts of a baby out of my mind. I knew from his comments seven years before that his main priority would be to keep me well, and I remembered as if it was yesterday his workaday reaction to my last miscarriage. I wondered if he was hoping I would miscarry again. It would certainly make his life easier: one fewer potential cancer patient to treat.

  Bernie, I said to myself, you’ve done it now. There’s no going back. This is a baby you have wanted for so long – you are risking everything for it. It dawned on me that in the eyes of the medical establishment I was being irresponsible; but for me I was obeying a compulsion stronger than sense. It may not have been a rational, sensible, thought-through choice, but it was a deep and instinctive biological and emotional need. It was a decision I had made with my heart and soul. He thought I was mad, yet I had never felt saner.

  Despite this inner conviction that I was somehow doing the right thing for me, for my family and for my unborn child, I was sick with worry. My body was changing by the day, and these changes – fascinating as they had been during my previous pregnancies – now brought with them new fears. Were my breasts sore and lumpy because of the pregnancy hormones, or could I feel a new tumour in its early stages? Was the pain in my lower back normal or sinister? Was I tired because my body was working overtime to establish the pregnancy, was I exhausted from trying to look after two young children, or could this be the first sign of lymphoma returning? I fretted constantly about losing the baby, and every time I went to the bathroom I told myself not to be surprised if I was bleeding. However, when the morning sickness started around the fifth week, I began to believe that this little embryo was really there, making its presence felt, and I felt a small shiver of pleasure through my anxiety and nausea.

  I didn’t talk about it to the children. Richard seemed to have forgotten for now, and since I showed no outward signs of being pregnant, Sarah was not aware of anything.

  They were at each other in those first few weeks though more than ever, and it seemed as if I was constantly breaking up fights. Maybe I was less involved with them, perhaps I left them to their own devices more than usual. Certainly I was wrapped up in myself and my fears, and I know how my moods can affect them. I would wake up each morning, throw up, then have a shower, running my hands over my body – checking for any signs that the cancer was back. Once dressed, I would put on my Happy Mummy face, have some dry toast for breakfast and get the kids ready for school. It was only when I returned home that I would sink into a chair and weep. I was so full of dread, so afraid that my pregnancy would bring back the cancer. It was as if a dark shadow was waiting in the wings to envelop me. It felt so close I could almost reach out and touch it.

  Gerard kept me going through those first few weeks like never before. I cannot put a number on the times I would call him at work and offload my worries of the day. He always had time to listen, and always offered some reassuring words.

  ‘Bernie, don’t forget that the first few weeks of any pregnancy are like a rollercoaster. You’ve got all those hormones whizzing around your body. They are bound to make you feel more emotional than usual.’

  ‘I know that’s true, but these are the very hormones that might trigger the lymphoma again.’

  ‘Listen, we don’t know that for definite. It has always been something the doctors thought was just a possibility. They don’t know everything. I reckon it was caused by that bash from the table. If you find a lump obviously we’ll have to get it sorted, and we’ll face that if we have to. But please don’t go terrifying yourself about things that aren’t there.’

  I knew that was true, but at times I just could not stop crying. I felt I was going to be the ruin of our family. We had all been so happy, so fortunate that I had survived the lymphoma. Not a day had gone by since I had finished the steroid treatment that I did not think about cancer and wonder if it would come back. Now, here I was almost actively seeking it. How could I endanger Ger and the kids like this? How could I do something that might take me away from them for ever? How on earth was I going to survive the next eight months of this? It couldn’t be good for the baby if the mother was a nervous wreck – I had read that the adrenalin flooding my system from anxiety and stress could cross the placenta. I willed myself to calm down.

  Appointments had been made for me at the same hospital where I had been treated for the lymphoma. I was to go for regular check-ups with the obstetrician, and after each one I was booked in with my oncologist. The twelve-week appointment was looming – the first time I had been back in the hospital since dropping the bombshell.

  ‘Ger, can you come with me to the hospital next week? I have an appointment to check the baby, then I need to see your man again.’ I couldn’t say his name, I refused to think I might become a cancer patient again.

  It seemed odd to be going to a different department, turning down unfamiliar corridors, but once we were through the heavy swing doors of the gynaecology and obstetrics department we might just as well have been in a different world altogether. There was the sound of lively chatter, and parenting magazines and children’s toys filled the waiting areas. Everyone seemed cheerful, healthy, comparing bumps and due dates. The receptionist was smiling. It struck me forcefully: pregnancy wasn’t a disease, it was a state of positive health in which a woman’s body tends towards strength and vitality. We sat down next to a red-faced young woman who looked as if she might give birth any moment. Ger raised a mild eyebrow.

  ‘Hello,’ she breathed. ‘I was due six days ago and I’m here to find out if I need to be induced.’ We chatted for a bit, and I explained I was here for my twelve-week scan. While we were waiting, one of the nurses took me aside for the standard urine test, blood test and blood-pressure check. I returned to find her still firing questions at Ger.

  ‘Is this your first baby?’ she asked me. ‘How have you been feeling?’ For once I was lost for words, and I looked over at Ger for help. Luckily her name was called at that moment.

  ‘I don’t feel like a normal pregnant person,’ I whispered to Ger.

  ‘You’re not. You’re my wife,’ he rejoined.

  The obstetrician was a jolly grey-haired woman in her fifties. She immediately put us at our ease as she asked all the usual questions about my other pregnancies, dates, blood group, family history and so on. She then examined me, gently pressing my abdomen to check the position of the top of the womb. Then she frowned slightly.

  ‘Is everything all right?’ I asked. I knew that, as a forty-year-old, I already stood a greater risk of something going wrong with the pregnancy – let alone the other risks we knew about.

  ‘Mrs Bohan, I know your history. I can quite understand how you are feeling – this must be a terribly worrying time for you both. However, I am going to assume that everything is goi
ng to be fine. To me you are just another pregnant woman. Right, let’s have a look at this baby then.’ She switched on the screen.

  I have always loved the way an ultrasound scan gives you a brief window on the secret life within you. That day Ger and I watched the mass of swirls on the screen and tried to decipher the vague outline of a tiny form. The obstetrician pointed out the head, spine and feet. I could see it throbbing.

  ‘There’s the heartbeat!’ she exclaimed. ‘And, looking at these measurements, your baby seems absolutely fine.’ She printed out a floppy black and white print for me to take. I felt an absurd rush of love for this fuzzy blob, and was unable to speak for a few moments.

  ‘I would like to see you every month from now on until you are six months pregnant, after which we can relax a little more. If you have any questions or problems, or anything unusual crops up, give me a call. In the meantime, do try and enjoy your pregnancy. You’re going to be fine.’ She ushered us out of her consulting room and we made our way over to the receptionist to sort out the next few appointments.

  Gerard looked at his watch. ‘We’re just in time for the oncologist.’ My excitement at having seen our baby on the scan suddenly evaporated, and we walked slowly down the corridor full of dread. Now I had seen it on the screen I wanted to protect it all the more. If the cancer had come back I made up my mind to refuse any treatment until it was born. Ger’s face was grim. I decided not to tell him what I was thinking.