Costanza had not thought about what she would do if he never came outside or wasn’t home. Sit there all day, all night? Very possibly.
But there he was, and there she was, slowly getting out of the car. When she exhaled, her breath marked the air with thin white plumes that quickly disappeared. Her heart was racing. She had a bag with her—not candy, though she had thought of that, but apples. She had stopped at a roadside stand outside town, where at this time of year they sold only jars of jam, some tired-looking cabbage and potatoes, and apples. At the moment it had felt like a charming idea; now as she carried the bag, she could only think of the poisoned apples in fairy tales, fruit delivered by murderous stepmothers. A stepmother—though not murderous—is technically what she would have been to this little boy, if everything had been … everything it wasn’t.
There was something else about fairy tales. They were full of barren couples, or couples who had to wait years and years to have a child, who, as soon as she—almost always she—was born, was menaced or stolen or was expected to be handed over to a resentful harridan or a fiendish old man who had some kind of hideous leverage over the new parents. This thought occurred to Costanza, then vanished like one of her breath plumes.
She approached the fence, she and her witch’s offering.
The boy, Ricardo, took a break from his kicking to scratch his right ear. Morton used to do that, when he was writing. He always scratched his right ear too. It made her heart stop: a gesture so characteristic of that difficult, self-enclosed, maddening man, reproduced so precisely in miniature in this child. His child.
She looked at the child who had come from Morton Sarnoff, a child like, and utterly unlike, the one he would not allow her to go the distance to try to conceive. Wasn’t it enough, merely to have seen him? What was she going to say to him, anyway?
She lingered at the fence for another moment, then started to walk back toward the car. She hung the bag of apples off one of the fence posts: an offering, or trash. Either way, a mystery.
* * *
At dinner that evening she told Henry about her day and she told him that she had decided: she was ready to come in for treatment now. He listened closely, then said, “Part of me hates Sarnoff for keeping this secret from you, and part of me wants to thank him for his inadvertent help.” He pushed himself back from the table. “Though … though if I’m going to be totally honest, Costanza, I guess I wish you could have come to this on your own, without needing this—this push, this prod or whatever from the past.”
Or whatever? It was hardly that, far from that, to her, but she had no idea how she was to convey, to someone who had not experienced it, what it felt like to have lived with Morton, to have tried for more than a year to conceive a baby with a man who knew that he was fertile but withheld that knowledge from her, and therefore consigned her, however unintentionally (but was it unintentional? Was it not, despite that moment when he was dying, the great egoist’s last great act of egoism?), to a period of sustained doubt and anguish about what her body could, or more accurately couldn’t, do. The anguish part Henry could no doubt understand, since he was faced with it, as he himself had told her, nearly every day at work, but the deception was altogether different.
“I’m sorry,” she said, “but I needed clarity—more clarity. And now I have it.”
“And I’m glad that you do.”
“So? Where do we begin?”
“You make an appointment to come in—well, I make an appointment for you.”
“I can do it myself. As far as possible, I would like to be treated like anyone else.”
“Anyone else,” Henry said dryly, “would have to wait three months to see me for the first time.”
“I’m going to see you?” Costanza fought, and failed, to keep the emphasis off that one word.
“Well, if not me, who then? I mean, if you want the best treatment, the best eyes on the situation…?”
The situation. “Yes, but … but would you treat your own sister?”
“I wouldn’t be trying to conceive a baby with my sister, now would I?”
“You know what I mean. Don’t physicians, typically, refuse to turn family members—and close friends—or girlfriends—into patients?”
“Typically, yes. But fertility is not typical medicine.”
Costanza took this information in and tucked it away for further review. “There’s something else. I’d prefer it if nobody in your office knew about us.”
“But why?”
“I don’t want the eyes of the world, your world, on me. It’s going to be hard enough for me as it is.”
Henry considered for a moment. “We can arrange that, if you insist.”
“I do.”
* * *
On one matter at least Costanza capitulated and let Henry set up the appointment, which he did, for eight o’clock on the following Monday morning. She had no way of knowing how unusual it was to have an initial evaluation with Dr. Henry Weissman at that hour. Mornings were when he saw cycling patients, not new ones. The fact that Henry had had her slotted into the morning schedule set Costanza apart—but in a way that, at least for the moment, would be evident to only a few members of his staff.
At eight o’clock in the morning Henry’s waiting room was packed almost to the last seat. Costanza had to stand in a line, a long line, before she could check in. Afterward she was given an eight-page questionnaire to fill out.
When she finally sat down, Costanza surveyed the room. Most of these women were on one side or the other of forty, as she was. Nearly all of them had buried themselves in reading material or in their devices, thirty—more—self-contained islands on a sea of muted, deliberately soothing gray-green carpet. Judging from their clothes, they appeared to be largely professional, or in any event sufficiently well-off to afford the cost of infertility treatment. These women were used to being in charge of their lives, or being under the illusion that they were in charge, but in Henry’s waiting room, in Henry’s clinic, they had come to a place where both that fact and that illusion were taken away, completely. It was like sitting in a hall of mirrors: these women didn’t look up because they were afraid of seeing their yearning, also maybe their fear, reflected back at them. It was much easier simply not to engage.
Costanza didn’t see herself belonging to this sisterhood—and yet here she was. A series of bad, or unconscious, or half-conscious decisions brought her here, though they didn’t always feel like decisions in the moment so much as life unfolding, life carrying her on its current, away from her father’s death, away from her mother’s tentacles, away from Genoa, away (eventually) from Italy itself. So many things made more sense to her now, looking back. It made sense that, losing her father at fourteen, and losing him the way she had, she would be drawn to older men (Stefano, Morton … Henry, though of all of them he was closest in age, at fifty-five, to her). It made sense that, for years, she poured herself into her work, protected herself with her work, so that she wouldn’t have to test (or expose, or risk) herself in other areas of her life. Convincing herself for years that she didn’t want to have a child even made sense, a certain sense, until all of a sudden it didn’t.
Costanza wondered if all these other women in the waiting room had gotten themselves as wrong as she had gotten herself. What if, instead of reading, or texting, or hiding behind their earphones, they all started speaking, what a conversation that would be, what a chorus of regret and anguish! And anger, probably that too. And heartache. Not a chorus; an opera.
She turned her attention to the forms. The first questions she answered easily. She had had none of the illnesses listed. Heart, lungs, kidneys, liver, bladder—all fine. Medicines: vitamins, aspirin for headaches, sleeping pills for the worst insomniac nights. She had never had surgery, unless you counted wisdom teeth. Her menstrual cycle was regular. She moved on to her family history. Her mother had a variety of age-appropriate ailments; Costanza named them as best she could. Maria Rosaria had been fe
rtile, yes, and had in fact had Costanza when in her late thirties, which was considered a seriously advanced age at that time.
The next questions concerned her father. They were easier to answer than those concerning her mother, since he had been physically robust until he died, and nowhere was she asked about his mental health. As such forms tended to, however, it did ask if he was alive or, if dead, at what age he had died and of what cause. Generally when Costanza came upon this question she would write car accident or plane crash—people didn’t often ask follow-up questions when you said that your father died in a gruesome way. For some reason, however, on Henry’s form, in Henry’s clinic, her first impulse was to write down the truth: that one searing word. Suicide. Suicidio. It was no more palatable in Italian. She got as far as the s, then stopped. She thought of several reasons it might not be prudent to tell the truth. What if she went ahead with the in vitro treatment and took the drugs that, she knew from her reading on the subject, might color her emotions and moods? If she reacted strongly, might people (Henry’s colleagues, Henry himself) think that it was her father coming out in her, a genetic instability, instead of the drugs? Might they adjust them downward as a consequence or offer her lesser alternatives that would reduce her chance of becoming pregnant?
Swimming accident, she wrote. He had been swimming off the Punta with his eyes closed, plowing ahead, unaware that he was on a collision course with one of those jagged, just-submerged rocks. He hit the rock, and the impact knocked him out instantly. Or maybe—more plausibly—he had swum out too far and a fishing boat had sped by and failed to see him skimming along the surface of the water. That had happened to a woman from Milan three or four summers back. Her body parts washed up as far north as Sori.
“Costanza Ansaldo?”
Costanza had not noticed the nurse. Tall, and with short silver hair, she had approached from a hallway on the left. “The doctor is ready to see you now.”
* * *
Henry was standing behind the desk, his shirt and well-knotted tie covered by a crisp white jacket. “Ms. Ansaldo, I’m Dr. Weissman. Won’t you sit down?”
She sat. Henry sat. Susan, the nurse, sat in the subordinate’s chair to his right. They both uncapped their pens at the same time.
“What brings you in to see us today?”
It was she, after all, who had asked him not to tell anyone about their connection. She hadn’t imagined he’d be able to act so credibly.
“I suppose I want some information. I want to explore how I—how I—”
“Might become a mother.”
She nodded. “Yes.” She hastily added, “My—my partner, he is—at a work conference this week. He regrets not being able to be here. Deeply.”
So she could act too.
He nodded. “Today is about figuring out how best to proceed. Costanza—may I call you Costanza?”
“If I may call you Henry.”
“Of course.” Indicating with his head, he said, “Susan is my oldest nurse. I mean the nurse of the longest standing here.”
“Oldest on both counts,” Susan said, without looking up from her notepad.
“We go back to the beginning of my practice, just about. She’ll stay with us while we talk now, and afterward, during our exam.”
“You’re going to examine me?”
She must have put too much vocal stress on that examine, the way she did on that you when Henry first brought up the subject, because a wrinkle appeared in Susan’s forehead.
“Well, yes, of course.”
Costanza sat back in her chair, a gesture of submission.
“Tell me how long you’ve been trying to become pregnant.”
“In my current … relationship, a few months. With my late husband, much longer.”
“How long exactly?”
“A year … more. There were months we may have mistimed.”
“You tracked your ovulation.”
“By temperature at the beginning. Then with the kits.”
“Which one did you use?”
She told him. He made a note.
“Was your husband ever checked out? For his sperm count? Motility, morphology?”
“My husband, my late husband, fathered a child when he was in his fifties.” She flashed on the moment when she’d showed Henry the review of Morton’s book and had burst into tears. “I—I have come to believe that the problem lies with me.”
“Why do you say that?”
“My present—partner, he also has fathered a child. Two children.”
Did Nurse Susan’s forehead wrinkle again, or was that Costanza’s imagination?
“But you say you have only been trying for a few months.”
She nodded.
“At thirty-nine, do you know how long, on average, it takes a woman to conceive naturally?”
She shook her head.
“Between a year and a year and a half. So until we examine you and run some basic tests, I wouldn’t leap to any conclusions. I would assume, in fact, that it’s merely your age. We can help with that.”
“You can make me younger?” she said wryly.
“In a manner of speaking—yes.” Then: “When are you expecting your next period?”
“Wednesday. Possibly Thursday.”
“Your cycle is consistent?”
“Twenty-eight, sometimes twenty-nine days. It’s in the ques- tionnaire.”
“I like to ask for myself.” Henry made another note.
Unless they found something out of the ordinary through tests and on physical exam, he explained, on the third day of her next period, with the “day” beginning anytime before midnight, she would come into the office for blood work. The results would give them her random day-three levels for FSH, or follicle stimulating hormone; LH, or luteinizing hormone; and estradiol, or estrogen. They were looking for figures below a certain number, eleven or twelve at the most, since the opposite, elevated figures, would suggest a decreased ovarian reserve, which was a strong predictor of egg quality. These figures and the results from the exam and the ultrasound he planned to do would likely indicate whether she should go straight to an IVF cycle or possibly have an IUI, or insemination, first.
As Costanza listened, she tried not to think how many women, and couples, had sat where she was sitting, hearing the same plain, detached presentation. Perhaps it was extra detached, on account of her—of them. Or because of the charade she had insisted on.
“There are other things to look for, as I say,” Henry continued, “but assuming that everything checks out, this is the most pertinent information we need. Do you have any questions?”
“I’d like to know what would happen next.”
“On day two of your subsequent cycle we begin an IUI or a round of IVF treatment. Most likely, given your age, the latter.”
“Just like that?”
“Naturally there’s a whole protocol of drug treatments, ultrasounds, and other procedures, but you’ll learn about all this in time.”
She had had to beg Morton, and here was Henry offering to make life with her—for her, potentially. She felt … what did she feel? As if her body were floating over the chair rather than sitting on it—and as if she weren’t quite inhabiting that body either.
“Anything else?”
She shook her head.
“Then Susan will show you to the examining room.”
* * *
The floating, the bodilessness, were actually a help. It made the prospect of Henry examining her almost palatable.
Costanza changed out of her clothes into a shapeless robe. She sat in a chair rather than climbing onto the examining table. She sat and she waited. She waited and she wished that she had some work with her, instead of a magazine she could not bring herself to focus on, or something to do with her hands, such as knit. She wished that this were a robe that kept her warm, instead of offering no protection against the overly chilled air. She wished that the windows were cleaner, and that the clock on the wa
ll wouldn’t tick so loudly. Ticking clocks irritated Costanza, but a ticking clock in a room frequented by women whose biological clocks were ticking cacophonously was too much to bear.
But she bore it. Even if she did imagine herself asking Henry, quietly and in another context, if he had ever given any thought to what it felt like for the patient to sit in these soulless rooms and wait.
And wait.
And wait.
Eight minutes … eleven. Did they think it took a woman in the twenty-first century longer than two minutes to step out of her slacks, sweater, and panties?
Thirteen. Window washers, on a regular contract; an abstract print; a flowering plant; a book of poetry, sensitively chosen. Or a collection of travel essays, inviting the patient to wander somewhere, anywhere, else. Color on the walls. Why was there never any color on the walls in these godforsaken places?
Fourteen. Sixteen.
After sixteen and a half minutes—the clock had an additional diabolical hand that swept around its face, wiping away time down to the second too—Susan opened the door. To her credit she apologized for taking so long, explaining that Dr. Weissman had had to answer an emergency call. She hoped Costanza could understand.
Costanza said that, yes, she could understand.
Susan weighed her and measured her height. She took her blood pressure, her temperature.
“He likes to start from scratch,” Susan said as she made notes on Costanza’s chart.
“You’ve known Dr. Weissman a long time.”
“Twenty-eight years.”
“You must have quite a good sense of him by now.”
Susan placed the chest piece of her stethoscope over Costanza’s heart. “Quite.”
“You think he’s a good man—a good physician, I mean?”
Susan answered as she listened to Costanza’s heart. “Both.”
“But you couldn’t really answer that differently.”
“I could, but I wouldn’t. Mainly because it’s true.”
“Mainly.”
“Twenty-eight years is a lifetime. It’s like a marriage.”
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