by Tracy Slater
FIFTEEN
THE MISCARRIAGE CHANGED me in other unexpected ways, too. On the July day when the clinic doctors cut the dead embryo from my belly, I’d awaited the procedure on a cot in the surgery prep room, struggling to understand the Japanese nurse administering my IV. I had one of those moments where the mind separates briefly from the body and we stand outside our experiences looking in. I can’t believe this is happening, I’d thought. Not because I hadn’t known miscarriage was a possibility or because I believed my story was sadder than anyone else’s. Millions of women miscarried—or didn’t—every year in situations far worse than mine. Rather, the whole experience seemed so surreal. The barren prep room walls. The once-life inside me. The nubby blue curtain pulled around the sides of my cot, the barely decipherable commentary from the nurse. The laminaria sticks made from seaweed that the doctor had inserted into me that morning to dilate my cervix, after which I was told to go home, rest, and come back in the afternoon when the sticks had expanded inside me, hour by aching hour. I imagined the doctors now in the next room, laying out a tray of sharp instruments, waiting for me to fall asleep.
Then another thought slid into my brain, and with it, I slipped fully back into my body. If this is what we have to go through to meet our baby, then it’s where I’m supposed to be. The conviction felt clean, strong, pure.
As I mourned the miscarriage over the next few weeks, that determination stuck, then dug in deeper as the months wore on. With each cycle that I felt my mastery over my body wane, my ability to conceive recede further, my focus grew on finding something I could control. When Toru asked if I wanted to go back to Boston for a break, I told him no. I was committing to Japan full-time now, only willing to go home if I had a month where the doctors told me I couldn’t try conceiving—and then, only for a few weeks.
Although Japanese insurance doesn’t cover IVF, the procedure here costs only about a third of what it does in the U.S., so we weighed what we could afford and agreed we’d either try four more rounds or quit when I turned forty-five in a little more than three years, whichever came first. I grasped on to the plan as if it were a lifejacket in a tide I couldn’t turn. The night after we’d learned our embryo’s heart had stopped, I’d seen Toru shudder and then break with grief for the first time since his mother’s accident, but now he took to reminding me that “no matter what, we are together in always.”
My fears still hadn’t dissolved about whether motherhood would overwhelm me so much I wouldn’t be able to bond with a child. Yet like a runner in a race, what ultimately pulled ahead was that sense our baby might exist in some way or place, be waiting for us. I didn’t know what this feeling meant or how someone who had so little belief in fate or the spiritual could be driven by such urges. But I’d married Toru without understanding in my brain how our relationship worked when we were so very different, when for years I had striven for a life that looked nothing like the one I’d chosen. Maybe I didn’t need to get it; I just needed to go with it. Because the alternative was worse.
While my infertility was challenging my preference for logic over instinct, it also changed my feelings about being in Japan. For the first time, Osaka was a place I was choosing for my own reasons, not because of Toru’s career or family obligations. I knew we could never afford five rounds of IVF in Boston, especially not at my age with my poor prognosis, when insurance would be unlikely to cover any of it there, either. Our setup in Osaka, with me working freelance writing jobs part-time from home and Toru earning enough for me to work fewer hours, would also make it much easier to manage the fatigue of treatments.
At the fertility clinic, the doctors declared my uterine lining too thin for a new embryo transfer. I’d heard that acupuncture could help, so I found a Japanese practitioner of Chinese medicine around the corner from our apartment. Neither he nor his receptionist spoke English, but I muddled through an attempt to explain my situation. First, I tried detailing my predicament to his receptionist, a whippet of a young woman at a high, bare desk. On the wall behind her hung a diagram of a man’s body facing front and then back. He had blue and red dots snaking up and down his limbs and torso and over his skull, each energy point connected by a web of black lines.
“I’d like to do acupuncture. I had a baby inside, but it died. Nine weeks. Soon, I’ll become forty-two,” I stumbled in broken Japanese, arcing my hand over my abdomen to mime pregnancy while the receptionist nodded and smiled and then nodded and narrowed her eyes and said “Aah, so desuka?” “Oh, is that so?” I didn’t know the word for uterus, and I couldn’t remember the one for thin, but I thought the term “narrow” or “skinny” might work, explaining in more broken Japanese, “I do IVF now. But the doctor says my stomach is too skinny.”
The receptionist eyed my torso. She may have even raised an eyebrow. “Chotto-matte!” she said, “Please wait a bit!” then called out, “Sensei!” “Doctor!” A tall muscular Japanese man stepped out from behind a curtain to the side of the desk. My attempts to explain my diagnosis didn’t go much further with him, either, despite repeated hand signals toward my belly and then holding up my thumb and forefinger and placing them a few millimeters apart in an attempt to mime “thin.” How the hell does one mime “uterine lining”? I thought, as I felt my face go hot.
We finally managed to book me an appointment for the following week. I’d made it clear that I wanted to get pregnant, that I was doing IVF, and that I was forty-one, and I figured we could at least go from there. When I got home, Toru wrote a note in Japanese. When I gave it to the acupuncturist, he nodded as he read it, then laughed with his head tipped back, repeating my “too skinny” comment a few times before he pulled out a new pack of needles.
After the clinic finally declared me ready to complete my next round of IVF, I tried not to get my hopes up, despite our earlier good luck. “Keep warm your belly,” Toru would remind me when we went to bed, sometimes adding, “And keep warm your foot.” We told Toru’s father I was doing another attempt at in vitro and now had a new embryo inside me that we were hoping would take hold, and every night at dinner, he would peer at me carefully, then ask in English, “How is your baby?”
• • •
BY 2010, I was forty-two and my third embryo transfer had failed. Late at night, while Toru slept next to me in bed, I’d lie teary-eyed in the dim pool of light from my bedside table and troll online for books about holistic approaches to fertility, particularly for women of “advanced maternal age.” During the day, I mined the forums for advice from other women. I started different fertility diets and then stopped running, walking my four-and-a-half-mile route instead to conserve my energy and “nourish my blood,” although I had no idea what that actually meant.
Where I drew the line, or to be more accurate, admitted an ambivalent defeat, was with “positive thinking.” A lot of the books I read and the women on my Over 40 IVF forum promoted the importance of visualization and happy thoughts. “Love your embies and imagine them snuggling in for nine months!” ran one such commentary. I couldn’t stomach the idea of calling my embryos “embies.” They were invisible cells, not cartoon characters, and even though I longed for the future they might hold, I couldn’t honestly say I “loved” them when they were mere two- or four-unit blobs. What if that’s my problem? I sometimes wondered. Maybe my inability to be a positive thinker was preventing me from getting pregnant. Or my continued ambivalence about motherhood. On one hand, I knew these fears were illogical and ridiculous. On the other, I felt guilty and afraid they were true.
Walking my route around Osaka Castle Park with six hormone patches stuck to my stomach, I seethed over some of the forum comments. One woman, newly forty-three and pregnant, suggested that every single time you went to the store or strolled down the sidewalk, you should imagine pushing your future baby in a carriage. “Never, ever stop thinking positive thoughts!” she admonished, and I imagined her rubbing her growing belly with a triumphant smile. Of
course she’s saying that; she’s pregnant! I fumed, my arms pumping by my sides while the patches on my abdomen chafed against my shorts. Above me, Osaka Castle rose on its hill, all white walls and grayish-green scalloped roofs, gilded figurines flashing late-afternoon sun from its peaks. I barely noticed.
When my forty-third birthday and the fourth failed treatment passed, I found myself confined within yet another bubble. In addition to the remove of being an expat in Osaka, I’d become encased in a new kind of limbo. I was the only woman I knew doing years of failed IVF in Japan, while around me everyone else moved on. Like a rough wooden Russian doll inside a collection of nested glass matryoshkas, I could stare out and others could stare in, but each layer separated me further.
By this time, Jodi had moved permanently back to the U.S., and almost everyone else I knew in Japan had young children. Most of my Boston friends were still childless or never wanted kids, and I’d Skype with them sometimes, but they were so far away. Meanwhile, I’d watch my fellow Osaka expats jiggle their infants up and down, and wipe their mouths, and check their diapers, and I felt both bored with their babycentric conversation and removed from the whole group. My energy depleted, I closed down Four Stories in both the U.S. and Japan. Every day became consumed either by where I was in my cycle, hope for the current or next round of treatment, or efforts to positively impact the unknowable workings of my body, as if my insides held a supply chain of eggs on an assembly line that I was stalling each time I tried to fix it. I imagined those eggs tucked inside my organs, once clean, white spheres now going dusty and sluggish.
Meanwhile, the frustration of not knowing whether we would ever have a child, where my life was headed, made me ache, and a new fear began to haunt me: Will I spend four years in the prime of my life trying to get pregnant and end up with nothing but failure and lost time? I tried to write about my sense of suspension, but I couldn’t call forth any meaning from it. I tried to work more freelance jobs, but I didn’t have the energy.
Toru was sad each time an embryo transfer failed, but he bounced back more easily than I. His outward life had barely changed: he still got up every morning, ate his white toast with butter and milk tea, put on his suit, and took the train to work, slowly advancing in his career at the pace he had pretty much expected. Meanwhile, my life had telescoped until it was hard for me to see much beyond the imagined mirages of what was happening at any given moment in the organs twining through my belly. The whole time, I had a quiet soundtrack looping in my head: How did I become this person obsessed with my ovaries?
One night, Toru told me that his company was considering moving us to San Diego, where his unit had an office. I tried to imagine us starting over in a new place: the relief of trying medical treatment, if somehow we could get sufficient insurance, “at home”—even though San Diego was thousands of miles from Boston. “But what about your father?” I asked.
Over the last year, Otosan’s movements had gotten even shakier, and he now needed a cane to walk. He’d also begun to stutter sometimes, ever so slightly, like the words got tripped up on his tongue for a moment before they resumed their usual course, a stream with a small pebble in its flow. We tried to get him to see a doctor, and after months of shrugs and other quiet resistance, he agreed to go. A series of appointments and brain scans yielded a diagnosis: Parkinson’s syndrome, a kind of degenerative constellation of muscular and nerve failures. The condition looked like Parkinson’s disease, but it responded less well to medication, and it usually progressed more quickly.
When Toru told me about San Diego, I knew if Otosan came with us it would be strange living together with my father-in-law, especially in America. But the idea of leaving him alone in Osaka was worse. I imagined him sitting on the couch in our living room in San Diego watching Japanese TV on satellite, like I did with CNN and Law & Order in Osaka; walking to the corner convenience store, dapper in a thin sweater vest. I saw him tapping his cane to each shaky step under a bright California sky, dipping his head in polite greeting to neighborhood teenagers skateboarding by. “Do you think your father would come with us if we asked him?”
Toru took my hand. “Thank you,” he said quietly.
A few nights later, Otosan came over for dinner. “Are you going to ask him about San Diego?” I whispered to Toru in the kitchen alcove while he grabbed a beer and I tried to finish the stir-fry. But Toru said nothing about the potential move during the meal. Finally, after I served the tea, I raised an eyebrow, and Toru nodded to me. I guess I’m going to have to be the one to broach the subject, I thought. In broken Japanese, I managed something equivalent to “Otosan, maybe Toru’s company moves us to San Diego. If we move, Otosan also wants?”
Toru’s father stared at me placidly for a moment, as if trying to sort through my mangled syntax. He sipped his tea, then put down the cup and turned to his son with a quiet string of words that I knew was a question by the way his tone ended higher. I expected their discussion to last a few minutes and include at least a modicum of emotional expression, especially on the part of Toru’s father as he absorbed the surprising news. I wasn’t holding out for tears or hugs or a frantic hour of questions, but I was bowled over when just a few moments later, Otosan nodded his head once, took another slow sip of tea, and then turned to me, still utterly unruffled. He pushed back his chair, delivered his usual “Gochisosamadeshita!” in thanks for the meal, grabbed his cane, and shuffled to the door.
Toru got up to see him out. I was too flummoxed to move. “Kitte kudasatte arigato,” I called weakly, thanking Otosan for honoring us with his presence. “What happened!” I asked Toru when he returned. “What was that all about? What did your father say?”
“Nothing,” Toru said, reaching for the pot to pour more sencha.
“Nothing? What do you mean nothing? Did you explain what I was trying to say? Did you tell your father about the move?”
“Ya, I told him.”
“Well, what was his reaction? Is he coming with us if we go? Did he seem upset? Or excited?”
“Oh, no reaction,” Toru said, turning for the couch with his teacup still in hand.
“What do you mean no reaction? Or is he in shock? Is that why he didn’t react?”
“No, not in shock,” Toru said. “Just no reaction. Not yet.”
He looked at me, and I shook my head and raised my palms, squinting my eyes as if the invisible explanation might become clearer that way. Toru sighed.
“We don’t know if moving yet,” he said simply. “So no need to really making any plan. I explain to my father, and he’s glad if we want him to come.” But, Toru told me, since this was all still just speculation, there was no need for his father to think too much about it. “We’ll worry the logistics later,” he said.
Over the next few days, I replayed the scene in my head, calling friends in Boston and Osaka to share my shock. “So his father just pushes back his chair, gets up, thanks me for dinner, and leaves without a word!” I narrated, “and I’m going, ‘Tof, what just happened?’”
But the more I thought about it, as I walked my endless loops around Osaka Castle Park, the idea of “worrying the logistics later” seemed kind of brilliant. Imagine, I thought, not trying to sort out future what-ifs until they became present realities. I knew I’d never achieve the equanimity of either Toru or his father; it just wasn’t in my wiring. And I knew just because they weren’t yet hashing out a potential future move—weren’t trying to solve its challenges before it became fact—that didn’t mean they didn’t have feelings about it. They weren’t perfect Buddhas, after all; they were human. But they didn’t need to fix all the angles of a situation before they knew there was really something to address.
There was a lesson here, a counter to my fear that I’d spend four years trying to procreate and end up empty. There would be no way to know what the outcome would be, and struggling against this truth would do nothing to change or solve it
. No one can tell you whether your body, in the end, will be capable of producing a child, or whether you’ll regret what you’ve lost in the process. All you can do is try to take care of yourself, to stay as healthy and engaged as possible.
I didn’t require positive mantras envisioning future babies. I just needed to live the life I had now as fully as I could and know that wherever I ended up, I’d tried my hardest in the time I’d been given. For now, I’d just do the best I could and worry the logistics later.
• • •
THAT FALL, Toru and I switched IVF clinics to one nearer our apartment. The new place was more expensive, but I was tired of going back to the old one, where our early good luck had bled into years of failed attempts.
The new clinic had a large, bright café where I could bring my laptop and sip hot rooibos tea while I waited, sometimes all morning or afternoon, for my turn to see the doctor or have blood tests or shots. The English-speaking head physician, Okomoto-sensei, was always dressed exactly the same: white medical coat and white polyester pants that stopped just above his ankles, with thick white socks and soft black shoes, his thinning hair swept sideways across his skull. When we met with him together, Toru and I always traded secret smiles over his outfit.
The clinic’s overriding philosophy called for banishing stress—a futile goal for women undergoing IVF. In one of our first meetings with Okomoto-sensei, he summed up his anxiety-free approach to infertility by describing their post-embryo-transfer protocol: I should remain calm at all times, he instructed; “Of course, you can cook and do light cleaning. But you should stay quietly around the house. And no running to busy department store sales!”