“Actually, there’s a lab on the second floor of this building that can do the blood draws. You can use that lab or any other. I’ll give you an order and you can take it wherever you like.”
“When will you get the results?”
“I could get them within the day if you get to a lab this morning. I’ll give you a call — certainly by tomorrow — with the results.”
“That’s great. I just want to shake this weird feeling. The sooner you know the cause, the happier I’ll be,” Sarah said.
“It’s a deal. Remember, Sarah, you’ve got Dr. Tanaka on the case now. Together we’ll solve this puzzle.” The smiling doctor shook Sarah’s hand again and said, “Please, say hello to Devorah the next time you talk.”
“I certainly will — and thanks. I appreciate you seeing me on such short notice.”
After the doctor left, Sarah dressed quickly. As she did the last button on her skirt she was relieved to know that whatever was bugging her would soon be identified. If she was lucky, there would be a treatment and she’d be back to herself in no time.
* * *
Sarah was in her office eating Chinese takeout when the call from Grace Tanaka came in around seven. Rick had texted earlier to let her know he was swamped. And from the looks of her desk, she’d be lucky to get out of there by ten.
“This is Dr. Tanaka calling for Sarah Abadhi.”
“Oh, hello, Dr. Tanaka. This is Sarah. Thanks so much for calling tonight.”
“I hope it’s not too late.”
“Oh, no, not at all. I’m still in the office. Did the blood work give you any leads?”
“Lots of good news. Your hematocrit and hemoglobin levels are good. Your white count shows there’s no sign of infection — so we can rule out mono and leukemia. Your thyroid function is normal, so we’re not dealing with hypothyroidism. But there was one surprise in the blood panel. Sarah, your blood work shows HCG — the hormone that’s produced during pregnancy.”
There was silence for a good fifteen seconds. “Sarah, are you still there?”
“Yes, yes, I’m still here…but I don’t understand. How can that be? My fallopian tubes are blocked. Perhaps the lab made a mistake.”
“Well, as I said, I’m surprised as well. All things considered, I would say the probability of a lab error is slight. And given your history, we really need to rule out an ectopic pregnancy — a pregnancy that implanted outside of the uterus, either in or near the fallopian tubes. I suggest you follow up on that right away. An ectopic pregnancy can be quite serious if not treated early.”
“I don’t understand how this could have happened.”
“Sarah,” the doctor responded calmly, “we don’t know exactly what has happened except that it’s likely conception has taken place. Do you have a gynecologist I can send these results to?”
“Yes…yes, let me see. It’s Dr. Scholl. Dr. Jared Scholl. I’ll get his number for you if you give me a minute.” Sarah found the number and read off the digits.
“Okay, Sarah. I’m going to call his office and make a referral for you. I suggest you see him as soon as you can. He’ll likely do an ultrasound to see where the embryo is growing — and then you’ll have the information you need for the next step. I want to reiterate the good news, Sarah: You’re healthy and your malaise is consistent with normal symptoms of the first trimester of pregnancy. You are not sick.”
Embryo. First trimester pregnancy. Not sick. Sarah was having trouble processing the doctor’s words. “Thank you. Thank you very much for that, Dr. Tanaka. I was thinking you might find a brain tumor or some other terrible illness. But pregnancy…I don’t know what to say. I’m astonished. But I do appreciate you reminding me that I am, in fact, healthy, and that is definitely a relief.” She realized she was rambling and that the doctor likely had other calls to make. “I’m going to call Dr. Scholl’s office tomorrow — and I’ll make sure he shares his findings with you. Thank you again. You’ve been a great help.”
* * *
Rick came to bed after midnight and, for the first time, Sarah turned away when he starting caressing her. She mumbled something about not feeling so great. He said he was sorry, kissed the back of her neck and instantaneously fell into a sound sleep. Sarah, on the other hand, proceeded to spend the night thrashing about the bed, imagining every possible ectopic pregnancy scenario, from dying on the operating table during surgery to suffering so much blood loss that she would be mentally impaired for the rest of her life. She’d handled a malpractice case with precisely that fact pattern. There was a downside to knowing too much.
The early dawn gave her an excuse to get out of bed and do something — anything — to take her mind off thoughts of early death or disability. She decided to clean the bathroom while Rick lay sleeping in the next room. She scrubbed the sink, tub and toilet as they’d never been scrubbed before. When she was done, she was spent.
After Rick got up and out, Sarah called her gynecologist. She was thankful his office started picking up at half past seven, but the call only heightened her fears. She could only guess what Dr. Tanaka had told Dr. Scholl, because his secretary seemed to be expecting her call. She fit Sarah into the gynecologist’s invariably jam-packed schedule with the last appointment of the afternoon. The woman told Sarah that it was essential that she come to the appointment with a full bladder, suggesting she drink three to four glasses of water an hour before her appointment.
She could ill afford the time it would take to go downtown to the doctor, but the truth was, her productivity was pathetic. Her mind kept generating one question after another, none related to the work on her desk: How could it be true? Did two esteemed doctors make a mistake when they told her she was sterile? What about the two years she had used no birth control with Tom? And if she had surgery for an ectopic pregnancy and the surgery went well, how long would the recuperation take?
There was also the whole issue of Rick. He had laid out his ground rules at the outset, and they were remarkably similar to hers. How could she tell him she had conceived? What if he thought she’d lied when she said she was sterile? If it was an ectopic pregnancy, maybe he could be a great support for her as she negotiated her way through surgery and recovery. That was, of course, if he’d be willing to wait around for her to come back to herself.
She drank the required quart of water and headed out of the office a few minutes after four. When she arrived at Dr. Scholl’s office, the waiting room was empty and it seemed most of the staff was heading for the exit. She was ushered into a room with an ultrasound machine and an examining table. After the technician left, she did as she’d been told. Taking off everything from the waist down, she got on the table and covered herself with the pink paper drape.
When the technician returned, she was in the company of Dr. Scholl, who offered a big hello and a handshake.
“So what’s this I hear about an elevated HCG level? Sarah, don’t tell me we’re going to have to write you up in a journal.”
Sarah’s hands and armpits were sweating and she had to pee. “Frankly I’m at a loss to know what to think. But I’m anxious to know what you find. Very anxious,” she said nervously. After a moment’s hesitation, she added, “And I also have to pee, so if we could hurry, that would be great.”
“Will do. We need you to have a full bladder in order to get a good image of your uterus. We’ll do this as quickly as we can,” Dr. Scholl said, switching effortlessly to high-efficiency mode. The technician put cold, clear jelly on Sarah’s flat belly — which only made the urge to pee more intense — and then started moving the ultrasound probe. In no time at all she focused it on one spot. There on the screen for all three of them to see was a tiny fish-like being, smaller than a dime, with its heart rapidly beating. Sarah lay there astonished.
“I’d say that looks to be an embryo at about four to five weeks of development. It’s implanted high up within the uterus, a very normal and healthy place for implantation. If you can wait another minute o
r two I’d like the technician to quickly scan your fallopian tubes and ovaries as well, just to be certain there is no other embryo developing outside of the uterus.”
“More…more than one embryo?” Sarah stammered.
“Oh, probably not, but I’d rather we just poke around to be sure,” the doctor said calmly.
The technician did a full tour of her left ovary and tube, and then her right. Then she wiped the jelly off of Sarah’s belly with a tissue and told her she could use the restroom adjoining the examining room. When Sarah emerged from the bathroom, the woman told her she could get dressed and meet Dr. Scholl in his office.
The five minutes she sat alone in the doctor’s office were the longest five minutes of her life. She had a feeling that no matter what he was going to say, her life was about to change. He walked in carrying some three-by-three–inch shots of her ultrasound. He put them on his desk and then sat in his leather swivel chair.
“When you first came to see me — let me see, it was more than five years ago — you brought your records from Dr. Farouzhan in Boston. He is one of the most respected reproductive specialists in the country. It was his assessment that your tubes were completely occluded. My follow-up tests confirmed his original diagnosis.”
“You don’t need to remind me of the diagnosis. A day doesn’t pass that I don’t think of its ramifications: I’m unable to conceive. So I don’t understand how I could have an embryo growing inside my uterus. I’m not saying I’m unhappy about it. I actually don’t know how I feel about it. I’m just trying to figure out how I became pregnant,” she said, biting her lip.
Sarah was not alone in her puzzlement. Jared Scholl was equally perplexed, but he made an effort to tame the incomprehensible with reason and probabilities. “There are things that we doctors don’t have a complete handle on, and I would have to say this pregnancy is one of them. I can only hypothesize that one of your tubes reopened a bit. You remember that when you had PID, the fimbria — the little arms at the end of the tubes — closed shut in an effort to wall off the infection. It was a survival response that kept the pathogens from spreading to the internal organs in your peritoneal cavity. In that sense, it was a good physiological response. But that closure ruined the functional anatomy of your fallopian tubes. It is possible, however, that a small opening occurred in the intervening years. It’s not unheard of but it’s very, very rare — highly uncommon,” Dr. Scholl explained. “And even if there was a small opening, the chances of the egg being released into that opening without functional fimbria to catch it and sweep it into the tube…well, they’re very low. However, it’s my best guess that this is the scenario that explains your pregnancy.”
“You mean I got lucky?”
“Well, it all depends on how you view this pregnancy. If you want to be pregnant, then I would say you are extraordinarily lucky.”
* * *
Sarah remembered little of her journey back to her Midtown office. The doctor’s words kept echoing in her head. From the time she was seven years old — when her mother had told her she would likely have no little brothers or sisters — she had wanted a baby of her own. When she was old enough to babysit, she became a favorite of the mothers in her suburban neighborhood. She loved babies’ skin and smell. She got a kick out of the way children tried to make sense of their world. She marveled at how kids grew and changed. If teaching hadn’t been such a low-status, poorly compensated job, and if her parents hadn’t shelled out so much for her Ivy League education, she would have chosen teaching over the law in a heartbeat.
So, before the subway doors closed on the uptown train, Sarah knew she would not interfere with the unexpected life growing in her womb.
As she walked into her office, she took stock of where she stood in the firm. She had worked hard and come very far, very fast. Another few years and she had a good shot at making partner. Since Tom had left — jumping ship at the mere suggestion of marriage — being a good attorney had been the driving force in her life. How would a baby fit into that life? Staring at the work piled on her desk, she wondered how she would get everything done with a baby. Other women with demanding jobs had somehow figured it out. She would, too.
But not that night. She couldn’t focus on anything other than the embryo growing inside of her. She made a perfunctory effort at getting her desk organized, left a few notes to herself about where to pick up in the morning and walked out of the office at half past seven. As she headed for the revolving doors, the lobby’s security guard teased her about skipping out early before wishing her a good night. Picking up some groceries at the market down the block from her apartment, she resolved to eat less takeout and more homemade meals. It occurred to her that an embryo the size of a raisin was already making its presence known.
She made enough primavera and salad for Rick in case he made it over to her place that night. As she ate, she scanned her apartment. Where would she put a baby? It was a decent one-bedroom — particularly for the city, where shoeboxes were called studios and windows, as likely as not, faced a brick wall. Her apartment was a walk-up, true, but it had hardwood floors, new appliances — including a washer/dryer combo — and windows facing north and west with views of the street. The location was ideal, with shops for essentials nearby and the river just a few blocks to the east. When she had time, she could walk to work. Central Park was close by. Could it be that in eight months she would be one of those women wheeling a stroller to the park?
Deep in her reverie, she heard a key turn in the door.
“Hello, Ms. Abadhi. It’s your friendly doctor here to make a house call,” Rick said before he kissed her hello. “Are you feeling better?”
Sarah panicked. What did he know about her feeling lousy? Had she said anything to him? And then she remembered. She’d refused his overtures last night. “Oh, I’m a little better. Have you eaten yet? I made dinner — hear that? I made dinner, homemade with fresh ingredients: pasta primavera and salad.”
“That sounds enticing, almost as enticing as the chef.” He pulled her to her feet and gave her a more robust embrace.
“You’ll have to wait for dessert,” she scolded playfully.
“How about having dessert first?” he suggested. “Let’s break the rules and have dessert first.”
Sarah looked at the man who had done the impossible: He’d made her pregnant. Yielding to his suggestion, she turned down the lights. They stripped off each other’s clothes and headed for the sofa.
Sarah made love with an urgency she’d never felt before. She wanted Rick safely within her. Everything else could wait. Rick matched her ardor. He’d never wanted a woman the way he wanted her. Sarah came and then came again just as Rick climaxed. Then they lay entwined on the couch, each lover breathing hard, astonished at the intensity of what had just happened.
After a few minutes, Sarah got up to use the bathroom, leaving Rick naked and alone on the sofa. He smiled when he remembered how he’d thought Sarah chilly when they first met. So much for first impressions. She was nothing if not passionate about the big three: work, sex and working out. Besides that, she was easygoing and easy to be with. Equally important, she wasn’t interested in getting a guarantee about the future. She was happy to take it one day at a time, and so far, they’d enjoyed every one. She was the perfect partner. He marveled at his good luck.
As she sat on the toilet, Sarah mulled over the idea of telling Rick her news. Given his take on fatherhood, there would never be a good time. But if not now, when? They had just made each other so happy. Emerging from the bathroom, she decided to bite the bullet. Standing at the living room’s threshold, she stared at the man who’d made her pregnant.
“What are you looking at?”
“I’m looking at one naked, sex-crazed guy, that’s what,” she replied, assuming the role of the irreverent Sarah she knew he liked so well.
“Well I may be sex-crazed, but it’s only because you make me cah-ray-zee,” he whooped. He extended his hand and, as S
arah approached, he pulled her back on the sofa. “I don’t think we need this robe,” he said, opening the tie to reveal her beautiful and somewhat-fuller-than-normal breasts. “And I love these. Oh, how I love these,” he said, caressing them.
“Rick, can we be serious for a minute?”
“Oh, yes, Frau Abadhi,” he said in a German accent, removing his hand from her breast and saluting. “I am now serious.”
“I mean it. I got some news today that I need to share with you.”
“News? Should I be excited or worried?”
“Well…,” she said tentatively.
He couldn’t imagine what was going on. Why was Sarah so serious all of a sudden? “Are you okay, Sarah? You said you weren’t feeling so great. Is everything all right?”
“I don’t know how this happened, Rick, but….” She took a deep breath, exhaled audibly and said, “Somehow I’ve become pregnant.”
In all his many years of enjoying the company of women, no one had ever dropped that particular bomb. “What? How did that happen? You said you were sterile. You told me we didn’t need to take precautions. What the hell, Sarah? What the hell? Were you playing me?”
Her fear was realized. He thought she’d tricked him.
“I’m sorry you think me capable of playing you. I would have hoped you knew me well enough to know I could never do that.”
“Well, what happened then?”
“The diagnosis of infertility was given to me by two doctors. I saw one of them today. Even he has no idea how this happened.”
Rick’s mind started racing to all the possible outcomes. There was only one that he could fathom, and that was erasing the mistake. But what if she wouldn’t abort it? Oh, God…what then? He wanted to pound his fist on the coffee table and scream obscenities, but instead he cleared his throat and asked as evenly as he could, “What are you planning to do?”
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