Unholy Birth

by Andrew Neiderman

  I shook my head. After my outburst in the hallway, my throat tightened so that I thought I would choke on anything. She patted me on the hand and went out.

  Normally, Dr. Malisoff, a tall, slim man with a perfectly trimmed black mustache and a head of coal black hair so thick that it resembled a tightly knit wig, took so much time with each of his patients that he always ran behind. However, his curiosity about me, as well as my mental state, caused him to abbreviate his examination of the other patient, and in less than ten minutes he was beside me. In the meantime Rhoda had me lie on the examination table, where she had placed a pillow.

  “What’s going on, Kate?” he asked as he checked my vitals on the chart Rhoda had begun. “You do have low blood pressure,” he muttered. “Which I should say is characteristic of pregnancy, so tell me, what do you mean by you’re not sure? You’re wearing a maternity outfit.” He smiled. “That’s not some new fad I missed, is it?”

  Through my tears and sobs, I related the past few months and the diagnosis Dr. Aaron had given me. He listened with those inscrutable dark eyes and then nodded.

  “I’m familiar with the condition,” he said, speaking of the pseudocyesis, “but to be honest, I’ve never seen a patient with it. Without further tests, I couldn’t tell you if you are suffering from it or not, but in any case, I’m not qualified to diagnose mental conditions.”

  “What tests?”

  He turned and nodded at a machine and a screen.

  “That’s a real-time scanner, ultrasound. It’s an indispensable tool for early diagnosis of many things, including an ectopic pregnancy. You know what that is?”

  “I don’t know much at all when it comes to pregnancy. I’m obviously new at this, despite how I look,” I said trying to find some room for humor.

  He smiled.

  “I imagine so. Ectopic pregnancies are commonly called tubal pregnancies, a pregnancy in which the fertilized egg implants outside the uterus. It can also implant in the ovaries, abdomen, or cervix. As the fetus grows, it bursts the organ that contains it, which obviously can endanger the mother’s life. There is also something we call molar pregnancy and the ultrasound is good at finding that as well.”

  “And what is that?”

  “An abnormality of the placenta caused by a problem when the egg and sperm join together at fertilization. There are two kinds, complete and partial molar pregnancy. Complete molar pregnancies have only placenta parts. There is no baby. It’s an empty egg. Nevertheless, the placenta grows and produces the pregnancy hormone.”

  “HCG.”

  “Yes, you know that. Good. The patient believes she is pregnant. She believes a fetus is forming as well. How would she know otherwise? The ultrasound will show there is only the placenta, no baby. As I said women with molar pregnancy feel pregnant, have vaginal spotting, develop nausea and vomiting. Cysts can form from the abnormally high amounts of HCG.”

  “You think that could be my problem?”

  “I don’t know yet, Kate.” He smiled and shook his head. “Insemination. I have to say I’m pretty surprised. I had no idea raising a child was something you and Willy desired. I can’t recall you mentioning the idea, especially the idea of actually having the baby yourself.”

  “It took us time to talk ourselves into it. For me to talk Willy into it,” I corrected. “It was always primarily my idea. I’ve been told that this condition, pseudocyesis, could be a result of my deep desire to be pregnant,” I said, mimicking Dr. Aaron and Dr. Yan. “It can be traced back to my childhood, in fact. As you can tell, I’ve been to a therapist recently to explore the causes.”

  “I see.” He returned to his doctor’s face, scrutinizing eyes, intense. “Give me an idea about all these symptoms you’ve been experiencing.”

  I described it all and as I added the weight gain, the leaking of my breasts and the increased quickening, his eyes widened and began to lose their inscrutability.

  “I’ve been told I can even produce a false positive on a pregnancy test.”

  “Yes, that’s true, but considering the time period you’re describing, I think we can establish or eliminate your concerns today.”

  He nodded at Rhoda who had been standing by with an expression of disbelief. Like most people, apparently, she had never heard of pseudocyesis or didn’t know the full extent of its symptoms. She immediately began to set up the ultrasound.

  Dr. Malisoff was always good at describing what procedures he would be using, what medications he would be prescribing, and he was always good at explaining a diagnosis. He was a master at helping patients understand their own issues and giving them a sense of comfort and security with the treatments he would prescribe.

  “This, the transducer,” he said, holding it above my stomach after lifting away my blouse and lowering the skirt, “emits very high frequency sound waves. I place it in contact with what we call the maternal abdomen and move it about as if it were a light shined from a torch to look at any particular content of the uterus. The ultrasound beams scan a fetus, if there is a fetus, in what we call thin slices. Not literally slices of course,” he added, smiling. “They are reflected back to the transducer, and,” he said, nodding at the monitor, “composed into a picture on the ultrasonogram.”

  “This is a 3-D ultrasound,” he continued. “State of the art. You know me and new, innovative equipment.”

  Rhoda smiled and nodded.

  “Anyway, it’s a great tool for picking up a fetal heart beat and possible malformations, but parents love it because they can visualize their child better and there’s some evidence that it has a catalytic effect for mothers to bond to their babies even before birth. We, in the business,” he said, smiling, “refer to them as reassurance scans.

  “Sometimes, because the ultrasound demonstrates an embryo but no clear-cut heartbeat; therefore, a missed abortion may be diagnosed.”

  I shuddered at the sound of that and even cringed. Was there something dead inside me? Had that been causing all these symptoms?

  “However, looking at you,” he said, smiling, “and listening to your description of the symptoms, which, as you properly described, are characteristic of a woman in her third trimester, and given the time period you have also described, I would have to say, we’re not going to find anything resembling a fetus, Kate. You can watch the screen then and see for yourself and end this anxiety.”

  “Why didn’t they prescribe this to me before? It would have been so much easier and I wouldn’t need any psychotherapy. It certainly would have spared Willy. I’ve been impossible to live with.”

  “I don’t know exactly why or why not you never had an ultrasound, but as you told me, your OB/GYN thought it was going to go away with real symptoms shortly and your therapist might have been concerned about the dramatic psychological impact such a discovery would have.”

  He held the transducer above me, hovering.

  “In fact, now that I think of that, I have to say I’m not completely comfortable about doing this without consulting the therapist. Perhaps I should have a quick phone conversation with her. You are quite upset and…”

  “No,” I said, afraid he wouldn’t go forward. “I need it to be proven or disproven to me. Besides, as you suggested, maybe I have some sort of growth, some sort of tumor, cyst, whatever! I can tell you that no one checked me for a molar pregnancy. No one even mentioned the possibilities you’ve been describing and supposedly I’ve been going to a specialist. I’m sorry I let them talk me into it. I should have been here from day one.”

  He looked at Rhoda as if he wanted her to be sure to make mental note of what I was telling him to do. Everyone is worried about lawsuits these days, I thought.

  “Okay,” he said. “Let’s get it over with.”

  He began. As the information was fed back to the transducer and interpreted on the monitor, Rhoda edged closer. The three of us watched.

  “There’s a heartbeat,” he said in a low, incredulous whisper.

  I put my hand
over my mouth to smother a gasp.

  The fetus began to take form on the monitor.

  He shook his head.

  “Kate, you are really pregnant.”

  I was at once relieved, but that was quickly followed by a feeling of shock and terror as well.

  “Is it…normal, healthy?”

  The picture continued to take form.

  “Prenatal ultrasound cannot diagnose all malformations and problems of an unborn baby, but from what I see here, it’s looking good, but…”

  “But what?”

  “The femur…the longest bone in the body…”

  “What about it?”

  “The length of this femur…”

  He looked again at Rhoda who was now staring at me as if I were from another planet.

  “What?” I nearly screamed.

  “It’s about 7.8 centimeters. The biparietal diameter is about 9.5 centimeters.”

  “What’s all that mean?”

  “It means this is a baby at term, Kate or it’s going to be one helluva giant. I can tell you what sex it is,” he added. “You want to know?”

  “Yes.”

  “It’s a boy, Kate.”

  He continued shining that torch, his metaphor for the ultrasound.

  “As far as I can tell, he looks like he’ll be about seven, seven and a half pounds. I feel comfortable saying this is a rather healthy pregnancy, but we’d had to watch it. I just can’t imagine it going much longer,” he concluded and stepped back, lifting the transducer away.

  I stared at the monitor for a moment and then looked at him. He took a step back from me as if he thought I might just explode and the baby would pop out of me like some science fiction creature. He had lost all his inscrutability. He was looking at me as if I were some nutcase after all.

  “What is it?” I asked. What more would he tell me?

  “You have to be wrong about all these dates, this insemination, Kate. I haven’t seen you for nearly a year, according to our records. It’s just not possible for a fetus to develop this quickly and for you to be this far along in a pregnancy. If I announced it, you’d make the cover of the American Medical Journal.”

  “Then I haven’t been imagining these trimester symptoms. They’re not psychosomatic. None of it is psychosomatic. When I felt what my doctor called a quickening, I was feeling the baby kick?” I asked. I needed to have him confirm it in no uncertain terms.

  “Yes, I would say so, absolutely.”

  “And when I was having the quickening, anyone else could feel it if she wanted to feel it?”

  “Most likely,” he said. He looked at Rhoda. “Ask any man close to being a father. Men love putting their hands on their wives’ abdomens and feeling their soon-to-be-born child move about. You can see the pride and excitement in their faces, no matter how big and strong they pretend to be. I recall it with all my children, and I’m sure Rhoda would say the same thing, right, Rhoda?”

  Rhoda nodded and forced a smile but then lost it again when she looked at me. She thinks I’m a raving lunatic, I thought. Probably, they both do.

  All of it, all that had happened to me, was happening to me, came rushing back. I couldn’t speak. I couldn’t even move. I just lay there looking at the doctor. I could see he was trying to figure out how to handle me, but I wasn’t crazy. I wasn’t.

  “Let me speak with this doctor you’ve been seeing. What was her name, Aaron?”

  As if to respond for me, the male fetus within kicked hard. I put my hand on my stomach and felt him kick again and again. The cold shudder that had fallen over me like a blanket of ice lifted and I felt a comfortable warmth. My cheeks were probably glowing.

  “No,” I said, swinging my legs off the examination table and sitting up to fix my clothes. “It’s not necessary now. It won’t make any difference.”

  “What do you mean?”

  “She’ll lie to you.”

  “What?”

  “They’ll all lie to you, Dr. Malisoff. Forget about it. None of that is necessary.”

  “Lie? Why should the doctor lie to me? What are you saying, Kate? Why isn’t it necessary to get to the bottom of this?”

  “I’ve got to go,” I said. “Willy needs me at the plant. We did the big White Party, you know.” I turned to Rhoda and smiled. “We’re swamped with new business, business beyond anything we dreamed we’d have.”

  “Kate, listen to me.”

  “I’m sorry, Dr. Malisoff. I’m sorry I threw off your patient load here. It wasn’t fair. Please apologize to each and every one of them for me.”

  He stood there, staring at me. So did Rhoda. The two of them actually looked quite comical to me. I smiled and opened the examination room door.

  “Just send us the bill,” I said. “It doesn’t matter. We’re rich now, very rich.”

  “Listen, Kate, just sit here for a while,” Dr. Malisoff said stepping toward me. “I’ll call Willy and…”

  “Oh, I can’t. There are so many things to do. Don’t worry about me. I’m fine now,” I said. “Really. I’m fine. Thank you for helping me understand. You’ll never know how much you did for me.”

  I walked out and closed the door on them. As I strolled down the hallway, I smiled at his receptionist and then at the patients waiting in the lobby.

  “Sorry,” I told them, and left the office.

  I waited for the elevator and then traveled down to the parking garage. Just as I got into my car, my cell phone rang. Of course, I had expected it. I didn’t even have to look at the phone to know who it was.

  “Did you hear, Willy? Did he tell you all of it? Tell you it’s a boy, tell you his size and his weight? He’s a sure athlete in the making.”

  “Kate, where are you?”

  “I’m in the garage at the medical center. I just got into my car.”

  “Wait right there. Don’t start the car. You’re not in a good state of mind. I don’t want you driving.”

  “Afraid something might happen to me? To our baby?”

  “Of course.”

  I looked around the parking garage.

  “I don’t see Trinity, but she’s here watching over me. I’m sure of that, Willy. No need to worry. They won’t let anything happen to me. They’re probably very excited about it all. Who knows how often they fail and how rare someone like me really is?”

  “Kate, I agree with you. None of this makes any sense. I’m sure we’ll get to the bottom of it. We’ll go to another specialist. Eve and I are coming for you. Just sit tight, you hear me?”

  “Eve and you?” I laughed. “I never told you, Willy, but remember that first night when I saw someone with Dr. Matthews? I always had the feeling it was Eve. She doesn’t sleep, you know. She’s not human.”

  “Kate, you’re talking nonsense.”

  “No, I’m not. I went on the Internet and checked out the story about her brother’s and his family’s deaths in Jackson. The police always suspected arson. They never thought it was accidental and now they’ve determined it was arson. They were murdered, Willy, and I think we know who did it and why they did it.”

  “Kate, your imagination is running away with you.”

  “No, it’s not, Willy.”

  “You’re just not thinking clearly. I’m sure there’s an explanation for all of it. Right now, you’re overwhelmed, mentally exhausted. It’s all happened so fast and we’ve been so busy. If…”

  “Yes, it has happened so fast. We are overwhelmed. How did we get the White Party, Willy? How did we get all this? They killed Isler, you know. That accident, that phony driver…they set it up, but maybe you were always aware of that. Were you, Willy?”

  “What are you talking about? Jesus.”

  “What did you do to get it all, Willy? What did you promise them?”

  “Get it? Kate, oh my God.”

  “Yes, oh my God.”

  “Listen to me. You’re very upset. I understand, but you have to calm down and wait for me.”

  “I�
�m calm. I’m finally calm, actually.”

  “I’m getting into my car, Kate. I’m on my way. I’ll come there without Eve, okay? I promise.”

  “They told me everything in the last phone call. They made it clear. Don’t you see how it all falls into place, Willy? Dr. Matthews pushing us to use Dr. Aaron, and this Dr. Yan recommended to us by Dr. Aaron? We should have thought about all that, Willy. The fox guarding the henhouse. We should have thought about it, or I should have. You didn’t want to think about it. You wanted only to build the business, and at any price, any cost.”

  “Keep talking to me, Kate. Accuse me of anything you like. I’ll stay on the phone all the way,” Willy said.

  I started my car.

  “Sure, I’ll keep talking to you. Dr. Malisoff thinks I’m confused about time. He basically said it was physically impossible for me to be carrying a fetus this developed in this short a period. He thinks I’m a nutcase, too. Did you tell him the truth? Did he ask you when I had the insemination? Well? Did you?”

  “He didn’t ask.”

  “You’re lying to me, Willy.”

  “I’m not lying. All he told me was I should get to you quickly and get you calmed down. He’s very concerned about your current mental state.”

  I laughed.

  “Everyone’s concerned about that. I’ve been thinking about Janet. What do you think really happened to her, Willy? Do you want to hear what I think really happened?”

  “All right, I’ll listen. What?”

  “She wasn’t strong enough for this, Willy, this accelerated pregnancy, and all the intimidation that came along with it. I’m sure she had plenty of phone calls and who knows what else. I guess we’re supposed to believe they didn’t know she had a heart issue. Maybe they didn’t have sophisticated enough machinery to spot that problem or maybe they didn’t care. They gambled. She was expendable. They must have dozens incubating out there, tossing the sperm dice all over the country. I imagine they have no lack of his sperm.”

  “His sperm? Whose sperm?”

  I laughed.

  “Like you don’t know. Who makes the deals? Who makes the promises? Who tempts and tempts until we succumb?”