Monday, March 31, 2008

Wired differently (warning: long and tedious).

I keep telling myself I'm not going to do this, I'm not gonna, nope, nope, nope...I am not gonna go into some long, pedantic holding-forth on theories of gender. I study this shit, I do research on this shit, I can bore a motherfucker at forty paces with this shit. Just ask S. Go over to her blog right now, I bet she's nodding her head.

And yet.

So I think men do sort of get the short end of the stick in a lot of ways. It's hard for us to get custody of our own children, there's an asymmetry in how much flexibility we have within our gender role, we're often portrayed in advertising and popular media as incompetent, the La-Z-Boy dictators with all the power, our women the power behind the reclining throne. We rule the world, but can't change a diaper. Ha-ha.

One of my sisters has a mother-in-law like this. Her husband was a sexist pig, and more or less raised a son the same way. One day she confides to my sister along the lines of "well, we know who's really in charge, right?" in that "oh aren't they cute little boys" tone of voice. Which would be kinda funny in an "Everybody Loves Raymond" kind of way except men do have a lot of social power, institutional power. Those overgrown man-children pass laws and send people to war, make more money, get better promotions, and keep women "in their place". So it's kind of fucked.

But see, here's the deal: All of that social power doesn't invalidate the problems men have. It just makes it harder for us to talk about it. It smacks of entitlement, of playing the victim. We are, to some extent, prisoners of our own stereotype. It's times like this, when we deal with grief and loss, when we are depressed, when we have to struggle to go on that it's especially evident, I think. Not because we try to share and get beaten down for it, but because socialization means that it never occurs to us to share to begin with.

Boring digression: There are basically two camps in gender research, at least in experimental psychology. I can't speak for other disciplines. One is the evolutionary camp, which says that gender differences are a product of evolutionary pressures: Men are dominant and aggressive because dominant, aggressive men were more successful at mating. Women are caring and nurturing because the ones who weren't didn't take care of their children and those traits weren't propagated. There's also parental investment: Children require more time and resources from women (9 months plus post-partum feeding and care) than men (five minutes, ten if you're lucky, twenty if he's had a few beers). So women are more caring than men, because they have to be. Gender differences are thus the product of evolution. Hard-wired into the brain.

The other is the social constructionist camp, which says that gender differences are a product of social expectations about men and women. Yes, there are real physical differences, but by and large what we expect from men and women are the result of different expectations. I won't get into a whole long explanation of how this works, but basically the longer you conflate the jobs men and women tend to do (because of those physical differences) with the traits required to do them, the more you assume that men and women naturally possess the traits required to do the job, because they're the ones doing it. Women are expected to be caring and nurturing, men are expected to be dominant and aggressive, and we reward those who behave according to these expectations and punish those who don't. Gender differences are thus social - primarily (though not exclusively) the product of consensual beliefs about what men and women are and how they should act.

My perspective on gender is a social constructionist perspective. I'm highly aware of roles and what it means to not fulfill them. I'm a big believer in conditioning, that we teach people how to be male and female within a particular culture from a very young age. And I think sometimes we mistake the result of conditioning for natural, hard-wired differences. Women tend to be better than men at decoding nonverbal communication, and men tend to use more concrete language than women. We get good at what we're taught to do from birth. Men are not taught how to share their feelings. At worst, we're taught to hide them (I don't give a fuck what Rosey Grier had to say in "Free To Be You And Me", it is not alright to cry).

All of this yadda yadda is a long and complicated way of saying that I think part of the problem for men is that we aren't really taught to express emotions in the same way as women. This goes for the men undergoing loss and the men in our social support network. And honestly? We might not even be capable of identifying our own emotions to some degree. It took me a little while to be able to articulate exactly how the loss felt to me. I'm a wordy bastard, and it took some serious sitting there and focusing on the feeling for me to find a way to articulate it. And that was mostly because I knew S would want to know how I felt. We're not wholly incapable of it, it's just not necessarily part of our regular skill set. Men in Western culture are by and large taught to do things, to act, to take care of stuff, rather than process and describe.

Which I think also gets to why it's expected that we just get back into the swing of things afterward, or why during the horrible parts we act instead of feel - it's what we're taught, and the more we've been reinforced for this behavior over the course of our life, the better it feels to engage in it. I handled communications for both of us in the hospital. When we got home, I ended up ordering people around and playing host, even when all I wanted to do was collapse. Why? I suspect on some level I wasn't really sure how to do anything else, and everyone else was supporting what I was doing.

I have to admit, the feeling of control that doing something gave me was comforting. And I've been more successful at transitioning back into work than S, partially because it's easier for me to find some comfort in having something to do. It also helps that the class I'm teaching this semester is one I've taught before, so it takes less work to teach it than a new class would. And there are times where I feel sad, and I tell S. Before all of this happened, she'd have to ask me how I felt about something before I'd tell her. I usually could once asked, but it just never occurred to me to just tell her how I was feeling. Now it does. Not all the time, but definitely around the loss of our sons. Even so, even with the focus on doing and working and all that, it took a lot for me to get back into it. Especially when you work with theory, it's hard to get all fired up after your children have died. Everything else seems so much less important.

I don't know that people have expected me to pick right back up - I get the sense that I'm being ridden a little less hard than I could be, and I appreciate that. I also noticed a little hesitation when I saw people for the first time afterward, as if they were waiting to see if I would just burst into tears or freak out. When I didn't, it made it a little easier to talk to me. And it's not like I was trying to hide my grief - it's just not something that's routinely on display. I think people might think more about it if it were more evident all the time. But it's not. My relationship with my grief is a subject for another post.

In the end, it's my opinion that our thoughts and behaviors are guided by how people expect us to act and how they act towards us in return. They take their cues from what we do, and we take our cues from them and from what feels right and has felt right in the past. Are men and women wired differently? Maybe. But wiring can be changed.

Saturday, March 29, 2008

It could be worse. It could always be worse.

I've gotten so much great support from the post on how others respond to me versus my wife that I want to elaborate a little if I can.

I don't think my immediate situation is entirely due to my gender. Part of it has to do with the difference between my doctoral program and S's. S is in an education-related program, and they tend to be a little more touchy-feely over there anyway. My program is a quantitative experimental program, and as a group we tend to be a little introverted. The joke is that "research is me-search" - we tend to study the things we don't understand. Since I work in a field that deals with how people think and behave as members of social groups, well, maybe you can see where this is going. On top of that, I'm not the easiest guy to get to know in daily life. A friend of mine once commented, "you know how some people have an aura? You have a force field." Even before all of this started, being social and developing and maintaining friendships was tough for me.

Part of it is also the "I don't know what to say" factor. And believe me, if people don't know what to say, I'd rather they not say anything than bust out something like "God has a plan for you" or "everything happens for a reason" or "you could always have another" or "you have two little angels in heaven right now" or "have you considered getting a dog?" The occasional "how are you doing?" might be nice, but if people are unsure, I appreciate not wanting to say the wrong thing, especially since "I don't know what to say" doesn't seem all that comforting. They don't know that that's okay, because they haven't been through it. On the whole, we have been extremely lucky to get a minimum of inappropriate comments. I see other people's accounts and I'm appalled at some of the insensitivity there. I don't take our good fortune on that front for granted.

In some ways, I think dealing with our chemical pregnancies was harder. They didn't impact me to the same degree as they did S, but I knew she was in pain and grieving. Still, we have absolutely no norms in our culture for near-misses. As horrible as the death of our sons was, at least people have some idea of how to respond to the death of children, compared to unsuccessful pregnancies. Those we really did get through on our own.

I also think about the comedy of horrors that is all of the huge life changes occurring in our immediate support network. Out of S's three closest friends, one lost her father the same day we found out Joshua was dead (detailed here), and another was both helping to care for her father, who suffers from dementia, while working, caring for two children, and dealing with her husbands' serious heart problem (detailed here). The third? She's actually having a pretty good year, and deserves it, because last year sucked for her. One of S's best friends in town is pregnant with her second, S's sister is also pregnant, and these two women have been tremendous support for her through our struggle with infertility. The festival of wacky circumstances continues, but it could always be worse. We have our physical health. We have two beautiful cats. The sun is shining. I at least take some comfort in these things.


I'm amazed by the compassion and reception this thing of mine has gotten. It's maybe even a little overwhelming, though not in a bad way. I guess, over the course of my life, I've gotten so used to working through things pretty much on my own, that having all of this is a brand new experience. I've said it before, but I'll say it again: I appreciate all of your comments and words of support, and try to respond when I can. I'm not the best person in the world at staying in touch, but this has just been amazing. Thank you.

This recent interruption in my posts has been brought to you by trying to put together a job application for a visiting professorship for next year in something like four days. Lots of running around and shrieking. Better now. Calmer now.

Monday, March 24, 2008

The strong, silent type.

Part of it is being a man.

The masculine gender role in Western culture is defined in part by agency - the ability to provide, to take action. The feminine gender role is defined in part by communion - the ability to connect, nurture, support. All kinds of traits and acceptable/unacceptable behaviors stem from this distinction. Expectations about appropriate responses to an event stem from this distinction as well. Not just how you should act, but also how others respond to you.

I am especially feeling this right now.

It's not even necessarily other people putting it on me as much as me putting it on myself - I assume that because I'm less prone to let my feelings overwhelm me, it must be my responsibility to take care of things when S can't. I may be the walking wounded, but I'm still able to walk, right? So I should keep walking. And I know from previous experience that keeping busy helps me to outrun pain, but right now, it's tough. The depression has set in in a big way, and just getting out of bed and doing what I have to do feels like a victory. I made dinner from something vaguely resembling scratch tonight for the first time in who knows how long, and just doing that felt like one more rung on the ladder out of the dark. I don't really want to do anything but sleep, surf the web, watch TV and play video games. But neither does S, and it's all got to get done somehow, so I do it. Time to grieve later.

It also affects how others respond to you. For the most part, we've been very, very lucky in how others have spoken to us. There's been some inappropriate stuff, but not really from unexpected quarters, and nothing too offensive. Honestly, I'd braced myself for much worse. But how people treat me is very different from how people treat S.

S has people asking her how she's doing, mostly being sensitive, checking in on her. For me, it's been mostly silence. I got condolences early on, but it settled very quickly into awkward silence, then less awkward silence, and now it never comes up. And I don't know if it's because I'm a man or what, but when someone does say something thoughtless, I don't want to say anything because I don't want to be perceived as playing the victim.

And I'm surrounded by baby stuff. I mean, of course it's on the cover of every magazine, all over the TV, it's all over the place. My advisor is pregnant. Another faculty member just gave birth and of course I get the email announcement. Why wouldn't I? Why would that be a problem? Sometimes when my officemate starts waxing rhapsodic about our advisor and how pregnant she's looking, I want to snap and say "look, I don't care how fucking pregnant she looks now, because we already have a weird relationship and every time I look at her, I see all of the happiness I should be getting ready to enjoy but won't be because my fucking children died."

Not one "how are you doing?" from any of the people I see every day. Not now. First week back? Sure. Couple months later? Old news. Maybe I should just be over it by now. Maybe I should just man up and get back to work. Gary Cooper, Steve McQueen, Clint Eastwood. The strong, silent type.

But it fucking hurts.

Saturday, March 22, 2008

Apropos of nothing.

I can still remember one of the first things S did that really endeared her to me.

When we first started dating, I was in a crappy job that I didn't like. Inevitably, our evenings together would start with me venting for about ten or fifteen minutes about my stupid job. After one particularly firebreathing rant, she looked at me with an amused expression and said...

"You don't scare me."

And, just, awwwww. I loved that.

Missing completely at random.

Antigone asked a good question in response to a previous post...

"What if there's no sense to be made?"

I think it depends on what's meant by "making sense."

I'm sure we've all heard it from well-meaning people: "Everything happens for a reason." The last thing I want to think about is what possible reason there could be for the death of my sons. I mean, there's the cause of death, but I know that's not what people mean. They mean "this wasn't some random occurrence, the universe isn't completely arbitrary and frightening in its uncaringness." And I know they're trying to make me feel better, and I know that it's a powerful human motivation to seek order. I try not to judge them too harshly.

Personally, I am generally okay with the idea that the universe is random and arbitrary. Knowing that this could have happened to anyone is actually more reassuring that wondering what secret rule or law I violated brought this suffering upon me. It's part of my worldview. I don't believe in God, I don't believe in higher powers. I believe that this is all there is, and that it's up to me to derive meaning from the events of my life. I make whatever sense I can, I figure out what good I can take away from something horrible. Whatever it is, no matter how small, if it helps me to grow or become stronger, then it hasn't been for nothing.

I have lost my sons for no good reason. I accept that, and I am stronger for knowing that I am able to survive it, if nothing else.

Friday, March 21, 2008

The purge, the long slow climb.

In the process of grieving our lost sons, a lot of things about how we live our life have sort of gone ignored. Lots of things that held over from before, the artifacts of a difficult pregnancy, stuck around because we were/are too busy being in shock to do anything about it. What I've found, over the last few weeks, is that trying to restore a certain amount of normalcy is good for me, even healing. And this means a lot of getting-rid-of. I finally got my hair cut about three weeks ago - I was already a little shaggy when we lost our sons, and by the end of the whole process, it was all I could do to shave off my week's worth of beard. But when I finally did, it felt good. And when I got the damn-near shoulder-length hair cut off in favor of my usual short, clean-cut look, a little more weight left my shoulders. It was one more step away from that awful, awful time.

As if this wasn't mundane enough, a few days ago I cleaned out our refrigerator, getting rid of some of S's staples from when she was still pregnant - the only foods or beverages she could take without getting ill. It left a lot of room, and again, I felt a little freer.

Mundane? Oh hell yes. But in each case, shedding something, removing it, made me feel a little calmer, a little lighter. Every reminder of those horrible weeks around the death of our children got shed, and it left room for something new. I don't expect it to take the grief away, but the more I can clear away, the easier it is to deal with what's left. The easier it is to deal with what's left, the closer we get to being people again, instead of victims.

Thursday, March 20, 2008

Who to the what now?

So having spilled a long, detailed, sequentially-if-not-chronologically accurate account of the loss of my sons all over the first part of this thing of mine (I never liked the word "blog" - to me, "blogging" sounds like what you do after you have too many beers and any number of cheap burritos), I should probably talk a little more about who I am and where I'm coming from. The absolute basics are in my profile, so I'll try to flesh it out a little.

*I'm a doctoral student in social psychology. Just to get it out of the way, no, I don't see clients. I'm not that kind of psychologist. Teaching and research are what I do. Some of my research interests have to do with gender roles, so I'll probably be touching on that here. And I'll try not to be too pedantic about it.

*The Political Compass puts me on the libertarian left, which makes me one of them there liberals. I will try not to go on too many rants - I have definite opinions about a lot of issues, but if they aren't germane to what I'm writing, I'm not going to go out of my way. Opinions on the culture will come up, though. So fair warning.

*Just to get this out of the way: I am an atheist, and have been one for many years. I understand completely that many people cope with their losses through their faith. I don't have that as a resource. God comes up a lot around this issue, though, and as sensitive as I try to be to others, this journal is first and foremost about how I'm experiencing our loss. If I say something about religion that offends you, please do not take it personally. I am not mad at you - I am mad at a culture that doesn't seem to see my perspective as a valid or healthy one sometimes.

*I am a man. More to the point, I'm a guy. In some ways, I'm a very typical guy. I enjoy movies with explosions, beer, poker, video games, and laughing my ass off at "Jackass," among other things. In other ways, I'm not a typical guy. I do most of the cooking, laundry, and grocery shopping, and my wife handles the bills. I don't like professional sports all that much, have been known to watch and enjoy film adaptations of Jane Austen novels, and have been tagged as "sensitive" more times than I care to count. Maybe that's why I'm writing about all of this stuff. I can't believe that my experience is that atypical, but I don't feel like I see the man's perspective on infertility and child loss all that much.

It's interesting, both S and myself have gotten comments to the effect of "I wish my husband wrote about his experience", and maybe this journal is a little of that too - I need to talk about it to people who understand, because on top of everything I've detailed until now, our support system is starting to fall away through no fault of their own. And even that was more focused on S than me. But also, it is my opinion that men sometimes get the short end of the stick. Not to go into a rant here, but I know I'm not the only man going through this. But I've heard from maybe one other man who has. Maybe somebody needs to take a step forward. Sure, I'll do that.

How I Got Here (Too Long, Didn't Read Edition)

Okay, for those of you who'd like a little background and don't want to wade through 6 incredibly long posts (and honestly, I don't blame you if you don't), here's the nutshell version:

1) My wife and I found out we were infertile the hard way a little over two years ago.
2) We did about 9 IUI cycles over those two years - the first 8 netted us three chemical pregnancies and not much else.
3) The 9th, sort of a "what the hell, we've got the drugs, let's do it" cycle got us full-on pregnant. With twins. Two chromosomally normal boys.
4) My wife was really sick throughout the first trimester, until about 18 weeks.
5) At the tail end of 19 weeks, at least one of the amniotic sacs ruptured, maybe both. This was on Christmas day.
6) One of our sons was already dead, and the amnotic sac for the other was leaking fluid steadily.
7) We decided, after much agonizing, to induce labor. Our other sons' chances were slim, the outcome most likely bleak, and infection was going to become an issue soon.
8) On January 2nd, we went in to induce labor, only to be told that state law forbade it at that hospital.
9) We went to another hospital, and after a messy, painful, difficult delivery, our sons Jacob and Joshua were delivered into the world. Joshua had been dead for several days, and Jacob didn't survive the delivery.
10) This is an attempt for me to make sense of it all.

Tuesday, March 18, 2008

How I Got Here, Concluded: "How Are You Doing?"

I'm pretty sure I slept well until past noon after the delivery, and I really didn't care that I did. Somewhere along the way, I found myself past caring about a lot of things. I brushed my teeth, but that was about it. I was already overdue for a haircut and a shave when everything started, and by the time the delivery happened I was starting to get sort of a Jesus/Manson thing going on. I didn't care. I had tunnel vision. All I saw was S, and until she was done with the hardest thing she'd ever have to do, everything else could go hang.

All I remember about the next day was the silence and peace relative to the noise and chaos of the night before. Again, we were in a part of the wing away from all the parents of living children, and a falling leaf decal on our door marked us as someone who'd experienced a loss. S had gotten a transfusion because she lost quite a bit of blood during the delivery, and this meant she got almost no sleep, because they kept waking her up every couple of hours to change bags and get her vitals. Her family came back at some point, I remember them going to get me some lunch. The anesthesiology supervisor surveyed us for the quality of the epidural. We told him it wasn't great. I suspect dude got a C for that one.

A grief counselor came by and brought us teddy bears. We'd expressly asked that pastoral care not come by as they did the last time we were there - God talk wasn't going to do anything but piss us off. But, teddy bears? Really? There was one big one and one small one. Maybe it was mama bear and baby bear (no papa bear, apparently), but my first thought was one bear for each - Jacob was the big one and Joshua was the small one, because he died sooner and was smaller. I'm still not sure what the reasoning was, and we were both polite, but come on. Teddy bears. Except that as S and I started talking, we held onto the teddy bears, and it was actually pretty comforting. Soothing, even. Our cats weren't there to pet, and they're usually pretty good about knowing when we're upset. Our smaller one will sit right down on your chest or lap and curl up into a little ball, and our larger one will sit next to you, reaching out to touch you with one paw. We refer to this as the Paw of Concern, or Paw of Connection, or Paw of Reassurance, depending on the situation. I love our kitties.

I forget what the grief counselor said - yadda yadda sorry for your loss, blah blah grief, etc. She wasn't bad at her job or anything, I just couldn't care less what anyone had to say. I was in shock. I think the social worker went over postmortem options with us - did we want the photographs, the clothes in which they were photographed, measuring tapes, etc.? There's like a whole fucking industry around memory boxes and mementos. Find a need and fill it, I guess, but it sort of reminded me of all of the wedding magazines S stacked up around our apartment while we were planning our wedding. do you commodify something that's supposed to be transcendent? I mean, I see how it's done, but...I don't know. I'm sure people find solace in these boxes. I just don't need to see a fucking price list or discuss the options. I'm over here dying a little inside. I couldn't care less about a photo album or engraving or anything. I can't even being to imagine what it must be like to buy a casket.

We opted for photos, as any of you who read my wife's blog probably know. For me, it sort of felt like the best option I could endorse for the future with respect to the present. I too had read of people bathing and dressing and holding their stillborn children, and at that moment, I felt exactly like S describes in now. I knew if I held them or even saw them, I would probably snap and lose what little grip I had on my sanity. But I didn't want them to go unmemorialized or unremembered. We agreed that photos would be a good idea. I didn't want to see them right then - I've seen pictures of dead children before, and I know how deeply sad and horrifying they can be. I wanted to remember them as they were when they were alive, squirming around, working hard to grow, kicking each other in the head as I'm sure they would have as 8-year-old brothers. That was a very happy time, and I needed every little piece of happiness I could get. But I also knew that how I feel now is probably not how I'm going to feel 10 years from now. The 27-year-old me is nowhere near the 37-year-old me. Needs change, and the photos felt like a way to be ready for that.

I know S has looked at the photos, and from the way she describes it, it's about what I thought, and knowing what that probably means, I don't need to see them. I'm glad we have them, but I don't need to see them.

Then there was the remains. What a wonderful word. Did we want to bury them? Not here. Here isn't home. If we ever return here, it will be to visit friends, not the graves of our dead sons. We asked to have them cremated. I remember thinking back to when we had S's cat cremated, and how we had to pay extra to have her cremated separately. It offended me a little - dude, what, you think if I've gone to all this trouble, I won't care whose ashes I get? But I recognize that there are varying degrees of sentimentality about pets. So we sucked it up and paid the extra bucks. And I thought to myself "well, at least that won't be an issue now."

Except they asked us the same question.

Apparently, at this hospital, they do mass cremations and return ashes free of charge. There's just no guarantee they're your child's ashes. They're the ashes of many, many children. And politely? FUCK THAT. It's bad enough that my sons are dead, now you're going to tell me I have to give you money to ensure that it's their remains I get back? Of course I'm going to do that, and I'm going to wonder what this says about us as a culture the entire time.

I think I would have probably gotten even angrier, but again: Shock. It was one more thing on top of every other thing. I think there was some other paperwork or some shit, but honestly, everything I had was focused on trying to find something good and comforting to focus on, not because I wanted to prevent the inevitable freakout, but because I wanted something to make me hurt a little less, if only for a little bit. Whatever I had left was focused on S. We both spent the entire day on a rollercoaster - sadness, grief, dark humor, relief, exhaustion, comfort in each other. Whenever she had trouble, I played Director of Communications - I'd talk to S when we were alone, sort out what we wanted to do on any particular issue, and then tell people what we needed when necessary. I bitch and complain about all the work I was still having to do, but to be honest, part of me needed to do something. I needed a sense of control over something. I just wish people had been a little better about giving me room, or at least a little more aggressive about getting me to let go of some of it.

We'd gotten a friend to come over and move maternity clothes and baby books out of sight so when we got home S wouldn't have to look at them. On some level, being home felt comfortable, familiar - I could shower and eat and sleep in a real bed. On the other hand, it meant that the rest of our life was starting, and when the initial shock wore off, the rest was going to come down like a ton of bricks.

The day after the deliver, S's brother went back home. No, strike that - he went to go hang out with his fiancee (who was pissed that he'd been gone for five or six whole days) in Boston before returning home. Over a weekend. I'm still not really over that.

But that's how I got here. And everything from here on out is going to be about where "here" is and how I'm navigating the new normal, as a grieving parent, as an eggheaded academic, and as a man. I appreciate the attention and support, and hopefully this will become more of a dialogue than a monologue. Ask S - I can monologue with the best of them.

Monday, March 17, 2008

How I Got Here, Part 5: "There's Been A Misunderstanding..."

Our regular OB gets into town around this time. He opens up the office on New Year's Day to examine S - yet another ultrasound. His professional opinion is that S isn't retaining enough fluid to really help the baby grow - she's been leaking steadily the whole time. He thinks that at this point, we're just waiting for infection to set in. So we make arrangements. This means scheduling an appointment at our local hospital - they'll test S to make sure she can handle an epidural (stopped the heparin many days before), they'll give her the epidural, then they'll give her pitocin or misoprostol or cervidil to help cervical dilation and start labor. And all of our hard work, over like that. Or so we think.

Having come to some sense of closure, having resolved ourselves to a course of action, we get up early on the 2nd and go to the hospital. We get S ensconced in a room at the end of the hall, away from all the other moms-to-be. There's a flower on the door, which tells staff coming in that there's "been a loss" in this room. Meaning "for heaven's sake, no bright and chipper smiles and proud mama-and-papa talk."

Oh, but wait: Just as we're getting settled in, physically and emotionally, the nurse comes in and begins apologizing profusely. Apparently, there's been some misunderstanding, and the nurse manager hadn't been told that the OBs were going to have the nurses administer labor induction drugs. The nurse explains that she's not allowed to do that, and gets the nurse manager...

See, it's like this: In the benighted shithole of a state we call home, the Attorney General wrote an opinion saying that nurses doing exactly this - administering labor-inducing drugs in cases where the child is not viable - is too much like "practicing medicine." Specifically, too much like abortion. Which apparently makes the Baby Jesus cry. Ours is a small hospital - an attending and a bunch of nurses in the OB unit. The attending can't be available on an hourly basis to push the drugs, and the nurses are forbidden from doing it.

So we've prepared ourselves for the hardest thing we're ever going to have to do, and we're being told that we can't do it. Not here. Not now.

The nurse manager hates it too. The hospital wrote a letter of objection. Nurses have been doing this for years. Until some old man decides it's wrong. Doesn't matter. They can't do it.

So what option do we have? Back to the other hospital, which is a teaching hospital, and has tons of residents available to do what needs to be done. I've gotten smart by this point. I pack a change of clothes and a toothbrush. I think some books, too. Hospital time goes slow. Hurry up and wait.

When we get to the hospital, we're put in a triage room, S gets a contraction monitor, they draw some blood to make sure she can get the epidural, and in comes a resident who is apologetic and sensitive. He tells us that state law requires that we be counseled about "alternatives" before undergoing labor induction, as well as fill out forms indicating that we've been counseled and have undergone a mandatory 24-hour waiting period (you know, to make sure this isn't one of those rash, impulsive, spur-of-the-moment decisions). Bless them, they already had the forms filled out and we never saw them. The resident told us these were stupid, awful requirements, and he was sorry we even had to hear about them. After awhile (hospital time, so slow), another resident came in, all chipper and all smiles until she read the chart. She explained a little about what would happen, did some intake. We got moved to an examination room that doesn't look like it sees a lot of use. The staff are apologetic - they'll move us to another room as soon as they can, but they're getting slammed. And they are, I can hear it.

Specifically, I can hear a heart monitor in the next room over. Someones' healthy baby, heart beating away. In the other room (the one with whom we share a bathroom), there's a celebration going on. Another happy, healthy birth. I go out into the hall to get something to eat (already familiar with the Chinese takeout place in the food court) and heart monitors echo all the way down the hall. The sound of living children fills my head. None of them mine. None at all.

An anesthesiologist trainee puts in the epidural. Were I his instructor, I'd give him a B-, maybe a C+. Unfortunately, it was my wife on whom he was getting that grade. Apparently, she had a big nerve, and he kept hitting it. Under any other circumstances, I'd probably find it a little funny, in that "let's poke the brain and see what happens" kind of way. As it was, I was tired of seeing my wife in pain. Finally, after three or four tries, they get the catheter in. They have to keep rolling her onto her side to get the medicine to distribute evenly, because one side still isn't losing feeling. This will be important later.

The resident on our case wanted to treat it aggressively - basically, hammer S with huge doses of pitocin, get through it quickly. Which would be great, except the pitocin, over several hours (hospital time, so slow, time standing still in a room with no windows), didn't take. Contractions ramped up a little, then plateaued. No dilation. Hours. Shift changes, new doctor takes over. S gets some phenergen for nausea and to knock her out. While she's asleep, I talk to her family. They're trying to figure out where to go (the hospital's about 45 minutes away from where we live), do they stay here, do they go back, they want to get back quickly after it happens. Brother-in-law keeps whining about how with all the talk they could be halfway back to the hotel by now and I wonder for the 837,000th time why the fuck he even came. At best he falls asleep on the couch and isn't an active pain in the ass. I take charge (again, they're here for me too) and send sister and brother-in-law back to their hotel. Brother and father get a room at a place near the hospital.

This is when things start to get blurry. I think maybe an hour or two after the family left, the new doctor started administering cervidil, which worked fast. Contractions, dilation, and it becomes immediately apparent that the epidural didn't quite take. S can feel the contractions up one side of her body, and she's screaming. She's in so much physical and emotional pain, there are nurses and a doctor, the whole thing strikes me as a hideous parody of birth - she's going through all the agony and effort of labor to deliver dead and dying children. I hold her hand, I tell her to push, I stroke her head, just like we would if our children were being born alive. I keep telling her that I'm there, that I'm not going anywhere. I have no idea how long it took, all I could see was her and all I could was hope it would be over soon.

Once the boys were delivered, the nurses took them away to photograph them for us and keep them so we could see them the next day if we wished. I waited until S had fallen asleep and sat back in a recliner, and it occurred to me that I could close my eyes if I wanted. I texted S's father and let myself fall back into the dark and quiet.

I think at some point her family came through, but I was completely out of it. At least, until they started delivering the placenta, which was I think an hour or two later. I slowly became aware that S was screaming again, and it was like something from a nightmare. All the lights were out except for ones around her, throwing sharp, stark shadows everywhere. I could see a lot of blood on the doctor's arms and on the sheets, and I was so tired that I couldn't move. All I could do was watch helplessly. I just couldn't move. S was so out of it from pain and grief that she was asking for Tylenol, something, anything for the pain. The doctor asked if she was sure she wanted Tylenol, and S just wanted something for the pain. The doctor asked for 3 of morphine, and then S screamed again and she upped it to 5. I didn't relax again until I heard S start snoring. I knew she was asleep then, and if she was asleep she was no longer in pain. I've never been so happy to hear her snore in my life. Such small things.

A nurse gave S a sponge bath and I couldn't get over how small and vulnerable she looked as the nurse cleaned her up. How surrendered she was to the care of another. She looked like a child. The horrible ironies just kept coming. At around 6am or so they got us moved to another room, a nicer room in the other wing. The nurse was someone who'd seen us when we were there on the 26th and 27th, and she'd already made up the couch bed for me. She said to S "when I saw it was you, I made up the couch because I knew your husband would be right by your side." I was touched. How could I be anything but? How was this anything but us, together, side by side? How does anyone else get through this?

I kept it together long enough to change into pajamas and brush my teeth, and collapsed on the couch bed. I don't think I woke up again until around noon.

Next time: The rest is silence.

How I Got Here, Part 4: "We've Made Our Decision."

So we get back home and settle in. S's father, sister, and brother-in-law are at a nearby hotel, but there's at least one of them with us all the time. On some level, I think we're still in shock. Something about being in hospitals makes it hard to keep track of time. It's a little disorienting. We come home, and I walk S upstairs to the bedroom and get her tucked in. No moving more than she has to, check her temperature every 6 hours, she's like an invalid. I walk into our kitchen to get something to drink and am greeted by a spray of broken dishes everywhere and two very frightened cats. Apparently, while we were at the hospital, one of the shelves in a kitchen cabinet broke, and the dishes and mugs on it flew out. Normally, I would probably flip out - I really liked these dishes and the cats seem really freaked out. We've been gone for a couple of days and who knows when this happened. However, all I can muster is dull surprise. One of our babies is dead, the other may die, so sure, why not come home to a kitchen full of smashed dishes? As long as Christmas vacation is all about chaos, fear, and everything going to shit, why not smashed dishes too?

I'm glad S's family is here for this. I love my parents, but I'm not sure "good in a crisis" is on their list of assets. S's family took care of her mom in her last days with cancer, they know how to organize and delegate and take care of business when someone's health is on the line. Mostly. More on that in awhile.

So finally at around 10 or 11 or so her family goes back to their hotel. We go to bed, I try to spoon her like I always do, but she's a fragile thing now. She's uncertainty embodied. Infection, premature contractions, more leaking, I'm afraid to hold her. Afraid of what's going to happen in the middle of the night. S's mother started dying in the middle of the night, though it was morning when she finally went. This felt like the same kind of vigil. Something could happen at any time. Felt like it did when S's beloved 15-year-old cat was dying of lymphoma and having seizures. Snap awake in the middle of the night because something bad is happening and demands action. Sleep becomes a minefield. Honestly, I can't remember how I slept. I might have been so exhausted that I slept fine.

Sure enough, we wake up the morning of the 28th and S has another huge gush of fluid and some contractions. So early in the morning, back to the ER. Another day on hospital time. Contractions never get worse, fluid continues to leak, nothing to be done, back home we go.

("Nothing to be done" just occurred to me now, it appears throughout the play Waiting for Godot, a play about two people waiting for someone who should arrive, but hasn't, or maybe won't. How very apropos.)

For the next three days, we wait. We escort S gingerly from upstairs down to the couch in the living room. Temperature every 6 hours. Watching, waiting, waiting, waiting, waiting.

S's family tries to look out for me, there's a lot of "we're here for both of you", but they're here for her. Part of it is the family dynamic - she's the middle child, feels everything, does a lot of crying, there's that sense that she needs to be protected. Never mind all the hard, ugly shit she had to do for her mother. I know she's tough. I believe in her. I'm worried about her, I find myself playing host, fixing people lunch. I think I'm trying to outrun it. Her father keeps getting on my case about our litterboxes. He's afraid S will inhale particulate matter and get some hideous infection, something no doctor at any point anywhere ever has even remotely considered a problem. There are all kinds of other things that could use doing, but he just won't shut up about it. I know he's afraid of losing a grandson and a daughter, but I'm afraid of losing a son and a wife. And yet, I'm apparently the one get bitched at. I know he's trying to protect her, but it's hard for me to keep a civil tongue in my head. S's sister is super-helpful, but her husband is pretty high-maintenance, so she's dividing her time between looking after S, helping me, and looking after him. Somehow I find myself doing a lot of the work that I think they're supposed to be doing for me.

Then there's the whole issue of who gets to know what and when. S's father takes care of his mother-in-law, who lives in a retirement community. No way in hell does she get to find out what we're going through just yet, but Dad is explaining his relative absence on a cold. S's younger brother is there to look in on her, but he pitches a fit over having to pull grandmother duty instead of being where the action is. So S's uncle comes out (from, for Chrissakes, New Mexico) to the East coast to look after her so brother can soothe his feelings of being left out. This is shit for which I have exactly zero patience at this point, and it's beginning to feel at points like people aren't here so much for us as to meet their own needs. My family wants to come out too, but we don't need everyone out here. So do they want to help us, or do they want to feel like they're doing something? Their needs and fears and insecurities are, in the words of a TV show I like, an NMFP. Not My Fucking Problem. S's brother gets into town, sulks when people don't pay attention to him, cleans our kitchen and our car, and it's appreciated, really it is, but I wish he'd asked me where dishes went when he cleaned the kitchen. I found myself hunting for specific dishes and pieces of cookware for weeks after that. But he meant well. When I get a break from what feels like herding the people who are there to help, S and I talk about our options.

To say it's tough is a huge understatement. We've been talking about the worst-case scenario ever since Christmas. The price for expectant management is the ever-present threat of infection, and as bad as losing both of my sons seems, losing both of my sons and my wife is utterly terrifying. And yet, here we are, the future of our remaining son in our hands. It used to be when S would ask me what I wanted for some gift-giving occasion, I'd say "I want to decide who lives and who dies." And now that's exactly what I have to do.

The entire experience has to this point been a mixture of aching fear and removed amazement. Even as S and I decide the fate of our remaining son, there's one part of me screaming inside that I don't want to lose anyone else, and another part thinking "holy shit, I am actually being called upon to make this decision. Some people will go their entire lives and never have to consider this decision. Holy shit."

S and I come to a decision on New Year's Eve. We've gone back and forth, and it seems like our son's chances are bleak. We have to avoid any more complications for a month to even get to the bleeding edge of viability, when the really awful hard part starts, and the chance of having a healthy child are small. To go through all of this for another month at least, just to watch him suffer, in pain in the NICU, hooked up to machines, struggling to's too much. What kind of life is that? What kind of life will he have? We were okay with the idea of raising a child with Down's, but that's more of a known quantity. Are we capable of spending the rest of our lives taking care of a disabled boy? Are we those kind of parents? We're relying on a months'-plus worth of things to go right, just for a shit chance at a hard life. On New Year's Eve, we gather S's family at the house and tell them that we've decided to pursue active management.

Next time: We know what we have to do. Being able to do it is a whole other matter.

Sunday, March 16, 2008

Interlude: Thank you, thank you, thank you.

Thank you all for the supportive comments and positive feedback. I want to respond, but it may take me a little bit. Writing out the history of what happened to S and myself is a little like running a marathon. It's long, arduous, and every post leaves me exhausted. It won't always be like this, and not everything I write will be as long as these posts have been, but I feel like I need to have some background, some context in place before the pithier observations begin.

Until then, until I catch up, until I get my breath back: Thank you. All of you. Your response has meant a lot to me.

Saturday, March 15, 2008

How I Got Here, Part 3: "I Have Some Bad News..."

I came back to the hospital the next morning, and they hooked S up to a fetal heart monitor - which was only finding one heartbeat. I tried not to let it bother me too much, partially because I have a tendency to get really anxious really quickly, a tendency I've worked for many years to control. Also, S was going to get upset enough for both of us, I knew that. So I tried to remain optimistic - after all, it was a pain in the ass to find one of the heartbeats under the best of circumstances. To my mind, it was too early to start panicking. In retrospect, maybe part of it was denial. The OB brought in a crappy mobile ultrasound machine and tried to find the second heartbeat that way. Still no dice. We waited, and waited, and watched TV, and waited for the radiologist. This was a state with which I was to become very familiar over the next week or so. Sitting on a plasticky hospital room couch, watching the most innocuous thing we could on cable.

In the time it took the radiologist to get set up for us, it had started to sink in that it was possible one of our children was dead. I don't think either of us wanted to say anything, because once it was said out loud, it became real. Somewhere in the back of my head, I started preparing myself for the possibility. Our regular OB was away on vacation, hell, everyone was away on vacation. It was the day after Christmas. The town was empty and quiet. It felt like we were trapped in some time bubble where everything went slowly. It was starting to occur to us that this might not be as simple or nonthreatening as we'd hoped.

The radiologist came in and brought the really good ultrasound machine up to our room. The tech was someone who'd done a transvaginal on S during a previous cycle that ended in a chemical pregnancy. During the ultrasound, S had an ovarian cyst rupture, and my only other memory of that day was her out in the hall outside the ultrasound room, screaming in pain and me trying to find the nurse who'd said "I'll be right back with something" several minutes before. Fortunately, he did a much better job this time.

Unfortunately, the news wasn't good. There wasn't a second heartbeat, there wasn't movement. Baby B, as he was known at this time, was dead. Our other boy still had a nice strong heartbeat, but amniotic fluid was a concern. The OB came back to the room after looking at the scans. He'd passed them along to our perinatologist in a neighboring city, and their recommendation was to get S there right away to get her into a larger hospital with a high-risk OB unit. Without a chance to shower or change, we were off.

Checking in was a hoot - the reception desk was in a small room already crowded with people, and we felt like we were sitting on a ticking time bomb, like we could lose our other baby at any second. Even better, in came a woman who was already in the throes of labor - breathing and everything. So no, that wasn't too upsetting. They moved S into an examination room, hooked her up to a contraction monitor. S had been having mild contractions the whole time, which added to the whole time-bomb feeling, like she could deliver at any moment. A shitload of doctors came to talk to us - obstetricians, our perinatologist, and they scheduled another ultrasound and an appointment with a neonatologist.

Basically, the diagnosis was premature rupture of the amniotic membrane. Our boys each had their own sac, their own placenta. So at least one sac had ruptured, and the other was leaking. So they laid out our options. This is where the euphemisms started flying fast and thick.

Three obstetricians came in to talk to us. One option, they said, was "expectant management." In essence, we could go home, S could go on bedrest, taking her temperature 4 times a day to make sure infection doesn't set in, and hope we could make it to 24 weeks. We were at 20 weeks when this happened, so that meant a whole month of pins and needles, bedrest and remaining ever vigilant for infection. And what, pray tell, would that month of hell buy us? A 50% chance that our living baby would survive birth. Yay? The other option was "active management", which to me sounds like some seminar you send Brad from the Chicago office to as a way to improve his vertical effectiveness at empowering employee resources to go proactive on deliverables or some shit. (There's a reason I'm in academia.) This was just a fancy way of saying that we could induce labor, which would straight-up kill our living child, because at 20 weeks, he wasn't going to be capable of breathing on his own.

Then in comes our perinatologist. He kind of rubs S the wrong way, but I can relate to him. He's not quite House, but they share some common DNA. He thinks expectant management could work - S is still losing amniotic fluid, but he thinks as long as she keeps producing it we're actually in good shape, because it's essentially carrying bacteria away from the babies, which also makes infection less likely. He thinks there's enough for the surviving baby to develop lungs. He doesn't tell us what to do, just that he thinks we have a choice. We still need to get another ultrasound and talk to a neonatologist. I'm on my cell phone to friends and family, leaving messages, updating people. We get moved to a nicer room.

I will say this - the rooms at this hospital are sweet. S gets the usual hospital bed, I have my fold-out couch bed and a recliner. It's amazing how quickly small things become important. S and I talk about how we're going to handle this. S is having trouble talking about it without crying, which is going to make it tough to communicate with the staff. I don't really cry that much. Which is a topic for another post. I ask her if she wants me to do the talking when she can't, and she says yes. So I am now Director of Communications for Team Married.

S's father has come back into town - he basically got home from one visit, and turned around and came right back out. Her sister is on the red-eye from the West Coast. We don't know it yet, but we're in for a long wait.

Now, S and I refer to it as "hospital time" - nothing happens quickly. It takes us forever to get another ultrasound, which ends up telling us nothing. Not only does it end up telling us nothing, but it only does so after an extended wait in a lobby filled with mothers and squealing children. Constant reminders all around us. The tech points out our living baby's strong heartbeat, and it kills me a little inside. We're having to seriously consider letting them both go, and the tech is not making it one bit easier. The doctor who looks at the scans has no discernable personality, and it's a little disconcerting. Maybe one day, all of us will have our ultrasounds read by androids, but right now it's a little weird.

We spend the better part of the day going back and forth - a month is a long time, and 50% isn't great odds-wise, but if it means a living baby, that's the important part, right?

And then we speak to the neonatologist. This is around 7pm on the 27th. S's father, sister, and brother-in-law are there. All the nurses and residents have been very apologetic about the wait, but the NICU has apparently been getting hammered. When we see the neonatologist, we can tell it isn't a lie. She looks really strung out and really sad. How much of it is the death she's seen and how much of it is knowing our situation better than we do I don't know. But she lays out what that 50% survival entails for our child.

If our baby survives birth...if...there's brain bleeds, respiratory problems, lifetime disabilities. About four months in the NICU hooked up to machines. Will he be okay? Who knows? Every day will be a struggle. And that's if we can make it another month without infection setting in, without premature labor, without anything else going wrong, because everything else has been going absolutely fucking swimmingly so far.

We decide to try expectant management, After a day of making phone calls that all begin "I have some bad news...", a little hope helps.

S's father-in-law drives us home, and his driving is more terrifying than anything else we've faced that day, in that moment.

Next time: Yes, but no, but yes, but no.

Friday, March 14, 2008

How I Got Here, Part 2: "Well, I Don't Have A Crystal Ball..."

Leading up to the holidays, all of the disruptions we'd experienced were becoming almost routine. S uses the phrase "the new normal", and I think this is about the time I started to understand what that means. It was perfectly routine for S to be: a) throwing up, b) feeling like she had to throw up, or c) completely without appetite because she'd just finished throwing up. We had cans of Ensure and SlimFast in the refrigerator, what she could and couldn't eat changed every week, trips to the hospital for IV fluids happened every couple of weeks, so regularly that I came to regard them like I would one of her night classes. No big thing, she'll be home tomorrow morning. I got used to fixing meals for myself alone. No big deal. It's the new normal.

Ordinarily, this would be painful and difficult and cause for tremendous concern and upset, but we were having twins. We couldn't get a straight answer on the sickness thing. Some people swore they'd go away after 20 weeks or so, others said it was just the first trimester, yet others said they were sick the whole time. Great. Still, we were chin up and enduring, because we were having babies.

That all changed on Christmas day.

The Christmas break was going to be less eventful than average, I thought, because we weren't going anywhere (what with the puking and all) . My father-in-law had just been to visit, and I spent Christmas Eve at school catching up on some work. I thought we'd have a quiet Christmas - S had just started to get her appetite back around the time her father was here, so I figured we'd sleep in, then I'd make us breakfast (I'm kind of the cook in the relationship) and we'd watch some movies, snuggle on the couch, enjoy the quiet.

Except that when S got out of bed, there was a huge gush of fluid. No debating, no mulling or pondering, we threw on clothes and headed to the emergency room.

Of course, it's Christmas, so pretty much nobody is there. We're sitting in the waiting room, getting more anxious every second. Everything is suddenly very tenuous, as if our entire lives are teetering on the edge of a steep cliff. Once we're finally admitted to triage, the ER doctor does a quick Doppler scan and hears one heartbeat. But the pH test seems to indicate it isn't amniotic fluid, and the Doppler scan is a shitty little thing, and our boys had already demonstrated a talent for squirming around to avoid detection. So I wasn't terrified just yet. The obstetrician on duty was, like, our least favorite OB in our very small town. Very old-school, silver-haired guy with some problems in the bedside manner type area. (He couldn't find a heartbeat on our friends' baby at 8 weeks, so his first move was to give her pamphlets on miscarriage. That particular miscarriage is coming up on 2 years old.) Exactly the kind of doctor you can imagine telling an off-color joke to some golf buddies at the country club. The radiologist would be in tomorrow, he said. I spent the day with S, then went home to change and shower and get some sleep. I was still the picture of optimism at this point - probably a high leak, it'll get better. Wasn't amniotic fluid. All will be better. We're still having babies. Right?

Tune in tomorrow, when the entire medical staff pretty much says "wrong."

Thursday, March 13, 2008

How I Got Here, Part 1: "You Mean People Reproduce For Free?"

Well, how did I get here?

It all started in earnest about two years ago. My wife (let's call her S so I don't have to keep typing "my wife" over and over again) and I are in two different doctoral programs at the same university. She's a couple of years behind me, and in late 2005, we'd finally gotten to a place in our lives (financially, emotionally, and otherwise) where we could actually consider having children. Our thought was, of course, that we would just make with the unprotected sexing and a week or two later, voilá! Baby! Oh, for those days back again, when we were young and naive with the stars in our eyes.

So a few months of this approach wasn't really working, and we made an appointment with a reproductive endocrinologist. Over the course of multiple procedures, we determine that S has a clotting disorder, polycystic ovaries (well, that we knew about), mild endometriosis, and a cervix positioned at about 9 o'clock. So even if there weren't all those other things, my sperm would have to be capable of making a 90º turn to get where they need to go. Which isn't happening, because sperm analysis suggests that my swimmers are wandering around like they've been given wedgies and had their shirts pulled over their eyes. Basically, our chances of getting pregnant the old-fashioned way are damn near nil. So what do we do?

What we did, starting about two years ago, was begin a battery of vitamins for me to improve the quality of my sperm (we're talking multivitamin plus extra C, extra B-complex, selenium, zinc, folic acid, and Clomid to address a testosterone deficiency). For S, there were vitamins, baby aspirin, subcutaneous injections of heparin, and medications for the polycystic ovaries and clotting disorder.

And that was just for everyday use. When it got to be that special time, that certain time of the evening, when the lights are down low, Barry White's playing on the stereo, and we look at each other in that way...

...oh, who are we fucking kidding. Babymaking meant giving S an intramuscular injection of HCG in her butt to trigger ovulation (giving "tapping that ass" a whole new meaning), then getting up at some unholy hour the next day to go to the RE's office so I could go into a tastefully lit private room and do what all men do into a little plastic cup (with a disturbingly rough edge), and give it to a nice lady in the lab. Then we'd leave for a little while, grab some breakfast, and come back so S could climb up into a stirrup chair and have a little date with a speculum and a catheter. 15 minutes later, we're off to begin another cycle of waiting, peeing on sticks, fretting, hoping, and trying not to hope all at the same time.

At first, it all seemed really weird. I understand why people object to calling it "natural" conception if it's just sex, but with the visits and the doctors and the pills and the needles and the catheters and everything, it does seem about as unnatural as it gets. After the first two or three, it started to seem commonplace.

By the time we were on cycles 7 and 8, it was downright routine. We had sharps containers in the bathroom, boxes and boxes of alcohol prep pads. I bought one of those days-of-the-week pill organizers to keep on my nightstand. Every now and then, I'd look at our stocks of medical supplies, and wonder what we'd become that this was normal. But the alternative was no children.

We ended up doing 9 IUI cycles, all told. Three of those resulted in chemical pregnancies, and we were starting to lose hope. IVF wasn't really a useful option for us, because our problem wasn't getting pregnant. It was staying pregnant. So we started buying books on adoption. Neither one of us said anything out loud, but it wasn't looking good. However, we still had enough drugs (HCG and Lovenox, the fancy blood thinner) to do one last cycle. Hell, maybe 9th time would be the charm, right?

Well, it turns out it was. We got a positive pregnancy test, and another, and another. S went in for the blood test, and her beta value was doubling, and doubling well. We held our breath. S felt different this time - she started getting queasy. It was morning sickness, and although we weren't going to say anything to anyone else, we started to get excited. Well, S did. I'm a defensive pessimist. I wasn't going to let myself get excited until we got close to a trimester. We both knew people who'd lost children before the first trimester, and didn't want to get ourselves and everyone else excited for nothing. Still, S remained pregnant, and the queasiness bloomed into full-on constant nausea and puking. It sucked, but we figured it meant things were going well.

I can still remember the first ultrasound. Our RE pointing out two gestational sacs. He said "there's two of them in there." We were having twins. After all of this time, we were having twins. I was in shock, but not exactly excited. Not yet.

I remember when I did get excited. It was when we went to see a perinatologist, to do the early screening and nuchal translucency scan. I heard their heartbeats for the first time, and saw their little limb stubs moving around, kicking, developing backs arching and flexing. Two little pre-humans, working hard at growing. My heart skipped a beat. It was real. It was going to happen. We were going to be parents. We'd brought life into the world. The miracle of life - well, life and a fuckload of medical technology.

There was some drama around the results of the screening - we had an RE, a perinatologist, and a local obstetrician, and the lines of communication sometimes sucked a lot. All I remember was the OB saying was "yadda yadda 1 in 8 chance of chromosomal abnormality on Baby B" and we flipped right the hell out. What did he mean? Down's? Trisomie 18? 21? One of those things the baby won't survive? WHAT? Only notice we got from the peri was "we want to make an appointment with you next week", and S was all "fuck that, we're going in tomorrow." After a phone consult, we find out that we have an 11% chance of one of them having Down's. That was our worst-case scenario.

I deal with data a lot - percentages reassure me. S has worked with children with developmental delays - we both have some idea of what's involved with Down's. We feel like we can live with these numbers, and we make an appointment to do the amniocentesis. We find out that we have two chromosomally normal boys. It's starting to become real at this point. It sinks in. We're having boys. We start picking out names, and we tell friends and family and people in our programs. We're out of the closet, and people are delighted for us.

Next time: Worst Christmas Ever.

Tuesday, March 11, 2008

Gotta start somewhere.

And you may find yourself living in a shotgun shack
And you may find yourself in another part of the world

And you may find yourself behind the wheel of a large automobile
And you may find yourself in a beautiful house

With a beautiful wife

And you may ask did I get here?

In 2003, my wife and I moved from the East Coast to a small town in the Midwest so that I could enter a PhD program. Uprooting ourselves from our friends and family in the process...

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground

Into the blue again/after the money's gone

Once in a lifetime/water flowing underground.

...and now I find myself spending most of my free time on the couch, staring at whatever is on television or at whatever video game I'm playing.

And you may ask yourself
How do I work this?

And you may ask yourself

Where is that large automobile?
And you may tell yourself
This is not my beautiful house!

And you may tell yourself

This is not my beautiful wife!

Graduate school hasn't actually gone the way I expected. I don't have a great personal relationship with my adviser, my self-confidence is low, and I don't have much of a social life. I have a great marriage, but the rest of it has been sort of a struggle.

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground
Into the blue again/after the money's gone
Once in a lifetime/water flowing underground.

And now I'm sitting on the couch, staring at a blinking screen.

Same as it ever was...same as it ever was...same as it ever was...
Same as it ever was...same as it ever was...same as it ever was...

Same as it ever was...same as it ever was...

We've had our fair share of tragedy since we've been together - pets and parents and other relatives dying, we were together at the foot of her mother's bed when she died of cancer, we were together on September 11th. We're not new to "getting through it."

Water dissolving...and water removing
There is water at the bottom of the ocean

Carry the water at the bottom of the ocean

Remove the water at the bottom of the ocean!

So after plenty of angst and culture shock and uprooting and whatnot, we finally got to a place in our life, at the age of 35, when we could actually think about having children. Silly us, we thought we could plan when we were going to have kids, as if we'd turn down the lights, put on some Barry White, and 9 months later? Baby. As it turns out, it wasn't going to be so easy. Over the last two years, we have become very familiar with the language of infertility.

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground

Into the blue again/in the silent water

Under the rocks and stones/there is water underground.

Two years of work with a reproductive endocrinologist, charting, testing, pills, injections, appointments. Two years of this, and all we'd had to show for it was three chemical pregnancies. Three times getting positive test results that evaporated in a few days' time.

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground

Into the blue again/after the money's gone
Once in a lifetime/water flowing underground.

We were getting to that point where you start to give up. We had enough donated drugs to do one more cycle, and we thought "what the hell?" So we did it. And the results on my sample came back as the best yet.

And the test came back positive.

And then the beta doubled well. Really well.

Turns out we were pregnant. We got an ultrasound.

We were pregnant with twins.

And you may ask yourself
What is that beautiful house?
And you may ask yourself
Where does that highway go?
And you may ask yourself
Am I right? I wrong?

And you may tell yourself

My god!...what have I done?

It wasn't an easy pregnancy. My wife was puking her guts out every day, sometimes multiple times a day. But we were pregnant. We were having twins. We were having chromosomally normal twin boys. All I could do was walk around the house, exclaiming "BOYS!"

We picked out names, and started to think about a baby registry.

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground

Into the blue again/in the silent water
Under the rocks and stones/there is water underground.

That was then. Now, all I can think about is Christmas Day.

Letting the days go by/let the water hold me down
Letting the days go by/water flowing underground

Into the blue again/after the money's gone

Once in a lifetime/water flowing underground.

We lost Joshua on Christmas Day.

We lost Jacob on January 4th.

Same as it ever was...same as it ever was...same as it ever was...
Same as it ever was...same as it ever was...same as it ever was...

Same as it ever was...same as it ever was...

And so now the days go by, day turns to night, I go through the motions, teach my class, do my research, talk to people, shower and shave, and at the end of it all, I end up on the couch, in front of a blinking screen, letting the days go by, wondering how it all ended up like this.

This is my way to try and make sense of it. Make sense of it and talk to other fathers out there who have lost their sons and daughters.

(italicized text: Lyrics to "Once In A Lifetime" by the Talking Heads)