Chapter 1

(Note: The Prologue should be read first.)

© 2016 Rebecca Bryant


September 2009.  Newly married; let’s procreate!  I am thirty-nine years old and the miracle of new life awaits ahead.  My husband and I fully expect sperm to meet egg as per the normal course of civilization, and the prospect is thrilling: a bit of him, a bit of me . . . beautiful, inevitable, piece of cake.

First things first: the intrauterine device (IUD) my body has housed for seven years must go.  Though a nightmare to install way back when, removing this device proves a breeze . . . but nothing else ahead will be.  A tiny, thankfully collapsible, T-shaped piece of copper, the IUD was designed to repel sperm once installed, and has done so throughout my thirties.  So ably so that later, in my forties sans device, I half-suspect my uterus still assumes the IUD is in there, or at minimum some kind of leftover mystical metallic residue remains, messing up the mojo.  How strange to consider now that this artificial gizmo was hosted — living — inside me for so long.  My body can evidently support unnatural contraceptive doo-dads as it suits, just not real little beings.

For most of ladies’ lives we are relentlessly cautioned to prevent the unwanted pregnancy.  Everything is no, no, do not become that embarrassing big-bellied teenager walking your high school’s halls . . . do not be forced to own up to that shameful, career-postponing hook-up . . . do not screw up your life with ill-timed children at all costs . . . until suddenly (or, for my fellow late bloomers, maybe not-so-suddenly) it’s Go! Time.  

This is a difficult trick to pull off.  Mentally, physically, emotionally, the message has perpetually been to avoid the now much-desired condition.  The grooves have been grooved, the subconscious protest placed, appropriate control measures taken.  From fourth-grade sex ed class on, the default message has been “Don’t be a dummy!,” but now our bodies must instantly switch over to the pursuit of motherhood, in an act of reckless abandon: unprotected sex.  

I always figured I’d know in my bones when I was truly ready to try for my own well-scheduled child, and I did.  Only problem?  Events in my chronological life ran a little behind a more helpful biological timeline.  When the IUD is whisked out of me and into the garbage for good I am, unwittingly, impossibly, by all conventional medical standards, far into geezerdom.  I have never yet attempted to have a child, never especially wanted one, have been fastidious in thwarting “accidents.”

Now I want this baby to happen more than anything on Earth.

To be clear, when my husband and I begin TTC (“trying-to-conceive” to message board acronym newbies) I already have a wonderful family.  This is my second marriage, and the right one.  It happily comes with major fringe benefits: two beautiful stepkids, mostly grown.  Handily, I even get one of each flavor — a boy, a girl.  If my hubby and I could go back in time and do it together as young people ourselves, this is exactly the formulation we would desire.  

In lieu of the impossible, however, being a stepmom is pretty damn awesome.  It comes with its own brand of unique perks and rewards that non-steps will never know; a particularly exclusive and fulfilling experience in itself, just as being “real” mom is.  Growing up an only child, with parents who split in my teens, this much family life is already way beyond anything I’ve known, and I am deeply grateful.

Still . . .  it’s hard not to feel like I’ve, uh, missed a few steps.  Despite the significant plusses, there’s no avoiding that this is not “normal” maternal trajectory.  As fortunate as I feel now for my personal pre-fab starter clan . . . it is different.  I am somehow still not a full-fledged mother, have not put in the time or lived the experiences.  I myself have not conceived, nurtured, brought to term these two joyous lives.  Keystone events — entire pregnancies! — have been missed, early bonding experiences unexperienced, no cute little toddler time witnessed, zero baths performed, nor starter books read.  I remain a novice, an outsider in such departments.  The lack of logging this quality time stings.  Only photos and videos reveal to me a surreal time that I was not part of; shared family memories and old jokes are not fully shared, and can never be.

Further complicating the emotional landscape: my husband is a decade older than myself.  This has the upside of instilling an advance sense of child-rearing security — Hurrah, we’ll have experience on our side!  Been there, done that! — while simultaneously sucking me into an even older demographic than I’d already naturally fall into.  Society’s forces, we quickly discover, are determined to view me more as potential grandmother material than as a prospective new mom.  

Sure, I might feel like my life is just beginning at thirty-nine . . . but, when I step into being stepmom, suddenly I’m locked into being neither fish nor fowl to outsiders: too “old” to still produce my own genetic offspring, too young to be my current children’s actual biological parent.  Though we’re close enough for me to freely use words like “daughter” and “son” in reference to my adopted twenty-somethings, these uses seldom pass muster except with the incurious.  Upon a second tier of questioning — “Your daughter/son is how old?!” — I’m sheepishly forced to admit to the “step” qualifier.

This is an exasperating Limbo Land.  Stuck here, I’m impossibly behind the curve even as I’m somehow ahead of it too.  My same-age girlfriends have not yet ushered two kids through college, have not co-ordinated the logistics and counseled the life issues of almost-adults on top of standard marital and household duties.  I’ve done this without the background of having actually raised children myself, or even having had any brothers and sisters growing up.  I’ve parachuted into this new home, this new life, and kicked ass in many ways . . .  but apparently have still not done the real major woman stuff.

What I’m desperate (greedy?) for, I suppose, is the best of both worlds.  The double-win.  I long to have my mind blown by the holiness of procreation, while simultaneously cherishing and celebrating the family we have already built.  Maybe it’s too much to ask for; maybe no one girl is entitled to both worlds.  Yet, at primal-woman-level, all I know is that I desperately need to hold our own baby in my arms one day.  

Our first time sans contraception, alongside the thrill and anticipation . . . a small, unsure voice rises in the back of my head: Gee, I hope this won’t be hard.  The thought is easily ignored, but often remembered, and becomes full-blown grimace-inducing in time.  Clearly some knowing part of me anticipated the coming years of trouble.  We have been astoundingly stupid in assuming this was a done deal.  

One cycle, two cycles, three cycles go by — turns out a woman’s repro system needs several rounds after IUD removal simply to recalibrate, not that this was ever mentioned to us by any of the doctors and helpers involved.  Even when I do eventually learn this unfortunate fact, it does not prevent me from believing I am pregnant each and every attempt anyway, from being whole-heartedly, bone-certainly sure that this is the time we triumph.  Each new Red Sighting brings a crushing blow . . . a reboot . . . then bravely back to the drawing board.  There has never been anything in my life to adequately prepare me for how eviscerating this roller coaster ride feels — it’s the scariest seat, on the most heinous attraction, at the worst amusement park ever designed.

By Christmas Eve, ovulation timing could blessedly not be more perfect — ahh, of course!  What could top the sacredness of conceiving on this, the most magical and appropriate of nights?  All the “no’s” will now lead to one major “yes!”; despite our ignorant protests, funny, funny Life has orchestrated the most elaborate prank haha! Still not so.  (Well, it is all a terrible joke for sure. . . .)  My husband and I come to the painful, if all-along-obvious, realization that this is definitely going to be a whole lot harder than we had planned.  

Until Victory Day then, we not-so-patiently wait.  My unsatisfied yearning to nurture is palpable daily.  Should we get a dog?  Consider adoption?  Not yet on either count.  I take up a Meals-on-Wheels delivery route in a meager attempt to fill the void.  I need to take care of somebody.  For now, the disadvantaged and unfed will do.


Catherine F. is on the toilet again.  Catherine F. is usually on the toilet when I arrive.  She’s in her bathroom, not getting out anytime soon, can’t hear the doorbell.  I let myself into her modest, weathered home and proceed to the kitchen table to unpack her lunch.

The lady on the can is ninety-five, slow-moving, sharp-tongued.  Your classic firecracker.  She does not care in the least that I have caught her with her pants down.  Again.  If anything, she’ll ask me for help pulling them back up.  She can’t see me, can’t see the empty Diet Pepsi cans that litter her grimy kitchen, which she also can’t see to clean.  Her house is not quite Hoarder-level — that comes a few stops later, at a terrifying trailer I’m also obligated to visit on the North Liberty M.O.W. route — but it’s pretty darn gross.  

I suppose Catherine F. appreciates my visits well enough, in her way.  She doesn’t seem to have much contact with the outside world and I try to be unhurried and accommodating when I bring her meal on Tuesdays.  I open the carton of milk in the specific way she desires (both ends pulled), speak loudly, carefully, entertain whatever chores she might have in mind for me to assist her with, even though that’s not really what the stop is supposed to entail.  Sometimes I’ll come back after my other deliveries and play a game of Rummikub with her.  She’ll offer me a Diet Pepsi.  There’s something sort of special about it.

When Catherine F. is done with me, she’ll abruptly shoo me off, which I’ve learned not to take too personally.  At ninety-five she can call whatever shots she wants.  Before my dismissal today, she presents me with a rose from a bouquet her niece recently sent for Catherine’s birthday.  Last week she offered me some God-awful cookies, made with You-Don’t-Wanna-Know-What from that home-ec disaster of a culinary lab.  I accept the rose, don’t eat the mystery snack, feel touched to share these small gestures of near-normalcy with this ancient woman.  At the end of her days, she just wants to function as per usual.  To continue.

I continue on to Sad Pam, in her fluffy, girly bathrobe, two-hundred and fifty pounds.  A lifelong smoker, she’s that tragic mix of young-old that slays you.  Outwardly: excessively, purposefully cheerful . . . but inwardly: the despair she’s working to mask is easy to spot.  She’s alone, depressed, utterly unhealthy.  I find Sad Pam much harder to encounter than Catherine F. because she still has so many years to turn her life around, but likely won’t.  Unlike independent Catherine F., still mostly-functioning by herself in her own space, Sad Pam, half-a-century younger, lives in an assisted complex and is frequently surrounded by various members of her social services team: a nurse, a case worker, her mental health to-go person.  She needs all their attention, and more.  Sad Pam always greets me enthusiastically — I’m bringing food after all — but it’s hard to escape the overall impression that her heart is breaking from life.

From here there are a dozen or more stops: Mr. A., quiet, widowed, two mangy cats, a patch that covers a horrible pink-eye problem . . . middle-aged Martha W. in a trashy pre-fab, broke and plain but wishing to be more, dressing for a job interview . . . the elegant Simone D., with her wildly intriguing stories of a late husband who invented The Computer when he worked for the Department of Defense in the 1950’s, plus various other colorful, if dubious, spy mission/conspiracy yarns . . . the grumpy wheelchaired asshole who always yells at me for making “noise” (i.e. knocking) outside . . . the sweet, blessedly normal older couple with dogs and a well-kept garden . . . the crazy-rich lakeside house with an unseen, disembodied voice that calls out from a far room, or leaves me very specific instructions via post-it notes re: food-fridge placement.  

And, of course, the scary Casa-Hoarder Trailer: one stale boxy room, two lung-clogged hackers, tons of trash, wretched smells, a hairy shirtless man hooked up to a machine who barely budges, only grunts.

A surprisingly wide variety of people request the Meals-On-Wheels service.  Some of these folks qualify via various federal and state programs, while others have caring relatives who pre-arrange to cover expenses, and a few folks simply opt to pay out-of-pocket for the daily convenience (although not for the delicious taste, as far as I can tell — NOT that I ever plan to actually sample the blobby, bland-colored fare. . .).  

It’s basically mass-style cafeteria food, but with a personal twist.  I pick up the supply of meals I’m supposed to deliver every Tuesday from Iowa City’s Senior Center, where a big happy Guamanian man named Frank runs the kitchen.  Frank takes great pride in his establishment and would take supreme offense at any suggestion of his grub being sub-par; he’s doing this gig only as a secondary retired thing, after a long stint operating the local Veterans Administration’s food service.  Frank knows a whole lot about industrial-sized servings of food-like substances and is fun, forceful, likes to chat.  Back in Guam, Frank supposedly owns some property he is trying to sell for $5 million, and once he’s done that: he’s outta here.  While it’s hard to doubt Frank, it’s also hard to believe him.  The guessing game adds mystique.

Out in the dining room, Catherine F. would fit right in at the Senior Center eating and playing Bingo: fussing, disagreeing, impatiently waiting for the next number to be called, needing to get to the bathroom asap.  Regularly witnessing so many old souls at the end of their days like this is a sobering and enlightening gift; the Landscape of Life so vulnerably on display consistently provides helpful reminders of what to do — or try not to do — to survive one’s time in this world properly.  For every poor, hunch-backy being seemingly lost to the years, there is another admirable someone like smiling, rainbow-suspendered Al S., spreading a positive word and uplifting message wherever he goes, literally wearing a happy face button and corresponding real expression.  Al S.’s frail wife Shirley sells meal tickets at a small table near the serving line while her people-lovin’ husband gamely works the room, mingles and grins, wields his happiness bromides.  He especially enjoys talking to the ladies, in particular to the “young” ones like me.  At least to Al S., I am indisputably young.  Hallelujah.

Every day around noon, at a puzzlingly nice piano in the corner, eighty-something “Broadway” Melvin T. plays old standards and showtunes, adding some appealing atmosphere to an otherwise potentially drab affair.  This isn’t just any lunchtime concert, however.  Rumor has it that Melvin T. had a genuine career on the Chicago stage once upon a long ago; now he’s biding his time, entertaining on a much smaller scale, at a discount price (Senior Center meals = $2 per).  

Melvin T.’s repertoire is impeccable, as is Melvin T.  It wouldn’t be surprising if the piano were his own.  He’s probably worked out some kind of arrangement to park it in the dining room and play as suits, rather than to keep it in his too-small complex apartment; everyone wins.  The crowd gathered daily shouts out various old-timey requests and Melvin T. delivers big-time.  During one extraordinarily touching, impromptu performance I was privileged to witness, a spry, grey-haired lady named Gloria joined him for “Pennies From Heaven” and crooned exquisitely while Melvin T. tickled the ivories.  The room was transformed; we could easily have been back in a dance hall in the 40’s.  Age, like everything else, is what you make it.

Being allowed into strangers’ lives, homes, and refrigerators like this has been transformative for me as well.  Besides bringing temporary relief from my own unmet life goals, these mini-tableaus regularly re-frame for me what being alive is really about.  A unique shift in perspective happens Feeding Humans: eventually the various characters become not so much strangers, as acquaintances of the strange kind.  They know me, I know them, but only for a few minutes a week.  Nevertheless, I’ve been in some of their most intimate spaces, been privy to some of their most personal personal problems.  What can be more exposing than needing to eat, pee, breathe, touch, sing?  And, though the interactions are depressing at times, observing such a wide spectrum of people in their native habitats leaves a deeply lasting impression: What journeys we are all on!  How little we can really control!  And, how inevitably unprepared all of us are for what unfolds . . .

I didn’t think much about any of this prior to trying to have a baby.  During my travels now, though, I’m uterus-deep in thought, insight, ache, hope, and pearls of quasi-wisdom.  Whatever other people want to believe about having children later in life, it’s hard to deny that substantially more maturity comes with the territory.  If I had had a kid in my twenties, now that would not have gone well . . . but if I can still pull this off now, well sheesh — at least my husband and I know our way around life a little.  Impassioned/Defensive Conclusion: How damn presumptuous it is for anyone else to believe they know when a woman should attempt to bear young, or when she should not.  Nobody but the woman herself gets to make this call.

I spend the greatest amount of time, and learn the most, from Catherine F.  Her house, and especially her living room, where we play Rummikub, document a stunning fifty years spent in the same location — half of that time with a husband long-passed, half by herself.  She did not have any children.  The absence of an extended clan to watch over her now is notable; only the afore-mentioned niece monitors her activities and seems to provide any assistance.  Catherine F. is essentially all on her own, in the twilight of her run.  I’d want to guzzle down the Diet Pepsi’s too.

On the wall, in numerous black-and-white photos, Catherine F. and James F. make a handsome young pair.  The change in her from then to now is dramatic; she is almost completely unrecognizable as the same person.  Framed and frozen in time, the happy newlyweds are ghostly apparitions of a much earlier era in Iowa, when everyone lived on a farm, families all knew one another, and life was bucolic.  Without additional photos of their kids and grandkids, however — and only images of extended mostly-adult relatives instead — it’s not your typical Life Wall.  To my eye, in my own childless state, Catherine F.’s living room seems woefully incomplete.  Her spare collection represents everything I do not want to have at my ending, and stands as an eerie reminder of how quickly it all goes, how much time can clobber us if we proceed unaware.

I never ask Catherine F. why she does not have children; maybe I can sense the decades-old pain.  Something is amiss there, something does not wish to be re-examined.  But even at a crackling ninety-five it surrounds her, fills the room.  A living room . . . but not quite.

One week I show up and Catherine F. is not there — for realsies this time.  I enter the house, check the bathroom, see the soda cans, leave again with her food.  It’s okay, she’s gone to doctors, the hospital before.  A few days later, I call but her phone line has been disconnected.  I know what this means, although I never receive full confirmation.  Coincidentally, I’m also moving on: from Meals-on-Wheels to the Johnson County Crisis Center’s food bank.  

After five decades, a new phone number opens up.  Sadly, the next account holder will most likely have no idea of the feisty lady, and the lifetime of conversations, that came before.  


IUD Insertion Day, 2002.  The beginning of my (non-) reproductive journey.  True to form, things are already not going well.  A rapidly expanding team of docs, nurses, and wide-eyed medical students stands over me, my legs splayed on an examination table.  The sure-breeze routine IUD install has encountered a major snafu.

Forty-five minutes into a ten-minute (tops!) procedure and my now-clearly oddly-oriented lady parts have the whole team flummoxed.  My angle, it appears, is not textbook.  I feel like an alien, being worked on by a crew of bewildered but fascinated scientists.  One by one they enter the room to inspect, gasp, take a stab at getting the folding shiny metal “T” through the vaginal canal and into its new uterine home.  One by one they reach the roadblock.  My cervix cannot be found.  

I am, resoundingly, a freak.  

Until this point, I have not been hugely aware of my body and its intricacies.  I probably couldn’t have located the errant cervix either.  However, I am not a medical professional.  Looking back, it wasn’t the naive if malformed guinea pig at fault here — this team obviously didn’t know what the hell they were doing.  This procedure shouldn’t have been that hard.  The downside of having world-class University clinics at one’s local healthcare disposal is that these institutions often double as teaching hospitals . . . and sometimes the supervision is, ahem, limited.  Or, perhaps, the basic expected level of competency just wasn’t there to begin with.  Whatever the case, this starter ordeal probably should have been the first sign that my upcoming decade-plus tango with standard Western medicine practices might leave much to be desired.

Wake-up call missed.

In addition, I’m actually doing this whole IUD-thing back-asswards: most ladies get these things put in after popping out all their kids, but somehow I seem to always be bucking the trend.  For me, at age thirty-two, nothing is more important than getting off the hormonal horror show of the birth control pill (early OB-GYN doc to me: “PMS? Good luck with that! (Missed Warning Sign #2 . . . check!)).  Consequently, the spiffy little contraceptive gizmo currently not getting put into me had been deemed the next best preventative option, especially considering I have no plans for spawning young-uns anytime soon.  

Truth be told, I still don’t really know what I’m doing with my life at all.  Sure, some of my girlfriends began their families over a decade ago, but I’ve never been one to buy into that hurried “clock ticking” pressure.  A knee-jerk resistance to that pressure is all I do know.  It’s always seemed such an impractical, nonsensical call to action: Okay, so things might be running a bit behind schedule here . . . but am I really supposed to run out pronto and create Junior without having found a suitable father?  Do my needy ovaries simply send out the Brat-signal and Mr. Daddy materializes out of thin air to accommodate?  

Am I seriously supposed to consider going to a sperm bank when I’m barely in my 30’s?  Freeze my eggs when I don’t even have insurance to help pay?  What’s a clueless, untogether girl to do?  My late blooming is not really all that late.  Yet.

My only plan is to stick with the only plan I know — to not know — at least until I know otherwise.  After a ridiculous amount of focus group-approved brow-wiping and hand-holding by the nurses, my new IUD at last gets shoved into place.


Whackatorium waiting room, early 2010.  My fortieth birthday unhappily approaches.  Still no baby dust.  Today the quality of my husband’s sperm must be analyzed, despite his having flawlessly fathered two healthy children in the past.  Two weeks ago, we double-checked the viability of my fallopian tubes, just to make sure nothing hinky was happening in that department either.  Such are the “His” and “Hers” initial steps of fertility-sleuthing, after we have so far endured seven unsuccessful natural cycles on our own.

We are finding that there is an inviolable, logical order to this detective strategy, just as we have come to learn there is a fundamental, widely-accepted way to proceed in Western Medicine as a thirty-nine-year-old woman desiring a child.  However silly or ineffective-appearing the steps, such seemingly unquestioned conventional “wisdom,” has governed all our actions to date, and thus now causes us to hunker down in an embarrassed, closet-sized room deep in the bowels of the hospital for our turn to enter an even weirder, gross, hard-surfaced chamber.

This is not just any waiting room, mind you, and we are queued up to enter not just any clinic chamber.  Everyone knows exactly what you’re there to do.  More daunting still, you can’t exit until you’ve completed your task.  Well, you can leave “empty-handed,” — sorry, there’s no way to prevent your filthy mind from the double entendres — but then everyone out in Closetland will most certainly sense your humiliating defeat.  The “successful” folks emerging from The Chamber with a spring in their step don’t do so from ecstasy of orgasm; that extra bounce is born from sheer relief of escape.

Sitting here with my husband, watching the embarrassed patients come and go, preparing for our turn, is not an especially pleasant way to spend one’s lunch break.  Relaxing into things just ain’t gonna happen.  The awkwardness in the room is palpable; no one wishes to be sighted, let alone hear their names called out . . . except that having your name called out is the only way to leave this suffocating space and get on with other mortifying affairs.

Waiting rooms in Fertility World, it shouldn’t be surprising, universally suck.  These spermy goings-on are at least thankfully tucked away, I suppose, whereas my appointments in the Women’s Clinic don’t even bother to separate the healthy, hugely preggos from the desperately-trying wanna-be-Mamas.  Such a set-up is profoundly inconsiderate of the Building Design People — either a cruel oversight, or an intentionally “just grin-and-bear-it” decision with sexist undertones.  The boys get emotional cover, all the privacy to jerk off that they require, aside from brief exposure to some internal chuckles from fellow patrons or staff . . . while the girls must deal full-on publicly with each and every hard blow resulting from their pregnancy impairments, even the losses.  

When a woman emerges from an ultrasound room after bad news, there’s no mistaking what’s happened in there either, yet the first thing she’ll be confronted with in the midst of her heartache is half a dozen big bellies, not hers, and a multitude of strangers’ stares.  This is hardly the same as dealing with some temporary shyness after ejaculating for science.

For my ovarian “looksie” procedure — a standard, mouthful of a thing called a hysterosalpingogram (“HSG” in more user-friendly lingo) in which I am strapped to a table and violated by misc. instruments, fluids, and cameras — my husband, the ultimate Mr. Mellow and my sole personal calmness strategy for the day, is not permitted to stay in the room with me.  Husbands faint.  Mine does not, so we protest, but Hospital Policy has pre-decided the companionship issue here non-negotiable: it’s simply not worth the “risk” of letting my chief supporter (a.k.a. Big Ol’ Wuss-Pants) see a big needle full of blue dye get poked into his beloved’s unmentionables.

Lady partners are perfectly welcome in the Whackatorium, no prob.  We’re permitted to accompany our men and engage in whatever combo of indecent acts get results.  Super.  Score one for Teamwork.  But how to reconcile that the providing of moral support for on-demand monkey-spanking is a given . . . while the gal getting a sharp implement stuck into her privates during an HSG might also wish to see a familiar face, but can’t?  

Herein lies the core tension we are already starting to feel on our (mis-)adventures.  This whole Business of Fertility — B.O.F. — is devoid of something fundamental: heart.  If only a “Women’s Clinic” could look after their lady patients’ emotional welfare as well as they detachedly prod and analyze physical bodies, announce dry statistics, and cling to precious procedure . . . there might be fewer scars inflicted.  One’s soul nurtured, respected, left intact.  A couple’s journey and spirits uplifted, not quashed, no matter the extreme odds.  

Instead, the system designed to rig new living beings into existence often blunders inexcusably in supporting the currently living ones.  In the absence of a more thoughtful, humanized approach, sperm retrieval (snicker, snicker) becomes about sex — while ovaries somehow do not — and this jis-getting activity is distressing, uncouth.  Something to hide away.  Now we are dealing with sexual bodies, and that is scary . . . but not so much the prospect of an older woman never giving birth to the child she longs for.  

Yet how is our baby-wanting much different from those folks on my Meals route who wish to eat?  From Catherine F. who needs to pee?  From Steven D. seeking a mate, or Zane K. longing to croon?  It’s all basic, primal stuff, all deserving of tender compassion and understanding.  We are each and every one of us vulnerable, exposed to Life’s harsh elements.  At the Crisis Center . . . at Song Reach . . . in the Senior Center lunchroom . . . at the University of Iowa Hospitals and Clinics.  

Ultimately, we’re all out there, stuck with our pants down.


Enter Steffi.  Or, rather, P.A. (Physician’s Assistant) Elizabeth Graf, whom the hub and I immediately start referring to, between ourselves, by her new nickname — after the German tennis player.  We hardly even understand why we do this, other than that this chick needs some lightening up, so Steffi she is.  Steffi is stiff, impersonal, focused on business.  She’s not exactly unpleasant . . . but not exactly pleasant either.  She’s someone who, like the docs, nurses, and insurance company reps, we become forced to know a lot more closely over the coming years than we would originally wish.  In time, Steffi becomes a sort of stand-in for the detached, robotic-ness of the entire system.

Steffi humorlessly runs my HSG procedure.  You’d think that with all the zany equipment around and ridiculous positions a patient — me! — gets contorted into, that she might crack a smile or send a warm vibration your way.  Not gonna happen.  Steffi relates better to the machinery and to the x-rays, to delivering standard operating instructions as read straight out of a manual.  This is a shame, because the environment here is daunting.  The room feels more like a full-fledged operation is impending, not merely a quickie checklist matter.  There’s a large imaging contraption prepped to hover ominously over my abdomen, and the typical gynecological absurdities abound, including every gal’s favorite foot stir-ups.  Oh, goody.

I’ve been advised this procedure will feel like a common pap smear test (ouch!), only a bit worse (ouch ouch!): more discomfort, harder cramps, a weird warming sensation . . . plus, you know, the “normal” invasively humiliating maneuvers that give OB-GYN appointments their charm.  It is an outpatient test, performed while awake and without general anesthesia, although the med peeps do highly recommend taking ibuprofen beforehand (and this is definitely a good idea, I find out).

We are examining for tubal patency and normalcy of the uterine cavity.  So, essentially: can my girls actually kick out the eggs they’re supposed to or what?  To answer that pivotal question, an iodine-based blue dye gets squirted through the cervix — assuming this latest team can locate mine — and then x-rays are taken.  Where the blue shows up = whew, a-ok.  With any luck, one reasonably-shaped uterus, and two completely unblocked fallopian tubes, should become clearly, neon-cyan defined.  

Steffi’s nurse-helper lady tells me it’s natural to feel nervous.  Fuck yeah, I feel nervous.  This could be the whole shooting match right here: if my tubes don’t demonstrate proper function, then our pregnancy dream is a non-starter.  There’s a lot on the line psychologically, in addition to the massively vulnerable physical ordeal.  

The main thing even holding me together is a widely-believed, poorly-substantiated, urban-ish myth popular on many of the TTC websites: that a major by-product of having an HSG performed is that the procedure itself makes a woman “super-fertile” for the next several months (something about flushing out the tubes, cleaning the uterus, or maybe priming the ovaries, or possibly all of the above).  Well now, that makes everything sound a bit more attractive!  A goldmine of needed info, and “free” fertility boost — a killer two-for-one deal.

Plus, there’s rolling!  Once things get underway, I find I’m required to switch from side to side for various imaging angles — speculum and gear and whatnot still clamped, protruding from crotch — while Big Camera looms and snaps away.  Nobody mentioned that this would be happening.  

But take a deep breath!  Hold, click.  Turn, repeat.

There better be third-fallopian-tube-level news at the end of this and my reproductive plumbing be transformed into the most sparkly fertile-fresh reproductive plumbing in all the land.

Hangin’ here with Steffi & Co., rolling, repeating, I recall the last few times a group was huddled around my vagina.  That traumatic IUD install, eight years ago . . .  the relative ease and excitement of removal of the same IUD last fall (somewhat cancelled out by the lack of disclosure re: uterine recovery time, ugh) . . . the apparently now-long road ahead with undoubtedly more, and probably worse, of this same shit.  Flashes of other procedures from my past, also not gone well: a permanent, noticeable-from-a-distance divet remaining on my arm from an unnecessary lipoma (fatty deposit) extraction, an appendectomy — plus bonus abdomen scar! — which I likewise learned after the fact I did not truly need.

Older, semi-wiser now, I’m tentatively starting to wonder if these people, like so many of the rest of us, may not always know what they’re doing.  Human imperfection is fine if you, say, sell gardening equipment.  Not so swell here in the hospital.  Nevertheless, the tendency is to automatically grant these folks authoritarian status, to assume they are even god-like in a way with their knowledge and powers . . . but what if they actually are mere mortals?  Mere mortals, mostly well-intentioned, simply needing to collect a paycheck like everyone else?

This is not a fully-formed idea for me, not quite yet.  I still trust.  But the seeds are gradually being planted, even as I’m not managing to implant my husband’s seed.

Back in the Whackatorium, things are not much more reassuring, or comfortable.  This place is basically one solid industrial-firm surface — sheer “clean-up-ability” of everything clearly taking high priority.  There’s a rock-hard linoleum floor, some very uninviting seating-like flat, unyielding structures of the bad restaurant booth ilk, and a mini-bathroom area with toilet, sink.  A frighteningly-convenient sliding panel is built into the wall nearby.  We’re instructed that this is for specimen passing — Order Up! — to the lab once we’re done.  (Yes, the lab is right there on the other side, gulp.)

Near a beaten-up tv, soft-porn video and magazine materials are available for any solo dudes needing an assist.  Despite my previous gender disparity complaints, which still stand, comparatively few couples actually choose the togetherness option as we have.  Lucky for them too, as pulling off any genuinely amorous activity under these conditions is impossible; it’s hard to figure out where to even be.  Add to that the stress of a room full of nerdy workerbees only feet away, waiting on you to perform, and the stakes are high, the romance low.  

Hubby and I are pre-committed to experiencing every step of this journey jointly, however, so with this, too, we comply even as we feel a tad chagrined, and doubtful about the process.  Is this really how babies are made?  What happened to Mr. Stork?  If only it were that simple.  Mr. Stork never had to deal with a much too-tiny collection container, or navigate the weird wall spinner.  Upon completion of these tasks, our sample disappears into the Great Unknown, a place which one can only hope is the appropriate destination for such contents.

Emerging from The Chamber again, there’s paperwork to sign, a clinician to face.  She tells us we may go back to The Closet now, or walk around elsewhere while we wait for our results, if we so desire.  We desire.  We stroll the hospital, distracted, while Loverman’s sperm is spun and analyzed, motility counts assembled, any misshapen swimmers identified.  We’re given one of those wireless lighted buzzer discs to let us know when we should return.  I’m definitely sensing a new themed chain restaurant in the making.  

We’re pretty much wrecks.  Just as with the HSG, there’s a significant outcome coming at the end of this ordeal — we need to not be torpedoed by some unassailable spermatazoan fact that even our most optimistic sense of determination can’t ignore.  Estimated wait time until potential doom = one hour.

Steffi don’t care.  It’s all just data to her.  Steffi’s Steffi-ness isn’t all bad, fortunately: she’s brisk, efficient, somewhat informative.  Once she has the HSG x-rays in hand, the needles hid and husband permitted back into the room, Steffi dryly analyzes the multiple images of my blue-stained innards and walks us through what there is to see: my retroverted uterus (though I’ve heard the descriptor before, this is helpful to actually view), ovaries, tubes etc.  She reaffirms that the “tipped” angle of my womb, while for some reason endlessly confusing for the medical pros, shouldn’t cause any problems as far as conception or pregnancy goes, despite any potential blood-flow issues abdominal massage enthusiasts warn against.  It turns out a whopping twenty percent of the female population is born with this particular lady part bending backwards, which is a relief to hear, but also makes me wonder all the more why I was treated as such an oddity previously.

As far as the all-important open runways for egg take-off, I’m given the all-clear.  Huzzah!  The iodine has colored all the appropriate places; I am ready and available for whatever future oocytes wish to mature, pop out, and join with their soul/sperm-mates.  This is fantastic news.  Not one to let a happy celebration go unquashed, Steffi quickly reminds we are an older couple, and spontaneous natural pregnancy will nonetheless not be easy, even with normal fallopian status.  It just won’t be blocked tubes stopping us from success.  

Oh, go hit some tennis balls, Steffi.  I visualize my ovaries propelling multiples of eggs out at high velocity like a serving machine toward a racket just to spite her.

The verdict on the male side of the equation is happy too.  After the tortuous hour of wandering, we bring our restaurant buzzer back to the lab and claim our results: my husband’s lil’ dudes are indeed still plentiful and viable.  Another day, another absurd experience.  And . . . another clearance.  

Physically, there is nothing obviously wrong with either of us, no obstacles that might prevent conception.  Amen.  So far we have done everything we’ve been instructed to do, despite the seeming unnecessariness, and the dispensing of useless, even inaccurate, information (smiley-face ovulation kits one doc recommends to us reveal the utterly wrong intercourse timing my OB-GYN had delivered as gospel — hint: not every woman out there ovulates on day 14 of a 28-day cycle, as neat and tidy as that might be to tell your patients.  Also, sperm must arrive before that event, not on the day of.).

We have been obedient investigators, although granted with a few more questions than most.  We have tried to not over-worry and to trust in the process, and we are now yet again propelled forward to the next action item, and will continue to be propelled in a miserable, protracted game of wait-and-see steps as the clock urgently ticks.  

The standard OB-GYN line regarding couples actively engaging in unprotected sexual intercourse, but not yet bringing home baby, is to keep trying for one year.  After a full year without success, you are officially labeled “infertile.”  Congrats!  For women over thirty-five, however, the trial period gets shortened to six months.  For women over forty, fuggedaboutit.  Well, not exactly — they’ll entertain your plans with a wink and a nod and a few stern cautionary words, and semi-reluctantly perform these tests we just did . . . but really, what the hell are you even doing?  What are you waiting for?  Do not pass “Go,” do not collect $200, go immediately to Jail, er, the world of ART, or Advanced Reproductive Technology.

If we weren’t prepared before, we are really not ready for this.

Continue to a description of Next Chapters.

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