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Learning to Walk with a Limp
You will lose someone you can’t live without, and your heart will be badly broken, and the bad news is that you never completely get over the loss of your beloved. But this is also the good news. They live forever in your broken heart that doesn’t seal back up. And you come through. It’s like having a broken leg that never heals perfectly—that still hurts when the weather gets cold, but you learn to dance with the limp.
― Anne Lamott
Locate me in a preoperative holding area, perched on the edge of a plastic chair, a thin volume of poetry by Cornelius Eady in my hands. I’m not looking at it but into the flushed face of one of my twin daughters, Hannah. She is adorned in blue surgical bonnet, hospital-issue gown, an IV snaking into the top of her right hand where a kindly nurse has taped the needle just so. A flimsy curtain hangs from the ceiling, ostensibly to offer privacy, but of course we can hear every utterance, toilet flush and beep, click and conversation. This will be the second knee surgery in 10 weeks, the first of which was an unexpected grisly open surgery that has required her to hobble around on crutches for almost three months. She is trying to exude equanimity. I see through this gossamer of bravado. We have been through a lot, she and I, since I first glimpsed her under the lens of the embryologist’s microscope where three bug-eyed embryos squatted, perfectly dividing orbs of the promise of life.
Hannah’s knee disease, which is supposed to occur only in German Shepherds and certain horses, is pernicious, causing the articular cartilage to die, leaving a surface that should look as shiny and smooth as a cue ball, but instead is pocked and blanketed in layers of eroding tissue like a landscape wounded by land mines. For two years, Hannah has trooped her way through pain, different treatments, and hospital visits to end up in this preop area attended by two of the most kind nurses I have ever met. This condition, though certainly not desirable, reminds me that there are no guarantees in life — that infertility treatment does not necessarily result in a healthy daughter.
This is life with its attendant randomness, dispassion and warmth by turns.
While Hannah recovers, her father will take over my watch, while I leave to go do an embryo transfer. I know this patient well, and I am certain that she will feel much as I did while awaiting the embryo transfer that birthed Hannah. I was excited, scared, a bit bewildered. This patient will be excited, scared, a bit bewildered. She will search the faces of Dr. Albrecht, the embryologist and myself for clues to see if we know more than we are letting on. I thought this same way, thinking that surely the team must have more answers, must feel more certainty than they were letting on. Which embryo should we choose? How many? And of course will I have a baby?
The truth is that although our profession has certainly made incredible, staggering advances since embryonic Louise Brown sat under the lens of her embryologist’s scope, as a discipline, we are ourselves in the embryonic stage. We know a lot these days: we correlate hormones to physiology, we can look at snippets of embryos in an effort to predict which ones will probably result in a healthy baby. We recommend powerful fertility drugs, commonplace vitamins, certain activities, and meditation. We take a dim view of vigorous exercise and eschew all but the most researched evidence. As a field, most of us work long hours, trying to better ourselves, our profession, but most of all, we work in this field because of people like the above patient who show up in our waiting rooms, fidgety, scared, apprehensive and oftentimes doubtful that a pregnancy lies in their future.
I will meet the patient whose full bladder will add to her anxiety. Her husband will sit off the to the side, all of us will stare intently into the murky pictures on the screen of the ultrasound monitor. I have learned over the years how to position the transducer and to steady my hand so that I can maneuver the transducer in almost infinitesimally tiny movements so that we see the tiny white flash of catheter then the smallest of movements as the fluid that bathes the embryos is instilled at the top of the uterus. It will be a brief, anticlimactic procedure. Dr. Albrecht will answer questions, pat her hand and remind them that we are here for them. I will dim the rheostat, then leave the patient and her husband to sit in the hushed stillness where they will tell each other how much they are loved, dream of the day they will cradle their baby and maybe trade some nervous laughter.
I will return a few minutes later to review the plan for the next two weeks before her pregnancy test, the longest two weeks I, as an IVF patient, ever lived. They will return to home, and I will return to take up vigil by Hannah once again, as she struggles to open her eyes and asks for something impossible like a a bean burrito with guacamole or one of the puppies that we are training to become service dogs, or maybe even for her great grandmother, my dearly loved, now departed grandmother.
And as she does these things, and I hunker down to wait for her to blow off the gas, I will remember that this — yes, this young woman in bed with a comically gigantic knee, one of the three embryos that sat unmoving on the stage of the embryologist’s microscope — will one day dance again, however hesitantly. And that she, like we peeps who have looked infertility in the eye, will write a new story. Our stories. You’ll notice us on the dance floor — we’ll be the ones with a bit of a limp.