Thursday, November 28, 2013

Lucky


Let's start by stating the obvious:  Once you've been privileged enough to bake with a Kitchen Aid, a spatula, an arthritic arm, and a $10 hand mixer just don't cut it any more.

Then again, there are other things to consider.  Last week I took the second volume of a deposition of a man who, after returning to work following the holidays last year, slipped, fell, had one emergency spine surgery and two subsequent spine surgeries, and lost temporary use of all four of his extremities.  His mobility is much improved since I took his deposition in July, but undoubtedly as his family gathers this year for Thanksgiving they must be remarking at how much their lives have changed.

Thanksgiving is an American holiday, of course.  We are probably the people in the world who have the most to be thankful for.  Even my deponent lives in a country where there is a system in place to provide for an injured worker.  That is a privilege.

I will eat today.  I will eat until I feel I may burst and then I will take a break and then I will eat again.  Some time this evening I will say good night to my loving family and venture with my kind-hearted boyfriend to meet my wonderful friends in a bar that I love and we'll sing karaoke and swap food and laugh and I will have a perfect day.  Somewhere else in the world someone is living a life quite the opposite of my own.  They didn't do anything to land themselves there, any more than I did anything right to get so very lucky in life.  We both ended up where we are by the roll of God's providential dice.

Maybe an outsider would look at me and only see the most glaringly unlucky part of my life.  It can be easy to slip into focusing on what I don't have on a day like today.  Gabriel's absence is obvious and painful.  I wonder what kind of picky eating habits he would have developed.  Perhaps unlike his momma he would love pumpkin pie the most.  I would have to require him to take two bites of everything on his plate before he could have pie, and that could take hours, but it would be worth the wait to watch the smile spread across his face at the sight of the burnt orange triangle, topped with Cool Whip.  I've missed my son all morning.  I miss my son every day.

But as I baked a pan of pumpkin cake bars, this year's alternative to one of my less-favored Thanksgiving staples, I could feel Rocco move contentedly inside of me and a feeling of contentment came over me too.  My life is what it is.  I lost my son and I will always feel that loss in my core.  Still, I have so much to be thankful for.  I am grateful that God has chosen to bless me as He has, and I have been so very blessed.  I don't deserve it, certainly not anymore than anyone else I know, but this is the life I've been given and I love it.  I think I just might be the luckiest girl in the world.


Saturday, November 23, 2013

Monday, November 18, 2013

Scanning the Grey



It's been more than 7 years since Elise Broadbent barreled into the recently re-named bar The Wright Place, where I was working the remaining months until I would leave for law school.  She must have been about 23 years old at the time, which means her son Bailey must have been about 2.  She was a single mother, unexpectedly raising a child on her own, barely more than 5 feet tall, with dyed black hair with purple streaks in it.  She'd recently lost her job at the Rockin' Rodeo, which closed after a fatal shooting outside of the nightclub.  She was vibrant, outgoing, and annoying as shit.

Elise was at The Wright Place for an interview, and when she was hired I figured she'd come and go like most bartenders do, but she stuck around for the three years that I was away at school, and for another three years after I returned.  I went back to work at the bar, reluctant to commit to full-time practice, just as Elise was beginning classes at the junior college, determined to build a career for herself after years of bartending and scraping by to take care of her son.  Semester after semester she produced exemplary grades, and toyed with the idea of getting a degree in psychology, until some inspiration struck her and led her in the direction of ultrasound technician.  She began researching programs and figuring out what she needed to do to get into such a program.

Early in the Spring 2011 semester, when was just beginning a medical terminology course, she asked me in the office at the Wright Place what was wrong.  I told her that my unborn child had been diagnosed with anencephaly.  She broke down the word and quickly realized what the problem was.

I had, by that point, learned to tolerate Elise, but going forward we became true friends.  She kept my secret until I was ready to publicly disclose Gabriel's condition.  She put her hands on my belly and felt him move, as vibrant and alive as she was the day I met her.  The day Gabriel was born she came to the hospital to meet him, one of a short list of people invited to meet Gabriel face-to-face.  She was the first to ask if she could remove his cap to look at his exposed defect - She looked even before I did.  On his fifth day of life she brought her then 8 year old son to my home to see Gabriel, unexpectedly holding on days longer than we ever dreamed, to see him again.  She held him, and her son stroked his face lovingly, with Gabriel wearing no cap and his oddity exposed for them both to see.

As my marriage crumbled, as my life crumbled, as I crumbled, Elise was there to nurture me with kindness and cocktails.  She was the conduit for establishing the friendship I now share with Blake and Lindsey, and the three of them are the best things I got from my divorce.  New, real, and meaningful friendships were the last things I expected at this point in my life.  A friendship was the last thing I expected the day I met Elise Broadbent, mistress of colored hair and karaoke.

The day Gabriel was diagnosed with anencephaly, an ultraound tech first detected the defect.  She alerted me that something was wrong, and that the doctor would be in to explain.  My doctor was not in the office, and so her partner broke the news that my child would not survive after birth.  She said to me, "We see this maybe once every five years in our practice."

Months later, my doctor was again out of the office during one of my routine prenatal visits, and the same doctor that had shattered my world saw me instead.  She didn't remember me.  In fact, even when I mentioned that my child had anencephaly, her memory was not triggered.  Instead she said, "You know, most of the time when that is diagnosed the child is just fine."  I stared at her wonderously.  "Hydrocephaly?  Right?" she asked.

"No. ANENcephaly."

"Oh," she said quietly.  "Yes.  Anencephaly is fatal.  I'm sorry."  I couldn't believe that just a few months ago, this woman had brought my world to pieces with a diagnosis that she admitted was rare and infrequently seen even in her business of delivering babies.  I couldn't believe that she shared a moment with me that was so intimate, and so life-changing, and so fucking uncommon, and yet there I was, just another patient.

But in another room of that same clinic, I bet an ultrasound tech remembered me.  If she is like Elise, who will complete her ultrasound program next month and begin her career very shortly, she went home and cried and privately mourned for the patient that she didn't even know.  I know this, because when Elise made her first diagnosis of anencephaly, she cried.

I frequently think that Elise and I are so close because we've each experienced severe trauma, probably more severe than the average person.  No one could blame either of us for just shutting down one day.  But we each pick ourselves up, and push ourselves along, and when we can't do it anymore, the other one does.

It's hard to believe sometimes that for all of its scars, Elise still has one of the biggest, most giving hearts of anyone I know.

Happy birthday, Elise.  You're 31, you're almost done, but the rest of your life has just begun.  And it's only going to get better from here.  These moments are your rainbow.  I love you.  And I'm so proud of you.


And you'd better not cry like a big, old diaper baby. 



Monday, November 11, 2013

The Flood





11:20 couldn't come fast enough. I grabbed a file and performed some obligatory reporting, but the task that should have taken 10 minutes took about 30. I googled "typing speed tests," hit the 'Start Clock' button and began pecking away. Mrs. Frisby, the head of a family of field mice, lived in an underground house in the garden of a farmer named Mr. Fitzgibbon. . . 68 words per minute, zero errors. I could do much better. I clicked the button for a new test. After several tests I maxed out at 78 words per minute, zero errors. Satisfied, and noting how much time I had been able to pass, I grabbed another file requiring only perfunctory attention until the clock read 11:00. I plastered a look of false bravado on my face as I told the staff I would be back in a couple of hours, and met Marcos in the parking lot, where we got into my car and drove to the doctor's office.

Immediately I noticed there was no ultrasound equipment in the room, and so I inquired of the tech who said no ultrasound was ordered for the day. When the doctor arrived I asked again.

"No. You won't have another ultrasound for quite a few weeks, until later in your second trimester."
I could feel the tears sting my eyes immediately. "But I thought - I thought that's what we would do today. I - I never would have consented to the last one, if I thought we would not do another one this week. I -" and the words from my last blog began spilling out of my mouth, "I need to know if this baby has anencephaly. It takes a great leap of faith to be pregnant again, but I need to know. I am stressed out wondering. I need to know!" and the tears were rolling and my voice was quivering.

"Everything appeared normal at your first ultrasound. . ." but I cut her off. "Everything appeared normal with my son, too, until one day it wasn't."

"I know. . ."  I wouldn't give her a chance to speak, I just kept pleading with her until she finally agreed that if there were a machine available, until she said with resignation that she would perform the ultrasound. "You're right.  It does take a leap of faith to get pregnant again."  She prefaced the impending ultrasound with familiar language to a lawyer: "I'm not a specialist. I cannot rule out anencephaly, especially not at this stage. I'm still going to send you to see the specialist. I can only tell you if the image appears to be normal, in my experience. I can't diagnose, or not diagnose, anything, and we're not going to take any action no matter what I see." With her waiver of liability having been made I said, unequivocally, "I want you to know it doesn't matter what you say today, or what the specialist says. It's not going to change anything. I'm not going to end this pregnancy. I just need to know." She nodded, and we proceeded.  Marcos held my hand, and I held my breath.

And there it was. You can't imagine how much that bright, round image of a baby's skull, taken for granted in so many pregnancies, means. Not until it's been decidedly missing from your child's ultrasound image. Not until you've wished you could simply take your own skull, saw it off of your own head yourself, to give it to your child. But there, clear and bold on the screen was the distinct image of bone forming a skull. Rocco rolled in response to the ultrasound wand, allowing us to see all angles. "As far as I can tell, within my area of expertise as a ob/gyn, not a specialist, there does not appear to be any grossly obvious deformity." I nodded at her conditional language, knowing it just her clinical training, knowing there was nothing gross about my son's deformity, knowing he was beautiful, and his little brother or sister is beautiful too, each in their own distinct ways.

In that bittersweet moment there was at once a flood of relief, and a wave of sadness as I grieved once again the day my world fell apart with my first lesson in anencephaly.  These moments will always be bittersweet.  Like the top of his own skull was missing, so Gabriel's physical presence will be missing from the rest of my life.  I feel it, deep in my bones.  I always will.  Faith, and a rainbow baby, don't replace the child that I carried, that I gave birth to, that I love from somewhere built into my core.  Faith only givea me the strength to believe that even though he is gone, I'll see my son again, and I'll be okay until I do.

Genesis 9: 13-17 "I have set my rainbow in the clouds, and it will be the sign of the covenant between me and the earth.  Whenever I bring clouds over the earth and the rainbow appears in the clouds, I will remember my covenant between me and you and all living creatures of every kind.  Never again will the waters become a flood to destroy all life.  Whenever the rainbow appears in the clouds I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth."  So God said to Noah, "This is the sign of the covenant I have established between me and all life on earth.

For years I've felt that I was on the brink of drowning.  I don't know sometimes how I managed to keep from going under.  There were mornings when I would wake up, and wonder why I would, why I should live to see another day and it was only by supernatural force that I carried on.  But my rainbow has appeared.  This time it is not an illusion.

Life will keep sending challenges, will keep throwing curves.  There will always be rain.  But now there's a rainbow in the clouds.


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Monday, November 4, 2013

Before This River, There Comes an Ocean

It takes a huge leap of faith to be pregnant again.

I remember the first time someone told me that I was brave for trying again. It was Randy, over a gin and tonic, with his blunt ways who first said to me after the miscarriage, "That takes courage to try again."

He said it again after Gabriel's diagnosis was revealed. Gabriel hadn't even been born yet, but my desire to have children was already evident and I was not at all surprised when Randy if I would try again after Gabriel. And again, I had no reservations about answering "Yes." Randy noted once more the courage that would be required, but added, "You had one flukey thing happen, then another flukey thing happened, but that's no reason to stop trying, they were flukey things." Randy, a fellow member of the California Bar whom I met in a different kind of bar, is as practical as I am and I took no offense to his description of events. I love my children in Heaven, but I know it is by some natural fluke that they are not with me today. Sometimes, these things just happen.

If I had to describe my level of confidence, I am 99% sure that the baby I am now carrying is going to be just fine. The odds are, he or she will be. Besides, I am a woman of faith. I am woman who is confident that between God and statistics, come May I will be holding a healthy baby in my arms.

It's the 1% that troubles me. It's only 1%, but it represents something so frightening that it can feel like it's consuming me. I don't know that I can handle one more heartbreak.

"This is girl season," someone told me recently. "Odds are, you're having a girl."

"I tend to beat the odds," was my response, the stinging nature of which was lost on this unassuming stranger. She couldn't know that only 1 in 1,000 pregnancies will result in an anencephalic infant and my son Gabriel was that 1 in 1,000; or that of those 1 in 1,000 pregnancies, upwards of 90% of them will result in the termination of that child so that less than 10% of those 1 in 1,000 babies will get a chance to live; or that among those children who are given a chance to live, only 25% of them will live for a day or more and so it was indeed a fluke that my sweet anencephalic baby boy lived for ten days, against the odds. She couldn't know that while I've played the odds and sometimes I've scored big and sometimes I've lost big, I have no idea how this pregnancy will play out when of the 1 in 1,000 women who have an anencephalic baby, 4 in 100 of us will have a recurrence. I have faith that it won't be me. But I know that it has to be someone. And it could very well be me.

With tentative faith I will report to my obstetrician one week and one hour from now and I will hope to hear the words that most people never have to consider: "You're baby's skull is perfectly formed." If you've never had to hear that your baby's skull is NOT perfectly formed, or words of similar effect, I urge you to fall to your knees now and thank God because you can't imagine how much it hurts, and be glad you can't. In that "What to Expect When You're Expecting" book you're told that you can generally expect that your baby will be perfectly fine, but you're not told what to expect when he's not. I could write a book on what to expect with terminal diagnosis and infant loss. I maybe already have.

Randy was right. It takes courage to have another baby. I didn't know, until I was doing it. I didn't know it would take strength to love again, until I was loving. I didn't know I would have to be brave in this time of good news, until I realized how scared I am. I didn't know, because I didn't care, because my longing was greater than my fear. But I'm doing it, all of it. Every day is a little bit easier, with a huge milestone yet to come. I can see this baby, I can almost feel him or her in my arms and against my skin. But, before this river, there comes an ocean, George Michael advises me. As I tread my way through the sea of Fear and Hope, sometimes barely keeping my head above water, I'm reminded that I keep doing it because if I want the reward, I've gotta have faith. A-faith a-faith uh.