Vital Signs (4 page)

With panties and a bra in hand, Marissa went into her closet.
While she dressed, she called out to Robert. Sometimes recently it seemed easier to talk to him without meeting his eyes.
“I’ve only told a few people about our problem, and only in very general terms. I’ve just said we’re trying to get me pregnant.
Everyone I tell feels compelled to give me unsolicited advice.
“Relax,” they say.
“Take a vacation.” The next person who tells me that, I’m going to tell the truth. No amount of relaxing will help me because I’ve got fallopian tubes that are sealed shut like hopelessly clogged drains.”
Robert didn’t say anything in response, so Marissa went to the door of her closet and looked into the bedroom. He was sitting on the edge of the bed putting on his shoes.
“The other person who is bugging me is your mother,” Marissa said.
Robert looked up.
“What does my mother have to do with this?”
“Simply that she feels obligated every time we get together to tell me it’s time for us to have children. If she says that to me once more, I’m going to tell her the truth as well. In fact, why don’t you tell her yourself so that she and I can avoid a confrontation.
Ever since she and Robert had begun dating she had been trying to please his mother, but with only marginal success.
“I don’t want to tell my mother,” Robert said.
“I’ve already told you that.”
“Why not?” asked Marissa.
“Because I don’t want to hear a lecture. And I don’t want to hear her tell me it serves me right for marrying a Jewish girl.”
“Oh, please!” Marissa exclaimed with a new burst of anger.
“I’m not responsible for my mother’s prejudices,” Robert said.
“And I can’t control her. Nor should I”
Angry again, Marissa turned back to her dressing, roughly buttoning buttons and yanking her zipper.
But soon Marissa’s fury at Robert’s mother reverted back to selfloathing for her own infertility. For the first time in her life, Marissa felt truly cursed by fate. It seemed unreasonably ironic how much effort and money she’d spent on birth control in college and medical school so that she wouldn’t have a child at the wrong time. Now, when it was the right time, she had to learn that she couldn’t have a child at any time except through the help of modern medical science.
“It’s not fair,” Marissa said aloud. Fresh tears streamed down her face. She knew she was at the edge of her endurance with the monthly emotional roller coaster of hope to despair each time she failed to conceive, and now with Robert’s increasing impatience with the process. She could hardly blame him.
“I think you’ve become obsessed with this fertility stuff,” Robert said softly.
“Marissa, I’m really beginning to worry about you. I’m worried about us.”
Marissa turned. Robert was standing in the closet doorway, his hands gripping the jambs. At first Marissa couldn’t see the expression on his face; he stood in shadows with his sandy hair backlit from the bedroom light. But as he moved toward her she could see that he looked concerned but determined; his angular jaw was set so that his thin lips formed a straight line.
“When you wanted to go this infertility treatment route I was willing to give it a try. But I feel it’s gotten way out of hand. I’m coming to the conclusion that we should think about stopping before we lose what we do have for the sake of what we don’t.”
“You think I’m obsessed? Of course I’m obsessed! Wouldn’t you have to be obsessed to endure the kind of procedures I’ve been going through? I’ve been willing to put up with it all because I want to have a child, so that we can have a family. I want to be a mother and I want you to be a father. I want to have a family.”
Without meaning to, Marissa. steadily raised her voice. By the time she finished her last sentence, she was practically shouting.
“Hearing you yell like this only makes me more convinced we have to stop,” Robert said.
“Look at the two of us. You’re strung out; I’m at the end of my rope. There are other options, you know. Maybe we should consider them. We could just reconcile ourselves to being childless. Or we could look into the idea of adopting.”
“I just cannot believe that you would pick this time to say these things,” Marissa snapped.
“Here it is the morning of my fourth egg retrieval, I’m prepared to face the pain and the risk, and, yes, I’m an emotional wreck. And this is the time you pick to talk about changing strategy” “There is never a good time to discuss these issues with this in vitro fertilization schedule,” said Robert, no longer able to control his anger.
“You don’t like my timing, okay. When would be better, when you’re crazy with anxiety, wondering if you are pregnant? Or how about when you’re depressed after your period starts again? Or how about when you are finally coming out of your grief and starting a new cycle? You tell me; I’ll come talk to you then.”
Robert studied his wife. She was getting to be a stranger. She’d become impossibly emotional and had gained considerable weight, especially in her face, which appeared swollen. Her glare was so cool, it chilled him to the bone. Her eyes seemed as dark as her mood, and her skin was flushed as if she might be running a fever. She was like a stranger, all right. Or worse: just then she seemed like some irrational hysteric. Robert wouldn’t have been surprised if she suddenly sprang at him like an angry cat. He decided it was time to back down.
Robert edged a few steps away from her.
“Okay,” he said, “you’re right. It’s a bad time to discuss this. I’m sorry. We’ll do it another day. Why don’t you finish getting dressed and we’ll head down to the clinic.” He shook his head.
“I just hope I can produce a sperm sample. The way I’ve been feeling lately, I’m hardly up to it. It’s not purely mechanical. Not anymore. I’m not sixteen.”
Without saying anything, Marissa turned back to her dressing, exhausted. She wondered what they would do if he failed to produce the sperm sample. She had no idea how much using thawed sperm would lower the’ chances of a successful fertilization.
She assumed it would, which was part of the reason she was so angry when he had initially refused to go to the clinic, especially since the last in-vitro cycle had failed because fertilization had not occurred. Catching a glimpse of herself in the mirror, and seeing the high color of her cheeks, Marissa realized just how obsessed she was becoming. Even her eyes looked like those of a stranger in their unblinking intensity.
Marissa adjusted her dress. She warned herself about getting her hopes up too high after so many disappointments. There were so many stages where things could go wrong. First she had to produce the eggs, and they had to be retrieved before she ovulated spontaneously. Then fertilization had to occur. Then the embryos had to be transferred into her uterus and become implanted.
Then, if all that happened as it was supposed to, she’d be pregnant. And then she’d have to start worrying about a miscarriage. There were so many chances for failure. Yet in her mind’s eye she could see the sign on the waiting room wall in the in-vitro unit: YOU ONLY FAIL
WHEN
YOU GIVE UP TRYING.
She had to go through with it.
As pessimistic as she was, Marissa could still close her eyes and envision a tiny baby in her arms.
“Be patient, little one,” she whispered. In her heart she knew that if the child ever arrived, it would make all this effort worthwhile. She knew she shouldn’t be thinking this way, but Marissa was beginning to feel it would be the only way to save her marriage.
March 19, 1990
9:15 A.M.
Walking beneath the glass-enclosed walkway that separated the main clinic building from the overnight ward and emergency area, Robert and Marissa entered the brick courtyard and started up the front steps of the Women’s Clinic. The particular color and pattern of the granite made Marissa think about all the times that she’d climbed the steps, facing innumerable “minor procedures.” Involuntarily her footsteps slowed, no doubt a response conditioned by the collective pain of a thousand needle pricks.
“Come on,” Robert urged. He was gripping Marissa’s hand and had sensed her momentary resistance. He glanced briefly at his watch. They were already late.
Marissa tried to hurry. Today’s egg retrieval was to be her fourth. She well knew the degree of discomfort she could expect.
But for Marissa the fear of the pain was less of a concern than the possibility of complications. Part of the problem of being both a doctor and a patient was knowing all the terrible things that could go wrong. She shuddered as her mind ticked off a list of potentially lethal possibilities.
Once Robert and Marissa were inside the clinic, they skirted the main information booth and headed directly to the In-Vitro Fertilization Unit on the second floor. They had traveled this route on several occasions, or at least Marissa had.
Stepping into the usually quiet waiting room with its plush carpet and tapestry-upholstered chairs, they were treated to a spectacle neither had been prepared to see.
“I am not going to be put off!” shouted a well-dressed, slim woman. Marissa guessed she was about thirty years old. It was rare in any of the clinic’s waiting rooms to hear anyone speak above a whisper, much less shout. It was as surprising as hearing someone yelling aloud in a church.
“Mrs. Ziegler,” said the startled receptionist.
“Please!” The receptionist was cowering behind her desk chair.
“Don’t Mrs. Ziegler me,” the woman shouted.
“This is the third time I’ve come in here for my records. I want them now!”
Mrs. Ziegler’s hand shot out and swept the top of the receptionist’s desk clean. There was the jolting shatter of glass and pottery as pens, papers, picture frames, and coffee mugs crashed to the floor.
The dozen or so patients waiting in the room froze in their chairs, stunned by the outburst. Most trained their eyes on the magazines before them, afraid to acknowledge the scene being acted out before their eyes.
Marissa winced at the sound of the breaking glass. She remembered the clock radio she had so wanted to smash not half an hour earlier. It was frightening to recognize in Mrs. Ziegler such a kindred spirit. There had been several times Marissa had felt equally pushed to the edge.
Robert’s initial response to the situation was to step directly in front of Marissa and put himself between her and the hysterical patient. When he saw Mrs. Ziegler make a move around the desk, he feared she was about to attack the poor receptionist. In a flash, he shot forward and caught Mrs. Ziegler from behind, gripping her at the waist.
“Calm down,” he told her, hoping to sound commanding as well as soothing.
As if expecting such interference, Mrs. Ziegler twisted around and swung her sizable Gucci purse in a wide arc. It hit Robert on the side of his face, splitting his lip. Since the blow did not dislodge Robert’s grip, Mrs. Ziegler cocked her arm for yet another swing of the purse.
Seeing the second blow in the making, Robert let go of her waist and smothered her arms in a bear hug. But before he could get a good grip, she hit him again, this time with a clenched fist.
“Ahhhh!” Robert cried, surprised by the blow. He pushed Mrs. Ziegler away. The women who had been sitting in the area fled to the other side of the waiting room.
Massaging his shoulder, which had received the punch, Robert eyed Mrs. Ziegler cautiously.
“Get out of my way,” she snarled.
“This doesn’t involve you.”
“It does now,” Robert snapped The door to the hall burst open as Dr. Carpenter and Dr.
Wingate dashed in. Behind them was a uniformed guard with a
Women’s Clinic patch on his sleeve. All three went directly to Mrs. Ziegler.
Dr. Wingate, director of the clinic as well as head of the in vitro unit, took immediate control. He was a huge man with a full beard and a slight but distinctive English accent.
“Rebecca, what on earth has gotten into you?” he asked in a soothing voice.
“No matter how upset you might be feeling, this is no way to behave.”
“I want my records,” Mrs. Ziegler said.
“Every time I come in here I get the runaround. There is something wrong in this place, something rotten. I want my records. They are mine.”
“No, they are not,” Dr. Wingate corrected calmly.
“They are the Women’s Clinic records. We know that infertility treatment can be stressful, and we even know that on occasion patients displace their frustration on the doctors and the technicians who are trying to help them. We can understand if you are unhappy.
We’ve even told you that if you want to go elsewhere, we will be happy to forward your records to your new physician. That’s our policy. If your new physician wants to give you the records, that’s his decision. The sanctity of our records has always been one of our prized attributes.”
“I’m a lawyer and I know my rights,” Mrs. Ziegler said, but her confidence seemed to falter.
“Even lawyers can occasionally be mistaken,” Dr. Wingate said with a smile. Dr. Carpenter nodded in agreement.
“You are welcome to view your records. Why don’t you come with me and we’ll let you read over the whole thing. Maybe that will make you feel better.”
“Why wasn’t that opportunity offered to me originally?” Mrs.
Ziegler said as tears began to stream down her face.
“The first time I came here about my records, I told the receptionist I had serious questions about my condition. There was never any suggestion
I would be allowed to read my records.”
“It was an oversight,” Dr. Wingate said.
“I apologize for my staff if such an alternative wasn’t discussed. We’ll send around a memo to avoid future problems. Meanwhile, Dr. Carpenter will take you upstairs and let you read everything. Please.” He held out his hand.
Covering her eyes, Mrs. Ziegler allowed herself to be led from the room by Dr. Carpenter and the guard. Dr. Wingate turned to the people in the room.
“The clinic would like to apologize for this little incident,” he said as he straightened his long white coat.
A stethoscope was tucked into a pocket, several glass petri dishes in another. Turning to the receptionist, he asked her to please call housekeeping to clean up the mess on the floor.
Dr. Wingate walked over to Robert, who’d taken the handkerchief from the breast pocket of his suit to dab at his split lip.
“I’m terribly sorry,” Dr. Wingate said as he eyed Robert’s wound. It was still bleeding, although it had slowed considerably.
“I think you’d better come over to our emergency facility,” Dr.
Wingate said.
“I’m okay,” Robert said. He rubbed his shoulder.
“It’s not too bad.”
Marissa stepped over for a closer look at his lip.