By Alex Behr
A new year. January 2001. I went alone to the next IVF appointment in San Francisco’s Pacific Heights, menstruating. Everything was mathematically planned out. I had been on the Pill for a month to regulate my ovaries, and now I’d stopped taking them. The doctor did an ultrasound in my bloody kootch. The nurse who took my blood to check for hormone levels said, “Hopefully it’s the last period you’ll have for a long time.”
“Thanks,” I said.
Though later, before I left, she said, “Everyone’s nervous the first time.” What did that mean? Was I doomed to failure? Yet she also said, “The lining of your uterus is thin. Everything looks good.”
The first set of injections would stimulate my follicles to produce more eggs than normal, and I would be monitored on an ultrasound, like any normal pregnant person, the follicles looking like the underside of a psychedelic mushroom, open to new life.
At home, though, Sam and I got in another fight. “If I get a shit job I’ll be too depressed,” Sam said.
“What should I do, just write you a check for ten grand and be done with it? Our marriage?”
He was working on a moth painting for a friend. “I’ve been busting my ass to get it done. I want to get adult illustration work and you’re telling me to get a shitty day job.”
“It’s not fair I have to work all day on projects I don’t care about, that I’ve done a million times, and I only have time to write fiction on the weekends.”
“Did you marry me just so I’d buy you a house?”
“Why don’t you go to school so you can teach art?”
“Fuck you. I don’t have to listen to your pressure.” He walked outside.
I’d woken to my landlady yelling at her mother. Through two sets of windows, iron grates, and the space of an alley, I heard her slap her. She screamed at her mother that she’d soiled her bed and wouldn’t get up.
Our building in the Lower Haight was managed and governed and terrorized at times by the landlords, who lived next door. Sam and I called them, collectively, “the Squareheads.” The landlord dyed his white hair with a cheap rinse, glowing purple in the sun. The landlord hunted wild boars in Marin to relax—with a knife—and stretched animal skins in the garage under our apartment. It was so full of broken stoves and fridges from two buildings’ worth of appliances, bags of recyclable half-empty oil cans, ketchup cans, and other debris that only one car, their maroon Caddy, could slip in. The landlord’s Silverado took the public parking space outside his home, as if he lived in the suburbs and could claim city-owned concrete.
At our kitchen table, Sam was giving me two injections of Follistim per night. Follistim was going to stimulate an egg to grow inside me, with any luck many eggs, as if I were a snake, a turtle, or a frog. Sam did not want to inject me, but I felt too scared to do the shots on my own. We had to follow the procedure and use sanitary measures; unlike the first time he pierced me, when he gave me a tattoo the night he fell in love. He was so calm and so orderly. So sanitary in his attention to detail.
This bout of IVF taught me that I was not a needle person. After my abdomen was swabbed with alcohol, Sam prepared the needle, making sure it was free of air bubbles.
Once the needle pierced my skin, I fell into a fifteen-second tunnel of pain. My finger in a light socket turned ON, but no bulb. Counting to fifteen, slowly, watching with my mind the searing across my abdomen. The stim drugs were mixed with an anti-coagulant property that caused the liquid to burn fiercely when it was injected.
The shots got easier as the days went on. I knew how long the pain would last each time. I could count through it, gritting my teeth, hating the burn.
After the follicles were stimulated, I would do one last shot of a drug called hCG, using an inch-and-a-half long needle. This drug would trigger the mini eggs to mature before they were retrieved.
The next time I went to the clinic, the water surrounding Alcatraz and Angel Island was dark green. The wind picked up flecks of white across the waves.
I rested on the examination table with goo on my stomach and looked at the ultrasound screen. I’d grown only four to five follicles instead of the fourteen to fifteen the doctors were expecting to find. Why? I was so frustrated and sad.
On the way to the pickup truck, I gave a dollar to a homeless woman in the street, walking with her kid. She touched my hand, and I wanted to wash it off. I feared she would cast a spell on me.
The next day, the doctor examined me again. She said six to seven follicles looked large, and she would look in a bunch of them to find eggs, exactly like an Easter hunt.
At home, again, I asked Sam, “Can you do just one thing per day toward getting work?”
But he said he couldn’t, because of the stress of IVF. I talked to him while he was doing standing meditation in his room, as was taught in our kung fu class. His back was near the wall, his eyes closed and his knees slightly bent; he suspended his arms in a circle for the flow of chi.
He said I smothered him.
At my last appointment before the big injection of hCG, the nurse commented on all my pinpricks. I’d been injected with Follistim many times, because I was at risk for not producing enough eggs. She joked about the city’s druggie reputation: “What, you live in San Francisco?”
Sam and I drove to the Sutro Baths, the crumbling concrete of a dead playland butting up against the Pacific Ocean. We walked through a cave to a rocky inlet, where the incoming tide splashed against the cliffs. Inexplicably, I felt happy that I had seven eggs growing inside me, ready to be harvested, maybe three to four were good, I thought. Yet only an hour before, I was ready to cry when I saw a pregnant woman with her guy, resting her hand on her womb. I wanted fairness. I wanted the practice space to be fair: an equal allocation of space, and no vomit smells. I wanted to have a baby. I felt that would be fair. I would be a good mom. I was ready.
The morning of the IVF egg retrieval, I got an IV in my wrist to administer the narcotics. Other women getting the same surgery were only a curtain away. I hadn’t felt pain from the last shot the night before, the hormone hCG, with the inch-and-a-half-long needle right by my ass. I felt like a pro.
I fell into anesthesia, blissful, cared for with a blanket tucked tight. After the egg retrieval, I loved exiting from the drugs in the post-op room, the slow cloudlike movement back into my skin, and the confusion. The nurse told me they got six eggs out. They’d hoped to retrieve more.
I was not alone. The woman beside me had twenty eggs taken from her, and her husband was effusive in his excitement. She said she had lost an ovary; that’s why she was doing IVF. Jealous. Competitive. I couldn’t feel happy for this stranger. I should, but I couldn’t be. Why twenty from her and I’d gone through so much pain for just six?
Sam held my hand. We talked about Charlie Parker, from the show on TV the night before. I had talked to the anesthesiologist about NPR, and the nurse told me I was babbling about it afterward, when I was still on drugs. Only a nerd like me would get high and try to discuss public broadcasting.
We took a cab home. I leaned against the vinyl seat with the window cracked, watching the people waiting for MUNI rides, bike messengers with their patched jeans and bulging bags skimming across the lanes, cars passing each other en route to highways and clogged bridges—the whole city an electric ribbon of movement. And pauses. And movement, through the gray and rain. No scent of sea breezes reached City Hall on Van Ness Avenue. We turned up Market toward Waller, where we lived.
The cabbie said, “You’re the calmest ride yet.”
I said, “Sedation helps.”
He said, “Tell me what you’re on.”
The nurse called me. Only one embryo had developed out of six. She said for most women, more embryos would have developed. I cried. I’d failed.
The embryo transfer back into my body would happen in a couple of days, at 11 a.m. on Saturday.
The nurse said, “On Saturday they’ll grade the embryo, and look at the number of cells and fragmentation—hopefully there’s none—and the embryo’s symmetry and roundness. In most cases, if it’s at an embryo stage on that day we’ll progress to a transfer.” She told me I might have an “egg issue.” Sam didn’t have a “sperm issue.” I didn’t care. I wanted that fertilized egg in me.
Before we hung up, the nurse said of Sam and me, “You guys are a cute couple.”
Sam held me. He just wanted me to be happy.
That thing, those dividing cells, were across town in a test tube or a fridge. I wanted it in me, so I could keep it safe.
The next morning I wondered if my eggs were bad because I’d started menstruating when I was eleven, going on twelve, and I had lost my virginity at fifteen, almost sixteen. The nurse had told me some women got pregnant with one egg transferred. Some didn’t with three eggs transferred. I woke up clutching my bloated stomach.
That afternoon, after seeing a movie with Sam and a friend, I heard a rustling in our back yard. No one lived upstairs anymore, although the landlord was constantly hammering or sanding down the remnants of the Victorian features. We hadn’t talked to each other for years, after he threw a pipe against a back yard fence and yelled at me. I was asking for too many repairs.
The back yard was huge, with an apple tree we were forbidden to pick from. It was overgrown and clogged with trash that couldn’t fit in the garage. Yet the landlord, I guessed, had brought a dog to live there. This dog’s name was Sunshine. A Golden retriever, it lay down on the concrete, quiet and scared. I knew from the life of the previous dog, who’d been kicked by the landlord, that this new dog would never get walked or live indoors. It was a guard dog of snails and old cans of used motor oil.
I called animal control. Sunshine needed food and water and shelter. It was a stinky dog. I could dwell on that neglected dog instead of being nervous about the embryo transfer. I wanted “it” inside of me. I wanted it to burn itself into being.
Sam held me all night, with hands warm and strong, but I was tired on Saturday, headed to the clinic. We got there on time, at the high rise overlooking the San Francisco Bay, but no one was at the front desk. No other patients were in the waiting room. I knew that if the embryo had split after twenty-four hours, the chances were good that it would continue to be healthy. This was what I hoped.
In the exam room, the doctor put the catheter in my vagina to transfer the dividing cells into my uterus, with its lining so healthy and full. I kept my shirt on. All this effort to create life, yet these cells were less fortunate, and far less active, than a package of yeast in flour and water. He wasn’t my usual doctor, yet he was kind. When I got off the exam table, I dripped tears onto a side table, looking at the results and the magnified photo of overlapping circles: the dividing cells, whatever would be or could be my baby.
The doctor talked in numbers. “There is only a ten to fifteen percent chance of the embryo surviving because it’s a grade three, not grade one or two,” he said. “It’s fragmented.” So much for my high GPA in high school. The doctor warned of an increased risk for Down syndrome if (if) the embryo managed to develop further. He suggested I had an egg problem (to go with my blocked Fallopian tube problem). I would require more tests the next time I did IVF. He assured me there would be a next time. Today was not the baby time. The next time, the doctors would test to see if I had a high FSH (follicle-stimulating hormone) level, which meant my body was trying harder to produce eggs. For so many years I had sex and never wanted to be pregnant. Now I was pregnant, technically, and I cried.
At home, my sister called. She said if there were more healthy cells in this microscopic thing inside me, then they would take over, and the fragmentation would stop. I didn’t know how she knew, but she had a lot of facts that came easily to her. “It’s not hopeless yet,” she said, while I cried. Meanwhile, there was the dog, Sunshine, in the back yard, barking and whining all day and all night.
The next day, my breasts felt bigger. I was so angry that it took four years for a doctor to order a hysterosalpinogram to check my tubes, considering I’d had an abnormal pap smear and a cone biopsy in 1985, and that my FSH levels weren’t a tip-off that I might be having trouble producing eggs. I was angry at Sam’s procrastination, the doctors, and Blue Cross, and angry about prior casual drug use. Had smoking pot or trying acid or snorting speed once or twice affected egg quality? Did tripping while watching Lolita cause some fatal internal mistake?
I had a fragmented embryo inside me, battling to be healthy. There was no water for the dog outside besides what we provided, there was just leftover garbage food—old potatoes—for her to eat. I worked at home and lived at home, so this dog had become my problem.
At band practice, Jessie said that in New York, the notorious rock singer GG Allin slept in her bed, unbeknownst to her. He threw up on the wall and gave her crabs. “I slept with so many junkies I felt death all around me,” she said. I didn’t tell her there was life in me, or so I hoped.
January 31, 2001. I wrote in my journal, I’m one week pregnant. Or more weeks, considering that doctors traditionally count pregnancy from the start date of the last menstrual cycle—conception and implantation being so imprecise for most women.
Two days later, our landlords’ daughter brought the dog, Sunshine, to the sidewalk. The daughter lived next door, and most days I could hear her singing out the window, usually Madonna songs. Now I could hear her yelling, so I opened the front door.
“Speak nicely to the dog,” I said. “Put food in the dish, not next to it. Pet her; she’ll like it.” The daughter’s parents weren’t around, so the girl was talking to me. Usually she ignored me, as her parents must have instructed her to do. She was developmentally disabled. Nice then mean to us, depending on her parents’ whims.
“She loves you,” I said.
“I know.” Yet she yelled at Sunshine like her mom yelled at her.
I walked down the steps and Sunshine tried to sniff my butt.
Later, I bought food for Sunshine and put it in a metal bowl in the back yard. The next day the bowl was gone—I called the landlady to complain.
“I consider this harassment. This is personal. She says she didn’t take your bowl. Do you want me to beat her in front of you?”
My heart was pounding. It’s bad for the baby, I thought. I needed to calm down. I stood outside, feeling her rage. She had the economic muscle, as the landlady, to make our lives miserable. We were too stubborn to move, and our rent was artificially low.
I found the metal bowl, the cause of the fight with my landlords. It had a large dent in the side, this five-dollar bowl. It was buried in the back yard by the woodpile.
On February 5, I was sure I lost the baby. A large chunk of blood fell into the toilet. So that’s how it ends, I thought. The ordeal would begin again. Before the blood, I felt I was going to stay pregnant and have a daughter. Bye, bye, baby.
I woke up at two in the morning and sobbed for an hour, with a quiet racking of my body. I didn’t want the neighbors to hear next door, through the curtains and iron gate. I was frightened that I wouldn’t produce good eggs the next time.
That morning, exhausted, I saw the daughter, outside. She had her belt off in a hitting posture. She was about to beat Sunshine for wandering on Waller Street, when the dog wasn’t even wearing a leash. Then it began to hail. Rain followed, rushing into the gutters, melting the frozen ice.