Non fiction

Unborn

Most people hate their tumours. They hate the invasion, the corrosion, the unwarranted terrorism. I bonded with mine. I read to it, stroked it, took it swimming and wondered if it felt weightless in the water. I murmured words of encouragement; sang to it, dreamed about it. I imagined what it would look like, wondered how it would turn out. I learnt to knit and forced myself to eat my greens because I wanted it to grow healthily. I started a spreadsheet for the costs.

I wasn’t insane; I didn’t have a death wish. I had experienced more of cancer in my quarter century than most people do in a lifetime. But I thought my tumour was a baby.

*

‘Two lines, Johnny, we’ve got two lines! La laa la la laa, we’re going to have a baby, we’re going to have a baby!’

We got married in May, John and I. My doctor had already made me promise that I would come off the combined contraceptive pill as soon as I had captured acne-free wedding photos. I had been having migraines, a pill-related risk factor for blood clots and strokes. We used condoms for a month while I perused leaflets on my contraceptive options. There was a wide variety of chemical cocktails available to suppress my fertility––that modern female illness. Never mind that the reproductive system isn’t a stand-alone area of anatomy, but instead interacts with over 150 different physiological systems. I began to get disillusioned with my options.

‘Why not try for a baby? We’re married, aren’t we? Besides, they say it takes six months to properly come off the pill and it can take two years to conceive. Two and a half years is a long time, when you think about it, Johnny. Nothing to lose by trying.’

I didn’t mention how many friends I knew who had got pregnant as soon as they came off the pill. We fell that first month.

*

Marco enters a city; he sees someone in a square living a life or an instant that could be his; he could now be in that man’s place, if he had stopped in time, long ago; or if, long ago, at a crossroads, instead of taking one road he had taken the opposite one… he must go on to another city, where another of his pasts awaits him, or something perhaps that had been a possible future of his and is now someone else’s present. Futures not achieved are only branches of the past: dead branches.[1]

(Italo Calvino, Invisible Cities)

*

‘I can’t find a heartbeat, love. I’m sorry. It looks like you’ve had a miscarriage. It’s strange though, all the pregnancy sac is there… I just can’t find a heart.’

Miscarriage. Surely there had been some mistake. I willed the sonographer to keep looking, to keep probing deeper until she could see the flutter of a tiny heart beating twice as fast as mine. I knew it must be there. The clicking of the sonographer’s mouse was the only sound in the room; a monotonous metronome marking the moment our short-lived hopes died. The nurse patted my arm. I tried to say something, to question what I was being asked to accept, but all I could manage was a croak. The pats turned into a squeeze. I couldn’t see John’s face; he was sitting behind me. The dim room took on a funereal air, the nurse and sonographer conversing in hushed tones as I cleaned myself up. A routine blood test and some miscarriage leaflets later and we were ushered out into the sunshine.

‘Hello is that Mrs Whitell? Sorry it’s late. I’m calling from the Royal Hallamshire––you came in earlier today for a scan. I’ve got the results of your blood test and the scan in front of me and I’m afraid you’re going to need to come in first thing in the morning for emergency surgery. If you’d like to make your way to ward G1 for 8:30am, nil by mouth of course, and we can explain everything then. I’d rather not go into it over the phone… we will explain more fully in the morning.’

*

My Dad came over from Italy, where he lives, to celebrate his 50th birthday. It seemed the obvious time to share the news, with all the family gathered, glasses full for toasting. I was only five weeks pregnant at that point. Some people prefer not to tell anyone until the fabled twelve week-scan––the end of the vulnerable first trimester. It’s become something of a superstition: ‘Nooo, you can’t tell me yet, it’s not twelve weeks; you’ll tempt fate!’ Does it really make any difference? At twelve weeks I was a mere three days away from an unstoppable haemorrhage that would land me in Weston Park Cancer Hospital, waiting to start chemotherapy. If we hadn’t told people, would it have changed anything? Would we have only shared good news and kept the cancer to ourselves?

*

I’m always surprised to find men in areas of medicine unique to the female body. I don’t know why. I don’t expect cardiologists to have heart disease or urologists to know what renal failure feels like––though they do have hearts and kidneys. The doctor who told my 16-year old best friend that her symptoms were ‘just normal period pains’ was male. She had ovarian cancer and died a few years later. How could he have known what normal period pains were supposed to feel like?

Perhaps male gynaecologists and obstetricians can offer a professional sympathy rather than empathy. Perhaps gender has nothing to do with it. My male gynaecological surgeon was very kind. He made a point of asking me first if I minded the stream of medical students and junior doctors, before he let them in the room. They all wanted to see what a medical rarity looked like.

*

‘Oh love, I am so pleased! So excited! Are you feeling sick yet? Keep a stash of crackers or dry biscuits with you; they’ll see you right.’

My Mum was beside herself with excitement. This was her first grandchild, a moment she had been dreaming of for a long time. As a primary school teacher, she had worked with children most of her life. It’s in her nature, being good with children. I wondered if it was in mine, if it was a genetic trait that could be passed on. If not, then the alternative was to trust that chance and circumstance had moulded me into a woman suitable to be entrusted with little lives. Perhaps it was a combination of the two: the predetermination of my genes mixed with the quality of my upbringing. Both elements were out of my control, combining to impact on my future children’s characters and lives, and eventually, in turn, on theirs.

I told my Mum over the phone as I wanted her to be the first to know. Getting her to promise not to talk to anyone about it, even for one day, was exceptionally difficult. When I saw her a couple of weeks later she pressed a plastic bag into my hands, quivering with emotion. Curious, I opened it and drew out an intricately detailed lace shawl. It smelt familiar, a salt-fresh and clean scent that had been stowed away in childhood memories. My Mum rushed to explain its significance, how my Gran had knitted it for my older brother when he had been born. It was almost a talisman of what it meant to be a woman in my family. I took it with reverence and superstition, carefully stowing it away for the day when I would need it, still more than seven months away.

Six months later, my Mum asked for it back, to give to my brother’s new girlfriend who found herself pregnant. Perhaps it was childish––ungracious, even––but I refused. The reassuring smell was beginning to fade by that point.

*

‘Is there any chance there’s a baby there?’

‘No, none, I’m afraid. There’s no foetal viability with a molar pregnancy. Essentially, your placenta has grown out of control and become a tumour. Surgery is the only option. In very small number of cases, chemotherapy can be required as well.’

I had an abortion. In essence that’s what the surgery was, though slightly more complicated. I spent an hour in recovery away from my husband and parents-in-law. I hadn’t been able to get in touch with my Mum; her phone just kept ringing. I allowed myself to cry in that dreary room, telling myself it was because of the pain. A nurse sat with me for a while, holding my hand and wiping my tears while my arms still felt too heavy to move. Did she know why I was there––why I’d had an abortion? I wanted to defend myself to her, as if she had the power to absolve me: ‘I wanted my baby, they took her away, I wanted her, believe me, forgive me…’ I should have fought harder to keep her. I entertained myself with fantasies of a braver me jumping up from the trolley that wheeled me down to theatre and running out into the sunset, gown flapping open, not a care for dignity, doing something, anything, to protect my unborn child. The cowardly me––the real me––had simply conceded to the supremacy of medicine, meekly following its orders.

*

‘Hope everything goes well––don’t get too excited––I can tell you from experience the downs are very down if things don’t work out! But I’m sure everything will be fine. Just look after yourself––take lots of exercise and do yoga––apparently it's good for you!’

I only bothered to tell one Auntie, my Auntie Mel. She still calls me by my inexplicable childhood nickname: Boo-Anna, or Boo for short. It’s a name that fell out of use at home when my older brother reached puberty and started hissing ‘―bs’ every time someone called me Boo, winding my ten-year old self up so much that the name was banned. My Auntie Mel––still allowed to call me Boo––lives with my Uncle Dave in a duplex flat in North London. When we were kids I used to love going to London, the city full of mile-high escalators, open-top buses and waxwork figures. It’s my last remaining childhood home; the rest claimed by divorce, old age and destitution.

They don’t have any children. I donated some of my eggs to her when she was going through IVF. She wouldn’t accept them at first, but I insisted. I worked out the number of eggs that they would take––around fifteen––reasoning that I wouldn’t need them at that stage of my life anyway. If they didn’t go to her, they would only be flushed away each month. This was one of the first questions I asked my gynaecologist: was my molar pregnancy caused by the egg donation procedure? Was that where it all began? He was quick to answer no, to reassure me that it was a freak and rare occurrence. There’s no reason for it, he told me; they’re not sure why it happens.

*

‘Ellie, be careful! Don’t climb all over her, she’s not feeling very well.’

Not long after the operation John and I went to stay with his family in Rugby. Everyone gathered round for Saturday lunch. Quick squeezes or pats on my shoulder were emotion enough for an English family. I couldn’t meet their eyes. I focused instead on staring at the natural patterns of the wooden table––spidery lifelines like a rebellious ECG––wondering where their paths began and ended. My five-year old niece clambered up onto my lap at the dinner table, wriggling into a comfortable position. The sudden impact of pressure against that painful epicentre of my femininity made me exhale audibly. A shard of ache detached from my womb, shot up my abdomen and settled in my solar plexus. I pressed my cheek to the top of her head. She smelt of grass and watermelon bubble bath.

The next day we went to a child-friendly restaurant, so the kids could let loose in the soft-play area while the adults ate and chatted. Five steps out of the car and I could tell something wasn’t right. I unhooked myself from John’s arm and escaped to the toilets, sitting down on the dirty lid while the cubicle around me grew whiter and whiter. I pressed my arms to the walls, trying to locate myself in reality. Someone was breathing heavily; it distracted me from my efforts to not let normality slide from my fading vision until I realised it was me breathing like that. I was swallowing huge gulps of air as though I had grown gills. As my vision began to clear I found myself staring at the filthy underside of the toilet. Some last-resort biological instinct screamed at me to get some sugar and something to drink. Obediently, I clawed my way up the cubicle wall to my feet and staggered out to the bar, gasping for Coke.

*

A couple of weeks after we found out I was pregnant, I talked John into a trip to Mothercare. I sold it to him as a fact-finding reconnaissance mission, but really I wanted to undergo the rite of passage into the world of cute teddy bears and miniature clothes. I’d previously only been able to snatch glimpses of this faery kingdom by walking past the brightly lit windows, or nipping in to buy a present for a friend. Expectant or actual parents must pulse with some sort of ‘genuine parent’ phosphorescence so the guardian shop assistants know who to smile at. They just know when you don’t belong.

Every item seemed to shimmer as though spun by Rumpelstiltskin himself, or perhaps by the Borrowers on tiny, replica looms. As I fingered the soft downiness of bedspreads and baby grows, I remembered a childhood fear: I had always believed that I was infertile, ever since I was old enough to comprehend my own womanhood. As a young girl, when daydreaming of the future, I never saw myself with babies––young children, toddlers, yes, but never new-borns. I believed this so strongly that I had conveyed it to John before we got married, just in case he wanted to back out. He paid no attention to my woman’s intuition.

Which came first, the river or the ocean?

*

The chances of having a molar pregnancy are rare, only 1 in 12,000. Although we are born with 1 million ova and have 300,000 remaining at puberty, a woman will only release 300–400 over her reproductive lifetime. The rest simply degenerate.

It was early October, almost a month since my surgery. John was working a late shift that evening and I had two friends keeping me company: Diana and Helen. I was glad it was those two; both had science backgrounds and weren’t squeamish. I had been swimming earlier in the evening for the first time since the operation. Perhaps that had an affect; the inertia of fluid outside my womb at odds with the fluid within. I had also visited a seriously ill friend in hospital earlier that day––perhaps that acted as a portent––or perpetrator––of coming disaster. Perhaps I was just grasping at something or somewhere to lay the blame.

We lounged about on the sofa, drinking wine and gossiping away. On the table behind me was a letter, half-forgotten, that I had received earlier that day from the gestational trophoblastic disease team at Weston Park Cancer Hospital who were following me up after my operation:

We received your recent urine sample and have detected a rise in your HCG levels. While this may be nothing to worry about, we would like to keep a closer eye on you over the next few weeks and would appreciate it if you could send in another urine sample, in the enclosed test tube, as soon as possible.

I gave a sudden spurt of laughter at something in the conversation and that’s when I felt it. A sharp stab of pain in my lower abdomen and the sensation that I’d started my period. Saying nothing to the girls, I hurried to the toilet and as I sat down a surge of blood gushed out of me, dragging with it great jelly-like polyps of tissue, like debris, into the water. I began to panic as the bleeding didn’t stop. I managed to catch some of the lumpy masses in a wedge of tissue and wrestle on a super-size sanitary towel left over from my post-operative pack.

Back in the living room, shaking, I showed my friends my bloody specimen. They were concerned but calm, pulling me back into my usual efficient problem-solving frame of mind. I quickly dialled the number on the letter and spoke to the on-duty doctor. She told me I needed to be admitted so they could monitor my blood loss.

Why didn’t my empty egg break down? Surely it wasn’t as stable as the rest; the degenerative process must act like an evolutionary sieve––only the strongest eggs survive. Was it the only vacant ovum in there? if we had chosen to get pregnant the next month, would everything have happened differently?

*

‘Don’t worry, if you do have to go on to chemotherapy, this is the best cancer there is––the one you want to get.’

Diana drove me to Weston Park, while Helen went to pick John up from work. It was 9:30pm by the time we approached the hospital. Diana was panicking about where to park––it’s a notoriously busy area of the city congested with hospitals. She chose the first spot we found, a ten-minute uphill walk from Weston Park. I wasn’t in a state of mind to question her choice, or to point out that the car park was bound to be empty at this time of night. We walked up to the main entrance, Diana alternatively pacing on ahead, then walking back to where I was slowly and steadily moving along––legs bowed outwards like a novice cowboy. She stopped short of the door and I remembered the last time she was in a hospital was to see her dead father laid out. I felt a warm rush of gratitude towards her, and I threaded my arm through hers so we could both lead each other inside.

There’s something eerie about hospitals at night, especially non-emergency hospitals. Dimmed corridors lend ghostly shadows to empty wheelchairs, while nurses’ whispers sound like shades murmuring to one another. We wound our way to Ward Two and reported to the nurses’ station, as instructed. A round of observations later and I was hooked up to IV fluids, my blood pressure dangerously low. The doctor came to talk through blood transfusions with me, but I didn’t want one unless it was absolutely necessary. I knew that you couldn’t donate blood if you’d had a transfusion, and as a regular donor I wanted to be able to continue. I didn’t know then after chemotherapy you can’t donate anyway.

Soon enough John and Helen joined us, and the four of us settled down to a game of cards. Everyone was joking and messing about, following my lead as I bantered away. The artificial hospital lights had drained the colour from John’s cheeks, giving him a paleness that was in contrast to his upbeat manner. Through the paper-thin curtains I could hear the nurses talking to the only other occupant of the ward, an immunocompromised woman on chemotherapy who had been rushed in needing immediate IV antibiotics.

*

Later on that night––long after John, Helen and Diana had been asked to leave and after a nurse had woken me up to check my blood pressure––I lay awake in my starchy bed listening to the inhale and exhale of my foam mattress as I moved from left to right. In my semi-sleep deprived state, alone, I turned over the events of the day in my mind. I knew what it meant to end up in the cancer hospital. I knew, even though they said they just wanted to observe me for a few days that I was headed for chemotherapy. What I didn’t know––what I couldn’t have known––is how pronounced an effect on my life chemotherapy would have.

I started my first round of chemo on Monday 10th October, 2011.

Amy Whitell

© 2014