Vital signs dmb 2, p.3

Vital Signs dmb-2, page 3

 part  #2 of  Dr. Marissa Blumenthal Series


Vital Signs dmb-2

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  Of all the ups and downs of the infertility treatments, this was something Marissa had not anticipated. It was all she could do to keep from kicking in the shower door while Robert finished.

  The dog, sensing her state of mind, ducked under the bed.

  Finally Robert turned off the water and stepped from the stall.

  Drops of water cascaded down his muscular frame. Despite his heavy work schedule, he still managed to exercise three or four times a week. Even his trimness irritated Marissa at the moment.

  She was unpleasantly cognizant of the extra ten pounds she'd put on through the course of her treatment.

  When he saw her standing there, Robert seemed surprised.

  "You're telling me that you won't come with me this morning to give a sperm sample?" she asked, once she knew she had his attention.

  "That's right," Robert said.

  "I was going to tell you last night, but you had a headache. No surprise, lately you always have a headache or a stomachache or some other kind of ache. So I thought I'd spare you. But I'm telling you now. They can unfreeze some sperm from the last time. They told me they froze part of it. Let them use that."

  "After all I've gone through, you won't even come in to the clinic and give up five minutes of your precious time?"

  "Come on, Marissa," Robert said as he toweled off, "You and I both know we're talking about more than five minutes."

  Marissa was beginning to feel more frustrated by Robert than she was by her infertility.

  "I'm the one who's had to put in all the serious time," she said, exploding.

  "And I'm the one who has been pumped full of all these hormones. Sure I've had headaches.

  I've been in a constant state of PMS to produce eggs. And look at all these needle marks on my arms and legs." Marissa pointed to the multiple bruises she had covering her extremities.

  "I've seen them," Robert said without looking.

  "I'm the one who has had to have general anesthesia and laparoscopy and biopsy of my fallopian tubes," Marissa shouted.

  "I'm the one who has had to endure all the physical and mental traumas, all the indignities."

  "Most of the indignities," Robert reminded her, "but not all."

  "I've had to take my temperature every morning for months on end and plot it on that graph before I even get out of bed to pee."

  Robert was in his closet, selecting a suit and an appropriate tie.

  He turned his head toward Marissa, who was blocking the light from the bedroom.

  "You were also the one who doctored the graph with the extra Xs," he said flippantly.

  Marissa fumed.

  "I had to cheat a little so that the doctors at the clinic wouldn't think we weren't trying by not making love often enough. But I never cheated around ovulation time."

  "Making love! Ha!" Robert laughed.

  "We haven't made love since this whole thing started. We don't make love. We don't even have sex. What we do is rut."

  Marissa tried to respond but Robert interrupted her.

  "I can't even remember what lovemaking is like!" he shouted.

  "What used to be pleasurable has been reduced to sex on cue, rutting by rote."

  "Well you haven't been 'rutting' very often," Marissa lashed back.

  "As a performer you've been less than the greatest."

  "Careful," Robert warned, feeling Marissa was getting nasty.

  "Just keep in mind that this rutting is easy for you. All you have to do is play dead while I do all the work."

  "Work? My God," Marissa questioned with disgust.

  Marissa tried to speak again but all she could do was stifle a sob. Robert was right, in a way. With all the fertility therapy, it was hard to feel spontaneous about anything that went on in the bedroom lately. In spite of herself, her eyes welled with tears.

  Seeing that he had hurt her, Robert suddenly softened.

  "I'm sorry," he said, "this hasn't been easy on either of us. Especially you. But I've got to say, it's not been easy on me either. As for today, I really can't make it to the clinic. I have an important meeting with a team of people from Europe. I'm sorry, but my business cannot always be ruled by the whim of the doctors at the Women's Clinic or the vagaries of your menstrual cycle. You didn't tell me until Saturday about this egg retrieval today. I didn't know you were going to give yourself that releasing injection or whatever you call it."

  "We've followed the same schedule as we have on three previous in-vitro fertilization cycles," said Marissa.

  "I didn't think I had to spell it out for you every time."

  "What can I say? When this meeting was scheduled we weren't involved with infertility treatments. I haven't reviewed my entire calendar with your fertilization cycles in mind."

  Marissa suddenly felt angry again. Robert went to the armoire to get a freshly laundered shirt. Above his head Joan Lunden was interviewing a celebrity on the TV screen.

  "All you think about is business," she muttered.

  "You have meetings all the time. Can't you postpone this one for half an hour?"

  "That would be difficult," Robert said.

  "The trouble with you is that business is more important than anything else. I think you have a mixed-up set of values."

  "You are entitled to your opinion," Robert said calmly, trying to avoid another round of mutual recriminations. He pulled on his shirt and started buttoning it. He knew he should remain silent, but Marissa had hit a sore spot.

  "There is nothing inherently wrong with business. It puts food on the table and a roof over our heads. Besides, you knew how I felt about business before we were married. I enjoy it and it's rewarding on many levels."

  "Before we were married you said children were important," Marissa retorted.

  "Now it seems that business comes first."

  Robert stepped over to the mirror and started to put on his tie.

  "That was how I felt before we learned that you couldn't have a child, at least not the normal way." Robert paused. He realized he'd made a mistake. He turned his head to look at his wife. He could tell by her face that the careless comment had not gone unnoticed. He tried to take it back.

  "I mean, before we learned that we couldn't have a child the normal way."

  But his restatement didn't mitigate the blow. In a flash, Marissa's anger dissolved to despair. Tears welled anew and Marissa began to sob.

  Robert tried to put his hand on her shoulder, but she pulled away from him and ran into the bathroom. She tried to shut the door behind her, but Robert pushed his way in and enveloped her in a hug, pressing his face into the crook of her neck.

  Marissa's whole body shook as she wept. It took her a full ten minutes to begin to recover. She knew that she wasn't acting like herself. No doubt the hormones that she'd been taking contributed to her fragile emotional state. But that knowledge didn't help her pull herself together any faster.

  Robert released her long enough to get her a tissue. Choking back new tears, she blew her nose. Now she felt embarrassed on top of her anger and her grief. In a shaky voice she admitted to Robert that she knew she was to blame for their infertility.

  "I don't care if we don't have children," Robert said, hoping to soothe her.

  "It's not the end of the world."

  Marissa eyed him warily.

  "I don't believe you," she said.

  "You've always wanted children. You told me so. And since I know all this is my fault, why don't you be honest about your feelings. I could deal with honesty better than your lying to me.

  Tell me that you're angry."

  "I'm disappointed but I'm not angry," Robert said. He looked at Marissa. Marissa stared back at him.

  "Well, maybe there have been a few moments," he confessed.

  "Look what I've done to your clean shirt," Marissa said.

  Robert glanced down at his chest. There were patches of dampness from Marissa's tears both on his shirt and on his half-tied tie. Robert took a deep breath.
  "It doesn't matter. I'll put on another." He quickly pulled off the shirt and tie and threw them into the laundry basket.

  Gazing at her red and swollen eyes in the mirror, Marissa had a hopeless feeling about the task of making herself presentable.

  She slipped into the shower.

  Fifteen minutes later Marissa felt significantly calmer, as if the hot water and suds had cleansed her mind as well as her body. As she dried her hair, she returned to the bedroom to find Robert just about ready.

  "I'm sorry I got so hysterical," she said.

  "I just can't help it.

  Lately all I ever seem to do is overreact. I shouldn't have gone off the deep end just because you don't feel like going to the clinic for the umpteenth time."

  "I'm the one who should be apologizing," said Robert.

  "I'm sorry for picking such an idiotic way of expressing my frustrations about this whole experience. While you were showering, I changed my mind. I'll come with you to the clinic after all. I already called the office to arrange it."

  For what seemed like the first time in weeks, Marissa felt her spirits rise.

  "Thank you," she said. She was tempted to take Robert in her arms, but something held her back. She wondered if she was afraid he might somehow reject her. She was hardly looking her best. She knew that their relationship had been changing through the course of their infertility therapy. And like her figure, the changes hadn't been for the better. Marissa sighed.

  "Sometimes I think this infertility treatment is just too much to bear, Don't get me wrong; I have no fonder wish than to have our baby. But I've been feeling the stress of it every waking moment of every day. And I know it hasn't been much easier for you."

  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 che
eks, 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.

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