Authors: Elyse Douglas
Rita smiled, understandingly. “Then you should—must—go and be with her.”
I reached for Rita’s arm, took her soft, thin hand. “I’m glad that you asked me. Very honored.”
With a last unhurried glance, she turned and walked noiselessly toward her car.
“Rita!”
She turned.
“I loved your story! I did!”
She gave me a half smile. “It’s not much…”
When Rita drove away, with a little “toot” of the horn, my body loosened and I sank into an intoxicated disappointment.
Chapter Three
Nearly two weeks later, on Friday morning, June 3rd, I left the apartment on 84
th
Street and started up Broadway toward the uptown subway. I looked skyward, seeing a spotted white sky rushing overhead, as if matching the pace below. The humidity was high and I felt its damp breath as I walked.
New York City came alive in small pieces of action. Cab doors opened and slammed shut; keys rattled; sudden footsteps emerged from brownstones and subways, marching to silent drums. Airplanes roared overhead, sounding like the ocean. Feet ran to honking cars and hissing buses. Traffic inched forward in lines of extraordinary stubbornness, cars creeping, straining for advantage; and now and then one would break away, finding the rare loophole and shooting toward the next stop light.
A forceful June sun penetrated the haze and shattered the earth into yellow squares, glinting lines and quivering dots. It flashed off fire escapes and windows, and made shadows stretch across streets.
I passed a wandering beggar with little mumbles on his thin lips; his smelly clothes leaving a foul, trailing scent. A businessman on crutches, clumsily grasping his briefcase, was curbside hailing a cab. Sleepy faces, shut tight to the world, seemed to drift toward newsstands, diners and delis. Prancing teens with predatory eyes moved off toward Amsterdam Avenue, their jerky bodies in helpless rhythm with their musical hormones.
I entered the bagel shop and ordered a toasted pumpernickel with cream cheese, and a small coffee. While it was prepared and bagged, I glanced through the window at a rotund man taking quick snaps at a cheese Danish. His eyes gleamed with pleasure.
I saw stacks of newspapers being tossed from trucks by little stubby men with massive arms, their voices blatant and loud. I stepped around dogs straining on leashes, and a squared-jawed policeman leaning toward a double-parked car, pen and pad poised to punish.
I watched attractive and freshly buffed women striking miraculously straight paths on spiked wobbly heels, heads cocked in cool confidence. I passed a movie theatre and followed rolling red electric titles across the glittering marquee. Through it all, I thought of Rita and wondered if she’d ever seen any of it and, if she had, if she liked it.
I didn’t take a cab. I didn’t want to get to the hospital quickly. I took the uptown number 1 subway at 86
th
and Broadway and stood in an open area at the rear of the car. No one spoke as it went thundering across the tracks. Heads were bowed, eyes fixed on something far away. Newspapers set definite boundaries, headsets piped in tunes, and another soiled man, slumped in the corner seat, slept.
I noticed a young girl, who was about 13 years old. She was blond and pretty, dressed in pink Capri pants and white tank top that had BROADWAY BABY written across her small breasts in bold black letters. There was a little rose tattoo on her upper right arm just below the shoulder. She was texting.
Tomorrow was Darla’s birthday, Saturday, June 4th. I’d counted the days. I’d often stared at the telephone, almost reached for it at least a dozen times, to call Rita, but I hadn’t. I had lain awake nights imagining the horror of losing a child—losing a child that way. An unspeakable horror. Unbearable. A wound that would never heal. I could not imagine it. My mind would shut off. How was Rita coping?
I left the subway and walked along 110
th
Street, turned north on Amsterdam Avenue and headed for St. Luke’s Hospital, where I was on the teaching staff. I made rounds with interns in the morning, and in the afternoon, I saw patients in my office across the street.
I wasn’t ready to go in, so I crossed the street opposite the emergency room entrance, and stood in the garden at the north edge of the Cathedral of St. John the Divine, sipping my coffee and trying to gather my thoughts. Squirrels crept from trees and bushes and begged, flicking bushy tails. I pinched off a piece of the bagel and tossed it toward them. Their delightful agitation entertained me.
I stared at the emergency room entrance and heard a wailing siren approach from downtown. Again, I thought of Rita. There was a great irony about it all. Rita had lost a child. Nicole and I would, probably, never be able to have a child—not naturally anyway: I was infertile. Not sterile, the difference being that my testicles did produce some sperm. Unfortunately, those sperm, what there was of them, were weak swimmers. They were “dumb” sperm. Very low IQ. They died quickly. I’d often pictured them inside the boat of Nicole’s body, like dying fish, hauled from the sea in great sweeping nets, flopping, writhing and gasping for life on the vessel floor, wide-eyed and panicked.
Nicole and I had discussed having children before we were married.
“I don’t want any children right away,” she’d said. “In a few years, after I’ve made partner. Then let’s have at least two.”
Less than a year later, she’d changed her mind and we met the cycles, enthusiastically, adding creative romance and humor. We failed. Then came the tests. My sperm count was less than 20 million per ml, which meant “the patient is infertile” or more correctly, “subfertile.” The medical term “OLIGO” means few. Therefore, oligospermia is the presence of fewer than the normal number of sperm in semen.
Reproduction is a normal human function that is absolutely necessary for the survival of the human species. Therefore, infertility is abnormal and it must have a cause. So I was tested for a pituitary tumor and testicular cancer. The tests came out negative. Then I learned that the most common cause of male infertility is varicocele, a term I’d learned about in medical school, but hadn’t thought about since. So I was tested for an abnormal dilation of the pampiniform plexus of the internal spermatic vein, and was informed by my doctor that this condition is frequently a contributing factor in male subfertility. Nicole and I were hopeful. Again, negative. Mine was normal.
The last specialist diagnosed me with nonobstructive azoospermia: lack of sperm. The spermatozoa are absent; there is something wrong with the productive organ that produces them. Dr. Harold R. Long had also gone to Harvard and, although he was 15 years older than I, we reminisced, joked and discussed the current medical crisis, before getting down to “business.”
“Alan,” he finally said to me, after a long calculated pause. “I’m sure you know that infertility is a problem for both you and your wife. It’s a ‘couple’ problem. Would you like to wait until Nicole’s here to discuss the options?”
I writhed uncomfortably. “No...”
Dr. Long cleared his throat. “Well, Alan, patients with nonobstructive azoospermia can be successfully treated by what is called Intracytoplasmic sperm injection, or ICSI. It is a technique performed as part of an in vitro fertilization cycle. Simply put, it involves the injection of a single sperm into each oocyte, in vitro, during an in vitro fertilization cycle.”
I felt my eyes glaze over. His words seemed to bounce off my ears and shoot off into the ether.
I felt the rise of a sickening disgust; the foul stench of failure. I did not want to hear what I already knew. Modern medicine had made the infertility business really rather simple—especially if you had the money—and Nicole and I had the money.
You want a child and you’re infertile? No problem. Try artificial insemination. It’s a simple procedure that involves injecting a sample of specially treated sperm from the male partner into the female partner’s reproductive tract. It’s performed with the husband’s sperm, unless, of course, the husband’s ejaculate has few or no live sperm. In that case, donor sperm insemination is a possibility. (For me that was out of the question and, knowing Nicole as I knew her, she would not consider it either.)
What about Intrauterine insemination (IUI)? Again, no problem. The sperm bypasses the cervix without encountering “hostile” cervical mucus which acts like a barrier to the sperm. Whenever I thought of this, a comical image of Nicole swiftly arose. She is dressed as
Brünnhilde
, from Wagner’s opera “Siegfried.” She is bedecked in a horned Viking helmet, chain mail and sword, gripping a formidable golden shield. She charges forward, sword and shield thrust high, poised for combat, as the helicopters from
Apocalypse Now
sweep overhead and
Ride of the Valkyries
thunders in my ears.
But then, my little comic opera chimera ends, my head clears and I refocus on the IUI procedure. IUI places the strongest sperm into the female genital tract to increase the odds that one of those charging sperm will fertilize an egg. The procedure is relatively quick and simple. It takes place in the clinic office. It usually causes little discomfort.
If these don’t work, then try in vitro fertilization. It’s more invasive than IUI, but the advantage is that it allows the physician to evaluate whether or not fertilization has taken place. IV fertilization can be confirmed since it takes place outside the body, in a laboratory.
I knew about these options. I’d discussed them with trusted doctor friends, some of which I’d gone to medical school with.
“It’s no big deal, Alan,” most said.
However, Marvin Addison, from Topeka, Kansas, who seldom smiled, drew caricatures of his patients and had the bedside manner of an old hound dog, had a different approach. He’d become an OBGYN, with an office on Park Avenue. He’d said, “I’ve seen this kind of thing fuck up marriages, Alan. Big time. Is Nicole committed? Are you? What happens if nothing works, huh? Then what?”
I left Dr. Long’s office coming to grips with the fact that something so basic to life as being able to produce life, was closed to me. I felt like I had failed the course “Man 101.”
I brooded for days. Became desperate. I finally swallowed my pride and secretly went to a Chinese doctor in Chinatown, Dr. Wong.
His shop was old, close, dimly lit and filled from the floor to ceiling with wooden file boxes that contained musty herbs and moldy spices. He wore a frumpy brown suit and tie, and often ran a shaky hand over his smooth bald head as he shuffled about the place, mumbling, squinting and nodding.
“Yeah, yeah… Burdock Root for you,” he said in broken English. I later learned it was also called Arctium minus. It is an ugly weed that grows profusely on the East Coast and in the Midwest.
Dr. Wong added, “Burdock good for impotence and sterility. Yeah, yeah. I also give you Yohimbe Bark. Good for erection. Good for impotence. Yeah. Use with caution.”
“Caution?”
“Yeah!” he coughed out. “Easy. Go easy. Good for impotence, but go easy.”
He handed me two folded brown paper bags filled with the stuff. I sniffed at them cautiously. “Have you had success with this?”
“Success yes! Good success. Yes. Good aphrodisiac, also. Start running. Build up body. Get stronger. You’ll have kid. Yeah, do it.”
It was ineffective. My sperm count did not improve. Nicole did not get pregnant. We put off the discussion of IUI and IVF. They weren’t “natural”; they involved time and commitment; they involved a change of consciousness; a recognition and admission of failure.
The word “natural” began slipping into our conversation in surprising ways.
“Disappointment is natural, Alan,” Nicole said, staring blankly, one morning at breakfast. “Especially when we’re both so healthy and young.”
At the ballet one night, I said, “It’s just not natural that they can dance that way.”
Walking in Riverside Park one Sunday Nicole said, “Nature always finds a way to keep itself going, doesn’t it? It just so natural for things to grow and blossom. Nature doesn’t need any help from us at all.”
At the Farmers Market on Thursdays, near Columbia University, the woman I bought wax beans, strawberries and fresh basil from said, “They’re all natural. I don’t use pesticides. Natural is best.”
Cracks began to form in our relationship: quiet indifferences, and then exaggerated concern when we realized them, and then forced humor, stunning contrivances and wise but cynical conversation.
One week-end at Great Diamond Island, Maine, Nicole and I stayed with friends who were political opposites: Bob, a conservative Republican who taught political science, and, Melinda, a liberal Democrat and gifted photographer.
We sat on their second story deck looking out on the quiet bay, sipping wine and breathing in the freshening air. Bob gave us a brief history of the island, and then waved to some young kids on bikes, who pedaled by on the narrow street below.
There was a lull in the conversation.
“It’s all about kids, isn’t it?” Nicole said.
Her comment struck like a hammer. We all knew of her flagrant sensitivity on the subject of children. I stared at her, confused. We waited, calculating our responses.
“Kids?” Bob asked, studying the wine bottle. His short hair was graying; his quick intelligent eyes always exploring.