I Keep Telling Myself, Nie Mój Cyrk, Nie Moje Małpy

I Keep Telling Myself, Nie Mój Cyrk, Nie Moje Małpy

Not my circus, not my monkeys.

 I stopped reading the Love & Sex section of The Guardian, for obvious reasons. Today, however, a piece caught my eye. Women and Desire: The Six Ages of Sex. I scrolled down to the woman in her 40s, started reading, and rolled my eyes. She’s 41. The only thing that kept me from laughing out loud is that I am at work, on a national holiday, when most people I know are off. This is a metaphor for my sex life right now. While most people I know are married or hooking up or consciously abstaining from sex I am removed from it. Anyway, like most stories, she was divorced in her 30s remarried and now that she is in her “forties” she is a mother having spectacular sex with her second husband. I wondered if she would be so cheery were she in my situation; divorced at 46 surrounded by married couples and younger single women and nearly invisible because, “The last thing most divorced men want is women of the same age, education and outlook. You protest: this is unfair. I can only tell you of my own experience, which is that mid-life men have high expectations, a situation exacerbated by being outnumbered three to one by women.”

My situation is closer to that of Stella Grey, the author of The Guardian’s Midlife Ex-Wife Column. She confirmed what I already suspected about love, sex, and online dating. In 2014, when she started the column, she was 50. She tried online dating for 693 days before her last first date. I’m about ready to give up before I even try. I have a knack for attracting deeply sexist men who are drawn to my strength then try and hold me down. Single men here are outnumbered 12:10. Take a room and let in one hundred men. Now let in one hundred and twenty women. You get the idea. Some of us go home alone.  I scrolled down tempted to make a comment, but found someone had made it for me.

“Yes, that was my thought too. I read ’41’ and may have audibly snorted.”

This was a response to a post by someone who argued that 49 is very different from 41. Like any woman in her 40s I would say that is true to a point. But, in my case, not in the way the commentator may have intended. At 41, I would never have dreamed of completing a marathon, running, keeping up with women and men over half my age in yoga and Pilates classes. Physically, I’m in the best shape since college. I own my home. I’m managing my finances. I have great friends-near and far. My sense of humour has returned. My life if infinitely better than it was six years ago, better than it was two years ago. That doesn’t mean my life is perfect nor does it mean that my life isn’t hard. No matter how many friends I have, in the end I am still alone. I have to fend for myself. I have to catch me when I fall.

In 2011, I was 41. We were living in a 600 square foot apartment about as far out in Philadelphia as one could be and still be within city limits. I was paying all of the bills, doing all of the chores, taking high-powered injectable fertility drugs trying to get pregnant, working full time, and dealing with my increasingly unstable husband. My ex would encourage me to go get more exercise but would saddle me with all of the household duties. I was working full-time and doing everything else and he would sit and play video games and wonder why I was so tired all the time. We did everything together. My friends were his friends. His interests were my interests. I stopped having things that were mine. When my camera broke it didn’t get replaced. When he needed things, he got them. He put his needs before mine and I let him. There was no escaping. As I sit here now, I almost typed not that I ever thought of escaping. This is when I started to think about, not just dream of escaping.

Deep down, I knew the injectable drugs were not going to work. I knew the numbers we were being told at the fertility clinic were inflated. We were given numbers like 50% success when the reality was significantly lower, closer to 23%. What I did not count on were his roller coaster moods. I had to be the steady one. He took my steadiness for callous indifference. Since he was falling apart, I had to keep it together and he resented me for it. I don’t know if it was a calculated maneuver on his part but I had no time for me. I couldn’t even think of me. We did everything together. My being alone was dangerous. He hated being alone more than being with me. So long as I was around his basic needs were being met. In the scheme of things, it is better to be wanted than needed. Wants change, but we resent those we need.

And now he needs someone else. I’ve already mentioned that his girlfriend is around seven months pregnant. What I have learned in the interim is that the house, I bought it and sold it to him when we split, is on the market. There were three bids on the first day, something I attribute to my superior taste and judgment. Last I heard it is down to two. I found this out when one of my friends saw me at dinner and said, I think I have a small sense of what it was like to be married to your ex. He went on to tell me how my ex-husband asked them to witness and sign some real estate documents in front of a notary. True to form, he had not bothered to find a notary and proceeded to have a “meltdown”, a “temper tantrum” when finding one proved difficult. My friend said, it was like dealing with a five-year old. To make matters worse, and also true to form, when he got what he wanted he abandoned them at the bank. I was mortified. My friend was right, he was describing the last three-to-five years of our marriage. The differences were that when we were together I did the legwork to keep the tantrums to a minimum and when he had meltdowns I was the one left to clean up the mess and mend the fences. It was never enough. He hasn’t changed. He hasn’t grown. It hasn’t been necessary.

But there’s something else and this is what surprises our friends the most. They’re still not married. Personally, it is nothing but a curiosity to me. Perhaps, both being divorced, neither has any interest in marrying. I can certainly understand. I have no interest in marrying again. Here is a man who had a definite trajectory for our relationship-courtship, marriage, children, career (his career), retirement, death. Yet, this time he has skipped a step or two.  He is still working as a scientific consultant but who knows if he and his collaborators will continue to get grant funding. Perhaps, like many things, he planned but did not think they would be so successful so soon. That, I think, was part of the episode with my friends. He knew the house would sell, just not so soon and he has no contingency plan. He knew she would get pregnant, maybe just not so soon. She got pregnant right after she moved in, if my math is correct. All of this is converging now and, as usual, he has no back-up plan. He has been working his entire life without a net. Someone, be it his parents or me, has been there to catch him when he fell and make him look good. I wouldn’t be the least bit surprised if his parents or her parents are there to catch them. Maybe they will live with her parents until they find a place to live? Who knows. Not my circus, not my monkeys. I have my own monkeys-like the recurrence of a benign brain tumour.

I watch all of this with a certain wonder. Sometimes I wonder why I spend so much time and mental energy on someone I no longer love and have no desire to be with. I don’t wish him ill but that doesn’t mean I wish him well. I want him to learn something, to have learned something, but it looks like he hasn’t. Someone else will be there to pick up the pieces for him.

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Getting Up and Going Home

Getting Up and Going Home

There has been some heavy reading in the press of late. Rachel Cusk of the New York Times reviewed two books on assisted reproduction. Earlier this month Jennifer Senior, also writing for the Times, reviewed The Art of Waiting. In the review, Ms. Simon writes the following.

“I thought quite a lot about what normal is and isn’t as I was reading “The Art of Waiting: On Fertility, Medicine, and Motherhood,” Belle Boggs’s thoughtful meditation on childlessness, childbearing, and — for some — the stretch of liminal agony in between. Her book is a corrective and a tonic, a primer and a dispeller of myths. It is likely to become a go-to guide for the many couples who discover that having children is not the no-assembly-required experience they were expecting. They will come away enlightened, reassured and comforted by her debunker mentality.”

I have to agree with Ms. Simon’s assessment, but for a reason she does not state here. You see, the author and her husband were successful. I doubt very much that anyone would recommend a book so wholeheartedly to anyone, single or married, going through this process had the protagonists not been successful. I doubt the other book, Avalanche: A Love Story, will be held up as a corrective, tonic, or primer. Cusk describes Avalanche as, “a harrowing and profoundly disturbing account of self-immolation in pursuit of an ideal, for what Leigh has failed to recognize about ‘creative life’ is that it too seeks to concretize the ineffable, and that it arises in people of a single-mindedness and determination so strong it can destroy them.” After years of trying, love, sex, trust, compassion, solidarity disappeared. The author’s marriage failed. She continues her pursuit alone. I did not. As I have said before, I did not feel the insatiable hunger for a child that many without experience. When it was over, I wondered where the love, trust, compassion, solidarity, the friendship went. Now I know. What’s worse, I went to being a person to a vessel to a non-entity. I am still struggling to overcome my erasure.

Having been through this process, I read these reviews to compare notes. I get everything I need from the reviews, so I don’t need to read the books. I know about the rituals, the infantilization of language (follies? embies? baby bump?), the seemingly endless menu of choices, the statistics (most of them inflated, in my experience) my ex would have understood the not knowing when to stop because he didn’t. I didn’t and don’t understand the not knowing when to stop, but then again it was my body and later another woman’s body who were undergoing these treatments. This is where most women who undertake this journey and I differ, and I wonder if they experienced the same clinic fatigue as I. Our clinic got tired of dealing with us because we were difficult clients and because we were failures. I also don’t think they knew what to do when the man, not the woman, has rampant babyfever. I was never desperate to be a mother, much less a biological one. Most of my friends are on that path now, or are about to embark on that path. It’s the largest not-so-secret club in the world. As a non-parent, I know a surprising amount about the rituals of parenthood simply because my parent friends speak so openly and freely about playdates, birthday parties, mommy boards, and mommy bloggers. I have nothing to say on the subject except to allow my friends who are mothers to vent about the ridiculous standards to which they are held. Of all of my friends who have children, none of them had to resort to IUI or IVF, and only one so far has had a hysterosalpingiogram. She told me about how much it hurt because she knew I’d understand. I don’t talk much about my experience because there’s no one to tell, really. No one wants to hear what I have to say.

These patterns are recurring in other aspects of my life. No one wants to talk about my failed marriage, except my therapist. No one wants to talk about the abuse, except my therapist. No one wants to hear about the loneliness because either they can’t relate or they worry that mine mirrors their own. I think I’m tired of talking about this, but I’m stuck and I can’t move. I’m bound by my own anger and I can’t find the end of the rope to untangle myself. Nothing I did was right in my marriage and I can’t even grieve properly. I want to scream and kick things, but there is nowhere to scream and nothing to kick.

Blessed Be My Ability to Define Myself

Blessed Be My Ability to Define Myself

Blessed be my brain – that I may conceive my own power
Blessed be my breast–that I may give sustenance to those I love.
Blessed by my womb–that I may choose to create what I choose to create.
Blessed be my knees–that I may bend so as not to break.
Blessed be my feet — that I may walk in the path of my highest will.” -Robin Morgan

I hate that poem mostly because the poet has fallen back on the motherhood standard to define woman. If that’s how she defines herself that’s one thing. A noted composer set this poem to music for the choir in which I sing. I resent it every time we sing.

After a blissful Saturday in New York which held me over for a couple of days, I came crashing back to Earth on Tuesday evening. They were an ordinary couple. He was lightly tanned, immaculately groomed, greying at the temples. She was lightly tanned, immaculately groomed, and pregnant. He looked like he was my age. She looked like she was around the age of my ex-husband’s girlfriend. After that it seemed like I could not escape women talking about how tough their pussies were. The example most of them invariably used was childbirth. A friend of mine bragged about how her pussy could take a pounding going in and coming out. She talked about the size of her son’s head at birth. In “Hit Like a Pussy” the author also uses the birth of her daughter as proof of the strength of her vagina.  To her credit, the author does state that, “I would never equate reproductive status with womanhood, because, just, no. Nor would I ever diminish the ways of becoming a mother that don’t involve pushing a human person through a vagina. So let’s put birth aside for a moment, because pussies are intended to do all kinds of things—primarily whatever their owners choose to do with them.” But it’s already too late. In “putting birth aside for a moment” she has already established the standard by which all other experiences will be judged. The same with the Village Voice review of Ali Wong’s Baby Cobra. Ms. Wong talks about wearing, “a frozen diaper because her pussy needs to heal from the baby’s head shredding it up.” Pregnancy and birth are the standard. Surgical instruments shredded my vagina and uterus. I used pads soaked in witch hazel on my vulva. I found out about that remedy myself. No one told me. I was sent home. Better luck next time.

The first surgery, a myomectomy, happened when I was 29. I don’t like to say I had my first surgery because it makes it sound like I elected to have surgery. I did not “choose to create” the tumours that invaded my uterus. When you read the literature on fibroids, writers can be a little cavalier. They are the most common benign tumour of the pelvis in women (Tintinalli’s Emergency Medicine) . Around 25% or white women and 50% of black women have fibroids during their reproductive years. Somewhere in the first paragraph you will see “Leiomyomas decrease in size during menopause,…” and “Most fibroids/myomas/leiomyomas are asymptomatic.” (Tintinalli’s Emergency Medicine, Williams Obstetrics, Current Medical Diagnosis & Treatment). Given their ubiquity, their general lack of symptoms, and the fact that they all but disappear after menopause it’s no wonder that medicine can be a little nonchalant even when someone who is symptomatic, like I was, comes through the door. I have heard all three of those facts from just about every physician I have seen. And my answer has always been, I am symptomatic. I am 30 years away from menopause. Watchful waiting is not acceptable. I have had my share of the caring and the cavalier over the course of my treatment.  The first surgery removed three small tumours.

After my first surgery, my gyn left her private practice and went into public health. I hunted around for another doctor and eventually found one. Symptoms were back with a vengeance within a couple of years: severe pain, bleeding through tampons/pads and clothes, pressure, bloating. She used real estate as an analogy for my suffering-location, location, location-put me on a progesterone-only mini pill and stopped taking my calls. I was suffering from morning-sickness like symptoms that lasted through lunch and my periods lasted three weeks out of four. Frustrated, I made an appointment with another gynecologist. Several ultrasounds later, I say several because I had at least two transvaginal ultrasounds that I can recall and I don’t know how many other ultrasounds, she found another two tumours and referred me to a surgeon who had an office upstairs. he looked at the ultrasound results and did a couple of his own and determined it would be a quick surgery-removing no more than three tumours, maybe four. When I came to in the recovery room he was there waiting for me. I removed 25, he said. That’s a lot, I slurred. Yes, it is, he replied and left. Later at the follow-up appoinrment I asked how the surgery went. It was tedious, like plucking grapes, he said. Would you rather have tedium or excitement in the OR, I asked? Give me tedium any day, he replied. I was 34 years old.

The symptoms returned when we were living in the intermountain west. Time and again, I got in the car for the two-hour drive to Spokane to see the gynecologist. The latest ultrasounds showed one tumour that was about the size of an orange holding court at the top of my uterus. It needs to come out, he said. The tumour? Of course, I replied. No, the uterus, he sighed. I hope you don’t mind, but I’m going to get a second opinion, I told him. I emailed copies of my films to my surgeon back in New York, who emailed me back the next day and said, if you can get here I will operate. I flew back in the fall. The pre-surgical consultation in his office was unforgettable. Marty the surgeon and his surgical resident hovered over my naked body as he proceeded to explain how they were going to “slice me open, yank the uterus through the muscle tissue, pop the top off, take out the tumour, sew me up, tuck me in, that’s all she wrote.” I’m right here, I said. I know, he said, you’re also one of my favourite patients. You think I have this conversation in front of all of my patients? He removed seven tumours, including the one that was the size of an orange. I My abdomen was distended and sore. I had a six-inch incision in my abdomen and an umbilical incision that changed the depth an shape of my navel permanently. A few weeks later I went back for a post-operative follow up and he found two more tumours on the ultrasound. Please let me take them out, he begged, I don’t want to send you home with more tumours. I agreed and I was wheeled into the operating room the following day. He removed 10 more tumours. I had my third and fourth surgeries when I was 36.

This was about the time when I started to make jokes about have more tumours than children or more instruments in my vagina than lovers. I laughed about it then, I don’t so much now. I knew after the second surgery that my chances of conceiving were virtually nil. I just did not think there was any recovering.  42 tumours covers a lot of real estate when your uterus is small. My ex, however, was not convinced. My periods were still long and very heavy, but he was undeterred. When we moved to Philadelphia and I started being treated at the fertility clinic. My gynecologist and I created a birth plan: three month bedrest, c-section, hysterectomy. Very simple!  When things started to go wrong, I had a hysterosalpingiogram. This is a hysterosalpingiogram:

  • You will be asked to lie on your back with your feet placed as for a pelvic exam. A device called a speculum is inserted into the vagina. It holds the walls of the vagina apart to allow the cervix to be viewed. The cervix is cleaned.
  • The end of the cervix may be injected with local anesthesia (pain relief). You may feel a slight pinch or tug as this is done.
  • One of two methods may be used to insert the dye. In one method, the cervix is grasped with a device to hold it steady. An instrument called a cannula is then inserted into the cervix. In the other method, a thin plastic tube is passed into the cervical opening. The tube has a small balloon at the end that is inflated. The balloon keeps the tube in place in the uterus.
  • The speculum is removed, and you are placed beneath an X-ray machine.
  • The fluid slowly is placed through the cannula or tube into the uterus and fallopian tubes. The fluid may cause cramping. If the tubes are blocked, the fluid will cause them to stretch.
  • X-ray images are made as the contrast medium fills the uterus and tubes. You may be asked to change position. If there is no blockage, the fluid will spill slowly out the far ends of the tubes. After it spills out, the fluid is absorbed by the body.
  • After the images are made, the cannula or tube is removed.

The hysterosalpingiogram was clear as could be. Not long after the hysterosalpingiogram, the doctor finally listened to me and ordered a hysteroscopy. I had been concerned about the condition of my uterus all along. My concerns, sadly, were justified. As the camera slipped through my cervix into my uterus I saw one large and countless small lumps being fed by an intricate network of capillaries. As he pulled around the large tumour what remained looked like the surface of the moon, grey, lumpy, lifeless. It’s not supposed to look like that, is it, I asked. No, he replied. It needs to go, I said. Yes, it does, he replied and he patted my foot. A month or so later I was recovering from a robot-assisted laparoscopic hysterectomy when my ex looked at me and said, I love you very much. No, you don’t, I thought and fell asleep. When I saw my doctor later, away from my ex, I chided him saying he didn’t provide any pictures. He laughed and said your uterus was shot. There was nothing left. I read the pathology report. I had diffuse uterine leiomyomatosis a condition where the myometrium is replaced by countless, benign smooth muscle tumours. It’s a rare condition with only 30 reported cases by 2001. I had also developed adenomyosis a condition where the uterine lining breaks through the muscle wall into the myometrium where it grows and breaks down during the course of the normal menstrual cycle. On top of that I had also developed Asherman’s Syndrome. Asherman’s is rare and preventable and my surgeon followed every prevention protocol, estrogen supplements and an interuterine balloon, but to no avail. Ashmerman’s is also treatable but not in my case. Having had close to 50 tumuors removed in 10 years, there was nothing to salvage.

I do not know what it’s like to give birth, but I know what physical pain is. The difference between you and me, a friend of mine once told me, was that when it was over I had a baby. Your pain kept you from bleeding to death. Your uterus had to work as hard as mine just to stop the flow of blood in your menstrual cycle. I got an epidural, you got Advil. For the last half of my marriage, I was changing a super plus tampon hourly. I kept extra clothes at work and in the car. I slept wrapped in a towel, if I slept at all.

I have secret knowledge. I know things most women (and men) will never know. I am an expert at getting blood out of anything (hydrogen peroxide gets blood out of just about any fabric). When a women talks about the pinch of a cervical injection or suture, I know that pinch. I know how to get out of bed with a six-inch abdominal incision and I even used that knowledge to help a friend get out of bed after an emergency c-section. I know how uterine contractions build to a plateau and drop off; how the pain subsides but doesn’t go away completely until the job is done. I know what it is to have to consciously breathe through pain. It infuriates me when politicians insist that women who need abortions get transvaginal ultrasounds, because it’s being used to induce guilt and shame. I know what it is to clean a pool of your own blood. I know how to scoot down an x-ray table using my arms because my vagina is full of surgical instruments and I can’t bend my knees. I know what it is to live with someone in total denial. I know what it is to be with someone who is so focused on his wants he has no regard for your health and welfare. I know what it is to be tossed aside figuratively for something any 12-year old can do, but not literally because he doesn’t want to be the bad guy. I know what it’s like when it’s “your fault”. I also know it is tender and soft and warm like any lover’s. I have enough scars on my abdomen that I look like I survived a knife fight, and you know what? No one fucks with me at the gym. I know my pussy is strong as hell because it is battlescarred like any mothers’.  I know these things because I am strong as hell and tender and soft and warm. I know what it is to define yourself as a woman using nontraditional avenues. I also know that you pay a heavy price, maybe not immediately, maybe not forever, but you pay.

 

I’ve Been Here Before. I’ll Be Here Again.

I’ve Been Here Before. I’ll Be Here Again.

-Can we talk about the last implantation?
-I’ve been waiting for you to talk about the last implantation. I’ve been giving you the silent treatment for the last two weeks waiting for you to talk about the last implantation.
-You’ve been giving me the silent treatment?
-Yup.
-Funny, I said, I didn’t notice.

Infertility is a time sink, a black hole. Time and space warp. Time, in particular, stretches out before you and collapses behind you, propelling you forward. The next menstrual cycle. The next appointment, The next round of injectables. The next insemination. The next consultation. The next implantation. The calendar rules your life in a way you never thought possible. It is a ruthless and intimate taskmaster. I kept my menstrual calendar in my Filofax. Every month I put little Xs next to the days I was bleeding and little dashes next to the days when I was most likely to be ovulating. When I had my requisite year of Xs and dashes, my doctors decided it was time to see a fertility specialist.

You learn a lot about your body and yourself when you’re trying to conceive. I learned that my menstrual cycle was 21 days long, which is on the short end of normal. I also learned that my periods were 10-12 days long. To put this into perspective, a woman’s menstrual cycle can be anywhere from 21-35 days long, the average cycle is 28 days. Menstruation typically lasts 3-5 days, but anything from 2-7 is considered normal. In a 28-days cycle ovulation typically occurs midway through the cycle. This does not mean that ovulation occurs on day 14 on the dot, but that it can occur anywhere from day 11 to day 21. In my case, if ovulation typically occurs midway through the cycle that would put it around day 10. It didn’t take a genius to figure out that I was bleeding, heavily, through my most fertile period-if I was fertile at all.

The first doctor we met with was all bravado and swagger. The walls of his office were covered with awards, newspaper articles, pictures of himself. His degrees were there somewhere. He sat back in his chair and nonchalantly told us the playbook, I think that’s what he called it. When I raised concerns about the condition of my uterus, he smiled and said why don’t you let me tell you what to worry about. I told him that after three hysteroscopic myomectomies and one laparotomy, I thought I was just as knowledgeable about my situation as he and that my concerns were justified. (In time I was proven right, but that’s a tale for another day.) As we left I thought, the only thing missing was a picture of his penis. We made our next appointment with a different doctor one known more for his clinical acumen than his bedside manner. He suited me perfectly.

In my experience, fertility clinics are not like other doctor’s offices. They are not looking to form a long-term relationship with you the patient. They want your treatment to be successful, they want you to come back when you want another child, and they want you to refer your friends. Everyone is enthusiastic and hopeful. They’re like cheerleaders. Ready? As the woman it’s your fault so you get the personal questions and invasive tests first, OK!  Great! Not responding to the drugs? That’s ok! Look at his sperm. It’s perfect! I remember feeling like the information I was getting was being dumbed down for my benefit; perhaps to spare my feelings. I looked around and saw that I was in a desperate place full of desperate couples. I wasn’t desperate.

As treatment dragged on we became like guests who’d overstayed our welcome. Between not responding to drugs, failed IUI attempts, a catastrophic fertilization failure where all of the embryos died, a successful fertilization of donor eggs, and four unsuccessful implantations, treatment dragged on for nearly four years. I freely admit that this part of my life is distorted and hazy. It’s like one of those stories where there are flashbacks within flashbacks. They ran out of reassurances. They never knew why procedure after procedure failed. I’d done the research and knew this was a roll of the dice at best. He took every failure to heart and could not understand why I didn’t. I tried to talk him into adopting or being a foster parent. You don’t know what you’re getting, he argued. I told him you didn’t know what you were getting with your own biological children. He asked, didn’t I want a little me running around? I told him the last thing I wanted was a someone running around with the same hangups and insecurities as me. Eventually they stopped talking to us. Eventually, he stopped talking to me.

A friend of mine asked me once if I felt like a failure as a woman. I shrugged and said that if my entire idea of myself as a woman was bound to my ability to reproduce then maybe I would, but it doesn’t so I don’t. The ability to have a baby doesn’t make one a woman any more than it makes one a man. If you’re young and/or immature when you have a child, you might have to grown up faster than otherwise. Then again, I have seen my fair share of couples where one partner takes care of the children and the other takes all the credit.  Who I am as a woman is about who I am as a person. I may not be the most conventional person, so I guess that doesn’t make me the most conventional woman. In the end I can’t be any other way.