!!!!!*****WORKING DRAFT*****!!!!!
The morning after dinner with Julia, I called the Ob clinic at Harvard Community Health Plan, intending to ask for a pregnancy test and initial appointment.
“When was you last period?” asked an impersonal voice on the other end.
I double-checked my date book, although I had it memorized already – January 17th, ten days before Howard had invaded my apartment and violated my tranquility. “The 17th. January,” I heard myself say in hollow tones.
“You were regular? Hadn’t missed any?”
I thought, this might be what the orals were going to be like? “Mum-hum,” I agreed.
“Any bleeding, spotting, cramps?”
“No.”
“Morning sickness, breast tenderness?”
“A little, I guess.”
“OK, we can set you up for an appointment on March 15th, Thursday. With the nurse. She’ll do a history, send off some labs, a pregnancy test and the other pre-natals.”
A flicker of dread flashed through me – the Ides of March. I shook my head almost imperceptibly, and asked, “Can I get one before that, a pregnancy test? Today, tomorrow?”
“We can do that, honey, but it won’t be ready for a couple of days, Probably not till after the weekend. And besides, this early, it might not be positive yet, even if you are. No need to come in, unless…”
“No, nothing’s wrong, I just thought…isn’t there a blood test, or something?”
“Yes, but the doctors, they say we’re not supposed to offer it unless a women’s bleeding, or high risk. Any medical problems, like diabetes? How old are you, again?”
“I’m …I’ll be 30 in May. No, I don’t have any problems like that.”
“Why don’t you just wait until you come in. It’s not like you’re going to do anything different before then, are you?”
I didn’t have the strength, after days at the clinic, evenings in the library, and nights of fitful sleep, to say anything other than, “OK, Thursday, March 15. Got it.”
At our first meeting in March, Julia and I started preparing for my upcoming orals.
“I’ll be the First Reader, of course, and the department chief will be the committee chair. Don’t worry about him, he’s just there to make sure the rest of us treat you fairly.” Dr. Klein smiled. “Fairly – that means we ask you tough questions, but don’t try to score points off of you. We’re not there to show how smart we are, but to make sure you understand your own work. When you do get the doctorate, no one should doubt your ability to review someone else’s study. Our reputations are on the line here, as much as yours. We’re not going to play ‘Gotcha’, Sarah. Stay poised, be yourself, and everything will go smoothly.”
I spent the next two weeks re-reading all of my sources, along with those evenings in the library scouring the psychologic and medical guides to periodical literature, looking for anything new which had come out that might be even tangentially related to adolescent mothers and their newborns. Totally immersed, I was able to forget for hours, even days, at a time, that my body was changing. Sometimes, when I woke up, the thought of coffee didn’t sit well, and my breasts did seem a little loggy, but most of the time, I could ignore whatever might be happening in my uterus.
At my pre-natal appointment, the nurse led me to the scale, and announced, “58 kilograms, 162 centimeters.” What is that in real money, I wondered. I’d never paid much attention to my weight, so I had no clue if I had gained any or not.
She started the interview with that horrid question, “When was your last period?” I knew after all my time in Ob clinics, following my research subjects, why that was so important, but I still wished I didn’t have to remember. We went briskly through my medical history, finishing with, “Do you have any questions, Sarah?”
I hesitated. That morning, I’d notice the faintest pink swirl in the toilet. “I’ve heard sometimes you can spot at 2, or 3 months?”
“Why, did you…?”
I nodded my head, and she went on. “We could have you examined, take a look, get the pap smear and culture out of the way. Maybe it would reassure you?”
“Um…I don’t know – a doctor does the exam?”
“Oh, you’ll like her, she’s one of our senior residents, really gentle, knows her stuff.”
A female gynecologist, Dr. Stephanie Seacrist, walked in, stethoscope slung casually over the shoulders of her starched white coat. With her no-nonsense blond hair pulled back tightly into a bun, and large-framed glasses enhancing her smiling eyes, I immediately relaxed.
Explaining everything I should expect, before she did it, she quickly finished the exam by feeling for my uterus and ovaries with her left hand, while pushing up from inside with two fingers of her right. Then, she took my hand, guided it down to my pubic bone, and said, “Here, feel that? Your uterus?” I nodded as she withdrew her hand, looking briefly at her fingers as she turned the glove inside out.
After she helped me sit up, she asked “Is it OK to talk now, or do you want to get dressed first?”
“Go ahead, it’s OK.”
“I do see a spot or two of blood in there, but there are no lesions, and your cervix is long and closed. So it’s probably nothing, just what sometimes happens – the placenta gets planted into new parts of the endometrium, that lining can shed a tiny bit.” She dropped her smile as she looked straight at me. “Your uterus seems a little small, for your dates, though. Maybe seven weeks-size instead of eight?”
“What’s that mean?”
“Oh, probably nothing, we never really know for sure when conception happens…”
“Even if you know the date when…”
“Yes, you see, sperm can linger in the uterus, even in the tubes, and we don’t know when ovulation happened, how long it takes for the egg to travel down.”
I looked away, frowning, and started to say, “I…”
She quickly went on. “We’ve got a new test now, called ultrasound. It’s not x-rays, no radiation, uses sound waves. At this stage, we should be able to see a baby in there, if it’s at least 7 weeks along. We call it ‘real-time’, because the computer turns the reflected sound waves into a black and white moving image of what’s inside. Maybe we could even see the heartbeat. Sound good?”
I nodded, getting more and more anxious. “When?”
“This is not really an emergency, so next Monday is probably the earliest we can squeeze you in. You don’t have to worry about coverage you know, it’s all part of the per capita we get from BU.”
I dropped my head, hoping my hair would hide the wetness welling in my eyes.
“Sarah, is everything OK?” Real concern flowed through Dr. Seacrist’s quiet question. “I saw the notes, from the nurse, the baby’s father’s not involved?”
I shook my head, felt the tears now flowing past my nose. I sniffed, saying nothing.
She took my hand. “You don’t have to go through this alone, you know.” She reached into her lab coat pocket and handed me a card after scribbling on it. “Here. You can call me, anytime. That’s my home number. We’re going to get through this, you and me.” Then, in a more business-like tone, she said, “My team’s on call this weekend. If anything – anything at all – happens, call the L&D number on there, ask for me, we’ll make sure everything is OK. All right?”
Biting the inside of my lower lip, I nodded. I wanted to say, thank you, but couldn’t get it past the lump in my throat. She patted my hand once, twice, then said, “Well, I’ll let you get dressed now. Remember, anything. Anytime.”
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