The Long Accomplishment

by Rick Moody

  But there was sort of no other way that we could afford the IVF cycle. It was give up on having a child together, or ask for help.

  It happened that it was the weekend we were visiting my family, in August 2014, and Laurel was intensely uncomfortable, distraught even, after what we’d just been through, and in lieu of weeping all day was sort of ghostly, as if partway into another dimension, a shimmering indigo-hued dimension of loss. She was a hologram of herself. Trying her best, but racked with sorrow. It was my fault for thinking that she could trust my family to comfort her, because there are kinds of hardship that are too hard for any but the most intimate of friends and family. My family was most experienced at the stiff upper lip, and offering a few scabrous jokes about how awful things were. Comfort was in distraction, not in any specific language of comfort. In fact, Laurel is and was best comforted by her mother, in my experience. My family, however much they cared, and I think they do, were going to have a hard time helping her.

  I determined that I would take a walk with my father to describe the IVF problem with him, and this I must have done, therefore, by leaving Laurel to fend for herself for an hour or so. At that time I didn’t really like leaving her alone at all. It was not our way to leave each other alone that much. I think in the years that we have been married, that I have failed to be in Laurel’s company overnight no more than five or ten times, and they were all in 2013–14, and not very many since at all. We just spent most of our time together.

  But I took the walk with my dad, around the airstrip on the west end of Fishers Island, a neighborhood near the ferry dock that is mostly quiet, and somewhat overgrown with wild raspberries and poison ivy. We talked about this and that, nothing serious, for a long portion of the walk, and then I finally had to bring up my particular problem. I went into some description of what our problem was, that we deeply wanted to have a child, but for some reason continued to be unable to do so. I told my dad about the twin boys, and the girl embryo before the twins, and all the surgeries, and so on, and then I told him that at this new clinic we were looking into they had a three cycle package for about the price of a new car, not a domestic model, for a slightly reduced fee. This fee was exclusive of medication, some of which would be covered and some wouldn’t. I told him our statistical likelihood of getting pregnant on one cycle was roughly 30 percent.

  I asked him if he would help us pay for the first cycle.

  It was possible to do all this, to have this conversation, and at the same time to be very uncertain about whether this was the right thing to do. Why allow one’s parents into this anguish? Why not, when they were in their late seventies, just let them go along thinking most things were mostly all right?

  My father said he didn’t think the odds were so great.

  He said he’d be happy to help, but that the odds weren’t so good.

  It wasn’t that we hadn’t thought about the odds, of course, it was that in our fervent wish to try to get to a pregnancy as the possible way to overcome the missed miscarriages, the repeated losses, we didn’t dwell on the statistical likelihoods. We did what was next, though sometimes a question might have been valid; but like a gambler on the table chasing the one big payout, we kept at it. I didn’t know how to put this into language for my father exactly. Some of it was hard to talk about. He said he would give us the money. Or, at least, he would give us what he could.

  The trip was worth it for this conversation, but it wasn’t easy for Laurel. Neither of us liked spending too much time in my former house, on Fishers Island, now my dad’s house (because he’d sold his and bought mine from me when I bought in Dutchess County). There had been a period when she and I were first dating, first spending real time together, when we made absurd numbers of trips to Fishers Island, just the two of us, in the deepest of the off-season, and wandered around there almost entirely ignored. (No one is completely ignored in the off-season, especially not if you are a “summer person” by association who has the temerity not to confine your trips to the warmer months, but still.) It is a time I really look back on with wistfulness. Not only because our lives are more encumbered now, or because there’s a way that all of our trafficking with the medical establishment made us less carefree, but simply because it was the beginning of knowing Laurel, and as with all such things, there was a storied quality to the beginning of the time with her that has to do with a different Fishers Island, a Fishers Island with different coordinates, and going back there now feels disappointing, because it doesn’t conform to the memories. I suppose, at this point, it would be accurate to say I can no longer bear Fishers Island, its pink and yellow and green, its loafers without socks, its privilege, its insularity, its political conservatism, its alcoholism, its ethnic and religious monochrome, its shortage of human kindness. I wrestled with Fishers Island, for twelve years, and then I moved on.

  In the meantime, in September 2014, with enough money for one cycle in hand (and the intense gratitude that one would associate with such a gift), we decided to try a new reproductive endocrinologist. Specifically, we went with a guy attached to one of the really high-end clinics. We didn’t know if we could possibly find a home there. But the doctor came highly recommended from a friend, and there was already a whole online group dedicated to nearly profane worship of his skills and kindness. The story of how this friend recommended him goes like this. One night I was performing at a gig in Westchester with a bunch of people, including the friend, who is a pianist and singer-songwriter, and Laurel and I needed a ride back from the gig, and she offered. Her car, it seemed to us, had great character, and definitely more than a hundred thousand miles on it, and at many points along the journey I worried if the car was going to make it. At last she dropped us in Park Slope, in front of our building, and then, when she attempted to restart the car after we got out, the car did nothing at all. The engine failed to turn over. We somehow helped to slay our friend’s car.

  She was nothing if not resourceful, though, and called a car service in Brooklyn, and asked if they could send someone to find us with jumper cables. Who knew you could call a car service and ask them to bring jumper cables? It was a brilliant solution. But the car service took a while. And somehow because I knew or had been told about our friend’s manifold problems having a baby, somehow we got on the subject.

  If her car had started easily, we never would have found our doctor.

  (By the way, the jumper cables worked.)

  The clinic she sent us to had quotations from Gandhi and Nelson Mandela on the wall in the waiting room, as though their desire to have people relax in the reproductive process was so immense that they would do anything to keep you calm and reflective. I think Laurel had to have a couple of exams by herself at first, while I waited in the lounge and compulsively ate these European tea cookies that they kept there for the patients. Laurel did in fact come out from these initial appointments raving about Dr. W.

  If there is a passage of unalloyed joy in this account, a moment when the suffering is commuted unmistakably, so that we might reflect on good fortune in hard times, this is that moment, and it has to do with our doctor.

  Simply experiencing in treatment a modicum of human dignity at this point would have been immense. Because the vast majority of news in a fertility clinic is bad news, you would think the medical professionals associated with such a clinic would have been educated into the nuances of dealing with people who have gone through many instances of bad luck, and who are reeling from it. And yet as the simplest possible way, the most convenient way, is to deny the full expression of consciousness to another human being, in order not to have to feel what another human being is feeling, we had grown used to this, used to peremptory and unfeeling examinations and consultations with the doctors in the fertility field, many of whom couldn’t remember having seen us before, or had nothing new to say about our case, and whose utmost accomplishment was to be found in a bland and emotionally detached professionalism.

  And then we met Dr. W
.

  As a practical matter, one doesn’t really understand some particular kinds of suffering, indignities verging on episodes of suffering, or indistinguishable therefrom, until the indignities stop. And so with Dr. W., who is really good at breaking down the highly complex world of assisted reproductive services such that it is manageable and doable, we didn’t understand entirely how much pain we had been in until he opened his mouth. He just manages to seem incredibly sympathetic without showboating, without overstating the case ever.

  He always referred to Laurel as “Mizzzzzzz Nakadate!” Like it was a euphonious name that should be undertaken with great care and jovial, avuncular respect. And he always spoke really slowly, and looked her in the eye, and came up with plans for treatment in a collaborative way. He was young (by my standards, maybe in his early forties), with short brown hair, and occasional eyeglasses, and he looked far younger. He was skinny, and always in scrubs, spoke with a certain kind of offhanded med school grace, but always with the indication of sympathy and an understanding of the traumatic events that brought the people to his door. He was, is, a relentless empiricist, all about the numbers and angles and probabilities, and at the end of the day this might have been his genius, the numbers and probabilities, but with us, and, as far as we can tell, with all of his patients, he manages to keep the numbers and probabilities offstage, in what is primarily a human interaction, sort of in the way that Oliver Sacks always understood the struggle of neurologically afflicted people to be a struggle for self-respect and dignity. Dr. W., in our particular case, always referred to a successful pregnancy as “our goal,” meaning the goal of himself and the team of Laurel and myself, as when, for example, a certain test might answer some questions “but will not get us any closer to our goal.” And the objective for treatment, every appointment, every day, for the many months that we worked with Dr. W., was always getting closer to “our goal.”

  He had a wife and kid himself, and was often flying back to Taiwan to see parents and relatives; also, he had and has one of the most unimpeachable reputations in fertility treatment in New York City, where there are a great number of people receiving treatment. And despite all of this Dr. W. never failed to answer an email message, no matter whether day or night or weekend or otherwise. This is perhaps to get him in hot water for people out there hoping to get in touch with the guy, but Laurel frequently would become anxious or have a question during off-hours, and while trying not to overburden Dr. W. would sometimes ask him a question when he might have been home with his family, and not one time did he ever fail to answer. No question was unreasonable, and no feeling was unwarranted. As Dr. W. told Laurel on one occasion: “My patients often have posttraumatic feelings.” He said it like he said everything else, with irreducible clarity. Excepting the original intake meeting, he didn’t belabor appointments, but, at the same time, he never failed to have a complete interaction, and never failed to manage the easygoing charm and the sly wit.

  To wake to a practice like this after three different practices where we felt like we were being treated like petri dishes that unfortunately had human anatomical bits attached was to feel waves of hope.

  Without going too far down into the nuances of IVF treatment, it’s fair to say that Dr. W. had one particular area of expertise that most or many reproductive endocrinologists think is debatable, and that is autoimmune disorders. In short, Dr. W. felt that Laurel had an autoimmune problem wherein her body treated the embryo like a foreign body and very quickly wiped it out. It may have had to do with her thyroid, which she began treating more aggressively while under Dr. W.’s care. Whatever was causing the autoimmune difficulties, he wanted to treat it, and so Laurel began with a certain medication well-known to television viewers, where it is frequently advertised as a treatment for a great variety of autoimmune disorders. She later tried a different medication of a similar cast.

  Throughout August and into September the only way to work through the ache of what we had gone through with the twins in July was to turn ourselves over to the reproductive endocrinologist called Dr. W., and to let the process take place, including the barrage of testing and the medicating, and to see what happened. We stopped talking to our families, who knew better than to ask, after the twins, and we stopped talking to our friends about it, and this is the way that infertility becomes a disease of silence, because it doesn’t do to get too hopeful publicly, and because every individual fertility event has its potential for failure. It’s stupid to encourage other people to try to encourage you, by giving them ammunition for their vacuous if well-meaning encouragements. We stopped talking about it, and in fact this is the first time I have talked about our time in the wilderness of fertility treatment in any detail.

  Even in the context of being married there was some hurt in the process of fertility treatment that didn’t always get expressed, because it was sort of in the category of things that we knew about each other, and so why get into it? Ideally, marriages should make room for this pain, should include discussion of this shared pain, but I like to think that holding the other person is good enough. Maybe just hold the person and talk about it all another time, so that there are moments of relief from the obligation to confess. But sometimes we were both so hurt that even bringing it up caused further pain. Looking back now, I wish I could have done better at listening, so that it was easier for Laurel to talk, and I’d be remiss if I didn’t catalogue that among my regrets.

  It was somewhere in this becoming of autumn that I decided I had to sell the Charles Manson autograph. Or get rid of it somehow. Whatever it took. It is true that I never totally believed the Charles Manson autograph was cursed, because what kind of curse is transmissible from party to party? You could make an argument that anyone who was stupid enough to keep a Charles Manson autograph in the house deserves to be cursed, and there may be validity to this point of view. I suppose I don’t believe in curses at all, excepting the completely literary sort that you see in the Gothic novel. Those seem like oneiric representations of a feeling that a person might have about her or his life, that life is a sequence of bad luck events. In literature, time will do all of these horrible things to you, because time is no respecter of individualism, or even human subjectivity.

  But the whole punitive concept of a curse related to the Manson autograph wouldn’t keep me from getting rid of it. I was, because I had obtained the Manson autograph in a trade, intending to trade it to someone else, perhaps someone who would appreciate it. And so there was a week of perusing these websites that are set up and maintained by people who collect autographs of mass murderers and serial killers, in an attempt to ascertain the market for my autograph. And it seemed there were a lot of his autographs floating around out there. Maybe it’s a prison thing, and maybe he obtained some advantage in the interior of his prison space, for doling out a certain number of autographs annually. Whatever the reason for the proliferation of Manson autographs online, the fact was that my Manson autograph was not worth that much, and I would really need to find just the right collector in order to get a reasonable return.

  I could have just thrown it out, of course, and then in this chapter I could have reflected upon just the right place to throw it out.

  But it seemed more sporting, given how I obtained the autograph in the first place, to try to find someone else who wanted it. That would thrust me out into the world of people trying to own paintings of Twisty the Clown.

  However, Laurel did have a friend who worked at Amoeba Music in Los Angeles, possibly the best record store in America, and this friend, who knew everything about music, seemed to want the Charles Manson autograph. He was a collector of serial killer memorabilia. I don’t know how the subject came up, but this friend did want to get just the right piece of vinyl for me from Amoeba Records in return for surrendering my Charles Manson autograph, and eventually what he came up with was a comedy recording from the beatnik period called How to Speak Hip. The album is pretty rare, despite being important to Br
ian Wilson, who gave the album a shout-out during the Pet Sounds sessions. It’s a comedy album about beatniks, really. The copy I got was missing the inner sleeve, I think, and was lightly foxed, as the book collectors say. But what I got for it was the privilege of ridding myself of Charles Manson and his autograph.

  As it happens, this week, three years after the trade of the Manson postcard for How to Speak Hip, in a class I now teach at Brown University, we discussed the differences between fate and magic, and whether fate presupposes a controlling hand, and an author, in order for it to take place. When Oedipus is fated in Greek drama, we know that the gods have made it so. But what about elsewhere? Does it make any logical sense in an empiricist present, or even in a liberal Protestant present, to believe that there is a destined quality to the turn of human events? Isn’t it sort of unrealistic to think this way? Baseball teams often seem to want to be the team of destiny as long as they’re winning, but what if they’re not winning?

  There’s a moment in Boccaccio’s Decameron where a certain nobleman is riding along the road one night, accompanied by a trio of blackguards who are about to deprive him of his clothes and his riches, and they ask him to whom he prays when traveling, and then they discuss these prayers for a while, before the nobleman is robbed by the blackguards, at which point they say something like: What good are your prayers now, sucker? We didn’t pray at all, and we’re going to have a good time tonight with all your money!

  In August, or was it early September, I traded away the Charles Manson item, and got the How to Speak Hip album, and at that point if I were legitimately cursed, or if Laurel and I were legitimately cursed, we might have ventured to believe that our luck was finally to improve. Or that fate would turn in our direction. That September, my daughter first ventured into the New York City public school system without incident, and then I started back at the NYU writing program where I taught in those days, and we did a lot of medical testing for an upcoming IVF cycle, and I took a lot of fish oil vitamins, and Laurel took some immune suppressing medication, and we lived life for thirty days, and it was fine. Maybe sometimes autumn is simply just another season.