by Sara Connell
“Okay,” Bill said, keeping his eye on the cars in front of him. “It’s good that we’re meeting with the specialists today, then.”
“Dr. Bizan said I have secondary empty sella,” I answered, feeling unable to repeat what she had cited as the cause.
I leaned against the seat and squeezed my eyes shut tightly.
“What is it, hon?” Bill asked, glancing at me and then back out the windshield.
“She said secondary empty sella is caused by trauma,” I said, trying not to cry.
“That makes sense,” Bill said. “Your ovarian cyst was a real trauma.”
I nodded and let out a jagged breath. The surgery had been a horrific experience. I preferred not to think of it and rarely did anymore, usually only when filling out a form that asked, “Have you ever been hospitalized?” Then images of that day would streak to the surface in shards: the metallic taste of adrenaline in my mouth; the excruciating pain; the confusion on the doctors’ faces as to what might be wrong, then the palpable shift in the room when they discovered the cyst and rushed me to surgery; being wheeled to the OR, my parents’ worried faces bobbing up and down next to me as they ran to keep up with the gurney; an IV drip of Demerol in my arm; an oxygen tube inserted in my nose; a blue protector sheet going up like a laundry sheet—no time for any explanation about what was happening. Counting backward from ten, nine, eight, seven . . . and then blackness.
I woke up after surgery in a private room, still with no clear understanding of what had transpired. I folded myself into the bed, pulled a pillow around my ears, and tried to become as small as possible. The surgeon came by on his rounds and told me about the cyst, that it had ruptured, that it had been a messy ordeal, and that the surgery had lasted six hours. He told me that my ovary had been removed and then, kindly, before I even asked, told me that what had just happened would not impact my ability to have children. That was when he told me that the human body was miraculous, that I would still have a period every month. That each ovary had more than enough eggs—hundreds of thousands, enough for many lifetimes.
I hadn’t been thinking of that trauma, however, since the moment of disclosure in Dr. Bizan’s office. When she said the word, my mind offered another exhibit, exhibit A, the memory of which now swam toward me now like a great silvery fish, its belly scales flashing glints of light into the deep, dark water in which it swam.
For so long I had not even really remembered. There were signs: hysterical reactions to hearing about children abused in the news; having difficulty staying in my body during sex; leaving the theater in the middle of a film if there was a rape scene. “It’s just a movie,” a boyfriend once said in college. “You act like it’s happening to you.”
In England, with an ocean separating me from my birthplace, the memories emerged. In my first acupuncture session, I watched, in full color, my mind reveal those events that I’d known in some dungeon of my mind had transpired, but had not consciously remembered until twenty-seven needles had been stuck into body, opening pathways that now had stories to tell. The acupuncturist had been as surprised at the revelation as I was and hurriedly handed me a business card: Irena Dashani—the therapist I would work with for most of my time in the UK.
As part of my healing, I wanted to name what had taken place in that cold, cement-floored room in our basement and then later what had transpired at a friend’s house with her stepfather. If I was going to go back to my family’s house at all, I needed to say what had happened there. I thought if I acknowledged it, if my family could bear witness, I could let go, integrate the experience, move on.
The more I was dedicated to my self-discovery, though, the more distant I felt from my family and the more my hope that I would ever have the discussion with them diminished. An opportunity came a few years later, however, during a phone call with my father. He’d called after one of our hotel Christmas visits, saying he’d felt me slipping away like the horizon from a ship.
“I’m not okay with just watching you go,” he said. “What can we do?”
I surprised both him and myself by telling him what I had uncovered in England. I said I wanted to be able to talk about my past with him and my mother.
“I don’t feel as if I can talk to Mom about this,” I said. A rule I’d adopted in the family and pledged allegiance to, though unspoken and without verification, had been not to bring up something that would upset her.
I heard silence on the line and the faint echo, the hollow sound sometimes present on international calls, reminding me we lived on separate continents.
“No,” he said. “I don’t think it would be a good idea.”
But I told her anyway.
It happened during my next visit, five months later, when I was alone with my parents after returning my sister to medical school. The weather was already hot for May, and my father had cranked up the air conditioner. We drove on a monotonous stretch of highway, tall pine trees and oaks flanking both sides of the road.
“I want to share something—some things—that happened when I was growing up,” I said.
My father kept his eyes on he road. He already knew the basics of what I was about to say. To my knowledge, my parents never kept anything from each other, and yet I had no idea if my father had told my mother what I was about to relate.
When I was six, two older neighborhood boys came over to play in our basement and began a game of Simon Says that turned sexual. When I protested, they forced me to touch them. Afterward, they told me I’d done something very bad, that I wasn’t a virgin anymore, and if my parents found out, I’d be sent away, or killed—just like Laurie, a girl on our street who had disappeared suddenly. (I found out later that she was not dead, as they had said, but had been sent to live with her mother in another state. But by then it was too late.)
And two years later, during a sleepover, Courtney, my best friend in the third grade, and I danced in our underwear for her father, who was drunk. I went to use the master bathroom, and he was waiting for me when I came out, naked aside from a yellow bath towel wrapped around his waist. He shut the door behind him. “I’m going to show you what grown-ups do,” he said, carrying me to the bed.
“He raped or molested me—I don’t know which,” I said from the back seat of the car, an Oldsmobile sedan my father had taken over from my grandfather when he died. I remembered only snippets from that night: the yellow towel, his arms around me, warm breath on my face, the vastness of the bed. The next clear memory I have is of being back in Courtney’s bedroom, she asleep and I pushing her dresser in front of the door and being unable to stop shaking.
For several minutes, neither of my parents spoke. My father’s head faced forward, eyes fixed on the road. My mother, too, had remained looking straight ahead in the front seat during my report. I don’t think I could have had the conversation had we all been looking at each other, or outside a moving vehicle. I was holding my breath. I watched the back of my mother’s head for signs of combustion, but she was as alive as she’d been ten minutes ago before I’d started speaking, her hair puffy from the humidity, her neck that had the same slope as mine. I could hear the tires roll on the road, the whir of the engine. The blowing sound of the air conditioner. When they finally spoke, they didn’t say much. My mother said she wished it hadn’t happened.
“How can you forgive something like that?” she asked, keeping her head locked forward, looking at the highway.
“They were probably abused, too,” I said, sharing one of the insights I had come to in my forgiveness work.
“Not them,” she said, still not moving her head. “Us.”
Having the conversation was what I had wanted. I saw no need for further forgiveness. The moment she’d spoken, I’d melted into the seat. I’d spoken of these events, and she hadn’t died. Neither of us had.
I felt elated afterward, struck by the lightness that accompanied my confession. My mother had stayed with me; neither parent had said it was my fault. What I did not a
nticipate was that the acknowledgment they gifted me with was, for a time, a one-time thing. I didn’t know how strange it would feel afterward when, for a period of several years, any reference I made to the abuse would be greeted with silence, as if the conversation in the car had not taken place, my words falling like snow.
After the experience, I’d moved closer, calling more regularly, sharing more of Bill and my life in the UK. But I’d kept a buffer of space, not venturing too close, proceeding cautiously in reconnecting.
Bill and I arrived at the Reproductive Medicine Institute (RMI), Dr. Colaum’s practice, at 10:01 AM. The office was located in a small, grid-shaped brick building on Ridge Road that looked like it had been built in the ’70s. The lobby was small and unremarkable. The air was stuffy and hot. June had descended upon Chicago with a burst of heat that seemed to have been saved underground all winter and was now being released in a long, ferocious exhale.
The air conditioner, if there was one, appeared to be broken. While we waited for the elevator, I fanned my face with the folder of information the office had sent in advance of our appointment. We rode to the second floor and walked down a short hall to suite 205. The waiting room was cool and serene, with low lighting and furniture from the federalist period. Whoever had decorated had done so with care, and with a love of Frank Lloyd Wright, apparently; framed works of his art and architecture hung on the cream-colored walls.
We were the only people in the waiting room when we arrived. I signed in with a receptionist, a heavier-set woman who introduced herself as Lorelai. Bill picked up a brochure from the table. “Did you know this?” he whispered, pointing at the bio page for Dr. Colaum.
Dr. Colaum’s brochure photo revealed a grandmotherly woman, perhaps in her early seventies, with gray-blond hair wrapped into a bun. Bill was pointing at the copy under the photo. “Dr. Carolyn Colaum, MD, is the mother of ten children.” The brochure went on to detail an impressive career as a researcher and clinician of reproductive endocrinology.
“Do you think they’re all hers, biologically?” Bill said, our heads leaning over the brochure.
“They are,” Lorelai interjected from across the room. “She conceived and delivered each one naturally, too. It was before the days of IVF.”
“That’s pretty amazing,” Bill said.
“I like the idea of a fertility doctor that’s so fertile,” I said.
“I agree,” Bill said. “Seems like a good sign.”
At ten after ten, a somber nurse named Rachel escorted us into a spacious office also decorated with federalist-period American furniture. Dr. Colaum was sitting at a large oak desk, in front of a wall that showcased more framed works by Frank Lloyd Wright. A large portion of the desk was covered with framed photographs of children and newborn babies.
“My grandchildren,” Dr. Colaum said proudly. “I have fourteen now.” I took in the bright smiles and cherubic faces of her brood and turned away. On the way into her office, we’d passed a wall filled floor to ceiling with baby announcements and holiday cards featuring what I guessed were the clinic’s assisted progeny. I felt anxious as I wondered whether we would ever have a card with our own child on it to add to the collection.
Dr. Colaum’s hair was pulled up in the same bun she’d worn in her head shot. She wore a large cut-glass necklace over a loose-fitting shift dress that hung to her shoes.
“It’s nice to meet you,” she said, extending her hand, first to Bill, then to me.
“Dr. Bizan referred you?” she asked.
“Yes,” I said. “I believe her office faxed you my file.”
“We didn’t receive anything from their office,” she replied. I grimaced.
“That happens,” she said. I’ll ask you whatever questions I need to know. What I want to do today is go over your history and then ask some specific questions relating to your reproductive cycle. Then I can make some recommendations.”
I shifted in the chair. I was annoyed that Dr. Bizan’s office had neglected to send the file. I didn’t want to go over my whole medical history again, but Dr. Colaum seemed like the kind of doctor who would want to hear everything for herself anyway. She asked about my menstrual cycle pre-Pill, how many years I’d been on it, and how long I had not menstruated. I told her about the MRI and the diagnosis of secondary empty sella.
As I answered her questions, Dr. Colaum took notes with a tortoiseshell pen, writing meticulously on a clean piece of unlined paper fastened to the inside of a folder. Peering down through crescent-shaped reading glasses on a chain, a black shawl draped over the chair behind her, she looked like a professor from Hogwarts. She gave no sign of her thoughts as she wrote.
At a certain point she stopped, leaned back in her chair, and stared past us at the back wall, or possibly the window. I dropped my eyes to her desk, not wanting to disturb her concentration. I could feel Bill’s foot bouncing against the side of my chair.
“Okay,” Dr. Colaum said, “here’s what I think.”
Bill grabbed my hand. I sat up straighter in my chair.
“First, though, do you know if you ovulate?” Dr. Colaum asked.
“Could I be, if I don’t have a period?” I asked.
“It’s unlikely, but possible. Have you ever used an ovulation kit, or checked your temperature and mucous membrane each month?”
My cousin had given me the name of the ovulation kit she’d used to become pregnant with each of her three boys. It worked like a pregnancy test: By urinating on a strip, the woman could figure out when she would ovulate. I’d bought one when I started acupuncture, thinking we could use it when my period started. I’d never opened it, actually had forgotten I’d bought it. I pictured where it would be now, gathering dust on a shelf in our bathroom next to a box of tampons that was also almost three years old.
I told Dr. Colaum I had not monitored my ovulation.
“Don’t worry. The next step I recommend for you both is to have the full panel of fertility tests. If we’re going to support you here, we test every aspect of fertility. You too, Bill. We wouldn’t want Sara to have all the fun.”
“Great,” Bill said, looking uneasy.
“From there we’ll have a clear idea of where we stand and what we might be able to do to help you.”
“There’s one more important question I need to ask before we go further,” she said, looking up at us from the folder. “It may be obvious because you are here, but I don’t want to make any assumptions.”
Bill looked at me and I shrugged. I guessed it would be something about our insurance information or financial resources.
“Do you want to be parents?” Dr. Colaum asked. “Specifically, is pregnancy and having children your ultimate goal?”
I squeezed Bill’s hand. “Definitely, yes,” we replied simultaneously.
Once we agreed to the tests, Dr. Colaum sent us over to see Rachel, the serious nurse, who took us to a smaller consultation room down the hall. She printed out a list of the tests Dr. Colaum had ordered and a calendar to schedule our dates. She handed me a large stack of papers with a description of each of the tests, instructions for how to prepare, and what to expect afterward.
Among the list was a hysterosalpingogram, a word I had difficulty pronouncing at first glance, designed to see if my fallopian tubes were open.
“We just call it an HSG,” Rachel said, sparing me. “I recommend you take some Tylenol or Advil before you come in. Some people feel uncomfortable afterward.”
Over the next two weeks, Rachel scheduled us for several appointments. I was to take the female fertility panel, which included the uterine ultrasound and evaluation and blood work to test my levels of the hormones estrogen, progesterone, and prolactin. Rachel scheduled Bill for a semen analysis to determine the quality and quantity of his sperm. We signed paperwork that stated we would pay for any lab tests insurance didn’t cover.
It was close to noon by the time we finished our appointment and left the office. My mind felt overloaded by the t
ime we got back to the car. As we turned back onto Ridge Road, Bill said, “I think we should go out to lunch. I’m getting a headache.”
“That was intense,” I said.
We decided to drive back to the city and go out somewhere near our house.
If we go to Que Rico, we can listen to mariachi music and pretend we’re on vacation in Mexico,” Bill said.
“Que Rico it is,” I said.
I drove to Dr. Colaum’s for the HSG at noon the following Friday. I hadn’t remembered to take the Tylenol that Rachel had recommended before the appointment, but I thought it was probably unnecessary. I’d been told I had a high pain threshold and believed this to be true. After my cyst had ruptured, I’d asked one of the nurses if that pain I’d been in was equivalent to what women experienced in childbirth.
“Good lord—no, sweetie. What you had was many times worse.” After watching a film on natural childbirth years later, I didn’t know if that was true, but I appreciated what the nurse had said at the time. It was empowering to think I’d already survived pain worse than labor.
The hysterosalpingogram worked via internal ultrasound. A bubbly nurse named Tracey escorted me into an examination room that held a hospital bed and several large machines. As I changed behind a screen, Tracey and I chatted about her work at RMI. She told me that she and her fiancé had just adopted a puppy. Dr. Colaum entered and directed Tracey to the ultrasound machine. She took what looked like a large condom from a box and pulled it onto a plastic tube attached to the machine next to the bed.
“This is a vaginal wand,” Tracey explained, squirting some blue gel onto the tip. “It uses ultrasound to let us see your reproductive organs from the inside.” Dr. Colaum inserted the wand and began to move it around from side to side. The gel was cool, and I could feel pressure but no discomfort.
“All looks good so far,” Dr. Colaum said to Tracey, who was taking notes. “I’m coming around to the right ovary now. All looks good here.” Dr Colaum moved the wand across to the other side of my vaginal wall. “Where is . . . ?”
