“Afric, I am so sorry that I couldn’t make it to this scan. I would have been there if I could have arranged it – just this time it wasn’t possible. You understand, Afric, don’t you? But I promise for sure that I’ll be able to make all the rest of the appointments – in fact, you might send me the dates so I can put them in the diary.”
I could tell by Luke’s voice that he did regret not making it; his disappointment was genuine.
“Honestly, Luke, don’t worry – most of the other women there were on their own too – it’s not a big deal at all, I promise.” I was back on track now. I had managed to steady my voice – it was easier when he was doing most of the talking.
“My pregnancy app says that the kicking should start anytime soon, that it normally starts at twenty-two weeks. Have you felt anything, Afric?”
I didn’t answer.
“Can you hear me, Afric?” he said and then repeated the question, at last registering that the phone coverage was not the best. “Can you hear me?”
“Yes – yes.”
“Have you felt anything? The app says that it’s like a sensation of having popcorn explode in your stomach – you should feel popping, just below the skin – have you felt anything like that, Afric ?”
I chuckled in an attempt to disguise my upset. “Really, Luke, you and your bloody app! You’re hilarious, you really are!”
“Honestly, that’s what it said – that from between week twenty and twenty-two you should be able to feel something, not quite kicking but an exploding-of-bubbles sensation. Afric, you know, I can’t stop thinking about it. I am really excited – it’s been a long time since I’ve been so excited about anything.”
The clouds were bloated; they could no longer hold their moisture. The downpour hopped off the white horses; from where I sat it looked as though the rain was fighting with the sea.
“You know, when the baby is born I won’t be travelling so much – it will only be for the next few months . . .” He paused. “Afric, that I can promise. We will have time together before the baby is born to sort it all out. I know things have not been great between the two of us in the last few months, with me travelling and being away so much. It seems like you have a great routine going on and then when I come home I disrupt it. I get in the way and annoy you. I’m sorry, Afric, sorry if things haven’t been easy in the last while.”
I placed the handset between my ear and shoulder and squeezed both my fists this time, digging my nails deep into my palms, the white of my knuckles peering up at me.
“This time when I come back home, I promise I’ll make more of an effort . . .” His voice trailed off.
“No, it’s not all your fault – these bloody hormones make me impossible to live with. I am sorry too, really sorry, Luke.” My voice began to tremble. I could feel my self-control slipping away from me. I pulled myself together and went on in an almost professional manner. “Let’s leave it now and when you get back we can sort it out. We’ll sit down and just work it out. I think that we just need to spend more time together as a family.”
“Did they say if it was a boy or a girl?” he asked, ignoring my comments.
“They can see but I didn’t ask,” I replied, retaining the same professional tone.
“I am so sorry you had to go on your own, to the scan,” he said.
I took advantage of the lag on the end of the phone to take a deep breath. “It was fine, really fine – it was only a scan,” I lied.
“Afric, I’m so looking forward to coming home. I know this trip is very long one – more than a week away. I am really sorry – Afric, I miss you so much . . . I just want to be home.” His tone was low, but not down.
“Love you, bye,” was as much as I could manage.
I was gone.
Chapter 3
So I got a taxi back there, to that building with the cream walls – same colour, just a different unit of the hospital. We whizzed past the seafront with people enjoying an early Friday-evening dip after a long day.
He had steel-grey hair, deep-blue eyes and a long white coat. The coat reached just below his knees; it flapped as though trying to keep up with him when he entered the room, a younger male understudy on his heels. He wore frameless glasses and he had some threatening-looking medical equipment dangling from his neck like an oversized necklace. He had a kind face. My mother always told me that you get the face you deserve in life. It was the type of face that you feel you could talk to, openly. My first impression was that he definitely deserved his caring face.
He told me it was a pleasure to meet me. I thanked him – I thought the pleasure must be all his. I would never consider an appointment with a foetal abnormalities obstetrician as enjoyment.
“Afric, did you come in on your own this afternoon?” he asked.
“Yes, my husband is away on business at the moment – he works abroad. He’s in China until next Friday – he would be here otherwise.” I felt it only fair that I should defend Luke in his absence.
He seemed to consider my response as reasonable, but not ideal.
His silence encouraged me to try to fill the gap.
“It’s Luke’s busy time of the year, so he’s away a lot pretty much from April through until July. I’m used to it now – well, it’s like anything – I suppose you get used to it, don’t you? It’s like being single all over again but with the security of being married, if you know what I mean.”
“Really?” was all he said.
“Well, yes,” I replied lamely.
“Did you tell anyone that you had an appointment here today?” he asked clinically.
“Yes, I told my mum, Lizzy. I told her there might be something wrong.”
He seemed a bit more impressed with that response. He looked anxious, as though he was done with the formalities and now it was time to get down to business.
“You hop up there.” Gently he indicated for me to move towards the examination table. “Let me have a look at your baby.”
I lay back and rolled up my top so that my bump was looking up at him.
“You know the procedure by now, don’t you?” he said.
“I do,” I replied.
“I believe Mary scanned you this morning and there were a few things she was concerned about?”
“Yes. She said there seemed to be some things that were not quite correct – she never got to the end of her list – there were things that she couldn’t find?” I surprised myself with how confidently I spoke about something I knew very little about.
“Afric, what do you understand from that?” he asked in a schoolteacher manner.
“Well, as of earlier today, I have a new vocabulary: three new words.” I sounded like a school kid answering the teacher. I steadied my voice and fixed my gaze on the calendar directly ahead of me. I didn’t look at him, his understudy or the nurse who had just entered the room. “I understand that there may be a question of the baby having an absent cerebellum, or a deformed cerebellum. Mary also spoke of possible talipes in the left foot.” My eyes remained fixed on the calendar.
He seemed satisfied with this response. “Well, let me have a look at what I can see and we can take it from there,” he said.
“Okay, that’s fine,” I replied, trying not to show I was scared.
His deep-blue eyes looked at me straight. “Yes,” he said. “It will all be okay in the end.” He said it in such a way that it sounded like hospital code for something else.
The female nurse sported equally dangerous-looking artillery; it just hung there from her thin neck. Without uttering a word, she leaned in beside the man with the blue eyes and squirted gunge on my ruinous bump. She never did use the dangling gadget or utter a single word.
The cold fierce-looking steel hand-piece of the monitor dug into my stomach.
“If I don’t talk it’s not that there is something wrong,” he said. “Where I can I will talk you through what is happening.”
His understudy remained silent.
<
br /> “Your baby,” he announced out of the blue, “is a girl.”
Just like that. All my dreams of guessing and wondering were gone. It was a girl. I didn’t reply.
My tiny baby girl was once again on a giant wall-monitor in black-and-white. Three sets of eyes were fixed on her every move on the smaller screen. He concentrated his efforts on her tiny head. To the naked eye, her head seemed a few sizes too small for her dainty body. He tilted his own head at different angles as he examined the screen.
“Your baby has a very strong heartbeat,” he said.
It was that bloody heart that continued to pump blood at a fierce rate around her underdeveloped body and kept her alive.
“Okay, I have seen what I need to see,” he said to his understudy, who remained nameless and silent but took it as his cue to leave the room.
The efficient nurse gently wiped all the gel gunge from my stomach. Then she was gone too.
“Afric, you can sit up whenever you’re ready.” He offered me his arm in the same way that a wrestler invites his opponent to an arm-wrestle.
I sat up with his help and swung my legs over the side of the examination table. He sat down facing me.
“I can confirm that what Mary told you is correct,” he said in a low clear voice. “There is an absent cerebellum and possible talipes and there may even be other complications that we can’t know about at this early stage. Afric . . .” He looked straight at me, right in the eyes, and his deep-blue eyes looked as though they might pierce my heart. “Afric, if your baby makes it to full term she will be both mentally and physically handicapped – that’s if she does make it to full term. And if she does, she may survive only days, or maybe only hours after she is born – at most a few months – she won’t survive for very long. At this stage, I cannot say exactly how severely physically or mentally handicapped she will be, but from what I have seen today, your baby will be profoundly handicapped.”
Then he said those dread words.
“I am afraid your baby is incompatible with life. Incompatible with life, Afric.” He repeated it as though to confirm what he had said. “Your baby has a foetal abnormality that is fatal.” He paused. “There are a few different syndromes where the cerebellum is either partially or fully absent. At a crude first glance from the scans it would appear that your little girl has an absent cerebellum. We can see no evidence of a cerebellum at all. This we can tell by the measurements we have taken of the baby’s head circumference.”
I swallowed hard. My concentration was fierce. I did not want to miss a single word. I needed to take it all in, to remember all these new phrases, so that I understood it all . . . so I could comprehend how sick my little girl was.
He continued with his clear and coherent diagnosis. “Some of the syndromes associated with an absent or partially absent cerebellum are Edwards Syndrome, Dandy-Walker Syndrome, Patau Syndrome and Joubert Syndrome. Some are fatal – others are not. An absent cerebellum is strong evidence of a serious condition where there is very limited brain development, other deformities such as problems with the spine, and with the feet – in your baby’s case it seems that is so – we can see evidence of talipes. An absent cerebellum can be an indicator of Patau Syndrome – but it could be, as I said, any one of a range of syndromes. Afric, we cannot at this stage tell you which syndrome it is. We would need to perform an amniocentesis in order to establish which one your baby has.”
He waited for me to respond, but I had no words to give him, so I nodded, a gentle nod.
“The syndromes are a result of a problem with chromosomes. You see, each person has twenty-three pairs of chromosomes, or forty-six in all, in each cell. For each pair of chromosomes you get one from your mother and one from your father. Any changes in the number of chromosomes, whether too many or too few, can result in disorders. In other cases there may be a change in the structure of chromosomes – some of the structure might be missing, repeated or altered – this too can cause these syndromes or disorders.
“An amniocentesis will give us a clearer picture of what was wrong with your baby’s chromosomes – it will also tell us if the problem is genetic or not.” The man with the deep-blue eyes addressed my eyes. “I would recommend that you have that now, here. I can perform it immediately for you.”
“Amniocentesis . . .” My mind wandered. I had heard so many different terms, so many unfamiliar terms, that my brain was frazzled. I must have seemed puzzled as I looked into his eyes. They were now more of a grey than a blue colour.
“What it means is we take a sample of amniotic fluid, using a hollow needle, from the uterus. An amniocentesis will detect ninety-nine per cent of chromosomal disorders. If we request the results of the test as a matter of urgency from Scotland we can get them back first thing on Monday morning. And we will then be clear as to what condition exactly your baby has. But, Afric – the results will not change the fact that your baby is incompatible with life. It might be a good idea to familiarise yourself with these syndromes, the ones I mentioned. The nurse will give you a list of them – best now to understand what you’re facing.”
I smiled half a smile, just to acknowledge what he had said.
“I’m afraid, Afric, there is very little else we can do for you.” He pursed his lips and very gently shook his head. He seemed genuinely sorry he couldn’t help any further. “There are decisions that you – you two as a couple need to make – together – to decide how to deal with this incompatibility.”
I sat there, upright on the examination table, like a lost little girl. It was like someone had flicked a switch in my life and my world turned from colour to a dull black-and-white. Along with the colour, my hopes, dreams and wishes for the future evaporated into thin air in the room with cream walls.
His steel-blue eyes awaited my reaction.
I had no words, nothing to say, so I thanked him. Imagine thanking someone for telling you that your baby was incompatible with life. Surely he must have thought that a little odd?
I was relieved this time he didn’t tell me it was a pleasure. How could it be a pleasure for him to have to tell a mother such a horrible reality?
That was why they gave him the kind face. That face had seen a lot of hurt.
Chapter 4
A Saturday in June, 2013
‘‘NHS Royal Merseyside Women’s Hospital. How may I direct your call?’’
I opened my mouth to speak but the words would not come out – they had got stuck, lost somewhere between the back of my throat and my lips.
“Hello? Hello – NHS Royal Merseyside Women’s Hospital – how may I direct your call?”
I hung up.
I walked from the bedroom through to the living room, and back to the bedroom. I sat back down at the window with the view of the sea and redialled the same number. This time I told the very efficient lady with the cockney accent that I needed the Foetal Medicine Unit.
“Yes, my dear, I will connect you just now.”
I waited.
“The line is busy – can you hold for a moment?” she enquired efficiently.
“Okay.”
Some elevator music played in the background; mindlessly I hummed to the familiar tune.
A different accent enquired gently if I wanted a consultation.
“Yes, please.”
“Let me see. Yes, you’re in luck – there’s been a cancellation. We can fit you in this Monday.” She sounded delighted with this.
I wasn’t. “Monday . . . Monday . . . do you not have anything sooner than that? Is there any chance you could fit me in tomorrow, please? I can come straight away – I can get a flight today and be with you tomorrow morning – first thing in the morning?”
“Today is Saturday,” she said curtly, “and we don’t do consultations in the NHS on a Sunday unless they are emergencies.”
“Yes, sorry, that will be fine – please book me in for Monday – that is this Monday coming, isn’t it? Sorry, I just want to be sure?”
&n
bsp; “Yes, Monday – the day after tomorrow.”
“But if you get a cancellation later today, maybe you could slot me in sooner?”
She ignored my last comment. “If you can make it here by ten in the morning we will see you then.” This was followed by a “Please hold”.
I could tell by her tone that this was the end of the conversation.
It felt all wrong. As if she didn’t understand how serious my problem was. God, maybe I had in error called a clinic in Liverpool where they did plastic surgery, face-lifts and that kind of thing? Jesus, I thought, maybe I had just booked myself in for a face-lift unknowingly. It was not that I didn’t need one – I did and never more so than in the last few days – the lines on my forehead were now ridges – but at the moment I had more urgent matters to attend to.
The hold music chirped in the background. It was the Rolling Stones, I was sure of it this time. “Beast of Burden” was the tune. She was still gone. I was still holding. And they were still singing.
I must have dialled the wrong number. Sure they hadn’t even asked me what I needed done or who I needed to see. Definitely I had called a plastic-surgery clinic by mistake – that was why they never had cancellations – sure why would someone who had been considering a face-lift for years, not to mind having saved up for it, then suddenly decide to cancel it at the last minute?
“Yes, where were we?” She was back in an even more efficient voice. “Yes – Monday at ten it is.”
I thought about asking her about the face-lift, but she seemed very busy so I decided against it.
“May I have your personal details?” she enquired.
Now that we had agreed a date and a time on her terms and conditions, the frosty manner seemed to have thawed somewhat.
“Afric Lynch,” I replied.
“You sound Irish – are you a resident of the UK?” she asked.
“No, no, I am not – is that okay?” I enquired nervously, afraid that I might piss her off again.
“Of course it is, no problem at all. We have an Irish package – that is the only reason I asked, darling. If you give me your email address we will send you the details.”
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