Jesus winks

There's an icon that sits on my bedside table, a red line drawing of Jesus, winking. My priest gave me this image during my pregnancy with Sam. The suggestion that what was happening to me, to us, might be a big fat joke was oddly comforting. We'd laugh about it all -- the bleak season of infertility, IVF, horrifying bleeding, relentless pre-term labor -- someday! But someday is now, and I'm not laughing.

I'm pregnant again, this time with what Brian calls our "free baby". The pregnancy has been entirely uncomplicated. So normal as to be almost cliche. In February, I felt nauseated on call, and took the contraband pregnancy test my intern swiped from the store room in our hospital emergency department: positive. Since then, I've tripped happily through my rotations, my expanding girth a conversational touchstone for my patients and my colleagues. Nothing to report outside a little extra swelling, a trifle more fatigue. I don't have so much as a stretch mark to show for my adventures.

Now I'm winding up and slowing down. My rotation these past two weeks has been "women's health", an ABIM requirement for medicine residents, especially those of us who spend a disproportionate share of our training in VA hospitals, caring primarily for aging (male) warriors. These two weeks are hardly sufficient time to balance the years I've spent prescribing phosphodiesterase-5 inhibitors and counseling veterans about prostate cancer screening, but here I am. Here we are.

Friday, I spent the afternoon at Stanford's reproductive endocrinology clinic. I gently suggested to my attending that perhaps the IVF clinic wasn't the best place for me, in my condition. Her response -- "Don't worry about it; if the patients have a problem, it's their issue" -- was entirely my point. (And made me think, well, look who got pregnant on her first try. That must have been so very nice for you.) But it wasn't only their issue: the flash of pain on the patients' faces when they met me was painful to me as well.

Then yesterday: Planned Parenthood. And you know, there was the same flash of pain on those faces when I waddled into the exam room in introduce myself. A flinch followed by a firm mustering up. Wielding the wand of the transvaginal ultrasound I measured centimeters on a grainy screen: gestational sac, fetal pole. Eligibility for the "pill" vs the "procedure".

And now I think I see that the wink wasn't merry. This is not an inside joke, but a serious business. Even though I've come through a short season of infertility with my happy ending intact, with Sam on my lap and a bonus baby on his way, I still remember exactly how it feels to be on the other side.