ONE



1
It got suddenly very quiet in the exam room.
I was just over six weeks pregnant, at the fertility clinic for a follow-up ultrasound to make sure my pregnancy was on the right track: not ectopic, not an empty egg sac, not a false alarm.
There were five of us crammed into the tiny room: a young doctor doing the ultrasound; the senior doc who'd overseen my fertility treatments; a nurse; my husband, Alastair; and me—lying on the table with my feet in stirrups and an ultrasound wand plunged up into my ladyparts.
Seconds earlier, the doc wielding that wand had been providing a running commentary on what we were seeing on the screen—a friendly little tour of my reproductive organs: "Right here's your cervix, here are your ovaries, and this, you can see, is your uterus—nice thick lining there—and right here … we should be able to see the … uh…"
There was (forgive me) a pregnant pause.
I held my breath and waited for the bad news: the embryo was gone or dead or implanted in the wrong place. This was going to be just one more disappointment, one more defeat. Who was I to think that my subpar reproductive system could actually sustain a pregnancy? And what had we been thinking, telling our parents the good news the same day we got a positive pregnancy test? Stupid, stupid, stupid.
The doctor now maneuvered the wand until it felt like it was horizontal inside me.
"OK, so," he finally said. "We appear to be looking at two pregnancies."
Two pregnancies? I thought. What the hell does that mean? How can one person have two pregnancies at the same time? Unless …
"It's twins?" I said, idiotically.
"Yep," said the doc. "Congratulations."
I looked up at Alastair, dumbstruck. I might have smiled a little, in a "holy crap, can you believe it?" sort of way. Mostly, though, I was searching for reassurance, proof that he didn't hate me for this. After all, it was my lazy ovaries, and their subsequent dosing up with fertility drugs, that had gotten us into this. And anyway, why had I been so eager to start down the road of fertility treatments? We'd only been trying for a year before we went the intervention route. We could have kept at it a little longer on our own. It might have happened.
Looking at him, I wondered if he was thinking all of these same things, hoping he wasn't. But I've known the man since I was eighteen years old, and there are still times when I find his face difficult to read. For a man as funny and often downright silly as Alastair is, his smiles are surprisingly few and far between. And although his eyes have an impressive capacity for twinkling—one of the qualities that drew me to him in the first place—his poker face is equally good.
He gave me what could be vaguely interpreted as a smile, squeezed my hand, and then squinted back at the ultrasound screen.
The older doctor, who had been sitting silently on a stool near the sink this whole time, finally spoke. "It's really something, isn't it?" His smile was thoughtful but smug, as if he'd known this all along. And maybe he had; my HCG numbers from the blood pregnancy test a few weeks earlier had been through the roof. Come to think of it, maybe that's why he was here in the first place.
I looked back at the ultrasound screen, and there they were: two little black beans in a field of fuzzy gray, each with a small white spot in its center where a heart would soon grow. Something about the fact that there were two of them made them seem more alive, more human, than I think would have been the case if there were only one. They were hanging out together. Keeping each other company. How strange. How utterly surreal.
The doc at the controls hit a button and the image froze. "We'll give you that shot to take home as a souvenir," he said. Then he looked over my shoulder at Alastair and said, very seriously, "Are you OK? Do you need to sit down? You look kind of pale."
"No, I'm OK," Alastair said, this time smiling for real. "But you're sure there are only two in there, right?"
Before we left the exam room, the doctors asked if we had any questions.
Any questions? I had about a million, tumbling and vaulting through my brain: Can my (rather petite) body handle this? Will I be OK? Will they be OK? What if they're born premature, with all kinds of terrible complications? And while we're at it, how are we going to afford this? Am I going to have to quit my job? Are our careers / social life / sex life over? And, dear God, what if I just don't have what it takes to be a mother of twins? I'd been nervous enough about the prospect of one baby, but this? This was ridiculous.
But the only question I could manage to choke out was: Could I really not eat cold cuts? Because of the bacteria or nitrates or whatever the reason was you weren't supposed to eat them when you were pregnant? Because I ate a lot of turkey sandwiches.
"You're probably OK with turkey," the younger doc said. "But I'd stay away from the more processed stuff, like olive loaf."
The older doctor nodded sagely. "I'd definitely stay away from olive loaf."

* * *

After shuffling numbly out of the clinic, squeaking our way over the shining, high-wax floors to the banks of elevators—I wondered how many other couples had made the same, dazed shuffle under similar circumstances—we had breakfast in the cafeteria on the first floor. Alastair got a very large plate of eggs, bacon, and other classic oh-my-God-I'm-having-twins comfort food. I got a blueberry yogurt and a decaf coffee. We sat across from each other at a wobbly table, silent.
I believe I eventually said something profound and articulate along the lines of "wow."
What else could I say? This was far too much of a shock, far too much to process at once.
Alastair, God bless him, was thinking much more clearly, and in a decidedly more positive vein. "You know, I've always worried," he began, "that if we had one baby, we might never get around to having another one. We'd get in the mind-set of having a two- or three-year-old and wouldn't want to go back to the whole baby thing again. Or we'd be busy with our work and the timing would never be right."
Alastair is an only child who'd always wished he had a sibling. Like me, he wanted very much for us to have two children.
"And," he went on—he'd clearly done a lot of thinking in the elevator and/or while waiting for his eggs—"there would have been the fertility issues, too. We might have had trouble getting pregnant a second time. Or what if we had one baby first, and then had twins after that? That would be pretty tough."
This way, he reasoned, we got our two children in one fell swoop. And yes, it would be hard, especially at first, but we'd do it. "To be honest," he said, "I think part of me was hoping we'd end up with twins."
No part of me had been. But I nodded, hmmed, and conceded all his points. They were good ones. They made absolute sense. Yes, yes, yes, this is good, I told myself. It's better than good. I'm excited. No, really, I am. We're going to have two beautiful babies. It's gonna be fine. It's gonna be fine. It's gonna be great.
And anyway, who was I to be choosy? For a while it looked like I wasn't going to be able to get pregnant at all, let alone twice at the same time.
We had started trying a year and a half earlier, not long after we moved back to Boston after a two-year stint in Iowa, where I got my MFA in fiction writing—along with a hankering for a baby. The urge wasn't so much physical (no tingling ovaries) as psychological: I started feeling maternal around babies, instead of just vaguely amused and slightly annoyed. I felt a growing sense of fondness and protectiveness for children. A few friends and acquaintances were starting to have babies, and when I held them, it felt more natural and more satisfying than it ever had before. For the first time, I could imagine myself as a mother.
Meanwhile, I was starting to feel like something was missing—this despite the fact that life was actually pretty terrific. I was working part-time as an advertising copywriter, as I'd done before grad school, while also working on a novel. Alastair, who's a singer-songwriter and musician, played on the folk scene in Boston and beyond, with occasional brief tours elsewhere in the United States and in Europe. He also worked part-time teaching guitar lessons. It was a lovely, semi-bohemian sort of life, full of books and music and friends and wine. A lot of wine.
But at just shy of thirty-two, I was getting a bit bored with the total freedom of our lives. We were responsible for no one but ourselves, and one very low-maintenance cat. Holidays rang a bit hollow, and weekend days began to feel a tad roomy. One Saturday morning I had the distinct and very strange feeling of waking up and thinking to myself, "Where are the kids?" As if we really ought to have some, and we should all be going to a museum or on a hike or something. Or cleaning out the garage. You know, family stuff.
Not that we were unhappy by any means. And, granted, there were some conditions in our lives that weren't ideal for starting a family. Neither of us was making a whole lot of money, nor had either of us actually "made it" in our respective artistic fields (whatever that means). The apartment we lived in was drafty and inefficiently laid out, and I would have had to sacrifice my office to use as a nursery, which I wasn't thrilled about. Plus, our landlord, a preternaturally energetic massage therapist and cycling fanatic, liked to tinker with his bikes in the basement at all hours while singing along in full voice to, among other things, gangsta rap. Many a morning we woke up to a gleeful string of F-bombs, bitches, and hos.
But we ultimately decided, as many couples do, that there would never be a completely ideal time to have a baby. I had a feeling it might not be easy for us, given the fact that my periods tended to be infrequent when I wasn't regulating them with oral contraceptives. If we wanted to have two kids while I was still firmly in my thirties, I thought we might as well get the show on the road.
Still, our attitude was, I'd go off the pill and it would happen when it happened. Maybe sooner, maybe later. No pressure. We weren't really trying. Just not not trying.
Ha.
Is anyone actually that chill about having a baby? Maybe they are. But in my experience—and that of my friends who are psychotic overachieving types like me—once I was in unprotected sex mode, I wanted to be pregnant more than anything in the world. It needed to happen Right Now. And if it didn't (and it didn't), then clearly we were barren and would never have a baby, so we might as well start saving for plane tickets to China, because we were going to have to adopt. No question.
I'd hoped that after ten-plus years on the pill, my cycles might have been whipped into shape, and I'd be more regular. But, well, no. I didn't get my first period until almost three months after I went off the pill. After that, they came anywhere from five to nine weeks apart. (Yes, this is one of those oversharing kinds of books.)
I did the charting thing—taking my temperature in the mornings and watching for various signs of ovulation—with the hope that maybe I could crack my body's crazy code and figure out what, exactly, was going on. But month after month went by with none of the temperature spikes that are supposed to happen before ovulation, no positive results on ovulation-predictor tests, and definitely no positive pregnancy tests.
Just lots and lots of dutiful sex, on the off chance that maybe, maybe, we'd just happen to be doing it when an egg decided to drop.
You can only have so much sex and actually enjoy it. We sure did give it the old college try, though. By which I mean that college was the last time we'd had so much sex. But this wasn't nearly as much fun.
It wears on you, not being able to conceive once you've set your mind to it. With every month that passed, every stick I peed on to no avail, my urge for a baby grew keener, and my faith in my body weaker. Suddenly I heard my biological clock not so much ticking as blaring the theme song from Jeopardy! I began to panic: how was I going to have the two healthy kids I wanted while I was still young and vigorous? I was practically forty!! (Quick reminder: I was thirty-two.)
Meanwhile, every other woman in the universe was getting pregnant, from Britney Spears to teenage meth addicts to an infuriating number of my female friends.
Seeing a baby or pregnant woman would frequently bring tears to my eyes. I felt as if the future I wanted for myself—the future I could imagine so clearly and that had seemed so natural and inevitable—was being kept from me behind a locked door.
After about a year of trying—during which time we bought and moved into a much more family-friendly house, gangsta-rap free and complete with small backyard—I decided it was time to go to a fertility clinic and see if we could figure out what the heck was going on with my reproductive system.
The tests revealed that I wasn't doing a whole lot of ovulating. Which is problematic when you're trying to make a baby. The doctors were optimistic, however, that with help from ovulation drugs, in combination with intrauterine insemination (the official, medical name for the turkey baster method) to get the sperm a little bit closer to the target, we had a very good chance of conceiving. We were fortunate enough to live in the great Commonwealth of Massachusetts, where fertility treatments are covered up to a certain point (is it any wonder we have the highest twin birthrate of any state?), and so we decided to go for it.
Before we started trying to have a baby, Alastair and I were always of the mind that we'd adopt if we couldn't manage to have a biological child. Back before we got married, when we were in our early twenties, we even talked about adopting instead of having a baby of our own. Alastair, in particular, felt that in a world with a burgeoning population and limited resources, where there were always children in need of loving homes, it was the more responsible and generous thing to do. But it's easy to talk in the idealistic abstract when you're nowhere close to having kids. And it's easy to say you don't feel strongly about having a biological child before you actually start wanting to have one.
Infertility sucks. And we only got a small dose of it: I was pregnant less than two years after we started trying. Which is nothing compared to the many years that some couples struggle.
I hope you'll pardon me while I interrupt this memoir with a brief public service announcement: if you know someone who is having difficulty conceiving, be kind to them. Do not say, "You can always adopt!" or "Have you tried taking X vitamin/mineral/herb supplement?" or "Maybe it's just not meant to be." Just tell them you're really sorry and that it must be so difficult. It is.

* * *

Something else happened in the midst of our conception quest: I tried to stop taking the antidepressants I'd been on since I was twenty-three.
My depression had never been what I'd call severe. I was never hospitalized or suicidal, and I'd never felt so awful that I couldn't drag myself out of bed in the mornings. But it was bad enough that when I was having a depressive spell, it interfered with my ability to work productively and handle social interactions with some modicum of normality.
The first time it happened was when I was twenty-three. I was living with a couple of roommates in a shabby but charming Somerville double-decker, loving my job as the assistant to the president and creative director of a smallish Boston ad agency—the same one I would return to seven years later, on a part-time basis, when we moved back from Iowa. My boss, generous and mentorly, helped me find opportunities to try my hand at copywriting, and I had dreams of becoming an advertising superstar, racking up awards and big bucks.
When I was in college, I had majored in anthropology and imagined I'd go into international development, or some sort of philanthropic career path. As in, nothing remotely like advertising. But at the nonprofit I worked at right after college, as an administrative assistant in the fund-raising department, my favorite parts of the job were the opportunities I had to write and be creative—working on event invitations and postcards, letters, and the like. Meanwhile, my father, a marketing consultant, had been urging me to talk to one of his contacts at a local ad agency—one he noted as being particularly cool and nontraditional, in a former warehouse in South Boston—just to get a taste of another potential career path out there, one where I might be able to put my creative abilities to work. I resisted; advertising? Why didn't I just shake hands with the devil while I was at it? But I was feeling increasingly frustrated and unsatisfied with my current job and decided to go for it. Six weeks later, I had a job offer and, without a second thought, hopped over to the dark side. And loved it.
So it didn't make any sense to me when, about seven months into the job, I started feeling edgy and detached. I felt oversensitive and easily offended, inclined to take things personally in a way I didn't normally. I began finding it more difficult to concentrate, and my drive and enthusiasm for my work vanished. In fact, I didn't feel like doing much of anything. I was tired and lethargic. It was as if I was looking out at the world from behind a dirty window.
And yet, nothing was wrong. On an intellectual level, I knew that I still liked my job and my life circumstances. Alastair and I had recently gotten back together after a tumultuous two on-again off-again years, during which we tried to figure out whether or not our college romance was meant to survive for the long haul. It was a painful transition. But things were solid now—in fact, we felt almost like we were falling in love all over again. Though we hadn't spoken it aloud, I think we both knew we were together to stay.
And as for any deep-seated, psychological issues that might be at the core of these blues I was having? I couldn't imagine what they might be. (And why would they flip on, like a switch, for no reason?)
I waited for the funk to pass; I tried eating better and exercising more. I tried doing yoga. I even bought a couple of aromatherapy candles (proof that I was, clearly, desperate). But I couldn't kick it.
It was Alastair who urged me to see a doctor.
We were taking one of our typical weekend walks—the kind that sometimes lasted all day: we would start out from his apartment or mine, usually wending our way to Harvard Square, stopping at shops along the way. Buying lunch. Perhaps catching a spontaneous matinee movie. Sometimes we'd walk ourselves over the Charles and all the way into Boston, maybe have dinner, and then take the T back to Somerville.
On this day, though, we didn't make it far before I wanted to turn back. I didn't feel like I could walk at full speed, and I wasn't having fun. All I wanted was to take a nap.
He tried to convince me to keep going. "Walking's good for you. I don't think it makes sense to wallow."
"I'm not going to wallow," I snapped. "I just want to be alone." I immediately regretted my tone, and added, "I'm sorry. It's not you at all. Everything's fine. I'm happy with us. I just don't feel good."
"OK, fine," he said.
"Please don't be mad at me."
"I'm not," he said, after a pause and a sigh. "I'm just disappointed. I thought we were having a nice day."
"I'm sorry," I said. And I was. But I felt too tired, too gloomy to keep going.
We walked slowly home, and as he tucked me into bed—it was a relief to be back in my own room—he said, "I think this is depression."
I protested that I didn't feel sad; I just felt … blah.
"But low-grade depression can feel like that," he insisted. "I think you should talk to a doctor. It may be something that medication could help with."
"It's not that bad," I said. "Not like what you had."
A contributing factor to why Alastair and I had had a roller coaster of a relationship over the previous two years was the fact that he was depressed. Of course, neither of us fully realized this in the midst of it. He attributed his low mood, lack of interest or motivation, and social anxiety to the stress of transitioning to life after college, and to uncertainty about our relationship. Which was, no doubt, at least part of the issue. But when he got to the point where he could barely function, he saw a psychiatrist. He got on medication. And not long after that, he felt like himself again.
The change was dramatic: I remember seeing him for the first time in several months—he was about to leave on a trip to Southeast Asia with his father and wanted to talk with me before he left—and being amazed. My God, I thought, here was the person I'd fallen in love with in college, twinkling eyes and all. Where had he been all this time?
"You might not be as severely depressed as I was," Alastair said to me now. "But I wasn't either at first."
"But, ugh. I don't want to take medication," I said. "It feels like wimping out."
"Look, baby, if you were diabetic, you'd take insulin. If you had epilepsy, you'd take whatever people with epilepsy take. It's the same thing."
Maybe. But I still saw medication as being something for people with severe depression. I was still working, still eating. Still showering regularly.
But I agreed to make an appointment.
The psychiatrist I saw a couple of weeks later—young, kind, and bearded—concurred with Alastair's armchair diagnosis and prescribed a low dose of Prozac. "All the things you're describing," he said, "losing interest, having trouble concentrating, sleeping more than usual, feeling like you're looking at the world from behind a dirty window—they're classic signs of depression."
I agreed to give the medication a try. To my delight, within a little over a week, I felt significantly better. And within three weeks, I was back in business.
Just over a year later, I tried, under my doctor's supervision (and against Alastair's protests), tapering off the drugs to see if I could manage without them. Apparently sometimes after an initial course of antidepressants, some people are fine and don't need them anymore. But within two months, I was depressed again. Back on the juice I went.
And yet, because I can be incredibly stubborn, I tried to go antidepressant-free eight years later, when we started trying to conceive. I knew that the risks to unborn babies from Prozac were minimal, to the extent that they had been studied. I knew it was one of those risk-benefit equations: does the emotional harm of my going off antidepressants outweigh the benefits to the fetus of my not being on them?
But I still wanted to see if I could wean myself off the damned stuff and avoid exposing my future offspring to selective serotonin reuptake inhibitors.
My psychiatrist—a different one now, older but also bearded—was skeptical, but he understood my concerns and helped me taper gradually off the drugs. For a couple of months, I felt fine. I'd taken the training wheels off my bike and—behold—I could ride without them.
But pretty soon, that bike started veering off the pavement. I felt anxious and irritable, and I teared up at completely random moments, like, say, when I saw a stop sign that struck me as particularly poignant. I kept telling myself that I was OK. It really was a poignant stop sign. But it wasn't long before I slid right back into the dim, depressive zone I knew so well and detested so completely.
I had hoped that perhaps after so many years on Prozac, my body might have healed itself—in the same way I'd hoped birth control pills might have healed my malfunctioning menstrual cycles. But pharmaceuticals generally do not heal; they only keep the symptoms at bay. They channel your neurons and hormones in more desirable directions, like tiny traffic cops. Take away the cops, and you get a pileup.
I couldn't stand the thought of being depressed while I was pregnant. I did not want to miss out on what was going to be, I hoped, one of the most meaningful experiences of my life. And I knew that I couldn't—simply could not—be the mother I wanted to be if I was depressed.
My father suffers from depression, too. For a time, when I was in my teens, his depression was severe—so severe that sometimes when I came downstairs in the morning to eat breakfast before school, he would be in a fetal position on the couch, wincing aloud, nearly weeping, from the pain of this thing inside him. And nothing that any of us did—pep talks, comforting words, hugs, jokes—seemed to have any effect. I hated that feeling of helplessness.
Starting then, I resolved not to bring the burden of depression into my children's lives if I could help it. I did not want that damned, dark beast breathing down my loved ones' necks.
And so I went back on medication.
Fast-forward a few weeks, and I feel like myself again.
Fast-forward a little more than a year, and I am elated: I wake up on a Wednesday morning, just shy of two weeks after our most recent round of fertility drugs and IUI, my breasts wonderfully, auspiciously sore, and take a home pregnancy test. Two pink lines appear. Hallelujah.



Copyright © 2012 by Jane Roper