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National Institutes of Health Bethesda, Maryland
As we sat in the stark basement waiting room in of one of the National Institutes of Health buildings, I thought Patti was more anxious than I was. She cuddled one-year-old John Paul on her lap, her left foot jiggling. Sitting next to her, Hunter held her hand. The three of us had the room to ourselves and we seemed to have run out of small talk after the long drive from the Outer Banks.
A dark-haired woman appeared in the doorway. The name on her white coat read S. Barron, RN. “Caroline Sears?” she called. She had a Northern accent, I thought, much stronger than Hunter’s. She’d barely pronounced the r in my last name.
“Yes,” I said, getting to my feet. “Can my sister and brother-in-law come in with me?”
“That would be fine,” she said. “Follow me.”
I walked ahead of Hunter and Patti as we followed the woman down a long bare corridor to a room nearly at the end. Inside the small room were six chairs arranged in a semicircle. The only other furnishings in the room were tall metal file cabinets that filled one wall.
“Have a seat,” the woman said.
I sat next to Patti and John Paul, who was beginning to fuss. He’d been an angel during the long car trip, but I think now we were all getting stir-crazy. Hunter took him from Patti’s arms and began bouncing him gently on his knee.
“I’m Susan Barron,” the woman said, settling into her own seat, a clipboard and file folder on her lap. Her gaze was on me. “I’m one of the designers of the study, though I won’t be the person doing your examination,” she said. “My role is to gather some information from you beforehand, all right?”
She opened the file on her lap and glanced at it. “You’re twenty-six years old, correct?”
“We received the records from your obstetrician, a Dr. Michaels. You’re about twenty-four or -five weeks along at this point?”
“And your pregnancy has been uneventful until your last exam?”
“Well, last two exams,” I said, shifting on the seat. I was tired of sitting. My legs ached. “Dr. Michaels told me a month ago that my baby’s heartbeat was irregular, but he didn’t think much of it. This last examination, though, he was more concerned.”
“Right,” she said. “And I don’t know how much information you were given, but our study is actually full. We have all the patients we need at this time. However, your brother-in-law here”—she looked at Hunter—“is a puller of strings, I see, and he was able to get you in.”
I smiled past Patti at Hunter. He sat there looking modest, but she was right. Hunter was a puller of strings. A fixer. I didn’t think there was anything that he couldn’t make right. Except for Joe. He couldn’t fix what happened to Joe.
“So you need to understand that this study is in its very preliminary stage as we explore the uses and limitations of fetal ultrasound,” she continued. “The technology is years away from being used on any regular basis and the images we can obtain are somewhat primitive. However, our previous study, as well as several recent studies elsewhere, had very good results in terms of accuracy, but not in every case, and I need to be sure you understand the limitations.”
“In other words,” Susan continued, “let’s say the ultrasound results appear to tell us there’s something wrong with your baby’s heart. They might be inaccurate. Conversely, they might give us the impression everything is fine when it isn’t. I want to be sure you—”
“I understand,” I said. Hunter had told me all of this. He’d explained the mechanism of the ultrasound. It was simply incredible to me that it was possible to visualize my baby while he—I felt certain it was a he, a miniature Joe—was still inside of me. Hunter said it wouldn’t hurt at all. He’d read about it. He was the founder of his own company, Poole Technology Consulting, in Research Triangle Park—RTP—where he worked with enormous computers. He had access to all sorts of technology and material the rest of us couldn’t imagine.
“Your baby’s father,” Susan said, looking at the folder on her lap. “Your brother-in-law told us he died recently?”
“Vietnam,” I said. “Right after Thanksgiving.”
“How difficult for you,” she said. “I’m sorry.”
“He didn’t even know about the baby,” I said. “He was only in Vietnam a couple of weeks.”
Patti rested a hand on my arm. It wasn’t a gesture of comfort so much as a warning for me to stop talking. Once I started talking about Joe, it was hard for me to stop. It was so unfair. Joe had been a structural engineer and we thought he’d be safe, away from the action. “I didn’t discover I was pregnant until a few weeks after I learned he was killed,” I said.
“Will you have help with your baby?” Susan asked, attempting to change the subject. I didn’t hear her at first, my mind back on the day the captain and second lieutenant showed up on my doorstep with the news that literally brought me to my knees.
“Yes,” Patti said when I didn’t answer.
“Yes,” Hunter agreed. “She has us.”
“I live with them now,” I said, coming back to the present.
“And where is that?”
“Nags Head,” I said. “The Outer Banks.” After Joe died, I’d moved from Fort Bragg into our old family beach cottage where Patti and Hunter had been living for the past couple of years. I’d expected the move to be temporary—just a few weeks off from my physical therapist job in a Raleigh hospital. But when I found out I was pregnant and my obstetrician told me I needed to take it easy, Patti and Hunter said I could stay with them as long as I wanted. Hunter worked three days a week at his consulting firm in Raleigh and I knew Patti welcomed my company when he was gone.
“Where are the Outer Banks?” Susan asked, confirming her Northern accent. Anyone south of the Mason-Dixon line knew where the Outer Banks were.
“North Carolina,” Hunter said before I could answer. “About six hours from here.”
“You drove a long way for this,” she said.
“I have to find out if my baby’s okay.” I folded my hands tightly together in my lap.
Susan nodded. “Fine,” she said. She asked a few more questions about my general health, which had always been good. “And how about the rest of your family?” she asked. “Do you have other siblings?”
“And Patti?” Susan asked. “You’re a biological sibling, right? Any health problems?”
“None,” she said.
Susan turned back to me. “How about your parents? How is their health?”
“They died in a car accident when I was fourteen,” I said.
“My.” Susan made a note in the folder on her lap, then looked up at me. “You’ve had some difficult times.”
I nodded, hoping this pregnancy wasn’t going to be one of them.
“How about your late husband’s parents? How is their health?”
“Good,” I said, thinking of my robust, tennis-playing mother- and father-in-law. They lived in Texas and they didn’t know about the baby. I’d been about to write them when Dr. Michaels told me something might be wrong. I was afraid to tell anyone after that until I knew the baby was okay.
Susan asked a few more questions about my pregnancy, which had been unremarkable, although the truth was, I’d been so distressed over losing Joe that I couldn’t have separated my symptoms of grief from symptoms of pregnancy. I worried my grief had somehow led to a problem for my baby.
Finally, Susan got to her feet. “Follow me,” she said to me. “You two?” She looked at Patti and Hunter. “You can wait here. Tight quarters in there.”
I followed her into a tiny room with an examining table, a wooden chair, two rolling stools, and a large machine bearing what looked like a small television screen. Susan handed me a pale blue gown.
“You can leave your bra on, but everything else off,” she said. “Put this on so it opens in the front. I’ll be back in a moment.”
I undressed as she’d instructed and climbed onto the examining table. My baby gave a little tumble inside me. He’d been an acrobat for weeks now. I rested a reassuring hand on my belly. There’s nothing wrong with you, I spoke silently to him. You are perfect.
Susan returned to the room followed by a very young-looking man with thick black hair, horn-rimmed glasses, and a white coat.
“Good afternoon,” he said to me. “I’m Dr. Halloway, one of the researchers, and I’ll be doing your ultrasound. Nurse Barron explained everything to you?”
“I think so,” I said. Susan had produced a stiff white sheet to spread across my lap and motioned for me to lie down.
“Is your husband here?” he asked.
“My husband died,” I said as I lay back on the cool leather of the table. I wished he had checked my file first so I didn’t have to say those terrible words again. I ran my fingers over the rings on my left hand.
“Oh,” he said. “Sorry to hear that.”
“Her sister and brother-in-law are her support,” Susan said. “The brother-in-law—that Hunter Poole you spoke with?—they’re both here.”
“Ah, yes.” He nodded. “You have an advocate in that pushy brother-in-law of yours, don’t you?” he said dryly. I couldn’t tell if he found Hunter’s pushiness annoying or admirable.
“Yes,” I said, grateful for Hunter and his advocacy.
Susan lowered the sheet to expose my big belly. It was hard to believe I had months yet to go in this pregnancy. Dr. Halloway squirted some cold gelatinous substance onto my stomach, then began running a smooth wand across my skin. Susan lowered the light in the room and indecipherable images appeared on the small screen. Both she and the doctor leaned forward, squinting at the picture. Their heads blocked my view, although every once in a while I had a clear view of the fuzzy moving image on the screen. If my baby was in that picture, I certainly couldn’t see him. How the two of them could make head or tail of what they were looking at was beyond me.
For at least two minutes, neither of them said a word as Dr. Halloway moved the wand this way and that, pressing it into my skin. What do you see? I wanted to ask, but I lay there quietly. In the light from the screen, I could see Dr. Halloway’s frown. He pointed to something on the screen, speaking to Susan in muttered words I couldn’t decipher. She also pointed to something and muttered her own response. My heart pounded in my chest. In my throat.
“Can you tell anything?” I asked finally.
They didn’t seem to hear me. Instead, they continued pointing and mumbling to each other.
After what seemed like a very long time, Dr. Halloway lifted the wand from my belly and Susan used a white towel to clean the jellylike substance from my skin.
“What did you see?” I raised myself to my elbows.
“Why don’t you get dressed and I’ll speak with you and your family about our findings,” Dr. Halloway said. I turned my head from him to Susan and back again, trying to get either of them to look at me, but they seemed to be avoiding eye contact with me.
“But what are they?” I asked, beginning to panic. “Your findings? What did you see?”
“Get dressed and we’ll talk,” he said, the lighter tone he’d had before the exam gone from his voice. “I’ve taken some pictures and I’ll show you then.”
Dr. Halloway met with us back in that small room with the semicircle of chairs. I didn’t know what had become of Susan. I sat between Patti and Hunter this time, and John Paul was nearly asleep in Patti’s lap. I introduced the doctor, who focused his attention on Hunter instead of me when he began to speak.
“I’m afraid there’s a serious problem with the baby’s heart,” he said, handing a couple of fuzzy black-and-white snapshots to Hunter.
“What do you mean?” I asked, trying to pull the doctor’s attention back to me. I was the one carrying this baby.
Hunter passed the photographs to me and Patti leaned over to see them. “How can you possibly tell anything like that from these … weird pictures?” she asked.
“Well, in many cases, we can’t be sure what we’re seeing because our images are still somewhat challenging to decipher,” Dr. Halloway said. “But in your case”—he finally looked at me directly—“what we can make out is quite clear. I believe even you will be able to see the problem.” He pulled his chair closer to us, scraping it on the floor. He pointed to a gray smudge on the image. “Your baby has severe stenosis of the aortic valve,” he said, “which, I’m afraid, will inevitably lead to hypoplastic left heart syndrome.”
“How serious is it?” Patti asked, as I searched the blotchy black-and-white images for my baby. I couldn’t find him. I couldn’t understand how anyone, no matter how brilliant and well trained, could find my baby in those pictures, much less my baby’s heart.
“I’m afraid it’s fatal,” Dr. Halloway said.
My head jerked up. “No,” I said. I felt Hunter’s hand come to rest on my shoulder.
“Fatal!” Patti said.
“How can you possibly tell that from these pictures?” I argued, suddenly disliking this man intensely. “This is just a study. The nurse … whatever her name is … Susan … she said the machine—the ultrasound—could give false information. That it’s just experimental and—”
“That’s often true,” Dr. Halloway said calmly. He was looking at Hunter again instead of me and I wanted to kick him to remind him this was my baby we were talking about. “But in this case,” he continued, “we were able to get a remarkably clear picture of your baby’s heart and I’m certain of my diagnosis. I’m very sorry.”
For a long moment, none of us spoke. “When he’s born, can he have surgery?” I asked finally.
“Your baby is a girl,” he said, “and no. I’m afraid there’s nothing that can be done for her.”
A girl! That was nearly as much of a shock to me as the news about his … her … heart, and I instantly felt even more protective of my baby. I looked down at those stupid pictures on my lap. I wished we’d never come. I hated this doctor. Hated Susan Barron. At that moment, I was close to hating Hunter for insisting I come here.
“I can’t lose this baby,” I said. “He’s—she’s—all I have left of my husband.”
“You have us, honey,” Patti said, though her voice, thick with tears, told me she knew perfectly well that she and Hunter were not enough to erase this loss.
“What are our options?” Hunter said, as if we were all pregnant.
“You can try carrying the baby to term,” Dr. Halloway said. “She’ll most likely survive the rest of the pregnancy, but with HLHS, she will die very shortly after birth. Or you can abort,” he added. “You live in North Carolina. You can have a legal abortion there due to a fetal anomaly, though it’s not an easy procedure at twenty-four—”
“No,” I said. “I can’t do that. What if you’re wrong?”
“I understand it’s hard to accept,” he said. “But you’re holding the evidence in your hand.” He nodded toward the fuzzy picture of my baby. I held the picture by the edges and I averted my gaze from it. If I didn’t look at it, I could pretend I still had Joe’s healthy baby inside of me. If I didn’t look, I could pretend this last hour had never happened.
Copyright © 2018 by Diane Chamberlain