What I Thought I Knew: A Memoir Read online

  Dr. Zagami, recently voted Best Fertility Doctor! by New York magazine, told me, “Your estrogen level is so low, the only way you could ever become pregnant is by immaculate conception. I’m putting you on ERT, estrogen replacement therapy, which I ordinarily prescribe to menopausal women twice your age. You could get pregnant with fertility drugs, but I strongly advise against it. As a DES daughter, your cervix is likely to dilate early in the pregnancy, resulting in premature birth. And with your small, deformed uterus, there’s no way you could carry a baby past six months, so you should never attempt to get pregnant. But look at the bright side; you’ll never have to use birth control again.”

  That night I wept for a long time. Brad sat quietly on the bed and held me when I was too exhausted to cry anymore. Our grief satisfied Patricia, our social worker at Spence-Chapin adoption agency. She had met many infertile couples who treated adoption as an insurance plan, while secretly hoping to have a real baby, so that they could be real parents. We passed the cathartic grief test, and she signed us up.

  We waited two years for a birth mother to choose us. Zoe was nineteen years old and didn’t realize she was pregnant till her sixth month, when it was too late for an abortion. She wanted to go back to college. It wasn’t the right time in her life to be a mom. We were at Julia’s birth, and held her moments after she was born. Though we knew Zoe didn’t want to raise a baby, it seemed like superhuman generosity for her to give her newborn baby to us. We were infinitely grateful to her for choosing us.

  Julia has heard this story often. It is part of our family folklore.

  At my New School University graduation ceremony in May of 1999, I walked down the aisle of the ornate chapel of Riverside Church feeling sick, anxious, and old. Michael was in the audience, briefly in town between performing gigs. He was touring for most of April. Tomorrow he would leave for two weeks in El Paso to create an original theater piece with Mexican American high school students. He had so much energy. I had so little. What happened to my eternal youth? Ubiquitous happiness? Was this menopause or was I sick? Was this misery my insurance policy against the Evil Eye, or did the Evil Eye cause this misery?

  Dr. Kay, the gastroenterologist, sent me for an abdominal sonogram and a CAT scan. He diagnosed me with anemia and reflux, and prescribed drugs and a low-acid diet. I asked him if I had to avoid drinking wine on our August trip to Italy.

  “Have plenty of wine, especially the local reds! I’d never forgive myself if you went to Tuscany and didn’t drink wine.”

  In July’s heat, I felt worse. “My hip joints are sore, my breasts hurt, there’s a hard swelling in my abdomen, I’m depressed, I can’t sleep.”

  Dr. Kay sent me to his wife, Dr. Jan Riley, a general practitioner. She sent me for a breast sonogram and a hip X-ray, both negative. “Ask your gynecologist to adjust your estrogen level,” she suggested.

  With my feet in stirrups, I asked Robin about my symptoms, while she performed an internal exam.

  “Why is my abdomen swollen?”

  “Middle-aged loss of muscle tone.”

  “But my stomach has never been so firm in my life.”

  “You’re a middle-aged woman in early menopause, and your figure is changing.”

  “Why do I feel like I have to pee all the time?”

  Her rubber-gloved fingers pressed on my cervix and the walls of my vagina. “You have a bladder disorder called cystocele. Atrophied bladder muscle, a common symptom of aging. You’ll experience some leaking when you sneeze and walk. The only way to cure it is with surgery, but the risks are worse than the cure.”

  She removed her gloves and examined my breasts.

  “Why are my breasts so sore?”

  “You have hard ridges as a result of wearing underwire bras for so many years.”

  “I don’t feel ridges.”

  “I do.”

  “What about my depression and insomnia?”

  “Welcome to menopause!”

  “Can you retest my hormone levels?”

  “No. I’d have to take you off the hormones for several weeks to get an accurate test, and your estrogen is too low to do that. Increase your exercise, start a weight-loss diet, continue the hormones, and see me in a year.”

  I dieted and forced myself to jog three miles a day, adding abdominal crunches and weight lifting to my regime. “Middle-aged loss of muscle tone,” I reminded myself, popping the button on my pants, then popping a Premarin—pre- for pregnant, mar- for mare, a female horse. My daily dose of pregnant horse estrogen.

  Scene 3

  Wedding Plans

  Michael and I set a wedding date of June 11, 2000, which gave us nearly a year to plan. In July, while Julia was in LA, we visited the short list of wedding sites in our low-budget range, though I wasn’t exactly in the mood. After Robin’s diagnosis, I had a recurrent fantasy of walking down the aisle at my wedding, having hot flashes and wearing Depends, Michael looking like a college kid, holding hands with his ancient bride.

  The round-faced young woman who gave us the tour of the Victorian wedding factory in central New Jersey wore a pale peach polyester bridesmaid dress, which matched the drapes, her hair ribbons, and her blush. Michael bated her with his charming smile and intentionally dumb questions. Unaware of Michael’s sarcasm, she rattled off at lightning speed her script of menu options for the tightly scheduled nuptials, the breakneck pace of her delivery mirroring the pace of the ceremonies—eight weddings each weekend, a feat accomplished by herding the guests at each wedding to a different room every half hour.

  The rustic Bear Mountain Inn, nestled in a beautiful mountain valley, was briefly the top contender, but we ruled it out when we returned with dozens of other betrothed couples for the complimentary food tasting, a parade of unidentifiable, identical fried things, variations on a theme of “pigs in a blanket,” introduced ceremoniously as fromage en croute and saucisses feuilletées.

  We weighed the merits of a civil service at City Hall, and reconsidered getting married at all. In late July, we found a place we both loved—an affordable, big old house in the country, ninety minutes upstate, with a wonderful in-house caterer. We paid our deposit and took a break.

  Scene 4

  Italy

  It was our first vacation as a family. Julia, who would celebrate her ninth birthday in Tuscany, was an adventurous and uncomplaining traveler—open to trying anything new—especially gelato, but even the cathedrals and museums at which most kids balk. Michael, also on his first trip to Europe, had an obsessive drive to see everything, and set a manic sightseeing pace. We sped around Venice for three days, riding gondolas and water taxis, taking in Renaissance sculptures and the Biennale exhibit of contemporary art, viewing the city itself as a work of art slowly being submerged in water—like Michael’s beloved and vulnerable hometown of New Orleans. At first I was energized by Michael’s and Julia’s high velocity tourist style. But each day I found it harder to keep up with them.

  Driving into Tuscany, Michael at the wheel, he took a wrong turn and we ended up in downtown Florence, stuck in traffic outside the city hospital. My hand on my hard belly, I had a fleeting fantasy of checking into the hospital. I would point to my Berlitz phrasebook at the Italian for “What’s wrong with me, Doctor?” He would smile condescendingly, borrow my book, and point to the phrase “Welcome to menopause!” which he would announce loudly in two languages, to the amusement of his colleagues. The Florentine traffic jam ended, Michael found the narrow, unpaved road we were looking for, and we drove up the mountain to our rented Tuscan cottage.

  Signora Francesca Gimaldi, our eighty-five-year-old landlady, whose leathered face was crosshatched with wrinkles, greeted us in Italian. She took a grandmotherly shine to Julia and promptly flagged down the rickety local bus, returning three hours later with two brown paper bags filled with fresh figs—one for her and one for Julia.

  Michael and Julia drove down the mountain to Florence over the next few days, to visit the Uffizi Gallery and t
o explore the city, but I was too tired to join them, so I stayed at our cottage. Signora Gimaldi and I rested on the gray slate patio together, two old ladies quietly gazing at the parched yellow grass, olive trees, and vineyards, the vines tethered to wooden stakes to support the ripening bunches of small, green grapes. I followed Dr. Kay’s orders, and drank lots of local red wine.

  Rome was beautiful but too hot to breathe. While Michael and Julia explored ancient ruins, cathedrals, and gardens, I became the American expert on Italian park benches. A Roman policeman shook me awake from a nap at the Villa Borghese Gardens and ordered me to leave.

  I was famished, but after a few bites I couldn’t eat. My cheeks were sunken, my stomach was bloated. On the last night of our trip, unable to sleep, I ran my hand over my abdomen. The swelling was bigger than at the beginning of our vacation. I put Michael’s hand on my belly.

  “What do you think it is?” he whispered, half-awake.

  “Either I’m pregnant or this is a tumor.”

  “You’ll be okay,” he said uncertainly, his hand tracing the hard curve.

  Back in New York City on Labor Day, I bought an over-the-counter pregnancy test kit. “Negative,” I told Michael.

  “How does that make you feel?” he asked.

  “Relieved. Disappointed. Scared.”

  “Me too.” He hugged me, picked up his suitcase, and left for the airport. He would be performing in Chicago all week, and would return late on Friday night.

  What I Know

  1. I have a large, hard lump in my lower abdomen.

  2. I’m not pregnant.

  3. I am forty-four and in early menopause.

  4. I have been infertile since the age of thirty.

  5. I have a bladder disorder.

  6. I have sore breasts, a result of wearing underwire bras.

  7. I’ve felt sick since April.

  8. I’m anemic.

  9. I’m depressed.

  10. I have been on hormone replacement therapy for fourteen years, which increases my risk of cancer.

  11. I’m a DES daughter, which increases my risk of cancer.

  12. My mother had breast cancer.

  13. I’m sure the lump is cancer.

  Scene 5

  Rosh Hashanah

  The Jewish calendar is a combined lunar/solar calendar. The months correspond to the moon’s cycle, the year to the Earth’s rotation around the sun. Because twelve lunar months is eleven days short of a solar year, a thirty-day Leap Month is added every few years to keep in sync with the seasons. Jewish holidays begin at sundown, and the first evening is called “Erev” or “eve of.” In 1999 the Jewish New Year, Rosh Hashanah, begins at sundown on Friday, September 10, four days after Labor Day.

  That afternoon I had a 1:30 appointment with Dr. Jan Riley. In the waiting room I thought about anything to get my mind off the frightening bulge in my abdomen. My first faculty meeting at The New School at 4:00 today. Rosh Hashanah dinner tonight at Sue and Larry’s. Julia has a play date with their daughter, Adria, after school. I’ll pick up a bottle of wine after my faculty meeting. Tomorrow I take Julia to Rosh Hashanah children’s service. Her choice. Funny how I grew up with minimal Jewish education, I only go to synagogue on Rosh Hashanah and Yom Kippur, but Julia has been the driving force for her own Jewish education; she asked for Hebrew lessons from the age of six and is committed to having a bat mitzvah. So foreign to me, but I take her to Hebrew school every Monday with her friend Sophie. I adore Sophie’s mother—we’re on the cusp of a genuine friendship. Damn it, I’ve been waiting for Dr. Riley for two hours. I can’t be late for my meeting.

  “How long have you had this?” asked Dr. Riley, pressing her hand on my swollen belly.

  “I noticed it a month ago. My gynecologist said it was loss of muscle tone.”

  “Did she do an internal exam?”

  “Yes.”

  “I’m sending you to Lenox Hill Hospital for an emergency CAT scan.”

  “I have a meeting for a new job in twenty minutes. Can I do this tomorrow?”

  “No. I think you have a large uterine or ovarian tumor. I can’t let you go the weekend without having this seen. It’s Friday. Radiology closes at four. I’ll call them and tell them to stay open for you.”

  It surprised me that I was so terrified to hear I had a tumor. It’s what I expected. Michael wouldn’t be back from Chicago till midnight, and was unreachable by phone. I called Sue from the hospital and told her I’d be late to dinner.

  “Can I to come to the hospital to be with you?” Sue offered. “I can get Larry to take care of the kids.”

  “No, I don’t want to worry Julia. Thanks for offering. I’m okay.”

  “This will make your organs glow,” said the nurse in the crowded Radiology waiting room, handing me a quart of a gluey, white, vile-tasting liquid. “When you finish drinking it, take a walk, and come back in an hour.”

  In the middle of Central Park, in the center of this frenetic city, Turtle Pond is an oasis. On this insanely beautiful day, the sun was just slipping behind the treetops. A redwing blackbird perched on a cat-tail. A white heron gracefully fished along the far shore. Five turtles, lined up on a log, stretched their necks toward the afternoon’s last rays of sun, toward the impossibly blue sky. The pond was framed by weeping willows, the willows framed by the Manhattan skyline. This might be the last time I would see Central Park in late summer. This might be my last Rosh Hashanah. Would I live long enough to marry Michael? To help Julia grow up?

  I walked back to Lenox Hill. I was the only one in the now shadowy waiting room, except for Jim, the young, black-haired radiologist, and his white-haired assistant, Jane, who were staying late just for me. The incandescent lamps had been turned off, leaving a bluish glow over the reception desk. They ushered me into a fluorescent-lit room and hooked me up to an IV, which made my mouth taste like aluminum, and dyed my glowing uterus and ovaries—and whatever hard and unwelcome mass was growing in them—purple.

  Directed by Jane over a loudspeaker, I lay down on a metal tube, which transported me inside the human-sized white cylinder, a sterile and profoundly lonely place. I wished I’d asked Sue to come to the hospital with me. Between repeated immersions in the cylinder, I glimpsed Jim and Jane through the glass window. Their faces, which I tried to read for clues, looked troubled and confused. Jane apologized over the monitor. “The X-rays aren’t clear. We’ll have to run it again.”

  When they were done, I sat in the chilly waiting area and fell asleep.

  “Mrs. Cohen. Mrs. Cohen.” Jim was gently shaking my shoulder. “We did find something in you, Mrs. Cohen.”

  “You did?”

  “We found a baby.”

  “What?”

  “We found a baby.”

  “What?”

  “We found a baby in you. Congratulations, Mrs. Cohen!”

  Obviously, this is a dream. I argue with him in my dream.

  “That’s impossible.”

  “Well, yes, we’re very surprised. Your medical records say you’re in menopause, and we didn’t expect to find a baby. It’s not customary to diagnose a pregnancy with a CAT scan. Not recommended. Nevertheless, as I say, there is a baby in you.”

  “I don’t believe you.”

  “We found a baby.”

  Maybe this is a semantic misunderstanding—a slapstick “Who’s on first?” dialogue, with “baby” a proper name standing in for something else. I try to figure out the joke.

  “What do you mean by ‘baby’?”

  “I think you’d better come to the ultrasound room and see for yourself.”

  I can tell it’s a dream by the script. It has that hard-boiled, noir dialogue of movies and dreams: “We found a baby in you, Mrs. Cohen!” “I don’t believe you!” “You’d better come to the ultrasound room and see for yourself!”

  Since my identity is predicated on my infertility, the statement, “Mrs. Cohen, we found a baby in you,” made no more sense than if he’d said,
“Mrs. Cohen, we discovered that you’re a man.” Or, “Mrs. Cohen, we found out that you’re black.” Or, “Mrs. Cohen, the CAT scan revealed that you’re a billionaire, or a dog, or a registered Republican, or a right-to-life lobbyist.” However, I’m beginning to believe the radiologist, in that way you believe what a dream character tells you, no matter how lunatic it might be. In fact I’m beginning to warm up to this idea of being A Little Pregnant instead of having A Big Tumor. Given a choice between a few life-affirming embryonic cells and a lethal mass of cancer cells, I’ll take the embryo!

  I can tell it’s a dream because, as so often happens in my dreams, I’m both inside and outside myself. It’s another recurrent dream of mine. I wrote a solo play about this dream of me, on the ceiling, looking at me on the examining table, looking at me on the video screen. It always starts out this way, in my dreams and in my plays, but I never know what’s going to show up on the video screen.

  The radiologist slathers my belly with warm gel and moves the ultrasound device—kind of like a computer mouse—over the gooey surface, matched by a slurpy, gloop, gloo-oo-oop sound. The video screen is filled with shifting patterns of gray dots.

  Maybe, in this dream, the video screen is a Rorschach test, an opportunity for self-analysis. In a dream a baby represents the self—I took a course on Freudian and Jungian dream analysis at Princeton—I’m going to give birth to my self.

  He stops moving the sonogram camera over my gloopy belly.

  Out of the gray haze, there is now a baby on the screen. It has a baby’s profile, rather pretty, with a button nose, parted lips, and an enormous forehead. A rhythmic flickering of light is its tiny heart, quick as a little bird’s heartbeat—ta-tinn-ta-tinn-ta-tinnta-tinn. . . . A thick, coiled umbilical cord floats from its baby belly, a teeny penis peeks between his legs. The baby has two feet, five toes apiece, two hands, each with five fingers.