Thursday, September 22, 2011. Approximately 2 P.M. Mount Sinai Medical Center, Department of Maternal and Fetal Medicine. Manhattan.
I am excited. I have been waiting for this appointment for weeks. I am going to have a detailed sonogram and undergo a quick, painless test to make sure the baby has all the right chromosomes. I'll have the results in time to announce my pregnancy to my family at my birthday dinner next week. That will coincide with the end of my first trimester. So far, no one knows but my husband. He's just finished a hearing in Brooklyn and is on his way to join me so he can see the baby too. Mount Sinai has sophisticated, high-resolution sonogram equipment, so we'll get a great picture to show my parents and Sam's. They'll be stunned and thrilled.
On the crosstown bus on the way there, a lady offers me her seat. I decline but ask her, "Is it obvious?"
"It is," she says. "Best of luck to you."
On the table in the clinic, the technician smears warm gel on my swollen belly and presses down with the transponder to get a good view of the baby. "Look!" I say. "It's starting to look like a baby! Hi baby! So those are the little feet that have been kicking me!"
She doesn't say anything, but she takes some measurements. Rump to crown, cerebrum. "Make sure you measure the nuchal translucency," I tell her. "At my first-trimester screen last week it was a little thicker than they liked. They wanted me to mention that to you."
She switches off the screen and says, "Stay put. The doctor will be right in." She then leaves me alone in the darkened room.
There's a quick knock, and I think it's the doctor, but it's not. It's Sam, having just arrived at the hospital. He sits on the chair next to me and I jabber away, telling him what he missed. "I saw the baby. It's really cute. Don't worry - you'll get to see it in a minute when the doctor comes in. The whole procedure is sonogram-guided, so you can watch it in real time."
The doctor comes in, introduces herself, and turns on the sonogram machine. She moves the transponder over my belly, back and forth for a few minutes. There's the baby on the screen again. Sam leans in to get a good look. It's a little grainy, but it's there.
Then the doctor says, "I'm not seeing any cardiac activity."
At first I don't understand. I'm thinking, cardiac problems we can deal with. It's the chromosomal stuff I was worried about. You know, because of my age. We'll call in a prenatal cardiologist or something and fix whatever you see. No worries.
But then there's a pause, and Sam catches her meaning a second before I do. He puts his hand on my arm. I turn and look at him, and I see a single tear making its way down his cheek.
I realize the doctor is talking and moving the transponder around. "There's no heartbeat and no fetal movement. It looks pretty recent, because the fetus is measuring true to your due date. I'll have your regular doctor call to discuss the next steps. You can get dressed."
She turns off the machine, turns on the lights, and leaves the room.
That's it? I think. Just like that, this whole thing is over? No more tests, no more pictures? Now I just go home?
Sam helps wipe the gel off my belly, and I sit up. The doctor comes back after a moment and hands us a box of tissues. Sam pulls out six or eight sheets from the box and presses them to his face. The doctor tells us she has called my regular obstetrician and brought her up to date; the office will call my cell phone shortly to set up the necessary surgery. The doctor says it was probably a severe chromosomal defect in the fetus, since the nuchal translucency measurement, a marker for chromosomal abnormalities, was indeed elevated. "I'm sorry," she says. "You seem like such nice people. Maybe I'll get to see you in here again sometime soon." And then she leaves.
On the way out, I stop in the bathroom, and I pass the technician in the hallway. She gives me a sad look and mouths, "I'm sorry."
The lobby is crowded with people. We go through the revolving door into blinding sunlight. The car is parked right outside, on Madison. We sit in it for what seems like forever. Sam answers a business call or two. He cancels all his afternoon and evening appointments. And then, slowly, he starts the car, and we begin the drive home.