Mixed Blessings (20 page)

He sounded discouraged, and Mark looked sympathetic and worried. He knew how badly Charlie wanted a kid, and he thought it would be the best thing for him, not to mention keeping Barbie down on the farm, which was just what she needed.

"Maybe you're not doing it at the right time. You can't just do it any old time, you know. There's a whole science to this.

You should ask your doctor." He wasn't too up on it himself, his first daughter had been conceived in the back of his car when he was nineteen and not yet married to her mother. And their second one was born ten months after the first one. After that she'd had her tubes tied, and his current girlfriend took the pill. But he knew perfectly well that there were right and wrong times to do it, and he wasn't sure if Charlie knew that.

"We've been doing it right on schedule, according to the books I've been reading."

"Maybe you should just relax then," he said conspiratorially.

"You're healthy and young, it'll happen sooner or later.

"Maybe." But it was beginning to depress him that it hadn't happened yet, and he was getting worried.

"You think something might be wrong?"

"I don't know." The worry in Charlie's eyes touched Mark, and he patted his shoulder and ordered them both another round of beers. It was a nice, friendly evening.

"You have mumps as a kid, or VD a lot when you were screwing around?"

"No." Charlie smiled at the earnest questions. "None of that."

And then Mark frowned, looking at his young friend with concern. "You know my sister and her husband had a lot of trouble having kids. They were married seven years and nothing happened. They live in San Diego.

And he went to a great doctor up here. My sister had to take hormone pills or shots or something, and I'm not sure what they did to my brother-inlaw, except that I know he had to wear Jockey shorts with ice cubes in 'em for a while. Sounds great, doesn't it? But barn, barn, barn, they had three kids just like that. Two boys and a girl. I'll get his name for you the next time I talk to her. He was some fancy guy in Beverly Hills, it cost them a fortune, but it was worth it. The kids are terrific."

Charlie was still smiling at the image of Mark's brother-inlaw wearing Jockey shorts filled with ice cubes, when their beers arrived, and they both laughed. Life was sweet sometimes, just being with a friend, and spending an easy evening.

He loved being with his wife, but he couldn't talk to her about the things he cared about, and everything she was interested in was so completely different. He and Mark had a lot in common, and Charlie really valued his friendship.

"I'm not sure if I'm dying to put ice cubes in my shorts, you know."

"Listen, if it works, what the hell . . . right?"

"It's too bad I'm not married to you," Charlie teased. "I like the way you feel about kids." He smiled at his friend.

"They're the greatest. I'll get you the name of the doctor," he said insistently, determined to help, as always.

"I'm not even sure something's wrong, maybe we haven't tried for long enough. I've only been really serious about it since June. They say it can take a year for even a normal couple to get pregnant."

"I wish I had been that lucky, just once." Mark rolled his eyes and they both laughed. "Anyway, what harm can it do to check it out? Then the guy tells you you're in great shape, you feel like a stud, you come home and throw her on the Boor and take her, and bingo, she gets pregnant. That's all the doctor does it's a little morale booster for the troops at home, right?"

"You crazy guy - . ." Charlie was more touched by his concern than he knew how to tell him.

"Me, crazy? Am I the guy who let his wife go to Las Vegas? I think you're the crazy one here."

"Yeah. Maybe so." Charlie smiled, but he felt better than he had in a long time, and the Mets were winning as they finished their beers. It was ten o'clock before Mark drove him home, and after he dropped Charlie off, Charlie walked slowly up to their apartment, wondering if he should see the doctor. It seemed a little extreme to go to a specialist so soon, and there was probably nothing wrong with him at all, but in another way, it might be reassurrng. It was odd to think of it though, considering the fact that Barbie didn't realize he was making a concentrated effort to get her pregnant. She had no inkling at all. In fact, he was the last thing on her mind that night, as she partied with her old friends, and ran into some guys she hadn't seen in years, in Vegas.

On Labor Day weekend, Pilar discovered for the third time in three months that she wasn't pregnant. She was depressed this time, but philosophical. She and Brad had already agreed that if it didn't work this time, she was going to see a doctor. She had been making discreet inquiries for a while, and Marina had told her about a reproductive specialist in Beverly Hills, and if she was as good as Marina's source said, it was worth the drive to see her. L.A. was only two hours away, and the doctors she'd called to check on her all said she was fantastic, and well worth it.

On the day after Labor Day Pilar made an appointment for the following week. Normally she would have had to wait months, but Marina's friend intervened, and asked if she would see her quickly, and she agreed.

And Brad had also agreed to go with her.

He wasn't entirely sure that he liked the idea that Marina had found them a woman doctor, but Pilar felt strongly about it, and he thought it was important for her to feel at ease with the physician they went to.

"What are they going to do to me?" he asked nervously on the drive down. He had had to recess the case he was on for the afternoon, which was something he did very rarely.

"I think they'll probably cut it off, check it out, and sew it back on. No big deal. They won't start the big stuff till next time."

"A big help you are," he growled and she laughed, grateful that he had come along. She was nervous about the visit, too, and she didn't know what to expect. But the moment they met Dr. Helen Ward, a small, neat-looking woman with bright blue eyes and salt-and-pepper hair, they knew they had come to the right office. She was intelligent and calm, totally focused on what they wanted from her, and clear in the information she gave them. At first, Brad thought she was a little too cold and too clinical, but as they talked for a while she seemed to warm up to them, and she had a nice sense of humor. She practiced medicine the way Pilar practiced law, with compassion and intelligence, but also with immense skill and professional precision. And it reassured both of them to see that she had gone to medical school at Harvard, and she was in her mid-fifties, which pleased both Brad and Pilar. She had been particularly clear that she didn't want a young, fiery, experimental doctor.

She wanted someone serious and calm, who would choose the more conservative routes, while still doing everything she could to help them.

Alter an initial chat, she began their charts, and asked them each intense questions about their health, and past and present medical problems. Brad was pleased to see how comfortable Pilar was with her, especially when she told her about the abortion she'd had when she was nineteen. She didn't like talking about it, but she had told Brad about it late one night, alter a lot of wine, but she also told him that to this day she still felt guilty. She had had every good reason not to have the baby, she had been a freshman in college, with no way of supporting a child, and the baby's father, her first affair, abs lutely refused to help her. Her parents would have disowned her, or worse, or so she thought. And she had been just terrified, and desperate enough to have an illegal abortion in Spanish Harlem. And now, more than once, she had found herself wondering if that abortion was part of the reason she wasn't getting pregnant. But Dr. Ward assured her that that wasn't likely.

"Most women who have even several abortions go on to have healthy children, and there's nothing to prove that women who have had abortions have a harder time getting pregnant. If you'd had a serious infection afterward, that would be another story, but from what you've described, it sounds pretty normal." All of which reassured Pilar immensely.

They talked about Brad's children, their birth control for the past fourteen years, and after she took their histories, she did an exam on Pilar, and found no noticeable problems. As always, with infertility, she was particularly wary of infections.

"Is there any particular reason why you both wanted to come here?

There's nothing in either of your histories that suggests any kind of complications, and three months of trying to conceive is really very early to be getting worried," she said encouragingly with a warm smile and, more than ever, Pilar decided she liked her.

"That's fine if you're sixteen, Doctor Ward. I'm forty-three. I don't feel like I have a lot of time to play around with."

"That's trve, and we could check a few things, your I"SH and progesterone levels, which could affect your ability to get pregnant, thyroid and prolactin, for the same reasons. We like to see your progesterone levels above a certain point to ensure conception. We can check your temperature every morning, and keep a basal body temperature, or BBT, chart. And we might give you a little boost with some chlomiphene, just to see if that helps. Chlomiphene isn't always useful in women over forty, but it might be worth a try if you're willing. It's a hormone that will fool your body into producing unusually high levels of progesterone, to help you get pregnant."

"Will it make me grow hair on my chin?" she asked bluntly, and the doctor laughed.

"Not that I've ever seen. It may make you a little tense though, a feeling of stress for the five days that you take it, and shortly thereafter. It causes some people minor problems with their vision, mild headaches sometimes, and it can cause nausea, mood swings, even ovarian cysts, but usually there's nothing major."

"I think I'd like to try it," Pilar said confidently. "What about anything stronger? Hormone shots?"

"I don't see any reason for that yet. We don't want to get overenthusiastic about interfering with nature."

She didn't want to go overboard on a woman with no obvious problems.

Dr. Ward suspected that, if Pilar could have, she'd have asked for more drastic measures, like in vitro fertilization, where they would provoke her ovaries to produce several eggs with the use of hormones, then take several of the eggs from her ovaries, fertilize them in a petri dish with her husband's sperm, and then put them in her uterus and hope she stayed pregnant. It proved very successful sometimes with the fertilization of the egg, if both sperm and eggs were healthy, but it did not guarantee that the patient would be able to stay pregnant. 

But at Pilar's age, there was no question of in vitro fertilization. Most centers refused to do it on women over forty. And I.V.F was not an easy process. It required heavy doses of hormones, careful removal of the eggs by experienced hands, and the procedure only had a ten to twenty percent success rate. But for the lucky few who succeeded with it, it was a godsend.

Dr. Ward did a few simple blood tests on Pilar, gave her a prescription for chlomiphene, asked her to start taking her temperature every morning before she got out of bed, showed her how to keep the BBT chart, and then she gave her a kit that would detect the LH surge before ovulation.

"I feel like I just joined the Marines," Pilar said to Brad as they left, carrying their kit and all Dr. Ward's instructions about when to make love, and when not, and how often.

"I hope not. I liked her. What did you think?" Brad had been impressed by her intelligent views, and conservative positions.

She refused to be pushed into doing too much just because Pilar was well-read and knew something about some of the more sophisticated options.

"I liked her too." Pilar was disappointed, though, that she didn't have any miracles up her sleeve. She seemed to favor a very conservative approach, but that was what they had wanted. And their options were limited anyway, because of Pilar's age. She was too old for in vitro fertilization, even if they needed it, and maybe even for chlomiphene, although she was going to take it.

Dr. Ward had suggested intrauterine insemination. She felt it might give them a better chance at conceiving, if Pilar didn't manage it on her own with the chlomiphene.

"It all seems so complicated for something that should be so simple,"

Brad said, still surprised by all the elaborate tests and medicines and mechanics for the infertile.

"Nothing's simple at my age," Pilar complained, "even putting my makeup on is a lot more work than it used to be." She grinned and he leaned over to kiss her.

"You sure you want to do all these things? That medication doesn't sound like much fun. You have enough pressure at work without taking pills to make you feel more stressed."

"Yeah, I thought of that. But I want to give us the best chance we can get. I'd like to try this." Now that she had made up her mind, she wanted to do everything she could to have a baby.

"Okay. You're the boss," Brad said warmly.

"No, I'm not. But I do love you. "They kissed and drove back to Santa Barbara after having dinner in L.A. at the Bistro. It was a pleasant evening for them, a nice chance to get away.

And when they got home, Pilar put out all her new treasures in her bathroom, the LH kit, the thermometer, the chart. And they had stopped to fill the prescription on the way home. She didn't have to start it for another three weeks, and only if she didn't get pregnant during this cycle. Meanwhile, she had to start taking her temperature, and using the kit the next day, and the following week she was going to try to get pregnant.

"It looks like an arsenal of hope, doesn't it?" Pilar smiled at Brad as they brushed their teeth, and she waved at all the paraphernalia on her dressing table.

"That's all right, if that's what we have to do. No one said it had to be easy, or simple. All that matters is the result, in the end." And then he sobered a little, as he leaned over to kiss her. "And if the result happens to be that you and I are alone, and all this doesn't work, then that's all right, too, and I want you to know that. I want you to think about that, Pilar, and try to make your peace with it too. It will be wonderful if it works, but if it doesn't, we still have each other, and a life full of people we love and who care about us. We don't have to have this baby."