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By Mark Nethercote, November 30, 2010 10:00 am

Saturday 28^th November 2009

Gestation: 9 weeks, 1 day

One year ago.

Ed knocks on the door at 5am, entering quietly.  Suse continues to sleep.

“The beta-HCG has dropped to 964,” he whispers.

“That’s way down,” I say excitedly.  Suse stirs slightly.

“What was it?” she asks, without opening her eyes.

“Two days ago it was 1529.”

“That’s great,” I say.  “That’s great.”

“The methotrexate must be working after all.  And, I imagine, from what you’ve said, you probably passed it earlier tonight.”

We all look at the specimen jar on the bench.  Our child, in a cup.  I feel a chill up my back.

“Anyway,” says Ed, sensing the spell we’re now under, “that’s good news, I think.”  We both nod.

“Hooray,” says Suse hollowly.

“Mmmm.”  He pauses for a moment longer.  “Given these great results,” he continues, focusing squarely on the positive, “I don’t think there’s anything for us to get too excited about.  I’m happy for you to be discharged, Susan.  If you’d like.”

I take a breath of anticipation, before looking across at Suse.

“You didn’t get excited when I came in bleeding from an ectopic, Ed,” Suse says pointedly.  “Sorry to be a worry wart, but I’m feeling a little cautious these days.  What, with the shit that’s gone down in my tubes and all.”  She looks over at me.  “I think I want to wait for an Obstetric opinion.”

“Okay,” I say, trying not to show my disappointment.  “No worries, love.  No worries at all.”  I reach over to touch her hand.  Still cold.

“Yes, fair call,” Ed says agreeing, “very fair call.”

He departs as quietly as he arrives.  Suse falls back to sleep quickly.  Meantime, I toss and turn.  Every time I doze off, there is another a cleaner, another orderly, another someone.  Each time they apologise, closing the doors, and I position myself on my four blankets once more.   Besides – there’s that thing sitting over on the bench.  It’s just a clot to everyone else.  To us, it’s a pot full of emotions.

Finally, I hear a murmur of voices outside.  There is a loud knock, and then the morning ward round shuffles in.  Seven people stand in a semicircle, while Ed retells the story.  There are official frowns and muted gesticulations.  We remain mute.

“I think we should repeat the ultrasound,” is the final consensus.  It’s hard to tell where the voice is coming from.

“Great,” we say.  Both trying to keep our eyes open.   Both not sure who to look at.

We fall back asleep.  Strangely, the next three hours are quieter than those from three to six.  At 11.30am, there is a knock at the door.

“Ultrasound, love?”

Sure.  White with two sugars, thanks.

* * * * *

Suse is wheeled around to Radiology.

“Hi, I’m Joseph,” says the youth with a sparse Movember moustache.  He twitches slightly as he leans in to shake my hand.  His palm is sweaty.  Not quite sure what to do with Suse, he waves awkwardly.  Kind of like what he does with all women, I’m guessing.

“Now, because of the gestation, I’ll need to perform an internal examination,” he says, his voice cracking on the word ‘internal’.  He clears his throat, rolling his thin shoulders forward, trying to stretch the tension from his neck.

“That’s fine,” Suse says wearily, “whatever, Joseph.”

“Okay.  So, I’ll just need to get you to sign a consent form,” he says.   A wise move for a man with a moustache.

Joseph prepares the probe, rolling the condom over the tip with less skill than I had at nine.  He clacks away at the controls on his machine, clearly more au fait with computers than with other parts of the equipment in the room.

“So you’re up here on holidays?” he asks, trying to make light.

“Yeah, Mark was able to get a couple of days off.”

“What do you do?”

“Mark’s a doctor,” Suse says.

The sweat droplets form instantly, just at the edges of the bum fluff on his upper lip.

* * * * *

“We did well to see the ectopic,” Joseph says, wiping his forehead on completion.  The probe swings around in his gloved hand, like he’s the main act at a Star Wars convention.

“So what was the final size?”

“Seventeen millimetres by twenty millimetres,” he says.

“That’s bigger, isn’t it?” Suse asks, looking at me.

“Yes,” I say quietly.

“How much bigger?”

“It was thirteen millimetres by thirteen millimetres.  Four days ago.”

Her eyes go wide.

“How can that be?  When the Beta-HCG was down?”  The last bit she says almost wordlessly, almost winded.

“I don’t know.  I don’t know.”

“It’s still growing?”

“It could just be from swelling,” Joseph adds, trying to be helpful.  “We can’t actually make out what is the actual ectopic, and what is just fluid or bleeding.”

“Okay.  So let me get this straight,” Suse says in her non-nonsense voice.  “We can’t see what’s going on.  We can’t tell whether the methotrexate has worked or not.  No one can make sense of any of this.”  She pauses for a moment.  “But there’s one thing we can say, without any doubt.  That no matter what is going on in there, I’ve got a fallopian tube which is more stretched, and more likely to have been totally ruined than it was four days ago.”

Pretty much.

* * * * *

to be continued…

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By Mark Nethercote, November 29, 2010 10:00 am

Saturday 28^th November 2009

Gestation: 9 weeks, 1 day

One year ago.

To their credit, everything is ready for the trip within thirty minutes.  Two large bore cannulas are in, the bloods are taken, the paper work is written and copied, and the ambulance has arrived.  In this time, I’ve been out to the car twice, past another melee of drunken schoolies, and returned with our folder.

Yep, we now have a folder.

I make it through the hospital security, my silver flecks of hair and lack of pubescent acne permitting me automatic entry.  That, and not sporting a black eye.  I return to the Resuscitation Bay, where a flurry of action continues to occur around my wife, lying there in the middle.  I move up close to Suse.  There she lies, tears forming at the corner of her eyes.  Her lips begin to quiver, as she stoically attempts to hold them back.

“Do you have a box of tissues here?” I ask.  Both nurses turn blithely, taking stock when they see Suse’s face.

“It’s been a rough couple of weeks, love,” one of them says.

“Month,” I say, a bit too harshly.  “It’s been a month.”

They both smile, almost grimacing, in that way you do out of compassion.  They continue to busy themselves with nothing.

* * * * *

Moments later, the ambulance crew arrives.  Oblivious to the previous mood, they bluster in, all cheer and exuberance.  It is a welcome break.

“Thank you,” one of them says, leaning close to Suse.  “I’m Paul.  We’re very happy to be leaving all of this underage machismo behind us.”

“And I’m Helen,” says the other, “and your round trip up north has bought us half a shift away from the Schoolies foolies!”  They laugh happily.  I almost crack a smile.

Suse is carefully loaded into the back of the ambulance, and we begin our ectopic joyride up the road.  I follow in the car behind.  I turn the heat down, and eventually, the air conditioning on.  I wind all four the windows down.  I turn the music up high, skipping between stations, alternating between House and Drum & Bass.  I bob my head in time to the music.  It keeps me alert.

The ambulance ahead speeds up and slows down, never keeping a steady pace.  I adjust the cruise control in response, happy for an extra task to keep my mind active.  I note the speed signs as we go, and the margin by which we break them.  But it’s the least of my current concerns.

The trip takes an hour.  I pull the car into a spot out front, jogging up to the ambulance to meet Suse as she is wheeled out.

“How are you, love?”

“Pretty damn good.  Paul and Helen have been laughing all the way.”

“Really?”

“They’ve been listening in on what their mates are having to deal with.  With the schoolies.  They keep thanking me.”

“Okay.”

“And they gave me a shot-and-a-half of morphine.”

I nod, looking at her sleepy smile.

“Sounds like your trip was more fun that mine.”

Suse is wheeled in, around past the glassed central work station, a virtual metropolis in comparison to Byron Bay.  Paul and Helen are directed to Room Twelve, five metres beyond a screaming toddler.  As we enter through the door, we see flowers painted on the walls, the neutral pastel colours, and the cottony soft Stayfree pads on the shelf by the bed.

This is the Room of Gloom.

Every Emergency Department in Australia has a room where they put their Obstetric disasters.  Often, these rooms have been decorated;  no longer the uniform, stale cream walls, but a slightly more colourful environment.  You don’t ever want to find yourself in this room, because it means that something bad has happened to you and your baby.

Except, we’re okay with this now.  We faced the gloom a month ago.  Right now, this isn’t the Room of Gloom.  This is the Room with a Door.

* * * * *

We unpack.  Within moments, a swish Latino nurse arrives.  He wraps a cuff around Suse’s bicep, inflating and deflating several times.  Numbers jump on the screen, flashing urgently.

“Wow,” he says, eventually.

“It always runs low,” Suse replies, her eyes closing.

“But, lady, it’s low,” he says, his knees dropping as he emphasises the word nervously.  “And you got an ectopic.”

“She’s a hummingbird, mate,” I add.  “Check the photocopy from Byron.”

He flicks through pages until he fixes on numbers, causing his heavy eyebrows to rise.  “Wow,” he says finally.

“It’s always like that,” I say.

He looks across at Suse, thrusting his hip out at an angle.  “Lady, you don’t wanna lose any more blood,” he says finally, leaving through the door with a flounce.

We are left alone for less than a minute before a large, crotchety thing waddles in.

“What’s the deal with the whole Brock and Nethercote mix up?” she warbles.

“Brock is my maiden name,” Suse says, “And Nethercote my married name.”

“Which is on your Medicare card?”

“Brock.”

“So why did you register as Nethercote?”

“Because it’s my name.”

“No it’s not.  It’s Brock.”

“Okay,” Suse says, closing her eyes.  She looks pale.  “It’s Brock.”

“I’m going to have to change it back to your correct name.”

“Knock yourself out.”

“Sorry?” the woman says, pulling her shoulders back so that her immense cleavage puffs out.  She looks like a wrestler.

“She means, do whatever you need to,” I say.  “It’s been a long night.”

She turns, shaking her head as she leaves, mumbling to herself, readying to lay an egg.

A few moments later, a Doctor comes in.

“Hi, I’m Ed,” he says in an English accent, all lethargy and experience.  He wears a wedding band.  Lethargic English husband.  Instantly, I’m a fan.

We talk.  Ed asks appropriate, relevant questions, before apologising for needing to repeat the blood tests because of the whole Nethercote/Brock naming saga.  We comply.  He performs a quick ultrasound, looking for free abdominal fluid.  He finds none.  Suse donates her blood, but keeps our clot in the jar as a souvenir.

Ed returns sometime later.

“Given that you had methotrexate and you’re haemodynamic stable, I’m not that excited.”  I look at Ed’s tired eyes.

“If a bleeding ectopic won’t get you excited, Ed, I don’t know what will.”  He smiles.  So will we see an Obstetrics Registrar tonight?”

“They’ll come by when they’re free.  Probably,” he adds, scratching his head in subtext.

“Are they in the hospital?”

“Ah, no.  I don’t think so.”

“You’ve spoken to them?”

“Yes.”

“Did they say they would be in?’

“They’re waiting for the results.”

“So we’ll see them in the morning.”

He smiles, exiting.

Within minutes, Suse falls into a slumber.  And I sit there, thinking.  About the bleeding.  About my reaction.  About my panic.  I might be able to hold my cool at work, but I’ve learnt just how quickly that all vanishes when it’s someone you love.  There is a quote, by Sir William Osler, the father of modern medicine:

“A physician who treats himself has a fool for a patient.”

And if he treats his own family, he’s brain dead.

* * * * *

I look across at Suse.  I watch her shallow breathing.  Her pale face.  Her dry lips.  I feel moved to tears as I watch her, finally peaceful in sleep.  I softly touch her hand.  It is cold.  I sit there, watching my precious wife.  Just watching her.

After a few minutes, I get up.  I exit the room, and search the department for blankets.  I find a loaded trolley.  I grab four, and bring them back in, placing them on the floor.  I lie flat on the ground, on a bed of three blankets, a fourth for a pillow.

And I think.

It is now 4.44am.

* * * * *

to be continued…

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By Mark Nethercote, November 26, 2010 10:00 am

Saturday 28^th November 2009

Gestation: 9 weeks, 1 day

One year ago.

I skid out of the driveway, driving on instinct.  The car hugs the eighty curves well at a hundred, and the sixty curves well at ninety.  We make it through the roundabout, past the police station and then there is nothing.

“Is it just up here?” Suse asks.

“I’m not sure,” I mumble.

“What?”

“I’m not quite sure,” I mumble again.

“Well, what did Sheila say?”

I pause.  “I can’t remember.”

“Why did you say you were okay?”

“Because…because I’m male.  And because I thought I could figure it out.”

“Figure it out?  Are you serious?”

“And because I’m fucking scared and I want you there now!”

I keep driving.

“Do you need to ring Sheila?”

“No!”

I speed along at ninety.  My foot pushes it up to one-hundred and ten.  We continue in silence for another twenty seconds.  And then I see it.  The Emergency sign.

Thank fuck.

We pull up, and jump out.  I grab the bags, and Suse gets out gingerly. We hobble towards the entrance, passed a gaggle of schoolies, punched up, and checking into hospital for a dose of sympathy.

This is the wrong place to come tonight.

We push through the fug of alcoholic fumes, and approach the desk.

“Hi,” Suse says, trying to smile, “I’ve got an ectopic pregnancy and I’ve started bleeding.  Heavily.”   The eyes of the woman behind the desk widen to match ours.

“Follow me,” she says, signalling with her finger.  We walk up the hall, and meet her as she emerges through a door.  “Come with me into the Resuscitation Bay,” she says quietly, yet urgently.  I feel myself calmed; this is the tone I would usually have.  If this wasn’t my wife, bleeding uncontrollably, that is.

Within moments there are two old-school nurses, women from another time, by Suse’s side.  They are nightshift battle-axes, tried and true.  “Sorry about the teenagers,” one of them says, curling her lower lip.

“That’s okay, we were teenagers once too,” Suse says.

“In a very different time,” the older one mumbles, sighing.

They fuss and sort;  with a maximum of fuss, and a minimum of sorting.  A cannula goes in with excruciating inefficiency, while observations are taken seamlessly.  It’s a strange paradox, this hospital.  Hell in paradise.

The doctor arrives two minutes later.

“So you’ve got an ectopic pregnancy, I hear?” she asks.

“Yep.  Lucky me.”

“Was it diagnosed while you were on holidays?”

“No, I’ve had it for weeks.”  She looks at Suse, uncomprehending.  “It’s been treated with methotrexate.”  Her look doubles.  “Medical not surgical…You explain, Mark.”

We run the history.  The doctor asks pertinent questions.  We answer them.  She examines.  Suse winces.  We get told Suse needs to be transferred to another hospital.  Ninety minutes away.  Do not pass go, do not collect anything.  Just straight on through.  This hospital is merely an outpost for teenage angst.

I look at Suse, and notice that the look of pain is increasing on her face.

“Is the pain worse, love?”

“I just really need to go to the loo,” she says.  I look at the doctor, who looks back at me, hoping that the feeling of urgency isn’t due to pressure from an increasing bleed.

“I’ll take her around,” I say.  The nurses and doctor appear relieved by my willingness to be the porter;  their own is caught up acting as a bouncer.  I help Suse into a wheelchair, and then wheel her to the toilet, past the drunken kids.  Even in their state, they show a modicum of respect, quietening, while the pale woman who looks like a ghost goes by.

“I’ll be just out here,” I say.  I kiss Suse as she stands.  Her lips are dry.  I keep the door ajar, watching closely, calling to her every few seconds.  With the other eye, I watch the teens.  One tries to stand.  He slips, falling back hard onto his coccyx, enough to cause the average man to pass out.  Instead, it wakes him up.

Like I said, we’re in a paradox vortex.

I watch as Suse stands.

“It was mainly blood,” she says.  She hands me the pot.  I hold it up to the light.  There are two large clots, suspiciously big enough to be the conceptus.  “Is that it?”

“I don’t know, love.  I hope so.  How’s the bleeding?”

“It’s eased off.”

“Good.  That’s really good.”  I wipe at my forehead, on hearing this.

“Could it be over?”

“Let’s not hold our breath yet, eh?” I say.

We lid the cup, and returned to the cubicle, where we hand it to the head nurse like it’s a bingo prize.

* * * * *

to be continued…

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By Mark Nethercote, November 25, 2010 10:00 am

Saturday 28^th November 2009

Gestation: 9 weeks, 1 day

One year ago.

This is getting silly.

It’s 3.53am on Saturday morning.  And we’re in hospital.

But we’re not up to this bit yet.

* * * * *

Suse and I make dinner, in this extraordinary guesthouse;  literally, guests of the house.  In this beautiful climate, we’ve not worn shoes or a shirt in four days.  I stand there, cutting up salad, looking through the gauze curtains blowing in the afternoon breeze, lifting the lid on the God’s rolling green hills behind.

This is the sanctuary to our ills.

We eat, and then head down to our room.  We watch a DVD, and for the hell of it, another.  It’s a Friday night after all.  We’re supposed to be on holiday.

Before we know it, it’s 12.30am.  We crawl into bed, holding each other close.  As I start to drift off, Suse touches me on the arm.  I stir.

“Honey, I’m getting pain,” she whispers.

“Okay.”

“I mean, I know that’s nothing new.”

“So, what then?”

“Well…it’s different.”

I feel a pall of doom come over me.  Just like that.  Like I’m in a Bronte novel or something;  like I just got consumption.  I brace myself, holding her tight.  We lie there, silently, for another minute.

“Oh, fuck,” she says, “it’s…Oh, fuck!”

Suse jumps out of bed and runs to the bathroom.  I follow.  She sits down hard, and within seconds, we both see red.  Blood dripping into the bowl.

“Oh, Jesus!” she yells.

I look again, and the stream continues.  I fumble at my pocket, pulling out my phone, opening the map function, and searching for the closest hospital.  I do this for precisely three seconds before sprinting upstairs.  There is a sliver of light coming from under Sheila’s bedroom door.

“Sheila!” I yell, wrapping hard on the door, “Sheila!!”

I fling it open.  There is a flash of white flesh, and the surprised faces of her and another man.

“Jesus, I’m sorry guys,” I say, shielding my eyes, “But Suse is bleeding, and it won’t stop.  Where is the closest hospital?  Is it Byron or Bangalow?  Do either even have Obstetrics?”

I hear the tension in my voice.  My medical cool has vanished.

This is my wife.

I turn and exit before the flesh can even be covered.

“How are you, babe?” I yell as I run.

“Okay.”  I hear the groan of someone doubled over in pain.

I skip down stairs, two at a time, entering the toilet to find Suse exactly like that.

“Sheila is sorting it out for us,” I say.  “I’ll get some things together.”  I grab the laptop, a couple of DVDs, and an odd assortment of clothing, stuffing them into a bag.

“Get a few pairs of undies, honey,” Suse yells.  I grab what I can find, shoving them on top of the computer.  Sheila appears behind me, finally clad in a gown, the phone at her ear.

“Lismore has Obstetrics, but you’re better off just getting to Byron and sorting it out from there.  Head into town, and when you get to the first round-about, turn towards the Police Station.”  I glance down at my phone, waiting for the map to appear.  “Are you listening, Mark?”

I nod as I look at her.  Her voice fades away to a buzz, as I find myself cursing the reception deadspots in paradise.  Why doesn’t paradise have phone reception?

“Keep driving, and beyond that turn, you can’t miss it,” she says, touching me on the shoulder.  “Did you get that?”  I stare at her, nodding some more, blinking hard.

I help Suse off the toilet, and we both walk her over to the sink.  She stands there, leaning hard against the taps.  I run back into the room, and grab a few more of Suse’s clothes but none of my own.  I’m acting like yet another useless relative.

“Get it together, you fucking idiot!” I whisper harshly to myself.  I grab at bottles of shampoo, scooping them in.

“Jeff can drive you if you need it,” Sheila says.

“We’re fine.”

“You got those directions?”

“Yep,” I say, shaking her away, as we stumble out towards the car.

* * * * *

To be continued…

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By Mark Nethercote, November 24, 2010 10:00 am

Friday 27^th November 2009

Gestation: 9 weeks

One year ago.

Not much to do today.  It’s Friday;  three days until the repeat injection.  If we have to while away the hours in the lead up to more chemo, there are worse places to do it.

But every twinge, every little bit of pain, every niggle is a source of concern.  My mind goes a little haywire, with the idea of this little monster, now no longer even human in my mind, having been zapped with a ray-gun, and still coming back for more.  It’s like that last scene in a movie, just as the hero – or his best mate, the slightly stupider one – turns away from the zombie, and goes for a high five, having not quite confirmed the extermination.

That’s how it feels.  We gave the zombie a zap;  it works 90% of the time.  But then we looked away, just like every other fool.  We looked away.  We went for the high five.  And the teratogenised little zombie started to grow again.  Like the undead.  Little fucker.

So we sit here in paradise, awaiting the last scene.  We are waiting for the sudden strum of violins, the shriek, as a hand reaches up from the lifeless green sludge on the ground, before we can turn with our methotrexate ray-gun, and zap it one last time.

Until then, we just have to wait.  Until the violins start up again, we’ve got to play the stupid best friend.

With a toothless grin across our faces.

* * * * *

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By Mark Nethercote, November 23, 2010 9:40 am

Thursday 26^th November 2009

Gestation: 8 weeks, 6 days

One year ago.

We limp along.  We sit around at cafés and on the beach, doing what people do at cafés and on the beach.  But with less energy.

We head into Byron Bay.  We drop into the pathology lab for the blood test, and then we go shopping.  We drag ourselves around, taking frequent breaks.  And slowly, piece by piece, we begin to enjoy the simple solitude.  That is, until my phone rings.

“Hello, is that Dr. Nethercote?”

“Yes, it is.”

“Charlene here with a result on Susan Brock.”

“Yes?”

“The Beta-HCG from today was 1529.”

I stop walking.  Suse looks me in the eyes.

“Charlene, can you please remind me what it was three days ago?”

“Just a mome…”  Suse continues to stare at me.  “1580.”

1580 to 1529 in three days.  It hasn’t dropped enough.

“Thank you, Charlene.”

I feel myself slide through confusion, then indifference, then anger, all in a matter of seconds.

“What is it?” Suse asks.

“1529.”

“What was it?”

“1580.”

“That’s not enough,” she says.

A second later, Suse repeats the pattern.

* * * * *

We both walk out of the store dumbfounded.

“How is it possible to have an ectopic, have methotrexate, have the levels drop, and then have them plateau?” she asks.

Well, this is how:

Methotrexate stops the division of new cells.  It binds to an enzyme called DHFR one-thousand times more strongly than folate does, and in doing so, messes up the whole system of cell reproduction.  As folic acid is needed to make DNA, it literally stops the building blocks of new cell creation.  And as it stops new cells from dividing, those that do so most quickly – like cancer cells, or new embryos – are the ones hardest hit by this drug.

It all sounds great in theory, doesn’t it?  Except that it doesn’t always work.  For us, it sounds like it did work for a while, putting a hold on production.  But it may have run out of steam.   It seems that Suse’s womb really wants to be fertile ground.  It seems this ectopic really wants to live.

We’ve got a tough little embryo that’s implanted in the wrong spot.  Here, like everywhere else, it comes back to the old adage: location, location, location.  Our GPS broke.  It sent us the wrong way.  We bought the best house in the worst street.  But once we landed on Mars, our offspring was ready to make a real go of it.

And the little bugger is still trying.

I follow Suse out of the store and back to the car.

“Open it, Mark,” she says, on the verge of tears.  I click the door open, and we both get in.  I begin to drive, but I’m not sure where.

I pull in around the corner into a parking lot, and park the car.  And Suse begins to cry.

* * * * *

I sit by the edge of the pool while Suse swims.  I try to read my novel, picking up my phone every few minutes to check the reception.  Suse gets out, and I jump in repeating the same.  I look around the grounds, at this perfect paradise, the tropical foliage, the white washed walls, the sultry weather.  It’s a tease when you feel this cold.

We swap once more.  It’s 5.13pm in Melbourne.  Suse touches the edge of the pool, turning for another lap.  When she reaches the far end, I pick up the phone, shaking it like it’s a box of Lego.  At that moment it rings, almost causing me to drop it.

“Hello?”

“Hi Mark, it’s Kath here.”

“So you’ve seen the levels?”

“No.”

“1529 today.  Only down from 1580 three days ago.”  Suse jumps out of the water, running over to the bench, splashing me as she does.

“Right.  How is Suse’s pain?”

“Oh, it’s not great,” says Suse loudly into the speaker phone.  “I’ve been bleeding for a month, Kath,” she says, pointedly.  “I’ve had pain for a month.”

“Where’s the pain right now?”

“Both sides.  But mainly on the left.  Should we organise to come back to Melbourne early?”

“When are you due back?”

“Sunday night.  Three more days,” I say.

Kath is silent for a few moments.  “No, I don’t think so,” she says finally.  Methotrexate works in 90% of cases.”

“Okay, but we’re not real hot on the stats right now, Kath,” I say, laughing hollowly.  “Only 3% of pregnancies are ectopic.  We’re not exactly hanging out in the lucky corner at the moment.”

“Yes, I understand,” she says.  “I still think the most important thing is for you to enjoy your holiday.”

“Oh, look, it’s been a blast,” says Suse sarcastically.

“Yes, yes, I’m sure,” she says solemnly.  “But all the same, I still don’t see that you need to break your plans at this stage.”

“So what next?” asks Suse, her voice tense.

“Well, I do think you probably need more methotrexate when you get back.  We’ll do a blood test first thing Monday, and if it hasn’t come down considerably, we’ll give you some more.”  I look at Suse.  She holds her belly like someone just shot her.  “Just try to relax,” Kath continues, in a completely un-facetious way.  “Try to make the most of the nice weather.”

“Okay.  Thanks Kath.”

“You’re welcome.  I’ll see you on Monday.”

The phone goes dead.  I look across at Suse.  She is white.

More chemo.

Chemo, chemo, chemo.

It just gets better and better.

* * * * *

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By Mark Nethercote, November 19, 2010 9:40 am

Thursday 19^th November 2009

Gestation: 7 weeks, 6 days

One year ago.

It’s been a rough month.  Literally.  A month.

It’s Day 26.  We’ve endured twenty straight days of uncertainty.  We’ve had two ultrasounds with two opposing views, four opinions from four different Obstetricians, and six blood tests, which have led to six different interpretations.

Three days ago, the Beta-HCG had risen to 3214.

From 2373 to 3214.  Up another nine-hundred.  And that’s since the chemo.

Worried?  Not our Obstetrician.

But us?  Absolutely.

* * * * *

Suse turns to me as I wake.

“The bleeding started up again overnight.”  I close my eyes again.

“Really?”

“Really.  And I had more stretching pain.  More tightness on the left side.”

“Mmmm.”  My heart falls onto my tongue.  “What time is your appointment?”

“Which one?”

“With the Hypnotist.  To quit smoking.”

“Eleven o’clock.”

“And when is the blood test?”

“Before that.”

I sigh deeply.  “So, I guess we’re riding on this blood test to find out whether our holiday to Byron Bay is on or off.”

“And with it, the promise of more chemo.”

“Or surgery.”

“Or nothing.”

“Great,” I say, my voice hollow.  I take a breath.  It doesn’t change anything.

It’s over.  It’s not.  There’s an ectopic.  There isn’t.  Chemo will work.  No, no it won’t.

After twenty days of waiting, it may all come back to an operation.

After all of this.

* * * * *

I head off to work.  Suse gets the blood test before her hypnotism.   If she needs more chemo and surgery, I’m guessing it will be a very short quit time.

Very short.

I try to concentrate.  I pretend to listen to parents, to the tales of their childrens’ behavioural issues.  My mind keeps diverting to visions of my own recalcitrant progeny, who has set up shop in the wrong street.

Best house in the worst street.  In fact, in the wrong street.

Time flies like muck.

The seconds stick to me like paint, refusing to tick.  I fumble through words, aching for it to be clean.

It never works like this.

I’m running late, I’m short on time, and it’s too early for a result.  But still, I try.  I’ve gotta try.

The phone peals in my ear before being picked up.

“Hello?”

“Morning, love,” says the cheery voice at the other end, “how can I help?”

“Hi there, this is Mark, one of the doctors from Richmond Health,” a non-existent entity until just this second, “ringing to follow up on a blood test of a patient of mine.”  My wife.

“Sure, love,” the woman smiles down the phone, tapping as she speaks.

I hear her breath.

In and out.

In and out.

And then she says it, “Two thousand, four hundred and eighty five.”

2485.

Down from 3214 three days ago.

This is the first indication that the chemo has worked.

I feel my shoulders fall, the knife move away from the skin, the chemo away from the rump, and the cigarette away from the lips.

“Thank you,” I say.

“You sound relieved.”

“I am.”  I close my eyes.  “You’ve just given hope that this patient may actually quit smoking.”

* * * * *

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By Mark Nethercote, November 17, 2010 10:00 am

Sunday 15^th November 2009

Gestation: 7 weeks, 2 days

One year ago.

We lie down on the bed.

After all of this, after this last month, I ran a workshop on Saturday and Suse ran one on Sunday.  Both of them were based on creating what we would love in the world.  I ran one on health, and she ran one on being a creative professional.

How ironic.

We are both spent.  We are spent in that way where you wonder if you’ll ever be able to get up again.  Our shared wallet is empty, and we’re scrounging under all of the dressers and between the couch cushions for spare coins.  But that’s all gone too.

And we are separate.  We are distant and alone;  lost on our own ships of emotion, heading across a vast sea, invisible to each other.  We lie there, side by side, within touching distance, and yet infinitely apart.

The light fades outside.  The room darkens.  And we rest there in silence, holding onto our thoughts.  We are both relieved by how well the workshops went, by what we created.  But they were solo victories.  Right now, we are not coupled.  We are single adults sharing a house.  We’ve reverted to old ways, hiding behind our pain, battening down for a rough tide.

I close my eyes.  And then I feel my wife’s hand touch mine.  Softly reaching into mine.

I want to retract.  I want to continue to be angry.  I want to be right, rather than happy.  I want to punish her.

But for some reason, I don’t.  I let her fingers weave between mine.  And then she rolls toward me, resting her head against my neck.

“You smell like cigarettes,” I say through a croaky larynx.

Her head falls.

“I don’t do it to hurt you,’ she whispers, a teardrop falling against my neck.  “Please let’s stop hurting each other.”

“Then stop.”

I squeeze my eyes tight.  And then I soften, relaxing my tightened shoulder, letting her into my crook, where she softly sobs.

* * * * *

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By Mark Nethercote, November 16, 2010 10:00 am

Thursday 12^th November 2009

Gestation: 6 weeks, 6 days

One year ago.

We hit the ninety-minute mark of staring at the walls in a hospital cubicle.  In that time, Fluid Lady is wheeled away, screaming at the inhumanity of it all.  And Scabby Man has disappeared, never to be seen again.

“I’m going to ask,” I eventually say, twenty minutes after the entertainment has ceased.

I return two minutes later.

“What happened?”

“Apparently the blood tubes are lost somewhere on the second floor.  It seems that nurse wasn’t the only one unaware of its existence.”

“What, so you choose to go privately and you get worse treatment.  Is that how it goes around here?”

“Let’s watch a movie.  It’s a sure fire way of getting the Registrar to come.”

Two minutes later, he does.  He’s all bluster and bravado, telling us about all of the bad things that methotrexate can do.  Just like a good doctor should.

“I advise Anti-D as well, because of your blood group.  As it is a blood product,” he continues, “it can contain all of the diseases as yet undiscovered, like HIV.”

“You were doing well until then,” Suse says.

“Sorry?”

“I’m pretty sure they discovered HIV a few years back,” she says.

He frowns. “You cannot have the methotrexate until the blood tests come back, in case you have liver disease, or leukaemia, or something else.”

“Sounds wonderful,” says Suse.  “So does that mean that someone has finally discovered the Private Pathology Lab?”

He leaves in a huff.

* * * * *

We talk some more, watch some more, eat some more, and wait some more.  I walk out at half-hour intervals, asking after the bloods.

“This is getting ridiculous,” I say finally, “I’m calling Joel.”

I grab my phone and dial.

“Hey Joel.”

“Hey buddy, how are you?”

“Suse has an ectopic.”

“Oh no.”

“And we’re in your Emergency.  And your mates have lost the bloods.”

“Okay, okay,” he says, pausing for a moment.  “Don’t worry, I know who’s on today.  Just give me a little bit of time.”

Within minutes, we are receiving the Royal Treatment.  We are no longer public patients.  We are mates of Joel.  And as such, we’ve been upgraded to first class.  Progress improves exponentially, the bloods are discovered and processed faster than I could effect at my own hospital.  Maybe Joel really is royalty.

“Sorry about the wait,” says a nurse, rushing in, adjusting her hair.  “Joel says ‘Hi’.”  She titters.

Not the Royal Treatment, more the Stud Treatment.

* * * * *

Suse is given the all clear.  As her liver and blood cells are perfectly healthy, it’s safe for us to poison them with abandon.

“You just have to wait for the porter to take you up to Oncology,” says the nurse distractedly.  The final nail.

We wait another fifteen minutes before we are granted passage.  We are escorted up to the fifth floor.  And here we meet Fadiya.

“You will be safe with me,” she says, her adorable Northern African smile putting us both at ease.  Here is someone who grew up in a harsh country, and who now works in Oncology.  The woman exudes calm.

I resist the temptation to hug her ample bosom, even if just to feel safe.  We sit again and wait.  Fadiya and a garrulous old chook check the drug dose.  I do too.  From thirty feet, I strain my eyes to see the dose, trusting Fadiya, but not the battery hen.  They calculate the amount correctly.  All good.

“You know what?” Suse says, breaking me from my spell.

“What?”  I look back around.  There I see my wife, a serene look across her face.

“Being somewhere like this puts things into perspective.”  I stare at her, not quite understanding.  “I may have an ectopic,” she continues, “and this may be a really shit situation we are in.  But, Mark, I do not have cancer.  I will not be returning to Oncology anytime soon.”

She squeezes my hand lovingly.  I look at my beautiful wife a while longer, wholly unsettled by the thought.  A moment later, our African queen returns.

“Now, my dear woman, this one will hurt,” she says.

“That’s okay,” Suse says, “It could be worse.  A lot worse.”

“Which cheek?”

“The left.”

Suse stands, leaning against me.  ‘I love you,’ she mouths, a peaceful smile extending across her lips.

“We’re going to be okay,” I whisper.

Fadiya takes aim, the needle goes in, and the plunger is pressed.  I watch the smile on Suse’s face dissolve, replaced by a look of shock.  The squeeze on my arm tightens, as she struggles to take an in-breath.

“Woah,” she says finally.

“I was right, yah?”

“Yah,” Suse says.

“And the Anti-D?” I ask.

Fadiya looks.  “It’s yet to be written up.”

The marathon is yet to be completed.

We wait some more, this time for the Resident.  A lovely fresh-faced whipper comes in.  He crouches and explains, and then writes the all-important words on a piece of paper.

Fadiya jabs the other buttock, and we are free.

A mere five-and-a-half-hours later.

* * * * *

We walk in the front door.  It’s warm inside.  We are the picture of solidarity.  The afternoon went okay, really;  as well as an afternoon can go where someone injects your wife with poison.  I’m frustrated at the time we spent there, and that paying for blood tests actually wasted an extra two hours.  But I was there to support Suse.  And in the end, that’s all that really matters.

“Why don’t you call in sick tomorrow, love?” she says.  I stand still.  “We’ve got our workshops on the weekend.  And I could really do with you being around tomorrow.  Just think about it.”

“Okay then,” I say, thinking for a moment.  “I’ll do that for you.”  I smile.

She smiles back.  For a sweet moment, we stand there.  Almost happy.

And then she walks to her bag.

“What are you doing?”

“Don’t come outside for a bit,” Suse says.

She is going outside for a cigarette.

This is not the behaviour of a rational human being.  So, my reaction mirrors it.  Building on itself, minute after minute.  All I can see, is that after chemotherapy, she has gone outside to suck down some more toxin.  So, if my wife is so intent on harming herself, I don’t want to have to smell it.

I open the front door.

“Don’t come outside!” she yells.

“Then get off the property!” I yell back.  “I can smell it in here!”

I am white with rage.  I am fuming like her fucking cigarette.  How can this woman, this strong woman – this glorious woman – smoke?  How can she poison herself like this?  How can she do that to me?

I take it all personally.  All of it.  I know I can choose how I react, and right now, I choose to be furious.  Fucking furious.  A whole narrative swirls around my head.  That this is about me.  That this is sand in my face.  That after five-and-a-half hours of standing by her side, of being there for her, of being everything a husband can be, she does this.  She does this to me.  Fuck me.

I storm from room to room.  I turn on lights, walk in tight circles, before blustering out again.  I end up in the study, staring at a blank screen.  Suse slinks back inside, heading straight for the shower.  I hear the water start;  the whirr of the electric toothbrush washing away the stench.  The fucking stench, getting in and killing even more cells.  How thick.  How fucking thick.

After twenty minutes she emerges, to make dinner.  I stay in the study.  She calls me, and I come out.  We eat in silence.  There is nothing else for it.  She asks me, on occasion, whether I want some more.  In a soft voice.  In a voice softer than I have ever heard before.

I say no.  I say nothing.

We sit and watch something;  who knows what.  We watch all the way to the end.  To the very end.  And still, it lasts not nearly long enough.  I am still white with anger.

All I can do is disappear.

I retreat to the study.  And I write.

This is all I can do.

This is my therapy.

* * * * *

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By Mark Nethercote, November 15, 2010 10:00 am

Thursday 12^th November 2009

Gestation: 6 weeks, 6 days

One year ago.

My phone goes again.  I take it out and look at the screen.  I see a picture of Suse’s laughing face, a grin on our wedding day.  I take a deep breath.

“Hey love.”

It’s another one of those calls.  I can sense it already.  Of course, the reception is bad.  But even through the noise, I get it.

“Et…”  Sigh.

“Sorry?”

“I’ve…”  Cry, sob, sigh, crackle.

“One more time, honey?”

“And…”  Another sob, another sigh.

“Look, this line is really bad.  I’ll ring you straight back.”

I hang up the phone and dial.

“Hey, love.”

“I’ve got an ectopic, Mark.”

“What?”  My world spins anticlockwise.

“It’s an ectopic.  They missed it on the earlier scans, or they couldn’t see it.”  She trails off.

“Where are you?”

“East Melbourne.  At the ultrasound clinic.”

“So what now?”

“Kath wants to see us.”

“Are you all right?  I can get a cab over there if…”

“…No, I’ll drive over to you.  I’ll pick you up.”

“Are you sure?”

“Yes.”

“Is that safe?”

“Don’t start, Mark.”  My world keeps rotating.  “Can you meet me?”

“Of course.  I’m gone.  They’ll cope.  I’ll meet you whenever you want.  You say when.”

“I’ll ring when I arrive.”  She hangs up.

I look around the room, like I’ll find an answer.  I head out.

“Are you ready for your next patient, Mark?”

“Ummm, I might be a moment, Raelene.”  I walk out of the front doors of the clinic, and then straight back in.  I lean my head over the desk.  “Raelene, I’ve just found out my wife’s got an ectopic,” I whisper.

Her mouth opens wide, before she closes it again.

“Say no more, everyone is gone.”

“Thank you.”  I walk out the door, leaving everything behind.

* * * * *

“Well, when an ectopic is this size, we can usually get away without surgery.”

“Really?” we both say.

“Yes,” Kath continues, “we can use methotrexate.  As a drug treatment rather than a surgical one.”

Our glamorous obstetrician sits back in her chair.  I think about methotrexate;  a drug for cancer, severe arthritis, refractory inflammatory bowel disease and other such conditions that, simply, will not respond to kinder things.  My mind whirls like a top.  It’s today’s trick.

“Chemo?”

“With a Beta-HCG less than 3500, and a sac smaller than 3cm, methotrexate is our preferred option,” Kath purrs.

I shake my head nervously.  I list my apprehension about side effects, like they’re pending humanitarian disasters.  I’m Woody Allen in a title fight;  laying out each concern with a feeble punch.  She absorbs each blow without even flinching.  Eventually I give up.

“What do you think, hon?” I say, turning to Suse.

“Have I got a choice?”  We both look back at her.  “I mean, really.  This pregnancy has to end, right?  I have no choice in that, do I?”  She sighs, pinching at her eyes.  “And if this might save my tube, then we’ve got to do it.  Don’t we?”

We all sit for another moment.

“So what do we do?” I ask.

“It needs to be done through the public hospital.  You’ll be admitted downstairs through Emergency, and then you’ll go up to Oncology.  It’s just a single shot.”

Fittingly, they don’t deal with dirty drugs like methotrexate privately.  We have to go and wait in Emergency for the public doctors to hand over this grubby injection.

* * * * *

We stand at the Triage Desk, a man in front of us.

“Is this Emergency?” he asks.

“Yes, it is.”

“I’ve got a problem with my abdomen.”  He points, lifting his kaftan and lowering the front of his tracksuit pants as he does.

“This is a women’s hospital.”

“Oh,” he says.  He walks away.  One of his thongs falls off.

“Can I help you?” the Triage Nurse asks.

“Hi,” Suse says.

With that, another man pushes in front of us.

“ ’Scuse me,” he bellows, scratching at the scabs on his arms, “Can I get through, please?”

“You just interrupted this lady,” the Triage Nurse says, cranking her bitch-voice up to nine.

“Oh sorry, love.”  Scabby Man goes to touch Suse on the arm.  I slap his hand down.

“Just ask your question, mate,” I say.

“Thanks, mate,” he says, turning to the counter.

“Do you know any of the patients in the Department?” the Triage Nurse asks.

“Nah, I just want to be in the vicinity of someone pregnant.”  We all raise our eyebrows.  For me, it’s in response to him knowing the word ‘vicinity’.  “But if you could point me in the direction of me partner, that would be great.”  Scabby Man laughs in my direction, rolling his eyes, picking at crusts.  It’s the ‘all-women-are-stupid’ eye roll.  I smile thinly.  He wears a blue singlet, revealing a variety of Asian symbols tattooed on his arms and back, unaware that they announce to all of Vietnam that he’s a cunt.

“If you would just wait, sir, I’ll be with you shortly.”

“No problem, no problem.  You guys feel free to go first.”

Suse smiles, and then begins to tell her story.  She uses the right emphasis on the word ‘ectopic’, she highlights her level of pain, and she appropriately mentions her recent bleeding.  Throughout at all, Suse remembers the rules of engagement.

“You won’t have to wait too long,” the Triage Nurse promises.  As we walk to the seats, Suse winks at me.

We sit.  The waiting room is empty, bar one other person.  That woman is very pale, blending in well with the wall.  Scabby Man is eventually let through.

“How’s your pain right now?” the Triage Nurse asks again.

“Oh, not great,” Suse replies.

We sit for three whole minutes.  Suse reads an old magazine, while I try to make out the breathing wall opposite, finally seeing her yellowed teeth as she smiles.

“Come through, love.”

* * * * *

First stop is the ancient porcelain scales.

“Wow,” I say.

“Aren’t they magnificent?” the nurse proudly replies.  “They’re from the old hospital.”  Suse is weighed in quarts, which are converted into bushels for simplicity.  She moves to the tape on the wall beside, which measures her in centimetres.  The old and the new.

We are ushered to Cubicle Six, to commence our vigil.  For a while it is novel;  it takes Suse fifteen minutes to even lie on the bed.  Eventually another nurse walks in.

“I’m here to take some blood.”

“We already did that upstairs.”

“Oh, right,” the nurse replies.  “Where exactly?”

“At the private lab on the second floor,” Suse says.

“There’s more than one lab?”

So they say.

* * * * *

We sit and wait.  We talk.  We check emails on my laptop.  We talk some more.  And we listen.

Within earshot, in an unseen cubicle, a woman is in pain.  It quickly becomes clear that she is in labour, is carrying too much fluid, and has battered veins following recurrent blood tests.

“I could really do with a fucken’ ciggie and a Jim Beam,” she says with emphasis.

“I just don’t understand why you need all these tests,” says a man.

“This has nothing to do with you!” shouts another unseen female.

“Yeah, all right, all right,” says the man, defending himself.

“Scabby Man found his partner,” I say to Suse.  She nods.

“So just remember, that this has nothing to do with you!” the screaming continues.  “And mind your own fucken’ business!  ’Cause you’ve got shit for brains!”

Everything goes quiet for a minute, before Scabby man appears outside our cubicle.  He stands there pensively, scratching.  He looks across at us, like we might be able to help.  We look away.

“This is my business!” yells the unseen man from the cubicle.  I look at Suse, frowning.  This isn’t Scabby Man in the cubicle;  this is another one.  There are two Scabby Men in the same department.  Cast from the same crusty mould.

“You’ve got shit for brains and you know it!” squeals the second woman.

Everything goes silent.  After a couple of minutes, the conversation starts up again, labouring on about everything else but that.  Fluid Lady starts to talk about her fear of needles, and the excruciating pain of the blood pressure cuff when it blows up around her arm.

“What does she think child birth is going to be like?” Suse asks.

I look back, and shrug.

And all the while, Scabby Man stands there scratching.

TO BE CONTINUED…

* * * * *