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By Mark Nethercote, July 29, 2011 10:00 am

Saturday 31st July 2010

One year ago.

I come to work today, ready for a weekend of fun.  Weekends are understaffed by nature.  Our skeleton-staff arrive to take over from the ghostly night crew.

“How was it?”

“Awful.  There was a transfer from out of town.  A cord prolapse.”

A silence descends.  This is never good.  We wait a few minutes until the boss walks in.

“A cord prolapse arrived at 6.30am.”

“How is it?”

“Not good.”  There is a silence while the story plays out.  “There was loss of the fetal heart rate, the cord prolapse was recognised, and there was an emergency Caesar.  The baby came out with a pH of 6.7.  Required seven doses of adrenaline before a heart rate returned.  Forty minutes passed between the last monitored heart rate, and getting it back.”

Fixed and dilated pupils.

On inotropes.

Ventilated.

Transferred here.

“Shit,” says my boss.

* * * * *

Intensive care is a funny place.  Humans are run like machines;  there are infusions, and ventilators, and machines that go ping.  Blood tests are done at frequent  intervals, fluids are calculated to the millilitre.

There is a lot going on with these tiny, premature babies.

But this time it’s different.  Here we have a full term baby, born on time, struck by horrific happenstance.  At the exact moment that the waters broke, out came the cord – ahead of the child.  With the skull fitting as tightly as it does through the pelvis, there is only ever a half-centimetre leeway in any direction.  The cord was squeezed between the head and the pelvis, and blood supply suddenly stopped.

Asphyxiation.

The Obstetrician did what he could, as soon as he could, immediately rushing to theatre.  As they prepared, a hand urgently pushed up against the head, trying to keep it back, trying to unclamp the cord.  It’s a tough job this one;  arm versus uterus.  The uterus wants the baby out, that’s what it’s designed to do.

The uterus usually wins.

We enter the room in Indian file, every head lowered, over to the baby.  Machines beep loudly, but everyone else is silent.  A group of nurses hover close.  All watching over this grey child.

This just shouldn’t happen.

This, yet again, is the definition of tragedy.

* * * * *

We stand around, my boss running the questions.  She has a grave look on her face.  Everyone does.

“How far away is Mum?”

“Three hours.  She hasn’t left yet.”

“She needs to get here,” she says urgently .  “This baby’s blood pressure is unstable.  I’m not sure how long we can keep her alive.”  By that, she means how long we can keep the heart beating.  The breaths are via machine.  The pupils are fixed and dilated.  Brain waves are absent;  the child is brain dead.  But for now, the heart is still beating.  The child is grey and lifeless, but – if there is any grace given in the healing this family is going to need – this little girl is still somewhat babylike;  somewhat soft and supple.

Not yet rigid, and not yet cold.

This fucking sucks.

* * * * *

There are four neonatal intensive care units in Melbourne.  This is just one of them.  Every day, families have their gravely sick infants transferred to these hospitals for treatment.

Today, this was so that the family has time to grieve.

The father arrives ahead of his wife.  With seconds passing like hours, we wait for the ambulance to bring in the mother.

Eventually she arrives.  We greet her.

“Perhaps we could go to another room to have a chat,” says my boss.

In respect of this unnamed family, I will divulge no more.  Suffice to say, that my boss manages the situation flawlessly, using simple, unconfusing, compassionate language, in a way that I have not witnessed in a long time.  It is far more common to see doctors fluff the breaking of bad news, than to see it done well.  Here, she does so with exemplary skill.

There is no correct way for the machines to be turned off.  They can in there, with their baby, or not.  They can take her to their room, or she can remain in the unit.  There in no rush for decision.  There is no right answer here.

I sit, watching this young mother, her tummy still full.  Tears stream down her face.  Her stoic husband sits by her side, rubbing her back, offering his support.  I feel the waterbrash rise in the back of my throat, thankful that it is not me giving the news.  This last nine months has touched me in a way that I can no longer be just a doctor in these situations.  Although my circumstances were nothing on the horror of this – I too, have lost a child.

I notice the wetness welling in my eyes.

Thankfully no one else does.

I’m not as impartial as I used to be.

The scene burns into my consciousness.  In this instant, I appreciate all that is good, and cruel, and even loving, in these pivotal moments in life.

I feel the full privilege of being here.

Of my job.

Of being part of this.

And of how these words, imparted with genuine humanity, can help their wounds to scar a little less jagged than they may have otherwise.

* * * * *

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By Mark Nethercote, July 28, 2011 10:00 am

Friday 30th July 2010

One year ago.

Suse still hasn’t got her period.  Her breasts are still tender.  She feels like shit;  lethargic and irritable.

“The only thing that would make this okay, would be being pregnant,” she says.

She’s pre-menstrual, but more than that, she’s pre-pregnant.

That’s the bitch about all of this.

She doesn’t want to be waiting for another period.

She wants to be waiting for a baby.

* * * * *

Meantime, I head off to work.  I’ve got a week working in the neonatal ICU before I start working for NETS, the Neonatal Emergency Transfer Service.

There are gluttons for punishment, and then there’s me.

As the final six months of my six years of Paediatric training, I’ve had this set up for a while.  But the timing is just priceless.  If I can’t have a baby, then I’ll surround myself in everything to do with them.  I’ll work in a place where every single employee and every single visitor is totally devoted to the brand new babies that have just arrived into this world.

That’ll help.

Still, all the same, it seems to work for me.  I’m as busy as hell on the first day, and two hours in, my phone beeps.  I check it, and find a text from Bel and Dan:

‘We are downstairs having a coffee.  We’re sure you are flat out, but give us a call if you are on a break.’

I juggle the thought, before deciding to run downstairs.  There I see them sitting in the café, staring off into nothingness, lost in thought.

“Hey guys, how’s it going?”

“Just had to come in to check on things.  They’re a little worried about the heart rate.  They say it’s sitting a bit high.”

I look at both of them.  Given what they’ve been through in the last two years, this isn’t fair.

“Can’t this baby give you any piece of mind?”

“Clearly not,” says Dan.  “He’s determined to give us grief right up until he’s born.”

“He’ll be right.  He’s just trying to give you grey hairs.”

I look at both of them and smile.  I can see both of their shoulders drop at the reassurance.   “Seriously, this sort of thing is routine.  Totally routine.”

I wouldn’t have a clue.  I know nothing about what the CTG looked like, what they found on examination, or any of the medical staff’s concern.

But sometimes, it’s all people want.  All they want to hear is that everything is going to be all right. Whether you’re a friend, or a doctor or both.  Even when you can’t be sure.

That’s all they want to hear.

* * * * *

I rush back to work, having left them both with higher shoulders than before.  I think of them all through the day, hoping they remain upbeat.  It’s a battle when they’ve been beaten down so long.  After four egg harvests and countless rounds of disappointment, your shoulders have trouble going up anymore.  It’s barely worth raising them before you know they just have to go back down again.  ‘But not this time,’ I say to myself, ‘not this time.’

The day flies by, and as I finish work, I dial Suse.

“Hey love,” she answers.  It’s like there’s been a shower, and her voice has come out.  “I got my period!”

The clouds have parted and the sun is out.  There’s even a rainbow.

If you can’t have a baby, then sometimes, a period can be the next best thing.

It’s time to start a new month.

* * * * *

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By Mark Nethercote, July 27, 2011 10:00 am

Wednesday 28th July 2010

One year ago.

I sit in the pub, looking across the table.

“Just get on with it, I reckon.”  Dan finishes this declarative statement, in his Scottish lilt, and takes a swig of his beer.  “We did a lot of farting around at the start.  I mean, really, when it comes down to it, I wish we’d just had a crack at IVF from the start.”

“Really?”

“Yeah.  Absolutely.”

“I thought you started IVF pretty early?”

“Nah.  Fuck no.”

“What did you try before that?”

“All sorts of shit.  Including turkey basters.”

“Really?”

“Yep.”

“I never knew that.”

“You never asked.”

“I guess I didn’t.”  I take a swig myself.  “Well, I guess they didn’t really know what the problem was with you guys.”

“Exactly.  Unlike you guys, where you know you’ve got a blocked tube, we didn’t have that sort of certainty.  We lost our pregnancy, and no one could tell us why.  So we had to sort of start at the start.  We did a round of hormones, and then tried the dye test, and gave it a few more rounds, and fucked around some more.  And eventually we got onto the IVF.  Personally, I just wish we’d done it from the start.  It took us four rounds, after all.”

“Four harvests?  Really?”

“Where were you this last three years?” he jokes.

“Being a guy, I guess.  I mean, I guess I had just lost count.  I don’t think I realised it had taken you guys that long.”

“It seems to have flown by for you, doesn’t it?”

“Yep.”

“Funny that,” he says, laughing.  “You only know how shit it really is when you’re the one standing in it.”

I sigh, taking another sip.

“So how many weeks are you now?”

“Bel’s thirty-nine weeks today.”

“Bloody awesome.  I swear, you’re the only pregnant couple in the last year that I’m not jealous about.  You guys have put in the hard yards.”

“I know.  And some of our mates don’t even know how many rounds we did!” he says, in mock disgust.  “We were pregnant before anyone else,” he says, nudging Adam playfully on the arm.

Adam has been quiet throughout this whole exchange.  As the guy with a kid, he knows to lie low through the IVF talk.

I look back across at Dan.

“Where are you working at the moment?”

“The Women’s.  In the neonatal intensive care.”

“Will you be there next week?”

“Yep.”

“Really.  What days?”

“Tomorrow until next Tuesday.  Why?”

“Because Bel is being induced there next week.  I might see you.”

“You don’t want to see me, mate.  You don’t want to be coming to NICU if you can avoid it.  Which you will.”

“Good point,” he says, nodding deeply.  He takes another sip.  “So you’ve done all of your tests?”

“Most of them, yeah.”

“But what about you.  Have you done yours?”

“Wank into a cup?”

“Yeah.”

“Sure did.”  He takes another sip.

“So what’d you get?”

“Sorry?”

“What was your score?”  I look at him, suddenly understanding.

“What was my count?”

“Yeah,” he says, trying to sound casual.

“Ummm, I can’t remember exactly.”  For as traumatic it was, I’ve forgotten very quickly.  “Two hundred and something.  Two hundred and twenty, two-thirty?”

“Bullshit,” he says quickly.

“No.  No, I think it was.”

“I knew I shouldn’t have asked.”

“Why?  What was yours?”

“Not telling.”

He takes another sip.  We all do.

Nowadays, I can happily talk about wanking without getting embarrassed.

But, it seems, chats about sperm counts remain well out of bounds.

* * * * *

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By Mark Nethercote, July 26, 2011 10:00 am

Monday 26th July 2010

One year ago.

Suse rises a few minutes before I do.  She quietly potters around the kitchen.  I go to the toilet, still in a sleep haze.  I walk into the bathroom, and then I see it.

The negative test.

We’ve been good.  For the last three weeks, we’ve been good.  We’ve enjoyed ourselves and loved each other.  I’ve been out of town for two of those weeks, and there’s a cliché reserved for just such occasions.

But the fact is, we’ve been in a good place.

Our counsellor, June, says that we are a couple of extremes.  By that, she doesn’t mean that we are two wild humans.  She means that, as a couple, we swing on a pendulum.  When we’re on an upswing, and things are good, they’re really good.  But when they’re not… they’re not.

I walk into the living room.  There I see Suse, her face tired and drawn.  She sits in front of morning television, chewing on porridge.  She doesn’t even pretend to be watching.

“Did you see?”  At first I can’t tell if it was her who spoke.  But there’s no one else around.

I nod.  I walk up to her and take her into a hug.  She relents, and I feel her body melt into mine.

“Even though it was the blocked side, I still had to hope.  Each time, every single time, I can’t help it.”

“I know, love,” I say, “I know.  Do you think I didn’t know what the pimples were about?  Do you think I didn’t think it too?”

She sighs, exhaling softly.

“Am I that obvious?”

“Well if you are, then I am too.”

I look at her eyes, drawn and sad.  It’s like I’m watching the pendulum itself, it’s swinging back that quickly.

* * * * *

I sit in the study, completing chores.  Nothing particular, just tidying up things from last week.

And then I hear it.

The soft sobs from the next room.

I walk out down the hall, and see my wife, in the same place that she was this morning.  Half the day has gone, and lots has happened.  But in mind, she’s remained here the whole day, just like this.

She lets out muted sobs, quiet helpless sobs.  I’ve seen my wife cry a lot in the last six months.  I’ve cried a lot myself.  I never thought I’d become a crying expert, but I do know the character of my wife’s pain.  And here, right now, there is no anguish, no sharpness, no anger to her pain.  Instead, I see a softness, a hollowness, an emptyness.  Quiet, tired hiccups.

These are her sorrow tears.

She sits, her head lilted to the side, her shoulders fallen, staring at the blank screen ahead.  I walk to her.  She barely sees me.  I slide onto our couch, and I take her head, resting it against my shoulder.  She falls into me.  It never ceases to surprise me how well we fit.  Me, all short limbs and stocky Cornish trunk, her, long flowing gracious appendages.  And yet, we fit very snugly.  Somehow, I was designed to fit this glorious woman.

She buries her head in further, her tears blotting against my shirt.  We sit there like this, for about twenty minutes.  Her tears flow smoothly as I stroke her hair.  I never thought I could be this comfortable around someone else’s grief.  I guess you learn it when you have to.

After a while, her shoulders stop bobbing, and the streams dry up.  Like I said, these are her sorrow tears.  There is no crescendo here.  Eventually they dissolve to nothing.

“What are you thinking?” I whisper.

“That I’m a barren old woman.”

“Nothing’s changed, honey,” I say.  “Nothing’s changed.  We’re in the same place as we were yesterday.”

“I know,” she whispers, a couple more sobs breaking through.  “It’s just harder to see that today.”

My own tear falls, as the pendulum brushes my cheek on the way past.

* * * * *

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By Mark Nethercote, July 25, 2011 10:00 am

Saturday 24th July 2010

One year ago.

“My boobs are really sore at the moment,” Suse says, turning to me.

“Really?” I say.  She pushes them with her hands, to confirm.

“Yeah.  Really sore.”

Half an hour later, she calls from the bathroom.

“I’ve been getting these little pimples on my nose.”

I walk around the corner to look.

“Where?”

“Just here.”

I look at the non-descript lumps, barely visible on the nare of her nose.  “I never get pimples there.  And now I’ve got an outbreak.”

“Well, there you go,” I say taking her into a hug.

I have no interest in my wife’s pimples.  I have a lot of interest in her breasts, I’ll admit that.  But I have no interest in her pimples.

But this isn’t about pimples.  Or breasts.  This is about something all together.

But neither of us is willing to say it out loud.

So instead, we imagine.

We know there will be a pregnancy test in a few days.

And for the moment, we just imagine.

* * * * *

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By Mark Nethercote, July 22, 2011 10:00 am

Friday 23rd July 2010

One year ago.

I walk into the Emergency Department, and begin speaking to the person from the Department of Human Services.

She tells me that the two children in the cubicle have been brought in after their mother was found intoxicated on drugs and alcohol.  The children were wearing little clothing, and were found cold.

I walk into the room, and examine the two kids.  The four-month-old smiles and laughs, as yet unscarred.  The two-year-old is quiet and frightened, startling at any sharp movement.

He is adorable, with blonde hair and deep blue eyes.

He has bruises all over his body.

Some people are animals.  Fucking animals.

As I stand there, I can’t help but think:

What would it be like to adopt these kids?

How would their lives be different, if I were their Dad?

* * * * *

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By Mark Nethercote, July 21, 2011 10:00 am

Tuesday 20th July 2010

One year ago.

I leap up the escalator, two steps at a time, checking my watch as I do.

It’s 4.57pm.

I’ve been running down Chapel Street for the last twelve minutes, having parked my car dangerously up on the curve, a couple of kilometres back, way back past the tram, and the stream of peak hour traffic snaking behind.

The doors slide open, allowing me entry into the sterile world that is Medicare.  Five women sit behind desks, each staring forward, turning their heads from side to side, waiting for someone to place ping-pong balls in their mouths.  I take a ticket from the wheel, like I’m about to order ham, and I wait.

None of them even pretend to look busy.

* * * * *

I stare up at the red lights on the wall, waiting for it to tick over to mine.  F903.  F904.  F905.  There’s no one else in the whole office.  F906.  They all stare forward, doing nothing.

‘F907.  Counter 2B.’

I look around, trying to locate 2B.  There are five counters.  And I’m looking for 2B.

“Hello?”

“Ah, hello,” I say.  “You must me 2B.”

“Yes.”

“I’m here for my refund.”

She looks at me, breathing deeply, like it’s all she can do to stop herself from picking up her staple gun and flinging it directly at my head.  Eventually she holds out a hand, fingers snapping for the form.  I hand it over.

She stares at it, before frowning.

“That’s funny.”

“It wasn’t all that funny, really.”

She looks at me before rolling her eyes.  “No, I mean.  It’s a 20H.  It’s funny.”

“And like I said, it really wasn’t that funny.”

“What do you mean?”

I raise my eyebrows saying nothing, and she looks back at the A4 sheet.  I watch as her pupils dance across the page.  A second later, her eyelids widen, and then she flashes me a glance.  She blushes.

“A 20F is something…”

“…No sir, it was my fault.  I… I didn’t see what it was…  I mean, I didn’t…”

“You hadn’t registered the test.  For the sample.”

“I… I guess not.”

She tries focusing on the screen, like it’s the first time she’s ever seen the green and black display.  She punches numbers erratically, her eyes glazing over as she goes a shade of white.

It’s like some new form of seizure.

Petit Wank Epilepsy.

* * * * *

Eventually, she takes the piece of paper, filing it in a draw at the bottom that hasn’t been opened all day.  She then hands me the cash, and a docket, being careful not to make contact with my hands.

“Will that be all?”

“Can I have my Medicare form back?”

“You’ve got your docket now,” she says, pointing with hands kept close to her body.

“Can I have a copy?”

“What for?  You’ve got your docket.”

I look back down at my hand, receipt sitting crumpled under the coins and notes.

“I guess I like to keep a record.”

“Docket,” she repeats, her whole body shrinking away.

Lepers are treated with more respect.

I throw the coins into the other hand, freeing up my right.  And I reach over, shaking her hand vigorously.

“Thanks very much.”

I turn, and exactly 5.04pm, I walk out of the door of Medicare.

And I guess that about sums it up.  Two weeks ago, I handed a cup to a woman wearing purple gloves.

And now, all I have as proof is a hand full of change and a docket.

* * * * *

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By Mark Nethercote, July 20, 2011 10:00 am

Saturday 17th July 2010

One year ago.

“Did you say that Western medicine has done fuck-all for you?”

I look across at Pete.

And I’m a bit pissed.

* * * * *

It’s a Saturday night.  Suse and I don’t get out much anymore. And neither do our friends.  We’re like a Harry Connick Junior remake of a once-great song.

And yet, we find ourselves, at this swanky French restaurant in Drummond Street, Carlton.  Pete and Cath have got babysitters for the night.  Elle has left Dave at home to look after their sick child, and Carrie is over from Tasmania for the weekend.  They’re all friends from Uni.  And they’re all doctors.

I look at Suse.

Here we go.

“Yeah, that’s what I said.”  I say it with a bit too much animosity.

“I’m just clarifying,” he counters.

“I mean, I know it might sound hypocritical when we’re about to start IVF.  But to this point Western medicine has done fuck-all for us.”

I look around at the table, this table of Western medical doctors that I trained with.  Each face sits somewhere between offended and amused.

“So that’s why you bought the candles and the salt?” asks Carrie.

“Yep.  I mean, on the day we moved into our new house, Suse started bleeding from her ectopic.  And since that time we’ve had – I don’t know – maybe ten, fifteen things that have gone wrong with her health.”

“So you really believe that there was a curse put on your house?”  She can’t stop herself from letting out a laugh.

“I don’t know.  But, like I said, everything that we understand, everything that makes sense to us, everything that science has shown us, has not been able to help us out.”  I hesitate for a moment.  “I actually think we’ve lost some of our wisdom.  In the last three hundred years, we’ve come to think that science has the ultimate answers.  And like all people falling into any trap throughout time, we think we’ve got it all sussed.  We think we understand it all.  I actually think we know less now than we did two thousand years ago.”

I look around the room, at this table of highly-trained, highly-intelligent human beings.  I don’t know how open they are to left-field shit like this, as I’ve never asked.  But I’m on a roll.

Shit, I’m on a roll.

“So is that the same as religion?” Carrie continues.  She’s the only one more pissed than me, and therefore the only one willing to walk into this conversation;  the rest of the table sees the warning signs.

“No,” I say, again with more venom than I mean, “don’t get me started on religion.  This is about spirituality.  There are people in this world who think that ‘The Power of Now’ is the best book in the world, and there are people in this world who think it’s a crock of shit.”  I look around, getting the distinct feeling that ‘shit’ is the group consensus.  “I just think that there is a whole lot of stuff that we don’t understand, I think that the way we practice is different to the way we will in thirty years, and I think that in thirty years, we’ll look back on ourselves and say, ‘Fuck, why did we not think more about Eastern Philosophies?  Why did we think we knew everything?  Why did we work so strongly to the evidence-based doctrine?  Why did we have to prove something to think that it was possible?’ ”

I look around the room.  Everyone is silent.

“I was just clarifying what you said,” says Pete, slightly bemused.

“Yeah, well, maybe I misread it.  I guess that this last year has really shaken everything we believe in.  And I guess – given the fact that Western Medicine hasn’t given us the answers – that we’re more than happy to whip out and buy a three-buck candle and some salt and burn it, if it gets us pregnant.  Shit, I’ll do it every day if it works.”

“So this is about faith?” Carrie asks, still wanting to understand.  I can almost hear the held breath of the table, hoping my rant is done.

“Yeah, I guess it is,” I say.  I smile.  “So, not bad weather we’re having, is it?”

I hear the table exhale in unison.

I take a piece of bread.  I take a bite, looking over at Suse.

She gives me a wink.

* * * * *

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By Mark Nethercote, July 19, 2011 10:10 am

Wednesday 14th July 2010

One year ago.

My wife’s a trooper.

Despite antibiotics causing an award-winning bout of thrush and ongoing nausea, despite ovulation pain causing a crippling ache requiring a hot water bottle and bowel-concrete-inducing doses of codeine, despite having been instructed to avoid the perils of condom-free sex for two weeks straight so as to not pass ureaplasma back and forth, and despite the fact that she is clearly ovulating from the right side, the blocked side, the side we have been told that we can’t get pregnant from – my wife is adamant about one thing.

She is adamant that we will be having sex tonight.

And we will enjoy it.

* * * * *

Which we do.

And consequently, we give ourselves the best chance of having a baby naturally.  Despite the fact that Western medicine has told us we’ve got bugger-all chance without a test tube.  Despite the fact that we’re doing it all wrong.  We’re doing it before the ureaplasma is irradicated.  We’re doing it without condoms.  We’re doing it on the wrong side.

So it’s the wrong side.  So it’s not supposed to work.

So what?

So fucking what?

We’ve got to hope.

We’ve got to hope that we can.  Even though we’ve been told that we can’t.  Even though we’re doing it all wrong.

What else can we do, but hope?

What good is there in turning over and giving up?

What good is there in waiting until everything is just right, just spot on, just perfect?

Life ain’t perfect.

It never will be.

Get on with it.

* * * * *

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By Mark Nethercote, July 18, 2011 10:00 am

Monday 12th July 2010

One year ago.

‘I was thinking I might drive up to Ballarat after tea tonight to make love to you.  Any objections?’

I don’t know that I’ve ever received a nicer text message.  I’m working in Ballarat for a couple of weeks, locuming at the hospital, just at the key time.

Desperate times lead to desperate measures.  I don’t know that anyone has ever driven from Melbourne to another town, just to have sex with me.

In fact, no one has ever driven anywhere to have sex with me.

If there is any advantage to not being pregnant, I guess this has to be it.

* * * * *

“Suse is driving to Ballarat tonight.”

“Oh, really?” Mum says.

“Yeah, she’s ovulating some time in the next forty-eight hours.  So it’s pretty important that we…”

“…Fair enough.”

“Do you need us to leave the house?” asks Dad.

“No,” I say, trying not to laugh.  “We only need one room.  Just don’t come into the room.”

It’s nice knowing how supportive everyone is.  It strips a lot of stuff away.  It’s like a little vignette has opened into our life, and after that, we’ve just let the shroud fall away.

All that stuff we used to keep secret.  I’ve never spoken to anyone about masturbating.  Never.  But since my experience at the hospital, I’ve told about a hundred people.  Equally, I don’t think I’ve ever told either of my parents about an impending sexual encounter.  Let me rephrase – I know that I’ve never told either of my parents anything about any of my sex life.

I guess things change when you’ve got blocked fallopian bits.

In response, you open up about everything.

Hoping to influence the tube.

* * * * *