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By Mark Nethercote, August 5, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

From heavy-hitting Section Five, they move to the big guns in Section Six:  Statistics on Congenital Abnormalities.

Before you try this at home, you should know:

Of naturally conceived pregnancies,

- 1 in 6 end in miscarriage

- 1 in 14 will be premature

- 1 in 30 will have a birth defect of a moderate to serious nature

- 1 in 100 will die at or around birth

- 1 in 400 will have cerebral palsy

And with this fun-filled stat grab, know that IVF and introcytoplasmic sperm injection have a 30-40% higher rate of congenital abnormalities.  That takes the numbers from 3-4% to 5-6%.  Is this because of the subfertility or the IVF itself?  It’s hard to know.

If you’ve take our broken parts and can’t make them work again, does that mean they’re bad mechanics?  Or just that they’ve done the best they can with what they had?

But there are other conditions, like Beckwith-Wiedemann and Angelman syndromes that may well be switched on by the culture products in the lab.

That freaks me out.

That really does.

And there is a list of other chromosomal problems that come with the territory of ICSI, where the sperm haven’t worked properly in the first place.  Thankfully, for me, this doesn’t apply.

Then there’s the risks that are inherent from multiple pregnancies, which occur more commonly with IVF.  Twins occur in 1 in 80 in the general population.  It’s 1 in 10 with IVF.  That leads to smaller babies, premature babies, more cerebral palsy, more perinatal death.  Not to mention the risks to mum’s physical health, let alone her mental health.

Twins would be Suse’s ultimate nightmare.

But regardless – regardless of everything we do right and what we eat right – IVF babies remain three times more likely to be premature, and of low birth weight.  We’ve cut out the smoking, drinking, becoming fat, smoking pot, injecting poisons, eating ratsack, mainlining crystal meth.

We’ve stopped doing all of that.  They’re no longer on our to-do list.

* * * * *

And then there’s the risks for Suse.  The risk of Ovarian Hyperstimulation Syndrome.  The theoretical risk of cancer due to IVF drugs.  Breast cancer. Ovarian cancer.  Cervical cancer.  Take home message:  Breast and ovary cancer are no higher in IVF women, but unexplained infertility can have a higher incidence of ovarian and uterine cancer.  Just because.

If you’re unlucky in fertility, you’re just unlucky, it seems.

Oh, yeah, and also, cancer sucks.  Don’t get it if you can avoid it.

And then, it launches into the final stinger:

The likely outcome of the whole thing.

Of all the eggs we get and fertilise, 2/3 will make it to day three, and only 1/4 will make it to day five.

Of those we freeze and rethaw, there is also a one-third attrition rate.

So, to use an example, if we get twelve to start with, and a quarter make it to day five, that’s three all up.  We implant one of them, and freeze the other two.  And there’s a chance that only one will re-thaw properly.

Shitbags.  That’s way worse that I thought.

* * * * *

So, like I said, this is our last month.  In a few more days, Suse will ovulate from the good side.  The egg and the sperm, should the twain both meet, could avoid this whole hullabaloo.

We should be so lucky.

If not, maybe I’ll read the IVF Friends newsletter and pretend I’m in the snowfields.  Or I could try some of their distraction techniques.  I’m already meditating, but they suggest massage, aromatherapy and low impact exercise.  And apparently reading helps.

Maybe I do need to look at Suse’s wax-covered book.

* * * * *

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By Mark Nethercote, August 4, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

This is a cycle.  You’ve got about a 30% chance each time.  That means a 70% chance of crying each month.

Sounds about right.

So, if we don’t get pregnant first time, Suse repeats urine and blood tests.  No more injections.  When she’s ready to ovulate, they thaw out one of our little friends, and repeat.  This, we call the Natural Cycle.  Snap freeze, then thaw slowly up to ninety-nine months later, microwave for twenty seconds, then put on a delicate cycle.

Air dry for best results.

* * * * *

The next section is my favourite bit.   It’s the Male Partner Information Chapter.

It begins slow:

‘Male partners with low sperm counts, and/or low sperm motility and/or abnormally shaped sperm and/or who have antibodies against their own sperm, are classified as “male factor” patients according to the World Health Organisation Guidelines.’

I imagine the guy with the low count, low motility, abnormally shaped juzz and antibodies is really glad that he just has ‘male factors’.

After this, they lay it on a bit thicker:

‘Please ensure 3-5 days of abstinence from ejaculation prior to your partners e.g. collection date.  Do not abstain for longer than 5 days.

Okay.  Ground rules are good.

‘Prior to producing your sample, please urinate and wash your hands.’ Before or after I touch my penis?

‘Label the container with your full name, date of birth, partner’s name and time of collection.  Unlabelled specimens cannot be used.’

Fair enough.

‘Ensure you have removed the top from the jar.’

What the fuck?

‘After you have produced your sample, we ask you wait approximately half an hour while we assess the sample.   You will be notified if a second sample is required, if not you may leave.  If you have been asked to produce a second sample, you will not be required to wait for the results, but will be asked to provide a telephone number.’

So that someone can laugh at you over the phone.

‘We understand that providing a semen sample on the day of the egg collection can be embarrassing and stressful.  We will endeavour to make this event as easy as possible for you.’

Except for providing any porn that won’t make you ill.

‘The semen sample may be produced at home and brought into the clinic in the appropriate sterile container.’  As long as you remembered to take the lid off.

‘It must arrive within one hour.  Alternatively, the sample can be produced at the clinic and your IVF Nurse can book an appointment for you.’

This is a service I was not aware of last time.  It probably costs extra.

‘When men are anxious and having difficulty producing a sample, a couple of hours break (i.e. a walk) may help.  Please inform our staff, so that they can adjust their laboratory schedule.’

If you have stage fright, just give us a call, and everyone in the lab will move their lunch break around, so that they can applaud when you turn up with your unlabelled pot without a lid on it.

* * * * *

To be continued…

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By Mark Nethercote, August 3, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

The Second Manual is a bit more juicy.  The ‘Treatment Cycle Handbook’ begins with some mundane details:

- the number of embryos transferred per cycle (one)

- freezing the embryos (yes, please)

- the use of donor sperm and eggs (no thanks, we’ll supply our own)

It then tells up about the sequence of steps:

- Grow follicles,

- Time ovulation with blood tests and ultrasounds,

- Collect eggs,

- Put them in a blender with your sperm,

- Wait five days,

- Reimplant,

- Worry.

It includes some interesting facts:

-  The follicles will be 18-25mm when they get them out, but the ovum within is less than the size of a pinhead,

As well as some information that I wouldn’t have even thought necessary to include:

- ‘One or two ultrasounds will be performed to find out how many follicles are developing, what size they are, and where they are growing.  The scan is done vaginally, where the scan probe is inserted into the vagina.  For hygienic reasons, the ultrasound probe is cleaned after each use and covered in a clean, disposable sheath for each patient, so there is no risk of developing infections from these examinations.’

Really.

* * * * *

It explains the steps one by one:

1.  First of all, they have to prepare the ingredients, starting with the eggs.  Sometimes, the mum-to-be will be given the pill or a nasal spray to suppress her cycle.  It’s kind of like the reset button on a computer.  Suse doesn’t need this, and some women don’t.  I guess her inbuilt reset button is functioning okay already.

2. After this, she is given something to get the follicles within the ovaries stimulated.  This, crazily enough is called Follicular Stimulating Hormone.  It’s a daily injection, with a pretty small needle into the bum.  This happens daily for ten to twelve days.  Meantime, they’ll suck your blood and variously use the condom-covered ultrasound, to monitor progress.

3.  When they’re close to ripe, the injections change to Orgalutran, our favourite transformer.   This is the hormone antagonist, used to stop the eggs from bursting too soon, which is what nature is hanging to do.  This way, as many eggs as possible will be ready for the picking on harvest day.

4.  Finally, for the 36 hours prior to collection, a third injection, Human chorionic gonadotrophin (hCG), is given as a final little kicker.  This ensures that they will be good and ripe.

5.  Today, after 10 to 12 days of injections, hopefully mum-to-be will have a bunch of 18-25mm follicles for collection.  You return to the hospital, where an unusually large needle will be used to collect aforementioned eggs.  This will be done under sedation, through the back wall of the vagina and directly into the ovary.

This is done by someone with a very steady hand.

6. Meantime, they casually mention that I’ll need to produce another sperm sample.  There is no mention of whether they’ve restocked their porn collection.

7. They promise to prepare my good-looking sperm, and give them a shampoo.   The ugly ones will go straight down the sink.

8.  If too many are ugly, they might ask for a second batch.

9. My remaining fresh and sparkly sperm will be put in the oven with Suse’s eggs.

10.  Leave them alone for 18 to 24 hours in a fertilisation medium.  I guess this is the romantic bit.  Despite the fact that it all happens in a petri dish, they leave them alone to get to know each other.

11. The next morning they check on them to tell you whether not they liked each other.  And, more precisely, how many of your eggs invited liked how many of your sperm.   This stage is called ‘pro-nuclei development’.

12.  They ring you with the results.  You’ll wait all day on the end of the phone for this one.

13. They then switch the surviving embryos into a new culture medium for the next two days.  Human albumin is used in the culture medium, spun down from human blood.  The go to acute lengths to explain that Suse may therefore be exposed to hitherto undiscovered deadly viruses, fungi, prions, or aliens from another dimension.

But they hope, almost as much as we do, that this won’t happen.

14.  On days four and five, they move our progeny into something called a blastocyst medium.  The change in the mediums simulates the hormones and enzymes that the embryos would naturally receive while travelling down the fallopian tubes and into their resting place in the uterus.  But, as we don’t have fallopian tubes, we’ll use test tubes instead.

15.  On day five, you get another call to tell you how many made it to day five.  It may be one, it may be five.  It may be none.

16a.  If there are none:

Cry.  Then, after a few days, pick yourself up, and return to step one.

16b.  If there is one:

Then it will be reimplanted on this day.  This time they use the medium sized needle.  Hang on, it’s not even a needle.  It’s just a pipette, to squeeze the little blastocyst back into the uterus.

16c. If there is more than one:

As for 16b.  But the leftovers go into the deep freeze for a rainy day.

17.  Hope.  Pray.  Do whatever you need to do.  Do whatever you can, to help that the blastocyst stick to the wall like silly putty.  Make your intentions.  Pray to your God.  Make offerings to your creator.  Make your choice.  Do whatever you feel, that will help you.

18.  Wait.

This period is filled with a lot of hope and anxiety, and they suggest keeping yourself busy.  You can have sex as soon as you like, but the woman is not allowed to play squash or gymnastics, or anything that can leave you gasping for breath.

Maybe they do it different to us.  Sex is about the only activity that does leave me gasping for breath.

But I guess they’re not talking to me.

19. A mere eleven days later, without anymore needles, ultrasounds, blood tests, or medical distractions, they do a pregnancy test.

20a.  If pregnant:

Laugh, cry, hug, be joyful.  Have trouble believing your luck, despite the eighty-one injections, twelve ultrasounds, two laparascopies, one dye test, and all of your prayers.

20b.  If not:

Try, try again.  If there are any left to defrost and reimplant, return to 12b.  If you’re out of stock, do not pass go, do not collect $200.  Go back to the start.

And cry.

A lot.

* * * * *

To be continued…

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By Mark Nethercote, August 2, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

So we’re into our last month of trying naturally.  August is our last chance before beginning IVF.  It’s the eleventh hour for nature.  The whole process is kind of surreal, to be thinking that September brings with it a genuine timeline for attempting conception – since we’ve been doing little else for the last 279 days.

And yet, after talking to Shelley, I’m kind of freaked out by the imminence of it all.  It’s weird that I could be, given how much I want it.  Had we managed to fall pregnant in the last few months, we’d now be well on our way.  If our first pregnancy hadn’t been an ectopic, then right now we’d have a five week old, we’d be sleep deprived, and on the precipice of our own insanity.

But instead, we’re not.

Instead, we’re still the infertile ones.

If we don’t get pregnant this month, injections will begin in about three weeks, we’ll collect the eggs in about five, and we’ll be reimplanting them in just under six.

In less than six weeks time, we will be trying to get pregnant.

Again.

With a little help from our friends.

But it all depends.

* * * * *

It depends on how many embryos survive.  In the time from egg harvest to reimplantation, the remaining numbers may be less than half.  Say they get ten eggs in the first place, more than five of them could be gone by day five.  Maybe all of them will.  It’s a tough battle at the beginning, especially when you’re living in a beaker.  We could go through a whole cycle, and get nothing.  Thank Christ the Government is footing the bill for the Orgalutran.

Suse has been urging me to read more.  She’s had a book by her bedside table, which has discreetly made its way across to my side, the cute black and white infant on the cover staring at me plaintively.  In it, a bunch of unlucky suckers recount how fucking hard IVF is.  I know that Suse gains solace from their hard luck stories;  it makes her feel less alone knowing that others have suffered too.  I just don’t know that I’m quite the same.  I don’t know that I need to learn the hard instructions.  I think I already know that.  Being a doctor kind of shows health’s short straws every day.  I really don’t think I need to read about them to know that they exist.

So instead, I turn to the manual.  I’m a manual kind of guy.  This is where we differ.  While Suse would choose to read a beautifully wax-covered collection of miserable anecdotes on the travails of being barren, I’d prefer to read the manual.

Men prefer manuals, women are from Venus.

So today, I open the labelled manila folder.

Yep, we have a labelled manila folder.

* * * * *

There are two manuals.  The first is called, ‘Guide to Getting Started Handbook, Version 3.1’.  The second is called ‘Treatment Cycle Handbook, Version 1.’  Both are A4 spiral-bound with a clear cover;  not dissimilar to my recent work contract.   Along with this I find a ‘Fact sheet about the Victorian ART Bill Update’, explaining why we’re being treated like criminals who need both a Police Check and a Child Protection Order.  There are also a smattering of pamphlets on ovulation induction, assisted conception, instructions for male patients, and long term sperm storage, in case I want kids when I’m seventy.

There are also the two editions of the newsletter that we have begun to receive from ‘IVF Friends’.  On the front cover of the July 2010 edition is a red British letterbox in a blizzard, piled up with snow.  The windblown side is almost snowed in;  Dr. Who’s door side is not.  On the August edition, we have a golden retriever, again in a field of snow, a small snowman plonked on his head.  Symbolically, I can only imagine that being barren is like a long cold winter, and ‘IVF friends’ are a communication group that you can use to call on friends.  As well as this, they will put up with you dumping your shit all over them.

* * * * *

I sift through more of the paperwork, to find ‘Treatment Cycle Costs Analyses’, another ‘ART Bill fact sheet’ (again apologising for suggesting we may be criminals), a ‘Service Agreement’, a ‘Safety Net Rebate Timeline’, and then the heaviest of them all, the ‘General Information Consent Form, Assisted Reproductive Technology Procedures Form’.

But first, the manuals.

The ‘Guide to Getting Started Handbook’ is a fluff piece.  Well, as far as instructions booklets go.  There’s the introduction, the Mission Statement and a Welcome Chapter.  They tell you who they are, and where they’re located, which is interesting, as we picked the book up from the clinic.  They spruik their research and development credentials and give percentages for causes of infertility (40% her fault, 40% his fault, 20% can’t blame anyone, damn it).  They talk about what tests needs to be done, what they do, and how big the needles are.

Check.

The most interesting chapter explains the history of the place, their impressive fertility rates claiming to be higher than other services in the state, and list their groundbreaking achievements since Carl Wood and John Leeton began Monash IVF in the 1970s.  They include:

- the first frozen embryo birth in the world

- the first donor egg baby in the world

- the world’s first pregnancy and birth from a sperm retrieval operation

- Australia’s first surrogate birth

- Australia’s first open testicular biopsy twins

- Australia’s first blastocyst baby.

About the only thing missing on that list is ‘first IVF baby’ – that honour taken by

Steptoe and Edwards in Manchester in 1978.  And while the claims five and six are getting into the ‘Guinness World Record for the Most Pikelets Eaten on a Thursday in St Kilda’ Type Categories, the first four are bloody impressive indeed.

This here is a world-class facility, which all began in a world-class University built out of brown brick in a suburb called Clayton.

For real.

* * * * *

To be continued…

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By Mark Nethercote, March 2, 2011 10:00 am

Monday 1st March 2010

Gestation: 22 weeks, 3 days

One year ago.

We drive through Melbourne’s dimming light, the rain clouds threatening overhead.  As we navigate our way through side streets, we finally pull up at our destination;  one of Suse’s old friends.  Belinda and her three children have flown from Newcastle for the week.  They’ve been here for five days, and in that time her kids have had gastro, and so has she.  They are staying with another family, in a house with three adults and five children under the age of six.

We arrive to a regular menagerie.  Children stream around out feet as quickly as snot does from their noses.  You can’t move without kicking or tripping over a toddler, all of whom seem to have come down with the bug.

“How are you?” Suse says, cautiously welcoming her old friend into a hug.

“It’s not all it’s cracked up to be,” Belinda replies, holding back a cough.  “I’ve never had as many colds as in the last five years.”

* * * * *

We sit down to a dinner of rice paper rolls and home-cooked pizza, attempting to avoid the mucus and drool.  We fail.  Suse and Belinda catch up, laughing and reminiscing while the kids run about, like a random off beat film clip, illustrating the stories being told.

It’s Melbourne’s first night of Autumn.  And it’s cold.

The conversation moves naturally to family and children.  The women sit and talk about what it means to have kids.  What it’s like to have them every single day.  I watch and listen, as Belinda and her host talk about how hard it still is.  I realise that Suse is quiet too.

“And you’ve had a rough trot, honey?”

“An ectopic,” Suse says, trying to look okay with it.

“You poor thing.  I had two miscarriages before these guys.”

“I did too,” adds the host.

“What happened exactly?” Suse asks, looking at both of them.

Belinda pulls a face, as if trying to retrieve the information.  “It’s all a bit hard to remember these days.”

“Do you think about it?” Suse asks of the host.

“Water under the bridge,” she says, shaking a carefree hand.  “Something that happened a long time ago.”

“I mean, don’t get me wrong,” Belinda adds hurriedly, “it’s a vital part of my history.  And it helped to shape the person I am today.”  She pauses.  “But that’s all it is.  A moment in time.  That happened a long while ago.”

I look at Suse, and watch her smile.

But what I really see is going on in her eyes.

* * * * *

On the way home, Suse remains quiet.  She peers out through the window, as the light rain continues to fall.

“Are you okay, love?”

“When women have kids,” she says, running a finger down the wet glass pane, “they get pregnancy amnesia.  It’s like a natural hard drive wipe.  They completely forget the traumas that they’ve been through.  Have you noticed?”

I pause.

“I see what you’re saying,” I say finally.

“They no longer remember how hard it was for them.  No one does,” whispers, her voice hollow.  “Not like you do when you’re in it.”

She goes quiet again, a little sigh escaping.

Outside, the rain-washed roads splash as we drive, providing a soundtrack to our mood.  Suse’s fingers toy with the condensation on the window, willing it together in streaks.

And all the while, she stares out at the cold, wet street beyond.

* * * * *

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By Mark Nethercote, January 5, 2011 10:00 am

Friday 8th January 2010

Gestation: 15 weeks

One year ago.

Terry walks down the aisle.

Under one arm, he holds a coffin.  It is white, and about twice the size of a shoebox.  It has polished silver handles, but there is little need for them.  It fits snugly into the crook of his armpit, wrapped in place by his massive forearm.

He is dressed in a red shirt with gold stitching; celebration colours.  For here, today, we are celebrating the life – the very short life – of Val.

Val is short for Valiant.

* * * * *

Val was born at twenty-three weeks gestation.  He had a brief, but courageous life, lasting two hours in his parent’s arms.  He should never have been born this early.  And having been dealt this hand, should never have lived even more than a few minutes.  At twenty-three weeks, a baby’s lungs are so underdeveloped that usually there is very little ability to breathe.  There is just not enough lung tissue to stay alive.

Five days ago, I missed a call.

“Hello, Mark,” Terry whispered into my voicemail, his voice beginning to crack.  “Kim went into labour, and… and they couldn’t stop it.  Our little boy was born just now, and they said he is…”  There is a pause.  “But he’s still breathing, you know?  Fighting.  And… and… I just don’t know what to do.”

Terry took a big breath, a long silence ensuing.

“I just thought…”  Another long pause.  “I don’t know what I thought.  I just… I don’t know what to do,” he repeats.  “And I thought… that you… might be able… to do something,” he finished, his voice fading as he hung up.

I rang back as soon as I heard the message.  It was nearly fifteen minutes later.

“Hey, Terry,” I said.

“Hello, mate,” he replied, his voice empty.  “I don’t know why I called you.”

“I do, Terry.  And I’m glad you did.”

Through the end of the phone, I heard Terry begin to cry.  This 220-pound Goliath, an ex-Novocastrian, broke down.  I sat there listening, my own lip beginning to quiver.

“I just… I don’t know what to do.”

“I know mate,” I said.  “Well, not like this, I don’t,” I continued softly.  “But I know what it is to feel helpless.”

* * * * *

Terry continues to walk down the aisle, the coffin tucked under his left arm.  Kim walks just behind, her hand lightly touching the lid as they go.  There is barely a bump to be seen in her belly, her other hand resting lightly over it;  as if to ease the ache.

Her eyes are vacant.  She’s retreated some place.  To a place of strength and reserve;  to make it through the service.  But it is a place of separation, too.  She is with us in body, but even now, she is in shadow.

Just minutes ago, Kim spoke with amazing courage and beauty, about her little boy who had left.  As did Terry.

In this:  undoubtedly, unequivocally, the most painfully moving funeral that I have ever attended.

I look across at Suse.  Her eyes are fixed on the couple.  On all three of them, really, as they continue their slow funeral procession.  Tears stream freely down her cheeks, unnoticed.

I grip her hand tight, but she does not avert her gaze.

I turn back, and I take it in.  With Terry in red, and the coffin in white, the scene merges from rich colour, to shade, and then into Kim’s translucent complexion.  Almost invisible.

And then it happens.

Terry stops, and his face screws up in agony.  His entire body bobs, his eyes clenching tight.  He brings his free hand to his face.  Kim stands there, her mask remaining flat, still, watching.  Silently, this huge man begins to walk once again.  In his celebration shirt, his face crumpled like paper, his own tears now spilling like everyone else in the chapel.

All the while, continuing to hold an impossibly beautiful coffin under his left arm.

Such sorrow.

I’ve never seen anything like it.

Nothing ever quite like it.

And I hope to never again.

* * * * *

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

Sunday 20th December 2009

Gestation: 12 weeks, 2 days

One year ago.

I speak too soon.

Tonight, we’ve invited Libby and Jack over.  It’s hard to believe, but they’re our first real guests since this whole thing began.  We’ve been in this house for six weeks without any one visiting other than our in-laws.

Anyone would think there’d been a death in the family.

For an hour before they arrive, we bustle around.  I set the table while Suse cooks.  I organise drinks while she clears things up.  We chatter away, but she is clearly distracted.

“Are you okay, love?” I finally say.

“Sure,” she replies, without looking up.  “It’s just that… this is the first time I’ll see any of my pregnant contemporaries since this all began.”

A wiser man would have seen it at that point.

But firstly:  Sometimes you just don’t want to look.

And secondly:  I’ve never, ever claimed to be wise.

* * * * *

We finish preparations, making the place spotless, like houseproud newlyweds.  Indeed, with our new home and lack of parity, we could pass as such.  We’re ready.  And so, we tend to the garden together.

This really must be love.

Forty-five minutes later, Jack and Libby arrive.  Fletch stands between them, a hand in each of his parent’s palms, tentatively swaying from side to side.  All three of them look exhausted, but the winner in this game is definitely Libby.  Her tiny frame, already burdened by milk-laden breasts, is further unbalanced by a sixteen-week bump that seems to protrude almost horizontally.

“Hey,” they say in unison, in the same flat tone.  Fletch wobbles between them.

“Hey,” we return.  We exchange hugs, trying not to stand on Fletch as we do.

“He’s being very quiet,” I say with surprise.

“This is the only break we get,” Libby says.  “When he’s just woken up.  A short, sweet respite,” she sing-songs, looking down at him.  I realise that I am staring at Libby, trying to understand how it is that she is still standing.  The physics of it just don’t add up.

We head inside.  Fletch looks at us as we talk, gradually warming up.  We all stand around him, watching the centre of their universe, as he thaws before our eyes.  Very quickly, he begins to look around, to notice, to peer, and then explore.  And then to walk, then run, then fall, then cry.  And then get up again.  Then bump once more, then squeal, then dribble, then cry.  And then finally smile.

Repeat ten times.

This is their life.

Within moments, he is back outside, and disappearing out of sight.   We follow him around the corner to find him, his eyes lit up, holding the garden rake.  Somehow, his boy-radar honed in on the heaviest, most dangerous garden tool he could find, and has made it his toy of the day.  Fletch journeys back and forth to visit it, over the next half hour.  Suse accompanies him as he does, finally earning an outstretched hand, as the adult most willing to comply to his rake fetish.

Eventually, Libby coaxes him back inside.  In here, there is nothing nearly as interesting as gardening implements.  And again, within seconds, he has disappeared.

“Where did he go?” Libby asks, a nanosecond having passed since we last saw him.  We all follow the scent, where we find him, in the bathroom, his thumb jammed in the hinge of the shower door.  There Fletch stands, in a silent, breathless, agonised vigil.  Jack leans down, unbending the hinge, extricating his son.  But the unbending motion causes a repeat squeeze, reiterating the lesson.

Fletch’s eyes bulge, his face blotched white, his mouth open wide, like one of those clowns you put ping pong balls in.  Tears stream down his face, sweat beads on his forehead, as he completes his education in new types of agony.

Those silent seconds pass, all seven of them, before he finds his lungs.  His breath holding done, he lets out an almighty squeal, our collective mass doing nothing to blunt the sound.  Libby bends down, threatening to topple over directly onto her pregnant belly, but again, she somehow manages to defy gravity.  She takes Fletch into her arms, and he gratefully buries his head into her shoulder.

“Oh, Fletch,” she says, sighing in sympathy, “again this week, darling boy?”

“What’s that?”

“He squashed his finger in a shower door last week too,” Jack says lethargically.  “It’s like his kryptonite.”

“Oh, thank God,” Suse says, “I mean, I’m sorry…  I mean, I was feeling awful that we hadn’t child-proofed the house.”

“You can’t Fletch-proof a house,” Libby says, shaking her head.  “There’s no way.  Absolutely no way.”

We all look at Fletch, shaking his head as he wails;  his puffy, bulging eyes streaming.  He sticks his finger into his mouth to suck it, to only learn that it makes things worse.  As his pain doubles, again his wailing becomes a breathless, airless squeal.

One of childhood innocence lost.

* * * * *

Fletch falls into a kind of coma, and for a couple of hours, we are able to conduct something resembling a conversation.  We eat take-away, while Suse concocts overly-strong gin and tonics for the three non-pregnant people.

Within a couple of hours, Libby is beginning to flag.  At 9.17pm.  Meantime, Jack is just starting to fire up.  For years, through our halcyon days, Jack and I would wind up as Libby readied for sleep.

Parenthood doesn’t change everything.

They pack up, and carefully cradling Fletch, make their escape without him waking.  As they leave, Jack puts his hand on my shoulder.

“I know you guys have had a rough period.  A really rough time,” he says.  “But don’t forget what it is to be together, just the two of you.  Try to cherish this time, if you can.  Because once you have kids, you can’t just push them back in.  There is no return policy.”

I smile, looking up at my tall, red headed friend.

“Thanks, Jack,” I say, hugging him.  “But you know how it goes.  We all want what we don’t have.”

* * * * *

We bid our friends farewell.   We clear up, before settling down to Season Four of ‘Entourage’.  Right now, we’re hooked.  And we can often lock in three or four episodes in a night.  But tonight, things are different.  By the second episode, as I look at Suse, I see a decidedly sad face staring blankly at the screen.

I press pause.

“What’s up, hon?”

“I don’t want to talk about it,” she replies.

“Really?”

I am met with the eyes.  The ones that say:

- Don’t question.

- Don’t try to reason

- Don’t try to understand

- And don’t push it.

So, I do none of the above.

I press play, and we watch in silence.

* * * * *

We get through three episodes before turning in.  Our ablutions complete, we move wordlessly to bed, where the game continues.  I read, while Suse bores a hole through the roof with her eyes.

And then, it happens.

In a matter of moments, her anger merges into soft grief, as she lets go, falling into my arms.  Her tense, taught muscles relent and release.

“How am I ever going to make it through Christmas day surrounded by your pregnant sisters?” she manages to whisper.

She begins to take breaths, deep breaths, sighing heavily.  It is her crying prequel.  Almost in questioning, almost a little confused.  Almost asking permission.

The sighs continue, on and on.  I stroke her long hair, cradling her close.  They increase in size, in emotion, in feeling;  a crescendo over minutes.

“Let it out, honey,” I finally say.  “Let it out.”

And with that she does.  She releases it all.  The tears come out, big and loud.  Like welts that need lancing.

She cries deep, and full, and bruised, and hurt.  She bawls, burying her head harder into my shoulder, her sweat and tears and snot soaking sweetly into my shirt.

The hurt, and the anger, and the unfairness of it all spills out.  The disappointment and loneliness and wrath seeps straight in.  For leaving her to this, for letting this happen to her, for keeping her from having what she so desperately wants.

And I hold her.  I don’t try to fix.  I don’t attempt to solve.

I just lie there.

Holding her.

* * * * *

Today, I rang the pathology place, and found out that the Beta-HCG was less than one.  Less than one.  It doesn’t get any lower than this.

It doesn’t get any lower than this.

* * * * *

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By Mark Nethercote, December 22, 2010 10:00 am

Friday 18th December 2009

Gestation: 12 weeks

One year ago.

Not much to report over the last week.  Suse and I have been hanging out, the two of us in reparation.  We’ve been tending to our collective wound, dressing it daily, applying liberal amounts of Betadine.  We’ve been resting and recuperating. We have barely seen a soul.

Being barren has never been so easy.

Tonight, we clear the cobwebs.  I catch the train in to the city for Friday night drinks with Adam and Dan.  Meantime, Suse goes over to Ella’s place for a girls’ night.  We will talk about footy and miscarriages;  they’ll discuss make-up and ectopics.

Standard fare, really.

* * * * *

I turn up to the Brewhouse at the same time as Dan.  It’s packed.  And despite the heaving mass of people to absorb the sound, the bare brick walls and concrete floor make it almost impossible to talk.  I can barely hear him over the din of the Friday night crowd, but he seems to have no problem in hearing my order for more beer.

We shoot the breeze, chatting about rubbish.  This quickly graduates to questions about Suse, and me, and miscarriages and footy.  It’s tough going, but we battle through.  At times he seems to avert my gaze.  I know that loss and grieving are not the standard male discussion points in Australia, but Dan’s a sensitive guy.  But so am I.  Right now, maybe a bit too much.

This continues for a few more minutes, an odd tenseness in the air.  He nervously slugs his beer, looking over frequently to see if Adam has arrived.

“I’m not that bad, am I?” I say, eventually.

“What, mate?”

“You look uncomfortable.  Is there something going on?”

Dan takes another sip.  He looks sideways, smiling awkwardly.

“What is it, mate?” I ask.  He takes another breath.

“Bel and I are pregnant,” he bumbles out, unable to make eye contact.

But I hear it.  Loud and clear.

* * * * *

Three years ago, Dan and Bel had a miscarriage.  Four weeks later, after ongoing bleeding, pain, and a rising fever, Bel had to return to hospital for surgery.

If ever there was a harbinger for our current predicament, they are it.

Dan and Bel are our hard-luck trailblazers.

Since then, they’ve had recurrent attempts at getting pregnant.  Each hurdle led to further disappointments, further investigations, and further obstacles.  They journeyed along, further further along the pathway, until they ended up at the end of the line.

IVF.

Each month, we’d hear the news of the next round.

Increasing odds, increasing costs, increasing anxiety.

Decreasing hope, decreasing chances, decreasing options.

They shouldered it well.  They carried themselves with aplomb.  They bravely imparted their latest setback, kindly keeping us updates.  Meantime, all around them the world was accidentally getting pregnant off toilet seats.  Whoops.

For three years, I’ve watched each and everyone of our friends get pregnant.  Sometimes, they did it in pairs for extra points.  Like synchronised swimmers. Each time, Bel and Dan bravely congratulated.  They bought baby gifts.  They visited newborns.  And they soldiered on, only to return to their fertility specialist for the next round of bad news.

Each time and every time, I saw that look in Bel and Dan’s eyes;  that one I’ve now seen reflected in the mirror.

When Suse and I broke the news about our ectopic, Bel and Dan understood.  They were sensitive to us in a way that you can’t be unless you’ve lived it.  You simply can’t be.  That hole isn’t there naturally;  it has to bore it’s way through.

I look up at Dan, waiting for his eyes to meet mine.  Eventually they do.  Something in the change in his expression tells me that at this moment, I’m now wearing that look.

It’s my turn.  The baton has been passed.

“Congratulations,” I say finally.  Right now, I’m thankful for the inability to hear my own thoughts.  “I really mean it, mate.  I’m so stoked for you guys.”

I take him in a tight hug, slapping him on the back.  I take breaths, trying not to stutter on each.  I never knew that breathing could be hard.

We break apart, and I look at him.  I even try to smile.  He smiles back, knowingly.  He slaps me hard on the shoulder, and even allows himself a little smile.  He quickly wipes it away.

At that moment, he spies Adam at the door.  Dan hurriedly waves at him;  we are both relieved for the distraction.  I wipe at my eyes as he does.

As Adam approaches, he glances at Dan.  They share a look.  Wordlessly, Adam knows that I’ve been told.

“Beer?” he says.  In fact I don’t think he even says it.  He mouths moves, he points at the glasses, and he turns and heads to the bar.

“I won’t go on and on,” I shout, “but I’m very, very happy for you guys.  If anyone deserves this, it’s you two.”

“Yeah, well,” he yells, raising his eyebrows, “We’ll see how it goes.  We’re not holding our breath just yet.”

Understandable.  If I’d had the disappointments that they’d had, then I’d be trying to breathe normally too.

Which is exactly what I’m trying to do.

* * * * *

In celebration, we get thoroughly drunk.

Suse and I enjoy our night apart, stretching out of our co-dependent web, weaved since the beginning of this debacle.  We let each other fly without clipped wings.

We each enjoy the freedom, the exhilaration, the return to normality.  To our lives.

It is a release.

And it’s nice to return to something approaching normal again.

* * * * *

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

Friday 11th December 2009

Gestation: 11 weeks

One year ago.

Suse has her blood test first thing.

Despite the continued bleeding, it’s been a week since the last test.  For seven whole days, we’ve been told to gird our loins.  Shit, if my loins are to be any more girded, I just might have to purchase a pair of chainmail undies.

At last count, the Beta-HCG was ninety.  Down from 432 ten days ago, and way below the dizzying heights of the mid-three thousands just two weeks before that.

Ahh, the roaring three thousands.  How I miss ya.

And despite our uncertainty, with the unflappable Kath at our side, we’ve made it a whole week without a test.

In fact, we’re doing okay.

So much so, that we’ve planned a trip out of town.  My Dad is directing a musical that he wrote when he was seventeen years old, way back in 1961.  ‘Barchester’ has been forty-eight years in the making.

If there has ever been an excuse to risk leaving the big smoke, this is it.

So it is, that Suse and I are in the car, in our driveway, at 3.34pm.  I look across at her.  We’re both buckled in, but I haven’t started it up.

“What is it?” she asks.

“Are you sure you’re right to go?”

Suse pauses for a moment.  It’s only now that I realise how quiet a dead car is.  She hesitates.

“Yes.”

I nod, raising my eyebrows.

“You sure?”

She looks across at me, a steely flash in her eyes.

“I’m not going to live in fear, Mark.  I’m not going to let this thing rule what we do.  We’re going.”

When I met Suse, the first lesson I learnt – and the one I most often forget – was this:

Don’t argue with a Brock woman.

I start the car, and reverse back, happy for the hum of the motor.  We make it four hundred metres down the road before she turns to me.

“They do have a good ambulance service in Ballarat, don’t they?”

* * * * * *

Mum and Dad meet us in the drive.

“Hello my darlings,” Mum says, taking me in a hug.  I hold her tight.

She then takes Suse in her arms, her little frame leaning up and into my wife.  I watch her bare arms, the muscles in her forearm tensing as she holds on.  They stand there for a moment, sharing something that I can’t touch.  A wordless, physical, womanly bond.  In that split moment, they appear fused.  Somehow, forever closer for it.

I feel my throat burn in thanks.

Patiently waiting at her side, is my Dad.  He does the same.  He takes us each, hugging us each, holding us each.  We melt in turn, relenting, saying nothing.  We are grateful for it;  like two little lost kids who’ve found their way home.

The four of us break apart.  And for a moment we are still, in the driveway, the speckled light dappling through the leaves onto the rambling path below.

No one says a thing.  No one is quite sure what is next, the script for this moment having never been run.  We look around, each at the other;  the light a little softer, made so by the wetness at the corner of our eyes.

* * * * *

Within half an hour, the champagne is flowing.  On the drive up, the concept of treating ourselves seemed lavishly over-indulgent.  But now we are celebrating.  What exactly, we’re not sure.  Being survivors, I guess.  Within minutes, we are tickled by the bubbles, giddy with the possibility lent to us in those first few sips.

Suse chatters away, her spirit freed by the release from the confines of our house.  My Mum listens, subtly steering, guiding the conversation out of the dark corners until the cobwebs are cleared.

My phone rings.  The room hushes instantly.

“Hello?”

“Is that Doctor Nethercote?”

“Yes.”

Suse looks at me.

“Today’s result for Susan Brock…”

“Yes?”

All three of them look at me.

“…Beta-HCG…  Five.”

“Five?” I say, a dumbfounded.

I don’t know what she says next.

I can’t hear her for the noise.

* * * * *

I hug Suse into me as we walk.

“I’m so relieved,” I say.   “So bloody relieved.”

“Me too.”

We head around a corner, the lights of the theatre now in sight.

“I would never have dreamed,” Suse continues, “that I could be so happy to be not pregnant by Christmas.”

“It seems your wish might just come true.”

She stops, pulling me in to a kiss.

“I feel free again!” she says, letting out a huge sigh.

“Because we’re not pregnant?”

“Yes.”

“Which was, in fact, what we both really wanted.”

“Yes.”

I let out a hollow laugh.

“We’re both stoked, because at long last, we’re getting the opposite of exactly what we really wanted.”

Suse frowns for a moment, digesting.  Eventually she smiles.

“Exactly.”

Down from ninety to five.  What a way to make a living.

Bloody great.

We aren’t pregnant.

* * * * *

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

Wednesday 9th December 2009

Gestation: 10 weeks, 5 days

One year ago.

The bleeding subsides, and then starts again.  The pain is settling, but it’s still there.  Suse’s energy levels continue to improve.

But the fucking bleeding won’t stop.

I go to work.  I have a really great day.  I see kids with soluble problems.  I am able to help.  I see no angry, resentful nor litigious parents.  They all turn up.  And they all want to help their kids.

And not one of them is bleeding.

I know, I know, I demand a lot.

* * * * *

When I get home, Suse is on fire.

It is the first day since this whole drama began that I can remember seeing her motivated.  As I walk in the door, she is at the computer, checking the last three weeks’ worth of emails.  She’s booked half of her coaching sessions for next week, and I can now see the top of the pile of things on her desk.

She is up and about.

This is the Suse of old.

I can’t even begin to describe the relief I feel to have my Suse back.  We all disappear at times, becoming ghosts of ourselves.  But at moments over the last month, she has seemed almost invisible.

My beautiful, powerful, wonderful woman has been a shadow of her great self.

Through all of this, I’ve done what I can.  I’ve tried to be supportive.  I’ve tried to keep positive.  But it’s all good and well for me to be the guy with the glass, marvelling at that splash of liquid at the bottom.  I’m not the one with clots coming out of my vagina.

Nothing comes out of my vagina.

Nothing that I’ve noticed anyway.

But I’m not overly observant.

* * * * *

So it is, that we sit here, in our house;  separate in our tasks, yet together.  We are in our home;  the one we own, together.  The very home we moved back into, as a married couple, on the day this whole saga began.

And my powerful wife is back.

And as I sit here, relaxing in the late afternoon, I hold a beer in my hand, just watching my wife.  Just marvelling at her.  She sits there at the table, her laptop in front of her, on the phone, doing several things at once.  I don’t even know who she’s speaking to anymore.  It could be her parole officer for all I care.  It doesn’t matter.  Because, then I hear her say it:

“I’m finally getting my shit together.  At last!”

I close my eyes and smile.

Yes, we are back.  The emotional wounds are healing.  We have supported each other through this.  We continue to prop each other up.

And we are getting there.  This is almost done.

Almost over.

Bar the bleeding.

* * * * *