Wednesday, March 19, 2014

Assumption of Risk

"We are afflicted in every way, but not crushed; perplexed, but not driven to despair, persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be visible in our bodies." --St. Paul, 2 Corinthians 8-10.

I had a really weird visit to my OB's office yesterday. In the first few seconds of my visit, I flunked my blood pressure test. My regular nurse is an immigrant with accented English who strokes my arm and says "Relax! Relax, Mama!" I almost always end up getting an even higher blood pressure score the second time she puts the cuff on my arm.

At some point, I'm going to explain to her that I need to take the blood pressure test outside my OB's office to get a more accurate reading. Simply walking into the same office where I found out that my Leo unexpectedly kicked the bucket 16 weeks ago is enough to spike my anxiety levels. Yesterday, that communication task seemed a little beyond me, so I focused instead on taking slow, deep breathes.

I spent a lot of time alone yesterday, waiting for my appointment. Jon stayed in the waiting room with our kids. My doctor was running late. The nurse just happened to have me wait in the same exam room that we discovered we lost Leo. I started to get scared about being alone in there. To calm down, I told myself "This is my Carmelite Cell." I started praying intensely.

I have this prayer I invented when my three year old went to her first emergency heart surgery in 2010. It's for those medical moments when things are either going to be a clear "up, down, or a maybe." I go through each of the scenarios and tell God "No matter what happens, I praise you."

My doctor came into the room. He asked a lot of questions about bleeding. (My low levels last week suggested that I'd have a miscarriage this week.) I told him that I've had no signs of bleeding, but instead more symptoms of pregnancy. He was excited. He said "Maybe we can find out some good news for you today."

When we did the ultrasound, I started praying again.  A sacrifice I made was to refrain from asking the first second "Is there still a heartbeat?" I waited patiently. My doctor is methodical and serious. He said "I'm just going to take some measurements first and then I'll turn the screen so you can see it also." He worked in silence for about 2 minutes. Then he said something about taking one more measurement of the fetal pole.

I thought "Well, that sounds positive." "Is there a heartbeat?" I asked.

"Oh yeah!" my doctor said. He flipped the screen around to me. The doctor, the "Relax Mama" nurse and me all had a moment of exchanging high fives. We did not expect to see a growing baby with a normal heartbeat on the screen.

I felt more relaxed after seeing Baby Matthew, so I started talking a lot. I told my doctor that if it was another girl I'd have enough for a Girl's Basketball Team! If it was a boy, I'd have these two perfect bookends 10 years apart. It felt really good to joke around. This baby is so loved.

Unlike the last visit, this time I made it into the official paperwork of my HMO. After I got changed back into my regular clothes, the doctor handed me a thick pre-natal questionnaire. This is my fourth pregnancy with the same OB, but I always go through the same issues.

Both Jon and I are carriers of the Cystic Fibrosis gene. (Cystic Fibrosis is basically a fatal, genetic lung disease). That generates a bit of buzz each pregnancy. I have to explain that we got diagnosed 11 years ago at the Genetics Department of Ohio State University. Jon has the really bad CF gene. I have this weird mutation of a CF gene that the experts don't think is active because of my negative family history. Basically even though it looks bad on paper, the experts don't think my kids are any increased risk for CF.  All my babies will inherit either my totally good gene or my "basically good to go" CF mutation every time.

Good doctors are science geeks. My OB follows logic this easily. We joke about how modern medicine sometimes makes mountains out of molehills with potential genetic problems. I feel at ease with him. I feel like we are kindred spirits.

It comes out of the blue a few minutes later when my doctor asks me "Would you consider termination for Cystic Fibrosis?"

I have to mentally translate the phrase "termination" to mean "abortion" because I'm not used to that lingo. I say "No!" In my head, I think "We would just treat the Cystic Fibrosis!" I'm not excited to sign up for repeat visits to Children's Hospital in Washington DC. But I'm not afraid of it either. The average life expectancy with CF is 35. I'm 39! There is a lot of living a kid can do with 30 plus years on this earth.

My OB asks me again. "So you wouldn't even consider a termination?" He leaves this blank pause at the end of the sentence like "Don't you need to at least ask your husband?" I shake my head No.  No, I do not need to consult with my husband. I'm grateful that we have unity on this issue.

Later the OB asks me twice about my willingness to consider termination of a Down Syndrome fetus. I say "No!' again. The Down Syndrome abortion issue is even more strange to me. A Down Syndrome diagnosis is a little scary to me because of the baby's higher risk of heart defects and childhood leukemia. Straight up Down Syndrome itself isn't fatal, however. I'm a teacher. If we get a Down Syndrome kid that would be another teaching challenge.

The whole nature of the conversation starts to freak me out. This mention of "termination" isn't the same thing that we go through with birth control. When we talk about birth control, my doctor understands this is against my Roman Catholic faith. He says "I have to ask you this, Mrs. Benjamin, Do you want a prescription for the pill?" I say "No thank you!" He says with kindness "I thought that would be your answer! Your kids sure are cute!"

I don't understand why our conversation about abortion isn't the same thing. A formality, but the option is clearly off the table.

I realize that my OB is scared for me. I've had two second trimester losses. This fetus is showing signs of being a little 'off'. He'd like to spare a nice Mom like me the pain of having a genetically damaged kid to care for.

The thing I was trying to explain, but failed in that emotional moment, is the legal concept of the Assumption of Risk. I'm 39 years old. I know that having a new baby comes with an increased risk of Down Syndrome. I've known for 11 years, that I could end up with a baby with Cystic Fibrosis. These are known and accepted risks.

Each pregnancy brings other, unknown risks. Quiet honestly, Autism scares me. Childhood cancer scares me. Also, weird genetic disorders that nobody knows about. My three year old had some roommates in the NICU that had some really hard birth defects. I'd rather not be the Mom of a son who has 16 different doctors curiously examining him before neo-natal surgery.

Assumption of the Risk means that when you enter a soccer game, you assume the risk of minor injury. You expect to get kicked in the shins or experience a minor shove. You can't get all furious and sue over the inherit risks of the game.

I feel the same way about having babies. There are some risks involved. Heartache is a risk. You might not get a perfect kid. But you always get "your kid." A little baby that maybe has the recessive gene that lets him do "taco tongue", or bright blue eyes like his Daddy, or nutty curly hair like his Mommy. Little Matthew might never get bigger than my smallest fingernail. His existence is still a miracle.

The last thing I'm going to do after preforming backflips in celebration over Baby Matthew still having a beating heart at 7 weeks is make a plan for his eventual "termination" if he fails a genetic test. I am this baby's mother. I've already Assumed the Risk.

When I think about what makes a Christian different from a more secular person, I think of St. Paul's description of the Christian life. It's a paradox. Christians are "afflicted but not crushed. Perplexed but not driven to despair." St. Paul says that the Christian must confront the reality of death.

I think all Christians wrestle with the reality of death. Some monks were pretty extreme in their quest. St. John of the Cross used to eat every meal with a real human skull staring up from his table. St. Anthony of the Desert spent hours laying in an open grave in his church cemetery.

Modern skeptics would label their behavior as "insanity."

There is something cool about this paradox. The more I'm comfortable with reality of death--this idea that I'm got a limited time on earth too, thus all things are transitory on earth-- the more beautiful my life becomes. I can see the things of this world in more vivid color.

I totally hate miscarriage. It sucks. It really hurts to put a tiny baby in the ground who I never got to hold in my arms.

Yet taking a risk after a heartache is really beautiful. I'm grateful I've got five noisy, nutty kids currently living in my house right now. I'm the Mother that I am today because of loss.

It's two sides of the same coin. Embracing the possibility of death means embracing the joy of life. St. Paul tells us that by "carrying the death of Jesus in our bodies," we can "manifest the life of Jesus" to others. I wish St. Paul's description wasn't so literal in the case of a potential miscarriage, but I'm honored to be on a spiritual path this Lent.