Echoes of a Heartbeat

I am still healing from something that happened to me one year ago. Something which catapulted me into becoming a totally different person.  

  * * * * *

Thursday, January 10^th. Night.

Life is wonderful right now. I successfully completed my first semester of student teaching, I am expecting, two of my friends are coming to spend Shabbos with us, and I will be flying out to see my family in Chicago in a week. The only slight stain on this pristine picture is the faint dab of blood I see in my underwear this evening. My sister assures me that everything is probably fine. My mother recommends I push up my first doctor’s appointment to early next week. I agree that this is a good idea. That way, the doctor can just confirm that everything is fine, and I can tell the rest of my siblings I am expecting when I see them in person in a week or so.

  * * * * *

That week, one year ago, something happened to me which I had never encountered before in my blissfully sheltered life. I had heard people whisper about such things, and sigh and shake their heads sadly as they discussed it in morose tones, but the full reality of what it meant was lost on me.

  * * * * *

Monday, January 14^th. Afternoon.

I sit with my husband, Elchonon, in the doctor’s exam room. On my phone, I have a list of pregnancy-related questions. They will not be answered. They will not be asked. They will not be relevant in about 15 minutes. Instead, we talk with the doctor about what the next step is, because she doesn’t see an image on the ultrasound. She is not picking up a heartbeat. She asks me if I’m sure I’m pregnant. I tell her I’m pretty sure. The doctor takes blood and sends it to the lab for a reading. We are sent home and told to await a phone call from the office with the information sent back from the lab.

They say that one in four pregnancies ends in miscarriage. I did not know this before I got married. I did not know this before I got pregnant. Even if I had known, I doubt it would’ve made what I went through easier. But perhaps I wouldn’t have felt as alone.

On the drive home, I call my mother crying, telling her about the blank ultrasound. Then I am cruel. I ask her not to call or text about it until we hear the results and share them with her. I know the last thing I need right now is more people’s anxiety compounded on top of my own.

  * * * * *

Of course, everyone has a different preference when it comes to privacy. There is always the question of how much to share, and what to keep to oneself. Sometimes I feel closed, nurturing this secret close to me, because it is so wrapped up in who I am that I don’t want to share it with other people. I need to protect myself from others’ opinions and remarks. Other times, I need to tell people, because it is so wrapped up in who I am that I want them to know, so they can understand me. And I need to lean on them, to not feel alone in this.

* * * * *

Tuesday, January 15^th. A long, slow day.

Tuesday brings us no news. I stay at home the whole day, doing nothing, just in case we need to run to the radiologist. Elchonon and I pass the day in a tense, anxious daze.

* * * * *

Several months ago, a few influencers started a campaign on Instagram, called #RealLossRealLove, to spread awareness that miscarriage is more common than people think, and that it is a normal experience. When I saw how many women have had more pregnancies than children, I wanted to shout, “I’m one of you! Yes, it happened to me too!” It was a relief.

* * * * *

Wednesday, January 16^th. The beginning of the end.

By now, I am a bucket of nerves. My husband and I agree that the best thing to do is to continue on as usual. We can’t handle another day like yesterday, just sitting around waiting to hear from the doctor. I run errands. I put a dress in my car to exchange at the store. I go to the fancy chocolate shop and pick out treats to bring to my family later this week. Dainty blocks of chocolate sit prettily on silver trays behind the glass display case, and boxes line the wooden shelves of the small store. I am texting my sister about which ones she would like when I get the call from the doctor’s office. I push my way out to the sidewalk to concentrate fully on her words. She tells me that the lab results are in, and they show the pregnancy-related hormones to be staggeringly out of proportion. She has made an appointment for me at the radiologist at 3:30. It is about 1:45 now. I can run home, grab a lunch for the road, and be there on time.

* * * * *

They say that one in four pregnancies ends in miscarriage. I did not know this before I got married. I did not know this before I got pregnant. Even if I had known, I doubt it would’ve made what I went through easier. But perhaps I wouldn’t have felt as alone.

* * * * *

3:15. The same day.

In the waiting room at the radiologist, I fill out the forms and wait anxiously with Elchonon. I don’t feel like watching the news on the little TV. Instead, I look up a term the OB-GYN had mentioned: molar pregnancy. I learn that a molar pregnancy is an abnormal fetus implantation which will not come to term. While I’m looking it up, I remember another term which had come up once, almost in passing, during my kallah classes: ectopic pregnancy. According to the internet, an ectopic is when the egg, coming from the ovary, gets lodged in the fallopian tube, rather than passing through to the uterus, where it should be.

* * * * *

I grapple with this question all the time: Should I tell people or not? Well, more specifically, should I tell my friends who are looking forward to having a beautiful family, or to those who are already blessed with babies? I ask people what they think. Some say, “Don’t tell kallahs. They are already so overwhelmed with the new information coming at them in such a short time. What is the point of giving them something else to worry about—something that they can’t do anything about anyway?”

I feel differently. I say that young women need to know. They shouldn’t have to find out from looking up a vague term on their phones in a doctor’s waiting room, ten minutes before hearing the same word from the doctor herself. I say, that when you get on an airplane, the crew goes over the emergency protocol, not because they fear something will happen on this flight, but because they need to be responsible. Better to have heard the instructions about the flotation devices under the seats and the lights along the aisle, because otherwise, in the case of an extreme situation, there will be mayhem when people don’t know what to do. My situation was emotional mayhem.

* * * * *

3:45 pm. At the radiologist.

The nurse calls us in. Her name is Aviva, and she is wearing a long pencil skirt and a tichel. I find this comforting. She is kind, but professional and business-like as she runs through the protocols. She hands me a sealed pink gown to change into and explains that she will use a wand to take pictures internally. I lay on the examination table, while next to me, Aviva clicks on her computer screen to capture images. With each click, my heart stops. She takes lots of pictures. I’m not sure, but out of the corner of my eye, I think I see a fuzzy image of a fetus on her screen. Her wand is not near my uterus. Aviva might have noticed me looking, because she tilts her screen slightly away from me.

Aviva finally finishes and steps out, telling us to wait for the radiologist to come in. A few minutes later, the doctor slips through the door. She is short and wearing a black top, leggings that cling to her, and sneakers. I wonder if she is dressed down because it is almost five o’clock. I feel bad. Maybe I’m making her stay when she is ready to leave for the day. She closes the door behind her and says simply and seriously, “You have an ectopic pregnancy. I’m so sorry.” I don’t know if she says anything else because I slam back down on the exam table, sobbing openly. Later, I learn that she speaks to Elchonon, before he and Aviva usher me back into my clothes and into the car. We are headed to the hospital. I am going into immediate surgery.

* * * * *

It is Shabbos Chazon. It is near the end of davening, and I am outside of shul, waiting for my mother-in-law. A woman I don’t know wishes me a mazel tov. “I’m sorry?” I ask, slightly confused. “Oh,” she says, “you seem like you’re newly married. Are you newly married?” “No,” I reply. “I’ve been married a year and a half.” She seems a little embarrassed. I am too.

We have a problem in our community. There is only one timeline which is considered normal for frum women: get married, have babies, be a mommy, be a bubby. If these things don’t happen in quick succession, something is off. Thus, a stranger can deduce what life stage I’m at, based on the fact that I am young, wearing a sheitel, and standing by myself. I do not appreciate her assumptions.

Sometimes I feel closed, nurturing this secret close to me, because it is so wrapped up in who I am that I don’t want to share it with other people. I need to protect myself from others’ opinions and remarks. Other times, I need to tell people, because it is so wrapped up in who I am that I want them to know, so they can understand me. And I need to lean on them, to not feel alone in this.

 * * * * *

4:15. On the way to the hospital.

The thoughts and emotions are coming swiftly and powerfully. I don’t know what is going to happen to me. I don’t know how Elchonon, sitting beside me, is feeling. Have I let him down? I am causing him pain. I know in my head that it’s not my fault, but emotionally, I believe that I am the source of this deep sadness which is already here, and that we both know will only be growing. I am terrified at the prospect of surgery. I have never had surgery, never even been admitted to the hospital. I am scared of hospitals and surgery because I am scared of pain. As soon as this thought occurs to me, I am also suddenly aware that I am selfishly feeling terror for the physical pain when I should be sad about the loss of this unborn child. I feel like a worm for letting my fear of “what’s going to happen to me?” override the other emotions. I am in hysterics. I can barely communicate with Elchonon. But he lets me take my time to find myself. He’s there for me. Steadily, strongly, and gently, he directs what needs to happen.

We check into the emergency room and wait with the other patients. This is starting to feel surreal. My brain is moving slowly, thinking inarticulate thoughts like, “You are in this ER waiting room like all these other nebuch people, so you must also be a nebuch.” The whole environment is so dreary. One young mother has two little girls with her, and they are antsy. An old couple sits with hunched shoulders, facing each other, maybe trying to carve out some small vestige of privacy in this room of shared misery. I try not to focus on the debris that people have left, like used tissues, and on one side table, a (thankfully, clean) diaper.

* * * * *

After this experience, about a half a dozen women share with me that they too went through a miscarriage. I am surprised. The stories come flooding in—about sisters, neighbors, aunts, mothers. How come I had to wait until I went through the pain myself to discover how common this is? Something about the whole attitude doesn’t sit right with me.

* * * * *

4:30. The emergency room.

As we follow the orderly through the swinging doors, it’s like we’ve stepped into a different world. It is so bright and white in here, and people bustle around quickly. The surreal feeling grows. Medical staff are in blue or teal, but I see patients too: one man hobbling around, holding an IV, in a much-too-flimsy gown, and most disturbingly, I notice a woman sitting up in a hospital bed, casually scrolling on her phone. Immediately, I start to panic, because I am scared that they’ll put me on a bed in the hallway too. I can’t go through whatever’s coming in the public hallway of a hospital. I clutch Elchonon’s arm in fear. I think I might be mumbling something along the lines of “oh no oh no oh no,” and I start to feel panicky hyperventilation rising in my throat and lungs again.

Relief. We are escorted to a corner room which contains exactly five things: a bed, an IV pole, a garbage pail, a sink, and a chair. The next hour and a half is occupied with meeting a steady stream of nurses, doctors, residents, and scribes, belonging to both the ER and OB units. A kind nurse named Laura hooks me up to an IV. I feel ashamed for the hard time I give her, but she doesn’t seem to mind. The worst part is over for a while, now that the needle is in my elbow.

Elchonon’s been cracking jokes with all the doctors and nurses who come in. I’m so grateful he can do that. I am so appreciative that the people around me are doing everything they can to keep the atmosphere from being dark and depressing. I don’t mean that we are in denial about what is happening, or that we are putting on a fake show of positivity. Elchonon and I are terribly crushed, and we are both comfortable giving expression to the storm of feelings passing through us. But it is all so bizarre that making jokes doesn’t seem out of place. I guess it isn’t any crazier than the total one eighty of finding out that we wouldn’t be having this baby after all. We know we will need to process that fully. It will take time. We are not in a rush.

Elchonon is kept busy filling out an endless stack of forms I don’t have the headspace to focus on. In the minutes when our room is empty of medical staff, Elchonon and I talk. We are starting to realize that we won’t be able to fly to Chicago on Thursday. We will need to tell the family. We decide to tell them the reason why. I’d rather have their support than my privacy. We make a Shabbos menu, since we will now be staying home. I dictate to Elchonon a list of clothes to bring me from home. I tell him how scared I am. He says he knows. He says he’ll be here the whole time. We’re in this together. I cry some more. We’re not angry about what’s happening. Just sad.

We reflect on how much Hashgacha Pratis has already shown itself in this situation. First of all, I say, the biggest bracha is that we caught this early. My life is literally being saved right now. Also, Elchonon points out, the medical staff is compassionate and understanding. Just look at Aviva from the radiologist’s office. She took the lead and guided us to do what had to be done. And Laura and the other hospital staff have been incredible. They don’t try to convince us that this will be easy, but acknowledge our loss, and do their best to make this as bearable as possible. I am assured that I am going to be ok, and I trust them, because, sadly, their job is to deal with situations like this on a frequent basis. Emotionally, I know it will be my own job to feel ok. But one thing at a time.

I am cognizant of another bracha: that my parents are medical professionals who can speak to the doctors and help us navigate this process. And one more big one: Elchonon’s uncle is a leading posek on medical halachos. We can call him on his cell phone at any time of day or night, and he will advise us on the spot of what the halachos of the situation are.

At around 6:00 or so, I meet the biggest bracha of all. Her name is Dr. Angela Wyatt, and she is my surgeon. She enters our room with a few other nurses and residents, whom she introduces as her team. Elchonon tells them that they look like superheroes, and Dr. Wyatt strikes a pose with her hands on her hips. Her presence is incredibly calming. She speaks slowly and clearly, and explains the entire procedure to me.

The surgery is called a laparoscopy. In the operating room, I will be put under general anesthesia. Then Dr. Wyatt will make an incision near my belly button (or two, at most, she assures me), so that she can go in and remove the fallopian tube where the pregnancy is. She explains that in order to see what they’re doing in there, they will need to pump up the area with gas, and that after the surgery, I will feel pain as the residual gas pushes on nerves that send pain signals to random parts of my body, such as my shoulders. The only other pain will come from my abdomen as I heal from the surgery.

* * * * *

When I tell people about my ectopic, they have a question. They don’t always ask it, but it is behind their eyes, or under their tongues. I don’t mind when people ask outright. Once I’m telling, I have little to hide. But for those who don’t feel they can ask, I answer their question for them—oh, the surgery has no effect on future pregnancies. Then they breathe a tiny sigh of relief, the same way I did when I asked the doctor that same question.

* * * * *

6:30. A quiet room in the maternity ward.

I am learning so much about hospitals that I never knew before. For example, there is an entire department called “Transport” which is responsible for moving patients around the hospital campus. Still on my bed and hooked up to an IV, a kind guy wheels me to a private room in the maternity ward. The walls are a soft purple, and it is quieter here. The cruel incongruity of being housed in the maternity ward is not lost on Elchonon or me. It is strange to be lying here, hearing babies crying periodically, knowing that new mothers are softly cradling them on the other side of the wall or down the hall. I feel like a trespasser, an outsider. I don’t belong here. My being here is a perversion of what this place should be.

Secretly though, I am happy to be out of the ER and in the maternity ward. I tell Elchonon that this is almost like a test run—now I know what it will be like to go to the hospital, im yirtzeh Hashem, for a much happier occasion. I like feeling prepared.

There is only one timeline which is considered normal for frum women: get married, have babies, be a mommy, be a bubby. If these things don’t happen in quick succession, something is off.

Poor Elchonon. While I have a luxurious bed which reclines to exactly the angle I’d like, he has the entirety of two stiff chairs to claim as his designated spot. He runs home to get food and bring the things we will need for our overnight stay. We have a long evening ahead of us; surgery is scheduled for 11:00 pm, because of those pizza bagels I had on the way to the radiologist. Apparently, anesthesia can only be safely administered on an empty stomach. Sorry, everyone. I hadn’t planned for emergency surgery this afternoon.

* * * * *

At the end of January, the spring semester begins. My final semester of student teaching. Every week, once a week, rather than go home after my last class on Thursday, I head to Dr. Wyatt’s office. There, a nurse takes a sample of blood, and I am sent on my way. The next day (or after Shabbos, because she knows I’m a Sabbath observer), Dr. Wyatt texts me that my pregnancy-related hormone levels are going down healthily. She makes me come in every week until the lab results show zero presence of those hormones.

I dread going each time. Despite the fact that I’ve survived surgery, I am still terrified of needles. On the drive over to the office, I need to actively slow my breathing and repeat to myself over and over, “It’s going to be ok.” Every week, I give a long disclaimer to the nurse about how I hate shots, and how ironic it is that my father’s a doctor, and I’m so sorry, and I know it’s ridiculous, and I’m going to be a teacher, and I’m in an eighth grade classroom this semester, and oh—your son is in seventh grade?, and on and on until she finally pulls the needle out, and I can breathe deeply again.

One time, the nurse who calls me in is the one I had the week before. She tells me that she saw my name on the list and remembered how nervous I was, so she took me back before heading out for the day. Through this whole experience, I am discovering that some people are saints.

* * * * *

10:45 pm. Waiting to go into the operating room.

I’m still on my bed, and I cannot wait to get this surgery started. Seriously. I’m nervous, but I can’t wait to just be put under. I am wearing this silly blue shower cap thing over my snood, just like the people around me. In the room with me is the anesthesiologist, who is a really nice older gentleman, and Dr. Wyatt and her team. I wish Elchonon were here too, but in another way, I feel strong for ultimately going through this on my own.

I chat with the team for a few minutes, and then someone comes to fetch us. I am rolled through yet another set of swinging doors into a bright white room. It feels pretty similar to what’s in the movies from what I can see, which is not much. They raise my bed using the buttons on the side, and I scoot from the bed onto a much narrower table. I am breathing deeply to stay calm. Then the anesthesiologist is putting the mask over my face and telling me to count to ten and then—

* * * * *

It is the middle of the spring semester, and in my Senior English class, we are reading works that pertain to the theme of defining and demarcating “life”. I read Body of Work by Christine Montross, a memoir about a woman’s experience as a medical student in the anatomy lab working with a cadaver. The way she describes the brutality of surgery, the paradox of laceration being necessary for healing, resonates with me.

* * * * *

3:15 am. The recovery room.

When I come to, it is because I am in pain. As I pass in and out of sleep and wakefulness, I become increasingly aware of a terrible aching pain in my abdomen that I cannot ignore. There is some sort of pressure cuff on both my legs which contracts every few minutes. I have no clue what that’s about. It doesn’t hurt at all, but it keeps waking me up, which is, at this point, a capital offense in my mind. All I want to do is sleep and not feel the pain in my stomach. Actually, now that I am more awake, I sense that I am sore all over my body. I look around and see Elchonon sitting next to my bed. I feel so bad that he is stuck here, awake, in the middle of the night. But I can’t tell him that, because I don’t really have the energy to string together full sentences. I go back to fitful sleep.

The next time I wake up, it is from noises. The recovery room grants each patient one curtained-off cubicle of privacy. That’s it. I am irritated by the loud hacking cough of a patient somewhere in the room, and by the nurses repeatedly calling, “Nancy! Wake up!” to another patient. I wonder what happened to Nancy.

In comparison to the recovery area, the ER and maternity ward rooms were five-star accommodations. The nurse who is assigned to me is not as attentive or understanding as the earlier one had been. She barely speaks to me. I don’t blame her. I wouldn’t be thrilled about having to spend the night tending to a groaning, groggy patient who needs her bedpans changed either.

Elchonon is by my side the entire time. That’s one of the ways you know someone loves you, by the way.

* * * * *

In the weeks following the surgery, I begin to think over the whole experience with a more macro view. I am confused and upset that I had never really heard the term “ectopic” before. As I mentioned earlier, miscarriage itself is barely breathed about. It strikes me as strange—something like miscarriage is an unthinkable tragedy, until it happens to you, and then you have to think about it. All of a sudden, you have to balance two conflicting attitudes. On the one hand, this is happening, and I’m alive, and I even think I’m going to get through this. But on the other hand, it’s apparently so horrible that no one even talks about it.

My take, now, is that it’s both.

Miscarriage is an intensely personal and unique experience. It’s a tragedy. But when it’s so tragic that it’s hushed up, the reaction is no longer authentic to what the experience is. It’s literally saying that “this experience is so terrible that people shouldn’t have to deal with it.” But if one in four pregnancies ends in miscarriage, as the statistics describe, then there are a lot of people who do have to deal with it! So rather than making them feel like they are in crumbling pits of despair, why aren’t we helping them by acknowledging that this is real? It exists. People live through this and raise beautiful families. Women discover inner sources of strength they didn’t know they had, and become different, better people. If this issue is silenced, the opportunity for growth is severely limited. The challenge for women who go through miscarriage is that much harder, because they need to struggle on their own to learn that what they went through, and everything they’re feeling, is normal and human, and even a healthy part of the healing process.

* * * * *

9:00 am. Back in my room in the maternity ward.

Now, the aching pain is more constant, but I am on strong medications to keep it at bay. Suddenly, the hospital staff seems eager to announce that I am recovering well and ready to be discharged. I don’t feel quite as ready. Things start happening quickly. A nurse tells me to order breakfast. I am mildly interested by the fact that there is an entire kosher menu, but I don’t have an appetite. I order Cheerios and applesauce. I tentatively walk to the bathroom, clutching my IV pole. Dr. Wyatt comes in to check on the scars (I have two) and says I’m doing great. She fills a prescription for pain medication. Another nurse readies the discharge papers. Elchonon goes to get the car, and I wait for Transport to wheelchair me down to him.

While I am waiting for Transport (they are taking forever!), I change from the hospital gown back into clothes. Except that Elchonon accidently brought me the wrong shell—this one is way too loose in the neck and sleeveless. I wear it under clothes that already go up to my collarbone. I don’t know what to do now. I make do with putting on my huge parka and zipping it up to my neck.

I am sitting in the room by myself, still waiting for Transport, when a Jewish woman walks in. Her long blonde sheitel is impeccable, she’s got on a full face of makeup, and looks super put-together in her denim skirt and striped sweater. She tells me that she is a social worker at the hospital and gives me this folder full of information about support groups and A Time and Jewish infancy burial services. She’s all kind and sympathetic, but she really irritates me. I want to tell her that if she wants to be an effective social worker, maybe she shouldn’t be so over-the-top in her presentation when the patients she’s visiting are exhausted from surgery and feeling like a nebuch, all zipped up in a stupid parka, wearing a snood and glasses, and sitting there by themselves, waiting for a wheelchair to come take them out of this place. But I don’t say any of that. I just nod a lot, and choke back tears, and ask Hashem in my head to get her out of here already. Finally she leaves, and I go back to feeling inadequate and like a nebuch again.

* * * * *

I have a friend who survived cancer. She is one of the strongest people I know, and a source of light in the world. Once I opened up to her about my surgery, she was completely understanding and empathetic. I knew she would be. She sent me a shiur, given on a teleconference to a group of girls suffering from chronic diseases, on the topic of infertility. My friend and I are not considered to have infertility. But the woman speaking, herself a social worker, touched on how to deal with others’ perceptions of assuming a girl or woman might not be able to have children. It was perfect for me, exactly what I needed to hear. I loved how the speaker brought up that in our society, from a young age, girls are being groomed, overtly and subconsciously, for the role of motherhood, and how it can be a loss of identity for a young woman to find out that she may not ever be a mother, or may struggle to become one.

* * * * *

January 18-19th. Shabbos at home.

I spend most of Friday in bed. I have my laptop, phone, and books around me. Elchonon makes me walk around every so often, acting on the doctor’s orders to keep the blood circulating. Elchonon cleans the whole apartment for Shabbos.

Later in the day, the delivery arrives. My family (spearheaded by my older sister), ordered all of our Shabbos food for us from a local grocery store. I think she was as excited to use the online ordering system as I was to receive all the food. Not only is it a huge help to us, but looking through all the pans and trying each dish provides a welcome distraction throughout the weekend.

Miscarriage is an intensely personal and unique experience. It’s a tragedy. But when it’s so tragic that it’s hushed up, the reaction is no longer authentic to what the experience is. It’s literally saying that “this experience is so terrible that people shouldn’t have to deal with it.”

It isn’t just Elchonon and me, though. Yesterday, I asked my friend Shifra if she would come to us for Shabbos. I needed someone else to be there, for support and distraction. Elchonon and I didn’t want to wallow. We wanted to grieve slowly and naturally, rather than intensely.

Shif brings the most thoughtful gifts with her: a handwritten note, chocolate, and huge fuzzy socks, which I put on right away. They clash wonderfully with the grey Shabbos dress I am wearing—the loosest thing I own. There is a large bandage over my stomach, and I am treating the area with almost reverent avoidance.

On Shabbos, we talk about the surgery and our associated feelings when we want to, and when we don’t, we read the newspaper or talk about other things. I go around the block once on Shabbos day. When Shabbos is over, Elchonon and I drive Shif home to Brooklyn. We’re that grateful.

* * * * *

It is a Thursday in August, and I am getting ready for an appointment with my general practitioner. I poke through our file folders to find my medical records for the doctor. I come across the documents from the surgery. I have never read them in full. I sit down on a chair and read the results from the sonogram, the order for surgery, the results of the surgery. I study an illustration depicting the congenital issue which caused the ectopic in the first place. On the sonogram results, I read the words: “There is a fetal heartbeat of 178 beats per minute.”

Even though I haven’t thought about this in months, I start crying softly. It hits me again that there was a tiny life growing in me which was obliterated. That heartbeat still has an echo. I don’t try to stifle this pain. I feel it, and let it ebb and flow on its own.

That heartbeat still has an echo.