Volume 10

One Halloween in grade school, my parents solicited the help of my three younger siblings and I to paste “vote yes for life” cards on candy bars to hand out to trick-or-treaters. I now realize that words like “pro-choice” and “pro-life” do not represent the emotional weight or humanity of a patient’s decision to have or not have an abortion.

In July 2021, I had used the copper IUD for 8 months. I became increasingly nauseated since my wisdom teeth were removed two months prior. When my period didn’t come when I expected in July, I decided to quell my anxiety and get a pregnancy test at Intermountain.

A nurse did the pregnancy test in front of me and told me it was positive. Time seemed to stop. I heard myself blurt out that I wanted an abortion. I admire how she handled those moments. She gave me a few moments to process what was happening and offered kind reassurance. She walked me to the front desk to schedule an appointment with an OB/GYN later that day. We were in the waiting room at the check-in station, and I was scared others would overhear. I felt embarrassed. She used the phrase “elevated hCG with copper IUD” at the front desk, which gave me a wave of relief. I was grateful that she maintained my privacy.

I drove home absolutely devastated and terrified. I tried to calm myself down, but I remember crying on my kitchen floor, feeling overwhelmed, scared, and alone. Later I went back to the clinic and learned that the pregnancy was 8 weeks. The gynecologist removed my IUD and explained that she had to send me somewhere else because she wasn’t allowed to give me the mifepristone and misoprostol needed for a medication abortion. Throughout the whole process, she was so kind and supportive. She gave me a phone number for a local Planned Parenthood, and I left. The abrupt send-off was the first glimpse of stigma I encountered. I called the number and learned about Utah’s online informed consent module that I would need to complete before a 72-hour waiting period. Additionally, I found out that the first available appointment to see an abortion provider in Salt Lake was a month out.

I called my partner on the way home, again feeling a wave of relief as he listened to me and offered his care and support. At this point, I had done enough research to know that at 12 weeks I may not be able to have a medication abortion. This could limit my choices to vacuum aspiration or D&C less than a week before medical school started.

At home, I started the informed consent module. I was startled by the high-definition images of various stages of pregnancy and smiling babies staring back at me from my laptop. About halfway through, I recognized that someone thought they had the right to shame me into making me feel bad about myself and my actions. At that moment, I realized how wrong it is to coerce or shape an individuals’ choices by imposing judgment on them.

I’d had enough. I shut my laptop and called the main Planned Parenthood number. My worries seemed to vanish as the caring person on the phone helped me find an appointment for the next day in Fort Collins. I threw my overnight stuff in a bag and called my partner to make sure he could come with me.

Within an hour, we were driving to Colorado. We found the cheapest motel we could find. Throughout the night, I heard yelling and fighting outside. The smell of cigarettes and grease from the burgers & fries we grabbed for dinner permeated the stuffy room. I felt ashamed and filthy, inside and out.

I was making an irreversible decision. This was the first time I would do something that I certainly couldn’t take back in any tangible way. A sense of grief mixed with consolation surfaced as I contemplated how my life would be altered by my choice. The following day, we got up early to take a walk before the appointment. Arriving at the Planned Parenthood, we were greeted by anti-abortion picketers. I again felt dirty, the shame bubbling up from my gut as my heart raced. Since the pandemic was still ongoing, I went in alone with the security guard for my appointment. I had another ultrasound, and this time I took the picture. I was touched that the staff asked if I would like it, even though I was there for an abortion.

I talked with the physician and felt relieved and comforted for the first time. She reassured me that we could take care of both the abortion and getting another birth control that day. I went back to the car to complete consent over the phone and learned what to expect with the medications. I took the mifepristone at the clinic and brought the misoprostol home to use later.

The next day, I took the four misoprostol tablets by placing them between my teeth and cheeks on both sides of my mouth. About an hour after taking the medication, my ears started ringing, and my apartment seemed to wobble slowly.I crouched on my bed in a child’s pose position with a hot water bottle. My partner comforted me as we watched TV.

I am so glad that he was there with me. His presence let me know that I was not alone. I felt lots of cramping and a bit faint. Periodically, he would help me get to the bathroom. A couple of hours later, I felt much better. While he went out to bring back some ice cream, I passed the pregnancy. I stared into the toilet bowl, stunned and unsure of how to think or feel in that surreal moment. Then, in classic medical student form, I decided to take a photo and make sense of it later.

I spent the next day with a close friend. We talked about everything that had happened, which helped me feel content. That evening, I tried to box up my feelings and ignore the grief that I was convinced I could skip over. It made everything worse. My partner and I cried together. We were confused, frustrated, and upset, feeling like we had been ill-prepared for the aftermath of our experience despite having no regrets. I spent time getting in touch with friends and family for the rest of the week. Later in July, I went on a long backpacking trip with friends, proving that I could find the strength to recover from my shame. On the way back, I spotted a tiny kitten on the side of the road and brought him to a shelter.

Things continued to be complicated. I cried through most of my first semester, especially during embryology. I questioned if I was a killer. Did my actions mean I was a bad person? Pictures of classmates’ families and children made me wonder what it would be like if I had chosen differently. Through all of the ups and downs, I never had regret over my decision. Instead, I had grief.

I am so grateful that I had the resources and support to decide that having a child at that time would not serve the child’s quality of life or my own. Without my car, my savings, my insurance, and my family and friends, I may not have had timely, safe access to abortion and social support during the time after.

Since my experience, I have become more attuned to the stigma surrounding abortion. Abortion is not is for irresponsible or “bad” people. Abortion is for everyone in our society, a tool that gives individuals the power to determine what is best for themselves, their families, and their communities.

I believe it is critical for those working in healthcare to recognize that because countless individuals have experienced traumatic events, we must be thoughtful about how we communicate with patients to prevent further harm.We must honor the privilege of caring for individuals amid life-changing situations. We must come alongside the patients we serve, respecting their values, privacy, and autonomy as they make challenging decisions.

My father was a professor of biology. His children were his first students. He taught us about skyscraping redwoods, legged tadpoles, predator and prey, newborn lambs and afterbirth. He took us outside and showed us what creatures do to survive.

Even on the day in 2012 as we waited for the doctor’s call confirming his cancer diagnosis, Dad helped my husband Peter and I plan a day outdoors—a canoeing excursion down Big Springs, the headwaters of the Snake River. We had to be back by four, when the doctor said he’d call, so we got up early. We drove until farmland became mountain meadows bordered with pine trees, the grass a little dry in the August sun but green by the river, which was clear and bright, washing every pebble copper-clean under dark, fishy shadows.

It was a near-perfect float: no storms, no punctured rafts to patch with chewing gum and row frantically to the end of the course. Only sunshine, white clouds, icy water splashed from boat to boat by hand and through plastic pistols. We welcomed the water’s bite, my seven-year-old brave with a paddle, my four-year old’s giggles trickling toward the sky.

One small disaster: little Sara, a family friend, stood up in her canoe and fell into the river. “I’m going under the boat!” she screamed, her lifejacket’s shoulders up around her temples, her hands clawing the hull as her feet kicked at the keel. My mother leaned over to pull her out of the water and the boat lurched to one side, making Dad, who’d been reaching from the back, lose his balance and fall in the water too.

There was no real danger. Sara needed only to stand up in the shallows and lift her head above the surface. The water came to Dad’s thigh, where the tumor inside twisted between muscle and bone.

But Sara’s panic called to that which skirted our own thoughts, keeping pace with us downstream. Watching us from the forest’s shadows like a cat.

#

That afternoon, Peter and our two children went to Sara’s family’s house, leaving me with my parents and my brother Shaun. The idea was that we’d be stronger in this sphere of nuclear family, while possibly shielding the kids from grief, new and raw.

After the doctor called, Mom and I went to the computer room to look up the words he’d given us: stage three sarcoma. We read about the treatments—radiation and surgery—and the prognosis. Dad walked in as we scrolled to a paragraph that discussed amputation. He sat, reading silently over our shoulders. Together, we stared at the screen.

Then Dad stood and said, “Well, I guess I’ll go mow the lawn.”

We didn’t look at him as he left. “Is that OK for him to do?” I asked my mother. Dad had Parkinson’s disease too. She shrugged, as if to say he’d do it anyway.

While Dad pushed the droning mower outside—slowly—my mother and I made cherry Danishes in the kitchen, because we needed to. We put on bright patterned aprons, mixed powders and pastes in a frenzy of sugar and flour, glaze, and gooey red pie filling. We tasted everything as though we hadn’t before and might not again.

My brother Shaun, useless as chef but genius as DJ, put on the new Daft Punk album, turned it up loud, and the three of us danced. I remembered a couple of disco moves from a dance aerobics DVD, and Mom tried to teach us the hustle. After a while, we heard silence outside in the seconds between songs. Dad had finished the lawn and would come in soon. When we heard the back door open, our dancing slowed, our eyes fixed on the entryway. Would Dad understand our meager mourning riot?

Dad entered the room in rhythm, thrusting out his neck, one hand on his head, the other outstretched, his legs marching in time to the music. It was an old impression of a water-dwelling bug that he used to do for his biology classes, and we cheered for him, relieved.

We danced for a while, as we used to when Shaun and I were children, when we were certain our parents would always dance with us, when we overestimated how many drum beats it would take to arrive at whatever came next.

My husband doesn’t like films in which a family dancing in their kitchen is presented as their “happily ever after.” But sometimes it’s all you can do: let the electronica vibrate down behind your sternum, fill the beats up with swinging hips and kicking feet, mouth full of cherries, head full of Snake River memories, hands full of other hands.

#

Once, I cleaned the back balcony of our apartment on a quiet weekend. At the time, Peter and I had two kids, a dissertation, and a job, so things had been piling up out there: a table, an easel, various toys, a fold-out cot with squeaky springs. Everything was covered in dust and grit from the parking lot. The bent aluminum of the cot creaked as I opened it to wipe down the vinyl mattress.

Then I saw them. A family of daddy-long-legs. The mother’s legs stretched three inches across, her young piled among them, white, each as large as a thistle head, but fragile—I’d already crushed some—with legs as fine as the hairs on my arm. They made the delicate, oblique movements of newborns. I felt the mother had been saying something important to them, and I had cut her off mid-sentence.

“Caleb, come see this!” I called. My son didn’t answer. He was watching cartoons, getting over a fever. His cheeks were pink and his damp hair curled at his temples. My husband dozed on the couch next to him, his feet on the coffee table. One hand rested on the book turned over on his chest, and his other arm held our daughter, her small fingers opening and closing on his skin, her lips parted as she slept.

They were all safe, sleepy and well-fed. The four of us had mostly avoided hospitals and poisonous arguments, collected our paychecks and kept most of our sanity. We rested in the shallows, riding the slow river down…but for how long? Were the aspens and pines already whipping by, invisible on the banks around us as the river twisted, carrying us toward an unmapped destination? Would we be able, there, to keep hold of each other?

On my dusty balcony, the arachnid mother seemed to look up from her half-lit home of warm decay and ask what was next. I paused: the creatures were so wispy, so insubstantial, it would have been easiest to wipe them away and wash my rag afterward.

Instead, I lifted the cot over the side of the deck, leaned over, and blew. The mother caught the wind first. Two more breaths and her children followed in clumps, like dandelion seeds wafting down into the grass. They remained there for a minute, tangled bits of confused lint, before dissolving from my sight into their brave new world of blade and dew.

#

For eight years after the river, for eleven years after the balcony, my family drifted in blessed shallows.

But today, I kneel in my garden, watching a mother wolf spider. She clutches a huge egg sac that falls away as she skitters from my trowel. The sac is round and white, a miniature golfball, an excised tumor. I have two of those growing in my right breast, maybe more. I learned about them in a digitized report this morning while sitting with my husband on our bed. The bright July world glares with this fact. Incomprehensible, jagged fractals of what-if spiral through my mind, my heart, my belly.

I herd the spider back to her sac. It takes minutes. Can’t she sense it there, in front of her? Why don’t her many eyes catch on this most precious object, one she built using her body’s paper, string, and grit? Why won’t she hold on? Why can’t she feel my need for her to be able to bear her children away?

At last she snatches the cradle with her spinnerets and journeys under the fence into the next yard. Relieved, I watch her go.

A brown mouse bears witness from among the weeds. He’s the one who’s been sneaking into the pantry through the fireplace at night, enjoying our warmth, our bounty for too long. Next week I’ll trap him and let him loose in the mountains, a place he has never once seen.

#

Two days later, my daughter splashes in a pine-ringed lake in the Uinta hills. She just turned twelve. Since the 2020 pandemic rolled over our state four months ago like a slow-moving tsunami, she and her brother have each grown an inch. Maybe two.

She lifts a stick covered in pondweed. “I’m just going to play in the shallow part until everyone else gets here.”

Drowning, I nod from my camp chair on the sand. Please, God, let her enjoy the shallows today. She’ll know about my diagnosis in a week, but first, her birthday streamers need time to come down. I don’t want her to think of cancer every year as she blows out her candles. She looks like a woman in her new tie-dye bathing suit, but I worry that her pubescent mental fettle is as delicate as the bodies of the newly-hatched darkwing beetles she keeps in her room. I wait on the beach, holding a scream under my tongue.

Aunts arrive, uncles arrive, cousins and friends arrive. Mom and Dad pull up in their SUV laden with kayaks and life jackets, and I help them unload. Dad stumbles on the gravel path. Every autumn, an MRI machine rolls the protons of his body to divine whether he can live another year drifting in the quiet water near the edge of an illness waterfall, never knowing whether cancer or Parkinsons will carry him over.

My parents have taught me how to live without screaming. They are still here. Today, so am I.

Peter and I row small, separate crafts across the lake. The aunties’ chatter, the cousins’ laughter grows softer as they shrink into the distance, their voices blending with the liquid sounds of lapping water and birdcall. Peter reaches a hand toward me over the green depths. We sparkle and break like glass.

I think of dancing in the kitchen eight years ago. Here we are again, in the deep. Again, we heed the music playing around us, knowing this song won’t last forever.

Any second a new one will start.