Out of the Clear Blue Sky

“Is that its hand?”

“It is.” Pregnancy really was a miracle. The wonder of my profession washed away the hatred I had for Melissa, at least for this second. For now, she was just a young woman with an unexpected pregnancy. We watched as the fetus moved, almost as if it was dancing. Beautiful. Miraculous that a human could form from one egg and one sperm.

“It looks like an alien,” she said, and I couldn’t help a smile.

“Its head takes up about half its length for now, but the body will catch up. The legs are teeny . . . see? But the eyes and nose and ears and even teeth have already started.” Her eyes were glued to the screen. I moved so we could see the profile.

“Can you tell if it’s a boy or a girl?” she asked.

“Not definitively. A few more weeks, and you can. According to these measurements you’re . . . twelve weeks and five days.” I checked the heart, the brain, the face. All normal. Four limbs, check. “Here’s your placenta, which is in a great place and looks completely normal. Plenty of fluid in the sac.”

“It already looks like a person,” she said, wonder in her voice.

Based on this timeline, Brad had fathered a baby while he was still married to me. Just when you thought the knife couldn’t twist any harder. My ex-husband would be having another child. Dylan would have a half sibling, nineteen years younger than he was. Brad would get another chance at parenthood.

Maybe. If Melissa didn’t get an abortion. I barely knew her, so I couldn’t guess.

I needed a nice long walk with Zeus. I needed my dad. I needed alcohol and homemade bread. I swallowed. Moved the transducer and did another measurement. Everything was normal. Do your job, do your job, do your job.

“Would you like me to print out some pictures?” I asked.

“Oh. Um . . . I don’t know. Sure, I guess.”

I took a few. “Okay, we’re all set here.” I turned off the ultrasound machine, wiped off Melissa’s belly with a warm facecloth, suddenly feeling ninety-four years old. “You can go to the bathroom now, then get dressed and come into my office so we can talk. I’m sure you have a lot of questions,” I said.

That was what I’d say to any patient. Give them a minute or two alone, then bring them out of the exam room where they’d just been given life-changing news.

“Everything okay?” Carol asked as I walked out.

“Just fine.” HIPAA. I wasn’t going to be able to talk to anyone about this. I was glad to be in my little office, because I needed a minute, too. Unlike Brad’s office, mine was tiny and crowded with books and journals. On my desk was a photo of Dylan, taken last year. In the picture, he was standing on our dock, the water sparkling behind him, his grin so dear to my heart.

I laid the photo facedown so Melissa couldn’t see it. It felt like I was protecting my son from her. My eyes were abruptly wet. Dylan might be a big brother after all. Not how I’d pictured it.

Melissa stood in the doorway. She was a lot more imposing in clothes—chic fawn-colored pants that stopped above her ankle, a sleeveless mock turtleneck sweater in exactly the same color. Looked like cashmere. Simple jewelry—gold hoops in her ears, a delicate gold necklace that probably cost more than I made in a month, and that frigging beautiful engagement ring. Her wedding ring was a diamond band. Those sparkles could hypnotize a person. I wondered how much they’d cost, and if I could steal them the next time I broke into their house.

That’s a very unprofessional thought, chided my mother. “Come on in,” I said. “Close the door.”

She did, then glanced around the room and sat in one of the two chairs. I’m sure it was quite shabby in here, quite working class to a person like her. “What would you like to ask me?”

“I . . . I don’t understand how the pill could fail. I was so careful. If I missed it, it was only by half a day.”

Brad would have another child. Not me. That part of my life was over. My body wasn’t getting my brain’s message about being professional. I folded my hands together, fingers interlaced, to hide the shaking. Pushed the personal thoughts away. It was a necessary skill for my job. Watching a tattooed seventeen-year-old boy play games on his phone while his girlfriend pushed out their child and not smacking him. Seeing a fifteen-year-old girl who’d been raped without bursting into tears and holding her like she was my own. Telling a woman that her baby had severe congenital defects and wouldn’t survive the pregnancy without bawling. I stuffed my feelings down all the time in this job. I could do it now.

“Well, no contraceptive is foolproof. If you had a few days where you took it a couple hours later than usual, that can give your ovaries the green light to produce an egg. The pill stops the hormone surge that usually causes the egg to release. If you were late taking it, an egg can be released by your ovaries. It’s rare, but not unheard of.”

She still looked confused. “But I had my period last month.”

“You had some spotting. Not a true period.”

“Dang it all,” she said under her breath. Right. She didn’t swear. She was too refined for all that.

“How are you feeling? Physically, I mean?”

She blinked those amazing eyelashes. How much time did she spend on looking this way, damn it?

“Well,” she said, and her voice quavered. “I, uh . . . we’re still covered by doctor-patient confidentiality, right?”

“Right. And we always will be.”

“Okay.” She twisted the aforementioned pony-choker ring. “Well, I’ve thrown up a few times. My breasts are sore. My skin broke out, which it never does.” Of course not. “I’m a lot hungrier than usual, and I’ve already gained eleven pounds.” She paused. “I can’t seem to hold gas in.” Her face flushed.

I bet she’d never farted before in her life. “Those are all normal symptoms of pregnancy. That pain you felt in the exam room is most likely the ligaments and muscles stretching in your abdomen, making room for your expanding uterus. But if you have really bad pain or severe cramping, or any blood more than a few drops, call us right away.”

“Gosh. There’s so much going on. My pants are tight already.”

I couldn’t help a petty feeling of triumph. “Are you on any medications, either prescription or over-the-counter?”

“No. I take a multivitamin, though.”

“Good. How about fatigue?”

She nodded. “Definitely. It’s hard to stay up past nine. I thought it was jet lag.”

And how was Paris? “Mood swings?”

Another blush. “I’ve been a little more easily . . . irritated.”

Wonderful! I hoped Brad was miserable. “Again, totally normal. Your hormones are going wild. This may also cause a milky vaginal discharge, so use panty liners.”

“Darn it!” She let out an exasperated breath.

I reached in my drawer and pulled out a booklet, handed it to her. “Here’s some information about what’s happening in your body. If you decide to stay pregnant, you should have a monthly checkup. If you decide not to keep the pregnancy, well, we can discuss that, too.”

“Okay.” She thumbed through the booklet. “It says the baby is as big as a plum.”

“Mm-hmm. There’s a nutrition section in there to help you make good food choices. No alcohol, no marijuana in any form, no illicit substances, no smoking, and go easy on caffeine, saturated fats and sugar. Drink at least ten eight-ounce glasses of water a day. At least. I’m going to write you a prescription for prenatal vitamins, and you need to take one every day.”

“Okay.” Her voice was meek.

“I’m sure you have a lot to think about, so call the office if you have any questions. Wanda is a fantastic doctor, but there are also many great obstetricians and certified nurse-midwives closer to the hospital.” Please pick one of them.

“Thanks,” she said. She stood up, her hair so straight and shiny. “Thank you, Lillie.”

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