Sometimes life serves you up a set of circumstances that causes you to challenge yourself in ways you never thought you would, to learn things about the world and yourself you never thought you would have to learn, and to do things you never thought you would have to do.
So it was that I found myself two mornings ago sitting underneath the umbrelled tables in front of the McDonalds at seven-thirty in the morning in Nogales, Arizona. In a few minutes, I would be picked up by a doctor I had never met before and driven across the international border to his clinic in Nogales, Mexico, a walk-up room above an unassuming street littered with store-front dentists and vendors selling fake Gucci sunglasses and, well, just generally littered.
In the van with R. and I would be a couple from the Bay Area (as they referred to it…being from the Chesapeake Bay area originally, I thought better of pointing out to them that there might be more than one), Mark and Kathy. We were two couples from two different states coming to a foreign country at the same time for the same reason: we were infertile and needed a treatment for recurrent miscarriage that the FDA in all its wisdom has determined to be “unreliable,” but which our (American) doctor–who is the leading specialist in the extremely specialized field of reproductive immunology–tells us we must have. So it was that we gathered in another doctor’s unassuming office above the unassuming street to exchange pleasantries before the procedure that we must have but that we cannot have back in our own country, in our own towns, near our own houses.
At first I think that it is nice to have another couple there. They are like us, even though they tell us that this is their second trip to the clinic. Their first treatment didn’t raise the leukocyte antibodies that need to be raised enough, so they are back again. I feel bad that they have to do this again. I am sure that they have experienced multiple miscarriages, as I have, which is the only reason to be there, after all. I am sure they are like me. Perhaps, also, being a bit out of my element, I am looking for familiarity. I want her to be like me. Then she mentions, casually, that they had a little girl a year ago, but “of course” they want to do it again. And I realize that, in fact, they are really not like me. Not like me at all. My stomach falls a little bit.
When it is our turn to go back to the exam room, R. takes the lead. It is his blood that the nurse will extract, 10 tubes in all, as R. lies back on an obstetrical bed between the ultrasound machine and the wall. The nurse, who the doctor has introduced to us as Maribel–”the same name as Maria Compagne in Spain”–has trouble operating the levers on the bed that raise and lower it. R. bounces around. I can tell he hates being on the bed. I silently wonder how he would feel about having to stick his feet in the stirrups, which, thankfully, I don’t have to do for this treatment.
After she’s done taking his blood, he sits up, intending to help her out by just hopping off quickly. She objects and makes him lie back down until she has raised the back and lowered the front to its original position. They speak in Spanish while she fumbles with the controls. I once again regret choosing to take French in high school. The doctor collects the vials and tells us to explore the town for a couple hours and then return.
We have been to Nogales before on purely sight-seeing trips and know our way around a little bit. We find a bakery and fill a bag with pastries and buy coffee and go sit in the plaza to eat our breakfast near this cool mural:
American tourists are generally very conspicuous in Nogales. But it is still early in the morning, before the Americans come to shop for trinkets and fill their prescriptions and get their teeth cleaned, and we are generally ignored, except by the pigeons. Pigeons are the same everywhere, I think. Later we do a little shopping at my favorite store in Nogales, where I buy some milagro art to add to my collection at home:
The pink fuzzy Mary is from Sante Fe. She is one of my favorites. The ball covered with milagros is my new purchase. Milagros are small metal (!) charms that are typically found in the shape of human body parts, but can also be animals, houses, cars, etc. In some Catholic countries (Mexico, Italy, India’s Goa region), you purchase the charms and pin them to a saint’s clothing (if your church houses a dead saint) or to a saint’s picture and ask for a prayer for that particular part of the body. Hearts are very popular.
I’m not Catholic, but I began collecting milagros about five years ago. And…yes…I do have a milagro in the shape of a baby that hangs from my keychain.
After two hours, we head back to the clinic. We go into the doctor’s office, sit across his desk from him, and he brings out two syringes full of clear serum, labeled #3 and #4. (Presumably, Mark and Kathy got vials marked #1 and #2.) This clear stuff is actually R.’s white blood cells, spun down from 10 tubes of the red stuff. I spread my forearms out on the desk, and the doctor injects me four times under the skin on each arm, emptying the syringes. It burns. It burns a lot. My skin puffs up a little.
This is all good, of course. The point of the treatment is to stimulate my immune system to react against R.’s blood/DNA. When I’m pregnant, my immune system can’t tell that the growing mass of cells is a developing baby because R.’s DNA isn’t differentiated enough from mine to register the baby as not my body, not my cells, not my DNA. So, my immune system attacks the growing baby as if it is a cancerous bunch of my own cells. The treatment (called LIT–Leukocyte Injection Therapy) is supposed to teach my body to “recognize” R.’s DNA as different from mine, so that when my body encounters it as part of the growing baby, it will know it is not a growing mass of my own cancer cells, but rather a baby, with a different bunch of DNA cells–and thus not attack it. Make sense? Yeah, it took me a while too.
Here is what one of my arms looks like just after the treatment:
When the doctor is done, R. hands him $600 in cash, which he pockets quickly without counting. It feels a bit like we’ve just completed a drug deal, which I guess, in a way, we have. Then we leave. We walk across the border, where we wave our passports at the Border Patrol guard who doesn’t even glance their way (probably not what you wanted to hear on September 11th), and back to our car, and back to the highway, and back to our life the way it was before. Except for these nasty-ass welts I have on my forearms. That now itch.
Challenges, it seems, often come and find you, rather than the other way around. Traveling to another country for a controversial fertility treatment that is outlawed by the FDA is not something I ever thought I’d do. When I first joined an online infertility support group last year, several of the board’s members would discuss the LIT treatments they were told by their doctor to go do. I would always skip over those postings. They didn’t apply to me: in 12 years of trying, I had never been pregnant and, therefore, had never miscarried, and I was operating on a strictly “need to know” basis. What I didn’t need to know, I wasn’t going to bother with.
But that’s the funny thing about the way things work. When push came to shove, I did need to know, and I did end up doing something I never thought I would (because I never thought I would have to).
And, frankly, adoption is the same way for me. It wasn’t something I considered seriously until I had to. Not that I did any agonizing hand-wringing about adoption when it did cross my radar screen. I was thoughtful about the complexities involved in adopting transnationally/racially, but I was immediately excited by the prospect too. I just never had thought about doing it until doing it became, potentially, my only way to parent. It was a challenge to my expectations that led me to adopt.
I think that’s often the way it goes. We get pushed into a learning experience, a growing experience. It’s not that we don’t want to be there, growing, changing, learning; it’s just that we aren’t always out there on the hunt for these sort of “teachable moments”–to borrow a colloquialism from the teaching world–because they aren’t the easiest things in the world. It isn’t easy to change. It isn’t easy to grow. That’s why it can be so wonderful.
Infertility pushed me to consider adoption. Miscarriages pushed me to consider alternative fertility treatments. This interminable wait for a referral may push me to consider a special needs adoption. And, although I know that a-parents who “switch” from non-special needs to special needs adoptions have a really bad rep in the IA community, I’d actually like to argue that their switch may be a part of their process, like choosing adoption in the first place may be a part of the process of coming to parent at all. Perhaps it’s not just a hypocritical grab at an expedited referral but, rather, a “teachable moment,” in which an impasse, a challenge to their expectations, causes them to re-think their choices. Causes them to grow.
I’ll write more about this subject of switching to a special needs adoption in the near future. Right now, I just wanted to throw it out there as something we’ve been thinking about, talking about. We were approved in our homestudy to adopt a special needs child because it’s what we wanted to do for our second adopted child from China. Now, it doesn’t look like we’ll get the chance to adopt a second time from China, given the length of the wait and our ages. So, we’re considering a new plan. Stay tuned.
And the IVF is still a go for January, if the LIT treatment and the other immunology treatments I’ve got scheduled, work. Life is certainly never dull.
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