The twin who didn't make it

I walked into my checkup pregnant with two children. I left knowing that life would never be the same

Published August 16, 2010 7:01PM (EDT)

There I am, leaving work for my fortnightly clinic appointment. I am 22 weeks and two days pregnant with twins. I think it is about noon, and I waddle through the icy parking lot, glad I took the whole afternoon off. It’s a grey day, with the flat, dingy light of a northern January.

Some details are very clear. I am wearing my coat from the winter before; the top button is the only one I can still fasten, and the rest of the material falls around me like a cape. It’s all of five degrees, but pregnancy has stripped me of the ability to feel cold, and my belly juts into the air. The shirt covering it is my favorite, all in shades of brown, with wide horizontal stripes over a pattern of thinner horizontal lines. The pregnant can wear such things without fear of looking wide, a fact of which I take advantage at every opportunity.

After the parking lot, there is a period of time populated by conjecture. I suppose I drove to the hospital via my usual route, and parked in my usual place. I imagine I checked in at the desk, and produced a urine sample in the bathroom while staring at the poster about fetal fibronectin testing. I am sure I was weighed, and ran through my medications and dosages with the nurse. These actions are absent from my memory of that day, but they are the things I did at every appointment. Maybe my brain failed to take their impressions because they were routine and multiple. Then it is clear again. I am sitting in an exam room, across from a cloying framed poster -- black and white with certain details hand-colored -- of a boy in a news cap kissing a little girl with a bow in her hair. The nurse with me is older, with a small serious mouth, a cap of curly brown hair, and glasses. I could probably draw her face for you now, if you gave me a pencil. She takes my blood pressure and asks when I last felt movement, and I answer with my standard uncertainty. I don’t keep track -- the distinct kicks and thumps are still new and random, and as for the squirming and popping, who can tell what is baby and what is bowel? Anyway, with twins I get an ultrasound at every appointment, and I am still talking as I climb onto the table and lie back, lifting my shirt. I tell her how painful walking has become, and that I think it might be time to curtail my work schedule. You’ve gotten so BIG overnight! she says, squeezing a ribbon of gel onto the transducer. I know! I laugh, and I see a flash of kicking legs as she slides it across my belly. She moves down to look at the boy -- Ames, I call him -- who is curled low with his shoulder against my cervix and an arm crooked over his head. His position makes it hard to see him clearly, so we pan up to his sister, Simone, and then back again, where Ames is still sleeping, and the nurse makes a little puffing sound of good-natured frustration, saying she's having a hard time getting a good shot of cardiac activity. (Babies! So uncooperative!) That's all the nurses check -- the doctor always finishes the ultrasound. "I'll let him find it when he comes in," she says. When she leaves to get the doctor, I lay there for a moment -- smiling, stupid -- before I know. I think I know. My eyes begin to feel hot and my own cardiac activity picks up. The nurse is gone for a long time, and when she returns with the doctor she takes a position at my side. The doctor picks up the transducer.

"I was looking at the records of your 20-week ultrasound to see if there were any indications," he says nonsensically, and then he points: "There. I'm sorry. You can see clearly that Baby A is demised."

It's so hard to remember the details. The harder I look, the more they skitter away, some solicitous, maternal part of my brain rushing to obscure my memory, holding it back from the scene of the crime the way policemen restrain relatives who return to find their driveways full of lights and sirens. I know tears slide down my cheeks and the nurse takes my hand, the purpose of her new position now evident. The doctor points to fluid accumulating in my son's chest, the thickening of the dura of his brain, the way the umbilical cord has become swollen. I remember thinking it looked like link sausage, or DNA. The doctor explains that these signs mean that it -- the demise -- happened more than a day ago. He cocks his head, looks at the screen: maybe three.

I don't scream or become hysterical. I don't roll around on the floor and wail. I just cry and cry, without making any noise. I cry and cry and cry.

I want to know what happened, but there is no tiny smoking gun to be seen. I am told that while they will analyze the placenta and check the chromosomes, in two-thirds of cases the cause remains "a mystery." Still, I'm assured his death wasn't caused by anything I did, which seems at odds with the previous statement. If it's such a mystery, how do they know?

I am not wild about the word choice, either: "Mystery" implies intrigue, as if to add a thrilling veneer to something that, personally, I don't find thrilling at all. They should be saying we don't know instead of in 2/3 of cases, the cause remains a mystery, as if my baby were being willfully obtuse.

There is another word I take issue with: babies should not just die two weeks after having every bodily system inventoried and pronounced ideal. That's not what "ideal" means. In fact, look:

1. Conceived as constituting a standard of perfection or excellence: ideal beauty.

2. Regarded as perfect of its kind: an ideal spot for a home.

3. Existing only in the imagination; not real or actual: Nature is real; beauty is ideal.

Ahh, number three. There it is. Existing only in the imagination. In grainy, shiny pictures in a folder in my closet. In a small bag of ashes.

The doctor moves on, looking at Baby B; Simone is flipping around, indecently enjoying the extra space. Ames is still and crooked at the edge of the screen, but Simone is waving, showing us her eyeball and tiny chin. I stare at her desperately. I need her to live. I wonder what it is like for her in there, what she knows.

I am left alone to call my husband Scott at work, and I tell him to come right away. One of the babies died. Later I realize I didn't tell him which one, and that for the drive from the bookstore to the hospital they are both equally dead, and equally alive.

It was already over as I walked through the parking lot from my office and drove away, had been over for days. Isn't it strange, how that works? The morning after my first kiss, I remember being struck by the way one's After is so unexpectedly visited upon Before. I'd woken the previous morning kiss-less, with no kiss prospects or plans, and there I was 24 hours later, kissed, worldly, a girl who had touched a penis. Almost as striking is the distance that can exist within what should be a sudden event. One Saturday I spent three hours of that distance doing laundry, only unaware that my current relationship was over because I hadn't yet gotten the phone call. I was already in my After, as I sorted whites from colors, I just didn't know it yet.

At my wedding, I walked down the makeshift aisle to "What a Difference a Day Makes," by Dinah Washington. That song had been a comfort to me during the year before Scott and I met, when the knowledge that nothing lasts forever was sometimes all that propelled me through my days. After we fell in love, the lyrics served as a reminder of the wonder that could be right around the corner -- though of course it goes both ways. It is still one of my favorite songs.

Alexa Stevenson is the author of the popular blog Flotsam and the memoir, "Half-Baked: The Story of my Nerves, My Newborn and How We Both Learned to Breathe," from which this is excerpted. 

By Alexa Stevenson

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