Saturday, February 26, 2011

Hope vs. Resignation

It's a new day.  And it pretty much sucks.

After many long hours and conversations with C, it has come to my understanding that it's possible that what my therapist has been trying to do is get me to accept that we may never have a family.  For the record?  I have always acknowledged this, but because I do want a family I want to try to focus on doing everything I can before I give up and the hope for a family and resign myself to a different kind of life.  I'm not saying "resign" as necessarily a bad thing, but what has to happen when all our options and attempts and chances have run out.

What I don't understand is why it's so important for me actively embrace this idea that we will not have children when there *are* at least a couple of options down the road for us.  Clearly, right now, we are not in a place to pursue them, but why is it so important to accept and resign before the fight is over?  Or, at least, over in my eyes.

C has, on occasion, asked me where that line will be, when I will know that I am done and we are done and have run out of chances. Will it keep moving?  I don't know the answer.  What I was hoping to get out of therapy was some exploration of what we've done so far, what I might be up for and not up for.  How do integrate these THREE different options into our life, rather than be strapped down and made to accept that we will never have a family ever.

Unless that's what she and Dr. Shrink believe and want me to get.  That IT WILL NEVER HAPPEN FOR US. That I am too fucked up and we as a couple are not fit to be parents.

I talk to my sister, and she says you know, there are still options out there and if you want kids (and she knows how I want kids) there are avenues to pursue when you are ready. You don't have to accept being childless YET. At some point it may come to that, but doesn't necessarily need to be right now.

Or, as C has also asked, am I going to go around and talk to shrinks and REs and adoption agencies until I find one who will tell me, "Sure, I can help you"?

I don't think so.

When my mother was sick, we talked to tons of doctors.  The ones at SK in NYC, cancer doctors all over the country. We all did research we all asked questions until it became clear that not only was her cancer terminal, it was terminal in the very near future.

Where I come from, you do everything you can if you really want it.  I curse myself not infrequently because of the way that I handled my/our infertility, pregnancy and the process of loss because I often feel like we didn't do everything we could.  I was prepared to risk infection and blood clots and god knows what else if it meant holding on for another month or more to try to save Jacob.  It never occurred to me not to until conversations with C made it clear to me he feared for my life, and not without reason. And so the conversation changed.

I used this analogy of how I see this situation with my therapist and all these people who are trying to help me. Well, at least my therapist.  I apologize if it hits a nerve or is offensive to you, but, for me, it seems to illustrate what's going on.

If, for example, some random woman, Jane, were to discover she had breast cancer, her first thought might be, "Oh, my god, I have cancer, I'm going to die." Not unreasonable.

After expert tests and examinations and meetings and second and third and fourth opinions, the doctors come to the consensus that the tumor is not small, but manageable in that a lumpectomy, (possibly mastectomy) and a round of chemo, and a round of radiation should eradicate the cancer and help her live a relatively healthy, long life, as the doctors tell her.  All she can think is, "Oh, my god, I have cancer. I"m going to die."

She is paralyzed with fear, and despite the pleading of her family to get treatment she does not. Think of all the people who love you, your grandchildren -- don't you want to see them grow up? "It's hopeless.  I have cancer. I'm going to die."

Her doctors talk to her and tell her that this cancer, while serious, is treatable, and with careful observation and management after treatment, she can likely live far past the clinical 5-year marker.  Of course there are no guarantees, so Jane is still in despair.  "I have cancer.  I'm going to die."

Her pastor comes to her and tells her that she has options, that despite the cancer, God has provided a treatment that may very well give her her life back.  "We cannot know what the future will bring," says her pastor, "but we can try to live our life to the fullest, to do everything we can to live and live well."

But she does nothing.  Family and friends, clinicians, religious leaders all say, "we have no promises, but we have hope, we have knowledge that may help us save your life."

All Jane can think is, "I have cancer.  The only thing we know for sure is that cancer can kill. All this talk about "maybe" and "likely" and "trying," it's all pointless because I have cancer.  I'm going to die."

And she does nothing to treat the cancer.  And, just as she predicted, she dies less than a year later, knowing she was right.  She had cancer, and it would kill her.

Heavy-handed, I know. I'm sorry.

To me, it's like saying, "You're infertile.  Sure, there are treatments, but they might not work and that might make you really upset, so you should just accept that you are going to live your life without children.  You need to accept this without trying anything else."

To me, a good therapist will help me understand what's happened so far, accept it and forgive myself and the (mediocre) doctors who were involved. Help me integrate that past into my present and my future. He or she would help me explore what my options are now, what the possible outcomes are and how I need to consider handling those.  Or if I could handle them.  How I can strategize living the rest of my life, given the limited options that I have.

Rather than making me accept that this is my fate and I really need to give up now to save myself heartache later.  It feels like all the professionals in my life are wanting me to be Jane and let go of any hope, despite the (albeit small) possibility that we could have a family.

Maybe it's the inverse of my story:  Jane says, okay, this is small, this is manageable.  I've talked to doctors, I've talked to survivors, I've talked to folks for whom treatment didn't work and I want to push as hard as I can so I can live my life. And the doctors all say, well, yes, there are treatments, but they might not work.  You have to accept that they might not work.  And she says, I know that.  But I need to have hope that they might because I want to live a long life filled with my family and friends and I want to see my grandchildren grow up.

And the doctors just say, Really Jane, we know that your cancer is in the early stages, and we could try to treat it, but it might not work. You need to know that, and maybe you should just put your things in order and enjoy what's left of your life.

That's kind of what this feels like, too.

The question of all questions for the infertile: When do I/we give up treatment and decide to live childless?

It seems like some have made that decision for me.  Is it lack of experience with infertility and loss?  Or is it just that I am SO very messed up, we are SO unfit or SO old, that even working to put things in order to get to a place where we can build a family -- biological or not -- is just that bad an idea and no one will say that?

I have to say, I really wonder.

Or maybe I should just let it go. 

When do you let go of something because the chances are bad?  When do you let go of something because it will hurt so much if it doesn't work out?

Jesus Christ, have I -- with the intractable depression -- with my feelings actually on the surface -- with that primal drive left wrought and bloody in a labor and delivery room -- have I proved right all those people who believed I was just a fragile little girl, incapable of dealing with (any realities of) life? 

Maybe I am.

Leaves me very few choices, I think.


wifey said...

You DO have choices. A friend of mine just lost her 20 week baby (her eigth pregnancy; she does have a 3 year old tho)after losing twins in the summer. Everyone is trying to tell her to walk away, to give up. And her answer is to quote Lance Amstrong: "Pain is temporary; quitting is forever." I find that inspiring because I feel like I am getting sort of the same attitude you are from the professionals that I deal with. I KNOW, I ACCEPT that things may not turn out the way I want them to; I still feel like I have to try everything. I don't think I could live with myself if I didn't.

Anyway, I just wanted to let you know that you are not weak and not alone, for what it's worth. Follow your heart.

It all sucks monkey balls, though, doesn't it?

Barbara said...

I am 43 and trying again (naturally) after losing George in 2008 at 20 weeks and a missed miscarriage at 9 weeks 6 months ago.

I think you will just KNOW when it's time to stop and no amount of counselling or "advice" will bring you to a decision you are not ready to make. We've been given very little hope but it's most definitely not time for us to stop yet.

I want you to know that you are not alone.

And I agree wholeheartedly with Wifey; it sucks great big hairy monkey balls!

Beruriah said...

I didn't respond yesterday or Friday because I'm still struggling over what to say. I'm just, continue to be, confounded by your therapist. Of course I only get a limited experience of what happens in your sessions, but she kind of seems meaner and more judgmental than helpful. I don't know. She just seems hell bent on convincing you of something that's outside her expertise. Does she really imply that she thinks you're not fit to be parents? That's cruel. That's not her place to decide and certainly having her suggest that, even implicitly, doesn't seem like a good thing in your relationship with her.

I don't know. I wish I had something more helpful to say, some ideas, but mostly I just want you to know we're thinking of you, and I have faith in you, as a person, a scholar, and a mother already.

Betty M said...

I haven't ommented for a while as I felt that I have nothing helpful to say. Today though I am angry at your therapist. What right has she to imply that you are not a fit parent or that you should stop trying? Isn't she there to help you decide what you want and what is best for you without projecting? I think you will know when you are done but it sounds like that is not where you are now. Wishing you all the best.

Anonymous said...

I don't think you're ready and only you will know when you're done ... others will be happy to give you their opinion but those opinions are not usually worth much. As someone who's had 6 mc and 3 ICSI, when my husband and I talk whether to do another ICSI, we know that none of our friends or family members can help us make that decision. The situation is too foreign to them all, and even though they try to help (which at this point, I tell them is to be supportive of whatever we decide), this decision is so unique compared to their life experiences. For us, it's not the low chance of an ICSI working or the cost, but the idea of another mc ... for the first time, I'm seriously feeling that I can't do another mc, even with the possible chance of a baby. It took me some time to come out of my last period of depression and I know the next one will be much worse. No one has the crystal ball that says when it WILL work so very rarely is the answer to stop clearcut. The idea of letting go is starting to feel easier and I can feel ... I'm close to done. I want a different life soon. I also think your therapist is a very bad match for you and I hope your sister can help you find someone better. The depression sounds very hard right now and I think that it won't be possible to make the decision to stop or go forward while you're in the depths you are. What I hear is depression and someone who is fighting to hang on despite it. That doesn't sound weak. It sounds grueling and although you're not functioning at a level you want to be, you are still flexing those muscles. Fragile little girl? No. First, get a better therapist. Maybe the hospital or clinic can guide you to someone who specializes in this. Deciding to stop now won't help your depression ... it doesn't sound like the right time to me.

Anonymous said...

The link to the post above is directing back to your blog.

Tash said...

Sorry I missed this, I've been really sick for days.

I can only speak to my experience which essentially boiled down not really to choice, but to movement -- to doing *something*, and getting unstuck. I was waiting around for a doctor to call me and say, "aha! We have it! We can test you at 11w and figure out if the baby will die or not! Go ahead and get pregnant!" and that call never came. And while I waited, I aged some more, and knowing it was likely to be a drawn out process getting pregnant, I froze and did nothing. When I finally decided to simply see an RE about what was up, and if I *could* get pregnant, I felt like the weight of the world was off. I really expected him to say, "no, no you can't," but I was already relieved that someone else was making the decision for me. Imagine my surprise when he told me I *could.*

I guess I say this because the decisions are enormous, and maybe you need to back up and simply take stalk of what in fact the decisions are at this point. And perhaps making that list in and of itself will give you some relief that you're moving somewhere away from the present. Movement is good, even in little tiny steps.

thinking of you.

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