The Examination

Here’s an essay I wrote soon after my first miscarriage, two years ago.

The Examination

“Scoot down to the edge of the table,” she told me.

I did as I was told–silently. The white paper beneath me crinkled. I looked at the construction work out the window next to me. A yellow crane hoisted a large concrete beam in the air. It swayed precariously over the workers’ heads, but they paid it no mind. I had watched them attach the cables to the beam as I waited in the examination room for the doctor. I’d sat in the blue plastic chair near the window and watched two workers, one in a yellow hardhat and the other in a red one. They’d moved quickly. I listened for the sounds of the crane, but the hospital walls were too thick. The air conditioner clicked on.

“You’re going to feel two fingers and some pressure,” she said.

I closed my eyes and imagined the beam free falling to the ground. The workers scatter. They would escape but only just in time. When I opened my eyes again the beam was still in the air, but the workers were out of sight.

After the examination, she left me in the room alone a little too long. I changed back into my clothes. I paced the dull white tile floor and fought my temptation to look in all of the drawers and cabinets. I studied a model of an IUD and questioned the safety of putting something that appeared to be coiled copper wire inside your uterus.

When the doctor finally came back, I sat in the blue plastic chair by the window again. I wanted to sit on the soft stool with wheels, but I knew that was the doctor’s seat. She wore a gold diamond studded wedding band and an engagement ring with a large diamond. I wondered if she had children.

She flipped through my file like she had never seen it before—like she wasn’t the one who wrote most of its contents. “So…” She looked up at me. Her shirt was cut low, a contrast to the blue scrubs she wore two days ago when I saw her in the emergency room. A diamond studded cross lay nestled in her cleavage. “Had you been trying to get pregnant?” she asked.

“No, it just kind of happened,” I lied. I don’t know why I felt the need to lie. I felt ashamed. I had been trying. I wanted a baby desperately—a girl. I had already given her a name.

“So you weren’t really trying, but weren’t doing anything to prevent it either?” She wrote something in my file.

“Yeah,” I continued the lie. My purse sat in my lap. It was heavier than usual because it contained a library book. I’d planned on reading in the waiting room but couldn’t focus. I’d looked at the same paragraph for half hour and finally turned the page out of embarrassment. I felt the weight of the bag with the book inside and wondered if this was how much a new baby would weigh.

“Because if you were trying I could refer you to OB.”

“No that’s okay.”

She eyed me suspiciously and flipped another page. “Have you passed any tissue?”

“No,” I lied again. A beige lump had come out of me two days earlier. I’d tried to pretend it wasn’t my daughter. I’d flushed it down the toilet and acted like I hadn’t seen it. I always wanted a girl with tight ringlets and an infectious laugh. I wondered what combination of my husband and me she would be. It was easiest to imagine her at four with full pink cheeks and bright eyes. I’d never imagined her as a beige lump of flesh swirling down the drain.

She wrote something else down. “You’ll need another blood test next week to make sure your hormone levels are still dropping.”

“Okay.” I didn’t want any more tests. I was tired of making small talk with people poised to jab me with a needle. I didn’t want another ultra-sound or pelvic exam.

This is what I wanted. I wanted to miss my period one month. I wanted to go to the drug store to buy a home pregnancy test. I wanted it to be positive. I wanted to have a good pregnancy. I wanted to feel the baby kick. I wanted to buy maternity clothes. I wanted to give birth to a healthy baby. I wanted to love her. I wanted to watch her grow.

The doctor continued, “Our ultra-sound found that you have a large fibroid that could be altering the shape of your uterus. This may make it impossible for you to carry a pregnancy to term. We could do an MRI to get a better look and possibly perform surgery to remove it. That would give you a better chance at having a child.” She flipped back to the beginning of the file. “But I see you have no insurance and the MRI alone will be $1000.”

“I can’t afford that,” I said.

“Right.” She snapped my file closed. “Just come in next week for your blood work.”

“I will,” I lied again.

I was going to name my daughter Sabina Grace. She was going to hold my hand when she crossed the street. She was going to kiss me goodnight. She was going to call me mommy.

Medicaid

I walked into the living room and my husband was sitting on the floor with his head in his hands. His wallet had exploded all over the floor. The carpet was littered with all kinds of cards: business cards, credit cards, and a new mysterious gold Medicaid card.

About a month ago, we received a Medicaid card and a letter in the mail saying that my stepson may or may not qualify for Medicaid. This is particularly entertaining because we never even applied for Medicaid. The letter basically said that the card may or may not be valid. It made it seem like we should just take the card to the doctor’s office and try it out. Maybe will have to pay full price for a visit. Maybe we won’t have to pay anything at all.

My husband promptly called Medicaid to find out what was going on and was told that my stepson did qualify and that we would get information in the mail about HMO’s. About two weeks later we received a letter telling us we had thirty days to pick an HMO. I did some research on the web to try to figure things out and didn’t get very far. My stepson needs to see a physical therapist and we need to find a plan that will cover that.

A few days after that letter arrived a woman called asking my husband for a bunch of personal information about my stepson. Eventually this woman identified herself as a support coordinator and said that my stepson qualified for CMS. CMS provides special services for children who have more medical needs than most. She said that she would call us back to give us more details about CMS.

A few days after this call, we got a letter from Medicaid saying that they picked a HMO for us already. When husband called to inquire about this the woman on the phone said, “You didn’t choose a health plan within the thirty days so one was assigned to you.”

“It hasn’t been thirty days since, I received the letter,” he said.

“You didn’t choose a plan within the thirty days,” she repeated.

We haven’t heard back from this support coordinator person. No one we call knows anything about what’s going on. The system is almost impossible to navigate. By the time we get this straightened out we’ll be moving to England.

Health Insurance

During my entire working adult life, the only time I have had health insurance was when I was living outside of the country. As an English teacher in Korea, I was covered under the Korean national health plan. After being in the country for a few weeks I received a small blue booklet that was my health insurance card.

Overjoyed at the thought of having health insurance, I used it whenever I could. Things that I would normally ignore sent me rushing off to see the doctor. Swelling in my big toe, time to see the doctor. More acne than usual on my face, time to see the doctor. Food poisoning, congestion, a rash on my arm, time to see the doctor.

I also enjoyed whipping my health card out at the pharmacy. The pharmacist would take my card and jot down some information before giving me my very cheap medicine. I usually wouldn’t use the medicine for as long as directed. That cream for my acne made my face itch. The medicine for my congestion made me dizzy. I didn’t really know what I was taking and that also made me nervous. I had a toiletry case full of ointments, creams and little packets of pills.

Now, even though I work in the health care industry, I don’t have the luxury of health insurance. I find myself feeling envious of those who do. My mother recently fell off of her scooter and shattered her shoulder. She has gone to several doctors and will eventually need physical therapy. She has insurance.

If I had fallen and broken my shoulder, I would have to send my husband out to cut a good straight branch off one of the trees outside of our apartment. We would use tape and string to fashion it into a splint for my arm. My husband would research healing time and physical therapy exercises on the internet, and I would hope for the best.