The registrar called me up and I went into a little room with an ultrasound machine and a medical couch covered in white filmy paper. The technician asked me to get onto the couch and she rolled some gel onto a plastic instrument while I lay there looking at the ceiling. The room was dim, evocatively dim, as if it contained a hidden pool of water somewhere. We chatted, I don’t remember about what. I had the sense that my voice was coming from somewhere else, like a small radio I kept in my mouth.
The technician pressed the plastic thing down hard into my lower abdomen then, and I stared upward and tried not to make any noise. My eyes were watering. I felt like at any moment she was going to show me a grainy image of a foetus and say something about a heartbeat, and I would nod wisely. The idea of making images of a uterus that had nothing in it struck me as sad, like photographing an abandoned house.
After it was over I thanked her. I went to the bathroom and washed my hands a number of times under the hot hospital taps. I may have scalded them a little, since my skin came up very pink and the tips of my fingers looked slightly swollen. Then I went back to wait for the consultant to call me. Rebecca and her family were gone.
The consultant was a man in his sixties. He squinted up at me as if I’d disappointed him in some way and then told me to sit down. He was looking at a folder with some writing in it. I sat on a hard plastic chair and looked at my fingernails. My hands were definitely scalded. He asked me some questions about the time I had been admitted to the hospital in August, what my symptoms were, and what the gynaecologist had said, and then asked more general questions about my menstrual cycle and sexual activity. While he asked these questions he was flipping sort of non-committally through his folder. Eventually he looked up at me.
Well, your ultrasound is clear, he said. No fibroids, no cysts, nothing like that. So that’s the good news.
What’s the other news?
He smiled, but it was a weird smile, as if he was admiring me for being brave. I swallowed, and I knew that I had made a mistake.
The doctor told me that I had a problem with the lining of my uterus, which meant that cells from inside the uterus were growing elsewhere in my body. He said these cells were benign, meaning non-cancerous, but the condition itself was incurable and in some cases progressive. It had a long name which I had never heard before: endometriosis. He called it a ‘difficult’ and ‘unpredictable’ diagnosis, which could only be confirmed with exploratory keyhole surgery. But it fits with all your symptoms, he said. And as many as one in ten women suffer from it. I sort of chewed on my scalded thumb and said things like, hm. He said there were some surgical interventions possible but they were only recommended in particularly severe cases. I wondered if that meant I wasn’t a severe case, or just that they didn’t know yet.
He told me that the primary problem for sufferers was ‘pain management’。 He said that patients often experienced pain during ovulation, menstrual pain, and discomfort during sexual intercourse. I bit down into the side of my thumbnail and started to peel it away from my skin. The idea that sex could hurt me felt apocalyptically cruel. The doctor said ‘we’ wanted to prevent the pain from becoming debilitating or ‘reaching the level of disability’。 My jaw started to hurt and I wiped at my nose mechanically.
The secondary problem he said was ‘the issue of fertility’。 I recall these words very clearly. I said, oh, really? Unfortunately, he said, the condition does leave many women infertile, that’s one of our biggest concerns. But then he talked about IVF treatments and how rapidly they were advancing. I nodded with my thumb in my mouth. Then I blinked several times quickly, as if I could blink the thought out of my mind, or blink the entire hospital away.
After that the consultation was over. I went back out to the waiting room and saw my mother reading my copy of Middlemarch. She was only about ten pages in. I went to stand beside her and she looked up at me with an expectant face.
Oh, she said. There you are. What did the doctor say?
Something seemed to close up over my body, like a hand held hard over my mouth or my eyes. I couldn’t begin to phrase the explanation of what the doctor had told me, because there were so many parts to it, and it would take so long, and involve so many individual words and sentences. The thought of saying so many words about it made me feel physically sick. Out loud I heard myself say: oh, he said the ultrasound was clear.
So they don’t know what it is? my mother said.
Let’s get in the car.
We went out to the car and I strapped my seat belt on. I’ll explain more when we get home, I thought. I’ll have more time to think about it when we’re home. She started the engine and I ran my fingers through a knot in my hair, feeling it stretch and then give way, the little pieces of dark hair snapping off and falling away through my hand. My mother was asking questions again and I could feel my mouth formulating responses.