The doctor raises two vials of light amber liquid before your mother’s eyes. Once again she is reclined on the ultrasound table, skirt lowered, shirt raised, belly slickened by the seagreen gel. Once again the black and white pixel wall looms at her side.

“This is your son’s urine,” the doctor says.

Yes.

Son’s.

So it is.

So you are.

He isn’t your mother’s usual doctor. He’s a specialist, a man in the business of needles. I’m being unfair, surely — no doubt his skills are expansive, diverse. But this is what he’s known for, admired and even, under certain circumstances, loved for: his wizardry with needles. Officially, his specialty is the high-risk pregnancy, and in the face of a term like that wizardry strikes me as anything but inappropriate. In the face of a term like that, most people will take all the magic they can get.

The two procedures this doctor is known and loved for, fairly or otherwise, are CVS (chorionic villus sampling) and amniocentesis. Both are dangerous. Both threaten the unborn child’s life. Both depend almost entirely on the skill of the practitioner, and there’s no way to consider either without entertaining notions of pain, blood, heartbreak, death. Your mother and I spent a long weekend contemplating exactly these notions, weighing them against this doctor’s legendary skill and several Vegaslike tables of odds. We’re not gamblers, your mother and I — this is what we discovered. In spite of the raucous mess we habitually make of our lives, we’re not rollers of the dice. We opt for the safe bet, the easy odds, every time. Which is why we’re here, or more exactly why we’re here now.

The doctor marks each vial with a grease pencil, red. “This is so you’ll see that we can’t confuse things,” he said. “That when you call for your results you’ll be sure they’re your son’s results and not someone else’s.” He places a sticker bearing a long string of numbers and a bar code over each.

He means to comfort, but instead he has disconcerted. It is a possibility I hadn’t imagined. The fact that he enumerates it so laboriously must mean it could happen — that it has happened, in fact. Another monster to fear. I can’t help projecting myself forward in time, sensing the echo of this instant around every corner of our lives as parents. Our son could be lost, mistaken, misidentified. Our son could be someone we never know.

Our son.

We forewent the CVS test, in spite of the doctor’s reputation. The odds were too much for us. Thus we’re here, now, for an amniocentesis. The doctor will insert — has already inserted, as you can see — a lengthy needle into your mother’s belly. He will invade your space, make off with a little of the precious fluid there. No wonder it’s common to see babies, in the accompanying ultrasound image, batting at the needle as it enters. From your perspective, he’s an armed thief.

“You can see I’m putting these into an envelope which is clearly labelled with the same number I taped onto the vials,” says the thief. Again the theme of mistaken identity. How many millions, I want to ask, were awarded to the couple who terminated a pregnancy after getting the grim results that belonged to someone else’s child?

I think of all the hands that will touch these vials, all the strangers who’ll manipulate the fluid in them, wheedle it into pipettes, pour into centrifuges. What they’ll know of you, long before we will. Strangers. They’ll be careless, some of them, inevitably. They’ll drop, or misplace, or misread after a long night of bad breakup or too many drinks. They won’t care. They won’t pause to imagine you in your pouch, how you fought to keep from giving up even this small amount.

Amniotic fluid is mostly urine, it turns out. This is what the doctor meant. You’ve begun your life in a sack of your own piss. It’s sterile, of course; all urine is, until it comes out. All the same, I’m isappointed for you. I wanted better for you already.

With this fluid those numerous strangers will conduct a battery of tests. They’ll draw a complete chromosomal map, your own personal Rosetta stone. Then they’ll start to read. It’s what you’re made of, and it’s already set. More than schools, more than neighborhood, more than the sound of your mother’s voice, it is this that circumscribes your future. The most obvious tests are for genetic anomalies: Down syndrome, spina biffida, a dozen others; detecting these is the reason most parents have the test done. But they can see other things too. They’ll have the source code, the blueprint. In theory, they could build another you, and maybe this is the reason for security measures. Tall; short; shoe size, hair color, fullness of lips — two vials of piss and the Vegas tables will reveal everything. And they won’t care in the least. No matter what they find, they won’t care in the least.

The doctor takes the envelope, smiles, leaves us alone to look for signs that he’s done his job less than perfectly.

On the way home your mother wept. You mustn’t misunderstand this. She meant nothing by it. It was a fleeting thing, melancholia passing like a cloud-cover chill. It came and went in a taxi on the FDR drive. We were curling onto the bridge. The river lay on our left, the city crowding us, looming over us, muscular and brick-heavy, to the right. The driver was whoever — Armenian, Uzbek, Cypriot. We were on our way home. A few tears, nothing more. She was wearing her nice pink jacket and skirt, the one we were married in, the first time, at San Francisco City Hall. The one she bought in her home town, in Italy. At least I think she was. At least, I remember it so.

A few tears.

“Oh,” she said. “I know. I know.”

She said, “But I might have been a little less lonely.”

Posted: July 18th, 2008 under Uncategorizable.
Comments: 2

The test is called a nuchal translucency, and it is both the height of technical sophistication and simplicity’s soul. Your mother will lie on her back on the table. She’ll expose the mound of her belly, the tiny rounded lump of you she can’t make sense of yet. The technician will smear this lump — this secret, still — with a jelly that in the low ochre light of the exam room looks mint-tinted, as if made of congealed drops of Caprese sea. There are hints of sex in the jelly’s sounds, in its viscosity, and these abut equally potent hints of whatever is sex’s opposite: science, maybe; clinical remove. The same is true of the technician’s wand. Your mother’s skin is soft and smooth and, yes, fruit-like; ripe. Maybe it’s the room’s quiet, maybe its glow, but your mother will again seem oddly unperturbed, submitting with uncharacteristic patience as the tech rolls the wand across her belly.

And there you are. There you appear in your gray-shaded hush again, little comma of light by the rim of the screen. You look less like a form of marine life now. You show signs of joining the species. They’re nearly microscopic, these signs, but magnified on the screen they enable us to entertain notions like fingers and knees.

The technician will take a series of measurements by drawing digital lines between points on the screen. She uses a mouse to do this, click and click, and the mouse leaves crosshair traces, comet trails in a summer night’s sky. In form it’s astonishingly reminiscent of my own work, all pointing and clicking and dragging over photographic acreage, sketching of lines that brightly glow. For an instant this will disconcert me. My work isn’t about reality; it’s about reality’s unmaking. I click, I drag not to connect people to the world but to separate them — to metaphorize, shift, reshape. In this room, with you on the screen, the technician’s motions are the same. Her purpose, though, is opposite. She doesn’t want to reshape reality, she wants to fix it. She wants to resolve, define it to the micron.

The most significant of the measurements she’ll take is of what’s called the nuchal, a fold of flesh at the back of your neck. Looking at the screen, it’s not at all clear you have flesh. It’s not at all clear you have a neck. The bulb of your head bows seamlessly into the longer, more floral bulb of your body, with scant pause between. Yet the technician lunges at her photons.

It is the nuchal’s thickness that matters here. It’s measured in units so small they signify dust in the world outside the womb. They signify dots made by a pencil, the width of a wisp of hair. The difference between too much and too little is immeasurable without the screen and its magnification, the concentrated calculating power of present-day microprocessors. In the natural world, in a sense, it doesn’t exist. It fails to register. Yet its implications are vast. They are life and death, in fact, because what the thickness of the nuchal signifies is the likelihood of certain potentially devastating genetic anomalies. A too-thick nuchal can signify Down syndrome, for instance, or — maybe worse — trisomies 18 or 21.

It turns out this is what we’ve come to. Not only can we see you, we can see past you. We can see your future, and in seeing we can make. Or we can unmake. It’s another in the long line of firsts we are facing as parents, each new and potent redefinition of ourselves that your still almost microscopic presence delivers. First there was the power to bring into being. Now there is the power to take out.

Parents don’t like to talk about this. There is precious little language for it. But here is the truth: a too-thick nuchal is news of a very bad sort. A too-thick nuchal prompts other tests, and those other tests — just the tests themselves, mind you — can be deadly. This will be where parenting is reduced to oddsmaking, gamblers’ logic. Phrases like one in two hundred and one in four hundred are tossed around, not with trackside giddiness but with gray sobriety, because it isn’t a windfall riding on the outcome but life itself. Kind of life, on one hand; life at all — existence — on the other.

The technician’s measurements will be forwarded to a lab, where they’ll be matched to the results of further tests done on your mother’s blood. From these combined outcomes, a series of numbers will be calculated. Your odds. There will be one number for Down syndrome, one for Trisomy 18, one for Trisomy 21. Black jack, roulette, and craps; horse racing and dog racing; football. Our job will be to examine these numbers and decide which, if any, of the remaining tests we will undertake. Will we opt to have a CVS procedure, in which placental cells are harvested for chromosomal scrutiny; or will we opt for the more traditional amniocentesis, in which the cells to be examined are gathered from amniotic fluid? This second test is far more established; its risk — to you, mostly, but also to your mother, and by extension, psychologically, to me — is less than half that of CVS. Yet it must be done when you are several weeks older. You will also be bigger, fuller, more human, more real by then. What would it mean if you beat the odds on an amnio, but did not beat the odds on Trisomy 21? How would we decide what to do, knowing you as we will, by then, that much better?

The CVS test is far riskier — unless, we’re told, it’s performed by a doctor who does such tests regularly. The risks with a doctor like that, we’re told, are equivalent to those in an amnio. And there is such a doctor, and he can do the test for us. But it must happen right away, within days of receiving the nuchal and blood test results. Which means there will be precious little time for the weighing of the odds.

The technician clicks and clicks, the beveled chock of the mouse more familiar than anything else in the room. On the screen, at the back of what must be, can only be your neck, the crosshairs are pinned. The line is drawn, then — chock — pinned again. On the table your mother, a stranger now to me, to herself, to everyone but you — on the table lies your mother. She is still. She is silent. She is parental.

Behind her eyes, I see the numbers whirl.

Posted: May 6th, 2008 under Uncategorizable.
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