Readings — From the May 2012 issue

The Art of Waiting

From the March/April 2012 issue of Orion. Boggs is the author of the short-story collection Mattaponi Queen.

It’s spring when I realize that I may never have children, and around that time the thirteen-year cicadas return, filling the air with the sound of their singular purpose: reproduction. In the woods where I live, their mating song, a whooshing, endless hum, makes me feel like I am living inside a seashell. When I visit my reproductive endocrinologist’s office in May, I notice the absence of sound in the air surrounding the concrete and steel hospital complex. In the waiting room, I test the leaf of a potted ficus with my fingernail and am reassured to find that it is real: green, living.

The waiting room’s magazine selection includes a thick volume of the alarmingly titled Fertility and Sterility. On the cover is a small, square photograph of an infant rhesus monkey wrapped in a white terry-cloth towel. The monkey wears a startled expression, its dark eyes wide, its mouth a tiny pink oval of surprise. A baby monkey hardly seems the thing to put in front of women struggling through fertility treatment, but unsure how long I’ll wait before my name is called, I reach for the journal. Flipping through, I find the corresponding article about fertility preservation in human and nonhuman primates exposed to radiation. This monkey’s mother, along with twenty other monkeys, was given an experimental drug and exposed to the same kind of radiation administered to women undergoing cancer treatment. On other pages, I find research about mouse testicular cells, peritoneal adhesions in rats, and in vitro fertilization of baboons.

Nonhuman animals don’t expose themselves to fertility-compromising radiation therapy, nor do they postpone reproduction, as I have done, with years of birth control. But in species with more complex reproductive systems—the animals genetically closest to humans—scientists have documented examples of infertility, hormonal imbalance, endometriosis, and even reproductive suppression. How does infertility affect them? I wonder, staring at the photo of the baby rhesus monkey, its round eyes designed to provoke a maternal response. Do they realize they may never be mothers?

My name is called, and a doctor I’ve never met performs a scan of my ovaries. I take notes in a blank book I’ve filled with four-leaf clovers found on my river walks: Two follicles? Three? Chance of success 15 to 18 percent.

On the way out, I steal the journal with the monkey on the cover. Back home, under the canopy of oak and hickory trees, I open the car door and sound rushes in, louder after its absence. Cicadasong—thousands and thousands of males contracting their internal membranes so that each might find his mate. In Tennessee it gets so bad that a man calls 911 to complain because he thinks someone is operating machinery.

A few days later, I visit the North Carolina Zoo, where Jamani, an eleven-year-old gorilla, is expecting. The first gorilla to get pregnant there in twenty-two years, she has attracted dozens of extra visitors each day since the announcement of her condition. She shares an enclosure with Acacia, a socially dominant but somewhat petite sixteen-year-old female, and Nkosi, a twenty-year-old, 410-pound male. The breeding of captive lowland gorillas is governed by a Species Survival Plan that aims to ensure genetic diversity among captive members of a species. That means adult females are given birth control pills—the same kind humans take—until genetic testing recommends them for breeding with a male of the same species. Even after clearance, it can take months or years for captive gorillas to conceive. Some never do.

Jamani and Acacia were both brought to the zoo in 2010, after Jamani was recommended for breeding with Nkosi, which was accomplished simply by housing the animals in the same enclosure. The zoo staff confirmed Jamani’s pregnancy with a home pregnancy test, the type you can buy at a drugstore. I ask Aaron Jesue, one of Jamani’s keepers, if either Jamani or Acacia seems to have noticed Jamani’s pregnancy, but so far the only change the gorillas seem to register is the increase in visitors to their enclosure. “Jamani is still the submissive female,” Jesue says. “We’ll see if that stays the same.”

Many infertile women say the worst part of the experience is the jealousy they feel toward pregnant women, who seem to be everywhere when they are trying (and failing) to conceive. At the infertility support group I attend, in the basement of another hospital an hour away, the topic of jealousy and petty injuries frequently begins our conversations.

“I don’t mind babies and children, but I hate pregnant women,” says one woman, trim and pretty, with a sensible brown bob. “I hate them, and I don’t care how that sounds.”

So we talk about that for a while: deleting Facebook friends whose frequent status updates document their gestational cycle, avoiding baby showers and children’s birthday parties. We talk about our fear that we will be left out, left behind, while our friends and relatives go about the business of raising their ever-growing families.

In the wild, infants represent competition for resources, and it is not uncommon for mothers to protect their young offspring from members of their own species. Jane Goodall observed chimpanzee mothers shielding their infants from contact with non-sibling chimpanzees for the first five months of life, pulling their infants’ hands away when they reached for nearby chimps.

In a marmoset community, the presence of a pregnant female can actually cause infertility in others. Typically only a single dominant female in a breeding group reproduces, often giving birth to litter after litter before any of the others has a chance. This is accomplished through behavior—some females simply do not mate—and also through a specialized neuroendocrine response to the perception of subordination, which, like the pill, inhibits ovarian follicular development and ovulation.

If a subordinate female does reproduce, her infant has a diminished chance of survival. One reason is infanticide, which most commonly occurs when a subordinate female gives birth during the pregnancy of the dominant female, who is often the attacker.

Yet marmosets are mostly peaceful animals. In fact, the cooperation among them is remarkable, particularly in regard to infant care. A dominant female will allow her offspring to be carried by other group members from the first day of life. Scientists have speculated that this dependence on helpers—marmosets usually give birth to twins—is the reason for behavioral and hormonal reproductive suppression. The animal world is full of paradoxical actions of gentleness, brutality, and suffering, often performed in the service of reproduction. Animals will do whatever it takes to ensure reproductive success.

For some humans, “whatever it takes” has come to mean in vitro fertilization (IVF), a procedure developed in the 1970s that involves the hormonal manipulation of a woman’s menstrual cycle followed by the harvest and fertilization of her eggs, which are transferred, as embryos, to her uterus. About 4 million babies worldwide have been born through IVF, which has become a multibillion-dollar industry.

“?‘Test-tube baby,’?” says another woman at the infertility-support group, a young ER doctor who has given herself five at-home inseminations and is thinking of moving on to IVF. “I really hate that term. It’s a baby. That’s all it is.” She has driven seventy miles to talk to seven other women about the stress and isolation of infertility.

In the clinics, they call what the doctors and lab technicians do ART—assisted reproductive technology—an acronym that softens the idea of the lab-created human. Art is nonthreatening. Art does not clone or copy, but creates. Art is often described as priceless, timeless, healing. It is normal to spend large amounts of money on art. It’s an investment. In contrast, in online message boards, where women gather to talk about their Clomid cycles and inseminations and IVF cycles, a form of baby talk is used to discuss the organs and cells of the reproductive process. Ovarian follicles are “follies,” embryos are “embies,” and the embryos not used in an IVF cycle, which are frozen for future tries, are “snowbabies.”

It doesn’t take long, in an ART clinic, to spend tens of thousands of dollars on tests, drugs, and procedures. When I began to wonder why I could not conceive, I said the most I would do was read a book and chart my temperature. My next limit was pills: I would take them, but no more than that. Next was intrauterine insemination, a relatively inexpensive and low-tech procedure that requires no sedation. Compared with the women in my support group, women who leave the room to give themselves injections in the hospital bathroom, I’m a lightweight. Often during their discussions of medications and procedures I have no idea what they’re talking about, and part of the reason I attend each month is to listen to their horror stories: I’m hoping to detach from the process, to see what I could spare myself if I gave up.

But after three years of trying, it’s hard to give up. I know that it would be better for the planet if I did (if infinitesimally so), better for me, in some ways, as a writer. Certainly giving up makes financial sense. The twenty-two-year-old me would have felt it was selfish and wasteful to spend thousands of dollars on unnecessary medical procedures. Better, she would have argued, to donate the money to an orphanage or a children’s hospital. Better to adopt. The thirty-four-year-old me has careful but limited savings, knows how difficult adoption is, and desperately wants her body to work the way she thinks it is supposed to.

A large part of the frustration of infertility comes from the feeling that fertility is normal, natural, and healthy, while infertility is rare and unnatural and means something is wrong with you. It’s not usually a problem we anticipate; from the time we are very young, we are warned and promised that pregnancy will one day happen. At my support group, someone always says how surprised she is to be there.

My parents married in their early twenties and moved to the country to live on a farm and raise a family. It took them thirteen months to conceive me, and my mother says that during those months of waiting she thought she had been ruined by years of birth-control. That’s how she put it—ruined—as if the rest of her working body, her strong back, her artist’s hands, her quick wit, did not matter.

Although I married almost as young as my mother did, at twenty-six, it never occurred to me to have children right away. Early in my marriage, I was a teacher in North Carolina, and I invited a public-health nurse to speak to a group of fifth graders. The subject of her talk was “your changing bodies,” a reliable source of giggles, but the nurse brought a hushed seriousness to the talk. She angled her face upward so that her lecture took on the air of prayer, and she handled the plastic models of the vagina and uterus reverently. “Your bodies are miracles,” she told the girls in a separate session. “They are built to have babies. That is the reason for menstruation, the reason for the changes your body will go through.”

“Your brains are miracles, too,” I told them later. “Bigger miracles than your uteruses. You don’t have to have a baby if you don’t want to.” But my words sounded feeble and defensive next to the nurse’s serene pronouncement.

My students, boys and girls alike, from kindergartners to high school seniors, talk about the children they will have someday. “My kids won’t act like that,” they say, watching an unruly class on a field trip. Or, “I bet I’ll have all boys. What will I do with all boys?” It seems far more common for them to imagine the children they might have than the jobs they might do or the places they might live.

Maybe imagining ourselves as parents helps us understand the scope of our lives. For years I have dealt with a dread of old age and death by reminding myself that I have not yet given birth. I can imagine the moment clearly—my husband is there next to me, my parents are waiting to meet their grandchild—and the fact that it hasn’t happened (always, it is at least nine months away) reassures me that some new stage of life is still to come. I’m not sure when people started asking me whether I have children—a couple of years ago, I think. “Not yet,” I always say.

The feminist writer Tillie Olsen’s book Silences includes a chapter called “The Damnation of Women” on the choice many female writers made between work and children. Olsen writes that it is not until the twentieth century that “an anguish, a longing to have children, breaks into expression. In private diaries and letters only.” Her selections from Virginia Woolf’s diaries in particular are extraordinary for their candor and pain. Woolf, who never had children, struggled with that for more than a decade, writing:

. . . and all the devils came out—heavy black ones—to be 29 & unmarried—to be a failure—childless—insane too, no writer. . . .

She seems to have conflated the failure to reproduce with a failure to write well, though she is only two years from finishing her first novel. In her thirties, still childless, just a few years from writing Mrs. Dalloway, she writes of “having no children” and “failing to write well” in the same sentence. It is only after embracing her writing as an “anchor,” when she is in her forties, that she makes peace with her childlessness:

I can dramatise myself as a parent, it is true. And perhaps I have killed the feeling instinctively; or perhaps nature does.

Because we spend much of our young lives dramatizing and imagining ourselves as parents, it isn’t surprising that even the strongest of us let the body’s failure become how we define ourselves. But nature tells us otherwise. The feeling of grief subsides; we think through our options and make choices. We work, travel, find other ways to be successful. While completing The Waves, at forty-eight, Woolf writes of a feeling of intoxication that comes from writing well. “Children are nothing to this.”

On the North Carolina Zoo’s Facebook page, Jamani’s keepers have posted a video of her latest sonogram. In a practiced pose, Jamani stands upright, clutching the steel grate that separates her from the zoo’s staff. Her belly is accessible through a small gap in the grate. Humans and gorillas are so closely related that staff members wear hospital masks to protect themselves and Jamani from viruses.

“Hands up, hands up,” one zookeeper says, clicking a training noisemaker while an assistant feeds her from a platter of vegetables. “Belly,” says the keeper. Jamani never lowers her hands, but the keeper continues to repeat the commands every few seconds. Jamani is praised for her compliance, and the black-and-white image of her baby, looking not unlike the human sonograms I’ve seen on Facebook, appears on the vet technician’s laptop. I’ve watched the video a dozen times, studying Jamani’s face for clues to her comprehension.

“So neat!” posts one commenter beneath the link.

“She is doing great,” adds another.

“The Baby is a cutie already,” writes a third.

Waiting outside in her enclosure during the filming, childless Acacia must be sitting on her haunches, chomping lettuce or carrots, oblivious to the fuss being made over Jamani, unaware of the fuss to come. Part of the reason for the attention is the rarity of pregnancy among captive gorillas, and its uncertainty. In 2010, only six successful gorilla births were recorded in American zoos, and even when infants are born healthy, the mother may reject her young. If this happens, Jamani’s keepers plan for Acacia to take over as a surrogate. Meanwhile, Acacia mates with Nkosi regularly, though she has taken birth control pills since 2001 and will remain on birth control until the Gorilla Species Survival Plan overseers determine that she is compatible with Nkosi. She may never conceive, but, according to her keepers, she seems content.

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