I.  Empty

I feel as hollow as the empty black circle staring at me from the screen. The nurse practitioner is quiet as she scans my uterus. A push to the left, a push to the right. Left, right, left, right. I gaze at the monitor, searching for what I’ve waited seven weeks to see: a white blob floating in a black ovoid sea, outlined by a bright white line.

Left, right, left, right. Back and forth, the cold probe pushes against my insides. The empty black circle keeps coming in and out of view. Nothing else. The circle turns into an oval, then a tiny dot, then back to a circle again. Still empty. A black jellybean with a white border. Nothing inside.

The discomfort from the probe is overshadowed by the growing pressure inside my chest. It feels hard to breathe. My throat burns. Gray and white lines, layers of uterine muscle, wink at me as she maneuvers the probe around my cervix.

The silence in the room hurts. I can’t help but speak.

“That’s not supposed to look that way, is it?” I say, more than ask.

She barely nods. Then clears her throat.

“No, not really.”

That's all I need to know. My husband squeezes my hand. I grip his fingers tightly. I cannot look at him.

“I often have a sonographer come in to confirm the exam findings, when things aren’t quite looking like what we would expect,” she says softly, taking the cold probe out of me and placing it on the ultrasound machine. She removes her bright, purple nitrile gloves and throws them in the trash can. Her movements feel painfully languid, in contrast to the panic building inside me.

Everything about the tiny exam room with no windows, my husband sitting silently beside me, my heels in the cold metal stirrups, feels wrong.

She touches my leg sympathetically. I’ve been in healthcare long enough to know that vaguely reassuring behavior is how we tiptoe around bad news. It’s worse than the news itself – it’s the way we walk around it, whisper about it, and look at it from afar, but not in the eyes, like a dying animal on the side of the road.

Things are not okay.

The sonographer comes in, an unsmiling woman with thick-rimmed glasses. She doesn’t say hi, doesn’t look at me. I fidget with the disposable paper drape across my thighs. Modesty feels like something tangible to reach for. I cannot grasp for hope; it left the room as soon as I saw the empty black circle.

The second woman coming in to do the exam feels like a cruel delay. I just want them to tell me the news I already know. I know her exam won’t change the result.

The sonographer walks straight to the machine by my feet, takes the probe and sticks it into me without a word or eye contact. Together, they spend five long minutes looking at the dynamic montage of black and white on the screen, speaking to each other in hushed broken sentences.

“No cardiac activity,” one of them murmurs.

I stare at the ugly speckled ceiling. I hate lying there, pathetically waiting to hear one of them say what I already know to be true. My throat burns as I hold back tears. Finally, a teardrop rolls out of the corner of my left eye onto my cheek. I allow the wetness of the drop to distract me from the weight I feel within me. I close my eyes, waiting for the pointless exam to be over, my body vulnerable and empty.

II. Black

The hormones were making me feel like shit. I had waited seven weeks for this appointment. My home pregnancy test was brightly positive very early on. All my symptoms were more intense this time around. Nausea, vomiting, fatigue and pelvic discomfort were unmistakably present from the week after the positive test.  I tried to be grateful for my symptoms, interpreting their presence as confirmation that all the hormones were doing what they were supposed to be doing. hCG, estrogen, progesterone and cortisol spinning through my blood, wreaking havoc on parts of me while promoting exponential growth inside me.

Every time I vomited in the toilet, I tried to be grateful for the meals I had been able to keep down. Every time I collapsed on the couch after a day at work, I tried to muster enough energy to smile and read to my daughter.

“I think I might be pregnant with twins!” I told my husband and a few close family members. I felt so pregnant this time, my second time around. I was throwing up multiple times a day, not just in the morning. I gained seven pounds within two weeks of my positive test. I willed myself to believe it was all going well, despite how unwell I felt.

Two weeks before the much-awaited appointment, I suddenly felt more energetic. The nausea was gone. I didn’t have any cramping or bleeding, so I was confident everything was fine; I was just getting a well-deserved break.

“Are you sure everything is alright?” my mother asked me, when I told her excitedly how well I was feeling at last.

I felt angry at the implication that something wasn’t right.

“Of course,” I said gruffly. “Everything is fine. No spotting or cramping. I’m fine.”

I hung up the call and pulled into my driveway, the evening sky already black.

III. Circle

“If you want to keep this, you can – some folks like to hold onto it,” she says, tentatively handing the postcard-sized ultrasound printouts to me. I sit up on the exam table and mechanically take them from her.

“When did it… stop growing?” I ask, the top of my mask wet with tears.

“At six weeks,” she replies softly, with kindness and sympathy in her eyes.

Six weeks. Here I was walking around for the past three weeks with something dead inside me. Something dead that I thought was alive. I try to wrap my mind around the thought and cannot.

The rest of the day is silence and tears.

That evening, I place the ultrasound picture in a journal I am keeping for my daughter who is three years old. It’s cerulean with soft skin and an orange elastic band. I write diary entries to her. I’ll give it to her when she’s older, maybe eighteen.

I lie on top of the unmade sheets and cry for half an hour. Finally, I pick up the pen and write.

 

You have been telling me you want a baby sister. I went to the doctor today because I am pregnant. But the ultrasound showed that the baby is not alive anymore. So, I am not really pregnant anymore.

Daddy and I cried together today after the appointment. You were still at school.

I feel so grateful for you, that you are healthy and happy. It is too easy to take that for granted. After today, I cannot view you, your life, as anything but a miracle. When I was pregnant with you, I was still in residency. I didn’t eat or sleep properly. I was always stressed. And yet, somehow, you were born healthy.

You are our blessing, Z. We love you.

 

The empty black circle looks stark and lonely against the gentle, off-yellow lined pages of the journal. I open my nightstand drawer and reach for another ultrasound printout – the one from four years ago, when the little oval wasn’t empty.

I gaze at the white pixelated blob inside the imperfect black oval and place it next to her sibling. I close the journal and turn off the light.

My daughter sleeps soundly, breathing and alive, down the hallway. Tomorrow, when we wake up, her love will slowly fill the empty circle that grieves my heart today.