Attending on Mr. Howell

Mr. Howell is through the door, cutting us off with his declaration – ”it’s negative”– and is already in forward thinking mode. He schedules a look at the Fallopian tubes in August (with dyes and X-rays). And then it’s my turn. I am passed a jar and a sheet of instuctions.

    ovary scan

    There has been no touching, no prodding, no undressing, no gloved hands. Private parts are still private. Mr. Howell’s fingers touch only his fountain pen. I fixate on the pen, a relic from another age, a talisman of effete refinement and thus – in this technocracy – a sly sign of status. His attention is on the buff folder and its contents, updated between our visits by clinicians busy with fluids and glassware, scanners and keyboards. Their findings, all numerals or terse nomenclature, are the runes from which Mr. Howell makes his interpretations. I watch his thoughts appear as wet black ink on the page before us.

    His manner is warm, his smile brisk but well meaning, and today he is excited. The progressive ultrasound scans showed a follicle ripening but the blood progesterone spike of 71 confirms it: Julie has ovulated. Suppressed for five years, this natural act has returned. Mr. Howell oversteps the mark and tells us what he cannot know for sure, that Julie will conceive. ”It’s going to happen now” he announces. This impresario of the ovaries is delighted with his work and I can’t help but be carried along by his sureness and delight. Have you been trying he asks? We have. Julie is one day late and suddenly he is out of the chair ordering her to the bathroom.

    I am alone with the medical student sitting in the corner. She has come late to medicine, after reading science at Liverpool, after trying out midwifery. Her disclosure tells of a search that’s not over and has little of Mr. Howell’s certainty. I feel a wisp of shame as she calls herself a mature student. In this place of expertise my own feelings of inadequacy are barely in check. I blurt out that my father was a gynaecologist and inwardly I smile, because this is what my mother would have said and I would have been angry for her for it. But, to my slight surprise, I said it with admiration. I notice how I am feeling more kindly about my long dead dad. I will never see this student again but something has passed between us and I have experienced more than I expected. I like to think a window like this appears in every day of my life and if I ever find otherwise there is only one reason: I am not paying enough attention.

    Mr. Howell is through the door, cutting us off with his declaration – ”it’s negative”– and is already in forward thinking mode. He schedules a look at the Fallopian tubes in August (with dyes and X-rays). And then it’s my turn. I am passed a jar and a sheet of instuctions. One day in late August I must wank into the jar, keep it warm (‘’we recommend keeping it close to the skin, under a shirt’’) and take it within one hour to the laboratory. The embarrassment in the room is a sure portent of the laughs we will have later and of course this is just what happens. We are counseled on sex (not before X-rays) and Mr. Howell takes stock of his strategy. He will tread a path that balances severity of intervention against progress as Julie crosses over into her forties this summer. There are several stages before we embark on IVF. ”I am just saying the word, putting it out in the room’’ Mr Howell reassures us. Julie has said she didn’t want to go there but Mr. Howell is good at his job. He is a professional, not easily deterred, used to results.

    One last test for Chlamydia sends Julie to the bathroom with a sealed spatula. When she comes out she knows she has come on. In the session she has been attentive and focused, Filofax open, ready with dates and histories, but now she has tears. The news in the room has caught up with her. First we learn things (in the frontal cortex) then we feel them (through the amygdala and the soft centre of the limbic system). Now her whole organism has the knowledge. On edge myself, panicked by her emotion, I start on the positives: this means the periods have stabilized, we go again. I wish I had simply shut up and summoned the courage to feel the sadness and to let Julie feel it too (because I suspect that’s how we grow).

    We book our next appointment. I look about me and notice the others, waiting as cramped couples for their time with Mr. Howell. Daily, in this room, there are lives are in rapid transition. Beside the secretary, neatly arrayed in their customized rack are A5 leaflets in four soft feminine colours, one each for the cancers of cervix, ovary, vulva and womb. I fancy that Julie and I are together describing a trajectory. It’s long-term (it has occupied Julie’s thirties) and increasingly benign: mistress, partner, wife, maybe mother. I feel a stab of longing for the mistress phase. The news today is making me breathless and not for the first time I wish I could freeze everything, sit down, and time out.

    Last year when the lump appeared we had gone to the breast clinic across the way. The waiting time for tests had presented a level of uncertainty we did not want to want to live with so we threw money at it. We booked into the posh hush of St John and Elizabeth, NW3 and went through three specialists orchestrated by Mr Doorman. The all clear prompted a planned programme. Julie had once required a total blood transfusion, in later years she suffered a thrombosis: like all worthwhile adventures this one will not be without its risks. Mr. Doorman told us a colleague, highly recommended, had moved to Brighton and was building his practice. At our first session we asked Mr Howell why he had moved. Have you worked in an inner city London hospital he asked. Was all his work on the NHS? He laughed (”Don’t worry , I haven’t found Jesus”) and told us a private fertility clinic in Hove was underway. Julie a tax payer since 16 thinks it extraordinary that we receive his attention for no charge. Both our shames emerge when we receive freely like this.

    Mr. Doorman had explained that anyway he could no longer see us. He was dropping his private work in order to return full-time to his NHS practice in the East End. I liked the way he said it, humbly, without making us uncomfortable. The wry humour that had characterized our sessions was still present. I was pretty sure Mr. Doorman had not discovered Jesus. I surmised he wanted to give more freely but there’s always an exchange. Something always swims back up the pipe. Mr. Doorman values something more than the money he will forego, and I won’t learn what it is. St John and Elizabeth cost us much money but Mr Doorman never sent us a bill.

    Back from the hospital the bank holiday weekend assembles and soon I set off with three teenage boys to X-Men 3. Our strides down the hill match step for step; our heights are within an inch of one another. We are in a good mood, expectant: we know the Marvel canon well and the gifted children of Professor Xavier are our favourites. Memories of earlier X-men outings provide me with an exact measure of how my children have grown. The movie does not disappoint – we give it four stars – and the talk up the hill is animated before I feel the pace and, suddenly, my fatigue.

    There are over thirty-five years between me and these young men. But I may have another son and there will be a new cycle of raising and rearing. There will be a new cycle of heavy lifting. Seeking to become more supple I have enrolled in a Saturday Yoga class at the next-door sports centre. For once I curb my impatience at the teacher’s counseling and shelve my shame (it’s nearly all women, and not young ones). I go with the flow and am surprised at what happens when we finish with a ten-minute relaxation. Flat on the floor, I am still and attend only to my breathing. I feel what it is like to have life and dare to hope that one new life may fill me with more. I appreciate the wisdom in my instructor’s teaching because I have been asked to adopt the postion of that which I will soon become. I lie in savasna, in corpse posture.

    Adam wakes us with a chime on his copper bowl. He presses his palms together, smiles and greets us in tongues.

    Om Shanti. Namaste. Have a nice day.