"I'll join you and Bristol in a moment," Dr. Wagner says evenly. "I'll talk to you together."
She doesn't deny that there's a problem, and that fact cuts through my protests like a shard of glass.
"Wait . . . I . . . okay. If we could just . . ." The possibility of something being wrong with our child has me stumbling. "If you could just tell me first."
"Mr. James." Dr. Wagner's reservations come to life on her face. "I'd prefer to discuss everything with you and your wife together."
I want to be the first line of defense for Bris. I've always been protective of her, but the shit that went down with Parker ramped up my need to shield her from danger, from pain. Anything wrong with our baby is pain like I can't imagine. A premonition of it skims across my nerves. It's times like these I hate those extra senses Ma says growing up street gives us, the ones that dig between Dr. Wagner's words, the things she says, into all the things she doesn't.
"I'll be there shortly," she says, finality in her voice. "Thank you, Mr. James."
Darla's biting her lip, anxiety in the eyes she slides between Dr. Wagner and me. If I had one minute alone with Darla, I'd get it out of her, but with Dr. Wagner standing guard over whatever secret they're keeping, I'm getting nothing. Resigned, I head back to the examination room. I open the door tentatively, not sure how I'll handle Bristol's questions on the other side.
But there aren't questions-she's fallen asleep again. Between the sleep her pregnancy demands and me interrupting her sleep this morning, she's exhausted. Her head droops to the side, her long lashes shadowing her cheeks. Her hand rests over the small bump, even in sleep, protecting our baby. I slide the chair beside the exam table and dip my head to kiss the baby through Bris's clothes. I do what I've been doing ever since we found out, and the ritual gives me some comfort. These words about what's possible ease my mind as I wait to hear what left Dr. Wagner's eyes so grave.
"Dwell in possibility, baby."
34
Bristol
Something's wrong.
If Grip's abrupt departure and lame excuse didn't give it away, Dr. Wagner's expression does, even though she tries to hide it beneath a mask of professionalism when she enters the room without the ultrasound technician. She goes through the same process Darla did, running the wand over my belly and studying the screen. She turns the ultrasound away to look at it, her mouth firming into a grim line.
She indicates that I can leave the examination table and take a seat beside Grip.
"Okay. What's going on?" Grip asks. "We'd like to find out the sex of our baby. Is there a problem?"
A brochure of some kind rests face down in Dr. Wagner's lap. Anxiety ratchets up, plucking at my nerves. I just want her to blurt it out if there's a problem. This delay only stirs fear inside of me.
"When Darla looked at the ultrasound," Dr. Wagner finally says, "she noticed something about the fetus."
"What?" Grip demands. "What did she notice?"
"Based on what we see," Dr. Wagner says, her voice careful, like she's measuring the words out in a recipe that has to be exact, precise portions of brutal honesty and compassion. "We suspect anencephaly."
Should that mean something to me? For all I know, that could be anything from a rash to . . . I can't play that all the way out. This baby isn't even born and I haven't seen the 3D ultrasound, but I've felt flutters under my heart. My shape is changing and my body is working overtime to grow this baby. Anything that endangers my baby's life could cleave me into un-mendable pieces.
"Ance-what?" Grip's eyes don't leave Dr. Wagner's face, but his hand bridges the small space between us until our fingers twist into a knot of solidarity. "What is that? How do we fix it?"
"An-en-sef-uh-lee," Dr. Wagner sounds out slowly. Her face still wears that impassive mask, but her hands clutch the brochure like she's steeling herself to say what needs to be said. "And you don't . . . well, you don't fix it. Anencephaly is a terminal diagnosis. I'm so sorry."
The word "terminal" multiplies, flying around my brain over and over until my mind is a hive of bees swarming, stinging. I struggle to pluck one lucid thought from the buzzing in my head.
"But . . . but how can you know?" My voice emerges from its hiding place high and thin. "You just look at the screen and hand down a terminal diagnosis? That can't be right. There have to be tests or-"
"Yes, we'll run an amniocentesis as a . . ." Discomfort crinkles Dr. Wagner's face. "As a formality, but I'm certain, Bristol. It's apparent even in the ultrasound."
I can't even cry. My arms clasp my little belly protectively and my hands shake. My extremities have frozen like I'm in shock. How could I not be in shock when she just ripped the rug, the floor-the earth from under my feet? I don't have a leg to stand on.
"What exactly is this condition?" Grip's voice doesn't sound like it belongs to him. He has one of those voices, so warm it draws you in, but right now, there's distance, distance and desperation. "You said it's terminal, but we don't know anything about it yet."
"Yes, of course." Dr. Wagner allows sympathy into her eyes. "Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. Normally, as the neural tube forms and closes, it helps form the baby's brain, skull, spinal cord, and backbone. Anencephaly occurs if the upper part of the neural tube does not close all the way, thus leaving parts of the brain permanently unformed."
The compassion deepens in Dr. Wagner eyes and she licks her lips, presses them together before continuing.
"This often results in a fetus being born without the front part of the brain, the forebrain, and the thinking and coordinating part of the brain, the cerebrum. The remaining parts of the brain are often not covered by bone or skin."
"Not covered by skin and bone?" The words forcibly eject from my mouth. "What does that mean?"
"It's why we can tell from the ultrasound that the fetus has anencephaly. Let me show you," Dr. Wagner says, turning the screen around for us to see. "Here, we can see that the top of the head and the brain are . . . missing, and there is only a thin membrane covering that portion, no skull or scalp."
A moan slices into her explanation, and I'm startled to realize it came from me. I cover my mouth, but I can't cover my heart. I can't silence the scream ricocheting in the chambers of my soul. It's piercing. It's painful.
"Many are stillborn." Dr. Wagner presses on despite flicking a concerned look my way. "Those who are delivered as live births will live minutes or hours, in rare cases, a few days."
"No," I mutter under my breath. "This can't be right. A test-there has to be a test, a second opinion."
"Yeah," Grip pipes in. "A real test, not just a blurry picture telling us our baby might have this condition."
"Like I said, we'll perform the amniocentesis, certainly," Dr. Wagner agrees.
Her pause drops heavily into the waiting quiet.
"I know this is a lot to take in," Dr. Wagner says. "But we'll need to discuss your options."
"We have options?" I ask, a harsh laugh cutting the inside of my jaw.
"Yes, options." Dr. Wagner looks from Grip to me and back again. "Decisions."
The word "decisions" sends a chill up my spine. Oh, God, no. She can't seriously be asking me to do that.
"More than ninety percent of parents with this diagnosis terminate the pregnancy," Dr. Wagner says quietly. "I know that's hard to process, but the fetus-"
"Stop saying fetus," Grip snaps. "It's our baby. Call it our baby."
Dr. Wagner nods, meeting the frustration and naked pain in Grip's eyes head on.
"I understand," she says, her tone simultaneously soft and firm. "But you will have to deal with these decisions sooner rather than later. We are . . . well, certain options are time-sensitive."
My fingers are numb. Tears swim in my eyes, suspended but refusing to fall, frozen there by the chill creeping into my bones and through every cell of my body.
"We'll take the amniotic fluid today to test," Dr. Wagner says briskly, standing. "And discuss . . . next steps once we have those results. It typically takes about ten days for NTDs, neural tube defects."
She's moving on, and I'm still dazed, shaken, shocked.
"Is the . . ." The word "fetus" stings the tip of my tongue. "Our baby, what is it?"
Dr. Wagner frowns, shaking her head.
"Until you decide how you want to move forward," she says, "I think knowing the gender will only make it more difficult."
"Let me get this straight." Grip tilts his head and runs his tongue over his teeth in that way that means he's nearing the end of his tether. "You give us a death sentence for our child-"