Ava, p.10
Ava, page 10
“You had more than you could handle. I didn’t want to add to that.”
Yes, my friend knows me, Larkin thought.
Aubrey hadn’t had medical insurance in college. Her parents had felt she was young and healthy and didn’t need it. Fortunately, during college, she never needed to go to the doctor. She bought a health insurance plan when she started medical school and made her first appointment with a health care provider since she’d had her IUD placed in high school.
Aubrey told Larkin that during her first year of medical school, she’d started having frequent vaginal bleeding, which she’d never had before. She also had pain during intercourse. During her pelvic exam, the gynecologist collected a cell sample from her cervix for a Pap smear. He called a few days later to let her know that she had cervical cancer, and it had been caused by one of the most aggressive strains of the human papillomavirus. The doctor said it had been decades since he’d seen a case of cervical cancer in a patient so young—not since the HPV vaccine had been introduced.
The cancer had already spread from Aubrey’s cervix to her uterus, making it necessary to have a total hysterectomy. Her ovaries were spared.
“I have homeless eggs now. Just tiny ovarian nomads wandering around my abdomen once a month with no place to go until they die and get reabsorbed in my abdominal cavity. On the plus side, I’ll never have a period again. So, yay?” She shrugged.
“I’m so sorry, Aubrey.”
“The irony of it all is that my mom didn’t want me to get the HPV vaccine because she was convinced it would make me sterile. Joke’s on her, right?”
“I remember. That’s awful. Have your parents been helpful to you through all this?”
“We aren’t speaking. My mom got furious with me for starting chemotherapy. She wanted me to take a holistic approach, and my dad supports her. She said I was poisoning my body, and I agreed—chemo is a toxic treatment. But it’s likely going to cure me. My oncologist is optimistic. So, I told them I was taking my doctor’s advice, and I was trusting the peer-reviewed research I had read, and they think I’m being naive. They told me not to call them until I came to my senses.”
“Jesus. Do they even understand that if you had gotten the HPV shot, this could have been avoided?”
“Sadly, they don’t have that kind of insight. But my brother has been amazing. He’s taken me to a lot of my appointments. Lance stayed with me after my surgery. He’s turned out not to be a total ass after all.”
“It’s great that you have him. And I’m so, so happy your oncologist is optimistic.”
“Thank you. I can beat this. It was hard coming to terms with saying adios to my uterus, but if I’m cured, it’s great.”
“Well, it’s not always a wonderful experience being pregnant.”
“Yes, I thought of you a lot through all this. I still want to be an ob-gyn even though I’ll never carry a baby myself. And I’ve decided to specialize in reproductive endocrinology and infertility. I want to help women who are struggling to get pregnant. Thank goodness there are some conservative senators that had children through IVF, so they haven’t put any restrictions on it yet. I guess when it affects them personally, the rules are different.”
“What would you have done if you were Dr. Beyer? If you had a patient carrying a baby like Maeve?”
“Unfortunately, the same thing. There isn’t anything I could have done, as much as I would have liked to help. I’ll keep voting, writing legislators, and going to protests. I’ll keep trying and hoping a better alternative comes along. In the meantime, how are you taking care of yourself?”
“Well, there’s the Zoloft. I’m on the max dose. And Spencer and our families have been great. My coworkers have been wonderful. It’s just going to take a lot of time. I’ll keep myself distracted with work. I probably need to find a hobby. I just need to keep my mind busy.”
She told Aubrey about attending the bereavement group the night before and said that faith-based therapy wasn’t for her. Zoloft kept her from sinking deeper into the dark depths of her mind, but she still worried she could be completely consumed by her sadness if she didn’t do something else. She just didn’t know what that would be besides finding a good therapist.
After she and Aubrey talked for a few more hours, they hugged each other tightly and said goodbye. Aubrey promised that if Larkin ever needed anything, she would do whatever she could.
“Be careful what you promise—you never know what I might need.” Larkin smiled. “And tell Lance thank you for taking care of you.”
CHAPTER 19
Larkin stayed at her parents’ house for a few more days until she felt ready to go back home. She spent that time sleeping, crying with her parents, and eating the assortment of comfort foods her mom made. Her mother tried her best to fill the void in her daughter’s belly and her heart with chicken and dumplings, loaded potato soup, and endless peach cobbler with vanilla ice cream. When Larkin left, her mom packed plastic containers of food to take home to Spencer.
When she arrived home after a three-hour drive, Larkin kicked off her shoes and set her suitcase by the front door. It was quiet in the house. The fresh-cut sympathy flowers that had filled the den were now gone, surely long since wilted and dry. Two peace lilies flanked the fireplace, and the small silver box containing all that was left of Maeve rested in the same spot on the mantel.
When Larkin heard her husband’s voice in the backyard, she walked through the house and onto the screened-in porch. She saw him in the yard, bent over as he looked into an open box that sat in the grass.
“Okay,” he said, speaking to the box. “Not too much longer and you guys—chicks!—will be out of this place and into your new home.”
Behind Spencer was a wooden structure that was about a foot off the ground and had a sloped roof. There were two small windows in front, outlined in white. A red painted door with a latch closure was between them, and a ramp went up the side to an area with a rectangular opening.
Larkin called out to him. “Hi! You’ve been busy while I was gone!”
Spencer excitedly jogged over to her as she stepped out of the porch and into the yard, warm spring grass under her bare feet. He grabbed her around her waist and kissed her slowly and gently. Then he looked at her with an exuberant smile. “I have been busy! I want you to meet the girls.” Spencer took Larkin by the hand and led her over to the cardboard box where four small, fluffy chicks rested on a bed of paper towels with seeds scattered about. “This is Layla, Roxanne, Brandy, and Angie.” He pointed to each chick individually and with certainty.
“How can you tell who’s who?”
“I really have no idea yet. That’s for you to figure out.” He laughed.
She recognized the names from 1970s songs they both loved, and it reminded her of the day she and Spencer had met and talked for hours at the library instead of studying. He remembered that she’d told him she wanted to raise chickens someday. She asked Spencer when he had planned this, and she learned that he and his dad had searched the internet for information on how to build a chicken coop while she was visiting her parents. They’d built most of it while she was gone. He still needed to put up the bale of chicken wire that was laid by the coop.
“So, what do you think?” Spencer asked, his arms spread wide.
Larkin scooped up one of the chicks and held it to her cheek. “I think I love Brandy the most. Or maybe this is Layla?” She held the chick in her hands and stared at its face intently as it peeped. “Or maybe you are Roxanne?” she mused. Then her tone grew serious. “I love all of this, Spencer. I need this. Thank you.”
“Great! They’ll need a lot of love, and we have plenty of that! And in return, we’ll have even more fresh eggs than what you already bring home from work. These chicks are Silkies. They’re supposed to be very docile. They don’t lay as many eggs as other breeds, but I also chose them in part because of their cuteness factor.”
Larkin sat on the grass next to the box. The chicks were more active now, scratching and pecking at the seeds. As she stroked their backs, their feathers were silky to the touch, just like their breed implied, and they didn’t mind being handled. Larkin could tell them apart by their distinguishing features, so she was able to decide who was who. Brandy was the chick with the most golden-brown feathers, Angie was the one with the whitest feathers, Roxanne was the one with the hint of red on top of her head, and Layla was the one who was the most aloof. Larkin patted Layla and murmured, “I hope you can ease my mind of worry. That’s what you’re supposed to do, right?” as the chick gently pecked at the ring on her finger.
As she played with the chicks, Spencer started installing the chicken wire fencing for the chicken run. Later, he would also install hardier fencing to keep out the foxes and coyotes he’d seen hunting in the fallow farmland behind their property. As he worked, she told him about her time with her parents and Aubrey, and Aubrey’s diagnosis. She didn’t mention the bereavement group.
Spencer told her to invite Aubrey over this summer. He would be completing the first year of his master’s program soon, and he would be free for a couple of months. He planned to spend that time doing freelance accounting work for small companies that needed help with processing expense reports.
“You don’t need to work, Spencer. I’ll be back at work Monday, and I had enough sick and bereavement time to cover the days I missed.”
“Nope. I want to work,” he replied as he continued to busy himself with the fencing and tried to distract himself from a recent conversation that began to resurface in his mind.
While Larkin was gone, Spencer had gotten a notification, via the hospital app on his phone, that the billing statement was ready. Technology had made billing quick, efficient, and ruthless. He looked at the itemized list for the hospital equipment, obstetrician, anesthesiologist, medications, neonatal care, private room, and so on and so on. The list seemed never-ending. When he scrolled down to the bottom, the estimated patient responsibility was $8,573. Insurance was expected to pay over $33,000.
He had called the hospital’s billing office to see if there was any way to lower the bill. When he spoke with the customer service representative, he asked, with a lump in his throat, if there was any sort of discount since their baby had died.
“I’m very sorry for your loss, sir, but the hospital incurs the same costs even if your baby dies. Usually more. We can’t offer you a discount for that.”
They were able to offer him a payment plan, but they expected it to be paid in full within twelve months. His parents had already given them a generous cash wedding gift last year, and he didn’t want to ask them for more. He planned to open a credit card to pay off part of it and work to pay the rest in cash. He was thankful Larkin hadn’t downloaded the app. He would never speak to her about the financial reality of having a dead baby.
He’d also received a statement from the crematorium: $599 for cremation, $150 for the silver memorial box, $25 for engraving. In total, they owed $9,347. He planned to work until he had covered all the expenses. If Larkin asked, he would tell her their insurance plan was taking care of it and leave it at that.
He remembered the sham couple who’d come into Jack Montgomery’s office asking for a life insurance policy for their pretend unborn baby. He realized how helpful that would have been now, but the definition of “life” was apparently one of convenience for those in power, and no one asked or cared for his input. And no one cared that his baby was now dead. It was just important to others that she was born, no matter what the mental or financial cost.
He was pounding a metal stake into the ground with such force that Roxanne hopped from Larkin’s hand and ran for safety, huddling with the other chicks.
“Are you alright, Spence?” Larkin looked at him with concern.
“What? Oh, yeah. The dirt was just a little harder in this spot, that’s all.” He stopped hammering and wiped sweat from his forehead with the back of his arm. “So, they are about three weeks old now. I’ll be making the girls larger brooding boxes in the next few weeks. When they’re six weeks old, they should be fully feathered and ready to move to the coop.”
“And when will they start laying eggs?”
“About eighteen weeks, when they hit chicken puberty and become hens. Ha! Right now, they’re pullets, young chicks that can’t lay eggs. They won’t lay as often as other breeds, but we should get at least a dozen or more a week. I’ll put a few golf balls in their nesting boxes to get them used to the idea.”
“Really? Golf balls? Was that your idea?”
“Nope. I’ve been reading about raising hens and getting tips. It’s so interesting. I was also reading about how they’ll lay fewer eggs in the winter.”
“Because of the colder temperatures?”
“Because of less sunlight. The more sunlight there is, the more they lay.”
Larkin started searching on her phone to read more about the egg-laying process: Chickens are the most fertile when they have sixteen hours of sunlight a day. When ultraviolet rays from the red spectrum pass through their eyes, it stimulates the pineal gland and triggers hormones to be released into the bloodstream, stimulating egg production.
“So, it looks like we could use artificial light to have them lay eggs when it gets darker, but I’d rather they just lay naturally. I want to give them a good life.”
“Agreed,” Spencer replied.
“I just want the chickens to be happy.”
“That’s what I want for you, Larkin.”
PART II
CHAPTER 20
The estimated national maternal mortality rate in the United States is 23.8 per 100,000 live births—but it is about 55.3 per 100,000 live births for Black women.
—Centers for Disease Control and Prevention
November 1, 1988
“James, James . . . James! Wake up. I can’t breathe.” Gabby shook her husband’s shoulder frantically. It was two in the morning, and the new father was groggy after being awoken from a deep sleep, something that had been elusive since bringing their son home from the hospital three weeks earlier.
“What’s wrong?” James Davis Sr. said. “Is it the baby?” He stood in a panic and checked the bassinet where their newborn was sleeping peacefully, having just nursed an hour before.
“No, no, no. It’s me,” Gabby said. “I can’t catch my breath. I don’t know what it is. I need to go to the hospital. Please take me now.”
He quickly put on his pants and shoes, gathered up James Jr., and stuffed a bag with diapers and wipes. His wife hadn’t complained during her entire pregnancy despite vomiting almost every day and waking up almost every night with cramps in her feet. She’d been in so much pain that she’d quietly walked around the bedroom, trying to get some relief. She’d had a natural delivery and been fearless and stoic throughout. For her to be scared now—that scared him.
He took the baby and bag to the garage, strapped James Jr. into his car seat, and pulled the car up in front of their Memphis home. Then he ran back inside to help his wife of three years out the front door and down the brick stairs before helping her get into the car. She was still wearing her nightgown and had put on her robe and slippers. She was always immaculately dressed for her job as an English professor, but he knew her clothing choices mattered little to her now. She just wanted help.
The hospital was about ten minutes away. James desperately wanted to speed, but the fear of getting pulled over overruled his instinct. He didn’t think a police officer would believe him when he explained why he was speeding—he figured an officer would only see a Black man breaking the law.
“How are you doing, Gabby?” he asked as he drove down the empty streets going just a few miles an hour over the speed limit, passing only an occasional service truck.
“Same,” she said breathlessly. “Something just doesn’t feel right. Please hurry.” She tried to slowly inhale the cold night air coming in through the car’s open window.
When they arrived at the emergency room, James pulled up to the double doors by the entrance and ran inside for help. A nurse brought a wheelchair to the car and assisted Gabby inside while James parked the car and got the baby.
When he walked into the emergency room holding his newborn son, who was still sleeping contentedly, the receptionist told him to go to bed fourteen. She buzzed him through the automatic doors leading from the waiting room to the seemingly endless exam bays, which were separated by curtains. As he made his way down the hallway, nurses and doctors hurried past him saying things like “GSW in Trauma one’s pressure is dropping” and “MVA in two is stable and ready for Neurosurgery to take him upstairs” and “Going to need a chest tube in one!”
When he arrived at Gabby’s bed, he heard a voice at the nurse’s station say, “New arrival in bay six is here for shortness of breath. Pulse ox ninety-five on one liter, tachycardic at one-thirty. She’s three weeks postpartum.”
James pulled back the curtain, revealing the area where Gabby was lying. She had plastic tubing in her nose and was sitting up in the exam bed, resting. When James came in, her eyes fluttered open.
“Sorry to worry you, baby,” she said softly.
“It’s fine, but please don’t do it again,” he said as he kissed her hand.
“How is Junior?”
James held the baby close to her so she could rub his cheeks. “Nonplussed like his mother,” he said.
“Mmm-hmm. ‘Nonplussed.’ Do you mean it as in the traditional definition of being ‘surprised and confused and unsure how to react’?” she said between short, quick breaths. “Or the informal, modern North American definition being ‘unperturbed’?”
“Whatever you think, professor. I am just a humble mathematics teacher.”
James was happy he’d been able to briefly distract her. He rocked the baby in his arms and paced, wondering when she would be seen by the doctor.
