Step 4: Happy families are all alike

I've been putting off writing this for a while now, but I think it would be dishonest for me to discuss my family's adoption journey without a candid discussion of the feelings behind the events that put us on this path. A preface here: emotions have always been difficult for me. On an intellectual level, I can discuss complex emotions and relate episodes from my past that are quite upsetting. However, it has always been difficult for me to just feel the feelings. I tend to revert to medical student mode and present the case, leaving the emotion out of the story altogether or else naming the emotion without giving it any power.

For instance:

A 30 year old married woman, Gravida 1 and Para 1, with a ten year history of endometriosis, had a complicated pregnancy and delivery of her biological child. She had progressive pelvic pain and dysmenorrhea despite multiple pharmacologic interventions. On the recommendation of her gynecologist, she underwent an elective laparoscopic-assisted hysterectomy and bilateral salpingo-oophorectomy to alleviate pelvic pain. Relief of physical pain was nearly immediate, but her post-operative course and recovery were complicated by a struggle to accept the reality of infertility.

All of that is true. The pain was terrible, and I felt better the day after the hysterectomy than I did the day before the hysterectomy. In fact, I took only two days off of work after the operation. It was easy for me to do, since I physically felt so much better.

And, of course, I was aware that a hysterectomy would be a permanent form of sterilization. I knew that I would have to take hormones to replace something that my body had produced naturally before the hysterectomy. I knew that I would never menstruate again (yeah!) and that I would never be pregnant again (um, yeah?!). I thought that I had weighed all the risks and benefits before having the procedure. Angry Driver and I talked extensively about the options beforehand, and his input was basically along the lines of "I would love to have one more, but I want you to feel better and we can always adopt".

I knew the consequences of the decision. I knew. I really did. However, that meant nothing in the weeks and months following my hysterectomy.

I started out happy enough. "No, really. I'm ok" became my mantra.
"It's fine. I'm lucky to have one child".
"I'll never have to buy tampons again!"
"There were no guarantees I would get pregnant again anyway".
"We are happy with one child, but we have always talked about adopting, so we can adopt if we want more children down the road".

Once I grew used to feeling physically so much better, I think the magnitude of the consequences of my decision started to become more apparent.  First, I resented my gynecologist. Looking back, it felt like I had been put in a no-win situation. I could continue to have terrible pain in the hopes of possibly having another biological child at some point, or I could remove all of my internal female organs and have pain relief. He hadn't wanted to prescribe pain medications. I had asked him to remove my IUD, but he told me it wouldn't help the pain. I asked about laparoscopic treatment for the endometriosis (I'd had the procedure years before with some improvement in pain) and he said that what I needed was a hysterectomy. When a two year old boy stands at your bedside day after day and says in his sad little voice, "Mommy hurt?", you feel like you are being herded down a chute with only one opening. I felt like my only option to be able to continue working, be a mother, and be a wife was the hysterectomy. So I had the hysterectomy. And, boy, did I resent it.

My seething anger toward the gynecologist gradually spread outward. It didn't really help that we had moved back to my hometown and it seemed like everyone I had ever known was pregnant. I kept telling myself that my pregnancy had been miserable, that I didn't even want to be pregnant, that I had no guarantee that I would have even been able to become pregnant, deliver a healthy baby, etc. There are no guarantees in life. The past is the past. It's done. Move on. I told myself these things, but I didn't believe them. Everywhere I turned, friends were pregnant. Colleagues were pregnant. People on Facebook were pregnant. I eventually concluded that Facebook is only for two types of people: happy people, and people who desperately want everyone to think that they are happy.

I was not happy. Of course, I couldn't lash out at Facebook friends or high school/college/residency friends. And, really, I wasn't mad at those people anyway. I was just pissed off in general. I don't know that I ever regretted having the hysterectomy, but I do think I regretted not insisting on having the IUD removed, insisting on a second opinion, insisting on an alternative procedure before doing something so irrevocable.

Since the deed was done and I couldn't really be productively angry at my friends or my gynecologist, I subconsciously directed my hostility and resentment to the one person who I knew wouldn't reject me: Angry Driver.

I'm not proud of this, but I found myself saying things like, "Well, you can always have more children if you want".

When that didn't get a rise out of him, I threw another, more powerful grenade: "If I die, you can get remarried and have ten more children. What about me? What do I have?"

Angry Driver refused to play into this, but I kept up the assault. It didn't help that my own parents married and divorced several times when I was a child, and I really did worry on some level that our marriage would fall apart and I would have to watch my husband cultivate a new family with someone else while I would never be able to have another biological child. No matter what I said, though, Angry Driver never did take the bait. He did nothing but reassure me or, if I was particularly vitriolic, ignore me.

Eventually, the resentment and hostility flamed out. Pseudo-acceptance was gradually replaced by a real acceptance that I had made the decision to have the hysterectomy, and it was up to me to live with the consequences - both good and bad. In my work as a physician, I frequently find myself counseling patients and families about treatment options. I tell them that all they can do is make the best decision possible with the information available to them at the time. Whatever decision they make is the right decision, since it is right for them and their family.

Those are easy words for a physician to say, but they are hard words for a person to live. Regret is the whisper that came when I saw pictures of an exhausted family holding a squalling newborn, or when I saw grinning siblings who were the spitting image of each other... and their parents. "What if?" was the voice that nudged me when I imagined a petite blond-haired, green eyed daughter who loves to read like I do and who inherited a passion for philosophy and cinema from Angry Driver. That little girl won't exist. She won't ever exist. And that made me so sad. At times, it still does make me sad.

Adoption could never happen for me while I was feeding that little festering monster of resentment and regret. Eventually, though, I stopped feeding it.

I knew that adoption was right for me when I found myself thinking about a child who looked nothing like me. In fact, I couldn't even picture the child well enough to know if it was a boy or girl. I imagined a child living without parents, without a solid foundation of love and support. I imagined that child jumping on the trampoline with Bean, snuggling in to watch Harry Potter (again!) with Angry Driver, and reading The Poky Little Puppy with me before bed. "I regret..." evolved into "What if?", and "What if?" became "Let's try".

When I started the discussion with Angry Driver, he embraced the idea, leaving me no doubt that he would love our adopted child just as much as Bean. I realized (I finally realized!) that he has dreams for his family too, and he had to come to terms with the consequences of the hysterectomy just as I did. I will forever be grateful that he was there for me when I needed someone to absorb my emotion. He was probably going through so much, but he lovingly carried my burden with his own. He loves me and he will love me. I am not an incubator for a baby; I am his wife and the mother of his child. When we adopt, I will be the mother of his children. As our discussions continued, we agreed that we both want a daughter. And we are lucky enough to be able to pick our child's gender this time!

Bean's first concern, of course, was that he would lose his playroom. When we assured him that the playroom would not be his sister's bedroom (but they would have to share his playroom), he was surprisingly amiable. I witnessed my son's own transformation as the process progressed. Initially, he said, "Will I marry my sister when we grow up?" Later, he said, "I won't go to China if it means getting shots". Lately, he chatters on and on about "When we get my sister..."

I think maybe Tolstoy got it wrong when he said, "Happy families are all alike; every unhappy family is unhappy in its own way." It is rare that life can be condensed to black and white, good and bad, all or nothing. There are certainly dichotomies, but black and white eventually bleeds into shades of gray.

All happy families are unhappy at times. Happy families are those that carry each other through those unhappy times.

Mine is a happy family...and it is growing.