Chapter 1: First Appointment
I let my husband do most of the talking. It was his idea, after all. Talk of artificial insemination scares me. From the start, I was against it. Some couples are meant not to have children -- That's my philosophy. If God didn't mean two people to bear children, then maybe they shouldn't. Too many people populate the world already, more than our natural resources can support. Why do you think we have global warming? What about the energy crisis, food shortages, pollution? The cause of all these problems is, fundamentally, more people than what our natural resources can support.
Plus, I also admit, I'm not particularly fond of the idea of having to go through a medical procedure. Doctors have always made me nervous. Just the thought of visiting the family physician makes my pulse race and my blood pressure rise. All those white lab coats, stainless steel instruments, the smell of antiseptic in the air; the combination of it all gives me the willies. And then there's the medical procedure itself, which frightens me even more, especially when it will involve at least two procedures: First to harvest my eggs and then another to have them inserted back into me -- and that's only if it works the first time. What if it doesn't? What if we have to try again and again? For all these reasons, I was against the idea of artificial insemination to have a baby, until now.
"What does your wife think?" The doctor asks from behind her desk.
Someone finally recognizes my presence. My husband can be a bit overbearing at times. He's done most of the talking so far. Not just in this doctor's office, but he sometimes does it around our friends too, answering for me, telling others what I think. He treats me like a child at times, so I am thankful when she turns to get my opinion.
The doctor is not what I expected. First of all, she is a woman. My husband is not the type to go to a female doctor. In fact, I'm surprised he didn't turn around and walk right back out of her office as soon as she introduced herself. Second, the doctor looks nothing like a doctor. Instead of a white lab coat -- or scrubs, as I guess they call it -- she dresses in professional business attire. A light blue blouse and slacks, very stylish, and with her hair bunched up on the top of her head to give her the look of a professional. I have a hard time picturing her in a hospital gown or operating room. She more resembles a schoolteacher, like as in a strict teacher not afraid to use the ruler.
Up until now, the conversation has been mostly between her and my husband. My only words were a weak "hi" and a "glad to meet you" when we first walked into her office. I felt too nervous and scared to say anything more. I still am.
"She's still thinking about it," My husband initially answers for me, like he so often does. "She doesn't like the idea of artificial insemination, and I don't think she is going to like this idea of natural insemination either. First she needs to think about it before making any decisions."
"Hold on!" I gently take his arm when I finally muster up courage enough to speak. He is a sweet man, my husband, but again acts overbearing. He was raised on a traditional Midwestern farm where the husband worked and the wife stayed in the kitchen. I guess that's part of the reason why he is so adamant to have children. He somehow feels incomplete without them.
"Hold on?" He looks back at me in surprise. He is not accustomed to me speaking my mind. "Katie, what are you saying?"
I take a deep breath to relax my nerves. "I'm not saying anything. I'm just saying we should hear her out. Her idea might have potential. At least it won't involve a doctor's office and a bunch of laboratory equipment."
A surprised look shows on his face. This was not the answer he expected. It was not the answer I expected to give either. The whole idea of natural insemination sounded crazy when I first heard it, that is, until I walked into Doctor Palin's office.
"Are you sure?" He finally asks.
"I'm just saying we should hear her out," I shyly admit. "I'd like to hear what she has to say."
"But do you understand what it would involve?" He asks with worry.
"It was your idea," I remind him under my breath so the stranger behind the desk can't hear. "If you're against it, then why did we bother to drive all the way downtown and take the afternoon off from work?"
The look of surprise on my husband's face turns to thoughtfulness. He doesn't answer, just looks at me with wonder.
"Would you like to continue?" Doctor Palin breaks the silence. She acts anxious, like she has a busy schedule, too busy to sit around listening to the two of us argue.
"Of course," My husband quickly gives in. "We don't need to make the final decision right now anyway."
"Of course you don't," Doctor Palin agrees. "In fact, I recommend you discuss and give it several days thought before making any decision. This is an important decision, and you both need to be comfortable with it."
My husband nods.
I follow his lead.
"Plus, there are a few blood tests you need to take before I can even consider you for the procedure," She addresses her next words to me. "We take great care here at the clinic to protect our patients from any sexually transmitted diseases or infections. You must therefore be tested for a large suite of potential conditions, such as herpes, syphilis, hepatitis..."
"I can assure you..." My husband interrupts.
"I'm sure you can," She interrupts right back at him. "Please, I don't mean to suggest you sleep around or your wife is a whore," She holds up her hand to stop him from interrupting any further. "It isn't just for your benefit, but for the benefit of all my other patients as well, and also the benefit of the eventual child. Many of the conditions can be terribly contagious and cause birth defects. They are also difficult to eradicate. I'm sure you can appreciate the fact all my other patients were also tested."
My husband wants to argue further, I can tell, but then I reach across to put my hand on his shoulder. I silently tell the man sitting next to me to drop it. The thought of me sleeping around like a common whore is laughable, and I would know if he was sleeping around.
"Now," Doctor Palin soon goes on. She opens a folder and takes out a pen. "First there are several questions I need to ask you. This isn't a procedure for just anyone. It won't automatically work for just anybody pulled off the street. There are certain contributing factors, prior medical conditions, family history, etcetera that make it more likely to work for some couples and fail for others. So to ascertain your own success, I need to first ask some questions."
I nod in response. We both do. This is the third doctor we have talked to about conceiving children, so I expect her to have questions. I even know what some of the questions will be, based on prior experience, or so I initially believe.
"Some of my questions may be a bit embarrassing," The doctor turns to my husband and warns. "But please remember I am a doctor, and the questions are important for me to help determine the root cause of the problem."
My husband nods again, looking very sure of himself, as if nothing could possibly embarrass him.
"About your size," Doctor Palin immediately goes right to the point. She speaks in a professional tone. "How long are you, when erect?"
I jump at this question.
So does my husband. He takes offense. "What's that got to do with anything?" He speaks louder than necessary.
"It has a great deal to do with everything," Doctor Palin stays unperturbed. She continues speaking in a level tone of voice as if accustomed to every man having the same reaction. "The longer the length, the deeper the penetration, and therefore the closer to the egg the sperm is deposited. I would have assumed your regular doctor already asked you this."
Size wasn't supposed to make a difference, I thought, or at least that's what I was always told. I don't remember our regular doctor ever asking the same question, or the specialists in reproductive medicine either. Or at least they never asked my husband in my presence, which now makes me wonder if they ever asked him in private. Her explanation does seem to make some logical sense when I think about it.
"Well, um," He is taken aback by her cool demeanor. "That is a bit personal, but if it's important."
"It is!" Doctor Palin assures him.
"Then I would say, maybe, a little less than five," He answers, embarrassed.
"How much less than five?" The Doctor now turns to me instead.
"More like four-and-a-half," I answer for him.
He scowls at me.
"Well, it's true!" I scowl back. "You could have answered yourself." I say it under my breath, so the doctor doesn't hear. The smile on her face, however, tells me she heard perfectly.
"That could help explain part of your problem," The smile disappears before my husband notices. "Perhaps this is simply a case were you are not of sufficient length to impregnate your wife? Normally it does not matter, but some women can be taken deeper than others."
My husband takes offense at her remark, I can tell, but he doesn't say anything. She insults his maleness, his ego, but does so with such professionalism he can't muster a fight against her. For a brief moment, I worry he might get up, storm out of the room, and leave because it is the only thing he can do.
Before he can do anything, however, the Doctor casually returns to her list of questions. "Now about your girth," She asks the next one. "Have you ever measured your circumference?"
Neither one of us says anything at first.
"When fully erect, of course," She quickly adds as if to make sure we understand.
"Well, um," My husband continues to hesitate. This time I know better than to answer for him, even after the doctor turns to me to question after he is not immediately forthcoming.
"I guess about four inches around," He answers more accurately to this question.
"Very interesting as well," Doctor Palin responds and writes it down. "A short length in combination with a small girth compounds the problem," She speaks while looking at her paper. "It may not seem obvious, but a wide girth helps. It stimulates the response within the female body, and the more intense the response, the higher the production rate of female estrogen, which further increases the probability of a successful pregnancy. This could explain why you have not been able to get pregnant, although it is in no means the only explanation."
No doctor ever told us this before. Perhaps that's because all our other doctors were male. Or perhaps they talked to my husband about it in private. He might have been too embarrassed to tell me. I start to wonder, and then I quick try to remember to perhaps ask him about it later.
"And what about your stimulus?" The doctor interrupts my questioning thoughts to ask of me. "How often do you experience orgasm when the two of you have sex?"
It takes me a moment to realize she addresses the question to me. "Well, um," It is now my turn to feel embarrassed. "Actually, I don't normally." Actually, I never do, hardly ever, but I'm not brave enough to say this with my husband sitting right beside me.
"Another point of interest!" Doctor Palin responds again. It seems to be her common response to every question. "And what about frequency? How often do the two of you have sex?"
At least this question is familiar. Our regular doctor and the reproductive specialists asked the same thing.
"Three times per week since we've been trying to have children," My husband answers this question with more confidence. "We've been told to attempt it more often, but both of us have full time jobs and are tired during the week. We're in a hurry to get to sleep most of the time."
Actually, he's the one who always wants to go to sleep. He gets home, watches television, eats dinner, and then usually falls asleep on the couch while watching some more television. By the time we get to bed, he's not much in the mood. I consider pointing this out to the Doctor, but hold back, hoping I may later get to talk to her in private.
"I hear that from a lot of couples," The Doctor plays along with his excuse. "I suppose it is one of the disadvantages of today's modern lifestyle."
My Husband likes this. It reinforces his argument. Ever since we first got married, he's been pressuring me to quit my job and stay home. Since we started having trouble conceiving children, the pressure has only increased. In fact, he believes the primary reason for our failure is the stress and physical exertion of my job, but I never believed the job of a waitress was particularly stressful.
"And how long does it usually last?" She turns back to me. "I mean from the time of initial penetration to final ejaculation, how long does your husband usually last?"
The words she uses give me a thrill; words like "penetration" and "ejaculation." They shouldn't thrill me, I know, not in a doctor's office. She uses the terms in a clinical sense, but still I can't help it.
"Ten, maybe fifteen minutes," My husband answers for me.
Doctor Palin ignores him. Her eyes stay focused on me, as if waiting for a response, wanting only my estimate.
"I guess that's about right," I know he exaggerates, but give in anyway. "It's not like I ever timed it using a stopwatch."
I let out a slight giggle as I say this. A picture forms in my mind: Me with a stopwatch and my husband on top. The picture makes me laugh. Doctor Palin smiles back and seems to think it funny too.
"A longer penetration time can also be of benefit," She smiles but does not allow any other emotion to show through. I suspect she knows the real answer to her question is something less. I hope I get a chance to talk to her afterwards, outside the presence of my husband, and set the record straight. If we really do want to be successful, then I think we need to be honest and give her accurate answers.
"And what about quantity?" She finally turns back to him. "After this quick ejaculation of yours, would you say you ejaculate a large quantity when you cum?"
Her choice of words surprises me. She adds another to thrill me. I've heard them all before, from our regular doctor, but they somehow sound more thrilling coming from a female. I especially like the way she indirectly hints, probably on purpose, that even ten or fifteen minutes is too quick in her book.
"I guess I do!" My husband answers, perturbed. "How should I know?"
Doctor Palin nods. "Fair enough," She agrees. "I'll check your medical records when they arrive. You should have already been tested for quantity."
I think about this and wonder how he was tested. There is only one way I can think to test it, but have a hard time imagining my husband submitting to such a test. If he ever did so, he never gave me any indication.
The doctor goes on to ask us less personnel, not so sexually-related questions. She asks about any prescription medications, past medical procedures, even any illegal drug use. My husband admits to once puffing up a marijuana cigarette and having a few beers over the weekend, but that's about it. All I ever drink is a glass of wine on special occasions. Neither of us ever had any major surgery, certainly nothing to prevent us from bearing children.
"No surgery at all?" She looks me in the eye and asks more pointedly, as if she thinks I might be telling a lie.
"None," I take offense at her silent accusation, but then recall. "Well, yes, there were my tonsils when I was a little girl."
"And nothing else?"
"Nothing at all," I assure her.
"Not even your breasts?"
I suddenly understand the reason for her disbelief. She thinks my breasts are artificial, enhanced in size, and I can understand why. They certainly are larger than the average.
"They're completely natural," My husband comes to my rescue before I get the chance.
"Just asking," The Doctor holds up her hands in a way of apologizing. "Your answers certainly make you potential candidates for the procedure," She closes up the file and the questionnaire inside. "We still need to run a few tests, yes, but I believe there is an excellent chance I can help."
"You really think so?" I ask with hope, surprised at the speed of her conclusion. I had expected a lot of tests, perhaps more questions too, but then her questions did dive right to the point.
"We still need to run a few tests," She repeats her disclaimer as if to make sure I fully understand and don't jump to any conclusions too soon. "But I think your problem may be as simple as inadequate size during penetration."
"Wait a minute!" My husband doesn't like this. He starts to get up out of his chair in opposition. Doctor Palin holds out the palm of her hand in an invitation for him to stop and sit back down.
"Please, it's very common," She casually explains. "I know all you men like to think you are big down there. It's a sign of masculinity, you believe, but it's impossible for every male to be oversized. There's something called the law of averages. Some men are longer, and some men are smaller. It's no different than the breasts on a woman.
The doctor uses my breasts as an example. "Take your wife, for example," She makes a point of looking at them from across her desk. "Bras are purposely made in a large variety of cup sizes. We have a whole lettering system to categorize them. Your wife is probably, what, a D cup?" She asks of me.
"Double-D," I quickly correct.
"So that would put you in upwards of the 98th percentile," She translates into more scientific terms. "Which means your breasts are larger than about 98 percent of the population. They are certainly a lot larger than my own," She glances down at her own chest as if to point this out. "But this does not make me feel inadequate as a woman. I am no less female than what you are," She looks at me and then turns to my husband. "Just as you are no less male than any other man."
He does a comparison too, I notice, my husband, taking a quick glance at me and then a much closer look at the Doctor. It is something he can relate to, I suppose, something any guy can understand. He knows all about my heavy double Ds, but must take a close look at what the Doctor may have hidden behind her business attire. I figure he tries to picture what she might look like in the bare.
"Plus, some women simply need to be penetrated more deeply than others," Doctor Palin breaks his stare when she goes on. "That's just the way they are physically built inside. Just as some men grow longer on the outside, so do the hormones in the developing fetus cause some women to develop deeper on the inside. It's not as noticeable on a woman because it occurs inside, to her internal plumbing, but it happens."
Her explanation seems to have some merit. "Could they cause a large chest size too?" I think to ask. "I mean these hormones that cause a woman to be deeper inside, could they also cause larger breasts? Could my large breast be a sign that I'm also deep on the inside?"
Doctor Palin brings her hand up to her chin and thinks about this. "Interesting theory! You certainly do have some heavy breasts," She looks right at them. "But I'm afraid there's been no proven medical correlation between the two. Still, interesting theory!"
She continues to think about it.
"So this could be the source of the problem," My husband nudges her back to the situation at hand.
"Possible," Her hand lowers. "You take an under-average male combined with an over-average female, and pregnancy becomes nearly impossible."
I like the sound of this. This Doctor may have something. I turn more relaxed and for the first time feel she actually may be able to help. What she says next makes me feel even better.