“This procedure is relatively straightforward and safe. Do you know what it involves?” the doctor asks Anna. He pauses for a moment; he takes her fixation on the mosaic of scuff marks on his shoes as an indication that she doesn’t know She has already told him that this is the first time she has set foot in a hospital since her foot saw the light of day, the joke met with an obligatory chuckle and smile from both. The doctor sits up in his chair, his eyes following the creases on his navy chinos.  Anna wonders how many days he has been wearing the same pair, imagining him stepping out of them into the bed in the evening, and back into them the following morning.

Anna slumps in the chair, the pain in her pelvis getting worse. There is a constant dullness to it, but occasionally it throws a strong punch at her, the kind that brings you to hospital. She wonders if she has bled through her pad, and crosses her legs in the hope that it will stop the bleeding, or at least hide any more blood that has run onto her pants. Anna and her husband had been trying to have a kid for about five months. She didn’t even know she was pregnant until she saw the big clots. Then this pain. She slumps further as if it were an odometer of her pain, and her foot collides with the coffee table separating her and the doctor. The doctor feels the table move slightly and tucks his legs away.

He proceeds:

“It is a day procedure, meaning you’ll go home the same day.

 

++++It is performed in a sterile room with you under a local anaesthetic.

 

++++++++++It isn’t painful, but it might be a little bit uncomfortable.

 

++++++During the procedure, the doctor will give you some medication

 

Soften and dilate your cervix

++++++++++++Retained products of conception

 

+++++++++++Incomplete miscarriage

 

+++++++++++Suction

 

++++++Scrape

 

++++++Roughly twenty minutes.

 

++++++++++++You might

 

++++get some light bleeding for two to three days after.

 

++++++Risk

 

+++++++Tear

 

+++++++++Scar

 

+++++Infertile

 

++++++As I said, relatively straightforward and safe.”

 

His words stitch together, knitting no pattern, or at least none that Anna can recognize. She listens with her eyebrows, rising and falling with his words, pausing when he does. The yellows and greens of the paintings of the small interview room are washed by the sterility of the white walls that engulf them. She wonders how many nails have etched their anxious thoughts into the couch she rests her hands on. She clasps her hands in her lap, choosing to instead let her tongue roll thoughts onto the roof of her mouth.

He hands her a consent form, and rummaging around in his pocket, takes out a black Paper Mate pen for her. She notices that the line where she has to sign already has an X marked on it with a light blue Biro. She wonders how many pens are involved in her care other than the black Paper Mate on the other side of the coffee table.

 

“Thanks, doctor.”

 

Through his cheeks, Anna can see the doctor glide his tongue around the outsides of his teeth as if he is trying to drain the last drops of caffeine from them. He flicks the pages in his notebook back and forth. Anna notices that he isn’t even looking at the pages. Must be a habit.

“We have booked you in first thing tomorrow morning, at eight thirty. You just come back to the reception outside this room.”

“Okay.”

“Do you have any questions?” The doctor continues looking at his notebook, deciphering the maze pattern of notes that crawl around the page. Anna begins to form a thought with her lips and catches herself. The doctor looks up at her and gives a warm smile. Both their shoulders relax a fraction.

“Am I allowed to have a coffee, or is this one of those things you have to fast for?”

“You are definitely allowed to have coffee before. The coffee cart is normally open before I get here at seven thirty, so it will be open before you go in. But you should get coffee on the level that you entered on, at the very end of the corridor, near the green lifts. They’re the best. Well, my favorite.” The doctor begins talking with enthusiasm and eagerness, catching himself midsentence and finishing off the rest of his reply with haste as if apologizing for beginning it.

“That’s good to know. Thank you.”

“Any other questions?”

“How long after the procedure can I eat?” She continues with the culinary line of questioning, unsure how to ask what she really wants to know.

“After about an hour,” the doctor answers, lowering his voice and leaning forward slightly.

“Yeah, where can I get lunch afterwards?” she asks, and without pausing, continues, “Is this a thing that is going to keep happening to me? I mean, is this just a one-off or could it be a recurring thing now?”

“Anna, I am sure you know this, but this is not your fault. Although, we don’t talk about it often, twenty percent of pregnancies, planned or unplanned, will, unfortunately, terminate in a miscarriage. In over ninety percent of cases, there is no reason that can be identified and the future pregnancies that a woman has will go smoothly.”

“And what if I am in the other group?”

“If you are in the less than ten percent of women who have more than two or three miscarriages, there are some tests that we can do to uncover the cause. In majority of those cases, there is a cause that can be identified and treated.”

“Should I get tested for those things now, just in case?”

“Theoretically, you can. Unfortunately, it won’t be covered in the public system because, in the vast majority of cases, it doesn’t happen again. And we don’t want to put you through the stress of searching for something that is unlikely to be there. But if that is something you would to do, as some women understandably do, a private obstetrician can undertake some of those tests for you.”

Anna, having held her gaze at the doctor while they conversed, asks one last question:

“Will you be there?”

“I will make sure I am. I can give you a recommendation for where to get lunch then.”

Akhil Bansal is a medical student and aspiring writer living in Sydney, Australia. He is interested in narrative medicine, enriching our understanding of the interplay between medicine and the human condition. He has published numerous academic articles, and his fiction has been published in journals such as Overland and Ballant.

Header image by Marilyn Hallett Granzyk