Ghosts in the Womb

The first thing we see is a shadowy approximation of a womb. It’s a man, or a man-shaped fetus inside the womb. The staged uterus stretches like a red hollow drum. He beats at the fragile, translucent skin. It resists his fists and feet, but eventually it splits open along its thin-seamed lines and he bursts out, gasping. He lolls on the dusty floor.

I put my fists on my stomach. I’m watching a staging of Frankenstein taped for the camera. I have never been so hungry in my life. This is the kind of hunger that there’s no feeding: for sex, Communion wafers, for thirsty love. This is what it’s like to have a child, and then the Creature gets up. He’s the Creature now, all stitched and angry-welted together, and when he opens his mouth he howls, long and guttural. No, I think. This is what it’s like to have something alive inside of you.

In 1544, Mary Tudor, Bloody Mary, stops menstruating. Her doctors read the sheets like star charts, looking for dots of blood to chart her pregnancy. The royal surgeon finds only a little spotting, but Mary’s belly begins to swell. Her handmaidens wash linens, boil waters, and tug out the stitches that hold her dresses together to make room for the child.

She gets down on her knees to pray for a boy, and spends long hours fingering the rosary until the motion is engrained in each tendon, each flexor to the dorsum of the fingers. Her doctors measure her in strings and ribbons. Philip of Spain, counting back days and weeks, thinks she cannot be pregnant, she cannot, but the story goes far and wide. Mary Tudor splays her satisfied palms on her stomach. The boy stirs in her womb. See here, she begs anyone who is nearby. She even summons her house-arrested sister, Princess Elizabeth, from confinement to witness the birth. See, here, my belly. Trace your fingers down my linea nigra. Feel my boy.

Nine months later, a rumor spreads that the Queen has given birth. Untrue, but some villages raise huzzahs and mugs of ale, lift banners in honor of their imaginary prince. The court begins to whisper. Philip counts time again over his rosary, thinking, praying: there can be no child. Finally, another month later, her belly deflates and her breasts dry of their salty-sweet milk.

Where is God’s favor for you now? ask her enemies. A pseudocyesis, her doctors finally declare, a phantom pregnancy. A little ghost flickering inside her womb. Mary thinks of Mary, Virgin and Mother of God, who carried the Prince of Peace across travels. Why has God done this to her? She eats and eats: quinces, orange peel, ambergris, cloves, musk, rosewater. Fill her up again.

A few years later, she conceives again. This child is less imaginary. But he’s not what she wants, either. Instead, she grows a swollen, pinkish lump that’s bruised and yellowing. His head is clotted with dark blood and swirling tissue. He contains thick globular fat and an extra tooth, which is the only human thing about him. Mary, Mother Tudor, never delivers. This child dies alongside her.

Centuries and four children later, my mother, another Mary, thinks she may be pregnant again. If we have a girl, she says, reaching for her cup of coffee that sits precariously next to the gear shift, we’ll name her Hannah.

Hannah is a name that my parents have been saving for as long as I can remember. I try to imagine her as a colicky baby. Hannah. I like her already. She seems more convenient and prettier than my real younger sister. But there’s no Hannah for my mother, of course. Not a phantom pregnancy, just an early menopause.

Years later, my mother embarks on a crusade to finally lose the baby weight she had put on with her four children. She eats whole grains and takes up Zumba, which, as far as I can tell, is a way for middle-aged white women to touch the exotic. She loses 25 pounds, but then a belly appears. She touches this new weight and drape of her skin.

It’s really strange, she says to her sister on the telephone. I look almost pregnant.

Cancers, like voracious infants, grow quickly. Their hungry little hands cover whatever they can. Some cancers can even look like a child. Women gain a little pregnant belly, uncertain of how to stage or name it. Their uterus may grow enough to fit a twenty week fetus. At twenty weeks, a fetus weighs ten and a half ounces. She is sexed, and she begins to produce her own waste inside of her intestines.

At twenty weeks of cancer, who’s to say? Some of them can linger for years before they’re discovered.

Ovarian cancer is the cruelest trickster of them all, and will sometimes register positive on a pregnancy test. Its blastocytes are sticky and round, and cling to each other before they emerge out of the ovary and migrate to the womb or lungs. Susan Sontag wrote that we imagine cancer as a result of a terrifying emptiness, a barrenness, but the truth is that cancer contains nothing but abundance. These are cells that simply work too well. They are smarter, faster, and better than the obedient, tired cells of the body that know their place.

Cancer cells are those violent twins that forever double themselves. An exponential explosion, and their borders slip away from other cells, twisting and buckling to form their own peculiar edges and abnormalities.  A double Reed-Sternberg cell, a cancerous cell in Hodgkin’s Lymphoma, caught and stained with blooming violet dye, looks to the untrained eye like a zygote.

Like Mary Tudor, women and their doctors discover that tumor-pregnancies share most of the same symptoms with a normal one. Pelvic discomfort, or what women know more instinctively as the low deep twinge inside the belly, lower back pain, a persistent and nagging fatigue, even the need to urinate more frequently: are all experienced. The only thing missing are three things: a fetal heartbeat, the appearance on the ultrasound, and a child.

A tumor can interrupt blood and bile flow, or cause parts of the body to change color or begin to operate differently. A child, of course, can have the same effect. Women can lose function of their bodies after pregnancy. Bladder control weakens, the ability to walk is interrupted, and even blindness might occur. Their bodies disobey. Freckles, scars, and moles turn suddenly withering black. Skin can yellow or redden, the whites of the eyes suddenly struck a pale, unfriendly gold. Hair grows, lush with hormones, or it shatters, the nutrients drawn elsewhere.

Is there no way of knowing?

Dogs, with their keen attention to metabolic waste, can smell both child and cancer.  Before we smell the sickly sweetness of a body overrun with sugar, or the wet hay and semen of a birth, dogs nod, knowing by the earliest air. Before the age of ultrasounds and PET scans that clocked cells by their degrees of abnormality, a spaniel could read his mistress’s change first. He curled up protectively against her belly, then howled when someone came to take him away.

Our basset hound says nothing, but she has been distracted with her own grief, the death of her companion Labrador a year before.

Do you see this? my mother fusses, pointing at the strange, lumpy skin of her abdomen while she waits for her oncologist. She pulls my hand over to feel it. It rises, soft and mutable as dough. Do you think this is the lymphoma?

A little girl’s name, soft and sweet and strange. Not Hannah, this time, but Lymphoma.
It turns out that fetal and cancer cells don’t only share that same wild reproduction, but their very coding, their expressions (why is it that the words we use to describe cellular actions are so very human?) are shared.

Microchimerism is what it’s called. When I grew as a fetus, kicking inside my mother, cells slipped out of me through the long line in her placenta, that fat bloody organ that nourished me and was consequently discarded after birth.

Being myself, the subaltern in my mother’s system, I remind her immune system to continue working. Just enough— I am just different enough— to urge her. Pay attention. Look for intruders. My cells tug at her skirts. Be alert. Look, look. Watch out for the strange men that linger, for the women with tired eyes, and the hungry boy with the empty fists. My cells, I imagine, are suspicious enough to thrive inside of her. In person I am dreamy, frequently not noticing what goes on around me. My mother pulls me back: don’t walk. Walk.

Or, of course, my fetal cells could have caused all of this. Pregnancy acts as a mild immunosuppressive that tells the mother’s body to protect the “foreign” fetus. After birth, the walls spring back up, but it’s sometimes too late. Women who have had melanomas previously will have higher rates or recurrence or metastasis during or immediately after pregnancy.

My mother, too, links pregnancy and cancer, as if by instinct. What does she suspect? She is six out of nine cycles done of the chemo. I can slip their names on a chain: rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone.

It’s like labor, my mother muses after one late-night discussion of chemo. She has all the wearisome symptoms. Sores and the metallic taste, the fatigue and the hair loss, but can you really hate it when it ends with the love of your life in your arms? She smiles at me, then. In the lounge (I always think the lab, but it’s really nothing more than a circle of armchairs and IV poles), she barely looks at me.

On our shared birthday party (we were born three days and twenty-seven years apart), each of us bakes a cake as a surprise for the other. Hers are dry, box-made chocolate cupcakes with little paper ballerinas that spin on top. I bring a double-layer chocolate cake, home baked. In a better story, I would make my mother well with this offering. The icing roses are lumpy and thick-petaled, and Happy Birthday! Mom! reads like a badly translated letter.

She puts her arm around me and tells me how, on her birthday, she was miserably pregnant. Two weeks in labor, she says, or at least that’s what it felt like. She tells me, laughing, of back labor. The pain is now a tender, funny memory.

I learn to make stories out of the string of test results. White Blood Cells, 3.83. Still in the Normal Zone. After every cycle, she receives another injection that tells her body to fight. It massages her shoulders and urges her back into the ring. Three cycles left. Can she bear it? It sounds like so little. Just nine weeks. Just over two months. That’s not so long, is it?

In the meantime, I am five months gone without a period. Could I be pregnant? my new doctor asks, not correctly reading bisexual and partnered on my chart. I laugh, and she stares me down over the clipboard. Using nothing for protection? Nothing at all. Eventually, when she puts my fumbled explanation together, she sighs and nods. Must just be stress, she says. Don’t worry about it.

What I do learn is this: there are two ways for cancer to die, apoptosis and autophagy. The first means that the cells essentially commit suicide. A self-abortion, if you will. Proteins destroy what’s needed for survival, stripping the cancer cell just as it has done to the body of the host. Macrophages clean away the shrunken cells, scrubbing away all trace of its presence. Nothing is left—no bright glowing lines on the PET scan, nothing at all to show that it was there.

Autophagy is when the cells devour each other. Like fetal competition, where a twin may be reabsorbed by the mother’s body, these cells may leave the faintest trace of their remains. If there was any system of justice among this cancer, it could hold itself accountable.

Chemo, my mother writes on her blog, which normally filled with bright, chattering updates about her own condition, is the opposite of being pregnant. Your body is not your own, doing strange and miraculous deeds—only the cells are being destroyed instead of created. The un-pregnancy whose birthing results in the return of my body to myself.

I decide that if I can’t beat death through words, then give me salt and good food. I gain twelve pounds eating everything I can, ignoring that it’s still death that gives me life. Eggs are unborn sacs, their yellow hearts punctured and soaking the toast. Meat, of course, is its own kind of moral crisis. I want it seared rarer and rarer. My fork stabs neatly through the soft center of a veal chop, and the fibers part easily before I lift it into my mouth. My mother’s body is now baby-soft without her hair. At long last, even her eyebrows gradually splinter and fall out.

What’s next is worse: Prednisone delirium and rages, hours in which she weeps over nothing. She runs into my room at 3:30 in the morning to ask me to remind her of my address. She wants to ship a coat, she says, to my sister, but her apartment isn’t reliable.

What can I do? I give her my address.

When I’m making my mother’s lunch later that day, I think, encouraged by myself, I can do this. If my mother is dying— and there is a possibility that my mother will die— then the irresistible conclusion is that I should have a child. I think: I can do this. I can counteract this. Somehow, magically. If my mother dies: I will have a child. If my mother is dying: I will be pregnant.

I don’t tell anyone, at least not at first. I carry it around with me and sip on it. In each difficult moment (she falls; she threatens to drive herself when she can barely stay awake) I stop and think: I could have a child.

I have never once broken off the path that I have, rather arbitrarily, assigned to myself for my life. The one rebellion that I have had is fairly marginal, all the things considered, and that’s falling in love with a woman instead of a man.

So far it doesn’t prove to be a possibility; my mother responds to the chemotherapy. All the same. I start reading pregnancy blogs, I begin reading birth stories. I follow those week-by-week predictions of pregnancy. Imagine, if I were pregnant, a month ago, this week my fetus would begin to form major organs (heart, stomach, liver, kidney) and systems (digestive, circulatory, nervous).

In the chemo lounge, I turn and see the new parents in the parking lot, carefully hoisting a car seat between them. What’s strange to me is the clean and puffy fabric that guards the baby. I want the thick, ropy umbilical cord, proof of life. The laboring, the birth. I don’t trust the clean, pastel-bright version of childbirth. I learn the ways that things might go increasingly wrong. I am drawn again and again to the photo of a plastinated pregnant woman, reclining, fetus still in her uterus. Stillbirth, miscarriage, prematurity. I study photos of tiny, transparent fingers.

Not that, I remind myself. Life, living; chai, chaya. I start browsing pages and pages of sperm donors to imagine my own child. I can choose between Jewish and non-Jewish descent, know what makes up their blood, search for markers of disease and discontent. I go so far as to pay for pictures of men with red hair, to search for ones that look like my partner. The lesbian-owned bank informs me that every vial, average $600, arrives frozen and prewashed. I can’t afford a child now.

Besides, my mother is so far, so good. Seven months of chemo might award her with five, ten years of submission, or it could kill her tomorrow. I have years, years, and a presumably working reproductive system, enough to bring a child into this world.

But of course cancer is also alive. My mother is alive. Her cancer is vital, teeming with rot, full of everything. Even when it dies, traces still remain, beaten down into submission but promising to reappear. Even after remission it still haunts her body. Her last PET scan is alight with the faintest traces of lymphoma, curling in wait. When it reappears is the question, now, not if. I delete the pictures of the donors, but I can still trace their frozen smiling faces, their blood types, and their histories.

This is new terrain, the country of fetuses that stall in the uterus, of carnival jars covered with dark fabric, the pages and pages of possible fathers. This is a child beating the red drum in the night. When I close my eyes I conjure the fractal splotch of blood, the glowing smoke on the sonogram, all of us waiting for a return.