Page 21 of Counting Backwards

“Sorry,” I mumbled sheepishly, returning my attention to the pamphlet.

I wished I could pick apart that statistic in the leaflet and question whoever had compiled the information. Was anyone accounting for the fact that women were probably much more likely to seek treatment for infertility than men? And how could you even call it a “couples’ problem” when so many of the people seeking reproductive assistance were single?

Despite the umbrage I felt looking at that page, the idea that my empty womb was somehow my fault felt the most logical, the most obvious. I liked to remind my work associates of Occam’s razor, the theory that the simplest explanation is usually the correct one.

The door from outside pushed open just as a car on the street honked. I looked up to see Vance walking in, and my whole body relaxed at the sight of him. Before I even stood to greet him, a nurse appeared at the other end of the room.

“Jessa Gidney?” she called. Her chipper voice was teeming with optimism, an emotion I wished I, too, could feel. Yet as I stood from my seat, nothing but dread pushed me forward.

Dr. LaRusso was an affable man in his late fifties, which Gram always said was the perfect age for a doctor. Old enough to be experienced but still young enough to give a hoot, as she put it. He had a full head of salt-and-pepper hair and a nose that was slightly too large for his face.

After the examination, I changed from the paper gown back into my work clothes. Vance and I were shepherded from the exam room over to a carpeted office, where the doctor was already seated behind a desk.

“Sit, please,” he said, not looking up from the folder before him. He was making notes on the paper inside.

We settled quietly into the plush armchairs opposite the desk. Vance reached for my hand and gave it three quick squeezes.

I turned toward Vance, taking in his burgundy V-neck sweater, his black slacks, and the subtle dark circles beneath his eyes. Most days, he wore a suit to work. He felt that being dressed formally allowed him to project the right image when interacting with clients. Today’s more casual attire meant something else was going on at work, something keeping him at the office instead of going out entertaining. Normally, I would have known exactly why he was too busy to meet with clients, what deal was heating up, and why he hadn’t arrived home before I was sleeping. I realized this with a pang of guilt. I’d gotten so wrapped up in my pro bono case that the only personal issue for which I had any bandwidth remaining was our effort to conceive. Each time he brought up anything else, I found myself tuning out. I squeezed his hand back. He deserved better than what I’d been giving him.

“Right,” Dr. LaRusso said, finally looking up at us. He smiled broadly, straight white teeth on display.

“I have several pieces of good news,” he started. “First, plenty of healthy couples devote six, nine, ten months to trying to conceive before it actually happens. And longer. A delay of a few months isnot a medically significant phenomenon. Many of my peers won’t even meet with couples until they’ve been trying for at least a year. Second”—he held up two fingers—“is the fact that physically, Jessa, you seem to be shipshape. We’ll have to wait for the blood work to come back, but on initial examination, you present as perfectly healthy. Though you’re in your thirties, you’re still young enough to carry multiple children to term without issue. The ultrasound revealed no causes for concern. The fact that your period arrives regularly and without excessive pain is also a promising sign.”

“What about the miscarriage?” I asked, referring to my pregnancy the year before.

The doctor nodded like it was a wise question.

“There’s always the chance that a miscarriage could result in uterine scarring, which could complicate later conceptions—but initial testing doesn’t seem to indicate that’s the case here. We can conduct more specific explorations, but I’m not seeing anything to warrant it. At least not yet.”

“So what’s the bad news?” I asked.

“Not bad news,” the doctor said, “just a to-do list.” His eyes shifted to Vance. “When the cause for lack of conception is not obvious at the initial stages, sometimes we have to do more digging. I think it’d be worthwhile for you, Vance, to get checked out. A semen analysis is quick and easy. Given the relatively brief time you’ve been trying, I’m not overly concerned. But if you’re feeling impatient, gathering information in the meantime won’t hurt. If everything looks okay with the sperm concentration and motility, we can take it from there.”

Vance sat up straighter in his chair.

“Shouldn’t we wait for the blood work to come back first? Couldn’t this be a hormonal imbalance or something?” he asked.

I fought the urge to smack him. Why couldn’t he even imagine that he might be playing a part in this—some role other thanjust the supportive husband? And honestly, was he even doing that?

“Certainly,” Dr. LaRusso said. “It’ll only be a couple of days for the bloods. By the time you get an appointment for the semen analysis, you’ll have heard from me about those results anyway.” He opened a drawer from his desk, pulled out a card, and offered it to Vance. “Here is the doctor I recommend for male fertility exams. She’s excellent. Unless you have someone else you’d rather see.”

Vance looked down at the card and swallowed. A vein in his jaw had begun to pulse, and his visible distress took me by surprise.

Dr. LaRusso seemed to notice Vance’s change in demeanor as well.

“I don’t want you two to worry,” the doctor said. “You are at the very beginning of the process, and science in this area has come an incredibly long way. We will work through this as a team, leaving no stone unturned. You understand?” He gave us another big smile, waiting for each of us to nod in agreement.

After collecting our things, we left the quiet confines of the medical office and emerged into the afternoon commotion of Seventy-Ninth Street. We made our way through the damp wintry air toward Third Avenue, where we would each take different subways back to our respective offices.

“So that was good, I guess?” I asked as we walked, wrapping my arm around Vance’s elbow and inching closer to him.

He kept his lips tight and shook his head.

“What’s wrong?” I asked. “The news was positive. Shouldn’t we be happy that he couldn’t find anything the matter with us?”

“With you,” Vance shot back. “He couldn’t find anything wrong withyou.” He kept his eyes trained straight ahead as we walked. “But now I’m supposed to get put under a microscope too?”

“What’s the harm in a quick check, just to make sure nothing’s amiss?” I couldn’t imagine the fertility exam for men being anywhere near as intrusive as what I’d been putting myself through. As far as I knew, all they needed was a sperm sample, and Vance could take care of that on his own.