“You’ve already had blood drawn and we’ll screen that for cancer markers. Your ovaries aren’t enlarged,” he told her, “but I want to do an ultrasound of your uterus. It’s bigger than it should be. You might have fibroids. They’re not that unusual for a woman your age who’s had children. And you have no family history of cancer, Sarah.” He gave her a reassuring smile. “So don’t assume the worst.
She nodded. She’d spent time on the internet researching symptoms. The only things she could figure out that it might be were ovarian or uterine cancer. But Dr Gruber was right. It was easy to assume the worst when diagnosing yourself on the internet. She would let him tell her.
Beth, Dr Gruber’s nurse, came in to be present while he did the ultrasound. Sarah winced at the cold gel, and watched his face when he turned the screen away from her.
Beth stood beside her. “Just relax,” she said. “And breathe.” Beth held Sarah’s hand, but she didn’t say, Everything will be OK.
Because, Sarah thought, it wouldn’t. They could just look at her and see something was wrong, that she was dying.
Sarah couldn’t see the screen, so she kept her eyes on Dr Gruber’s face, which was why she saw his fleeting expression of shock and dismay before he schooled his expression to the careful neutrality she guessed doctors practised in front of mirrors when no one was looking.
“How bad is it?” she asked.
His eyes were fixed on the screen, while his hand moved the ultrasound probe over her lower abdomen in tiny, tiny circles.
“How bad?” she repeated.
He didn’t look at her. “It’s not cancer,” he said softly. “And it’s not fibroids.”
“It’s worse?” she whispered, still seeing that shocked expression that had flitted across his face, and wondering what could be worse than cancer.
He still wouldn’t look at her, and her breath caught in her throat. Instead, he stared down at the floor. “You’re pregnant, Sarah.”
She was so startled, she laughed out loud, and he turned to stare at her. “Pregnant?” She shook her head. “Twenty years you’ve been my doctor, and that’s the first funny thing I’ve ever heard you say.”
But he didn’t smile. His eyes didn’t meet hers.
“Wait. You’re serious? You think I’m pregnant?”
“I know you’re pregnant,” he told her. “I can see the heartbeat. I can see the baby. You’re about two months pregnant.”
Dr Gruber kept one hand fixed firmly on her abdomen, and carefully turned the ultrasound around so Sarah could see the screen. She knew what to look for, and she didn’t need to have the baby pointed out to her. She could see the tiny heart beating, could see the blurry curved shape of the child within her.
She was pregnant.
He did a screen capture, took the ultrasound, and then handed her a towel to wipe the gel off her belly. “Thank you, Beth,” he said.
Beth let go of Sarah’s hand, nodded and left.
When the door closed behind her, Sarah stared at the picture Dr Gruber printed out, brow furrowed. “This is impossible. Sam had a vasectomy. And there has never been anyone but Sam.”
She looked up to find him watching her, his expression distant. “I did the vasectomy,” he said. She heard the coldness in his voice. “This happened right when he died, Sarah. Could have been a few days before, could have been a few days after.”
She sat up and pulled the paper examination gown down, not liking the tone in his voice or the flat disbelief in his eyes. “There has never — not once — been anyone but Sam. Not for any reason, not for one minute.”
Dr Gruber looked at her. “Then how do you explain the pregnancy?”
“You screwed up the vasectomy.” She wasn’t smiling when she said it.
“A vasectomy that worked just fine for you two for . . . what, ten years? Vasectomies have sometimes reversed themselves,” he admitted. “But the odds of Sam’s doing so and of you getting pregnant at the exact time that he died, when there are so many simpler explanations ...”
Her hands knotted into fists. “There are no simpler explanations. There are no other explanations at all. I fell in love with Sam in eighth grade. I never dated anyone else, I never kissed anyone else and I sure as hell never slept with anyone else. So unless you’re going to try to convince me that immaculate conception is more likely than a vasectomy reversal, or that people really do get pregnant off of public toilet seats, then we have one, and only one, theory to work with.”
He dropped it, changed the subject. “Your third pregnancy was bad. It nearly killed you. This one could finish the job. You’ve had a recent trauma. You’re not handling this pregnancy well. You need to consider terminating. For your sake, and for the boys’ sake.”
She slid carefully off the exam table, tucking the paper gown tight around her backside. “Thank you for letting me know that I’m not dying. And thank you for ruining the first good thing to happen to me since Sam died.”
On the way home, she bought a pregnancy test, and she checked for herself. Yes, she had the ultrasound picture, but the blue stripe on the stick was the ritual. It was the way she should have found out.