Escape from the Monkey House

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I used to be a Project Runway devotee, and I crushed hard on Tim Gunn, you know, in the kind of purely platonic way a twenty-something girl loves a gay, silver-haired fashion-god. In one episode, Gunn approaches a contestant proudly constructing a frock trimmed all over with long, stringy locks of human hair. He counsels the young designer,

I have this refrain about the monkey house at the zoo. When you first enter into the monkey house, you think, ‘Oh my god, this place stinks!’ And then after you’re there for 20 minutes you think, ‘It’s not so bad,’ and after you’re there for an hour it doesn’t smell at all. And anyone entering the monkey house freshly thinks, ‘this stinks!’ You’ve been living in the monkey house.”

As a byproduct of the remarkable adaptability of human beings, I have too many times emerged from intolerable circumstances in my own life baffled, wondering in awe, How did I put up with that for as long as I did without going stark raving mad? And, maybe more importantly, Why?? This sentiment provided the backdrop for my first OB visit with my new doctor, whose kindness and professionalism was magnified by what I now see as the insane conduct of the OB I used for my previous pregnancy.  For example, I cannot count the number of times when he would counter my concerns about episodes of profuse bleeding or constant vomiting that was leaving me with dehydration headaches or jitters over the ongoing threat of miscarriage with the remark:

Well, this is the farthest you’ve ever gotten, so just be happy.

Being that he was mostly naive about the IVF process and even more under-informed about PGD, all my consultations with him would be largely dominated by prolonged question-and-answer sessions about my treatments and the inner workings of genetic embryonic screening until I started to feel like I ought to bring a white board and some visual aides to my check-ups. Once, I felt especially exposed because he was engaging me on these technicalities, once again, with his door wide-open and regular pregnant ladies lining up at the nurse’s desk ten feet away to check out. I interrupted him to ask if I could shut the door, and he said no. So much for HIPAA in that office! When the shit hit the fan with Dakota’s first anatomy scan, he called me to tell me that I needed a repeat scan because “they couldn’t rule out” a structural abnormality.

“Does the report say that they imaged something abnormal or were they just unable to get a clear picture,” I asked.

He said, “Well I think if they had seen something, they would have put it in the report.”

Relieved, I confirmed, “Okay, so they didn’t actually see anything abnormal,” only for him to repeat,

“If they had it would be in the report.”

When I got to the MFM three days later, he turned the computer screen around so I could read what was sent to my OB, wherein I learned that they had indeed written plainly in the report that his stomach was way up in his chest cavity, shifting his heart to the wrong side of his body, and that the real purpose of my follow-up visit with them was to begin assessing the extent of the problem and connect me to a fetal clinic in the city with the equipment and expertise to fully evaluate him. This dishonesty, this cowardice, this betrayal was the last straw, and I requested copies of my records from his office that week, but I’m left wondering in retrospect why I put up with his bullshit for so long. This is the practice that sent me home with a shoulder shrug and no follow-up plan in 2009 when I was pregnant, bleeding, and suffering stabbing pains so intense they rendered me immobile on the couch for four days (i.e. my first ectopic pregnancy). This is the man who responded to my tears over my second (chemical) pregnancy loss in 2010 with the exasperated question,

Do you really think you’re not going to get pregnant?

Ha ha ha, joke’s on you, Dr. K. Or maybe joke’s on me since I’m the idiot who went back there. I guess I’m more like my mother than I think, and I’m just stubborn about change. Or maybe I was stuck in the monkey house too long, acclimated to the stink of doctors who mingle arrogance and incompetence dangerously into a blasé dismissal of valid concerns. For sure I dealt with my fair share of that on my tour of IVF clinics in the New York area.

My appointment with the new doctor on Tuesday was akin to finding the perfect bed, the perfect bowl of porridge after sampling a few others that never felt right. When I talked to him about the extent of my nausea and my difficulty keeping fluids down, we discussed a category A medication that helps. He set my fears at ease by taking the time to discuss how extensively it has been studied. When I asked him for guidance in making the choice between the risk of an amniocentesis and versus the likelihood that Dakota’s microdeletion would recur, he told me I was “way off in the stratosphere” of statistics but mentioned a prenatal screen that would help me make that decision and gave me a referral for an MFM and pediatric geneticist he trusts implicitly. When I shared my anxiety about gaining weight from the constant snacking needed to keep the vomiting at bay, he reminded me that I am making two people and that the first trimester doesn’t last forever; he encouraged me to try to make myself comfortable until the nausea ebbs; he joked that I wouldn’t be heavy for long with two kids running around. He was gentle. He validated my concerns, offering empathy and solutions in response. And, for the love of God, he closed his office door!

Why didn’t it occur to me that this existed or that I deserved better when I have advocated for myself so fiercely in the treatment process? Part of me wonders if I felt like such a freak of nature when I arrived pregnant at the regular doctor that it seemed normal when he treated me like one.

19 thoughts on “Escape from the Monkey House

  1. That class a drug is amazing (I know which one it is because there’s only one) and it saved me, seriously. I’m so glad you’ve found a better Doctor. There’s no reason to put up with crap like that. Good for you for being your own advocate.

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    • It is saving my life! I still throw up a few nights a week, but I can function at work. I was having so much anxiety about being trapped in a classroom, hurling into a garbage can (embarrassing!) in front of teenagers who have no idea why and would be like, What the hell??

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  2. So glad you switched. I switched OBs around 16weeks and I had the same feeling- why was I putting up with that?! I was so much happier. Glad you are getting better and more sensitive care!

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  3. This reminds me of domestic abuse and its patterns and makes me reflect on how I followed a similar trajectory to you. Shame, a sense I was somehow to blame (for first being infertile then having recurrent losses, for otherwise being the defective one, for choosing a stupid Doctor the first go around, then a stupid RE, and another, for being sexually abused as a kid and too effed up by it to want to have kids until well into my 30s, for not jumping ship immediately when my GP dismissed me raising the possibility of my immune system being at play in my losses, on the list goes). Why did it take so long to get out of that cycle of treating me like I was the idiot? I don’t have an answer. But I do think back to the one abusive relationship I endured and that it took his hands around my throat and throwing my puppy across the room for me to believe myself and my therapist (despite all friends and family saying how lovely he was and how I ought not give up as I “always” do on relationships). Why did I stay until then with that idiot? And why did I keep on with the stupid thoughtless doctors for years?

    The abuse answer is easy for me now. It started small after coming out of the blue and in my dogged way I said I will show him I am trustworthy. It will be okay. And by the time it was plenty clear it would never be okay I felt so worthless I didn’t even raise my eyes when the yelling and vacuous accusations began. I was broken. Flat. Empty. I didn’t have it in me to see a way out or that I deserved one.

    Maybe I stayed with hopeless medical help because the trail of brokenness that accompanied trying to conceive and then trying to stay pregnant broke my spirit? Clouded my judgment? Left me bewildered? Maybe it is the societal lesson to believe professional caregivers have our best interests at heart? Who knows. What I know is that by the time I left each of those shitty situations and sought the help I needed I was at the tail end of my rope.

    I hope neither of us ever ends up at the end of our ropes again before we bid adieu to the monkey house. I’m so glad you’re getting qualified and compassionate care now. I hope all goes well with the drug and you can sail through some part of this pregnancy. And of course that all ends well. For once. Damn it.

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    • Yes, it’s any wonder why we have to be pushed so far to make a break from a situation that, in retrospect, was so obviously unhealthy. I mean, the whole potentially deadly ectopic pregnancy should have been enough, but noooooooooo. Crazy story about the battery in your past. I’m glad you have built a new life free from both abusers.

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  4. So relieved for you that you have found a doctor so caring and gentle in taking care of your needs. Your previous OB sounds so ridiculous! I hope that the medication will alleviate your symptoms so that you can function and enjoy this pregnancy as much as you can.

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    • Yes, I have to really dig into the search for a high-risk guy. As great as my new doctor is, I don’t want my history sidelined by someone who deals mostly with normal people all the time.

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  5. So glad you were able to switch to someone more sensitive and helpful for this pregnancy! Your old doctor sounds awful – there just aren’t words for someone who wouldn’t even close the door for privacy, such a basic expectation. Hoping this anti-nausea drug helps get you feeling better quickly and for the rest of the pregnancy to be as uneventful as possible.

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    • It’s crazy because it’s so obviously illegal. I could almost see forgetting or hoping maybe the patient wouldn’t know her rights, but the gall to be explicitly called on it and to deny the patient the right to privacy is just appalling. Yet I stayed…

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  6. I think women are conditioned to accept bad behaviour from those in authority, and drs of all sorts are so often seen (or felt) to be in authority, rather than in a partnership. I’m glad your new doctor sees it more as a partnership.

    I’m still shaking my head at your old dr’s refusal to shut the door. Sadly, I know that the response to your ectopic pregnancy was and is still all too common, all over the world.

    There was a major scandal here about 30 years ago of a breach of standards between patients and their OB/Gyns, and it – along with the informed feminist debate at the time – changed the way I would react to Drs forever more. It saddens me that 30 years on, the medical profession can still be so arrogant.

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    • Yes, I think you’re absolutely right! It’s interesting because I’ve spent most of my life rebelling against gender expectations (being assertive when it got me labeled as a “bitch,” standing up to the pressures to change my name when I got married, and more) but this particular bit of conditioning is still lurking deep down, it seems. Even the *bag guys* we come across in our lives teach us something about ourselves.

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  7. Wow, what an awful doctor you had. And hooray for the good one, who closes his door and reassures. Who on earth says “this is the farthest you’ve ever gotten, SO BE HAPPY?” That is beyond insensitive. And shutting the door shouldn’t be an issue, especially if you explicitly ask for it. I’m sorry you had those experiences prior, and lived in the monkey house for so long. Shame on that guy, for so many reasons. I hope this new doctor keeps up the wonderful work!

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    • The most ridiculous part of it is that THIS was his attempt at being encouraging. I promise you: I witnessed his tone, like, “Don’t worry so much; you’ve made it farther than ever!” The result was that all my concerns were dismissed. I think he just had no concept what to do with a preggo coming from infertility of my caliber.

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  8. Hey Goldilocks — glad you got to the proper bowl of porridge. We humans adapt to everything, including bad doctors and Bizzaro World presidential candidates. The knock is on the insensitive SOB, not you.

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