Decision in Cohen Clinic

January 24, 2022

Rowen shivered in her hospital gown as she peered over her mask to survey the room. Pristine walls and cabinets glistened white against the spotless stainless-steel fixtures. The cryo vault door—also  stainless-steel—loomed  hopefully  behind her.   The only decorations were Dr. Emmett Cohen’s many degrees, fellowships, licenses: and posters depicting various aspects of in-vitro fertilization and frozen embryo transfer—all in scrupulously-cleaned hermetically-sealed frames. Even through her mask, she could smell ozone combined with a lingering trace of disinfectant. The room exuded sterility. Its message was clear; no stray microbes would dare threaten the implantation room’s precious cargo or any procedures undertaken here. The very presence of three-year-old Marcy, even masked and wrapped in a much-too-large isolation gown, starkly contradicted that message.

Earlier this morning, when Rowen arrived at the clinic with Marcy in tow, Violet had immediately called Dr. Cohen for advice. His reaction was nearly instant; Dr. Cohen had almost stomped into the waiting room. His neck darkened and an artery pulsed too fast in his right temple. “Small children are plague rats!” he ranted through clenched teeth, “especially those who go to daycare. Whatever were you thinking?”

“I know it’s not ideal,” Rowen had apologized, “but there was no help for it. Our babysitter canceled at the last minute and neither backup answered their phone. It’s too early for daycare and even when I called the emergency number, they said today’s legal kid capacity was already maxed out. I had hoped Marcy could stay in the office with Betty. Where is Betty, anyway? Poor Violet is stuck doing all the paperwork, on top of helping you with the implant.”

“Oh, she got called to the police station a little while ago,” Dr. Cohen had answered. “The Birthers have been at it again. Apparently, they want us to leave fertility and childbearing to random chance and ignore special situations—like yours—when fixing them is quite possible. Not only have they vandalized the building, we also got more threats. It’s not the first time for either vandalism or threats. But this time, as she drove in, Betty thought she saw the guy packing spray paints into his trunk and driving away. Anyway, the police wanted her to view a lineup. So far, all the threats seem to have been just intimidation—no violence.”

“He still hasn’t decided about Marcy or the implant: time to ask directly,” Rowen had thought. “So, Dr. Cohen, as many appointment reminders as I answered saying I was going to be here, I presume bringing her along was better than cancelling?” she confirmed.

“Correct,” he’d conceded. “Your bloodwork points to peak implantation readiness and Violet already began thawing your embryos.” Dr. Cohen only seemed slightly less irritated. “We just need to wait a few more minutes for the final test results to confirm that your uterus is ready.” He turned to Violet. “Would you please wrap Miss Marcy in some sort of isolation gown, mask, hair bonnet—you name it? She can wait with you,” Dr. Cohen glared pointedly at Rowen, “in the treatment room.”

Marcy hadn’t been particularly happy with being swaddled in her poorly fitting personal protection cocoon. But now, after whimpering a while, she was allowing herself to be distracted by a mirror—sterile—and Violet’s hastily sanitized computer tablet.

Rowen waited. Despite her concern over potentially distracting behavior from Marcy, her thoughts wandered. She had waited so long for this day—specifically chosen to remember Adrian. Adrian, with his too-long black hair, laughing brown eyes, freckled skin, and punny sense of humor. Adrian, who had always been able to make everything about their lives seem better. Adrian, who had insisted on going to Spain for their wedding. Life with Adrian had been an adventure.

But then his vague symptoms had begun: unexplained lower back and groin pain, fatty tissue over his pectorals. “Looks like I’m growing boobs,” he’d commented, seemingly unconcerned. “Apparently, desk jockeying isn’t actual exercise.”

They’d joined a gym the next day, and six-thirty A.M. barbells and stair-steppers became their habit. His breasts had continued to grow, not because of muscle mass. The vague pains increased. “I may be growing boobs, but the exercise is doing some good,” Adrian had joked. “My balls are also growing.”

Rowen’s heart had plummeted. Foreplay that night had included her checking those growing balls herself—for more reasons than sexual stimulation. Inside his swelling scrotum, both testicles were also swollen—with an obvious lump on one. The next months were a nightmare of tests and biopsies… and chemo. But they had followed the oncologist’s advice and collected sperm and eggs before treatment. The resulting embryos remained—intact, frozen, safe—when Adrian needed an orchiectomy. None of it had been enough.

Three days before his twenty-nineth birthday, Adrian had slipped away, taking Rowen’s heart with him. Today was their wedding anniversary.

Their plan had been to celebrate this day together—after Adrian was well again—using embryos that hadn’t been affected by chemo. The decision to go ahead with the implant without him hadn’t been easy. Rowen remembered too many distracted days and sleepless nights when she wrestled with her desire for his children. Was she really making the right decision? What gave her the right to purposely bring children into a single-parent home, no matter how desperately she wanted a piece of Adrian to survive?

The decision could have been financial. Frozen embryo transfer was expensive: raising children even more so. But the embryos were already there, waiting. How could she not do everything she could to bring those embryos to life?

Rowen had worked doggedly. At first, their savings, depleted by Adrian’s catastrophic illness and a one-income budget, had barely kept up with the storage fees. She moved into the cheapest apartment she could find where she felt safe, sold everything she could, took every available minute of overtime, worked ceaselessly toward promotion, and saved every possible penny for the months when she might not be able to work.

Finally, she felt she had saved almost enough. It would have to do; her biological clock was ticking much too loudly.

Marcy was her first frozen embryo transfer, obviously successful. She was the female version of Adrian, right down to his freckles and a toddler edition of his belly laugh. Sometimes, it was all Rowen could do to keep from weeping when she looked at her. And now, Rowen would live their dream: a family with children—plural. She ignored the possibility that every passing month lessened the chances of a successful transfer, a viable pregnancy. Already, the child existed in her fantasies; and she loved the potential baby—or babies—to distraction. A boy just like Adrian, she was almost positive; Dr. Cohen had assured her the odds were excellent for a boy. He hadn’t ruled out twins. But boy, girl, or twins were fine with her, as long as they were Adrian’s.

Marcy’s chortle suspended her reverie. “Look, Mommy, a kitty,” she said, pointing to the tablet’s video. Rowen’s response was interrupted when Violet and Dr. Cohen entered the room.

“Everything’s a go,” he said, smiling. “Technically, you may be a geriatric mom, but your equipment looks like it’s still healthy and functioning.” As Violet helped her adjust her position on the treatment table, Dr. Cohen turned to open the cryo vault. Lighted red letters warned “1 defrost in progress, 2:47 minutes remaining.” Steam swirled out of the vault and obscured rows of liquid nitrogen tanks that filled transparent drawers.

Rowen could see a red light on one of the drawers; she couldn’t tell which one. “This is it,” she thought happily. “In nine months, Marcy will have a baby brother. And Adrian, wherever you are, here’s your second chance for immortali—”

An overpowering boom assaulted her ears; the lights went out. Dim emergency exit lights bathed the room in red. She felt rather than saw Violet leaning over the treatment table, on her. Dr. Cohen pulled the drawer out of the cryo cabinet, but set it down to drag Marcy away from the vault’s open door. “Damned Birthers,” he sputtered, and then gasped as large ceramic ceiling tiles fell. He struggled to close the vault’s heavy door. A roar crescendoed. Steel beams and insulation fell from overhead, crisscrossing over the ceiling tiles on the floor.

A warm stream spurted over Rowen’s chest. She touched it and her fingers came away bloody—black in the red light. She looked toward her stirrup-trapped feet and saw a ceiling beam on Violet’s head, her crushed skull obvious even from this angle. The spurting stopped but blood still oozed from her neck. Violet’s eyes were wide and staring. “She was protecting me,” Rowen realized with a pang. The unmistakable smell of burning chemicals intruded.

“Open the door. Get out! Get out now!” Dr. Cohen shouted. “ ’F fire hits nitrogen, we suffocate!”

“Marcy!” Rowen screamed, but no sound escaped her throat.

“Mommy!” Marcy cried. Abruptly, the sound became a howl.

“She’s alive,” Rowen thought with profound relief. “I’m coming, Baby,” she yelled, as she struggled to free herself from the debris—and Violet’s dead weight. After an adrenalin-powered thrust, Violet’s limp body fell to the floor with a sickening thud. Rowen extricated her feet from the stirrups, got down and stumbled toward Marcy—and Dr. Cohen.

“Here… take embryos… there’s twelve,” Dr. Cohen grated. “Betty can… go to… backup… find out… whose.… Karl Weiss will… fit you in… implant today.… Store rest… only chance,” he urged, indicating the drawer.

In the faint red light, Rowen finally saw that the heavy vault door had fallen, trapping Dr. Cohen’s legs. Now, she understood. She picked up the drawer. “Oof! Heavy!”

“Sixty-seven… pounds.… Don’t… drop it,” he panted. “Hurry!”

“Come on, Marcy. You’ll have to walk so I can carry your brother.”

Marcy, whimpering, hoisted herself to a stand and then started to take a step. She screamed. It was an “I’m hurting” scream. Rowen looked and saw a bend in Marcy’s leg where there shouldn’t have been one. Rowen leaned down and clumsily picked her up. “Hold on, Marcy. I have to carry this, too.” She tucked the drawer under her other arm and then reached under Marcy to hold it with two hands. Marcy’s arms twined tightly about her neck; she still screamed. “I can do this,” Rowen insisted to herself. “It’s only a hundred pounds,” she groaned. “Only a hundred awkward and a third of it squirming screaming-I’m-in-terrible-pain pounds,” the still-sane half of her brain reminded her, “not barbe—” Screaming cut off; little arms around her neck went slack. Rowen leaned back to hold her better. She could feel Marcy’s warm breath above her hospital gown. “Whew! She’s still breathing, must have passed out,” Rowen thought, as both the drawer and Marcy slipped precariously in her grasp.

More ceiling beams fell between her and the exit. Now, the only opening was low and narrow—too low, too narrow. She struggled to fit into the gap. Marcy’s warm breath caressed her shoulder. Rowen’s loose hospital gown caught on a crossbeam; it tore as she jerked it away. And then, while trying to protect both her precious burdens, she fell sideways on some sharp tiles. It was no use; there wasn’t enough room. And she needed one hand for support while crawling through the red darkness, picking her way through the rubble. Fire crackled closer. A muffled whump sounded from the vault.

“Run!” Dr. Cohen wheezed. “Don’t… come back.… Nitrogen… suffocates… minutes… no warn—…”

Rowen couldn’t make herself look at him.

Her great gulps of air weren’t enough; she fought a wave of dizziness and held her breath. “Too big… Too heavy… Can’t bring both! No time! Choose? How? Both my babies. More than mine. Can’t!” flickered through her brain. Tears burned as she resolutely—gently—set one bundle down and crawled, scrambling hurriedly, breathlessly, through the wreckage, carrying the other from the room.