Julie Buntin
The COuntdown
First Trimester
On the ultrasound screen, the baby flailed like the roly-polies my sister and I, decades before, loved to trap and flip over, poking their bellies until they clenched into a tiny, armored circle. It’s alive, I thought, staring at the pocked drop ceiling. Right now, the baby is alive. I exhaled into my mask, inhaled the hot fog back in. The doctor moved her wand against my belly, fiddled with a knob, told me to listen. A quick, insistent whoosh, too loud and fast to be coming from the creature the doctor said was my baby. “Everything looks great,” she said, and happiness knocked on a door somewhere inside me before worry locked it out again. According to a calculator I’d found on the internet and filled in with my age at conception, my weight, I still had a 2.1% chance of miscarrying. A few weeks earlier, that number had been over 10 percent. Every day, women saw their babies on these screens, only to learn, weeks or months later, they were gone. Since my first positive pregnancy test, I’d checked the calculator upon waking, before meetings, while listening to my husband talk, entering the current date and then later ones, watching the probability fall, waiting for the day I’d finally trust the baby was safe.
After swabbing my cervix, the doctor asked me to raise my arms and then gently opened my gown, marching her fingers around the perimeter of my right breast. Alive, I thought, trying to banish the dread that had become my entire personality. Alive. She moved to my left breast, paused. I flushed. I was sweating, the room close and windowless, my mask damp on my face—had her fingers slipped? They moved again, probing something. Can you feel that, she asked, and I brought my fingers to meet hers.
Yes? I said, though I could not.
Hours later, while my husband slept beside me, well after the doctor put in the call for breast imaging at the Cancer Center, I lifted my left arm just as I had at the appointment where I’d seen my baby for the very first time. I walked my fingers around the outside of my breast and there, just there, I felt it—a painless little lump. Firm and lobulated, she’d written in her notes. Two by three centimeters. Something new, its meaning and future unclear.
Less than a foot away, the baby was moving around, or in one of its ten-minute sleep cycles. The baby was about triple the size of the lump: a strawberry, according to the app on my phone, a Hot Wheels car. I knew exactly when the baby had started growing in my body. The ghostly pink line had appeared on the paper strip thirteen days past ovulation (13DPO, to use the shorthand of the fertility message boards), a couple days before my period was even due to start.
As for the lump, it could have been there for a long time, or just a few weeks.
Maybe it had come seven months earlier, say, Christmas Eve, 2019, when my husband and I drove from Brooklyn, our home of many years, to Ann Arbor, on the cusp of two new jobs, a life that would have space—we hoped—for a baby. Or, more likely, the lump arrived in concert with a blastocyst implanting into my uterine wall, late summer, one of those nights I’d spent awake, scrolling through the headlines. By then, the serrated panic of the early days of the pandemic had given way to a haze of numbness, a privilege I was lucky to afford. My sister was waiting on delayed unemployment payments, her money trapped in a labyrinth of portals and verification. My mother, also unemployed. Then my brother, too. A couple times a day, a detail broke through—that my sister had lost her glasses, had no contacts, was riding her bike without being able to see—and I startled out of myself, waking up for a moment. But I was already awake.
I already love the baby, my husband said, right before he fell asleep, right before I lifted my arm to see if I could find the lump. Did I already love the baby? I wanted the baby to survive. But no, I couldn’t say love, not yet. Too many things could still go wrong. I had to keep track, a job that left no room for any other feeling.
The months we’d spent trying to conceive, I learned a lot about things that go wrong. My periods were regular, but extremely painful, which could be a sign of something. My nana had struggled to get pregnant, and one of my aunts tried and tried but never did. First COVID was a faraway news item, then it was upon us. Our classes moved online. I was afraid to touch our groceries. My sister wasn’t doing well, but we weren’t saying relapse. The convention center where I’d once unpacked boxes for a book publishing trade show was turned into a field hospital. Nobody was sure whether masks made any difference. Hubris, to keep trying for a baby as the world fell apart, but what if it took us a while? And weren’t we—we said this guiltily, gratefully—safe enough? COVID was everywhere, a huge red stain spreading across Southeast Michigan, but we were non-essential, and could conduct our entire lives from our laptops. When I Zoomed with friends in New York City, sirens shrieked in the background, siren after siren after siren. A friend got COVID and didn’t even know they had it; another got so sick she couldn’t move for days, still couldn’t taste a thing. As the weeks went on, one lost a grandparent, another a coworker, another an ex. What if we lost one of our parents before giving them a grandchild? Between classes and meetings, I refreshed the numbers of the sick, the dying, the recovered. Something weird was happening to time. I read Reddit forums about trying to conceive, and became convinced a hernia repair from my twenties might have caused scar tissue to clog my fallopian tubes—or maybe I wasn’t pregnant yet because I drank too much, or because I didn’t deserve what I had, or because a bomb was waiting, its fuse lit in the childhood that had suggested a very different future for me, and now it was ready to go off. I’d stopped taking my antidepressant because I wanted to be medication free for the possible baby, and I was pretending that the maniacal, obsessive looping of my thoughts was normal, considering, well, everything, and not a sign of the disorder I’ve struggled with most of my life. I called my sister, and we talked about how I wasn’t pregnant yet, about her conviction she couldn’t have babies, and she sounded off, talking so fast her words threaded together, but still, we weren’t using the word relapse.
My husband and I tried for a while without really tracking anything, and when that didn’t work, I started the ovulation sticks. A couple of months later, I was pregnant. But I tested for HCG so early my first positive was barely there, a whisper of pink. I might be pregnant, I told my husband, but also maybe not. It could be chemical, a false alarm. I tested again, several mornings in a row, lining the tests up on the windowsill and trying to gauge whether they were darkening in a way that indicated my pregnancy would stick. The pandemic was getting worse or we had reasons for hope, depending on which headlines you read, but either way, the numbers of the dead kept ticking up. I waited for the anxiety pumping through me to turn to joy—I was pregnant, finally!!—but instead it intensified. Every time I peed, I checked the toilet paper for streaks of blood. I told a couple of close friends and then warned them I could miscarry at any time—the first doctor’s appointment wasn’t until around twelve weeks, the chances were so high. Congratulations? they said. I turned thirty-three; the baby, ten weeks old, was officially a fetus, with eyelids and flexing elbows. On the phone with a friend in my backyard, a bee came whirling out of the grass and stung my forehead, my hand. My fingers doubled in size. My husband went to CVS for Benadryl and after I sanitized the box and swallowed the pill, I pictured the baby inside me dissolving, a little heartbeat I’d already failed to keep safe.
The lump felt more real than the baby, maybe because I could touch it; in my first trimester, it was my body’s most concrete change. I pushed on it until I thought it should hurt. It didn’t. I rolled onto my stomach, the only way I can sleep, not a pregnancy-friendly position. My sheets smelled like the organic lavender detergent pellets left behind by the people who’d lived in our house before us. A few weeks before the ultrasound, when I was eight or nine weeks along, my sister had been evicted from her room for hoarding, for pacing her shared porch at night and shouting at people who weren’t there. When had she last smelled clean laundry? I couldn’t understand how things had gotten so bad, what turning point we’d missed. Before the pandemic, she’d been working in the kitchen at the Cheesecake Factory. Now she was sleeping in a tent, maybe, if she was sleeping at all.
The last time we talked, I’d gone through the questions: Are you okay? Where are you living? Can I help you?
I’m fine, she said, over and over and over again.
I’m pregnant, I interrupted. Because what if I never got another chance to tell her?
Wow, she said, but her voice suddenly sounded far away. Cool! She was at Fred Meyer, trading bottles for change. My phone is trolling me, she snapped. Every time I pick it up, the camera is on. It’s watching me. A few minutes later she had to go. I’m sick, she said. I’ll call you back when I take care of it.
I don’t know if she heard me about the baby. She was getting on her bike when she hung up, the same bike she’d fallen off in the earliest weeks of the pandemic, while I’d been thumbing through some message board. She’d broken her collarbone. I was terrified she’d get COVID in the hospital, or on the streets, when she was buying heroin or meth. She broke her collarbone once when we were kids, her in first grade, maybe, me in third. I don’t remember how, except that K was just like that, always getting into stuff. The time she got stuck, cross-legged, in a crock pot, and we had to shake it upside down until she fell out. Her arm in a green sling, a game of Battleship spread out on the hospital sheets, sun shining off the new box. No cast for a broken collarbone, but still, I was jealous. When you’re a kid, after the pain, if it’s an accident and you’re otherwise safe, it’s almost fun to break a bone. What does it feel like when you’re thirty-one?
I’m sorry, this is supposed to be about the lump. About being pregnant during a global pandemic, existing in a state of abstract panic, of disaster both imminent and removed. The illusion and limits of safety. But here’s my sister anyway, because whenever I write she sits down next to me. After the Fred Meyer call, her phone went straight to voicemail. It was her seven thousandth phone of all time. That’s how it felt. I have dozens of numbers for her saved in my contacts.
K 10/18. K summer. K Clackamas County. Old K. K not active. K real. K use this one.
Laundry smell, her face. I never see it like it is these days, mostly toothless, jaw rattling on its hinges, a frantic, searching glint in her greenish eyes, the matted hair. I see her at eighteen, long black ponytail, the spatter of freckles across the bridge of her nose, the scar jagging her left eyebrow from the time she rode her bike straight into the wall of Bill and Carol’s Party Store.
I guess I fell asleep, because my bladder woke me up. I got up again and again, until the room went colorless with dawn, to pee. I’d had a couple weeks of food aversions, otherwise my pregnancy symptoms were minor—that, too, a miscarriage risk—except all night long I navigated around the bed in the dark, and in between trips to the bathroom, I thought about my sister. Where did she pee? Who was in the tent with her? If my sister had a lump, no one would ever know. Malignant, benign: it could be anything it pleased.
Second Trimester
80 percent of breast lumps are non-cancerous. No one seemed worried about my upcoming appointment at the Cancer Center, not even my mother, who kept forgetting about the lump; my sister had gone fully MIA, drifting around somewhere in Portland, where fires licked the perimeter of the city and the air quality was red, red, red, among the worst in the world. In between reading about the fires, about the temporary shelters they were building for the homeless near the trail where my sister maybe lived, I Googled. Pregnancy-associated breast cancer—breast cancer diagnosed during pregnancy or in the first postpartum year—most commonly appears in women between the ages of thirty-two and thirty-eight. It affects one in 3,000 pregnant women. Not high odds, but not impossible ones. It felt good to look at the facts, to sift through years of careful research instead of diving into the mystery zones of COVID, of my sister, where my questions yawned open, too big for beginnings or ends.
The mass was not tender to the touch, as a cyst might be. It felt firm, maybe rigid, but what did I know. I began, calmly, with the same degree of distance I approach various facts about my sister’s life—as when, days before my first ultrasound, in a fit of missing her, I Googled her name, and was confronted with a mugshot time stamped from a few weeks prior, my sister crying, her cheeks hollow and slack—to allow myself to think about what I’d do if the lump were not benign. I would wait to start chemotherapy until deeper into the second trimester, when it’s safest for the fetus. I would be too toxic to breastfeed. Probably I would survive, but if not, my baby could.
In the days before the appointment, I bided time in a kind of mental waiting room, a space defined by uncertainty. I know this place. If too many signs of doom accumulate, I move right in, though in a way, part of me is already always there, because my sister hasn’t been well, not really, since she was fourteen or so, and every day I am afraid she will die. The held breath. How you track the markers on the horizon—the clouds gathering, the wet spark of distant lightning—and countdown to the noise.
In the Cancer Center’s actual waiting room, several chairs were x-ed off with masking tape. The woman across from me, her gray hair pulled into a low bun at the nape of her neck, wore a baggy mask that dipped below her nose as she tapped on her phone. I swallowed an angry noise—though, for whom? Her lack of consideration for her own safety? The other women? Myself? She was certainly higher risk than me. The baby? We were in the hospital’s basement, the air stagnant except when the doors to the windowless corridor swung open. All of us wore thin robes over our shoulders. Our breasts, those fraught zones of trouble which could both give life and ruin it, cold beneath.
In another unventilated room, a nurse congratulated me as she felt me up. Your first? she asked, her fingers zeroing in on the lump. Yes, I said, but it felt like lying. I still had months to go, most of them containing a test either I or the baby needed to pass. I preferred avoiding all talk of the baby; this was about the lump. Is this—she pushed it with her finger—what your doctor found?
An ultrasound tech circled my breast with a gooey wand, around and around. Finally, she stopped, pressing it into my skin so long and hard it hurt. Unlike when I saw my baby, the screen was a cosmos of sinister light, nothing moving through it, however alien, that could be mistaken for alive. Okay, she said abruptly, and left. After a long time, she came back with a piece of paper. The ultrasound didn’t turn up anything definitive, she said. Pregnancy can cause a lot of changes in the breast tissue. But if you feel another lump, or you feel like this one is getting bigger, you should come back. Can you please sign this? It told me my results were inconclusive but likely non-cancerous. The purpose of my signature, as far as I could tell, was to excuse the Cancer Center from liability for any negative outcome of me following their advice.
Of course, I didn’t want to be sick. But can I call what I felt relief? It lasted a second, before being replaced with my pandemic baseline—instead of having access to the full range of human emotions, an ongoing calculation of risk management had become my temperament. Every locked-down day, we sidestepped the virus—curbside pick-up for groceries, no social contact except outside at a safe distance, glasses and one of our rare KN95s for all visits to the OB-GYN—and I diligently adhered to the rulebook for a healthy pregnancy, taking my prenatals and restricting my caffeine intake and exercising. And yet, even after the most immediate crisis had been ushered out the door, its scent lingered. The lump was still there. It was nothing, or it was nothing for now. I would have to wait and see.
Once again, I’d gotten off, like my sister never did, with a warning. Everything I’d ever wanted was coming true: I had meaningful work with solid benefits, a baby growing inside me, a supportive partner. Other women in the Cancer Center’s waiting room that day had gotten different news. I dipped back into the fertility forums I’d abandoned after reaching my second trimester and saw some familiar users, their IVF postponed because of COVID, talking about giving up. My mother-in-law’s friend died, days, it felt like, after we learned she was sick. My sister’s most recent number stopped even going to voicemail. It felt wrong to be so joyless and afraid, when there were reminders all around me of how much worse things could be.
But after months trying to conceive, and then months of miscarriage terror punctuated by the adrenalized semi-event of the lump, when I thought of the baby inside me, my anxiety just kept unspooling, as if I’d thrown a roll of thread down a long hallway. The baby, lump-like, was another unknown on the horizon. Not only could I not picture the person I was growing, I had no idea what the world would look like when—if—it arrived. Sometimes I took a selfie to capture my expanding belly and sent it to a couple of people, but only when asked. At night, I felt for the lump—still there! Though I’d left the Cancer Center vaguely worried the lump might someday morph from inconclusive to worse, after a few days it joined the long list of facts from 2020 I couldn’t order into sense.
At around eighteen weeks pregnant, I felt the baby move. It was the middle of the day, and I’d just taken a shower. I hadn’t been sleeping well and sprawled out in my towel on top of my bedspread, in search of a nap. And then I felt it, the sharp flip of a fish who, in rising to the surface of the water, struck the drum of my belly instead of the open air. Just once, as if it learned a lesson. Of me, because of me, but unmistakably a creature with its own will, whose fate I could influence but not control. A flash of certainty, for the first time since the air had become a carrier for an invisible, deadly virus. I knew. Not only was my baby alive—it wanted to live.
The pattern, throughout my second trimester, went like this: We’d go weeks without hearing from my sister, and then a voicemail from one of the hospitals in the Portland metro area, saying she’d been admitted. They’d keep K for a few days, a week, but no matter how many calls my mom made trying to coordinate a place for her in rehab or transitional housing, how many conversations she had with doctors, asking why K couldn’t be checked in for long-term care, they’d release her to the streets. Don’t worry, one nurse said. If she comes back often enough, they’ll admit her for longer. What if she dies before then, we wanted to know. No one had an answer for that. K was found sleeping in a construction site. The hospital transferred her to a prepaid motel room, where she colored all over the walls and burned towels in the bathroom and dragged pounds of rocks and sticks in from the outside. The staff called the police, and K was checked in to the hospital again. Released, at her own request. Weeks with no call, K living anywhere, nowhere, and then, a voicemail from another hospital. My mom flew out to Oregon, the pandemic surging, and met K in the psych ward. I worried my mom would get COVID, but I was also worried that this was K’s real rock bottom. How many relapses does a person get in a single lifetime? I talked to K for a few minutes, for the first time since Fred Meyer—her voice small, as if she were muttering from the bottom of a well. K’s drug of choice is meth, it is heroin, it is “some white powder,” it is whatever she can get. But she’s also mentally ill. A cluster of diagnoses that change depending on the doctor, the drug that brought her to the hospital’s door: bipolar, schizophrenic, borderline personality disorder, PTSD.
According to my mother, showing up at the hospital was a mistake. It made the nurses and doctors, overwhelmed with patients like my sister, feel more comfortable releasing her. But how can an unemployed fifty-nine-year-old woman take care of her actively using adult daughter during a global pandemic? We called rehab centers that took OHP, begged them to hold her a spot, but my sister refused to go. The way my mother tells it, K literally escaped the day they checked out of the hospital, hopping on to the MAX train and disappearing in search of a fix. When I hear this story, I’ll admit—I am angry. Why didn’t my mom have a better plan? How could she just let her go? And then I look around my comfortable house, packages piling up in the foyer, bottles and onesies and teethers, thoughtful gifts from friends. Letting her go is exactly what I’ve done, am doing, too. There’s nowhere for me to put down this blame, so I take it in.
Inside me, the baby swivels and flips, practicing for its unimaginable future—the life I can’t protect it from.
Third Trimester
In my health app, each of my past appointments with my OB-GYN includes a “visit summary.” Under a category in these summaries called “Problem list, pregnancy complicated by” it says: Left breast mass, 2x3 cm, unresolved. It says: Supraventricular Tachycardia (CMS/HCC), unresolved. It says: Depression/anxiety, unresolved.
But the baby isn’t unresolved. The baby progresses. The baby’s due date is far away, closer, and then almost here, corresponding almost exactly with the one-year anniversary of the first COVID shutdowns in the United States. The baby passes all the tests. We have sonogram photos of its nostrils, its feet, its spinal column. By every rubric of pregnancy, a healthy baby. At thirty-six weeks, my OB-GYN feels my belly, prods it with the ultrasound wand. I see a blob, hear the racing whoosh of a heartbeat, familiar to me now, reassuring. “Not particularly small, not particularly large,” she says. Normal. Aside from the problem list, I am “normal” too, no gestational diabetes, no preeclampsia, no placenta previa, no cholestasis, not one of the complications I obsessively read about, monitored myself for. I feel huge and distorted, unable to shave my legs or put on my own shoes, and my face looks different to me, wider in places, new grays in my hair, deeper wrinkles around my eyes. Sometimes when my husband comes in from a run, I’m enraged by his beauty, that he looks exactly the same as he did the day I found out I was pregnant. I rarely sleep at night, and rely on naps to get anything done, but after five months of insomnia I am almost used to it. When the baby kicks, I can put my hand on its intelligent foot, an insistent, sudden mound on the left side of my abdomen, so strong at times it makes me gasp. At night, when my husband reads to me, I feel the baby turn toward its dad, as if to better hear the words.
My husband and I go to pick up sandwiches from a place near our house, and for the first time in my pregnancy, a stranger tells me congratulations. Why, I think, and then—oh. The baby, she can see it, and acknowledgment from a person who is not my husband, not my doctor, not one of my friends shrunk to the size of my iPhone screen, sends effervescence through my veins, a feeling so light and happy I almost don’t recognize it. Joy? It’s confirmation I didn’t know I needed, that my pregnancy is happening in the world—that my baby will happen in the world—not just online, or in my mind.
The weird refuge of anxiety, how, when you’re in the throes of the loop, rehearsing every possible deviation into nightmare, you can almost believe you’re keeping the thing you dread from reaching you. And yet, even knowing this, my brain slots into its familiar groove, swapping outdated fears for impending ones: C-section rates and fourth-degree tears, new variants, the possibility of COVID transmission from the vaccinated to children, the vast mystery of the soon-to-be living baby, if it will be healthy, happy, the ways I am bound to fall short as a mother, whether the world will get more or less dangerous, and for whom, how I will explain any of this to the baby, the fact that I was one of the safest, most protected people on the planet, and I still spent every day of my pregnancy terrified. Don’t forget about the lump, my brain whispers. You never know. A dirty trick I can’t stop falling for—trying to worry my way into being ready for whatever’s coming.
The baby doesn’t care about the dark thoughts I cycle through at night, or about the disasters that happened and the ones we avoided, the smoke from both still rising in the air. We summoned it here, and now the baby is ready to be born.
Every few weeks or so, K calls my mom from a different stranger’s phone. She never calls me, though she has my number memorized. K is alive, I think, when my mom shares the news. Right now, K is alive. We measure the days between her calls. Have you heard from her, I text my mom, knowing the answer, when my body tells me it’s been too long. Have you heard?
My sister and I shared a room until my freshman year of high school. I slept on the top bunk, she slept on the bottom. We grew up an hour north of the forty-fifth parallel, a land of violent late summer thunderstorms, warm and cold fronts meeting over Lake Michigan and releasing torrents of rain, a precursor to the months of lake effect snow that turned our dead-end road into an icy tunnel.
The room would flash with a silent, staticky blaze, the hair rising on my arms and legs. I was older, but lightning scared me more, and I shot down the ladder and climbed into bed next to K, pressing my back against hers. My sister and I counted together, the numbers a bridge we walked between panic and safety. Sometimes we only got to one before the room shook with noise; sometimes to four, to seven, to fifteen. When we heard thunder we stopped, divided by the total by five, and that’s how we measured the distance of danger, whether it was moving away or coming closer, exactly how scared we should be.
I keep on counting, through the hours right after the baby is born. I count when they take him from me, my blue boy with his cap of hair as black as K’s, so much bigger than they predicted, because he needs help to breathe, and I do not stop, not even when they disconnect the wires and tubes and I finally bring him home, counting and counting, as he reaches his curled fist towards my face, my way of warding off whatever might be waiting for us out there, tomorrow, or never, or soon.
I wonder if, wherever K is, she is counting, too. I wonder when it will make sense to stop.
Julie Buntin’s debut novel, Marlena, was a finalist for the John Leonard Prize and named a best book of the year by over a dozen outlets, including the Washington Post, NPR, and Kirkus Reviews. Her writing has appeared in the Atlantic, Vogue, the New York Times Book Review, Guernica, and elsewhere. Her novel-in-progress won the Ellen Levine Fund for Writers Award. She teaches creative writing at the University of Michigan.