Hardcover, I tell you. Full price!

Dear Liza Mundy,

I am a fan.  Let me tell you how big a fan I am: I bought your book in hardcover.  I think it's fantastic — provocative but not gratuitously so, balanced, well researched, and humane.  It's rare to find journalism that raises the essential questions of the ethics of ART without pissing me right off, but in Everything Conceivable you did it beautifully, nimbly avoiding sensationalism and finger-wagging and settling instead on a neutral-to-positive observational tone that recognizes what's at stake for those of us who face those questions on a very personal level.

I'm also a habitual reader of your columns, emitting a gusty sigh of relief every time I see that Slate, in its coverage of reproductive issues, has showcased your thoughtful approach rather than devoting precious, precious pixels to William Saletan (whose full name in this house is pronounced I Fucking Hate William Saletan).

So now that we have my iron-clad fangirl cred out of the way, can I just ask what the hell you were thinking?

I read with interest your column in Sunday's Washington Post magazine.  That is a fancy way of saying "read while trying to keep my eyes from rolling back crazily in my head."  See, I agree passionately with the central point you make, that insurance coverage for fertility treatment would reduce the incidence of high-order multiples.  I just wish you hadn't pegged that argument to Jon and Kate goddamn Gosselin.

Maybe you know this, but maybe you don't, so I'll be blunt: Lots of infertile people loathe the Gosselins.  Oh, sure, we can identify with them to a degree; most of us have had to let financial considerations affect our reproductive decisionmaking in one way or another.  Plenty of us have had to decide whether to proceed with a cycle that could have resulted in a multiple pregnancy, and understand the dilemma they faced at the time.  And although many of us can't relate to their decision to continue their HOM pregnancy, many can, and even applaud them for doing so.

It's everything after, Liza!  The demands that the state of Pennsylvania extend Medicaid nursing care to their sextuplets — at the time a year old and healthy — because "society has a responsibility to help with the children, since modern medicine promotes the use of fertility drugs, which can lead to multiple births."  The soliciting of donations and what some feel has been a marked lack of graciousness when given gifts.  The acceptance of trips, a house, and cosmetic surgical procedures — Hair plugs?  Awesome. — as if it were all no more than their due.  And lest we forget, there's the little matter of the shameful and continuing exploitation of their children.  (Oh, yes, I, mommyblogger, did go there.)

My point is that it made me cringe to see you hold the Gosselins up as an example, even as an example of ART gone awry.  They're a lightning rod both within the ART community and outside it, and I would be sorry to see your cogent argument get lost amid people's feelings about them.  You know — I know you know — that there are far, far more...well, normal people contending with the same basic question the Gosselins faced: What's to be done when the most medically appropriate treatment is out of our financial reach?  And even though the family's travils serve as a useful and timely peg, I wish you hadn't hung your otherwise great reporting on it.

It is, as I know you appreciate, a big damn uphill battle, this insurance coverage thing.  I witnessed that firsthand last week, as part of RESOLVE's Advocacy Day.  I was a volunteer meeting with legislators — okay, fine, legislators' aides — asking them to support the Family Building Act, to require that any insurance plan that offers obstetrical benefits also offer infertility coverage.  I did my very best "to make the long-term benefits clear: fewer high-order multiples, healthier children, less exhausted parents."  Only I left out the part about less exhausted parents, because I think that part of the argument is way weak.  And I added my own flourish about ending up with more pocket cash for my own set of hair plugs.

Kidding.  Kidding!  It's the tummy tuck I'm saving for.

Anyway, one of the most basic principles of persuasion is that you don't introduce a negative.  If you are, for example, asking a polite but uninterested 22-year-old with a purple ball-point pen to convince her boss, a ranking member of the Senate Health and Education Committee, to support the Family Building Act, you don't mention Nadya Suleman unless she does.  (If she does, you create a disturbance — "Look!  Over yonder!  I think I might see an anthrax spore!" — and run.)  It clouds the issue and invites objections.  And God and ART patients know there are already enough of those.

So I guess what I'm saying is that I hope, in future, you won't introduce your own negative, diluting your message, which is a powerful one, with trivia.  I mean, come on: "Would better insurance have saved their marriage?"  Does anyone really care?

Don't get me wrong.  I still think you're pretty thoroughly excellent, and I appreciate your work more than I can say.  I think it can stand on its own, and it deserves to, without the silly trappings.

Love,
And I am not being sarcastic,
Julie

P.S.  Wait a minute.  I am reconsidering.  If invoking Jon and Kate gave you the leeway to be informal, using phrases like "doctors often stuffed lots of embryos into a woman's uterus," you know what?  I approve.  Carry on, Liza.  Carry on.

Father's Day

I'm sorry; I'm just a bit goopy today.  I'm missing my dad, like always.  The last time I saw him was Father's Day weekend in 2007, so he's very much on my mind.  (Nothing out of the ordinary, that visit, unless you find it sad and kind of freaky, as I do, that his children's gift to him that year was a Kevlar bulletproof vest.  Yyyeeeeah.  So much for Project Keep Dad Alive.)

My father loved his community and served it energetically.  I'd known about some of his efforts, like his membership in the Sheriff's Auxiliary (hence the vest); others I found out about only later.  Learning that he'd ridden with the Patriot Guard, a group of motorcyclists known for keeping Fred Phelps and his ilk at bay at the funerals of U.S. service members, made me cry.  (So did the presence of those good men and women at his visitation and his funeral, standing silent in respect.  God, did I cry as I thanked them.)  I'm sorry I didn't know that before he died.  That fact adds a dimension to my understanding of him that I didn't have while he was alive.  Even now I feel like I'm still learning who he was two years after he died.

What I did know — was fortunate enough to know — while he lived was how much he loved us.  I'd thought I knew it all along, but, hello, generational recapitulation, I now feel I didn't truly get it until I had kids of my own.  I remember so well when I had that epiphany.  I was sitting across from Charlie in the car of a Ferris wheel as we looked out across the fairgrounds a few summers ago.  His face was utterly alight: incredulous, a little bit apprehensive at the rocking of the car, so bright and observant, alert and, I don't know, just alive.  And I remembered doing exactly that with my dad, sitting stopped at the top of the wheel.  I was always disappointed to feel the ride lurch back into motion.  When I was a kid, that time at the top never lasted long enough.  Sitting there with Charlie, I felt that way again for entirely different reasons.  And so, I suddenly realized, had my dad.  He watched me with the very same pride, affection, concern, amusement, wonder — he loved me the way I loved Charlie.

If I hadn't had the chance to feel it myself, I wouldn't have fully appreciated it.  Last year at the fair, on the Ferris wheel again, I cried, understanding.

I am grateful, but also sad.  Infertility takes so much from us, starting with children conceived and born easily, of course, but continuing down through trust in our bodies; social connectedness; a feeling of purpose; and, oh, pretty much everything else you'd expect.  It can also put us at an impossible remove from our parents, the people who once knew us best.  As a consequence — and others may be more perceptive, so I speak only for myself — it can keep us from knowing, on that visceral, experiential level, how much we ourselves were once loved. 

Infertility did not, in the end, rob me of that precious knowledge.  But I know what I might have missed, and how lucky I am that I didn't.  Lucky to know how loved I was.  And terribly sad to have lost it.

Are you there, Internet? It's me, Margaret

Attention!  Attention!  I am about to talk about my period!  I warn you so that if frank talk of menstruation unnerves you, you may hastily click away, because I'm about to gross even myself out.

I am having a little problem, Internet, and I don't know what to make of it.  Rather than calling my doctor, a qualified, compassionate, and licensed medical practitioner, I thought I'd turn to my experienced friends inside the computer.  The Internet's not going to ask me questions I can't answer, like, How long has this been going on? and When was the last...? and How many days?  Because, I mean, who can be bothered to keep track when the subject is abnormal vaginal bleeding?

My periods have always been regular.  My particular flavor of infertility — Drāno lutefisk fiberglass ripple — has never had to do with ovulation.  I do it — did it? — like clockwork, day 13 or 14 of a 28-day cycle.  A reassuring and dependable sequence: blood-mucus-mittelschmerz-nothing-blood.  It didn't do me any good, but, like a beloved pet that thinks he's people, my reproductive system thought it was normal, and, well, that was something.  (Who's a good right ovary?  Who is?  You are!  Yes, you are!  Okay, not good exactly, but...)

But everything's recently gone haywire.  For the last few months I've had basically a week on, a week off.  A seemingly normal period begins.  Maybe there's blood for a shorter time than I'd been accustomed to in my younger years — oh, my God, listen to me, it's like at age 38 I am declaring my vagina a sacred burial ground.  Apply to tribal elders before digging —  but basically normal.  Then comes the mucus, that clear and stretchy stuff all the books assure me is the fertile kind, which I swear to you on a stack of little red books I never once in my life saw before I met exogenous gonadotropins.  Then the little bit of fullness and cramping I feel right around ovulation, earlier than I'd normally ovulate.  And then...blood.  First as streaks in the mucus, then as real red bleeding.  With mucus, and plenty thereof.

Which, well, huh, that's weird.  But it goes away after a few days and I figure it was just a strange short period, so I take off my white bikini and reluctantly stop riding bikes and doing gymnastics and straddling a white horse cantering down a beach with sugar-white sands.  I bid goodbye to my attractive friends, also coincidentally menstrual.  It's a shame because you know that slumber party we were having in that all-white room on that fluffy white down comforter?  You know, where we were laughing like assholes about a joke you, the impatient viewer, don't actually get to hear?  Well, the joke was real damn funny, and we all had an awesome time.

Aaaand now back to our show.  Except not!  Because instead of the 28-day bloodless, bikiniless, balance beamless furlough I'd expected, about ten days later, there I am bleeding again.

It's strange and I don't like it.  I haven't done a lot of — oh, let's call it research, real doctors loooove it when we call our half-assed late-night Googling research — because virtually every pixel Google owns wants to tell me that I'm entering menopause, and who needs to hear that when I have years of fecundity ahead of me?  And I haven't called my doctor because, as I said above, I haven't yet done careful enough tracking to do anything but stammer equivocally when asked a sensible question.  (Help me, President Obama.)  So I'll ask you, tiny corner of the Internet: What's going on here?  Has anything similar happened to you?  And will you come over in about ten days' time and join me in a pillow fight?  Do wear your white pajamas. I want us all to match.

To the distinguished gentleman in the Pharaonic headdress

Dear Composite Member of Congress Totally Not Based on Anyone in Particular:

Hey, how's it hanging?  I mean, of course, the fate of this great nation, which you hold in your powerful hands.  I was in no way referring, in an irreverent and vulgar manner, to any part of your august person that may or may not be pendulous.  But now that you mention it...

Couldn't help but notice that photo on your web site of you and your wife flanked by — how many is that? — eight?  Eight children?  Fheeeeeeeeeeeeeew.  (That's me whistling, onomatopoeia-style.)  You sure look nice with every single one of you wearing a white shirt and jeans.  I always think those let's-all-dress-the-same photos are adorable.  It tells me, "Here is a family that prizes homogeneity, complacency, and a monochromatic lowest-common-denominatorism over sloppy-assed individuality."  Kudos to you, I say!  Kudos!  Or I might, if the word "kudos" had ever before passed my lips.

About that family of yours.  I mean it — it really is a nice picture.  I can tell from your expression that you're proud of those kids, and you should be.  They look healthy and vibrant, and gathered around you and your wife, my God, do they look loved.  I can tell that from body language alone, unobscured even by the blinding white oxfords.  (Thanks, by the way, for not opting for turtlenecks.)

But back to your august person, neither more nor less but exactly as dangling as befits an elected representative of such distinction.  Seeing those eight magnificent kids of yours, I'm going to go out on a limb and assume you haven't faced any fertility problems.  Which is good!  I'm glad for you!  Your picture would look a lot different, I bet, if you had.  There might not be so many children.  There might be fewer.  They might not look like you.  There might be none at all.

Imagine what that would be like.  What if that picture were different?

It's hard when you can't build the family you hope for.

I will be in your D.C. office on Thursday, June 25 as part of RESOLVE's Advocacy Day to ask you to address that fact.  To affirm that you understand that your constituents need your help.  To convince you to take action on the following points:

• Shore up access to adoption by extending the adoption tax credit.  The current provision is set to expire in December 2010.  If this is allowed to happen, the amount of relief available to adopting families will decrease from $12,150 to a maximum of $5,000.  By supporting H.R. 213, you can protect your constituents' financial ability to adopt.  Waiting families are counting on you.
• Guarantee greater access to medical care by requiring health insurance plans to cover treatment for infertility.  By co-sponsoring H.R. 697, the Family Building Act of 2009, you'll be delivering on that promise you made to improve health care for your constituents — more of whom suffer from infertility than you know.  And you'll still be keeping that promise to make health care affordable — comprehensive coverage could actually reduce overall insurance costs.

But this is just an outline.  I will dazzle you with the facts in person.  How did I get so lucky, you are asking yourself, to have the chance to behold such an unstoppable juggernaut of persuasion in action?  (You only think you're thinking, How can I make sure to be not only out of the office that day, but on a fact-finding mission in some faraway place where she can't find me?  But you're not.  Because that would be ridiculous.  I promise I would find you.)

As to why?  Mostly, I guess, because I got mine.  I have my family.  After expensive procedures, years of uncertainty, and nothing much propelling me but nerve and a sick feeling in the pit of my stomach, I have two loud, beautiful, strong, improbable, wonderful, wonderful boys.  And it guts me to know that others  won't get that because they can't afford to try.

When I was in the thick of treatment myself, I couldn't have mustered the emotional energy to make much noise about this.  Now I can, because although God knows I love a spirited game of What Did You Just Put in Your Mouth?  Now Spit That Out Immediately, I am a woman of broadly varied interests and, yes, I believe I can spare the time.  And I know the value of who I have, which galvanizes me: Everyone who wants a family should have a chance to create one.  I'm asking you to help give them that chance — people I care about, but also people I'll never meet.  People like you, only not as lucky; like your colleagues — some of whom, I guarantee, have wrestled with infertility without your even noticing; like me.  You could say, in the most general sense, that I'm asking for a friend.

So on June 25, I'll come knocking.  Tell your aides.  I know they'll want to welcome me warmly.  Plus I want them to be ready to take notes.  Because aside from my earnest pitch, I'm probably gonna have a few more suggestions about that picture.  Next time may I recommend you and your crew deck yourselves out with just a little more pizzazz?  Maybe something in a golden snake hat?

Thanking you in advance, I remain,
Your friend the constituent,
Who actually did vote for you,
And even threw some campaign dollars your way,
Go on, check,
Julie

P.S. to interested onlookers: You come, too.  We need your help.  And, my God, so does your congressman.

Bleeding Kansas

I don't care how incongruous it might seem for me — at last and gratefully a mother — to rage at the murder of Dr. George Tiller, one of the few remaining doctors in the U.S. to perform late-term abortions.  It's not, and I'm doing it.

I am also donating to Medical Students for Choice, which works to secure training opportunities for pro-choice future physicians, and to the local arm of the National Network of Abortion Funds, which raises money to provide assistance directly to women in need seeking care.

I echo the NNAF's statement: "[A]ll women should have the right to decide whether and when to become a mother.  Every woman should have the right to shape her own life and the right to care for herself and her family with dignity."  And no one, no one should be harassed, threatened, hurt, or, my God, killed for assisting women in exercising those rights.

I know — believe me, I know — not everyone who reads this feels as I do.  If you are moved to say so in the comments, please do so respectfully, not for my sake but in acknowledgment that whatever you may feel about abortion or those who facilitate it, a man is dead, has been killed in cold blood, in an act of homegrown terrorism.  And if you do feel as I do, please take action.

Femme nue avec fromage, c. 2008

I know childbearing changes women's bodies.  I knew it would affect mine, even beyond the changes infertility itself incurred.  (Mushy white laparoscopy scars?  Check.  Persistent painful ass lumps from progesterone shots?  Check.  Fibrous wodge of scar tissue in the bend of each elbow from blood draw after blood draw?  Check.  Line forms to the left, fellas, for anyone itching to cop a feel.  You know you want to.  Don't be shy.  Palpaaaaate meeeeeee.)

I volunteered for pregnancy, after all — ha, understatement; I did the equivalent of blowing one half of the selection committee and blackmailing the other — and was willing to pay the physical price.  Most of the changes to my body didn't occur until Ben; for some reason I got off easy with Charlie, if you ignore my body's brief but passionate antepartum interest in bucket-kicking.

I am not especially troubled by most of it.  My bra size is back to normal — humming the alphabet song in illustration, and scatting artfully a few notes in, if that gives you any clues — and when I am clothed (read: shored up by the several flying buttresses of the Wacoal 85185) my breasts look as firm and youthful as ever.  (That is to say not very, but then a rack of these dimensions doesn't exactly call to mind visions of sylphlike ballerinas and unholstered gamboling nymphets.  Think sturdy lactating peasant and you're more in the general ballpark.  But a well-contained sturdy lactating peasant.)  Unclothed, I resemble something you would see in a glass case at the Museum of Natural History.  I will not blame you for hustling your children by quickly.  But then you probably don't want them to see my caveman spouse's Australopithecal wang, either.

But I expected those changes.  That's normal, after all.  So are the varicose veins that lace my right leg from knee to ankle.  They don't hurt; they're merely unsightly.  I like to think they make me look a little like one of the X-Men, like when Jean Grey went all batshit evil.  Since this is the only way in which I could ever be supposed to bear any kind of resemblance to Famke Janssen, I'm okay with that.  (My awesome mutant superpower is developing life-threatening blood clots.  Oh, it's kind of self-defeating, I suppose, but you work with what you got.)

And I am only slightly dismayed by the fact that while I am down to my prepregnancy weight, even my pre-cycling weight, that weight seems to have redistributed itself.  I am not exactly sure what's thinner, but something has to be, because I have a greater tendency now to hold on to mass around my midsection.  You know how our body shapes are said to tend toward either apple — weight around the belly — or pear — weight around the hips and thighs?  I am an apple.  I am a fruit bowl.  I am an entire goddamn orchard, if you want to know the truth.  In spring I positively swarm with bees.  But, again, this isn't exactly a problem, unless I ever want to purchase an article of clothing that is fashionable, flatters me, and fits properly.

But, really, all these things are okay.  I am grateful, and I am not especially vain, and I am especially lazy, so I find acceptance very easy.  Stretch marks, fine.  I think of them as racing stripes.  Permanent changes to my nipples, fine.  Useful adaptations for nursing, even though neither of my children would be able to pick them out from a police lineup.  ("Number three, step forward...now put on the ski mask...and the wig...and the Groucho glasses...and the scary latex Nixon mask...Yes, that's her!")  Even the C-section scar I have is fine, considering that not a year ago somebody made a swift seven-inch slash in my abdomen and withdrew from it an entire new person.  Funny thing about that, though.  When I told the nurses which doctor was slated to perform the surgery, every single one told me how lucky I was.  "He's an artist," one of them cooed, speaking of his virtuoso skill.  Yes.  She cooed.  (Nurses, don't ever do this.  It creeps your patient out.)

Which, I mean, I don't know.  Maybe he is an artist.  Maybe creative caprice is the reason for the only postpartum change that truly unnerves me, the weird subcutaneous blob that now resides on the left side of my abdomen, three inches southeast of my navel.  It's soft and kind of wobbly, a noticeable asymmetrical protrusion where nothing stuck out before.  If the doctor is an artist, he is a sculptor, and he works in human fat.  Or maybe in washed-rind cheese.  And in my educated opinion, he does the kind of work that makes jerks in museums scoff and say, "Oh, sure, that's art.  My kid could do that." 

Of course, if I can't blame the doctor, I guess I have to accept that in an indirect way, my kid did do that.  Suddenly my eye is newly informed and I'm seeing that bulging fist of cheese in a more appreciative light.  Why, it challenges what we thought we knew about, uh, tangerine-sized clumps of fat.  Insistently it prods us to reexamine our aesthetic relationship to an unsightly gob of blubber.  It occupies the space, long believed merely philosophical, where beauty and suet collide.  With the advent of this seminal work, adipose tissue serves no longer as simply a loose connective mesh of fat cells, but as a ringing indictment against — oh, let's just say man's inhumanity to man.  "Within my indistinct margins," the work seems to whisper, "can be found a shrine to the human spirit, in all its courage and its frailty.  And also a ham croquette."

My son the artist.  He's some kind of fucking prodigy.