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09/11/2008

Bad patient. No cookie.

On day one postpartum, the OB who performed my C-section came into my hospital room and asked me if I had any questions.  I was nursing Ben at the time, feeling blissed-out and invincible.  "Nnnnope!" I told him, and turned my attention back to the newborn cherub nestled against my breast.  Well, and the wall-mounted television.  I make no apologies; it was five minutes to the hour and I had to see if the girl on My Super Sweet 16 got the tricked-out Mercedes SUV she'd sworn she'd die without(Oh, don't judge me.  You'd have wanted her dead, too.)

On day two postpartum, things were a little different.  My OB came into my hospital room and again asked me if I had any questions.  "Yes," I said, rabbity-eyed and blubbering.  "How come I can't have a cookie?"

Er, perhaps you need more information to put this into the proper context.

I had gestational diabetes, diagnosed early in the pregnancy.  Throughout the subsequent eight months my blood sugar control was impeccable.  Just the right combination of discipline, luck, and, oh, yeah, ever-increasing doses of insulin resulted in numbers that stayed, on the whole, remarkably stable.  Every week I'd fax my tidy spreadsheet to my maternal/fetal medicine doctors, and they would pronounce themselves impressed.  And I would feel virtuous.  Determined dieters have a saying: Nothing tastes as good as being thin feels.  Well, for me during pregnancy, no fluffy white food laced with delectable animal-derived fat tastes as good as being smug feels.

Look, smug's tasty.

Anyway, despite my good numbers, at every scan I was warned that Ben would be big.  Really big.  Like canteloupe-through-a-drinking-straw big.  Like no-way-can-your-vagina-manage-that-Chevy-Impala big.  I worried about this, thinking that maybe my postprandial readings hadn't told the whole story, that my diabetes wasn't as well controlled as it seemed to be.  But Ben's actual size at birth revealed that the predictions had been inaccurate — hey, who could have seen that coming? — which relieved that worry and made me feel even more self-satisfied.  Ha, I thought, when I was told his weight, I did this right.  I knew I was fifty kinds of kickass maternal awesome.

Gestational diabetes is expected to resolve immediately upon delivery because the placenta, which has been throwing its meaty weight around, is no longer present to terrorize the pancreas into a freaked-out insufficiency.  So the day after Ben was born, I celebrated by ordering the most lavishly carb-laden breakfast the hospital would provide: Cereal!  With milk!  And a banana!  And whole-wheat toast!  And it was the best low-fat whole-grain portion-controlled meal I'd had in 39 diabetic weeks.  What's that they say?  Complacency is the best sauce?

The next morning, having enjoyed it so much, I attempted to order the same breakfast.  But the woman on the phone who'd begun to take my order stopped me.  "Wait, the banana takes you over your carb count."  My what, now?  The same thing happened at lunch, when I tried to order the spaghetti and a salad and a carton of milk and a cookie.  This is how I found out that my OB had put me on a restricted diet for the duration of my hospital stay.

I would love to report that I met this news with equanimity — I can do anything for three days — or even icy rage.  No; instead I cried.  Friends, I sniveled.  Over a hospital meal.  In that moment I was a Catskills punchline made wobbly hormonal flesh: The food is really lousy, and the portions are so small.

The subsequent conversation with my OB was unpleasant.  I didn't express myself well; I was a weepy mess, resembling nothing so much as a thwarted child.  This undermined my point, which had to do with the paramount importance of patient autonomy, the value of discussing a plan of care in advance, and the immutable principle of OH FOR GOD'S SAKE I AM ALLOWED TO HAVE A SINGLE CHOCOLATE CHIP COOKIE, YOU CONDESCENDING TOOL.

He didn't respond well; his manner was defensive and paternalistic.  With a final passive-aggressive flourish, he offered to discharge me early if it was so important to me to eat what I wanted — the dirtiest of tricks, since we'd already discussed that Ben needed to stay to make sure his jaundice cleared.  So by the time we got around to any other questions, I was already feeling I was at a disadvantage.

I asked the single question — well, the single question that did not pertain to baked goods — that had occurred to me since he'd last been by: Did he notice anything unusual while he was rooting around up to his elbows in lady pelvis?

And as a matter of fact he had.  I was too rattled to absorb much, and too demoralized to ask him to dumb it down sufficiently for me to understand in my runny-nosed state, but what I think I heard is that my ovaries are mangled almost beyond recognition.  He used the phrase "streak ovary," which the good Dr. Google, who wants me to have cookies, has illuminated only so far as to tell me that either I have Turner's Syndrome (no); I'm intersex (I...I...don't think so, though I...nnnnno, I don't...think so); or I'm really, really infertile.

Which makes his subsequent question about contraception — yes, he asked, too — even funnier.

All of this is a ridiculously wordy way of explaining that I am truly dreading tomorrow's six-week checkup.  I am angry at the doctor for any number of reasons, the cookie actually being quite low on the list.  Somewhat higher is my suspicion that if I hadn't asked, it wouldn't have occurred to him to mention the smoking craters in my abdomen where once were functioning gonads.  (He also chose not to volunteer the information that Ben was delivered courtesy of the vacuum extractor.  What else haven't I been told?  What haven't I thought to ask about?  Did you find the Lusitania, Doctor?  No?  Okay, how about the Bismarck?  The Edmund Fitzgerald?  Jesus, do I have to name them all?) 

Also, I'm mortified by my behavior the last time I saw him, disappointed in my own weakness.  I wish I hadn't been so sloppy.  I wish I'd been more articulate and less emotional.  I wish I hadn't given him an excuse to discount what I was saying.  I'm uncomfortable with the dynamic I played into, and I'd rather not see him again.

Finally, though it is not really relevant at this point, as curious as I am about my ovaries and what the ramifications are, I don't exactly need further confirmation of what's been obvious for a few years now: I'm really, really infertile. 

Or, hey, maybe I am carrying around some ambiguous sexual anatomy.  Either way, much to my embarrassment I'm still a little pissed about the cookie.

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