I have received three major shocks in the past five months.
The first shock came mid-April, when my wife Megan sat me down on the couch to show me her positive pregnancy test. This was joyous but unexpected news. It had taken us three years of trying, including rounds of fertility treatments, before we’d finally succeeded in having a baby together: Clio is now a precocious 19-month old. This time, I just learned, no such treatments would be necessary. Clio was going to have a younger sibling!
The second shock came a few weeks later, after Megan’s first appointment with the Doctor after learning of the pregnancy. I was not able to attend, as I was at work. Upon arriving home from Track practice, I was greeted with this announcement (transcribed here, word for word, with apologies for the profanity, though if ever there was an appropriate moment to let loose a swear word, this would be it):
Megan: Do you want to see the ultrasound?
Noah: Oh, yeah. I didn’t know you got one.
Noah: How’s Doctor Spencer doing?
Megan: Well, she’s as excited as I am, because we’re having twins!
Noah: No fucking way.
Megan: Yeah (laughing). I’m not kidding.
Noah: (Incredulous) what?!
Megan: Yeah (laughing). Two babies!
Noah: Oh my God.
Megan: (sighing) yeah
Noah: (Looking at ultrasounds) I suppose this was fate.
You must understand something. I am a twin. My wife is a twin. We always joked that we were destined to be parents of twins, but in actuality the odds of twins having twins is infinitesimally small. This new revelation filled me with equal parts wonder and trepidation. We’re having twins! Will I ever sleep again?! I was soon to learn more information about our little ones: they are identical, and they are girls. I marveled to my wife that the contours of our life together were becoming clearer – I teach high schoolers, and at their age, the future is all hope and mystery. Can any 18-year-old truly know what their life will be like at 36 (or 37, my current age)? When we married, we knew we wanted a family, and now that dream seemed to be becoming a reality. So this is what life had in store for me: a job as a teacher and coach at Hinsdale Central, a home on a cul-de-sac in nearby Willowbrook, a loving wife, and three adoring daughters. No doubt my 18-year old self would be pleased with this outcome.
Then came the third shock. Identical twins, we were informed, carry higher risks than more conventional pregnancies. Unlike most expectant moms, Megan was instructed to schedule more frequent ultrasounds, just so that the Doctors could keep a closer eye on the twins’ development. At our week 16 checkup, (Thursday, June 22nd), our Doctor came in to review the ultrasound and delicately told us that they’d noticed an abnormality: one twin was growing faster than the other. A few other data points from the ultrasound readouts concerned them. We were told it may be possible that what they were seeing were early signs of a troubling development known as ‘Twin to Twin Transfusion Syndrome’ (TTTS). A relatively new surgery (developed within the past 20 years) to treat this affliction is the best hope for addressing the problem (a shunting off of blood from one baby to the other) though success rates hovered in the 70% range. We were told to return on Monday – if the symptoms worsened, we would need to make immediate plans to fly to Houston where some of the nation’s best maternal-fetal specialists work.
We exited the hospital in a daze. I put my arm around Megan and whispered to her, “life has just thrown us a curve ball.” She made it to the car before the tears came. We sat together in our sun-baked Honda Civic in the middle of a busy hospital parking lot, Megan sobbing and me staring into space (my own tears would come later that day, as we lay together on our bed watching a video about TTTS sent to us by our Doctors).
Monday, June 26th, the day of our 7th wedding anniversary, began for me as most summer Monday’s usually do – with a long run around Waterfall Glen. I was grateful for the tranquility such a run provides, using it to calm my nerves. Practice over, I hurried home, showered off, and exchanged pleasantries with the babysitter before getting into the car with Megan for the drive to our clinic in Glen Ellyn. We spent the car ride discussing possibilities and reviewing questions we had for our Doctors. I felt something equivalent to pre-race jitters as we entered the doctor’s office and waited to be called back to the examining room.
This time, I was more mentally prepared for the unexpected. The past few days had been tough, as we’d had to make many of the phone calls no one wants to make and hustled to put into place plans in the event we’d need to be flown to a hospital out of state. The interregnum had allowed time for Megan and I to process what we’d been told, to research treatment options and outcomes, and to vent emotionally. We were better positioned to learn what the fates foretold. Which was this: it appears the condition of the twins was not, in fact, TTTS, but rather a different but related condition called ‘Selective Intrauterine Growth Restriction’ (SIUGR). Since I am not a doctor, I will refer to the Children’s Hospital of Philadelphia’s website to explain: “Selective intrauterine growth restriction (SIUGR) occurs when there is unequal placental sharing which leads to suboptimal growth of one twin.” SIUGR evidently occurs in about 10% of identical twin pregnancies. It can range in severity, with the worst cases resulting in the death of one fetus in utero while the best outcome to be hoped for is a birth of two babies at 34-35 weeks. Unlike TTTS there is no treatment. We must simply watch and wait.
Subsequent appointments have confirmed this diagnosis. On our most recent visit, at 18 weeks, we learned one of our babies weighs about 7 ounces and the other 5. Encouragingly, the smaller baby seems to be receiving appropriate blood flow and is growing, albeit not as quickly as her sister. We have to hope she continues to grow and gets far enough along to be safely delivered. If we can make it to 28 weeks, our odds improve. If we get to 32, we are looking better still.
For the runner and the coach, exercising control over as many variables as possible is the most valuable currency we have. Yet, here Megan and I find ourselves in a situation where we have no control. It is a truly humbling experience, a reminder that free will is, to some degree, mere illusion. There are forces shaping us, in utero and out, that we have no power to impact. For once, there is no running or coaching analogue. Hard work and determination are irrelevant to this particular situation. Chance rules.
I often use the metaphor of the unfinished book when discussing an upcoming season with my team. Some chapters have already been written, I tell them, but you guys get to help write the conclusion. In the coming months, the narrative of our teams’ season will parallel the narrative of Megan’s pregnancy. I’ll have some power to shape one outcome, but none to shape the other. In both cases, by mid-November, the stories will likely both have officially been told.
At this time, when the ending is not yet known, I hope to live each day with gratitude: for Megan, who carries our babies and who, through the sheer force of her love would will them to health and safety, if such a thing were possible; for the doctors and nurses who have exhibited expertise, compassion and honesty in helping us understand our situation; for our family, friends, and colleagues who have formed for us a network of support that has made this episode so much more bearable; for having good health insurance(!); for the guys on my team who inspire me daily with their youthful enthusiasm and sense of purpose; and for little Clio, who reminds Megan and me always that no matter what happens, we can never say life has cheated us, and whose smile and laugh brighten even the darkest days.
So we journey on, ever forward, into the great unknown…