Green Hills Literary Lantern

 

 

Vitamin A

 

 

 

(first published in The Write Place at the Write Time) 

 

As far as honeymoon spots went, they’d found the perfect place:  Italy’s Cinque Terre—sharp hills speckled with purple lilacs, fresh lemon groves, pastel houses, and the sparkling jade Mediterranean flowing onto beaches dotted with umbrellas.  

“Get over here, you sexy thing,” Maya shouted to her new husband. He teetered a bit too close to the edge of a jagged cliff. They were trekking from Vernazza to Corniglia. Ben smiled, then motioned as if he was going to jump off into the sea, teasing her. Maya didn’t find this funny. Her stomach roiled and her chest tightened. Ben came over to her, removed the red bandana that was keeping the sweat off her tanned face, and kissed her slow and deep. She touched the scruff growing along his strong jaw line. He kissed her again, harder.

They hiked the Via dell’Amore, on their way to Manarola. Invigorated, they climbed a narrow, twisty, medieval staircase and popped open a bottle of Prosecco. The sun glinted off the faux champagne glasses Ben took out of his backpack as the waves gently crashed on the cliff face below. He looked very sexy with his brown hair messy, blue eyes squinting in the sun. His red T-shirt showed off his muscled arms.

 “Cheers!” He looked at Maya adoringly, ran his fingers through her shoulder-length dark hair.

 “Salut! Can it get any better than this?” Maya replied.

 

Four weeks later, she took the test.

It was positive.

Maya looked again. The two most perfect lines formed a plus sign on the stick. This was what she had been waiting for ever since she was little, when she’d pretended that her Cabbage Patch Kids were real children.  

She brought in two different timers and her favorite yellow antique clock from Rome, the one with a miniature Piazza Navona painted on it. Her parents had bought it for her when she was a kid.

She peed on a second stick.

She waited.

 

She ran downstairs to tell Ben. He was mowing the lawn, trying to make piles of the colorful leaves that had fallen. He would be stunned off his ass. She’d told him that it would take six months to a year, like all her friends had said. No one expected a honeymoon baby. Before she could tell him, she ran upstairs to check just one more time, to make sure both sticks still had plus signs. They did. She looked again. Should she go to the store and get another one?  

“IT . . . HAS . . .  A . . . PLUS . . . SIGN,” she said out loud.

She ran downstairs again and looked at her husband though the kitchen window. He was smiling like he always did when engaged in mundane tasks. This was one of the things she loved about him, his love for the simple things.  Maya ran toward him. “I’m pregnant. Holy freakin’ shit!”

His face turned white at the news, but then the corners of his thin mouth curled. He hugged her and she inhaled his delicious, sweaty odor. He smelled like freshly cut grass with a hint of sweet, fading deodorant. He sniffed her left ear like a puppy; the way he did when he was excited about something.

“May, are you sure? How could it have happened so fast?”

“You must have Superman sperm. Or maybe all of those espressos from Italy made them shoot up super quick.” She shrugged. “Or maybe I’m a fertile myrtle.”

Maya was extra cheerful the next day, but she had to calm herself for her patients.

“It’s ok to be anxious.” She leaned in toward her first patient, Tessie, tried to show her compassion and empathy.  “Stop blaming yourself. You can’t always control your feelings.”

“No, it’s not ok!” Mild-mannered Tessie raised her voice, startling Maya. “Do you have any idea what this feels like? These daily panic attacks are debilitating.”

“Are you asking whether I’ve experienced this directly?” Maya hedged. “Well, no, but I’ve worked with several patients, and—”

“It’s utter hell,” Tessie interrupted, “Maya, what should I do?  Some days I’m curled up in a ball on the couch. I can’t cook dinner for my family.”  Her expression echoed her frustration and shame, her eyes watering as her jaw clenched.   

“I’m here with you.” Maya smiled her encouragement. “Can you pay extra attention to the distraction techniques I told you about? The deep breathing, and going down the list of things that might take your mind off your feelings, like a hot shower, a walk, or a funny show?

“Here is the number for a psychiatrist that I love. Maybe you just need some medication for a bit to get you through this rough patch.”

Tessie’s jaw tightened further. “I don’t want any meds. I want to fix this on my own.”

“Tessie, you have an organic condition. If you were diabetic, you would take your insulin, right? It’s the same thing,” Maya reasoned.

 

Tessie left the office with the psychiatrist’s number in hand. Maya’s mood shifted as she rubbed her belly. She rummaged in her purse for her cell phone to tell her best friend Mimi the good news. Instead, she found the tube of Retin-A cream she had been taking for eight years. Was it ok to take during pregnancy? She went to her office computer and started Googling.

Big mistake.

 “Surely the likelihood of any teratogenic effects would be low because it is a topical medication and less than 10% crosses the placenta,” the dermatologist said when she called him, frantic after what she’d read online. “We’re talking about a micron of Vitamin A. It’s a category C medication, and we tell our pregnant patients not to take it because in very large doses it can cause damage to the fetus. But again, yours was a topical cream, which contains a small portion of vitamin A. And most of it comes off the next morning when you wash your face. It even rubs off into the pillow if you’re sleeping on your stomach.” The dermatologist was trying to reassure her.

But Maya did not always take the time to wash her face every morning. And she never slept on her stomach. She was sure of that.

 

The following day, Maya cried to her OB. She listed the birth defects she was certain she had caused after reading what excessive amounts of vitamin A could do to an embryo during the first trimester.

“Maya, you’re barely even two weeks pregnant. I wouldn’t worry at all. It’s like my patients who come to me freaked out that they had a drink or a cigarette before they found out they were pregnant. The first two weeks are sort of like a free pass, because the placenta has not even attached. Nothing in your system has gotten to the baby yet.”

“But I read that as soon as implantation occurs, anything the mom consumes can affect the baby. And I read about Accutane and everyone knows how horrible—”

“Maya,” Dr. Berg interrupted, “Accutane has at least one thousand times the amount of Vitamin A that was in your face cream. Don’t worry about it. Relax. Enjoy your pregnancy.”

“But I also read this in-depth report from a clinic studying teratogens,” Maya persisted. “When women took Vitamin A on day twelve, their baby was born with massive deformities. Is that day twelve post-implantation or day twelve post-fertilization?”

           

                                                     ***

At the wedding of a former college roommate, Maya tried to put on a happy face. She and Ben snuggled together, Maya sitting on Ben’s lap. “I can’t stop kissing you,” he said.

Weddings always reminded them of their own courtship. They’d been married for only a few months but had met and started dating in graduate school ten years earlier. Maya had been smitten the minute she saw Ben’s blue eyes. She fell for his grungy look, the short, low pony tail held in place with a rubberband. And his love for Camus. Her mother had said, “Oy vey, you finally date a Jewish guy and he’s a hippy, with a ponytail, no less!”

But her parents also adored Ben, for his quiet confidence and fierce love for family. He had treated her parents as his own as soon as he got serious about Maya, inviting them over with his own family for Sunday night dinners in his tiny apartment.  

Maya slipped off Ben’s lap and moved across the table to tell her best friend their news.

Mimi jumped up, hugging and kissing Maya.

“DO NOT say a word, Meem. You know me . . . I’m scared that just saying this aloud will make me miscarry.”

Mimi started crying. “I’m gonna be an auntie!  And of course I’m so happy for you,” she added quickly. “This is what you’ve always wanted.”

Maya’s lips quivered. Her legs were trembling. She bit at her fingernails.

“What’s the matter, May? You’ve got that look you get when you’re worried.” Mimi frowned. She knew the expression on Maya’s face all too well: hazel eyes wide open, eyebrows raised. “And you’re biting again.”

“I’m petrified, Meem. I’ve been using Retin A on my face for years. I read last week that you’re not supposed to take it in pregnancy and now I can’t help but imagine the worst. Ben thinks I’m nuts.”

Mimi laughed and tried to brush Maya’s concerns off. She was familiar with her friend’s anxieties.

“I can’t stop looking at the internet. I’m up all night reading about people who have accidentally used a Vitamin A skin cream to find out whether their babies were ok. I never measured it; didn’t know I was supposed to. This is one of the vitamins that doesn’t leave your system. It stays in the liver and spills into the bloodstream, which means it can get to the baby! You can take as much Vitamin C as you want because you pee it out, but Vitamin A is toxic.” Maya had tears in her eyes. She was shaking.

Mimi held her hand. “May, I’m sure you’re totally fine. What did your OB say?”

Maya shrugged. “I called him twice and went to see him. I even called my dermatologist. They both said not to worry, that it’s so early, and that it’s not even an oral medication so barely anything would reach the fetus. But you know—”

 “Of course I know you, Sweets,” Mimi interrupted. “But you’ve got to listen to the docs. Come here, give me a hug.”

Maya hugged Mimi but whispered, “I’m afraid that all of my anxiety is going to hurt the baby. You know, the increased cortisol and everything?”

“You can’t help being you. You’ve been a worry wart your entire life. Nothing bad happens when you think it will, so try to calm down. Everything will be ok.”

“But do you ever remember me being this anxious?”

“Are you kidding me?” Mimi looked shocked. “Remember when you moved to Manhattan for your internship after the London bombings? You were so afraid Ben would be caught in a terrorist attack on the train coming to visit and that it would be your fault. And you would only go through the Lincoln tunnel when it wasn’t rush hour. You couldn’t sleep for weeks. You called me crying.”

I remember, Meem,” Ben chimed in, sauntering up to them with an India Pale Ale in hand. Only Ben would not care that he was the only person wearing a gray suit to a black tie affair.

“She called me ten times a day at least,” he told Mimi.

Then he sneakily sniffed Maya’s ear.  “You’re fine, I promise,” he said. “Let’s go dance.”

They danced the Hora. Despite the festive mood Maya couldn’t shake her intractable guilt.

Will our parents forgive me for using the skin cream?

Will they protect our child if it’s born with some horrible defect caused by excessive vitamin A?

Ben swung her around the dance floor. It reverberated from the 12-piece band. “Come on Maya, let’s do our silly shaky dance.” She shook. She danced. Will my child have a heart defect? Neurological problems? Will Ben ever forgive me for ruining our child?

 

When dessert came, Maya felt like she was in a daze. The coffee and tiramisu was served in its perfect little china. People’s mouths were moving slowly. She could not take a full breath. Her upper back hurt.

“An 8 ounce cup of coffee is nothing,” one friend sitting with them boasted. I mean, look at the size of a ‘cup.’ I must consume, like, forty-eight ounces a day!” 

“I know, right? I have eight cups a day at least,” Ben joked. “Between my research and the students I barely have time to breathe.” He laughed. “But I love what I do. I really do.” He grinned the half-smile that told Maya he was content. She rolled her eyes. Nothing bothered her happy-go-lucky husband.

She bit into the creamy tiramisu. Vitamin A was in milk. It was in this dessert. She tried to calculate the amount of milk she’d been consuming daily. Way more than 8 ounces. She had two, three, sometimes four bowls of cereal a day. With milk. How much vitamin A was in all of that milk? She recalled one of the milk cartons’ labels: High in Vitamin A Content.

Vitamin A.

Everywhere.

In the cream she had in her decaf coffee.

In the smoothies Ben made for her daily.

The ones where he added the protein powder with extra vitamins.

Oh fuck.

In the chocolate milk.

In the loads of fortified cereal she’d eaten several times in the past few weeks because she was so nauseous.

She deserved to die.

She looked up at a watercolor of the Amalfi coast hanging on the red-brick wall in the reception room to calm herself. Capri. She thought back to when she and Ben visited there on their honeymoon. They’d had sex on one of the small rocky beaches. It had been daytime, but they’d managed to do it. That might have been when the baby was made. She’d had endless cappuccinos that trip.

More milk.

No one would forgive her.

Ben will leave.

She looked over at her husband. He didn’t look back. The watercolor looked darker now, with long shadows thrown from diners’ heads covering it. Were the sailboats off Capri capsized? The water looked frenzied. Maya gasped, unable to breathe suddenly. She started to cry. She whispered to Ben, “We need to leave. Now.”

“What’s wrong?” One friend asked, looking concerned.

Ben nodded to Mimi.

Mimi stood up to help, putting her arm around Maya.

“Sorry guys, we gotta go.” Ben sighed deeply, rubbing his face as he got up. He knew there wasn’t anything wrong, just her growing fear that cut all the fun in their lives short these days. He wouldn’t meet Maya’s eyes. “She’s not herself.”

On the way out, Maya insisted they stop to see the glittery pink-haired psychic hired as entertainment for the wedding. Madame Antonia predicted that Maya would have two children. “Two boys,” the psychic said definitively. Maya got up to leave the table but the psychic tugged at her hand. “Wait . . .  Take good care of yourself, you hear?” she urged.

 

“I’m not well,” Maya admitted as she and Ben walked through the parking lot to their car. He would not look at her. “I need help,” she pleaded.

“You’re fine,” Ben insisted. “What would you tell one of your patients who sounded this irrational? Just talk yourself out of it. Come on, already. Get a grip.”

I hate you, she thought. What the hell is wrong you? Just help me. BE HERE FOR ME. But she couldn’t say anything. Who could blame him? What was happening to her? She couldn’t wait to get home to check the labels on the cereal. I must check that protein powder, she thought. Measure the milk. And the prenatal vitamins. How much Vitamin A is in those?

It was all too much to keep track of. Maya fell to the pavement. “I’m done,” she said. “I can’t move.”

Ben reached down and pulled her up. “You just need a good night’s sleep. Everything will be fine.”

She reached for Ben’s hand. His grasp was loose, half-hearted.

 “Listen to me! I don’t feel right. Something is off. What the hell is wrong with me? Stop blowing me off. Something’s not right.

Ben exhaled sharply. “Maya, come on already. Stop this. You’re fine. It’s just your crazy hormones. You have to be calm for the baby. You’re acting nuts. Snap out of it or—” He caught himself before finishing the thought, but he didn’t have to.

                                                                        

 Maya sprinted into the kitchen, poured milk into a measuring cup, dumped it into a bowl. She’d definitely consumed way more than 8 ounces a day. She read the labels of her favorite cereals. She couldn’t get to them fast enough. The boxes flew off the shelves: Smart Start. Rice Krispies. Lucky Charms.

How much Vitamin A was in the cereal? Twenty-five percent of the daily allowance? How much was beta-carotene? How many times a day had she eaten cereal? How many ounces of milk? Had she drunk milk before bedtime?

Yes.

How much?

And what about milk in her oatmeal between classes at school?

String cheese.

Carrots.

That yogurt from the specialty store.

How much Vitamin A?

She called Kellogg’s, fingers tapping, heart speeding.

“Is the 25 percent Vitamin A beta-carotene or preformed Vitamin A?” Maya asked.

“I’ll go ask my manager,” the girl on the line said.

Maya couldn’t wait for the answer. She knew it was the bad vitamin A, the one that stays in the liver and becomes toxic, especially to an embryo. Shaking, she buried herself in a grey wool blanket. Where the hell was Ben? Through a peephole in the blanket, she stared at the wall.

She slumped into the spare bedroom. Why wasn’t Ben checking on her?

She walked into their room. He was in bed. They stared at each other. Finally Maya scuttered back out of the room. 

She shuffled back in again. ”You’re supposed to be by my side.  Not against me.”

“Maya, I’m trying. What else can I do? There’s no use talking any sense into you. You need to be strong. You can do this. I know you can. Come on, May, please?” His eyes had tears in them. His face was flushed. He was sweating which he always did when he was angry or nervous.

“Just hold me. Be here for me. Please.”

Ben held her as best as he could. She could tell that his heart wasn’t in it, but he held her limply while he turned on the TV and watched basketball.

***

 

As a clinical psychologist, Maya was the one to heal others. But now her thoughts were spinning, grabbing, pulling her from reality. In her third trimester bouts of insomnia crippled her. “Cognitive behavioral therapy is the gold standard of treatment when dealing with any type of anxiety disorder,” she told her undergrad class through a thick, unrelenting mental haze.  She felt like a fraud, completely disheartened by the profession she’d worked so hard to be a part of.

            After class, she remembered the session with her patient Tessie months earlier.  She’d thought she knew what her client was experiencing. She had researched anxiety disorders for years. But she didn’t know. Not until now. Now she was crawling out of her skin. She could not sit still. Akathisia was the clinical term for inner restlessness. She felt she might drop dead from a heart attack at any moment. Complete despair surrounded her, like quicksand, or all-consuming darkness. She had to end the semester early.

 

On the way to the psychiatrist, Ben stared straight ahead. He wouldn’t hold her hand. “Ben, I don’t know what’s happening to me.” Maya could barely keep her head up. “I haven’t slept for the past three nights. I’m losing it. Am I going to die?”

Ben said nothing.

 “Textbook obsessive compulsive disorder,” the compassionate psychiatrist who specialized in peri-natal and postpartum depression and anxiety pronounced. She removed her trendy glasses and looked squarely at Maya and Ben’s bewildered faces, issuing this diagnosis after Maya described carrying money in her pocket as a child while walking to school in case a robber jumped out of the bushes; always telling her parents how much she loved them for fear that if she did not tell them enough they would die; and as an adolescent, checking on her younger brother several times in the middle of the night to make sure he was breathing. As an adult she obsessed that if something happened to any of her loved ones it would be her fault. A car accident on the way to meet her for dinner? Her fault for choosing the time, the location, the type of cuisine.

“Magical thinking,” in clinical terms. A term Maya had learned about in an anxiety disorders seminar. Funny how she hadn’t realized that she had been doing it her whole life.

“You’ve been suffering from severely untreated OCD for years,” the psychiatrist said.

“Seriously? I really think if had never looked up the Vitamin A, then—”

“Nonsense. You were a loaded gun. The hormones and your vitamin A focus were the trigger. Make no mistake about this: you need to be on medication.”

 More medication? Now? How the hell could she have missed this? Maya felt humiliated. She would never forgive herself.

“But what about the risks to the baby?” Ben asked. “I really don’t want Maya to be dependent on meds. Can’t you suggest something else?” he pleaded.

He and Maya were seated at opposite ends of the maroon sofa.

Ben’s an idiot, she thought.  She wanted to jump out the window.

“The risks are far greater for your wife by not taking medication. This is a no-brainer. She must be on medication to stay alive. To keep your baby alive. Your baby will be fine. I promise you.” She said it so compassionately that for a brief moment Maya felt relieved.

“Maya has an organic condition. It’s no different than someone with diabetes needing to take her insulin,” her doctor explained.

How awful it felt to hear those words. “But don’t you see?” Maya said, “It is different. I’m a psychologist. But I can’t even fix myself.”

“Do you think marital therapists never get divorced?” the psychiatrist quipped. “Or cardiologists never get heart disease?”

“I don’t care,” Maya shouted. “I’m ruined! I’ll never be able to practice psychology again. What happened to the old me? Where did I go? I loved life. I feel like a monster. Who does this happen to? I had the best life. Now I can’t do anything.” She reached out for the psychiatrist, black mascara tears streaming down her puffy cheeks.

Ben put his hand on Maya’s back. “It’s gonna be ok. Everything will be ok.”

Maya knew better. She laid her head in his lap, sobbing. She would never be the same again. “I won’t blame you if you leave.”

“I’m not going anywhere,” Ben said. “Stop feeling so sorry for yourself. We know what the problem is.  It’s not your fault. But you’ve gotta pick up the pieces and take your meds and listen to the doctor. We still need the right car seat, bottles, and stroller. And what about newborn clothes for the baby? You’ve got to find a way to do it, May.”

He paused, then continued. “Are you going to be like this forever? Because I don’t know how I’ll cope with it.”

 

***

She had never felt so close to others’ suffering.

On the walk home after her 28th-week check-up, Maya had vivid images of being abandoned by everyone who cared for her. She was certain she would harm her baby more from the meds she was taking. The baby would be born with Persisent Newborn Pulmonary Hypertension from the Zoloft. She wouldn’t make it. Or she’d be in withdrawal from the Ativan, have serious neurological damage.  

Ben would leave.

Her parents wouldn’t live forever.

Who would she live with?

Maya visualized herself in a state facility, no teeth. No hair. No visitors.

Then she would kill herself.

Maya wobbled down 8th and Spruce towards Suburban Station among the successful men and women in their tailored suits and the doctors in their scrubs. They were all texting and looking important and impatient. Not long ago she had been right there with them. She gazed at the twenty-somethings, laughing, smoking, teasing one another after happy hour. This had been her for most of her life.

 But now she felt more kinship with the homeless people on the street. She offered her turkey sandwich to a man who reeked of alcohol. He was slumped over in the cold and musky underground train station. He could barely raise his hand. She gently placed the sandwich in his lap. She understood now why people drank to excess. Maya said hello, looked him straight in the eye, and gave a shy but understanding smile. His vacant eyes stared ahead, unwavering. Eventually, his gaze focused on her. His eyes remained flat, defeated. Hers were flat and defeated too.

 

When she arrived home Ben barely looked at her. He had his nose buried in The New Yorker, relaxing in his favorite green chair. 

She tiptoed towards him. “The OB said again not to worry at all. That this is ridiculous to worry about. You know . . . what everyone has been saying this whole time.”

 “I’m not surprised.” Ben barely looked up. He crossed his left leg over his right, took a sip of beer as he stared at her. He was clean-shaven and looked so professional, coming home from a long day of teaching undergrads.

“This is what I’ve been telling you non-stop. This is what everyone has been telling you. I can’t take it anymore. Just take your medication and stop obsessing about it. You have to. Do want to end up on fucking morphine?” He chugged the rest of the beer, looked back down at The New Yorker.

Maya huffed up the stairs and tried to lie down. She was clutching her tube of skin cream. She re-read the instructions, even though she had them memorized. One should apply only a pea-sized amount on the face each night.

Despite the extensive reassurance from her OB just hours before about the cream, and the anti-anxiety meds she was now taking, later that night Maya tossed and turned in the guest room. Had she put on too much of the acne cream? She went to the bathroom.  

 “Where are you going, Maya? Get back in bed,” Ben said impatiently. He’d heard her from their bedroom down the hall. She sat on the toilet and measured out the cream in the size of a pea, over and over again. What kind of pea exactly though—small or large? She took out a brown paper lunch bag that she kept hidden under the sink. In it were three different sized peas. Maya poured the cream onto them to see how they matched up. Even though she had done so before, she re-counted the days between refills at her pharmacy. The medication was supposed to last for 3 months minimum. She grabbed a piece of scrap paper out of the trash, searched for a pen and frantically did the math. Fear burned through her as she flinched from what she already knew: She had refilled on average every 1.5 months for the past several years. That meant she had used twice the recommended dose most nights.

She walked onto the tiny Juliet balcony attached to the guestroom. The wind was brutal, but Maya paid no mind. She stood there in her silky white maternity nightgown, looking up at the brilliant moon. She leaned over the railing. Stood up again. Rubbed her belly. “I love you so much,” she whispered to her baby. She leaned over again.   

I could easily jump.

She looked at the snow-covered grass below.

 I can’t feel like this forever.

Her OB had once told her that this experience would make her a better therapist one day. She had almost spit in his face.

Anything would feel better than this.

She quickly turned and walked back into the bathroom. She stared at the yellow razors hanging from the soap bucket in her shower.

She felt drunk as she pulled one of the razors down. She was on a high, her heart thumping. She took the razor and carved a three-inch slice in her knee, just to see what the pain felt like. The blood trickled down her leg. The sight of it brought her back to herself.  This is not how this is supposed to turn out.  

Maya stumbled out of the bathroom, dizzy and wheezing heavily. She collapsed onto the hardwood floors. She stayed there for two hours, panting and weeping.

Ben was fast asleep.

She went into the spare room, turned on a lamp and made herself look in the mirror. Where am I? She searched for an answer. She could hardly recognize herself. Half of her hair had fallen out. Her eyes were droopy and she was pale. What the hell happened to me? Where am I? She looked down at her belly, then back in the mirror.

Maya felt a sharp punch. Her baby, reminding her that some part of her wanted to live more than die, no matter what the cost.

                 

***                                          

A few years later, Maya stood in front of the Residence Medaglie d'Oro in Rome, the place she had lived while studying abroad with Mimi during college. The same place she had excitedly showed Ben when they traveled there for a vacation before they were married. Now Ben was teaching in Rome and Maya and their daughter were with him there.  

Maya marveled at how outwardly nothing had changed at the Residence Medaglie d'Oro, with its courtyard boasting large cobblestones surrounded by lush gardens. While Maya held Ava’s sweet, sticky hand, she gazed knowingly, lustfully, at all of the study abroad kids wandering around, innocent and happy.  When she was their age her main concern was where she and Mimi would go on the Eurail the next weekend.

As her family eased into the Italian lifestyle, Maya found it curious how she hadn’t noticed the bags under the women’s eyes she’d interacted with daily years ago; the women awoke at dawn to make pizzas in the pizza rusticas that lined the streets of Rome. She and Mimi had always gone to the one that had the best potato and onion pizza. The owner had a son in a wheelchair, with feeding tubes and his head tilted upward. He sat beside the pizza counter, smiling, in his own world. What that poor woman and her son had endured.

Maya and Ava roamed the cobblestone streets while Ben taught, each day a new and unplanned adventure. They smelled the delicious homemade gnocchi and espressos. The scents of the foods and wines brought tears to Maya’s eyes. She was able to experience things so many others were not. Maya bribed Ava with gelato and toys just so she could sit in the trattorias for hours, chatting with the warm Italians while eating bruschetta and drinking red wine.

She envied the carefree families she saw each day walking the streets and in the parks. She wished she could be like those relaxed moms. She also envied the moms with more than one kid. She wanted another so badly, despite what she had gone through. Ben was reluctant, so they decided to postpone trying until Ava was five.

Her anxiety waxed and waned throughout the day, but it was her constant companion. She remembered what her psychiatrist had said to her after she gave birth: “Your identity has completely shifted.  I knew you wouldn’t be better right away. You may never be quite the same again.”

She tried to give herself the advice she had recently given to a client drowning in a deep clinical depression.

“Is there any upside to this?” Maya’s patient asked. “What is the point of suffering like this?”

“It’s awful, I know. It truly is horrendous. But I’ve learned that we can’t help the way we respond to things. All of us are hardwired differently. But I can tell you that people who have emerged from this darkness have appreciated certain moments—individual moments in time— more deeply. That’s all we have, really. They feel the warmth of the sun on their skin. They’re grateful for the rare times they laugh at something. Really laugh. Gut-bursting laughter. Notice those brief moments, even if they only shine for a minute or so. Embrace them.”

Her patient had smiled.

Now Maya smiled at the memory.  

She looked down at her precious Ava, with chocolate gelato all over her face and neck and the top of her frilly pink dress, with her huge smile, and Ben’s blue eyes, mischievous and sparkling. She was giggling and running around Maya in a circle. Maya couldn’t help but burst out laughing too, tickling and kissing Ava all over. The love she felt for this child was like none she had ever known.

 

One day Maya, Ben, and Ava were picnicking in Villa Borghese with several other families. It was a bright and beautiful day, the sky a deep blue with no clouds. All the parents were drinking wine at noon. The kids were jumping, giggling, and running around.

Ava ran to Maya and Ben and gave them a deep hug. “I love you, Mommy and Dayee. I love Eealy.”

They met an Italian family who invited them for long, lazy dinners with wines from Tuscany. They were swimming at the fancy club Alessandro and his family belonged to, having a blast splashing in the pool with his wife and their two little girls, when Maya felt a sharp twinge in her lower abdomen.

Two weeks later, she woke up with itchy legs and a fierce untamable hunger.

She took the test.

It was positive.

 

 

 

 

Amy M. Stein is a clinical psychologist, clinical trials consultant, and adjunct professor of psychology at several schools in the Philadelphia area. She graduated with a B.S. in psychology from Penn State University and with Ph.D. in Clinical Psychology from Temple University. She is currently working on a collection of short stories as well as an early chapter book series for third graders.