by Joanna Kadish

I sat with my best friend Terry, each of us holding our newly minted babies. Terry’s baby, Casey, was born breach, as was mine. But I didn’t feel any ill effects. Terry spoke of lingering pain from a cesarean her doctor performed against her wishes.

“Too many cesareans are performed because doctors are afraid of being sued,” Terry said. “It’s really gotten ugly.”

She mentioned a report in The Lancet October 2018 issue that says the rate of cesarean sections has tripled globally since 1990. In some hospitals, more than 70 percent of births occur by Csection, putting moms and babies at risk. Women who do not need a caesarean section and their infants can be harmed or die from the procedure. 

We were sitting in her living room in San Francisco’s elite Pacific Heights district near Lafayette Park in a Victorian-inspired home she inherited from her grandfather. It embodied everything beautiful about the forty-niners and the gold rush era. Terry’s grandfather made money selling prospectors tools of the trade.

I felt guilty; I couldn’t identify with what Terry had gone through and what she was still going through, and I wanted to offer my sympathy, but I didn’t know what to say. I scoured my brain for comforting words.

My daughter, Sarah, only a month old, technically still a newborn, slept peacefully in my arms. Everything would have been perfect, except my belly looked like a balloon with all the air punched out of it and ungainly. It was disheartening, but I knew my shape would improve. I had a child out of it, a beautiful child with the most angelic face framed by the sweetest cloud of soft brown hair. My labor wasn’t painful, probably should have been. My baby’s head started grinding into my spine, and I chickened out, asking for an epidural, which they readily gave me. My husband guided my breathing and alerted me when the electronic fetal monitor told me when to push.

But the narcotic turned me into a floppy noodle, and the nurses complained I wasn’t pushing hard enough. They physically used their hands to push on my stomach simulating the action of my own muscles. I was ashamed of my sorry performance. As far as being a woman destined to suffer though the birthing process, I was a fraud. At least in the eyes of my mother who said it was the destiny for women to suffer.

I wanted to go back in time and re-experience the birth of my baby, feeling robbed of the rawness of birthing process. Given the choice again, I would have refused narcotics like Terry did. I planned to do it without drugs the next time.

She was the brave one. I had never known her to do drugs that she didn’t absolutely have to take. Terry had rheumatoid arthritis and taking corticosteroids to reduce the inflammation: A double-edged sword that can lead to osteoporosis, cardiovascular disease, and weight gain. She already experienced weight gain, and started taking another drug to suppress the immune system response, but then she had to deal with an increased risk of infection.

“I don’t know if I can keep my job,” she said. “I may have to go into research. But I love my patients, I can’t conceive of doing anything else.”

Terry’s husband, a freelance photographer, was gone on a business trip, so it was just us girls on the couch, breast feeding our babies, and talking.

Sarah began fussing. The proximity of my heavy milk-filled breasts drove her crazy, and like a sex addict strolling through a high school gymnasium, she reached for them, her expression greedy. At her cry I could feel the pad inserts in my nursing bra getting wet. I sensed what a cow must feel when it’s constantly milked, the physical demands; always on call. I took off my bra and brought my dripping nipple to her frantically groping mouth, her hands moving like windmills through the air. She pulled at my nipple with her lips, acting the oversexed lover before settling down to suckle. The vibrations from her suckling thrilled deep inside me—I could feel my contracting uterus radiating to all parts of my body, a feeling that went beyond a mere lover’s caress. I recalled telling my husband a few days ago that I didn’t need him anymore, now that I had Sarah. He adopted his sad face.

Listening to my little one suckling with her strong, toothless little mouth, her little nose snuffling, and watching her hungry little face lapse into satiated, orgasmic animal bliss, the evolutionary imprint of a primeval, sensual pleasure that dates back to the time of the first mammals, tiny sloth-like creatures, filled me with the most intense emotion.

“Would Sarah suckle another mother’s breast?” Terry asked out of the blue, or so it seemed to me.
“I know my child,” I told her. “She won’t want your breast. Not even her father, whom she has known from the minute she was born, has been able to get her to accept my milk through a plastic nipple. Nor has he been able to convince her to lie against him in the nursing position. He rocks her to sleep every night with her back to him, never facing him. She won’t allow it.”

“Yeah, but he doesn’t have a breast full of milk.” Terry’s baby was still sleeping in her arms. Her baby was calm, even stoic, never fussing, even for her mother’s breast; Casey waited for her mother to offer it. “In previous centuries, women used wet nurses. Maybe your child will come to me.”
“She’s no pushover.”

“Come on.” Terry the scientist looked excited, her muscles tensing. “I’ve always wanted to see for myself. If a baby’s hungry enough, can she be persuaded? Please lets’ try with your baby…as an experiment?”

I told Terry that she had no chance. Sarah was implacable about her feeding; she physically had to be affixed to me all the time, refusing all plastic substitutes, preferring instead to suckle on me nearly nonstop. I could not leave the room without her strapped to me. I often fell asleep feeding her. Many nights I’d wake up in the middle of the night to discover her still suckling an empty breast, and I’d switch her to the other breast, by that time filled to bursting, and likely what woke me. This is not something doctors recommend. The literature cautions the risks of the mother turning on her baby and crushing her. I didn’t worry about this, even when I was asleep I felt her presence. I knew instinctually to stay upright against the pillow and not turn over. I took her everywhere. This baby was singularly driven, content only when attached to me like a little amoeba. Whenever the urge struck, I fed her. It didn’t where. I threw a blanket over me if we were in public. I never saw anyone look at me in askance, or say anything negative about it. It seemed to me that most people never noticed her undercover, suckling away, as oblivious to the blanket as most onlookers.

Casey lay quietly on her mother’s lap, her eyes at half mast, her head nodding, seemingly nonplused by all the activity around her.

After burping Sarah, she vomited most of it on the towels I had positioned around me beforehand. I promptly fed her round two until she was satiated. Usually it took a few feedings before she could keep anything down.

Terry exclaimed over my daughter’s vomiting, saying she had never seen a baby projectile vomit like that. I pointed to the bath towels I used to catch the spills, from experience I knew how far away to place the towels, never more than a few yards. Unlike most babies with this disease, she gained weight and looked strong despite losing at least half of what she took in. The doctors said she would grow out of it. I didn’t mind turning into a food factory, always a superabundance flowing, I never lacked for milk, perhaps because I never said enough is enough, or let’s not overdo it.

I ate as much as I wanted and still the weight fell off me. The forty pounds I had gained at the all-you-can-eat buffets during pregnancy vanished in a trice.

“All babies are connected to their mothers by the pheromones released in the womb,” Terry said. “But your baby and mine are bound more closely to us than that. They recognize us by pheromones secreted by the apocrine and sebaceous glands in our nipples and underarms. Babies who don’t breastfeed don’t have this connection.”

“My mother never breastfed me,” I said.

“My mother didn’t either.” Terry gently jiggled her daughter, whose eyes were swiftly closing. “Doctors back then thought formula was better, and then the research showed the superiority of breastmilk, and physicians had to do an about-face. Breast milk is better in all ways: it offers more protection against illness, and the protein and iron levels are beautifully calibrated.”

“My mother breastfed her last three,” I said, “but they didn’t appear to be any more connected to her than the rest of us.”

“That must have been weird for our mothers to have all that milk in their breasts begging to come out and not letting their babies at it.”

“My dad read the contents of the formula she was feeding my brothers at the time, it was soy-based, and he asked a research doctor, a friend of the family, about it. Doc Halpern advised my dad that soy might not be so good. He had been researching this for decades, and said that the use of non-fermented soy has been linked to digestive distress, immune system breakdown, thyroid dysfunction, cognitive decline, reproductive disorders, cancer, and heart disease. My mom heard from her doctor to stay away from cow’s milk, because there’s not enough iron and too much calcium and casein, which makes it even harder to absorb the nonheme iron. On unaltered cow’s milk, a baby pees nonstop to get rid of the excess protein and minerals, and suffers dehydration. So she switched to a hydrolyzed formula with very little cow’s milk protein in it. And that worked okay, but it wasn’t better than human milk. And what did it do to her body to have all that unused milk sitting in her breasts? Could that be what caused her breast cancer?”

“Studies have shown a higher risk for cancer in mothers who don’t breastfeed,” Terry said, rocking her child, who looked fast asleep.

“Crazy, huh? And she never went for mammograms, not until it was already too late; the cancer had spread to her lungs.”

“Doctors and nurses are negligent about their own health. Caregivers often forget we can get sick, too.”

“How long will your hubby be gone?”

“Back next Friday. I’m counting the days.”

“I’m thirsty,” I said. “You don’t mind if I get something for us to drink, water or tea?” I stood up and put my sleeping daughter into her Moby wrap, a soft sturdy fabric wrap that secured her tightly. “What would you like?” I kept her strapped on me, knowing the minute I stepped out of the room she would sense it and cry.

“Water’s fine.”

“I’ll be right back,” I said and went to the kitchen, found two glasses in the cupboard and filled them with water from the fridge.

“My dad was the same way, as you know,” I said, coming back and putting a glass of water on the coffee table in reaching distance.

“He was the worst,” Terry said. “He never went for checkups.”

Terry used to work for my father summers while she was in medical school. That’s how we met. I was in sophomore year of high school, and found Terry’s advice invaluable; she helped me navigate the treacherous shoals of teenage adolescence, and encouraged me to speak up more and take calculated risks. She was the one who alerted me that my father worked too hard and didn’t exercise enough, and suggested he walk more. I asked him to take walks with me but he said he had no time, in this fatalistic manner he adopted when speaking of his health, and that when he could catch a minute he’d do it. I didn’t want to fight him on it, but that response, and others, like the time he said it was “too late” for him, worried me. Terry said she’d work on him too. But neither of us could turn him around to our way of thinking. We knew if he had gone for checkups, they might have zapped the cancer before it spread and he’d be alive today. Terry was a stickler about checkups, and developing habits like getting enough rest and eating healthy.

Talking like this with Terry felt cathartic on one hand, and depressing on the other. It was truly one of the saddest things, knowing that if my father had been more vigilant about his own health, he’d still be around. My mother might have been persuaded as well, if he set the example. Then they would have met my child, my brothers’ children, and my sister’s daughter. They would have gloried in their grandchildren.

My father waited until he lost weight and experienced the telltale extreme fatigue red flag to run tests. Then he moved slowly, saying he had to think about it first. He and my mother weren’t getting along, they disagreed about everything, and it wore them both out, for us it wasn’t so bad, at least we could escape. As things stood, none of us could stand to be in the same room with both of them in it. Whatever the initial disagreement was lost on everyone, years later, she couldn’t stand to see him happy and would say some cutting thing to bring us all down. She won the fight, if you can call it a win. He felt a sense of malaise about everything, including his life. By the time he started treatment, his cancer had already spread below his esophagus. He told me once cancer hits the stomach, there isn’t much that can be done, the cancer cells replicate too quickly. His cancer likely evolved from the laryngopharyngeal reflux disease he suffered from, a known precursor, but in those days there was no treatment, much less a cure.

My father was 75 when he died. Not young, but it’s conceivable that he might have lasted longer if he had not delayed treatment. My mother died shortly thereafter. With him gone, she fell apart.

Thinking about his laryngopharyngeal reflux disease led me to worry about my daughter’s immature sphincter causing her to projectile vomit. Medical research shows why it occurs in babies, but not what causes the sphincter to stop performing in adults. The disease in adults is not fully understood. I didn’t know if I or any of my brothers or sister had suffered from an immature sphincter in the throat, or if there could be a link between the two diseases. My mother and father never talked about health when I was a child, and yet they were both medical professionals, so go figure. The research I’ve done on my own comes up with dead ends. Doctors I consulted assured me that in Sarah’s sphincter would mature, probably in her first year, and she would be fine. But a sliver of doubt remained.

But Terry kept pressing me to allow her to try suckling my Sarah, her eyes glowing with the purity of her intention. I wavered. If I didn’t know her better, I would say she exuded vitality and health. The corticosteroids did a good job of suppressing inflammation. Denying her wish made me feel heartless, like someone who takes candy from the dying. I felt my shame like a cold wind blowing through the room, making my skin shiver.

Looking at the pleading expression on Terry’s face, I disregarded my innate horror of having anyone else’s nipple in my daughter’s mouth and agreed reluctantly. “The minute she starts crying, hand her back,” I said. “I don’t want you pressing her to you if she struggles.”

Terry put Casey down in her bassinet. Casey didn’t stir.

Terry sat down again. “Okay,” she said, reaching her arms out and flicking her fingers impatiently.

Terry’s daughter Casey suckled every few hours, no more. I told Terry she was lucky to have such an easy child, but I was not being sincere. I knew that my daughter was more interesting.

Sarah started wailing when she was put up to Terry’s breast and flung her arms about, her hands balled up into fists. As Sarah’s cries grew more determined, my own breasts tingled and swelled, my nipples rigid, milk leaking, I begged to have my daughter’s tiny baby mouth back.

“Stop,” I cried. “You promised.” My voice sounded to my ears stressed to the point of nausea. I had a sick feeling in gut as if I needed to throw up.

Terry returned her to me and I snuggled her, a feeling of relief washing over me, gratified that my baby refused Terry, and that my baby and I were connected by this invisible force. Terry’s daughter woke up from the soundness of her sleep and started crying. Terry took her to her breast.

In high school I loved learning about human biology, I read everything I could on the subject, and my father and I would discuss what I had learned. Sometimes Terry joined our discussions. They tried to steer me into pre-med, but my math skills were so abysmal, I decided regretfully not to pursue it.

I thought back to the time, only a month ago but if seemed like a lifetime, when he called me and said in an unemotional tone that he had cancer, sounding like he was talking about a patient that he didn’t have a stake in. I rushed home, despite my extreme pregnancy, in that critical period two weeks away from my due date, flying 3,000 miles to be near him. I waddled into the house and saw him looking healthier than I had ever seen him. Gone was the puffy, tired complexion from overwork and lack of exercise. He said he had started walking with his live-in nurse, and he was eating healthier.

That first morning I was home, we fought over the granola, a food my father had never touched until his diagnosis. I voiced my surprise, knowing how much in the past he spurned it.

“The science has changed since I was in school,” he said.

His nutritionist advised him to eat roughage. I went out to the grocery store and made sure there was plenty of granola and salad so we could both have as much as we wanted.

A few days after my return to New York, my daughter was born. My father wanted to hold his granddaughter, so I flew with her only a few weeks old, so he could see her before he died. She cried when I put her in his arms, so I cozied up with her so he could touch her in the relative safety of my lap, where she enjoyed having him hold her fingers and coo at her. I could tell it tore at his heart, knowing he would never see her grow up. That same day, several of my brothers came in from across the globe and we sat together on the back deck listening to my father reminisce about his own father’s end of life, and the friends he wished he had kept in touch with, and hadn’t when his family and practice grew. I suggested he look them up and call them, but he said it was too late.

My father didn’t want to die in a hospital. He hated hospitals, having worked as a surgeon for most of his working life. He thought them cold and institutional. He wanted to be at home, surrounded by family. “I’ve spent plenty of time in hospitals, I’d rather die at home,” he said.

I understood what he meant. The hospitals he had worked in were filled with the sick and dying, sterile factories filled with the smell of antiseptic. I didn’t find them cozy, either, having visited with him frequently while he was on the job. But it was weird having him at home; weird that we could spend whole days together. Being with my father at a time when he was not rushed or in a hurry to get somewhere made it easier for him to express his emotional side, something he had kept hidden much of my growing up years. And there was John, my father’s male nurse, a sweet soul always with a song on his lips cheering us up when any of us felt low. He sang to my daughter: “Baby face, you’ve got the cutest little baby face.”

I sat with him the day he died, holding his hand, musing on our memories of good times we had spent together. Holding his frail, emaciated hand, I felt helpless, knowing there was nothing I could do to ease his pain. He said that the process of dying reminded him of being thirsty in the desert and searching for water, and finding none. As the pain worsened, fed through a tube, his pain kept at bay with fentanyl, he died in his sleep.

I took Sarah with me to visit Terry after he died, as soon as I was able. Terry now specializes in geriatric medicine, the one field where her disease isn’t such a liability. Her patients don’t mind if she can’t do some things, they understand what she’s going though.

The research has yet to show conclusively what triggers her disease or how it can be stopped, but scientists have discovered a lot about our bodies and how they work, yet there’s so much we don’t know, so much to learn. A couple of the most current theories, that bacterial infection or an overproduction of nitric oxide in cells inhibits the natural process of programmed cell death, leading to a lot of damaged cells messing up the work of healthy cells. Rheumatoid arthritis itself, along with some of the medications used to treat its symptoms, can increase the risk of osteoporosis, weakening bones and making them more prone to fracture, and that’s the danger Terry has to live with.

Terry hopes a cure can be found soon.

I hope science figures out this puzzle before it’s too late for Terry.

About the Author:

Joanna Kadish was a regular freelance contributor for the New Jersey Regional Section of The New York Times, and several regional newspapers and magazines, including The Cleveland Plain Dealer and Asbury Park Press. She received a few awards for her essay and feature writing from the Society of Professional Journalists. Her short fiction has been published by Literary Orphans, Cultured Vultures, and Citron Review. Joanna was a finalist in the Black Coffee & Vinyl Presents: Ice Cultures project, summer of 2018, Cutthroat 2016 Rick DeMarinis Short Fiction Contest, and received honorable mention in GlimmerTrain’s Emerging Writers Contest for 2015 and 2016.She holds an MFA in creative writing from Bennington Writing Seminars in Vermont, and her undergraduate degree in literature and philosophy is from UC Berkeley.