Down in Flames

World Trade Center Twin Towers in New York City before September 11th, 2001.

An infant struggles, like a cat evading a bath, in the arms of the teenage mother sitting next to me. The young woman—really only a girl—is perched on the narrow plastic chair attached to mine. She bumps me hard on the shoulder as she wrestles with the unhappy baby.

I shift in the cramped seating and avert my gaze.

The September night is unseasonably cold, and I wonder what private tragedy has caused this too-young mother and her T-shirt-clad tot to venture out alone.

The teen bumps me again as the infant stiffens in her grip, its small body gasping for air between wails. The mother apologizes this time, her face flushed and tired, and I nod, too caught up in my own misfortune to offer any response.

I glance at my husband sitting on my other side, his arms crossed and his eyes shut, making the best of a bad situation. I turn away, pushing down the panic in my chest. With no other option but to continue waiting, I gaze up at a small TV.

An amateurish video shows a passenger jet flying too low over the skyline of New York City, a towering Lady Liberty visible in the distant background. Moments later, the aircraft flies into a skyscraper while the camera operator repeats Oh my God over and over. The plane explodes like a bomb, flames and wreckage shooting out all sides of the precariously tall building.

The scene cuts and I watch as another airplane cleaves the tower’s twin, duplicating the fiery devastation.

The screen goes blurry and then clears as the camera shifts, zooming in on one of the towers. Huge clouds of black smoke pour out of a gaping hole, flames shooting out at the bottom. The view lurches and then steadies, strangely soundless. We glimpse distant objects falling—or could it possibly be people jumping?—to their deaths.

The TV switches to a different view, and we watch as floor after floor of one tower collapses down onto the lower levels, the whole skyscraper—and all its occupants—gone in a matter of seconds. Debris billows out from the vanished building like fallout from an atomic bomb.

As the monstrous pall dissipates, something pokes up above the ominous cloud: the mortally wounded twin tower abandoned by its mate—precarious, damned.

The scene cuts.

Down on the street, panicked people flee the toxic cloud. Impossibly large snowflakes choke the air. Rubble and smoke are everywhere. Two firemen, like spacemen on an alien planet, stare up at the remaining monolith, their thoughts easy to read: How much time do they have to get out? Not enough.

The scene shifts back to the amateurish video of a passenger jet skimming the skyline of New York City.

The images were recorded three days ago, the shock and horror drained out of them now by endless repetition.

I blink and look away.

Outside, beyond the heavy glass doors, dense clouds shroud the waning moon. Cold rain falls, struggling to become snow. The portal slides open, letting a damp chill in off the wet streets.

I shiver and slide closer to my husband.

A young man in a dark suit and tie strides into the large room, black dress shoes squeaking and leaving muddy footprints on the worn, grey-flecked linoleum tiles. Wordlessly he disappears through an inner door.

I look away.

Against the far wall, drawing breath with difficulty, a grizzled old man sits in a wheelchair. He looks like the sinewy trunk of a juniper atop a barren bluff of sandstone. I can hear the wind blowing the lifeless sand around him to the rhythm of his respirator.

Rest, sweep. Rest, sweep.

Next to him, a woman with gray just starting to touch her tangled locks sits rocking a child and humming a lullaby about pretty little ponies. She strokes the wispy flaxen mane of the young child asleep across her lap, a fleece blanket clutched in the child’s miniature hand. The woman’s eyes are sunken, her face lined with fatigue. She finishes the song and lets out a deep, tired sigh. The child stirs and mutters in her sleep. Her mother takes up another tune.

Across from me sits a middle-aged man, his face drained of all expression, his chin in his hands, unmoving. Unknown malady.

A young boy, perhaps ten, sits in the corner looking pale but otherwise unafflicted. His father sits next to him staring at the clock. Two women, early twenties, wearing nearly identical thigh-high plastic boots and short leather skirts, sit huddled together to my left. The darker-haired woman leans her head on the shoulder of her friend, an ice pack wedged against her cheek, eyes shut. Her companion cradles a cell phone in her lap—long, wine-red fingernails clicking against the plastic as she converses with an unseen other.

Without warning, a woman dressed in colorful scrubs—stylized zoo animals parading around puffy alphabet letters—pushes through the heavy door. The frown on her face clashes with her cheerful clothing as she leans her shoulder against the door. All heads turn as if to a shrill whistle.

“Where is the boy with the insulin overdose?” she asks, her voice devoid of emotion.

As if unexpectedly called on by the teacher, the man next to the pale boy abruptly raises his hand, his voice mute. Letting the door swing shut behind her, the nurse wades through the sea of chairs arranged at odd angles and bestows upon the father a pallid sandwich in a clear plastic container.

“Be sure he eats the cheese,” she says and then withdraws. All heads drop, shoulders slump, and hopes fade as the massive, windowless plank swings shut behind her.

Two gangly mid-thirties men dressed in faded scrubs enter through the glass portal. The sounds of traffic speeding by on wet streets splash through the opening behind them. An aura of smoke clings to the men like the dark side in a Star Wars movie. All eyes lift and fall as the acrid odor wafts across the room with the chilly, damp air. The men pass unchallenged into the inner sanctum.

Some time later, an exhausted-looking young woman slips out through the massive door, a sleeping toddler draped across her chest and shoulder. She tosses an afghan over her child—balancing its limp body with one arm and throwing the blanket with the other—a diaper bag clutched in her teeth. She lurches out into the frigid night, released.

Still, the wind sweeps around the tree, the baby sobs, the fingernails click, the humming mother strokes the mane of her sleeping daughter—and thick, warm blood leaks out of my body.

Tick. Tick. Tick.

I can wait no longer. I approach the small sliding glass window that separates those of us who are ill-fated from those who profess to help. I knock lightly, embarrassed by my need. A young woman looks up at me, blinking her bright blue eyes, but doesn’t open the partition.

“How. Much. Longer?” I ask, unsure if she can hear me through the glass.

She opens the panel a couple of inches and asks me which of the ubiquitous small, green slips of paper scattered across the counter is me. After a moment, I point to one, and she reads the words on the other side.

“Maybe an hour,” she says, “possibly less. It doesn’t matter when you got here, it matters how serious your condition is compared to the others.” She glances over my shoulder, surveying the room. “And more are probably coming.” She returns to her paperwork, sliding the window shut without looking up.

I walk back past the crumpled tissues, torn magazines, and cracked vinyl chairs, and collapse in the seat next to my husband. He places his hand on my thigh, and when I flinch, he quickly returns it to his lap.

We sit in silence as the clock ticks.

Muscle contractions—ten minutes apart now—take over my body like invisible aliens that feed on pain. Sweat breaks out on my upper lip and forehead as I try to breathe through the torment. When the aliens release me, I drop my head into my trembling hands—tears dripping through my fingers and falling onto the dirty floor.

The baby flounders against my arm. The fingernails click. The child cries out in her sleep. The wind gusts.

A stunning red-haired woman slides open the admitting window and pokes her head out—long, auburn tresses splashing across the counter like a mermaid. She glances at a small slip of green paper and then reads off a name.

No one moves.

I belatedly realize that she has mispronounced my name when my husband stands up and offers me his arm. With his help, I rise from the chair, my body consumed by shivering and my sweaty hair stuck to my face and neck. The nurse meets my eyes and then nods at the enormous door.

Tired and anxious faces turn to watch us.

In a small alcove adjacent to the office, the red-haired nurse points to a chair, and I gratefully sit. My husband glances around the cramped room and then stands behind me.

“When did the bleeding start?” she asks, her arms folded in front of her like a nun, her voice somber. “How heavy is it now?”

Nodding as I speak, she waits for me to finish, and then picks up a clipboard and writes on it. She sets the chart down and looks at my husband, then me. “If the cervix is open, the pregnancy is ended.” She squats down next to me and places her palm on my knee, offering consolation. “I’m sorry.” I glance away, tears filling my eyes, grateful for her simple act of kindness.

“I hope things work out for you,” she says and stands up. She turns and addresses my husband. “There is nothing we can do now except wait and see.”

She gestures toward another door.

My husband takes my arm and we pass into a dark and cavernous room.

Unsure of what to do or why we are here, we stand inside the door, surveying the shadowy chamber. Metal chairs are lined up in long rows in the half-darkness, all empty. Making some sort of decision, my husband puts his arm around my shoulder and guides me to a chair. The moment we’re seated, a short, chubby woman pops up from behind a half-height cubicle wall. Like a puppet on a stage, her head and shoulders bob above the partition in the gloomy light.

“Do y’all have insurance?” she asks, her cheerfulness chafing against my misery.

My husband nods.

She invites us to join her and then disappears below the puppet stage.

We stand, shuffle around the vacant chairs, and walk behind the cubicle wall to a row of desks, all of them empty except for one.

The cheerful woman is gone, and Cinderella’s wicked stepmother sits before us, her eyes locked on her computer. “I am going to take your insurance information,” she says.

We stand awkwardly in front of her bare desk—there are no chairs.

“Why are you here?” she asks, forcing my husband to speak the malediction aloud for the first time.

“Possible miscarriage.”

My baby is dying.

I can’t bring myself to say the words out loud, but the thought pounds inside my head as the contractions squeeze the life out of me.

“Name?” the insurance woman asks.

Unsure which one of us she means, my husband gives her both.

“You have different last names?” she says, her tone disapproving.

“Yes.”

“Are you married?”

“Yes.”

“But you have different last names?”

“Yes.”

She looks up at us for the first time, her expression annoyed at the gall we have coming to a hospital late at night, supposedly married—but with different last names—and making more work for her.

“Are you certain?” she asks for the fourth time.

“Yes,” my husband says, his voice strained.

“My computer has someone with your first name and her last name.” She reads off the stranger’s name and then his birth date. “Could this be you?”

My husband shakes his head, confirming yet again that he knows his own name.

She glances up, her eyes darting back and forth between us, and then orders us to sit—the chairs have been pushed underneath the table behind us. We pull them out and sit as she turns back to her computer.

I cry. My husband looks at his feet. The woman types.

“Social Security number?” she asks. “Occupation? Date of last tetanus shot? Religion? Living will? Dietary restrictions? Emergency contact not in the same household? Date of last period?”

The pain has become excruciating—contractions five minutes apart now—and I hunch over, trying to concentrate on my breathing. The red tide is washing out of me and taking away three precious years: thirty-seven failed attempts to conceive followed by this one faltering success.

“Look,” my husbands says to her, “we’ve been waiting for over three hours, can we please see a doctor?”

“Yes, of course. Give me a minute.” The woman yawns and takes a drink from her water bottle, adjusts the sleeve of her blouse, pats her thinning, poorly-dyed hair, and returns her attention to the computer.

I sit in the chair, shivering uncontrollably between contractions, and force down the urge to vomit.

Without a word of explanation, the woman leaves her desk and vanishes behind the cubicle wall.

I look at my husband, asking with my eyes if he has any idea where she went, and he shakes his head.

We sit there, not knowing what else to do.

A few minutes later, she returns with a baby-blue ID bracelet and five sheets of impact-printed paper, each a different color. She grasps my elbow and attaches the bracelet to my wrist, taking great care to tighten the thin plastic band as much as possible, the sharp corner where she has snipped off the tail cutting into the bottom of my hand. She holds up the stack of paper and tells us to return to the waiting area—the original waiting area.

When I ask how long we will have to wait, she meets my eyes for the first time.

“I have no idea.”

My husband looks as if he’s about to protest, but I put my hand on his arm and shake my head.

It’s too late.

We return to the waiting area.

The cheese-challenged boy and his father are gone. In their place are two Goth teenagers: a young Count Dracula and his pale date, hands held awkwardly across the aisle, copious metal jewelry clinking as one of them shifts in the chair.

My husband leads me to the same row of attached plastic seats, and just as he is helping me into the chair, the colossal door opens.

A tall, beefy guy with long curly hair calls my name, pronouncing it correctly. He’s wearing slate blue scrubs and enormous black boots, like some real-life Rescue Heroes doll.

We follow him down an empty corridor to a tiny examination room.

“Lucky thirteen,” he says as we enter, his voice deep and resonant. “I’m your ER nurse, Billy.”

I sit down in the only chair, unable to summon the strength to get on the examining table. Billy Blazes tells me to undress (“Everything off”), instructs me to put on a gown—an absurd euphemism for the paper scrap he hands me—and then leaves, his fawn brown curls bouncing down his back as he shuts the door.

I follow his instructions, shivering between contractions in the thin paper covering.

There is a knock and an elderly, well-dressed gentleman enters the room. He introduces himself and outlines how I will spend the middle of the night: a blood test and an ultrasound followed by an internal check to determine if my cervix is open. He will return when all the data has been collected. His words fly against the marred walls and slide across the shiny silver table to fall limp on the floor. After nearly four hours of waiting, we see the doctor for ninety seconds.

We wait.

Thirty minutes later, a short, chubby man pushes a large cart into our very small room. Maneuvering as though in a Pac-Man game, he rolls the cart past a lamp, turns the corner in front of my husband’s knees, and then pushes the rolling table between the wastebasket and the wall, cautious not to bump the stirrups sticking out from the table. Avoiding the empty stool, he parks his cart centimeters from my knees. While assembling his tools, he tells me he is here to draw my blood and insert an IV.

I jerk my arm away. “An IV? Why do I need an IV?”

“This is the ER, ma’am. Everyone gets an IV.”

He waits for me to place my arm on his table, then takes a shiny pair of scissors out of his coat pocket, slides the cold metal blade against my wrist, and snips off the ID bracelet, dropping it theatrically in the trash. “You know who you are.”

Before I can protest further, he sticks a needle in my arm. A bright red pearl forms where the metal enters my skin, and the prick of pain restarts the contractions.

I let out a sob.

“Am I that ugly?” he says, a smile in his eyes.

I look away.

He fidgets with his feet as he waits for the vial to fill, humming tunelessly to himself. When it’s full, he sets the full test tube on the cart, tapes down the IV receptacle, and stands. My husband asks how long it will take to get the results.

“An hour,” he replies, his voice soft and apologetic. “Good luck.”

My husband nods.

The man pushes his cart back around the obstacles in the cramped room without bumping anything, advancing to the next level.

I stuff a never-ending stream of tissues between my legs—my husband whisking the used ones away and flushing them down the toilet—both of us amazed that someone could lose so much blood and still be alive.

We wait, uninterrupted, as the second hand on the clock ticks its way around the circular face seventy-five laborious times.

I hear a newborn baby cry in the room next to ours, the weak but insistent plea making my breasts ache and my heart grieve. Down the hall doors open and slam shut. A toilet flushes and flushes again. High-pitched laughter carries in from the hallway. The pool of blood on the thin pad beneath me spreads despite our best efforts, the flow unstoppable.

There is a knock.

A thin young man, prematurely balding, pushes in a wheelchair. “Ultrasound.” His voice is meek, apologetic.

He takes a large pad and two sheets from a cabinet, folds one sheet in half, lays it over the seat of the wheelchair, and places the pad on top of it. His motions are deliberate and comforting, like my grandmother folding fresh linens off a backyard clothesline. He helps me into the wheelchair, his touch gentle, and then folds the other sheet in half and places it over my legs and lap.

“That going to be okay?”

I nod. “Thank you.”

“You don’t want to leave anything valuable here,” he says to my husband and then steps behind the wheelchair.

But the room is small, and it takes a few awkward attempts before he gets the heavy, inward swinging door to open wide enough to maneuver the wheelchair backward through it. My husband picks up my purse and glances at me, saying with his eyes, “Well, at least something is happening.”

The floor in the hallway is covered with thick, rust-colored mats, and the wheelchair sinks into the rubber like a baby carriage in sand. I feel embarrassed that I’m not lighter, less of a burden. It’s not me who’s dying, I want to tell them, it’s my baby. Do something to save my baby.

But some part of me knows it’s already too late. I’ve lost too much blood and there’s no going back. I remain silent as my future tears away from the numbered weeks on my calendar, a due date that coincides with my own birthday.

Why am I here?

The kind man wheels me into a large room, draws the curtain, helps me up onto the bed, and then switches on an ultrasound machine in the half-darkness.

“I’ll go find a nurse.”

I try to rest between contractions on the cold, hard bed, but I am unable to find a comfortable position.

My blood flows out all over another set of clean sheets.

The man returns fifteen minutes later to tell us that there are no available nurses. He has no idea how long we must wait, but guesses it may be half an hour.

“It’s late, and the OR is busy,” he says apologetically.

Once I realize why the nurse is needed—the technician cannot start his exam unless there is a female observer in the room—I ask him to begin without a chaperone. He nods with obvious relief and offers me the appropriate form to initial. My husband rolls his eyes.

A few minutes later, pulling the probe back and forth across my belly, he can find no baby floating within.

“But don’t be too worried,” he tells me. “It is very common to have trouble finding the fetus this early.”

He places a clean, white sheet over my abdomen and legs, and takes out a vaginal probe.

The law prohibits him from inserting it, so he will hand me the probe, and I am to insert it into my vagina. Then he will reach under the sheet, take the probe from my hand, and begin the scan.

I wait for the current set of contractions to pass and then follow his absurd and awkward instructions.

He works for a few minutes: measuring and typing on the machine with one hand while he moves the probe with the other. He tells us there is a gestational sac, but it is smaller than it should be.

“Are you sure about your dates?”

I nod. I know the exact night the egg and sperm began their slow, doomed embrace.

“I’m sorry,” he says and looks back at his machine.

He wheels me back to the tiny exam room in silence.

A few minutes later, the elderly doctor knocks and comes in. My blood work is within the “normal” range for pregnancy he tells us. “Could you be seven weeks instead of twelve?” he asks, tapping the tip of his pen on the clipboard.

I shake my head.

“The last thing is an internal check to determine if your cervix is open,” he says and adds, “so we’ll know for sure.”

It is very late, and I am exhausted. I have had enough tests and questions and IVs and bloodstained sheets and waiting and waiting. “I want to go home,” I say.

My husband nods and turns to the ER doctor, his face pleading.

“Yes,” the doctor says. “I think that’s a good idea.” The man places his hand on my shoulder and gives it a soft squeeze. “I’m sorry.”

The door is barely closed before Billy Blazes bursts into the room.

He removes the unused IV and begins filling out the release papers. He works quickly, all the while chatting about his girlfriend (“my wife, really”) and her desire to get pregnant (“she was told she couldn’t, but ended up being able to”), and that her “body wanted a baby,” and he had to “support her wish,” and how you “just never know.”

“Right,” my husband says to fill the silence.

The ER nurse adds advice to drink water (“women never drink enough water, they think one glass is a lot”), watch for infection (“if it starts to smell, come back”), tells my husband to look for signs of too much blood loss (“if she goes white, bring her back in”), and then offers his professional opinion on our future: “You can always try again.”

There is a surfeit of silence as he finishes with my chart.

When he’s done, he looks up from the clipboard and winks at my husband. “At least it’s fun to try.”

He hands me the paperwork—my husband is still carrying the unused sheets of rainbow insurance information—and strides out of the room, calling over his shoulder as the door closes, “Go home and get some sleep.”

Two days later, when I am changing my pad, I find a small, ivory-colored bijou resting amid the red stain. It is stark white against the crimson blood that has continued to gush out of my body, night and day. It’s less than an inch long and not identifiable as human—neither male nor female.

I pluck it out of the soiled pad and place it in the palm of my hand, its Lilliputian umbilical cord an improbable three or four inches in length. I rinse the embryo off in the sink and then open the bathroom door, intending to call my husband to come see, but the words die in my throat. The child was never real to him in the way it was to me. I shut the door again, cradling the tiny treasure in my hands.

I wrap the delicate masterpiece in a white shroud of tissue, tears streaming down my cheeks, and send it off to the sea.

I have no religion to lean on, no god to be angry with, no belief in a master plan to console me.

“Goodbye, little one,” I whisper, and walk back out into my life.

Afterword

All of us who lived through 9/11 remember the collective shock and fear we felt as we watched those horrific attacks. But my personal memories are colored by the miscarriage I had three days later. My husband was scheduled to fly out of the country on the twelfth of September, but the airports were all shut down. Because of that, he was home when my bleeding started and was able to accompany me to the ER (at the insistence of my ob-gyn). It was a small blessing in a sea of tragedy.

Like the vast majority of women who have miscarriages, I was able to get pregnant again soon after—just as the ER nurse had suggested. I gave birth to a healthy, full-term boy eighteen months after I wrote down this story.

To those who struggle with repeated miscarriages, my heart goes out to you. Perhaps it will help just a little to know that there are others who share your very private suffering and heartache.