Not My Daughter (22 page)

He made a dismissive sound. "They were already talking. I wasn't saying anything they didn't want to hear."

"You think so? For the record," she said quietly, "I was hired because the parents here wanted a different approach to running this school. I've had no problem with the faculty." Legitimately puzzled, she frowned. "I don't understand, Evan. I hire and fire my staff, which means that your job is in my hands. Doesn't that worry you?"

He stood up, even though she hadn't ended the interview. "Hey, I was just trying to help."

"Please don't."

Susan was itching to vent when she reached the barn Saturday morning, but something stopped her. It might have been the power of this place imposing its own kind of calm. Or the fact that Sunny and Pam were no-shows. Or the lure of spending the entire day dyeing wool, which, once they finished the last of the formulas, was what she and Kate did. Kate had staff to help get PC Wool out in quantity. But like knitting itself, dyeing was therapeutic.

They didn't talk much. Susan couldn't bear to speculate on what it meant for Sunny and Pam to be sitting this out, she was tired of thinking about the
Gazette
, and when Kate asked if she had talked with her mother since returning, she just shook her head.

They did discuss wool. That was acceptable.

Babies were not. But two little grandbabies must have been with them in spirit, because the colorway Susan and Kate worked up first was Robin At Dawn, which contained reds, browns, pinks, and blues--far more of the last two than Susan had expected, though hers was the hand that poured the dye. And even then, when Kate made a comment about Monday being the big day, Susan didn't follow.

"Lily's sonogram," Kate prompted. "Mary Kate and Jess are all fired up about it. They're still betting it's a girl. What do you think?"

"I think," Susan began but faltered. She had so much else on her mind besides a baby. "I think I'm still not ready. Are you?"

"No. I'm glad Lily's first."

They worked on a bit before, anguished, Susan stopped. "I used to fantasize about inviting my parents to Lily's wedding. She'd be marrying a great guy; they'd be an absolutely beautiful couple. And then when kids came, and I could tell my parents that they were going to be
great
-grandparents--wow, that would have been something. Now Dad's gone, Mom's not talking to me, Lily is doing exactly what they wouldn't want, and my job is on the line. How awful is that?"

Chapter 20

Susan began Monday with mixed feelings. On one hand, she was not looking forward to the sonogram. Sonograms made babies real. She wanted Lily's to stay abstract for a while longer, at least until she got the rest of her own life straightened out.

But she loved Lily, and since Lily was beside herself with excitement, Susan couldn't help but catch some of her mood. In Lily's mind, it was like the first day of kindergarten or the night before Christmas. The hospital where she had her appointment was a thirty-minute drive from Zaganack, and she chatted the whole way.

"They take pictures during the sonogram, did you know that, Mom? We get to take them home--and I
know
she'll look Martian, but she's four and a half inches long now. I'm going to frame the pictures. I mean, I am going to take pictures
constantly
once this baby's born, but these will be the very first. You waited to learn the sex."

"Lots of parents still choose to wait."

"Not me. I want to know for sure. Actually, they may not be able to tell me today. It depends on the baby's position. Thank goodness I'm this far along." She crinkled her nose. "I wouldn't like having the sonogram done transvaginally--I mean, I'd be okay with it, but transabdominal is more comfortable, and I think they can see more this way because they can move the probe more to get a better view. Doesn't that make sense, Mom? I mean, it'll be
so
much easier when the baby gets bigger. Mary Kate wanted to come, but I told her no. This time's just for you and me. That's how it should be, don't you think?"

You should be twenty-five and married, and your husband should be the one driving you
, Susan thought. But she was coming to accept that these things weren't to be. The baby was something else. Bracing for the reality of it, she was feeling flutters in her own stomach when the sonogram began. Lily lay on a table with the small swell of her abdomen exposed. The technician squirted a gel, spread it with the transducer, and images soon appeared on the screen. Reaching for Susan's hand, Lily drew her close to the head of the table, but the images were hard to decipher. The technician was patient, explaining what she saw, and suddenly Lily gasped.

"Omigod. Look, Mom!"

Susan felt the same amazement. Even in a grainy image, the blotch on the screen had become a baby. Moving her probe, the tech was able to show them its profile--eyes, nose, mouth--primitive but distinct--and familiar, though Susan would have been hard-pressed to say which one feature was Lily's. The tech took a picture, adjusted her equipment, and pointed out arms and legs. But the second Susan knew she was lost was when she saw the pulsing point of a beating heart.

This was why she hadn't wanted to hear the heartbeat before; a heartbeat meant life. She remembered the first time she'd heard it when she was carrying Lily. It had been the moment Susan truly realized she was a mother.

And now? In an instant, Susan's perspective changed. It was no longer about her teenage daughter being pregnant. Now it was about her daughter's child--her own grandchild--a very real human being. Susan felt pure awe.

The technician fiddled with the transducer, moved it higher, then to the left. She made a puzzled sound, to which Lily asked a worried, "Can you not see the sex?"

The woman repositioned the transducer. Susan kept her eyes on the monitor but saw nothing recognizable.

"You sure you want to know?" the woman asked, and when Lily cried an excited yes, she said, "See this?" She pointed to the screen. Susan squinted. "If I were to guess, I'd say you have a little boy in here."

A little boy. Not what Lily wanted. Susan looked at her daughter, and yes, those were tears in the girl's eyes, a brief "Oh" of disappointment--then a brilliant smile.

"A boy," she said, testing the word. "That's okay, that's okay. Mary Kate will die. She wanted a boy until Jess and I bugged her so much she changed her mind. So much for having another generation of girls."

If the remarks registered with the technician, she didn't comment. She was moving the transducer again, first one way, pressing a little, then another, and all the while her eyes were on the screen. She was looking for something.

"What do you see?" Susan finally asked.

"I'm not sure."

Lily picked up on Susan's concern. "Is something wrong?"

"I'm just trying to get another view," the tech said, but her voice was hesitant.

"You're not sure it's a boy?"

Susan didn't think it was that. Her gut told her that the tech saw something else. "What is it?" she asked.

Setting the transducer aside, the woman gave them a quick smile. "It's likely just me. My eye isn't trained well enough. Let me get the radiologist. He'll know."

As soon as the woman was gone, Lily turned large eyes on Susan. "She's worried, but how can something be wrong? I mean, I'm young, I'm healthy, I feel great."

Susan held her hand. "Everything's probably fine, but the reason they do these sonograms is to detect even the smallest little thing."

"Like what?"

"You'd know that more than me, sweetie. You're the one who's done all this research."

"Down syndrome. But there are serious calculations involved, and she wasn't doing any, so maybe she saw something structural, but everything that was supposed to be there was there, wasn't it?"

"Absolutely," Susan said. "I'm sure it's nothing."

"What if it isn't?"

"If it isn't, we'll deal."

The technician returned with the radiologist, who introduced himself, then said calmly, "Let's take a look," and picked up the transducer. Susan studied the monitor, trying to decipher something, but all she could identify was that little heart beating what she thought was a totally normal beat.

Finally, the radiologist pointed at the screen. "This is the baby's chest. I see the intestines," he moved the tip of a pencil, "and the kidneys, but they look to be outside the abdominal cavity."

Lily's hand started to tremble. Holding it tighter, Susan asked, "What does that mean?"

He moved the transducer again, but Susan couldn't see anything this time either. When he paused, he didn't look relieved. "This isn't uncommon. It happens once in about every twenty-five hundred births. We call it a congenital diaphragmatic hernia."

"Please explain," Susan said, knowing Lily would ask if she'd been able to speak.

"The diaphragm is a muscle between the abdominal cavity and the chest. It forms at the eight-week point, but occasionally it has a hole. When that happens, organs that would normally be in the abdominal cavity are not."

"His organs are
outside
his body?" Lily wailed.

"No. They're inside. They're just in the chest cavity, not the abdomen."

"What does
that
mean?"

"It means that there's less room for the lungs to form, so one or both may not fully develop."

"My baby will
die?"

"No. There are different severities of CDH, and even for the most severe, the survival rate is continually getting better. But I don't know for sure that this is CDH. We'll know more in a few weeks."

"Weeks?" If there was a problem, Susan wanted to
act
.

The doctor remained calm. "The baby's in no immediate danger. Right now, it breathes through the placenta. Typically, we monitor the fetus to confirm its condition and see if it worsens."

Lily started to cry.

Holding her, Susan said, "We need to know more. If the baby does have this, how is it treated?"

"Surgery after birth. Depending on the severity as the fetus grows, prenatal surgery is even an option." He spoke to Lily now. "Like I said, your baby is in no imminent danger. We'll send the sonogram to your OB." He checked the file. "She'll take it from there."

As soon as they reached the car, Susan called Dr. Brant, who suggested they come in on the way home. Lily was silent, pale, and frightened. The best Susan could do during the drive was to try to reassure her.

"Don't assume the worst, sweetie. The danger of early tests is that they can be wrong. It may be nothing."

But Dr. Brant was concerned enough after talking with the radiologist to refer Lily to a high-risk obstetrician. The first appointment they could get was for the next morning, which meant a long night of worry. Mary Kate and Jess slept over, and Lily had told enough other friends she was having the sonogram that the phone wasn't quiet for long. When Lily couldn't bear talking about it anymore, the two other girls helped.
Lily's sleeping. Everything's great. It's a boy!

Long after the girls turned off the lights, Susan was googling
congenital diaphragmatic hernia
, reading different accounts, alternately encouraged and discouraged. It was a case of a little information being dangerous, especially once her imagination kicked in. And she didn't know that the baby had this at all.

That was why she didn't call Rick. She had never called when Lily got a rash as a baby, not until the doctor knew what it was. If it turned out to be a heat rash, she didn't call him at all. That was what she wanted this scare to be--like a heat rash, gone by morning.

Jane LaBreia, the new doctor, was younger than Eileen Brant and had trained at Mass General. A small woman with short blond hair and a quiet manner, she was wonderful with Lily, for which Susan loved her. They had an instant rapport.

After examining Lily and studying the sonogram, she said, "I agree with the diagnosis. What I see in these pictures is consistent with CDH, but there isn't much we can do right now. At week twenty, we'll do a level three ultrasound, which is a more in-depth version of what you had yesterday. If the diagnosis stands, it will tell us whether the baby's condition is getting worse. If we need an even better picture, we'll do an MRI." Turning to Lily, she explained, "When a fetus has CDH, we worry first about the lungs being too small to sustain breathing, and second about the heart. Right now, your baby's heart sounds strong and perfectly normal. We want to keep it that way."

"How do you do that?" Lily asked in a weak voice.

"By monitoring it. If we hear stress and see the CDH worsening, we have choices."

"What choices?"

"We can do nothing and let nature take its course. Or we can operate."

Let nature take its course
. Susan knew that meant letting the baby die at birth, but of course there was another option. The pregnancy could be terminated now.

Mercifully, Lily had glommed on to the doctor's last option. "You'd operate before the baby's born?"

"We would. There are new, minimally invasive procedures. The results have been stunning."

"But there's a risk."

"Any surgery involves risk, but that's what pediatric specialists are for."

"My baby could still die."

"The chances of that are less likely today than they were five years ago. You should have a strong, healthy baby."

Lily looked like she wanted to believe her but couldn't quite.

"Really," the doctor insisted gently and said, "I recommend amniocentesis. The more information we have, the better. If we rule out other possible problems, we can concentrate on the CDH. Amnio entails a small risk, though, so perhaps you'd like to think about it."

Susan knew that the doctor's request wasn't an idle one. More than one of the articles she had read mentioned that a fetus with CDH often had other abnormalities.

With Lily bewildered and silent, Susan said, "How soon can it be done?"

Lily was grief-stricken. The plan had been to get pregnant, breeze through nine months like she'd breezed through AP bio, and pop out a healthy baby. Other people had physical problems, but not her, because her mother hadn't. Weren't these things hereditary?

But the doctor was telling them they had to wait and see, her baby may or may not need surgery, may or may not be normal, may or may not
live
--and her mother had gone ahead and scheduled a test Lily did not want to take.

She let Susan hold her hand until they left the building, but her resentment was building. Stopping halfway to the parking lot, she snatched her hand free and turned on Susan. "How could you
agree
to that, Mom? Amniocentesis can lead to
miscarriage
, which would be
fine
with you--you don't
want
this baby--but I do, and I
don't
want amniocentesis." When Susan reached for her, she stepped back. "This is
my
baby. I
told
you that.
I
make the decisions."

"There's a reason why the doctor wants it, Lily."

"To rule out other problems, but what other problems could there be? Isn't this one bad enough?" Internal organs in the wrong place? It was freaking her out. "I don't
want
amniocentesis. How could you schedule it without asking me? I was sitting right there!"

"Lily. I looked at you. You had a chance to speak but didn't."

"I
couldn't
. I was too upset. Don't you think this is a shock, Mom?"