In her high-school yearbook, under her name, they’d written I choose neither.
She’d used this logic in her grown-up life too. When she’d been asked if she’d rather have a prestigious grad-school opportunity with minimal funding or a fully funded position that was far less interesting, everyone had an opinion about which one she should take. But against all advice, she chose neither. It served her well; soon after, she got an even better grad-school offer in a better location in the same city as her sister, and she’d met her husband there.
Once she got sick, though, neither became less of an option: Would you rather have no breasts but live or keep your breasts and die? She chose life. There were many decisions like this, where the answers were difficult yet obvious, and each time, Julie took them in stride. But now, with this particular would-you-rather, this body-part roulette, she didn’t know how to choose. She was, after all, still getting over the shock of her recent miscarriage.
Her pregnancy had lasted eight weeks, during which time her younger sister, Nikki, had become pregnant with her second child. Not wanting to announce their news until the end of their first trimesters, the sisters kept each other’s secrets, giddily marking the days on a shared online calendar that labeled their progression for twelve weeks. Julie’s hash marks were in blue because she guessed she was carrying a boy; she’d nicknamed him BB, for Beautiful Boy. Nikki’s were in yellow (nickname: Baby Y), the color she planned to paint the baby’s nursery; as with her first pregnancy, she wanted the gender to be a surprise.
At the end of Julie’s eighth week, the bleeding started. Her sister was just beginning week six. As Julie was on her way to the ER, a text popped up from Nikki. It was an ultrasound photo with the caption Hey, look, I have a heartbeat! How’s my cousin BB? XO, Baby Y.
Baby Y’s cousin wasn’t doing so well. Baby Y’s cousin was no longer viable.
But at least I don’t have cancer, Julie thought as she left the hospital she knew so well by then. This time, she’d been there for a “normal” problem for people her age. Lots of people miscarried in those early weeks, her obstetrician explained. Julie’s body had been through a lot.
“It’s just one of those things,” her doctor had said.
And for the first time in her life, Julie, who had always lived in the land of rational explanations, was content with this answer. After all, every time the doctors had a reason for something, the reason was devastating. Fate, bad luck, probability—any of those seemed like a welcome respite from a dismal diagnosis. Now when her computer crashed or a pipe burst in the kitchen, she’d say, It’s just one of those things.
The phrase made her smile. It could work both ways, she decided. How many times do good things inexplicably come our way too? Just the other day, she told me, some random person walked into Trader Joe’s with a homeless woman who’d been sitting in the parking lot and said to Julie, “See that woman over there? I told her to buy herself some food. When she gets to the register, come find me and I’ll pay the bill.” Relating the story to Matt after work, Julie shook her head and said, It was just one of those things.
And, in fact, on her next try, Julie got pregnant again. Baby Y was going to have a younger cousin this time. It was just one of those things.
So as not to jinx it, Julie didn’t nickname the baby. She sang to it and talked to it and carried around her secret like a diamond that nobody could see. The only people who held the secret with her were Julie’s husband, her sister, and me. Even her mother didn’t know yet. (“She has trouble keeping good news to herself,” Julie said, laughing.) So it was me to whom she reported her progress, me to whom she described the heart-shaped balloon that Matt had brought to their first-heartbeat ultrasound appointment, and me whom she called when, a week later, she miscarried again and tests revealed that Julie’s uterus was “inhospitable” due to a fibroid she would need to have removed. Again, a welcome problem because it was so common—and fixable.
“But at least I don’t have cancer,” Julie said. That had been her and Matt’s other refrain. No matter what happened—all the daily annoyances big and small that people tended to complain about—as long as Julie didn’t have cancer, all was right with the world. Julie just needed a minor surgery to get rid of the fibroid, and then she could try to get pregnant again.
“Another surgery?” Matt had said.
He worried that Julie’s body had gone through enough. Maybe, he suggested, they should adopt or use a surrogate to carry the baby with the embryos they’d frozen. Matt was just as risk-averse as Julie—this had been a point of commonality when they met. With all of her miscarriages, wasn’t that a safer idea? Besides, if they went the surrogate route, they had the perfect person in mind.
On the way to the ER during her recent miscarriage, Julie had called Emma, a coworker at Trader Joe’s, to see if she could cover Julie’s shift. Unbeknownst to Julie, Emma had just signed up with a surrogate agency so that she could pay for college. Emma was a twenty-nine-year-old married mom who wanted to get a college degree, and she loved the idea of giving a family their dream as a way to make her own educational dreams come true. When Julie confided in Emma about her uterus problem, Emma instantly offered her services. Earlier, Julie had encouraged her to go back to school, even helping her with college applications. She and Emma had worked side by side for months and it never occurred to Julie that Emma might one day be pregnant with her child. But if her question in life had always been Why?, this time she asked herself, Why not?
So Julie and Matt came up with a new plan, as they’d had to do so many times since the beginning of their marriage. She would get her fibroid removed and attempt one more pregnancy. If that didn’t work out, they’d ask Emma to carry their baby. And if that didn’t work out, they’d try to become parents through adoption.
“At least I don’t have cancer,” Julie had said in my office after she finished explaining the baby setback and the plan forward. Except that while preparing for her fibroid removal, Julie’s doctors discovered the fibroid wasn’t the only issue. Her cancer was back, and spreading. There was nothing they could do. No more miracle drugs. If she wanted, they would do what they could to prolong her life as long as possible, but she would have to give up a lot along the way.
She was going to have to figure out what she could live with—and without—and for how long.
When the doctors first presented this news, Julie and Matt, sitting side by side in vinyl chairs in a doctor’s office, burst out laughing. They laughed at the earnest gynecologist, and then the next day they laughed at the solemn oncologist. By the end of the week, they had laughed at the gastroenterologist, the urologist, and the two surgeons they consulted for second opinions.
Even before they saw the doctors, they were giggling. Whenever the nurses, escorting them to an examination room, asked rhetorically, “How are you two today?” Julie would reply nonchalantly, “Well, I’m dying. And how are you?” The nurses never knew what to say.
She and Matt found this hilarious.
They laughed, too, when presented with the possibility of removing body parts where the cancer might grow most aggressively.