Egg Hunters

Making babies goes high-tech

published in DukeMed, Fall/Winter 2005. Download PDF file here.

Even now, Debbie Greer can’t help but visit the infertility message boards online. Nowhere is there quite so much hope and love mingled with such heartache and desperation. It flows out from the multitude of acronyms and abbreviations: IVF, ICSI, BFP. It blinks passionately from emoticons that flash smiling icons and sobbing symbols. There are women here who suffer from polycystic ovary syndrome, women whose husbands have severe male factor infertility, women who speak of egg retrieval and follicles and embryo transfers with the familiarity of a scientist. Women who have tried every assisted reproductive technology available, over and over again, for as many as 11 years.

Only a few months ago, Greer was one of those women, and like a member of some secret society, she continues to read the message boards to remind herself how fragile the journey from infertility to parenthood is. Because in July, she became one of the lucky ones. After undergoing in vitro fertilization at the Duke Reproductive Endocrinology and Fertility division, she received what she had wanted for more than four years: a BFP-Big Fat Positive pregnancy test.

Mixing Faith and Science

Published in DukeMed, December 2005

(Sidebar to “Egg Hunters“)

Rarely do you see a physician wear his religion on his sleeve. But David Walmer, MD, PhD, wears his quite literally around his neck, in the form of a green, gold, and maroon tie patterned with crosses, fish, and the word “faith.” As chief of the Duke Reproductive Endocrinology and Fertility division, Walmer knows his attire is not only a revelation of his character, but an outward symbol of what anyone–Christian, Jewish, Muslim, or agnostic–must possess to face the emotional and physical roller coaster of infertility treatment.

You have to believe, deeply, to go through these procedures–if not in God, then in science. Walmer happens to believe in both. For many of his patients, that’s a welcome fact. In fact, not only do more patients keep the dialogue on faith open with him through their medical journeys than not, many couples specifically come to Duke to see Walmer because of his Christian-focused practice. Many ask Walmer to pray with them before embryo transplants. Some just want the knowledge that they are cared for by a physician who unabashedly shares their faith. Others seek advice on reconciling the ethical issues that abound in assisted reproductive technology (ART) with their intense desire to begin a family.

Babies on Board

Published in The New Physician, March 2005

Even Sethina Edwards was amazed when she attended the “Welcome to Medical School” gathering at the University of Bristol in England last fall. One would not expect Edwards, a mother of two and a former freelance publicist, to be surprised by the fact that a whopping 75 percent of her classmates were women. After all, for the past six years, aspiring women physicians around the world have been turning to her for support.

In 1999, when Edwards decided to seek a career in medicine, she was pregnant with her first daughter. Training to be a physician is difficult enough without the complications of motherhood. “People thought I’d gone mad,” Edwards says. “Lots of people told me it was impossible.”

When to have kids

Published in The New Physician, March 2005

(sidebar to “Babies on Board“)

If all goes according to plan, by this time in 2007, Meredith Hancock will have a 1-year-old child and will be nearing the end of her first year of medical school. For this to happen, Hancock must first complete the prerequisites she needs to apply to medical school, take the Medical College Admission Test next month, get pregnant sometime after that, get accepted, have her baby and start training in fall 2006.

If, if, if.

“That’s my hope,” says the Sacramento resident. “I’d like to stay home a little bit before I actually start school. But I know there’s no good time, so I’ll just have to take it as it comes.” Indeed. Hancock and her husband may have plans for a family, but her medical training is the only thing she has certain control over, assuming she’s accepted. Visit the online chat forums of the Student Doctor Network or MomMD.com on any given day, and you will be bombarded with the question: When is the best time to have kids?

And it’s one, most women say, that not even a soothsayer could pinpoint. That’s because no matter how controlling you may be, Mother Nature is in charge when it comes to having children.

Preparing for Residency

Published in The New Physician, March 2005

(sidebar to “Babies on Board“)

You could say that Dr. Rivka Stein is infinitely comfortable in her own skin. That’s because the Brooklyn pediatrician arrived for her residency interviews packing more than just an unyielding set of expectations. She was also eight months pregnant with her second child. “So [the issue of motherhood] definitely came up as I waddled in there,” says the mother of four.

Stein, an orthodox Jew, says she never questioned her ability to have both a family and a medical career; in her community, the best timing for these things isn’t planned. But Stein did approach her residency search in an open manner and took control of her own situation—something many women are afraid to do, becoming apologists for their families instead.

Part-time Practice

Published in The New Physician, March 2005

(sidebar to “Babies on Board“)

There was a time when Dr. Erin Harris dreamed of becoming “a full-fledged country doctor, delivering babies, that sort of thing.” But four draining years in medical school, one year of family practice residency and one infant later, that’s all changed.

“Now I realize that I really can’t do that and have the life that I want,” says Harris, who became a mother in her third year at East Tennessee State University James H. Quillen College of Medicine and is in her second year of residency there. “I’m going to find a practice where I can structure things the way that I want them to be. I want to do three days a week, part time.”

The Lights on Main Street

If you make it on Broadway,
do you have an obligation to care
about the dying farming town
where your father grew up?
William Ivey Long believes you do.

Published in Carolina Alumni Review, November/December 2004

Through the open back door of the old bungalow, the rain is falling in sheets, the kind that would make a night out at the theater in a fancy dress less appealing. But there are no Broadway shows here, no movies either. No malls, no department stores, no restaurants serving foie gras or even Filet O’ Fish. Only the land and the buildings on it, and the people who have tended it for 10 generations, and that still means everything.

William Ivey Long ‘72, gentleman farmer of this northeastern North Carolina town, takes the rain as just another design element in this little production, the mud that his guests would have to tread through nothing more than a doable inconvenience, rather like a loose string on a hem. He’s dressed more like a Dockers ad – khakis, white button-down – than as the four-time Tony-award-winning costume designer for which he is best known, and the surprising truth is that Long is more folksy than he is Fierstein.

Yes, he owns homes in Massachusetts and Manhattan, has fabulous friends named Wasserstein and Stroman. But the 48 Broadway shows he has outfitted are nothing so special as this weekend’s Ivey-Long family picnic. Chicago, The Producers – even Hairspray – are far less compelling stories than the ones set on this little rural stage five miles south of the Virginia border.

Only one stretch of pavement shines brighter than the Great White Way for Long, and it is Main Street in Seaboard, North Carolina.

My Mother, Who has Cancer …

Written in August 1998, copyright 1998 Beth McNichol

When the lights went down in the icy movie theater and my family surrounded me — all of my family — everything was normal again. Of course it was. Six months had passed. I drew a long, cold sip of Coca-Cola from my straw and thanked God for simplicity, for days of nothingness. I was 19 years old. What did I know? I tossed my feet up on the back of the chair and looked beside me. Her head was covered with more than stubble now, though she still wore the wig, and the angry little bumps that once scattered the baldness, ugly and knee-weakening, had found someone else to pester. The villain was behind her; he had come and he had gone and as far as my father and my sister and myself were concerned, he would never call again. That’s how it works, right? That’s the sequence of events: biopsy, surgery, crying, chemotherapy, health. Cured. That’s how it works.

The nurse in the movie Best Friends inserted an IV needle into Jack Lemmon’s unwilling skin, fishing around for a vein, for some response. My mother shivered. She shivered and her left hand, the swollen one, went to catch the right hand that clasped over her mouth to stop the nausea and maybe the tears, too. Who knew this was what the film was about? I cursed the director, the screenwriter, the cameraman, Lemmon himself. Even as my heart told my hand to find my mother’s in the darkness, I knew that I could not do much to help. Not like Julia.

*****