APRIL
This time with my OB-GYN, there was no ultrasound screen to stare at.
Instead, Jackson and I sat in two separate chairs in Dr. Ryan's office, maybe two feet apart. My wedding dress was still on and sitting down, it suddenly felt too tight across my abdomen. I hadn't noticed a problem earlier, minutes ago when we had been dancing across the lounge area with all of our friends and family watching, happy as could be. Everyone congratulated us on the wedding and the pregnancy, and even if this wasn't when I planned these things in my life to happen, it was still with the man that had always wanted and I couldn't have been happier. It was funny, and cruel, how quickly life could change.
"I'm so sorry to pull you away from your wedding like this," Dr. Ryan apologized as she sat down beside her desk. There was a manila folder in her hand, undoubtedly containing the test results of our baby inside of it. "I didn't mean to take away from your day. But when results come in, I find it best not to wait. I couldn't come up and not tell you."
A pause followed where I'm certain that I'm expected to say something but I can't bring myself to. My hand rested on my stomach where our child was growing rapidly, or so I hoped.
Please, kick, baby. Please. Just kick.
No amount of will in the world could make the baby kick. I had felt it earlier and I was certain of it. Jackson had felt it too, it hadn't just been my imagination or some kind of strong gas. It had been a kick, proof that the baby in there was healthy and alright. I had been so sure of that much. But now, there was no such thing in certainty as I stared at Dr. Ryan with that soft, sympathetic look in her eyes. I had seen that look and I had given that look – to patients when I had to deliver the worst news of their life, to the family when I had to break their heart. I had mastered that look, keeping my expression perfectly manicured. It was a mask worn to try and make them as comfortable as possible, to soften the impossible blow that we had to deliver.
How was she about to break me? How was she about to break Jackson? Why wouldn't the baby kick now? I knew what we had both felt earlier. Please, let him just be asleep…
"What is it, Dr. Ryan?" Jackson finally blurted out the question that both of us wanted to answer, yet I couldn't find the confidence to just say it. Saying it meant getting an answer. Even if both of us were seated here, I wasn't sure that either one of us was ready for what she was going to say.
"The results of the amnio showed an abnormality." Dr. Ryan began, opening up the folder. She stretched it out across the table toward me, but I don't reach for it. I should and I can't. After a long pause, Jackson took it.
"What is it?" I finally blurted out the question, snapping out. "Just say it."
"The genetic screening showed that the baby has a partial extra copy of chromosome 21. Down Syndrome." Dr. Ryan finally stated clearly. "As you know, it's associated with intellectual disability, a characteristic facial appearance, and weak muscle tone in infancy. Affected individuals experience cognitive delays, but the intellectual disability is usually mild to moderate. People with Down syndrome may have a variety of birth defects. About half of all affected children are born with a heart defect. Individuals with Down syndrome have an increased risk of developing several medical conditions. These include gastroesophageal reflux, celiac disease, hypothyroidism, and more. There are also some behavioral problems that come along with it. A number of compulsive problems usually being the most prominent."
Down Syndrome.
A heavy breath is released and I shut my eyes, a hand coming up to cover my face as I focused on just breathing. Amnios could detect viruses and a plethora of other things on top of Down Syndrome, even though it was what most people would have associated with the genetic screening given that it was more common than some of the other results. But of all the things that it could have been, that was low on the list of terrible. It just… wasn't.
"The baby has Down Syndrome?" This time I reached out for the file so I could see a copy of the test results for myself. Jackson handed it over to me. "That's it?" I questioned.
"Yes," Dr. Ryan nodded.
I laughed. It's the wrong kind of reaction to have to information like this but I can't help but laugh as I straightened up from my hunched position before leaning back in the chair, shaking my head. There was so much fear when we had sat down here and now, it's evaporated.
"I don't… April." Jackson looked at me sternly, shaking his head. My hand came up and wiped away one of the stray tears that had slipped out of my lids. "We should talk about this."
"If termination is something that the two of you are considering, then we need to keep in mind that there is going to be a timetable for that kind of thing." Dr. Ryan spoke again as she looked sympathetically between the two of us. "But I'm not pushing you in either direction. If you want to, I completely understand why. And if you don't want to, then there are a lot of support groups that I can point you in the direction of."
"Thank you, Dr. Ryan." All of the formalities that Jackson had dropped before had resurfaced now with this information. He was stiff – he didn't look nearly as relieved as I felt now that I had actually heard the information. Now that I could actually see the results for myself.
"We aren't considering termination." I declared firmly, looking at Dr. Ryan. My hand pressed into my stomach.
"Well, we need to talk about it–"
"No." I cut Jackson off quickly, a wide-eyed glare shot at him. "We don't. Our daughter is perfect just the way that she is. Thank you, Connie."
XX. The two chromosomes that identified our child's sex had caught my attention from an undeniable curiosity though I had told myself earlier I wanted to wait to know. The sex chromosomes were so close to the chromosome 21 that I wasn't able to resist taking a peak. If anything, it brings to mind the perfect little child that the two of us were having all the more clear. We were having a beautiful baby girl. I could see now, more clearly than ever, the perfect little face and the bright smile that would fill her lips.
Standing up carefully as to not step on the end of my dress, it suddenly didn't feel nearly as tight as it had. I tucked the folder underneath my arm and turned toward Jackson, extending my hand out to him. He still looked stunned, processing the information that our child was not going to be ordinary.
"We do have a wedding to get back to, Mr. Avery." I smiled down at him.
"April..." Jackson pushed himself up slowly before taking my hand. His brows were drawn down together. "Don't you think now isn't the time for that? We should go home, talk about this…" He spoke as we began to walk out.
"I don't understand what there is that you want to talk about." Even though my brows furrowed looking up at him, the smile still remained on my lips, relaxed.
"Listen, I know that this isn't the end of the world. That there are plenty of happy families and kids with Down Syndrome. I get that." Jackson began, a sigh pushed out of his lips. "But this is still a big, life-changing kind of thing that the two of us need to talk about. It means those first years, all of those years, they are going to be harder than we planned for. And they are also those same years that the two of us are going to try to get established in our careers, you know? That's a lot. We got married today and not down the line because we didn't want to overburden ourselves. And I'm thinking the same thing that I was when we agreed to do this. I don't want either one of us to overcommit to something that we're going to regret or…"
I can't let him go on. "Regret? Seriously?" I stopped in my tracks, turning to face him and placing both my hands on my hips. "What about this is there to regret? This is our child, Jackson. Our daughter. Our little baby girl. Of course, yes, it's going to be a lot! I'm not an idiot. That's not above me. But I sat down in there thinking that our child was going to die, so hearing that they just have Down Syndrome? Yes, I said just Down Syndrome, and I mean it. I'm so, so okay with that. I am happy with that. Why aren't you?"
"I'm not saying– April, just calm down, okay? You're letting your emotions get the best of you." He held his hands up defensively.
"No, I'm not!" My voice rose a pitch. "But if you say that again, then they definitely will."
"Okay, okay." He ran a hand over his head. "I just… listen, I get that you're cool and level-headed about this. I get it. But this is something that I want to talk about and not in the direction you're expecting, okay? I don't want to terminate either. This is my baby just as much as it is yours. I respect that it is your body before you go there – but… that's my little girl."
Sighing, I glanced away before nodding. "Okay, then what is it that you want to talk about?" Slowly, we began walking down the hallway again.
"What the rest of our life is going to look like." His hand found mine, thumb rubbing my knuckles.
"We're going to be two surgeons. We're still going to be amazing parents and we're still going to have an awesome kid." I couldn't forget the words that he had said to me when he proposed. "Maybe she won't be a star athlete. That's fine! But she'll still be the little star of our lives. Isn't that the most important thing? Doesn't that matter more than anything else?"
"Of course," he muttered. "I get it. I do. I'm not being some ignorant asshole in wanting to ask these questions and talk about these things. I'm not the bad guy for having these questions. I'm normal. It's a normal thing to do when you find out about these things. There's a reason Dr. Ryan offered support group connections."
"I'm not saying you're the bad guy." I glanced up at him. "You just need to open your eyes a little."
"I'm trying." He sighed. "But it's hard when you won't say a goddamn word to me beside cliches."
"Why are you attacking me for being positive about this?" I stopped in my tracks again. "Why?"
"Because you won't let me react in any other way." Jackson's hand flew out as he spoke in frustration, motioning to nothing. "You can't let me feel the way that I want to feel. You just expect me to react the exact same way that you do."
My mouth opened but instead of yelling back at him, I shut it and took a deep breath through his nose. Maybe he was right. But a part of me was upset that he seemed so bothered by the idea that our child was going to have Down Syndrome. I couldn't help but wonder if he somehow blamed it for it – like I had done something to cause the nondisjunction when cell division occurred, creating our baby. He had been so worried. Maybe he did blame me for it. Maybe that was where the anger here was really coming from.
"Okay." The word came out slowly, nodding my head and blinking back tears that sprung up again. "Okay. Let's go home and talk it out."
This wasn't the way that I thought our wedding night would go. I thought we would stay at the reception with our friends until my feet hurt and I insist on being able to kick up my swollen ankles. But instead, the two of us drive home in silence. Our house is packed up from all of the work that had been put into finding a new apartment. We almost had a lease down on a new place, and a back up that was nearly as good if we couldn't manage to get that. Hopefully, by the end of the month, we would be out of our current apartment. But now, it only made the distance between us feel even larger. It doesn't feel like home, not the way it should have.
Our wedding night was supposed to be spent smiling and giggling, unable to keep our hands off of one another. A good portion of my pregnancy had been spent horny as could be, one the phase of morning sickness was mostly out of the way, more so than I was willing to admit. But now, my mind couldn't have been further from the idea of sleeping with my newlywed husband.
"Tell me…" I started, rubbing my thighs restlessly. "Tell me what you're thinking."
"Please, don't interrupt, okay?" Jackson began and I nodded my head. I'm… grieving, in a way. Grieving over the loss of who I thought my child was supposed to be. I am thinking about all the things she wouldn't be able to do. All the things she would struggle with. I'm thinking about how my mother, and maybe even some of our friends, are going to look at us, look at her, and wonder why we kept her. I'm scared of what the world is going to see and say."
Tears burned in my eyes and I nodded my head, slouching forward the best that I could. "Your mother isn't going to understand, probably." I knew and loved Catherine but I didn't know how she would react to this. I knew she felt differently about abortion than I did.
"Probably not," he agreed, sniffling. "I don't want to tell her just yet. I feel like I need some more time to sit with this information. To read up on it. Just because I know what textbooks say about it doesn't mean I know what it's going to be like living with it and raising a baby with it. I need time to figure this out. I need time to be happy about it like you are. I promise I will be. I just need time."
"Okay," I nodded my head. "We can take some time."
Time healed all wounds. That was the cliche people loved to throw around.
When we fall asleep that night, I'm in the comfiest pair of pajamas that I own and he was curled up behind me, his arm wrapped around my stomach. His hand could no longer cover it entirely like he was able to do before with the progress that my baby bump was making. But it didn't stop him from trying to hold every piece of me and our baby that he could.
It wasn't the honeymoon that I expected to have, but it was the one that I got.
Sex happened eventually but it wasn't bubbly and full of smiles. Instead of that, it was holding onto one another with a desperation like nothing else, the need to hold onto one another and not let go. In a way, it was more meaningful than anything that we had ever done together, any time we had fallen into bed and made love like this. It was something deeper than everything that had come before it. None of it was fueled by grief. All of it was about staying connected to one another, to make sure that the fight that started off our marriage wasn't the fight that defined it. We had to be more than that. We had to stay connected.
It was a quieter honeymoon that I expected, too, even if it was just an extended weekend. There was a lot of reading for both of us to do. Connie emailed us a few websites and support groups local to Seattle that we could check out in the next few months as we prepared for our baby to come. But really, all of it extended past the defined period of our honeymoon.
By twenty-four weeks into the pregnancy, I have to switch over reading about the baby to doing as much studying for the boards as I can. While most people would be spending the last two months prepping for it, I would be on maternity leave and consumed by all things baby. Jackson was going to take two weeks off right after the baby was born but I had talked him into working and preparing for the boards. Of course, that had been before the diagnosis had been made. I wasn't sure if he would stick to the plan now.
"How are you feeling?" Izzie asked, eyeing my bump and my flashcards.
"I'm fine." I flipped to the next card. "The sooner this is in my brain, the better."
"Smart," she nodded in approval. "You're probably the only one who's not going to be cramming and panicked in the nights leading up to the board."
I laughed, shaking my head. "No, I'll be too sleep deprived and up with a crying baby instead."
"Sorry." Her smile looked more like a grimace with the apology. "That didn't come out how I wanted."
"It's fine," I shook my head. "This is what I signed up for. I'm happy. This is my little girl."
After knowing for a month, we had come clean with the diagnosis. Hiding it had been pointless, especially with all of the literature that Jackson had been openly reading in his spare time. Everyone had been supportive. For once in our life, in my life, there had been no smart ass comments about what was going on. I wasn't sure if that was really a good thing. It seemed like even Alex and Cristina were too scared to make some kind of smart-ass comment.
"I'm glad that you two are so happy together." Izzie gave a more genuine smile with her words. "You're good people. You deserve to be happy. I did a little reading, too, you know… It seems like a lot of parents are scared when they get that kind of diagnosis. But they're all happier once they have that baby in their lives."
"Yeah?" I'd read the same thing. "You should share that with Jackson."
"I already did. He said I should share it with you." She chuckled. "You guys are so married."
I wiggled the ring on my finger, lifting up my hand before letting it drop. "We definitely are."
"Stevens!" Bailey's sudden presence in the room caused both of us to flinch and sit up a little straighter upon he entrance. I hadn't heard her come in – neither had Izzie, apparently. For someone with such a powerful and commanding presence, she sure was good at managing to sneak up on people when she wanted to. "Aren't you supposed to be with Shepherd right now?"
There was no point in arguing and she knew that. "Yes, Dr. Bailey." She nodded and quickly stood up, flashing me an apologetic smile and wave. "I'm going there right now."
"Good." Bailey nodded with a firm nod of her head as Izzie ran out before turning toward me. "Kepner."
"Dr. Hunt said it was okay if I came up here to study for a bit. The E.R. wasn't that busy with surgical cases today and he said that he would page me the minute that he needed help down there." I explained defensively, clutching at my cards a little tighter than before.
"That's fine," she waved her hands. "I'm not here to yell at you."
"Oh," I breathed out, blinking in surprise. "Is there something?" I asked slowly.
"Yes." Bailey sat down where Izzie had been moments ago. "Dr. Webber asked me to talk to you about your future here at Seattle Grace Mercy West." Oh, no. This wasn't a conversation that I was ready for.
But I forced myself to nod. "Okay…"
"Dr. Hunt and Dr. Webber have already agreed that they are going to offer you a position as a trauma attending here once you've passed your boards in a few months," Dr. Bailey started. A relief. "And both of them understand if you want to take an extended leave to take care of your little girl once she comes given the circumstances that you and Jackson are facing right now. We'll make sure that it's all covered and taken care of. We just want to make sure that you still plan on taking the boards this year at the end of your residency."
"I am. I absolutely am." I nodded firmly. "And thank you, Dr. Bailey… and thank Dr. Webber and Dr. Hunt. I am so grateful to be able to stay here and I promise, I am going to crush the boards. I know that it's not the most convenient timing in the world but I'm going to make it work, I promise."
"We do believe in you, Kepner." There was a soft smile on her lips, one that was rarely seen. "We just want to help make sure that nothing falls through the crack for either one of you."
"Thank you," I repeated myself. "We're not going to let anything fall through. I promise."
A promise that I knew we would keep.
Flashcard after flashcard, every word on them becomes familiar with me. The more familiar that the set of flashcards becomes, the more flashcards that I have to make. Jackson would use them too, I was sure of that. Every surgical possibility that could be brought up during my boards was put down on paper. I hoped.
Days off became increasingly rare even though there was a technical limit to how many hours we could work – even if I wasn't technically scheduled, I found myself at the hospital, studying and working on the more administrative aspect of my job. It seemed like there was always something for the chief resident to do no matter how much I had managed to get done the day before. It was twelve jobs all cram packed into one. The list was a never-ending one that just kept getting piled on with more and more. Some days, I even amazed myself that I managed to make my way through all of it.
I spent more time at the hospital than I did at our home, even after we finally move into a new apartment and unpack.
"Babe?" Jackson's voice called out from down the hallway. "Will you come look at this?"
Even though the control freak in me wanted to micromanage every aspect of the nursery, while he was painting the walls, there wasn't much that I could do other than sitting back and wait for him to be done. But upon his permission to enter the nursery, I quickly dropped my book and made my way down the hallway, hand over my mouth and nose to avoid inhaling the fumes.
"What's up?" I asked.
"I need your approval," he started. "I want to make sure that you like the stars."
Not wanting to completely overwhelm the nursery with pink just because we knew that it was a girl, we had found a balance between pink, yellow, and white. The walls were a soft pink and along the wall with her crib, golden stars were now covering it. They were dense at the top and became more and more sparse as they moved down, perfectly fading out.
"I love it," I smiled, stepping forward and placing my hand on the railing of the white crib. "I think it's perfect. And I think that the baby will love it, too." As I spoke, I reached for his hand and placed it on my belly.
Both of us paused to feel for the kick. "So that means she likes it, huh?" Jackson questioned with a smile.
"Yeah, it does."
"Good." He glanced around the nursery. Beyond the walls and the crib itself, a throw carpet on the floor, the rest of it still needed to be set up. But we had another three months to prepare for that. I was trying not to rush it. I didn't want to stress him out when he was worried about the actual baby herself, work, and our boards.
"Don't forget that your mom is coming over for dinner tonight," I reminded him. "She'll want to see this place herself and probably insist on buying something for it. I don't know what, but, knowing her…"
"Yeah, knowing her," he agreed. "Are you going to cook? Or would you rather go out?"
"I'll cook." I could pull something together, that wasn't a problem. "I'm just… worried. I know that you told her over the phone but the three of us haven't had the chance to sit down and talk about her." As I spoke, I rubbed my belly. Catherine's approval meant too much to me at times.
"What about your mother?"
The question caused me to sigh. I had called and told her about the diagnosis, slightly begrudgingly in an attempt to keep her looped into our lives in case she decided to change her mind and come around, past her outdated ideals. She hadn't been rude about it, of course. That hadn't been my worry. She hadn't even given me some talk about how it was a punishment. No, she had an eerily similar reaction that I did – she didn't see a thing wrong with it. It was validating to have someone else react in the same way. I just had wished that it came from someone else.
"She said that she wants to come to visit after the baby is born." Whether I liked it or not, the fact that she was so supportive of the diagnosis had made me soften up. "I said that it was fine and we could work out the details down the road. We didn't get more specific than that."
"Huh." Jackson clucked his tongue. "Well, you know, telling Mom that might get her on board. She would hate the idea that your mother was being more progressive than she is."
"Yeah?" I couldn't help but laugh, shaking my head. "Maybe you're right."
"And if all else fails, we can distract her with talking about names." His eyebrows raised. There was a hint of amusement swimming inside of his light eyes and it pulled a smile across my face.
"As long as she knows we're not naming it after her." I shrugged. "I still like Matilda."
"Great musical, but not a great name." He shook his head in disagreement. "And if you bring that up in front of my mom, she's definitely going to side with me on that one. Sorry, babe."
Leaving him to finish up with what he was working on in the kitchen, I tidied up the mess that I had made while studying in the living room before busying myself in the kitchen. The only perk of having recently moved was that everything in the kitchen was freshly stocked.
Deciding to keep it simple, I throw together a chicken parmesan and some spaghetti to go along with it. There was a bag of premade caesar salad already in the fridge and a bottle of red wine if Catherine or Jackson decided that they wanted to have some. It was hearty for the winter that had begun to really settle in outside, and I knew that I made a good chicken parmesan. All it took was putting on a little more cheese than the recipe called for, and suddenly, everyone seemed to think it was the most magical thing in the world.
With dinner in the oven, I got changed into a nice maternity blouse and a pair of pants that wasn't quite so suffocating over my stomach. It was a little nerve-wracking to have to talk to her in person, whether I wanted to admit it or not. I loved Catherine but she was opinionated and hard to predict. I didn't want to be on the other side of an argument with her. I wanted her to be happy for us. Really happy.
A knock on the door of the apartment caught both of our attention. Jackson paused and we shared a knowing look. We would have to go in on this together, no matter what was coming our way from the grandmother to be. We had to be completely in sync.
"Hi, Mom." Jackson's voice was the first thing I heard after the door opened. He and Catherine hugged.
"Hey, sweetheart." She replied. "Oh, April, come over here and give me a hug."
"Hi, Catherine." I smiled sweetly before leaning forward to give her a hug, not wanting my stomach in the way. Each day that passed, though, it seemed to become more and more prominent. "How are you doing?"
Pleasantries are exchanged as she comes into the house and we get her into the kitchen. Jackson poured her a glass of wine and I finished getting dinner out of the oven and spaghetti out of the pot. I was avoiding talking to her. It was wrong of me, probably, but I couldn't help it. She might have been progressive in the sense that she was very pro-choice, but I wasn't sure that she would be as supportive of the choice made in this situation, even if it was mine to make. Or maybe I was just too paranoid about all of this.
But when all of the plates are full of food and the three of us sat down at the table, each of them pausing to allow me to pray, there was only so much avoiding the topic that could be done. The truth was out there.
"So, how is the nursery coming along?" Catherine asked.
"Really well," I smiled.
"Yeah," Jackson agreed. "We've got all of the walls painted now, so that's out of the way. We're going to get the rest of the pieces tomorrow I think to finish pulling it together." He elaborated.
"Three or four more months, and you'll be making me a grandmother." Catherine eyed me.
"Yeah…" I picked up my glass and water and took a long sip.
"Jackson and I did talk one on one a bit about the diagnosis." Now as she spoke, she was staring directly at me. I could feel my cheeks burning. "I'm glad that you're so comfortable with it, even if I find it… unexpected. Especially during this time in your life, no one would have blamed you if you hadn't kept the baby."
I set down my glass too hard. "I would have."
"Of course," she murmured though I could tell she hardly meant the words. "Either way, whatever the two of you need, I am here. You have all of the resources in the world that you could possibly need. Schools, nannies, doctors and therapists, whatever it is, we'll find a way to make it work. I know you both want to work too, which will be an extra challenge, but we'll find a way to make it all work out."
"Yes, Jackson and I will too." I don't intend to include her but she was inserting herself entirely. "We've been looking into a lot of resources ourselves. I've been offered an extended maternity leave and I might take it. I haven't decided. But we can figure it out." I looked at my husband.
"Yeah," he agreed with a nod of his head. "Mom, I appreciate that you're trying to help, but we've got this. I promise. We know what we're doing. This is something we've put a lot of thought into."
"I see that," Catherine spoke, sipping from her wine glass. "But as I said, I'm here to help."
"We know," I answered too quickly.
"And we're very grateful for it," Jackson moderated. "But we want to try and do this on our own, as much as we can, Mom. It's our baby. We're going to give her the best life possible. We're all going to have the best life possible. I promise."
A little huff escaped her. "I understand." She nodded. "I don't mean to overstep."
The words are, admittedly, hard to believe.
But by the time that Jackson and I were walking her out the door, and he walked her out to her car, I did feel better about her role. Maybe there was some residual judgment, but now, it seemed as if the biggest problem with my mother-in-law was the fact that she wanted to help too much. I knew she didn't mean it in a way that insinuated that neither one of us was incapable of doing what was needed for our child, but she was just… overbearing. That would take a little getting used to. It had been a long time since she had such a presence in my life. When Jackson and I were kids, I hadn't minded at all. She'd been the coolest woman I knew.
Laying down in bed with a thick pillow between my knees, I laid on my left side. It was better for the baby but it does mean that I can't face Jackson. My right side probably wouldn't have been as bad, but the more that I had laid on my left, the more comfortable it had become.
"Strawberry…" The nickname slipped through his lips easily as he rubbed my upper back. "What's on your mind? I can hear you thinking."
"Our little girl." A weak smile fell on my lips even without his eyes on my face.
"Me too," he murmured. "I can't stop thinking about her."
"I know that she's going to be happy and that we're going to be happy once we're here. Izzie said she told me the same thing she told you. That families are always happier than they ever were before." My pointer finer traced little circles and hearts on my baby bump. Right now, she seemed to be asleep. It was likely she would wake up before I got the chance to fall asleep.
His breath was against the back of my neck. "I know that we're going to be happy once the baby is here. I'm terrified for that day to come. And I'm excited, too. But I know that it's going to be one of the best days of my life."
"It will be." That was one thing without any doubt.