April 1st, 2016—

Leanne sits against a yellow wall in the corner of a doctor's office. She is still in her scrubs, and Angels jacket from her shift the night before. She fidgets in the hard navy blue plastic seat beneath her. Her nostrils flare in frustration as she glances at her watch. Knuckles wrapping against the thick wooden door draw her attention. A white coat enters the room.

"Sorry for the delay I had to make a call to the lab."

"I get it, Dr. Sheets, it happens. I'm just here for my annual physical so I can get my refills and be on my way."

The greying primary care physician takes a seat on a grey wheeled stool. He scoots towards her, and places a hand on her knee.

"We have to talk about that."

She furrows her brow, "About what? I've been on the same medication for years. Are you suggesting that it has grown ineffective?"

"Has it?"

"I don't think so."

"Leanne, how have you been feeling lately?"

"I'm fine. I have a shift this evening though. I really would like to get out of here, and head home."

"No nausea, or vomiting? Headaches?"

"What? Why are you asking that? I already thoroughly filled out my medical history forms. Did you not read them?"

"I read them. I'm also reading your face. I already reviewed your labs."

"Why all of the sudden concern? It's just anxiety medication, which we both agree I need."

"I think that we should consider an alternative with a better safety profile."

She rises to her feet, "Why don't you just tell me what is going on here, instead of jerking me around?"

"Leanne, you're pregnant."

She starts laughing raucously, "That is hilarious."

His face doesn't soften, "It is a fact."

"No, it's not. That isn't even remotely possible."

"You're urine says otherwise."

"Paul, I am forty eight years old."

"I know. I've been your primary care doctor for twenty years, Leanne."

"As you recall I only have one ovary. The other one had to be surgically removed after the car accident."

"Leanne, I know that. I know all of that. So either you have a brain tumor causing a false positive, which I highly doubt, or you're pregnant. It is easy enough to find out. So focus just for a minute, please. I know your mind, and your pulse are probably both racing right now. Have you had any nausea or vomiting? Or any other symptoms that might indicate pregnancy?"

"Yes."

"For how long?"

She simply shrugs as she lowers herself back into her chair. "I have no real sense of time. Weeks, maybe months."

"What did you think was going on?"

"I thought it was just stress. I certainly have plenty of that."

"I had the lab run a qualitative hcg. Based on those I would say that you conceived sometime in early December. Does that sound accurate?"

"I… guess."

"I gave my colleague in the office next door a call. She has a slot from a cancellation in about ten minutes. She said that she would see you."

"Fine," she nods in agreement the way one does to get out of a room.

Thirty minutes, and one thin paper gown later Leanne finds herself at the business end of an ultrasound probe. She pushes her glasses up the bridge of her nose as a young OB/GYN manipulates the settings on the machine.

"Don't you have a technician for this?"

The brunette flashes a smile, "I do. I told her I would do it myself. I thought that is what you would prefer."

"I would prefer not to be here at all," she admits.

She nods sympathetically as she turns the screen towards Leanne. "I would agree with the lab assessment of gestation."

A heavy silence falls over the room. Leanne stares at the screen taking in every detail. The seasoned OB/GYN can practically see the thoughts trickling from her head.

"All of the anatomy is intact. How do you want to proceed? I can certainly give you my recommendations, but you seem like someone who already has an idea of what you want your next steps to be."

"I really just came in to get my prescription refilled."

"I am happy to refill your prescription."

"Without any question, or persuasion?"

"There is no guarantee another medication will work as well. Your situation is complex. What I know is that I am no help to a dead patient, and I understand that an antidepressant can make the difference between life, or death for a great many of my patients. The medication you're on is relatively safe."

"So then I can get out of here?"

"You need to schedule another appointment, but yes."

"Okay."

"Look, I don't know you well. Obviously we just met. I am a relatively thorough doctor, so clearly I read your chart. I really don't know where your head is, or if it makes a difference, but you seem like someone who like to have the facts when making decisions."

"That is a fair assessment."

"You can feel free to review the images on your patient portal, or I can print them."

"Electronically is fine."

"Maybe it doesn't make any difference at all to you, but if you do review the images the gender will be apparent."

She sits at her kitchen table wearing her scrubs the next morning after her shift. Her phone taunts her from the placemat. After a deep exhale she unlocks the screen. Her fingers dance across the keyboard. A series of thumb taps later an absolutely unmistakable image stares back at her. She scrolls through each image closely examining every single piece of anatomy.

Her grasp releases the phone, and she leans back in her seat. She clenches her jaw as her glances falls to the steaming cup of coffee in front of her.

"What did you really think was happening? Every time you tried to drink this damn coffee, and your gastrointestinal system refused? Did you really believe that your stress suddenly led to an ulcer, or GERD? You're a doctor, for pity's sake! Sometimes it's just a horse, not a damn zebra. Honestly, what were you thinking? Maybe you were just hoping that God wasn't so cruel."