Pelvic Ultrasound

Julia Pearl left the Diagnostic Imaging Center noticing how polite she was to everyone. Her instructions said she had to drink 32 ounces of water an hour before her appointment. No longer young and wild, she still didn’t like rules, drinking tea instead, because it was all she had in the fridge. She figured it would be hard enough to hold 32 ounces of liquid in her bladder and that the liquid wasn’t going to take some route requiring an hour to get from her mouth to her bladder, so she took the plastic bottles of tea with her and drank them just before she got to the ultrasound office. She had always obsessed about things. Today, the familiar obsessions about how old she was, how her life was over, how many mistakes she’d made in her life, how unlucky she felt, then quickly adding the thought that there were plenty of people less fortunate than she was, fearing the wrath of an irate god for her self-pity, caused the familiar heaviness in her chest to feel even heavier.

The receptionist was a blond, middle-aged, chubby, woman, who was still pretty. Julia Pearl thought the most surprising thing about her was her smile, not the string of red foil hearts and stars that she wore as a halo around her yellow hair, but the way she smiled as if she was a genuinely nice person and she wasn’t pissed off at everyone who checked in for diagnostic imaging. When Julia Pearl presented herself at the window, filled with 32 ounces of tea, the woman smiled, and for that, Julia Pearl wanted to embrace her, make her a friend, do something to show gratitude, but she said nothing, spoke in a polite and low voice, and tried hard not to do anything irritating. Julia Pearl knew she irritated people. She knew she hadn’t ever tried to be irritating to anyone so she tried hard not to do whatever it was that was annoying that she didn’t do on purpose. Her name for instance, she didn’t give it to herself. It wasn’t her fault her parents were expecting a boy. She got both grandmothers’ names since they hadn’t picked out a girl’s name. No one had a problem saying, “Mary Ann, or Mary Beth, or Betty Ann or Peggy Sue,” but every time she had to tell someone new her name, the person looked at her as if she was attempting to foist something on him or her that was just not right. Julia Pearl got the impression no one liked saying her name. She’d gotten used to it but still…

Julia Pearl had the request form from the doctor, the cards of her other doctors, and her medical insurance card ready to present. Being ready with her cards so the receptionist wouldn’t have to wait for her to find them was one way of not being annoying. Even though Julia Pearl knew they didn’t have anything else to do and weren’t going anywhere until break time or lunch time, she knew it annoyed receptionists to watch her rummage around in her purse for the information she needed to give them. Julia Pearl felt like crying. She often felt like crying but stopped crying a long time ago. She knew it was a waste. Crying didn’t change anything, nothing good or bad happened when she cried.

The nice receptionist with the heart halo handed her an intake form on a clipboard. Julia Pearl showed her efficiency by retrieving a pen from her purse so she didn’t have to ask for one and walked to a row of chairs across the waiting room, wooden with thin fabric padding, wondered if anyone sick had been in one of the available chairs. She chose a chair on the end, close to a basket of magazines, thinking that, had anyone been sick and waiting in one of the chairs, she would take less of a risk by choosing an end chair.

Julia Pearl looked up as she sat down and noticed an older man with gray hair and clean, pressed clothes sitting across from her. She half smiled then thought about how stupid it was to smile at a perfect stranger who just happened to be stuck in the same waiting room. In that same second she looked quickly down at the form on the clipboard and began filling it out. She wondered for a moment if he might be single and available. Perhaps he was and maybe he was even lonely and didn’t know how to meet a woman. Maybe she should turn her hand so he could see that she didn’t have a wedding ring on. Maybe his wife had died and he was a widower, lost and alone, wishing he had a companion, someone to share a movie or a walk or something. In the next flash of a second, she thought he had to be married because all elderly men with nice, clean pressed clothes who didn’t look disgusting were married. He was there waiting for his wife for whom he worried, knowing she was undergoing some frightening procedure because she had cancer or was getting a scan which would lead to a diagnosis of cancer, just like Julia Pearl. Only Julia Pearl didn’t have a nice husband to worry about her. Julia Pearl had burned all of her bridges and was now experiencing the part of her life where she was getting what she deserved, nothing, except maybe a diagnosis of cancer which would finally end the life she’d tried so hard to find, never finding the life she dreamed of, the life where she did have a nice man for a husband, who loved her and cared for her. No, Julia Pearl had always made bad choices thinking they were the right choices or making the only choice, she could make which wasn’t really a choice. She thought all of these things before she was to the third line of the form but that’s how it was. She could think entire stories before someone walked across a room. She was always thinking and often she was thinking the same thoughts she always thought which was why she called them obsessive. She didn’t think other people were like her. She knew she wasn’t insane or even a little bit crazy. She was pathetic. She knew that and she wished it weren’t so. She tried not to look pathetic because she was a professional and her career depended on her looking intelligent and not pathetic, certainly not how she felt most of the time.

She heard her name called and walked quickly to the open door. A technician, half her age, was holding the door for her. He didn’t smile nor did he frown. He led her into a room where the scanning equipment hunkered next to a short bed where it was quite clear that something would be hanging off the end. He said something to her in a low, monotone voice she couldn’t understand, his voice being that low and her hearing being that bad. She pretended she heard him because she didn’t think he was saying anything important.. She imagined he was telling her about the procedure, and she knew she’d find out about that soon enough. He pointed to the bed and she knew he meant for her to lie on it. He told her to pull her pants down below her hip bones, then he covered her with a sheet even though nothing was exposed She guessed the sheet was protocol whether you had something exposed or not.

She was surprised she couldn’t feel the clear gel he drizzled on to her. She thought it would be cold and wouldn’t have been too surprised if she’d felt warmth but she was confused when she couldn’t feel anything even though she saw it leaving the nozzle and dribbling onto her belly. He had a round face and round “John Lennon” glasses; cool even though John Lennon had probably been dead before he was born. He was as utterly disinterested in her as everyone else had ever been in any medical setting she’d experienced before with the exception of the haloed receptionist out front. She thought about telling him about John Lennon, thought about saying something friendly, decided she’d done that way too many times and the only thing it had ever gotten her was to make her feel like an idiot. So she kept her mouth shut and waited for him to run the scanner over her belly.

When he lifted the plastic scanner off her, he said something in a soft voice. Julia Pearl knew he was giving her instructions so she had to tell him that the plastic object hanging on a cord around her neck wasn’t an iPod but a volume adjuster for her hearing aids. She told him she was deaf and hadn’t heard what he’d said. As usual, he suddenly looked a bit more polite, whatever that was. She recognized that look. She just didn’t know exactly what it was because it was subtle, not like a smile or a frown, just more polite as if the disabled deserved an extra dollop of politeness. He led her out of the imaging room to a dressing room, a cubicle with a bench and a stack of blue hospital gowns neatly folded and pressed. He pointed to the bathroom and told her to go “relieve” herself, then come to this dressing room, take off her pants and underwear, put the gown on with the opening in the back, and then come back into the ultrasound room. After she got rid of 32 ounces of tea and came back to the dressing room, she looked at the gray, plastic, accordion door and thought about closing it before she undressed then realized no one was around and even if there had been someone, who would care about an old woman putting on a hospital gown? Who would care that she was in the process of getting a diagnosis of cancer, the dreaded diagnosis that would finally put an end to her charging up the hill of life, attempting to get it right, attempting to fit herself into the kind of life she saw other women living, the kind of life where women were cared for and didn’t have to worry, didn’t have to be afraid all of the time, didn’t have to regret every year of their adult life because they just couldn’t fit into that steady stream of normalcy where women were loved and cherished and husbands brought them flowers and cleaned their cars and smiled at them and sometimes just spontaneously hugged them because they were loved? No one. So she left the accordion door open and took off her black suit pants and black pantyhose and the toe cushions she wore on the second toe of each foot to protect the bony second knuckle from rubbing against her shoes, wearing the skin off of her toes, delivering her to her job obsessing about the pain on the top of her toes. She tucked the pantyhose into her pants and the toe protectors into her pocket, thought about whether or not she should go back into the room in her bare feet, decided she would look stupid walking down a hallway, where dozens of people walked in their dirty shoes, in her bare feet. She put her feet back into her black ankle boots but didn’t zip up the zippers because she didn’t want to look like she really meant to be wearing street shoes and a hospital gown. She clumped back into the examining room and discovered another plump woman, in a red sweater, young this time, perched on a stool next to the technician wearing John Lennon glasses and four-day-old stubble. She remembered, these days, women were always put in any medical room where a procedure was going to be done on a woman by a man where the woman was undressed or the procedure could in any way have the woman complaining about sexual invasion or harassment or something. It all seemed stupid to Julia Pearl. When she was young, no one gave a shit what women thought about things like that. All sexual harassment was expected and it was supposed to be flattering. If you complained, you were just an uptight, frigid bitch, that’s all. Over the years, other women had complained, even though Julia Pearl thought they’d probably mostly made up whatever their complaints were because no doctor had ever harassed her, just bosses and other men, like her neighbors or relatives. That’s how the new rules came to be so there was the woman in the red sweater, as if this young and completely disinterested technician even had the remote thought of Julia Pearl being a woman. Julia Pearl realized that when she was young and considered a sexy and desirable woman she wouldn’t have looked twice at this guy. He wasn’t her type then or ever and she thought he was decidedly unattractive even if he didn’t know she was a woman. He pointed back at the table and told her to lie down and scoot down to the end of it and put her feet into the stirrups. She lay down, he put a sheet over her from the waist down, and then he held up what looked like a very long plastic wand and began pouring clear gel all over it. Julia Pearl listened to him tell her to insert it like a tampon, resisted the impulse to tell him that no tampon ever looked like that unless there had been one for the bride of Godzilla. She thought about how much damn gel he was wasting and about how the health care industry was screaming all the time about the rising costs of health care before she took the wand from him. When she was ready, he took it from her and began moving it around while he stared at the scanner screen, which she could not see but seemed to fascinate the young blonde. Julia Pearl laid there, wondered if he would feel sorry for her when he saw that she was so full of cancer the doctor would just tell her to put her things in order and enjoy the few weeks or months she had left.

His face remained impassive. No one spoke. Julia Pearl decided against trying to be nice and make polite conversation. She just wanted him to get good images, wanted the documentation that would go back to her doctor and end the life of quiet desperation she lived, finally allowing her to cry, be afraid, be sick, be scared, be all of the things she’d always imagined she’d be if she were ever diagnosed with cancer, all of the ways she’d already been without a diagnosis of cancer. And she knew it would be like that, awful, sickening, she was afraid of dying and even afraid of being dead although she’d always insisted she was afraid of dying but not afraid of being dead. She’d never really thought before of what being dead might be like. How could she not exist?

He finally disposed of the wand without Julia Pearl seeing what he was doing. He and the blonde woman left the room after he gave Julia Pearl a hand towel and told her to get dressed, that she could go. As Julia Pearl dressed, she stared at the scanner screen, realizing he’d left the images on the screen. She hadn’t ever been able to make out what was what in an x-ray or any other kind of scan but she thought that maybe he felt so sorry for her he wanted her to know just how bad it was. She couldn’t tell what was what, she saw white places and dark places and wished she could remember if white was bad or dark was bad. She could clearly see that nothing matched. Whatever it was wasn’t symmetrical and that had to be bad since she was supposed to have a uterus that looked the same on both sides and ovaries that looked the same on both sides and she couldn’t see that. She didn’t even feel upset. It seemed like her entire life had been coming to this. It wasn’t what she’d hoped for but it was what she’d expected. She noticed the technician’s computer screen saver was a photo of a huge motorcycle as shiny as his ego and thought that the Harley represented wishful thinking on his part. His stubble covered up a weak chin. She knew that much for sure.

When she left wearing her black business suit with her single strand of pearls against her black cashmere sweater and her gold and pearl earrings, she passed the receptionist’s office and thanked a young woman standing there and thanked another woman coming down the hallway and wondered why she was thanking people and what she was thanking them for and then she thanked the blonde with the heart halo and left without looking to see if the married gentleman had retrieved his wife and gone or if he was still patiently waiting for her. She even held the outer door for a man half her age, not because she was trying to be polite but because she just couldn’t think anymore. She walked numbly to her car and tried to put her key into the lock, then remembering that’s not how cars get unlocked these days. She pressed the unlock button on her key and saw her dog curled up in his dog bed in the back seat as she slid behind the wheel. A wave of love washed over her, seeing him waiting patiently for her return. He loved her. He would always love her. She thought this would be just the teensiest bit easier, this having cancer, and dying, if he slept next to her the entire time. He would be such a comfort to her. She could imagine not being all alone, feeling like it was the two of them on just another journey, just another day where the unknown rules and everything is just the way it is.

Mary Julia Klimenko c. 2/10