Transcript of 11th Session between Charles Balis, M.D. and Ms. Sylvia Bows, Tuesday, September 24th, 1996 at 4 pm.

Ms. Bows: Hello Doctor. How are you?
Dr. Balis: Hello Sylvia. I'm fine. How are you?
Ms. Bows: I'm 10 weeks today.
Dr. Balis: Congratulations! But what do you mean? How are you counting?
Ms. Bows: Oh, I count by the older one. I can't go 42 weeks, or something, so the younger one is going to be premature no matter what I do. So the older one is 10 weeks today.
Dr. Balis: How do you feel?
Ms. Bows: I feel big and tired. I don't think I can get away with hiding the pregnancy for as long as I thought.
Dr. Balis: I agree. You are definitely showing.
Ms. Bows: I think Tom knows.
Dr. Balis: Why? Has he said something?
Ms. Bows: No. But I'm pretty sure he knows. He has been very quiet and even attentive to me at times. And he's looking at me funny. He is making me nervous. He is going to do something that I will regret.
Dr. Balis: Has Tom actually done or said anything to make you feel this way?
Ms. Bows: No, no, Doctor. It's nothing that obvious. But he made breakfast the other morning and then offered it to me when I came into the kitchen. I turned him down of course, but he did try to be nice to me. And he keeps looking at me. I feel like he is examining me--scrutinizing every part of my body. I feel naked when he does that. Like he could see through my clothes. See directly into my uterus. I know, now I definitely sound paranoid. But I can't help it. I feel my flesh starting to crawl and my hair standing on ends when he looks at me. I can't wait until he's gone.
Dr. Balis: Have you been talking some more to your lawyer?
Ms. Bows: Kelly said that she has everything ready and I just have to say go.
Dr. Balis: So what's keeping you?
Ms. Bows: I feel that I have to tell Tom about the twins before I serve him the divorce papers. I know it'll be ugly. Especially now that I think he knows already that I'm pregnant. I'm so sick lately that I feel all my energy draining out. To confront Tom when I'm weak I think would be a mistake. So I'm waiting. Although as time goes on I realize that I should just do it.
Dr. Balis: The morning sickness is usually gone by twelve weeks or so, right?
Ms. Bows: Not necessarily. Sometimes these symptoms last all the way up to five months of pregnancy. And I hate calling it morning sickness. I've been feeling nauseous during the day, in the evenings, at night, as well as during the customary morning hours.
Dr. Balis: Sounds like putting off talking with Tom just won't work.
Ms. Bows: You're right. I'll take him out for dinner sometime this week and tell him then.
Dr. Balis: Why dinner?
Ms. Bows: I just want to get him in a public place. Regardless of how explosive his reaction is going to be, it will be contained by being in the public eye. Tom would never let his composure down in public. And after dinner I can go to Rene's and...
Dr. Balis: Hide out?
Ms. Bows: Precisely Doctor. I'm admitting that I'm a coward but I'm also a woman in a delicate condition and I'm trying to treat myself nicely.
Dr. Balis: Hmm.
Ms. Bows: Maybe I can ask Rene to stay in a getaway car just outside the restaurant.
Dr. Balis: I see.
Ms. Bows: I'm just kidding Doctor. I'm very nervous about talking to Tom and I'm making light of it. When it really comes down to it, Tom really can't do much at this point. The most important thing is that I'm going to be a mother. I won the war. The rest are just residual battles.
Dr. Balis: Battles that you are planning on winning.
Ms. Bows: That would be nice. Although being pregnant is definitely a handicap. I had no idea that it would be like this.
Dr. Balis: How is it?
Ms. Bows: There is just a slew of problems. Some are even comical. I'll get up in the night because I have to go pee and then I realize that I'm very nauseous. So I put crackers next to my bed. I was told that eating saltine crackers reduces nausea. Well, while I'm not sure of the medicinal properties of crackers, I'm positive that they're not the right food to eat in bed. Between going to the bathroom, eating the crackers, and shaking the sheets, I get no sleep.
Dr. Balis: Sounds rough.
Ms. Bows: And I'm acquiring the most outrageous eating habits. I seem never to feel hungry. But every couple of hours I feel like I'm going to die if I don't get food. And when I feel that way, I have to have food now. And I mean immediately. I had to run out of a meeting last Friday to grab a candy bar and a coke. Luckily, as a computer company, we're well supplied with these necessities of life. I do have some crackers at my desk too, but sometimes a cracker just won't do. I'm beginning to feel like I should buy Hershey's stock.
Dr. Balis: Cravings for sugar are fairly common during pregnancy.
Ms. Bows: I can testify to that. Bathroom is the other thing. I feel like I'm spending half my days in the bathroom. I think I go there every half hour, a drop at a time.
Dr. Balis: Your uterus is still very low right now and is pressing against your bladder making it feel full and creating an urge to urinate frequently. This should pass in the next month or so, although it will come back near the end of your pregnancy.
Ms. Bows: You are making it sound so clinical, Doctor. I find it exasperating.
Dr. Balis: Doesn't sound like you're enjoying being pregnant.
Ms. Bows: I don't know who ever came up with this idea. The joys of pregnancy--what a joke! I don't understand how we ever reached our evolutionary level with such flawed reproductive system.
Dr. Balis: What do you mean?
Ms. Bows: Well think about it Doctor. Our ancestors were prayed upon by numerous predators. A pregnant female seems particularly vulnerable to an attack. She's getting bigger. Her center of balance shifts and she gets clumsier in her movements--bumping into things so to speak. She will have problems running and climbing, making escape from her predators dubious. She feels a constant urge to urinate and throw up--clearly an inferior design in the life and death struggles of the wild. And from what I hear, delivery doesn't sound like it enhances survival. At least now there are drugs and going off to the bushes seems to be optional. But survival of the fittest...?
Dr. Balis: I see you've thought a lot about it.
Ms. Bows: Just a bit. I was talking to Rene about it. She seems to have forgotten all the horrors of her pregnancy. She said that there must be a built-in mechanism for automatically erasing all the unpleasant memories of child bearing and birth, because women tend to have more than one baby and, most importantly, want to have a second baby after going through the experience of having the first. Rene maintains that if women and then men took turns having babies, human population would be on the decline--after watching their wives going through pregnancy and delivery, husbands would never consider going through that themselves.
Dr. Balis: Some women do enjoy being pregnant and don't experience all the unpleasant side effect that you seem to be having.
Ms. Bows: Don't get me wrong Doctor. I'm happy to be pregnant. I bought a ton of books. I know how each of my babies looks like on a given week of my pregnancy. I'm very excited about all their accomplishments.
Dr. Balis: Like what?
Ms. Bows: Developing hearing, growing fingernails, moving their arms and legs.
Dr. Balis: Have you felt the babies moving yet?
Ms. Bows: You mean kicking?
Dr. Balis: Yes. Can you feel them yet?
Ms. Bows: No not yet. I know that they are moving around a lot now. But what they are kicking is mostly water. My obstetrician said that I should start to feel something at about fourteen or fifteen weeks. I'm really looking forward to that.
Dr. Balis: Are you scheduled for another ultrasound soon?
Ms. Bows: In two weeks. By then, the older baby will be developed enough to tell if it's a boy or a girl.
Dr. Balis: Is it important to you?
Ms. Bows: Not really. It would be nice if one was a boy and the other a girl. But I would be happy with any combination. Two boys, two girls--I'm just so happy regardless.
Dr. Balis: Are you planning on having amniocentesis performed?
Ms. Bows: I was told that due to my age they strongly recommend that procedure. But I'm worried about it.
Dr. Balis: Why?
Ms. Bows: Regularly it is done at about sixteen weeks. But since one of the twins is younger, this date would probably be moved to eighteen weeks. If they find that there is something wrong with either of them, what could they really do? I wouldn't do anything that would put either of them at risk. Let's say one has down's syndrome. Am I supposed to have an abortion? But what about the other one? I don't see much sense in doing this test.
Dr. Balis: I'm not an expert, Sylvia. But it seems to me that it would be wise to follow the advise of your obstetrician. I spoke with Dr. Malleson and I find him a very knowledgeable and compassionate man. I'm sure he would only do what is in the best interest for you and your babies.
Ms. Bows: I know. I trust him too. But I'm also doing a lot of research in this area. I want to be as informed as I can about my pregnancy and about any decision I might have to make regarding it or me. I know that I'm a very unusual case. There will be a number of issues that will come up. And I have a feeling that doctors are trained to act and sound confidant even when they are not sure which course of action they should take. I feel that this is my only chance and I don't want to blow it.
Dr. Balis: I think it is very wise to stay as informed about your condition as you can.
Ms. Bows: I think so too. I read that a lot of women surrender themselves to their doctors. They seem to be unwilling to make any decisions or take any responsibility for their own care. That's strange to me. Having a child is one of the major decisions and life changes that a person can make. I think the responsibility for the well being of the child should start the moment a woman finds out that she is pregnant.
Dr. Balis: Do you believe in abortion?
Ms. Bows: I think it is a very personal decision. It's right for some and a mistake for others. I don't think that it is right for me. But I believe that it is wrong to make these kind of decisions for others, so I support free choice. When I still worked as a journalist, I wrote an article on women's rights and the abortion issue. It was published in the New York Times. You can look it up if you like.
Dr. Balis: I would be interested in reading some of your articles. I might do that. Our time for today is up. I'll see you next week at 4 pm on Tuesday, October 1st. Please call me if you get into difficulties with Tom and need to talk.
Ms. Bows: Thank you Doctor. I want you to know that you have been a tremendous help and support to me. I'm not sure how my life would have turned out if you were not around. Goodbye Doctor. As always, I will be looking forward to our next session.
Dr. Balis: Thank you Sylvia. Goodbye.
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