Transcript of 12th Session between Charles Balis, M.D. and Ms. Sylvia Bows, Tuesday, October 1st, 1996 at 4 pm.

Dr. Balis: [Sneezes]
Ms. Bows: Bless you. Hello Doctor, how are you? Do you have a cold? If you do perhaps we should reschedule--I'm worried about getting sick. When you're pregnant, there aren't too many options on what you can do for your cold other than some nose drops perhaps.
Dr. Balis: Hello Sylvia. I'm fine. I just have an allergy. And I would never expose you or any of my other patients to my germs if I was sick. Now how are you doing Sylvia?
Ms. Bows: I'm sorry about being so jittery. I didn't mean to jump on you; I'm just feeling a bit edgy today.
Dr. Balis: What do you mean?
Ms. Bows: I don't know. Maybe it's the pregnancy thing. I just feel like I'm on an emotional roller coaster--my moods go up and down, up and down, not to mention my digestive system. But I'm at 11 weeks and things should start to get better soon.
Dr. Balis: Are you counting each day?
Ms. Bows: Sort of. There are dangers at each stage of the pregnancy and as I pass that stage I feel like I can start to breathe easier.
Dr. Balis: Is there anything in particular that you're worried about?
Ms. Bows: Not really. There are clearly more problems associated with carrying twins and even more with twins of different gestational ages. I would venture to guess that every first time mother has a slew of worries. But why do you ask?
Dr. Balis: I had an interesting conversation with your brother last week.
Ms. Bows: Jeorge?
Dr. Balis: I have to say that I had quite a different image of him from your description.
Ms. Bows: Jeorge is a master at first impressions--I'm not surprised. So what did good old Jeorge have to say?
Dr. Balis: Quite a bit. He seems to be genuinely worried about you.
Ms. Bows: That's nice. He came to see me at work last Friday. Just showed up in the middle of the morning, unannounced, expecting me to drop everything and talk to him. I explained to him that I was rather busy and, if he was interested in talking to me, we could try to set a date convenient for both of us. He got angry, told me that I looked horrible, said something about Tom, and stormed out of the office. It's just like Jeorge to cause a scene. He does everything on a grand scale and is full of theatrics--a frustrated actor at heart. If he was really interested in talking to me--or even interested in my life--he would have tried to meet with me in private and not embarrass me in front of my office staff. Jerk. But I'm glad you liked him Doctor.
Dr. Balis: He was actually somewhat hostile on the phone to me, Sylvia. I just was expecting something else. But he did show what seemed to be genuine concern.
Ms. Bows: Yeah? What else did he say?
Dr. Balis: He said you had cervical cancer a few years back and that you were told that you would have difficulties carrying a child to term. Is that true?
Ms. Bows: Yes.
Dr. Balis: That seems like an important piece of information to neglect to mention.
Ms. Bows: There are always risks, Doctor.
Dr. Balis: True. But...
Ms. Bows: I'm willing to take this risk. I want to be a mother. I wasn't willing to play it safe and then spend the rest of my life playing the "what could have been" game. If you play your life, Doctor, in your head, what are the chances that you, a hard-core New Yorker, would end up living in San Francisco treating a pregnant woman for severe depression caused by her husband's vasectomy?
Dr. Balis: I see your point.
Ms. Bows: And I'm not some starry-eyed optimist. I'm doing everything I can to improve my chances. When I was at the hospital, they put a stitch in my cervix. This is to provide extra support to the growing uterus which my body can't do on it's own. I'm also cutting down on my working hours. I ordered a new chair for my office that will allow me to shift the weight away from my dysfunctional cervix. I will no longer take business trips or go to any meeting outside of SII's headquarters. I've stopped exercising including walking for any distance further than my parking place. And I stay off my feet as much as I can. I'll probably end up on bed rest for the last few months. I hope you won't mind turning our sessions into telephone conversations. As I said before, I'll do all that I can to keep my babies.
Dr. Balis: I'll be happy to accommodate your situation in any way I can. But why didn't you tell me?
Ms. Bows: Look Doctor, if I told you about all of this, you would have tried to stop me. Right?
Dr. Balis: I...
Ms. Bows: You would have. You would have insisted on acting rationally and playing it safe, just like Tom.
Dr. Balis: And Tom is another thing. Jeorge painted quite a different picture of Tom and your relationship.
Ms. Bows: What a surprise. Jeorge? Tom's little pet? He would take Tom's side? How remarkable!
Dr. Balis: Sarcasm aside Sylvia, Jeorge described Tom's perspective. He said that Tom is genuinely in love with you and always was. Jeorge told me that Tom was very concerned about you. That he was worried about your physical and mental health after the surgery. Jeorge said that you became obsessed with the notion of becoming a mother. He said that your whole family was worried about what could happen to you if you lost a child.
Ms. Bows: Did he mention Tom's noble sacrifice?
Dr. Balis: He said that Tom felt that that was the only way to insure birth control.
Ms. Bows: Well he was wrong, wasn't he?
Dr. Balis: Yes he was.
Ms. Bows: Doctor, there are always two sides to every story. As a journalist I know that better than most. But after I found out about what Tom did to me, I sat down and tried hard to write his story from a neutral perspective. But there's just no justification. None. What that miserable son of a bitch did was so horrible...he made a carefully considered conscious decision to unilaterally take away any chance I had at being happy. I shudder to think what would have happened if I didn't find out in time.
Dr. Balis: You're talking about understanding Tom's actions from a neutral perspective. Don't you think that you'd be the last person to be able to do that? As a journalist you understand how biases and prejudices creep into a story. Would you trust a reporter who is this close to a story? Who has so much to gain or lose from taking one side over the other?
Ms. Bows: It was always my job to be impartial and look for the truth.
Dr. Balis: Come on Sylvia, this is not that kind of situation. There is no way a person in your situation could stay impartial. You took the only side you could--yours.
Ms. Bows: Perhaps. But this is also the only side that makes me happy.
Dr. Balis: We'll talk more about that later. Did you ever discuss any other alternatives with Tom? What about adoption?
Ms. Bows: I didn't want to adopt and Tom would have never accepted an adopted child as his own. It just wasn't an option.
Dr. Balis: You don't think Tom will accept your twins, do you?
Ms. Bows: His acceptance stopped being an issue as soon as I knew about his vasectomy. Whatever voice he might have had on this subject he cut off two years ago.
Dr. Balis: I see.
Ms. Bows: I am no longer interested in Tom's fathering services. Or anyone else's for that matter. These children are mine and mine alone!
Dr. Balis: What about a surrogate mother? The genetic material would have been yours but you would have avoided the risk of miscarriage.
Ms. Bows: I thought a lot about it. I also did a lot of research. It's my impression that the surrogate business is still in its infancy, so to speak. There are too many cases of surrogate mothers trying to keep the kids even if biologically the child isn't theirs. In the United States, the courts seem to favor the rights of the surrogate mother. And frankly, when I put myself in a surrogate's position, I don't see how I could give up the child either. We're the products of a long evolutionary process whose main purpose is reproduction. Our whole biology, down to the molecular level, is geared toward finding the right mate and conceiving and raising our own replacements. When a body is carrying a child, the hormones and instincts don't know on whose chromosomes this baby is built. The body does everything it can to give life to the child. And it makes no difference who the father or the biological mother is. It's all the same. The body just takes over. I don't know if it's right to ask anyone to give up the child that they brought into this world. I don't think I could do it.
Dr. Balis: I understand that most times it's not an issue. Surrogate mothers are trained and experienced and understand what they are doing. I think many view it as giving a gift to couple like yours which has problems carrying children of their own.
Ms. Bows: You said the crucial words--most times. And then there is that other time when your child is not given to you and there is nothing you can do about it. You can never see your child grow up. You never have an opportunity...there'll be this person out there. This person might look like your mother or father, they might walk just like your grandfather did, they might sneeze a dozen times in a row just like your aunt does. There's this person who is a part of you and who you'll never know. And then every time you see a child about the right age, you'll look and wonder. I couldn't bear it.
Dr. Balis: So you felt that having a child yourself was the only option?
Ms. Bows: I don't see any other way. And as I said, I think the benefits outweigh the risks.
Dr. Balis: Tom clearly didn't think so.
Ms. Bows: No Tom didn't.
Dr. Balis: Jeorge mentioned that Tom was always actively against the idea of having children and never pretended to go along with your attempts at getting pregnant. That is not exactly how you presented the situation to me.
Ms. Bows: What, are you going to turn on me too? You're my therapist. You are supposed to be on my side. Do I have to battle you and my parents and Jeorge and Tom all by myself? I can you know. I can take you all on!
Dr. Balis: Sylvia, you know this isn't about taking sides. My job is not about being your advocate. My job is to help you understand yourself better. You certainly don't have to explain yourself to me, but if I am to do any good as your therapist, I need to understand the entire situation and not just a sanitized version designed to insure my sympathies.
Ms. Bows: Okay Doctor. I know. I implied that we were both trying to get pregnant, when really only I was. But Tom knew I wasn't taking birth control pills.
Dr. Balis: Did Tom try to practice other forms of birth control? Condoms? Withdrawal?
Ms. Bows: Tom was big on withdrawal. It matched his style--control over everything he does.
Dr. Balis: It seems to me that it's not only his style.
Ms. Bows: Hmm?
Dr. Balis: You have been exhibiting quite similar tendencies. You are one of the most controlling people I know, Sylvia.
Ms. Bows: I think I'll take that as a compliment. I like to keep close rein over my life.
Dr. Balis: You clearly do. Well our time is up. Same time next week? Or do you want to make it a telephone call?
Ms. Bows: I'm not ready for voluntary asylum just yet. I'll see you here next Tuesday at 4 pm, Doctor.
Dr. Balis: Good. Take good care of yourself and your babies, Sylvia.
Ms. Bows: I will. Or yes, I will also be bringing you some pictures next time. I'm going for my ultrasound next Monday morning. It's never too early to start a baby photo album.
Dr. Balis: I'll look forward to the pictures. Goodbye Sylvia.
Ms. Bows: Goodbye Doctor.
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