her annoyance rise. She wasn’t stupid, and yet doctors always explained biology as though she were completely uneducated, as though they were reading from a book about talking to patients. “Right, on day three,” she said.
“Yes. So you can come back in. Additionally, I’d perform a transvaginal ultrasound, that’s an ultrasound of your uterus.”
Elm’s patience ended. “Yes, I know what my vagina is.”
The doctor continued as though Elm hadn’t interrupted. “We do an antral follicle count where we, well, we count the follicles. That’s a pretty good indication of fertility. Would you like me to do that now?”
“Yes, please,” Elm said. She lay back down, her heart racing. Please, she begged silently, please let there be follicles. She tensed as the ultrasound wand entered her, and Dr. Hong pressed lightly on her abdomen. “Okay, three right,” she said to the nurse, placing her hand on the other side. “And four left.”
She removed the wand and took off the protective condom, placing it and her gloves in the bin. She immediately washed her hands. Elm sat up, nails thrumming on her thighs.
“I’ll be honest, Ms. Howells,” Dr. Hong said. Elm looked at her, her eyebrows so thin, barely visible. “I counted only three follicles on the right and four on the left. That’s consistent with poor ovarian reserve.”
Elm felt the nervousness evacuate her body. It was replaced by nausea, the precursor to a wave of grief. “So I’ll have to take a fertility drug.”
“Well,” Dr. Hong said. Elm thought that if the woman said “well” one more time she might throttle her with her stethoscope. “The fertility drugs stimulate the follicles. If there’s nothing to stimulate, then it won’t really work. You’re not a good candidate.”
“What about IVF?” Elm demanded.
“In vitro has the same problem,” Dr. Hong said. “I won’t tell you absolutely not, because you hear these stories about spontaneous pregnancies, but it appears very unlikely.”
“How unlikely?”
“With these follicle levels there’s a less than one percent chance of spontaneous conception,” Dr. Hong said. “I’m very sorry.”
Elm fought the lump that was condensing in her throat. “I see.”
“I’ll send you to a specialist, to do more tests,” Dr. Hong said. She made a note on Elm’s chart. “I’m sure you’ll want to exhaust all the options. And we do have the best-ranked fertility clinic here in the hospital.”
Elm had stopped listening. She made a mental inventory of her clothing—pants, trouser socks, blouse, belt. Don’t forget your sunglasses, she reminded herself. Don’t forget to fix that bra strap that was bothering you this morning. She didn’t dare look at herself in the mirror above the sink, sure that her reflection would make her cry.
She charged her copay and left the office, walking to the East River. The air had switched directions; coming off the water it was cool, almost sharp, and she let it blow her hair back as she walked. She imagined that it blew right through her, getting rid of all the liquid that troubled her: her blood, which kept her heart pumping and aching, and the tears, which were threatening now.
She held back until she got to her office, then closed the door and collapsed on the small couch sobbing like she hadn’t since Ronan’s funeral. It felt, in that moment, equally as painful, as wrenching, as the day she said good-bye to her son. This was it, then, no more children. No sibling for Moira, no feeling of fluttering kicks in her belly, no first steps, first words, first haircuts. From now on, only lasts.
The phone rang, a conference call that required none of Elm’s attention. She hit mute and put the phone on speaker while she worked on the breathing exercises her doctor had shown her to help her calm down. Soon her breath and chest regained their rhythm, and only the occasional sharp intake betrayed the magnitude of her disappointment. Next to her phone was the notepad with the web address of the cloning center. All week the website had been calling to her, and Elm had tried to ignore it, but as she half-listened to the phone, she traced the URL bold, then serifed. She drew a box around it, stars, vines snaking up the side of the page. And then she could deny herself no longer. She told herself it was out of curiosity that she typed in the address. It would be a laugh, as Colin would say. It took awhile to load, and Elm puffed her cheeks out with impatience. She threw