The Pill That Made Me a Poet
C18H20O2
I rub a hand across my bare belly,and it transforms into heavily bleached terry cloth. Turning my head on the pillow, I see a drive-through window, like the kind at McDonald’s, but the brightly illuminated room and the crib-like bed are five stories off the ground. Every few seconds, a different adult appears on the wall, pauses, and is replaced in a carousel of slides. An absence I sensed as a presence had recently administered to me, an angel different than Lorca’s counterpart to duende; than Rilke’s “Angels, (they say) don’t know whether it is the living / they are moving among, or the dead”; or Iowa City’s Black Angel. A wet towel had been placed on my chest to keep down a fever on an ascent past 104 degrees. By turning my head, I looked beyond my little self who was often still lying on an operating table or in a recovery area.
As a six-year old, I am wheeled on a gurney into a pre-op or recovery room and transition from first- to third person. This child patient opens her eyes despite anesthesia. She sees undressed and unconscious adults in a pre-op area bathed in sepia, the lighting dim as inside an appliance. Hospital sheets are draped like tarps. A slack adult face lies on a gurney a few inches away, a man’s bare arm and open hand with wedding band dangling outside a sheet. The patient can’t tell if she’s headed into or out of surgery. She shifts slightly but doesn’t feel the backspace of pain or restriction from IV tubing and the urine bag, which will be attached to a hole in her right side. The patient closes her eyes.
“I’m not ever myself; I am a metaphor of myself,” I say to my husband about what it’s like for me as an adult to talk to a doctor, any doctor.
Exposure
Dr. V explicates from his side of the desk, and my mother and I sit in low-slung plastic chairs, diminutive seating even for a six-year old. We watch slides Dr. V projects onto a narrow screen atop a bookcase between artificial plants and binders, a screening area suggesting he was in the habit of documenting his work. When I recently Google his name,“Harvard,” and “urologist,” what comes up is a white-haired Leprechaun’s face and the usual internal narrative of gratitude. How lucky I was that he’d been on sabbatical in central Maine, how he saved my life, how otherwise I “would have been on a dialysis machine.” Dr. V was the type of surgeon who practices “heroic medicine,” as Susan Bell says of specialists from elite teaching hospitals who helped girls and young women when hometown practitioners couldn’t diagnose birth defects.
In the plastic chair, I am learning as a young child that my body can be cut, peeled, suctioned, probed, grafted, stapled, and sutured. The body previously thought of as mine is opened and rearranged by many blue-gloved hands. Organs normally invisible are outed, glistening because of their disturbed privacy, their involuntary functions made the subject of inquiry. Something does pass out of the body—levitates, sees the self from above, third-person, to be captured in the surgeon’s dictations:
The patient was given general anesthesia and placed in the supine position. A Pfannestiel incision was made, sharp dissection was carried across the anterior rectus fascia. The recti were separated in the midline. Allises were used to grasp the bladder. The bladder was entered. The bladder was so retracted as to expose the left ureteral orifice. It was situated at the dome of a moderate sized ureterocele. Pictures were taken of this anatomical defect.
The patient was given general anesthesia and placed in the lithotomy position. The urethra was calibrated and accepted up to a #22 Otis bougie without difficulty. A #17 cystouresthroscope was introduced into the bladder. Inspection of the trigone revealed the following: the right ureteral orifice was stadium in shape. The right intra-mural tunnel was approximately 8mm and not on the interureteric ridge proper. It was in face lateralized.
The patient was returned to the Recovery Room in satisfactory condition.
Molecular mass of 268.35 g/ml
I was born with a tray of birth defects. I’m like the board game Operation or the surrealist parlor game Exquisite Corpse. Make a sidewalk outline of my body and draw four scars inside it—an equal sign on my lower abdomen, the bottom part made in 1976 and the top in 2005, a dime-sized circle on my left side also from 1976, and a four-inch line on my neck from 1992.
Just as flimsy tweezers move around plastic organs in the board game, parts of my anatomy were moved to different locations in my torso—a tube twisted so far to the right that it fires off aimlessly, like a street lamp (still illuminated) struck by a car—another part not attached at the right place on its organ. My anatomy was redesigned using unexpected shapes, occasionally primordial, with the incongruity of a lion’s head drawn on a plant stem. An organ revised into a crescent shape. Gill slits that manifested on my neck during my first month studying poetry at the Iowa Writers’ Workshop. The defects made themselves known over widely separate moments—malformation at age four, grape fruit-sized cyst at age twenty two, twelve weeks premature birth of my first child when I was thirty five.
Something toyed with me. It ran its chemical influence over me, that ball of rapidly evolving cells which now types this sentence. Normal development of the head and neck muscles occurs in the fifth gestational week and from gill-like pouches in the throat area of the seahorse-like fetus. In weeks eight through ten, a hormone is secreted in male fetuses the absence of which in female fetuses turns Mülerian ducts into the uterus, uterine tubes, and vagina. For females, urinary tract abnormalities occur in tandem with Mülerian anomalies.
5mg/day in weeks 7 and 8, increased to 10 mg/ day every other week through the 14th week
Beginning June 1969, Hawaii. Mother age twenty one, father age twenty-six.
1 gestational month July20, 1969: Apollo 11 Moon Landing
2 gestational months Mother suffering from hyperemesis gravidarum or persistent morning sickness. Cannot keep even cottage cheese or ginger ale down. Quits job at counter in gift shop.
2 gestational months August 15-17, 1969: Woodstock
3 gestational months September 1969: Parents move from Hawaii to Somersworth, New Hampshire. Mother possibly given a cocktail of endocrine disruptors by different obstetricians with father’s job relocation.
4 gestational months Mother is nearly twenty pounds lighter than before pregnancy.
6 gestational months December 1969 First military draft “lottery” for Vietnam War and first strain of HIV arrives in the United States.
7 gestational months Mother continues to have difficulty holding down food despite medication prescribed and is now thirty pounds lighter than before pregnancy.
Birth, March 1970, in Douglas Wentworth Hospital in New Hampshire, at the same time as my neighbor one house down on my street volunteered as a candy striper in the maternity ward.
March 1970 In a photograph mother wears a shift style dress with lace-up go-go boots and is skinny as Twiggy.
1971:Article published in New England Journal of Medicine links in-utero exposure to the drug Diethylstilbestrol (DES) to a rare cancer in girls.
1973: Research begun on psychosexual side effects of DES on males exposed in utero.
1983: The year in which Merrell Dow Pharmaceuticals stops producing Benedictin after a flurry of “preconception” tort liability lawsuits alleging gastrointestinal and limb defects in the wake of uproar over Thalidomide. Claims about Benedictin subsequently disproven.
2013: FDA reinstates Benedictin under the name Diglesis
August 2015: The FDA issued warning to Kim Kardashian to stop promoting Diglesis on Instagram where she had posted, “OMG. Have you heard about this?”
Diethylstilbestrol
DES or Diethylstilbestrol, with a molecular mass of 268.35 g/ml and elemental configuration of C18H20O2,was synthesized by a graduate student, Leon Golberg, at Oxford University in 1938 in research funded by the UK Medical Research Council. The United States Food and Drug Administration later approved DES for a wide range of uses: as an inexpensive hormone therapy for menopause, a lactation suppressant, a treatment for advanced prostate and postmenopausal breast cancers, as a treatment for infertility and miscarriage, and as chemical castration for sex offenders.
According to the Center for Disease Control, around 5-10 million patients were given DES in the United States between 1938 and 1971, including pregnant women and the daughters and sons of those pregnancies—called DES Daughters and DES Sons. By the 1950s, the drug was administered to tall girls to prevent excessive height, despite the fact that as early as 1939 researchers had seen indications that DES might be carcinogenic. For pregnant women, the recommended regimen was 5mg per day in the seventh and eight weeks of pregnancy, increased to 10 mg per day every other week through the fourteenth week (or just beyond the first trimester, the most vulnerable time in fetal development), to 25 mg until the fifteenth week, and then to 125mg in the thirty-fifth week of pregnancy. A 1971 FDA bulletin warned physicians against prescribing DES to pregnant woman, and by 1975, the FDA banned the sale of 25 mg and 100 mg DES pills.
DES, one of the first carcinogens discovered to be able to cross the human placenta, is now known to cause two side effects: clear cell adenocarcinoma, a vaginal and cervical cancer that was extremely rare in young women before the introduction of DES, and structural alterations of the reproductive tract that can result in infertility, pregnancy loss, and preterm labor. The drug is currently prescribed for urinary incontinence in dogs, though a foreboding “bone marrow suppression” is listed as a side effect for canines.
DES Daughters
A 40-fold increase in risk of clear cell adenocarcinoma of the vagina and cervix. T-shaped uterine cavity, hypoplastic uterus, endometrial cavity constrictions and adhesions. Gross cervical abnormalities are visualized in about 20 percent of exposed women. Twice as likely to experience infertility. An 11.7 percent excess risk of ectopic pregnancy (14.6 versus 2.9). Increased lifetime risks of spontaneous abortion (53.3 versus 38.6 percent). Loss of second-trimester pregnancy (16.4 versus 1.7 percent). Twenty percent risk of miscarriage versus 8% in unexposed women. Pre-term delivery (53.3 versus 17.8 percent).
53.3 percent
The thick cables of the new Tobin Bridge in Boston pass above me in the ambulance, like a giant centipede or a timeline alit in the night. I am losing the baby, I think because that’s what I’ve been told with medical certainty, as I am arrowed toward the emergency room at Brigham and Women’s Hospital, wheeled, rushed, swabbed, scanned, injected.
Patient is educated woman, is unmarried and has recently moved to area, feels depressed, says 9/11 has made her decide to have child, declined post-op prescription.
Because your twenty-one year old mother’s English is broken, umlauted, because it is 1969, because she did not finish high school in her bombed-out country of origin, because the white coat man speaking to her is Dr., because she follows authority and does not listen to Magical Mystery Tour nor does she smoke wacky tobacky, because she can barely stomach it (and often does not) when her husband spoons maple walnut ice cream out of the carton, because she can’t hold down cottage cheese and saltines, because morning sickness is like lying in a hammock in trees covered in Spanish moss inside a snow globe and wanting to sleep all the time in the bracken water light, because she moves with the man she married after knowing him for three months from one military base to the next, from a tropical island to a rugged New England coast line, because her friend in the apartment building who was writing a dissertation in mathematics is also experiencing hair loss though not from pregnancy kept her company between her rushes to the toilet, because she barely saw her own father and remembers how he took her age seventeen to the airport when she left her country, one shore to the other, the surf pounding, stomach roiling, balcony overlooking the Pacific. It’s not because of a class you took, a book you happened to notice on a shelf marked Poetry, a supportive adult or ten minutes with a college advisor, not because of a childhood literary prize or special inner ability, but because of some man who thinks he knows best, who sits across a desk from a young worried immigrant who has come in twice that week, man who is thirty-four years into his medical practice and two years out from retirement, who isn’t in the loop about latest medical developments or controversies, who doesn’t attend medical conferences, his practice located in rural New Hampshire or on a distant island, who hasn’t renewed his journal subscription since 1961, because it is 1969, and because all women seem unsure, if you were my daughter, I’m telling you what I would advise my own daughter, because as he flips through his notes next to the dic-ta-phone, the note pad from the pharmaceutical rep, can’t keep down food, the young woman who does seem thinner is looking at her hands in her lap, because though this medication is prescribed for miscarriage not morning sickness but maybe it’ll help, because he is also thinking that if she carries this pregnancy to full term he might ask if she wants to give the baby up, how to carefully inquire, he has that older couple in mind, you’re so young, you have a lot of time ahead of you, your husband moves for his work, wouldn’t it be easier to travel without a child?, because this is what the doctor told her, because she can’t handle throwing up again this afternoon, she puts the capsule to her lips, then the glass of flat ginger ale, then swallows.
Wantstobeadoctorsomeday
The microscope is 7.5 pounds without lens on the bathroom scale. A bronze and black monocular with a horseshoe-shaped base, equipped with a triple nose piece and a 10x eyepiece, the microscope was probably manufactured between 1895 and 1934. Rusting letters on the base say Spencer Lens Co., Buffalo, NY. A pink sash, tied by my daughter, makes the dusty microscope a portly general at a beauty pageant. I move close to the microscope for the first time in three decades. It has the smell of dust and much-handled dollar bills. Lacking specimen slides, I drop a corner of the sash onto the viewing platform, rotate the taller of the lenses, and shift the mirror.
Turning the knobs, the microscope tower slowly descends like a cautious apartment elevator. The “shiff shiff shiff”evokes my childhood bedroom, its pinkness and vacuum tracks in shag carpet. What I see through the lens is a mottled light—mold has infiltrated the lens—and the ear-nose-and-throat specialist who hung around my parents’ convenience store whenever my mother was working behind the counter. It’d been his microscope in medical school, and he’d gleaned that the freckled girl playing in the grocery aisles wantedtobeadoctorsomeday in the way children sometimes embrace a profession that had given them a traumatic past—social worker, police officer, teacher, surgeon.
A few years later, from a passing comment, my mother suspected he’d been in the operating room with the surgeon, his golf buddy, and that they both removed her varicose veins in a botched procedure in which she would lose too much blood and return home with legs covered in staples. Goldfish under dissection on a rainy after school afternoon. Eyes raised from the microscope to the way the light looked in the April grass on the leach field. Library anthology of poetry. The sudden feeling of wanting to write a poem—the exact break-away moment when I escaped becoming one of them and used what I had experienced in hospitals and in their offices in my own way, for poetry.
Well-nourished, healthy Caucasian female, age six
In medical records, you are undressed in the third person and put in the johnny of jargon and pseudo-objectivity. When I have requested my records, I have been surprised by the subjective house calls about my intelligence or socio-economic standing, that I am polite, articulate, a patient with a pleasant demeanor. I half-expect to see a note about the model of car I drive. With slides from surgery, the body is no longer the foundation. It’s a launch pad for elsewhere.
Writing in Bed
I tug the I.V. stand with the plastic bag for my urine around the playroom. I like the social scene of the children’s recovery floor in the hospital in the state’s capitol, Augusta—the ill-sorted and banged-up donated toys, the cartoons, the other sick or healing kids with tubes, urine bags, catheters, casts, stitches, or bald heads. I befriend a fellow townie who stuck his arm in a spinning clothes dryer. I like the Flav-O-Aid popsicles. I don’t like it when the medical staff circles my bed and discusses my case, and I hope one of my parents is able to get out of work and visit. At home, my younger brother and sister are growing into their pants lengths, readying for school, adding bone and muscle mass, eating after-school snacks, slipping ahead of me in the birth order while the birth defects and medicines are keeping me physically immature and slighter, and there’s talk of holding me back a year in school. I would grow up amid innuendo that I wouldn’t lead a normal life. Much was left unspoken despite how it directly concerned me.
As children mythologize and imaginatively reconstruct, I picked up crisscrossed meanings, implications, and foreshadowing and rebuilt. At night, I am tucked into bed by on-call nurses and left to process the day’s prodding and consultations. It was the start of many important moments pertaining to writing—of working through problems imaginatively and decoding vestigial images—while sitting in bed. These times setup my tolerance for working alone hours on end, removed from family and peers. I don’t go to the prom because I look like a ten year old. In high school, I wrote my first short stories and poems in my canopy bed. A persistent writing block breaks after my water breaks six and a half months into a pregnancy, this time in a hospital bed in a high-risk pregnancy ward, in what was supposed to be a two and a half month bed rest at Brigham and Women’s Hospital, Boston. When my writing block that had lasted since the graduate program at Iowa finally ends, I am wearing a johnny and looking at the view from my hospital window, a narrow opening of June sky above a still life of abandoned duct repair work, Dunkin Donuts coffee containers, leather tool belt, and wrench, left by workmen who never returned to the job.
A larger field of knowing
The loop of helplessness and frustration of yet another medical complication and needing to turn to the very class of experts who caused the problem in the first place sent me from one error to the next, misdiagnoses, wrong prescription, side effects, wrong medical records, false certainty, assumptions, callousness, baseless statements (you’ve lost the baby) (the technician taking twenty minutes to remember to confirm, the fetus is still there, heart beating), omission of crucial information, misuse of medical equipment, blasting 80’s heavy metal in the ambulance at midnight, stunning insensitivity, that baseless certainty.
What is normally thought of as a solid given was for me formed with a yellow dotted line, like a passing lane, and pass I did, in and out. It was like sending out a sonar ping, mistrusting doctors’ opinions and instead relying on internalized knowledge. Prewriting takes a similar trolling for answers, an inductive casting ahead for language to start or continue a poem. In 1952, Brewster Ghiselin described this back and forth in writers as a movement between “automatic and conscious production”—a ricocheting off of more controlled and conservative thought—the already known—into a “new order developing…in obscurity.” Jung suggested that for artists who approach the unconscious, “[t]he experience that furnishes the material for artistic expression is no longer familiar. It is a strange something that derives its existence from the hinterland of man’s mind.” I started writing poetry and used the same technique of scanning my surroundings, propelled by the levitation of the lyric or the side shadowing of the metaphoric. In return, years of writing practice have honed that intuition so that odd events are the side effects of poetry.
Ping
It’s 2002. On a dirt path in a city park, I see a series of images of a rider on a yellow mountain bike hurtling at me. I step off the path, and three seconds later a guy on a bike vaults over a gnarled root and crashes into the exact spot where I’d been standing. It’s 1996. I’m reading on my stomach on the school grounds of an international summer boarding school where I’m teaching, my back to a baseball game. The muted sounds of the game have a marsh to cross before they reach me, but I still feel I should change locations. It’s a sizeable distance, I rationalized, so I don’t move, but I can’t concentrate on the book because the impulse is intensifying. I cower, bracing for impact. As often when the premonitions happen, they’re a series of shuttered images, slow motion, and usually in yellow. A few seconds before the baseball slams into the back of my skull, I see an orb moving through the air, not round but an elongated yellowish in jerky still shots.
It’s 1999, and I’m fresh out of creative writing graduate school and on the job market for a position teaching writing, with nearly a hundred applications out in the mail. In the afternoon, while browsing in a kitchenware shop with my boyfriend, my hand passes in front of a placemat with the map of the continental United States, and my fingertips rest on a lime yellow Louisiana. I’ll be moving to Louisiana, I think. Later over dinner, a roommate remembers to tell me that someone from Louisiana State University had phoned. It’s 2003. A friend is telling me in the vaguest terms about problems with a guy she’s dating in Maine, not mentioning his last name, only saying that his ex-wife seems too present in the man’s life. I feel funny. I look straight at her, a yellow déjà vu filling my torso, and interrupt to ask if the boyfriend’s name isn’t J.S., a high school acquaintance with whom I hadn’t spoken in years. She is shocked because I am right. It’s 2004. In a car accident on an exit ramp, in a line of rear-ended vehicles, I’m catching my breath behind the steering wheel. I’m less than two months pregnant and headed to an appointment with a urologist to discuss possible pregnancy complications from my birth defects. (He’ll say no problems will arise, and five months later, problems most definitely arise.) The passenger door opens, and the software engineer I dated prior to meeting my husband slips into my passenger side seat, saying a voice had told him to leave work and drive on the highway to look for me. His polo shirt is yellow. His pants are yellow.
Ping
None of these incidents appreciates being put into language—it’s the first they’ve been typed—and they’re protesting. All the same, I enjoy the equivalency of dressing the uncanny in the same Times New Roman as other content. I am reminding myself to notice these events in real time before logic sets in. This receptivity to the irrational takes leaving behind preconceived ideas, a willingness to engage with the unknown, a risk. Likewise, the vital parts of a poem or essay can become misshapen by ambitious thoughts or premature exposure to outcome and audience. This type of knowing is what it means to be involved with poetry—using a phrase as a lure to see what I can pull from the preverbal, the unknown, the all-white of possibility—and receiving some type of response.
I’ve dropped my car off for an oil change at the local father & son mechanics. It’s an early November day, and I’m walking the mile back to my laptop on the kitchen counter. The road is industrial and ugly, a short stint between a bank of fast food restaurants, faltering shopping mall, and second-hand car and furniture dealers before the turn into our cul de sac. It’s not a safe place for a pedestrian, the constant whizzing traffic ten mph over the limit, no sidewalk, just this curb of petrified grass pelleted with bottle caps, butts, and broken asphalt, a strip mall with “Commercial Space For Rent” signs and a Rent-a-Rec—then a culvert with iced-over water, scrub trees. I pull my collar up to ward off the chill while trying to fend off a funk, residue from some minor slight, and I don’t care for the undertones of self-pity. I look toward the pre-snow sky and in a private conversation say, “The universe doesn’t owe you anything,” when something immediately catches my eye. It’s a twenty dollar bill, waving from the frost-stiffened grass curbside.
The bill is a parody of a twenty dollar bill, clean and crisp, unwrinkled. It feels brightened, as though a different light was cast on it than the November surroundings, as though the twenty dollar bill were in a collage and excised from another time and place. The next two yards of the curb are covered with fluttering money—tens, another twenty, fives, and a few one dollar bills. I look for a lost wallet or purse—or worse—a person lying in the culvert. Nothing. ($110 when I’m in my kitchen, counting like a startled bank teller.) For a moment, I just stare but then begin to stuff the money into a coat pocket, aware of what the sight of a well-dressed pedestrian in a butternut yellow wool coat picking money, lots of money, off the ground must look like to passing drivers. I text my husband, You’ll never believe what just happened. I joke how the cost of the oil change was more than covered by my extrasensory walk home, and my husband (who tends to be skeptical of odd experiences) asks if I’m crazy, this time taking the event seriously. He reminds me of the internal statement I’d made right before the money showed up and says it’s clear I can’t keep the money. I’m not supposed to keep the money. I release it. I give it away. Ping.
Material in this essay was obtained from Susan Bell’s DES Daughters, Embodied Knowledge, and the Transformation of Women’s Health Politics in the Late Twentieth Century as well as from the New England Journal of Medicine, Wikipedia, the Centers for Disease Control and Prevention, and Brewster Ghiselin’s The Creative Process.
Alexandria Peary is the author of six books, including Prolific Moment: Theory
and Practice of Mindfulness for Writing (Routledge 2018). Her new collection of
poems, The Water Draft, will be published by Spuyten Duyvil in 2019. She has recently published creative nonfiction in the Cimarron Review and Meridian, with a sequel to her lawn care essay coming out soon in The Gettysburg Review.
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