Psychiatric Evaluation

Part of the process of being a surrogate for someone is the “psychiatric evaluation.” Max, Bob and I took one whole day at Seattle Reproductive Medicine last February to qualify me as a reasonable and viable gestational carrier.

We met with doctors and therapists and gestational coordinators. Blood was drawn, tests were run, conversations were had, my uterus was evaluated, my armpits were poked and my breasts were prodded to check my lymph system.

A trial embryo transfer was performed, whereby a long, thin camera was pushed up through my cervix, revealing my uterus, while a hose, of sorts, was flushing water throughout the cavity. Filmy wisps of tissue floated past the camera lens that was revealing a view of my insides that I’d never seen before. I remember thinking to myself, “That doesn’t seem like a very nice place to grow up.”

As luke-warm water oozed down my inner thighs and was soaked into the pad underneath me, I looked behind me at Max, who was perspiring profusely, arms crossed, hands tucked tightly under each other. Funny. I was sweating too and we compared our circular pit stains, mine on my green hospital gown and his on his neatly pressed black shirt, when the doctors left the room.

What was I doing? Here I was in a room, with my feet in the stirrups and my childhood friend behind me, all my lady parts exposed for all the world to see; parts that he hadn’t seen in ten years since he was no longer interested in female anatomy after “coming out” years ago. I love him dearly, and in fact, many of my grade school journal pages are filled with stories of Max; how I thought he was the cutest, sweetest boy in all of elementary school and how I hoped he’d ask me to the carnival. Twenty-five years later, here we were, strapping in for the ride of our lives. The absurdity was too much.

We responded like we usually do, by giggling and cackling like two 12 year old girls. I remembered a conversation we’d had prior to the appointment that day where he said, “We’ll be with you for everything, all day, except, of course, all the naked, awkward vagina stuff.”

“Awkward vagina? Look,” I said, “If I’m going to have your baby for you, you better get acquainted with my vagina. You’re going to be seeing a lot of it.”

After the doctors had cleared my uterus for transfer, I got dressed and prepared for my next appointment with the psychiatrist. It was time for the psyche eval, and by this time, I was beginning to think I was maybe a little crazy for doing this.

I can pass physical exams, no problem. But psyche exams? What if she decided I was crazy? Not mentally stable enough? I could much more easily handle a negative medical diagnosis over a negative psyche eval. I began to prepare, in my head, and put on my, “I’m not crazy” persona, which revealed instantly to me that maybe I did have a little kiss of crazy in me. The self imposed pressure to answer the questions correctly was mounting.

The questions began. “So Carrie,” the psychiatrist opened, “Why do you want to do this?” Nothing like getting right to the point.

“Well, because I love Max and Bob. I think they’d be great parents and I want to help them,” I said. “And, because I ran my mouth off one night after too many glasses of red wine and said I would,” I chuckled.

Long pause. She tilted her head to the side. Didn’t think it was funny, I guess. “I’m kidding,” I stated as a twinge of nervousness crept into my voice. I was nervous, because that was a lie; the part where I said I was kidding. I have always relied on my red wine was the elixir that frees my tongue to say the most outlandish things.

It just so happens that one night, with cabernet gray stained teeth, as I toasted Max and Bob and their then pregnant 25 year old surrogate I cheered, “That’s so great you guys! But you shoulda asked me!”

It sounded good and I appeared, in my eyes, to be so giving and selfless. I said a little silent toast to myself for saying I’d do it, patting myself on the back for voicing my willingness to help, but knowing (sigh of relief) their surrogate was pregnant and I’d never be in that position. Until, of course, she miscarried a few weeks later. Damn you, red wine.

“You must really care about these guys,” she continued. “But, you realize that you are going to get really fat, right? You’re going to be required to take a lot of medication. These hormones can really cause you to pack on a lot of weight. It is going to be brutal. Has anyone told you about this process?”

“Yes,” I replied. “My best friend went through it five years ago. In fact, you know what’s crazy? I offered way back in college, before I even knew how amazing it was to have a kid, to carry a child for her if she couldn’t do it. She’s had a bad go with her reproductive parts,” I said. “Her mom took DES while she was in-utero and it messed up her reproductive organs pretty bad. Maybe I’ve always known that I’d be in this place some day, though I thought it would be for her. I’ve seen her go through the pain of this process. I think I’ll be O.K.” I said

“You are in a relationship?” she noted from my paperwork. “What does he think about this?”

I had to pause. So many things coming at me. Fat – check. Medicine – check. Brutal? O.K.. My relationship? My relationship?

“Does your boyfriend have kids?” she asked.

“No,” I replied.

“Would he like kids of his own?” she inquired

“He would have, yes. I don’t want anymore children, though. We’ve talked about it. He supports my decision.”

“Are you sure about that?”

My hesitation must have been my giveaway. I looked to the floor in search of the right answers. Under my shoes? I rolled my ankle to the side while thinking. No answers under there.

“Yes,” I trailed off. “I’m sure.” And then I drifted away in my head. I heard her continuing questions and I answered appropriately, but I didn’t really feel present in my body. Am I sure? Am I sure of anything? Can anyone be sure of anything? Will he support this? All the way? It’s one thing to talk about it, but another thing to live it.

Tim and I had just found each other again, after being separated for a year. It felt better than ever to be back with him, approaching each other from a place of awareness that we hadn’t experienced before. We had been a couple for years, but often acted in our own self-interest versus acting on what is best for both of us. How could I possibly think that carrying another man’s baby was acting in our best interest? Since I was back in a relationship now, was I entitled to make my “own” decisions still? Was my body still my own, though I shared so much of me, of it, with him?

The night I decided to carry this baby for Max and Bob, I went to meet with them alone, leaving Tim at home. I sat next to Bob and Max sat across from me, red wine all around. Was this a trap? No. I actually went to meet Max and Bob, knowing already that I had to do it for them. I wanted to do this for them. I had been working toward this moment for much of my adult life.

We arrived at the restaurant, knowing what we were there to discuss, but not knowing how to start the conversation. There was the customary catch-up on everything small talk that took us to the next round of red. I finally said, “Let’s get to this, fellas.” Max began to talk about their intense desire to share a family, but he didn’t get very far before the tears started streaming down his face.

The disappointment of losing their baby with their original surrogate was devastating and there was no pressure for me to make the decision, but they were just glad I was willing to discuss it. Bob broke next, and his pain was palpable just sitting next to him. And finally I broke. “Shut up. Stop, OK? No more. I’m going to do it.” I reached my hand across the table, held Max’s hand, and turned to Bob. “I’ll carry your baby.” We were all crying and the scene must have been quite shocking to our server who returned to check on us at that moment.

“You guys want another round?” she said skittishly. We all looked at each other and burst out laughing. “Yes,” we all said at once.

It was New Year’s Day, and we had just resolved to bring a baby in to this world together in 2009. We needed champagne. A quick stop to the 7-11 for a bottle of Brut, and we were off to tell Max’s mom and aunt. When we arrived, Jan and Kathy didn’t ask a word about our evening, though they knew the nature of our meeting was to discuss my willingness to help their family grow.

Max smuggled the bottle into the apartment and I continued the small talk routine until I could see that he was ready to pop the cork. Jan was standing in front of me and I turned to her and said, “Jan, what do you want to be called?”

“What?” she asked confused.

“What do you want your grand-baby to call you?” I asked.

“Are you going to do it?” she cried. “Are you going to do it?” She was starting to laugh and cry at the same time. I smiled at her and nodded yes. I heard the pop of the champagne behind me. She threw her arms around me and deal was been sealed. We had a toast, my head spinning from the emotion and the promises made during that evening. I had to get home to Tim.

When I returned, he was waiting for me at the foot of the stairs. “How did it go?” he asked. I got scared, suddenly.

“I’m going to do it,” I said. “I want to do it.” And I lowered my gaze to the floor. Ironically, I felt so selfish at that moment, making a decision like this. I had thought of him and every possible scenario of how this could make or break us, but after having gone through the past year on my own, I knew I had to stand up for what I wanted and believed in. Always. I wanted to be a part of this. I believe I was meant to be a part of this. And I so wanted him with me for this, though I half expected him to be disappointed.

But he wasn’t. He wrapped both arms around my shoulders and pulled me into his chest. “I’m proud of you,” he said. “I’ll support you through anything. I’m always going to be here.” The relief I felt at that moment was profound. I clearly underestimated his capacity to see the bigger picture; to see beyond the inconvenience it might have on us and see how much we were giving to our friends. I really love that man.

Am I sure he’s O.K. with this? And that brought me back to the present moment, in the office with the psychiatrist.

“It’s a huge sacrifice you’re making,” she carried on. “Not many people would do this. You’re doing a great thing,” she said.

I took a deep breath and saw the hope and fear in Max and Bob’s eyes as we made this pact. I saw Jan’s tears of joy at the possibility of one day holding her grandchild.
But mostly, I saw Tim’s face, smiling at me, genuinely supporting me and willingly making his own sacrifices for my friends to become fathers.

“We all are.” I smiled. “We are all doing a great thing.”

With that, she must have determined I was of sound mind to continue the process, because she stood, extended her hand to mine and firmly shook my hand. “Good luck to you,” she said.

I nodded my head and hesitantly smiled to myself.

“Good luck to all of us,” I thought.