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The consultation room is what happens when an architect is told make grief and hope sit in the same chair. Soft everything. A desk bare except for a rose-gold tinged model of the female reproductive system, and a box of tissues placed discretely.
There are two chairs directly across the desk – the decision chairs – and by the time the door finishes closing, Catherine has one, Mamá has the other, Elena has the wingback by right of being the facility, and Preston and I are on the small couch against the side wall. In the corner of our own fertility consultation.
Preston leans over. “We’re in the cheap seats.”
“There are no cheap seats. You saw the waterfall.”
“Gentlemen.” Rosenthal has seated himself and produced, from nowhere I can identify, a manilla coloured folder with our names on it. “Two fathers. One gestational carrier – familial, which I love; the courts love it, the holidays get complicated but that’s above my pay grade. Donor egg from our registry. Which brings us to the first real decision, and I want to hear it from the men on the couch.” He looks directly at us. “Whose biology?”
The room goes quiet. The mothers, to their credit, physically turn around.
We’ve talked about it, at 01:00, in the shorthand we do our real talking in. What we arrived at wasn’t an answer. It was a refusal of the question – because the moment one of us is the biological father, the world gets a tool it can use on the other one, and the world has never once been handed a tool it didn’t use.
“We don’t want to choose,” Preston says. “Is that – can that be a thing? Not choosing?”
Rosenthal smiles like we’ve just told him his favourite joke.
“It’s my favourite thing. In this office we call it the slurry method – both samples, prepared together, one insemination. The biology declares itself in nine months, and you can run the test or never run it. I’ve had families frame the results. I’ve had families burn them. The paternity becomes a surprise. Or a secret. Or, if you’re particularly wise, an irrelevance.”
“A surprise,” Preston repeats, and I can hear him falling in love with the idea in real time, because Preston has never met a dramatic reveal he didn’t want to co-parent with.
“Walk me through the numbers,” I say, because somebody in this family should hear them. “Eggs retrieved. Eggs fertilised. Embryos transferred.”
“A man who reads the consent form before signing it. I could weep.” Rosenthal leans back, laces his fingers over the burgundy. “The donor gives us one cycle – ten, twelve eggs if she’s generous. We fertilise all of them, Dr. Silva, every last one, because biology is a game of attrition and I have not lost it since the first Bush administration. Some won’t take. Some stall out by day three. By day five, we have what we have, and we grade the survivors like diamonds.” He holds up one finger, ringed, definitive. “And then: one. One transfer. The best of the class goes home with your sister, and the rest wait in the freezer, patient as money, in case you decide down the road that your kiddo needs a little brother or sister.”
“So ten fertilised. One successful implantation.”
“Yes, one transfer,” he agrees, warm as a handshake. “One pregnancy.”
And look. I understand the appeal. I feel it land behind my sternum, where I keep the small number of things I’d run into traffic for. But the doctor part of my brain doesn’t have an off switch, only a volume knob, and it has been reading the literature.
“What about multiples,” I say. “Stimulated cycles, combined samples, a freezer full of viable embryos – the multiple-pregnancy rates in assisted reproduction aren’t small, Dr. Rosenthal. Twins alone run north of–”
“Dr. Silva.” He holds up one hand, gently, rings catching the light. “You’re a trauma surgeon. If I walked into your department and quoted you the airbag literature, what would you do?”
“I’d listen. Data’s data.”
“You’d listen,” he agrees, “and then you’d do the thing you’ve done ten thousand times, because the literature is about populations and your hands are about the person on the table. So. One transfer.” He spreads his hands, benevolent, gold flashing. “Trust the process, Dr. Silva. I have done this more times than you have intubated.”
“You don’t know how many times I’ve intubated.”
“I know it’s fewer than this.” He closes our folder with a soft, final little slap. “Everything else is paperwork, and paperwork is what the lawyers are for. Now.” He crosses to a cabinet and returns with a binder the size of a paving stone, setting it in front of Elena with both hands, ceremonially, the way you’d set down a Torah or a cake. “The registry. Let’s go shopping for half your genome.”
Nobody warns you about the catalogue.
They warn you about the costs, the injections, the legal thicket. Nobody warns you that on a Tuesday morning you’ll be choosing the genetic mother of your children from a binder with laminated pages, and that it will feel like nothing you have a file for.
Each page is a person. Childhood photos only, ages four to eight, gap-toothed and squinting into old sunlight, next to columns of data. Height, education, medical history two generations deep. A handwritten answer to the question why are you doing this?
Catherine reviews the early pages like she’s seating a dinner party. “This one attended Vassar.”
“This one has her grandmother’s cholesterol,” Mamá counters, tapping a lipid panel. “Vassar won’t help her at fifty.”
“Donor 4471 plays the cello.”
“The baby doesn’t come with the cello, Catherine.”
Elena has the binder rotated toward herself, reviewing it the way she reviews everything – bluntly, fast, and out loud. “4482 is a hard no, the family history reads like a pre-existing-conditions clause. 4487 –” she pauses. “4487 wrote three paragraphs for ‘why are you doing this’ and the third one’s about her little brother. Flag her. We’re coming back.”
