On the first trimester (or baby chronicles: Part One)

March 21, 2018
4weeks 5days gestation

We found out on Wednesday, the second week of the Surgical Clerkship. Mackenzi took a urine pregnancy test the day before, but the results were inconclusive. I felt like I knew the weekend prior that she was with child. I didn’t tell her, though.

That morning, she debated whether or not to call out of the labor and delivery floor. A noreaster rolled through overnight and laid down a carpet of snow. The forecast told us the storm would get worse as the day progressed, peaking in the afternoon. I told her that if anyone would understand a day off for a positive pregnancy test, it would be OB/GYNs. Turned out to not need that, as the clerkship directors decided to call a snow day, except the surgical clerkship director, of course (my resident told me not to come in, so it all worked out in the end for everyone).

The first person that we decided to tell was Andre. We knew we couldn’t keep it from him, as it would slip out in everyday conversation or he might read the signs of great change regarding diet and lifestyle decisions. Why else couldn’t she eat sushi or drink some beer?

We woke Andre up from a nap.

I told him quickly, like pulling off a band-aid: “Hey Andre… Mackenzi is pregnant.”

Mackenzi began to tear up.

He opened one eye. Then both. “… Seriously?”

We hugged and cheered and had far too much energy for the warm house surrounded by snow. To bleed off our excitement, we spent the next hour or so romping around in the growing snow. A great way to ring in the new life.


March 23, 2018
5w0d gestation

Writing this on Friday after surgery lecture. Third weekend with Honey. Just told Joel, the first non-family and non-roomie to know. Mackenzi wants to tell some of her friends.

I realized that the criteria for telling someone about a pregnancy before the second trimester is that you must be comfortable telling them not only that you are pregnant, but that you have lost the pregnancy. That is why you wait until the second trimester to announce the news: if you are going to lose the child, it is most likely going to occur during the first trimester, secondary to chromosomal abnormalities or other early congenital defects that are not compatible with life.

So in this small Venn diagram section of the overlap, you have this transitional zone to safety of pregnancy in front of you and awareness of the pregnancy behind you. I know who I will tell now, before that magical 12wk gestational threshold.

Time for some phone calls and moments of surprise this weekend.


March 28, 2018
5w5d gestation

Told many of my friends from college. Making the rounds. A planned phone call out of the blue, can only mean one of two things: either something really good or really bad. This call fell into the former category.

By selecting those that we tell, we are creating a small club. Folks that we hold close and near and dear. These people know the change that we are currently starting. They have a secret together.

Part of me wishes that we didn’t need to hold the news back from the world. We need to know that the baby is going to be healthy. That the pregnancy will proceed. If we announce too early, do we jinx this gestation? Patience is the key, for now.

I still have a few people that I will tell. I look forward to these conversations, they are filled with joy and surprise and provide an excellent reason to catch up with a friend and to talk about some real stuff, like becoming comfortable with fatherhood.


March 30, 2018
6w0d gestation

Last night, we had friends over for a lovely resumption of Wim Hof and Chill. We invited folks over that we felt comfortable with, enough that they know about the pregnancy and this coming together served as a small celebration for the life brewing inside Mackenzi.

As we ate, I noticed that Mackenzi formed the center of attention. It felt natural. I could tell that she felt a bit odd being in the middle of everything, but perhaps that’s just a small growing pain, getting used to the changes that are coming up.


April 2, 2018
6w3d gestation

Felt feverish and nauseous after I came home from my first surg onc day. Walked Honey but felt so gross I just let her out and then went back inside to crash on my bed. I would later spend 20hrs in total laying down. During this time, nausea wracked my body and I couldn’t decide if I was going to vomit or just had really bad gas.

This episode served as a reminder at how much nausea really sucks and how much more empathy I needed for Mackenzi as she began to experience morning sickness all the time. When she came home, I asked for her forgiveness and advice for what she does when the wave of nausea hits.

She recommended seltzer water, some crackers as you can tolerate, and peppermint essential oil to stave off any reactions to specific odors.

Worked like a charm.


April 12, 2018
8w0d gestation

Mackenzi had her first nurse’s visit yesterday. We decided to go in-network. At least this way, we know the attendings and the residents and can at least make requests based off of who is working or on-call that night, whenever baby delivers. Devil you know, that sort of thing.

According to the nurse and her last menstrual period, she is actually more like 9wks along with an estimated delivery date of mid-November. Moved the time-table up, but not dramatically. With prime residency interview season starting in October, maybe I’ll take more early interviews and reserve some for later in February. Same for Mackenzi, she’ll probably interview later after a few months with the nugget.

I wish that I had gone to the visit. I got out of the OR early after a robotic surgery went sideways and the attending had to open the patient up. I was in a weird mind-space and just wanted to go home and lay down with Honey. I totally forgot that Mackenzi had the afternoon off to attend this nurse visit.

She called me after the visit to tell me about the new EDD, and she began to cry. Maybe the news overwhelmed her with feelings and the visit really cemented this new reality for us. We are having a child and they are barreling toward us and out of her. Maybe she just wanted me there, and I desperately wished that I could’ve held her. If this is a fraction of what it feels like to miss the delivery of your child, then I know that my interview schedule will be built around the pregnancy.

And I am totally okay with that.

My priorities have been shifting around. Thinking about the fact that we won’t be doing much international travel in the near future. We likely won’t be living alone for the next twenty or so years. Between Andre as a roommate now, our parents helping out with childcare, and then the child as a roomie, we have passed the threshold of just a couple, just Mackenzi and I.

In some ways, I mourn the passing of this memory. I loved the lazy mornings with Mackenzi, when clothes were optional and we slept on the floor of that small Tampa apartment. It felt so cramped with the float tent in the other room and all of my random things scattered about. It also felt full of love.

We won’t go back to those days. We will, however, go forward into something new. Something where we bring people together into a home and grow a family.

The mantle of fatherhood is beginning to settle. I notice myself more willing to take on chores and to clean, to take care of our space. I am quietly becoming my father.

Mackenzi told me a story from a few days ago. Honey had gone out to poop and has been really enjoying the spring greens that are popping up around our backyard. When she pooped, she had a good long tail of fibrous greens hanging from her butt. Mackenzi had to grab some toilet paper and wipe Honey’s doggy butt so that she didn’t butt-scoot on the carpet.

Total mom move.

I remember my dad cleaning a clogged toilet for me. I was far too old to allow him to do so, maybe during college or shortly thereafter. I had laid down a huge turd and the toilet wouldn’t flush. I told my dad, who happily grabbed the plunger and went to work.

It was stubborn, taking him maybe twenty minutes to get good water flowing again. I think he even needed to root around to dislodge it. I told him afterwards that I was sorry, that he shouldn’t need to do that for me. He smiled and said I’m still growing and that it was fine.

Total dad move.


April 16, 2018
8w4d gestation

Ultrasound day. What a high. The photos of the little one are on the fridge, as a daily reminder of what I cannot see but want to keep close to my heart.

The visit itself felt surreal. The ultrasound appointment scheduled next to my outpatient pediatric office, so I could’ve stopped by and said hello to my preceptor. Also, I think that I had my ultrasound day for Obstetrics in the Maternal-Fetal Medicine office upstairs.

Felt so odd to be waiting to get called back. To get brought to the ultrasound room. To be next to the probe rather than watching from the side, as a student. The ultrasound tech was skilled, as they usually are. She found the baby in a moment and gave us excellent views of the intrauterine gestational sac.

Mackenzi held my hand. She squeezed tightly when we saw the life for the first time. I distinctly remember the music playing in the background, a pop song that has been all over the radio recently. As we heard the heartbeat, the chorus played:

If it’s meant to be, it’ll be, it’ll be
Baby, just let it be
So, won’t you ride with me, ride with me?
See where this thing goes
If it’s meant to be, it’ll be, it’ll be
Baby, if it’s meant to be

I felt tears well as the tension faded. The pregnancy is viable.

I had asked Mackenzi earlier if she was nervous about this visit. She laughed and said yes. She held off on future planning until she knew that the baby would be safe, not planted in the fallopian tubes or elsewhere that would force a termination for mom’s safety.

With this set of images, I knew that we would begin to plan. That she would begin to create an emotional nest for our child.

And the dating of the pregnancy lined up with Mackenzi’s intuition, not the nursing visit/last menstrual period dating. We will have a Thanksgiving baby.

For the rest of the morning, we were like two newlyweds, gently touching one another and giggling together. For this morning, everything felt right.


April 17, 2018
8w5d gestation

The day following the US was a bit rough. Mackenzi felt pretty awful and she told me that she ended up vomiting in the bathroom of the hospital. A stark reminder that life as a parent is a one day at a time affair. Yesterday’s emotional high does not affect the events of today.

I’m again struck with the realization that I do not get to participate in the gestation of this child. I am allowed to observe. I can assist in small ways. I can bring her water when she needs it and I can help prepare meals.

But, the hormonal and physiological changes that are occurring in her body are for her to know and for me to guess. And this is just the first trimester. I can’t imagine how impotent I’ll feel during labor and delivery.


April 21, 2018
9w2d gestation

Yesterday, we had a lovely float session together after family med lectures. Friday night date night. After we floated, we then proceeded to eat all sorts of amazing Italian food in Bethlehem. It was a great night together, especially passing out in a carb-induced food coma afterwards.

Mackenzi mentioned to me that I’m falling in love with her again. I agree. In the months leading up to the positive pregnancy test, I can’t point to a single change or moment of clarity, but I did begin to exhibit behaviors more consistent with a long-term relationship. Changed my phone’s lock screen to her image. Facebook profile pic is now a sweet couple’s photo. Little things, signalling something.

I feel it stronger now. Watching her change. Watching the love that washes over her when someone gushes about the incoming baby. Watching her handle the shooting back pain and simultaneous nausea with grace and calm. I married the girl. I am falling in love with the woman.

Parents are coming next weekend. We’re gonna do some heavy planning for the Thanksgiving baby. I look forward to some good conversations with my parents as they approach grandparenthood.


April 23, 2018
9w4d gestation

We know some of the challenges ahead. Mackenzi has been battling chronic back pain with radiation down her leg for the past few months. An MRI revealed a disc herniation.

The challenge? This baby was exposed to those high magnetic fields probably around 2-3wks old. We weren’t sure if she was pregnant, she had missed her menstrual cycle but had tested negative on the urine dipstick. There aren’t too many studies on the risks of MRI exposure in utero, especially during the first trimester.

And then there is the issue of the chronic pain. I know that the pain will get worse as her body changes throughout the second and third trimesters. The pain will bathe the little baby in the signals that tell them life is hard and prepare for battle.

These are the known challenges. We had decided to opt out of genetic screening for the baby. We could complete the sequential screen, with an ultrasound at 14wks and some bloodwork to check for early abnormalities and inappropriate levels of proteins. But what would we do with this information? Would we terminate? Would we change our plans?

We know what challenges this budding life will face. Chronic pain in the mother. Early exposure to high levels of magnetic fields. We accept these risks. We will battle against these insults with love and joy.

Love for the life that will change ours. Joy for the right to bring a new voice into the world. So many people are already praying for this baby and we haven’t even made the formal announcement of pregnancy.

This baby is protected.

This baby is safe.


May 3, 2018
11w0d gestation

Had a moment of mild panic in the pediatric outpatient clinic earlier in the week. Realizing that I would soon be one of these parents, bringing their ailing child/favorite thing in the world and presenting it to the physician. Asking the doctor to make them better.

And that I would likely have multiple visits, interrupting my life and forcing me to stay up late, tending to the child. Checking their rectal temperatures and forcing myself to stay calm until an antibiotic takes effect, reducing the swelling of their developing inner ear.

I’m also struck by how different my experience of parenthood is versus Mackenzi’s. In so many ways, she is already a mother. She has to deal with the picky eating habits of the little one. She has to change her day according to the whims of the child. She gets to feel the little one within her at all times.

For me, I don’t think I will really feel like a father until I hold the child. Maybe when I feel the little one kick as we enter the latter stages of gestation. But even then, I will have to bother Mackenzi in order to interact with the child.

I do not get alone time with the child, not like Mackenzi does. I have to ask her to sit still, to let me meditate on the life within her, in order to meaningfully and physically interact with this life. I don’t get that one-on-one time until the baby is safely separated from her.

My experience with parenthood is binary. On-off. Mackenzi’s experience is on a spectrum, from sort of mom to more mom to breastfeeding and sleepless mom. I envy that.

For now, I make up for this lack of direct parenting by caring for our furry bundle of love, Honey. I have grown so close with her over the past few weeks with my easier Surgery schedule. She knows my cues and requests so that when we go outside I need not worry about bringing a leash.

When Mackenzi leaves before dawn for inpatient pediatrics, Honey will come upstairs and snuggle with me until the sun rises and wakes us both up. I hope for many more days like this with Honey.

And I hope for many days like this with my child.


Long Form Sundays

On Death Podcast

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