outlooks, I naturally become convinced that we cannot escape one of the thousands of cunning inherited diseases, each a deadly reef around which our genes must navigate.
Over tea later I am skimming idly through the New York Observer when I spot a full-page ad for Sloan-Kettering Hospital. It features a collage of sepia snapshots from a family album. A beaming baby romps in the foreground. Underneath the copy reads: âYouâve got your fatherâs eyes and your motherâs sense of humour. But how do you know you wonât get your grandfatherâs cancer?â
Wednesday, 22 July
Joanna
The actual amnio is booked at Beth Israel tomorrow, on condition we attend a âgenetic workshopâ at the hospital today.
Our counsellor introduces herself as Elena. âNow the first thing to remember is that amnio is optional,â she smiles, sizing us up. There are four of us altogether, me and Peter â the sole man; a homely looking black woman in an African print dress called Rita, and a large, dark-haired woman with fuchsia lips so startling in her whey-faced complexion that I canât stop sneaking glances at them.
âYouâre probably wondering what actually happens,â says Elena. âWe find the pocket of fluid known as the amniotic sac and extract some fluid with a needle. Ultrasound is used as a guide, so we donât hit the baby, and I should tell you to bring a bottle of water with you because a full bladder tilts the uterus and makes the ultrasound easier.â
âLast time I had an ultrasoundâ, interrupts whey-face, âthey told me to drink eight cups of water in fifteen minutes. I told them they were going to have an accident on their hands!â
âEight cups?â exclaims Elena. âI think they meant eight ounces.â
âWell, they said eight cups,â whey-face insists defensively.
âWell, for amnioâ, Elena giggles, âone glass is just fine.â
âDoes it hurt?â demands Rita.
âNo, an anaesthetic is not necessary, the abdomen doesnât have many pain receptors, it is mostly fatty tissue.â
We all nod in unison.
âExcuse me, but did you just say the baby is bathing in its urine?â interrupts Peter.
âYes,â says Elena patiently. âAnd drinking it.â
âOh, gross,â says whey-face, discreetly unwrapping a boiled sweet, smuggling it to her lips and disguising the whole action with a cough.
âMaybe Sarah Miles is right,â whispers Peter.
Holding up a sheet headed âChromosome Abnormalities in Live Birthsâ, Elena battles on, explaining how the babyâs cells are extracted from the amniotic fluid and cultured to see if all is well.
âNow, letâs look at what might go wrong with the actual process,â she says gingerly, glancing round to check weâre all still listening. I am frantically taking notes, Peter looks mildly embarrassed, Rita appears alarmed and whey-face, arms crossed belligerently, has mentally checked out from the whole process.
âOne in two hundred experiences a complication, though thatâs a national figure, and here the risk is probably lower,â Elena continues. I jot this down, vaguely aware this doesnât tally with my doctorâs figure. âItâs very rare, but the baby might be too active, in which case we would stop. And if the uterus is contracting, they may have to insert the needle twice.â
Thereâs a scraping noise as Rita pushes her chair back and drops her head between her knees, moaning. Elena passes her a bottle of water. âIf the baby moves towards the needle they remove it immediately. Or the needle may get stuck.
âAny time a chromosome is missing thereâs going to be mental retardation,â she adds soberly. âDownâs syndrome occurs when there are three number twenty-one chromosomes. The legal limit for abortion in New York State is twenty-four