Le Mot Juste

Reflections and remonstrations, sort of
OCTOBER 4, 2011 8:38PM

Our Dirty Harry Moment

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There’s a classic line in the first of the Dirty Harry movies where Harry Callaghan holds the gun up to the bad guy’s head and, through gritted teeth, says, “I know what you're thinking. ‘Did he fire six shots or only five?’ Well, to tell you the truth, in all this excitement I kind of lost track myself. But being as this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you've got to ask yourself one question: ‘Do I feel lucky?’ Well, do ya, punk?”

My daughter, at 39, and fourteen weeks into her second pregnancy, is having a rough time of it. With a four-year-old daughter, she and her husband were thrilled to learn that now they are having a boy. That, at least, has gone in their favor. Other things, not so much.

She’s been dealing stoically with persistent nausea, vomiting, general malaise and exhaustion that have been far worse than with her first pregnancy. She’d thought it was just related to her age. Until learning two weeks ago that she has a large cyst on her right ovary. A dermoid cyst, which is not the usual type, though not rare either. It consists, however, of cells of human tissue that actually grow into things like teeth, bones and hair. And it causes all kinds of hormone surges and fluctuations that lend to the nausea and fatigue. In addition, because of its make-up, it has a greater chance of developing a problem called a torsion, where it twists the fallopian tube and can result in the death of the ovary. She’s not so concerned about that, since she’d planned this as her final pregnancy anyway. She feels she can do without the ovary as long as the baby remains OK. 

But because the cyst is growing rapidly, her options are limited as to how long she can go before having it removed. And although some women manage to go to term with dermoid cysts, she’s been advised against it since it’s become rather large rather quickly – the size already of a small cantaloupe. No one can predict how fast or large it will grow and how much room it would leave for the baby to grow in. In addition, if it were to torque or rupture in the later weeks of pregnancy it could induce premature labor. 

No options are good, but the better one is to go ahead and have it removed when she is between 18 and 20 weeks. So, the surgery has been scheduled. She says she’s just ready to “get the thing out of there.” She is sick of feeling tired, and tired of feeling sick.

But now, as though she didn’t have enough to worry about, yesterday she got word from a geneticist who’d looked over the results of her genetic screening blood tests. It seems the baby has a 1 in 3 chance of being a Down’s baby.

Her decision now is whether or not to have an amniocentesis, a procedure that, though common, is not without risks. However, it will give them a definite yes or no answer, with a 99.5% accuracy. The question is, what do they do once they have the answer? Is this something we want to know? Is the shadow hanging over my daughter's pregnancy, this time that is supposed to be so happy and filled with hope and promise, is that shadow going to go away?

That’s why I call this is our Dirty Harry moment. The question that looms, ominous and chilling, is this: I have 3 bullets in this gun, punk. Do you feel lucky? Well, do ya?


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Oh that is not great at all Bonnie, it isn't easy for a pregnant woman to hear that she has a cyst, and that it is causing the problems you state. I would pray that she keeps her child, the doctors are not really sure of anything that medical science hasn't told them. There have been many advancements in children with causes, what child dosen't have a cause? If its not social, it's homophobic, if it's not psychological it's financial, there are many areas of humanity that are not perfect by a long stretch. But in determining that the baby is not in danger or at risk would a good choice. I hope she hears that all is well with the baby, and to put this in the hands of a good doctor and continue to read great books and seek council from people she could trust to guide her.