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A Real Family?

A few years ago, a Chicago-area fertility clinic ran a series of radio ads at the same early hour each morning. For weeks, I woke to a woman’s energetic voice cutting through the fog of my semiconsciousness, announcing her gratitude to the center’s reproductive specialists. “Without them,” she proclaimed brightly, “my baby wouldn’t have my blue eyes and my husband’s wide smile.”

Ten years earlier, I myself had driven twenty miles to the same clinic, several times a week, usually in a predawn stupor and infused with hormonal angst. After having my blood drawn, ovaries ultrasounded and medications adjusted, I’d race back to the busy clinic where I worked as a family physician.

My patients included many pregnant women, new mothers, babies whom I’d delivered and elderly matriarchs, so during visits I was often asked whether I was a mother myself. I learned to be honest (“Not yet!”) without giving too much away. But my professional facade broke down when I looked in the mirror; especially at the end of a long day in clinic, or after delivering a teenager’s baby at 2:00 in the morning, or when receiving the phone call at the end of yet another failed cycle, assuring me that a few small changes in the regimen would improve our chance of success.

After four years of treatment, I’d collected an embarrassing number of speeding tickets–plus twenty pounds, bruises from daily injections, scores of negative pregnancy tests and four miscarriages. I had not, however, achieved the center’s radio-announced prize: the baby who looked like my husband and me and shared our genetic makeup. Nor would my husband (who is also a physician) and I be counted in the “success” column for assisted reproductive technology.

Since ancient times, infertility has been portrayed as a curse, a sin or a failing. Modern science has medicalized it; but our collective psyche has been slow to catch up. For many, infertility remains as much an existential crisis as a physiological one.

The drive to pass on our genes through procreation has powerful roots in biology, family and society. We now know that human beings everywhere share in common all but a tiny fraction of our DNA. But that fraction fascinates us: It has the potential to bind us together or to differentiate us from one another; to unite us or to fracture us. Tens of millions of people worldwide have taken DNA tests hoping to learn more about their family connections, ethnic origins or heritable risk factors. Clearly our genes forcefully influence who we are and how we see ourselves.

As I’ve learned from personal experience, though, genetics is not the only factor in our identity–nor does it write the most consequential chapter of our story.

When it became clear that our path to a family was taking some unexpected turns, my husband and I sat down with the fertility specialist. He offered us a bewildering array of new options that promised an excellent chance of success: various combinations of donated eggs, sperm and reproductive organs.

When you’re privileged to have such options, you reach a crossroads: the choice whether to take the next step on a particular path, or to change direction altogether. No answer is right for everyone; there is no moral certitude or foolproof guide. And there are no guarantees, only a comfort level with the risks of any given choice. After much questioning, learning and introspection, my husband and I decided to forego further infertility treatments in favor of adoption–specifically, international adoption.

In some ways, adoption resembles a human pregnancy: It has a gestation period (almost always much longer than pregnancy’s forty or so weeks) filled with dreams, preparation, worry and doubt. Birthing a family through adoption lacks the physical pain of labor and delivery, but it is nonetheless accompanied by waves of exhaustion, panic and exhilaration.

We didn’t meet our children until they were seven months old–two bald and beautiful babies living in an orphanage thousands of miles away. We knew very little about the biological parents’ health and genetics, about the babies’ gestation and birth or about the quality of their nutrition, housing or social interactions. We faced a reality entirely different from the one we’d envisioned when first planning a family.

And yet, having relinquished control, when we gazed into the faces of our children for the first time, their eyes seemed to ask what had taken us so long–and we two scientifically trained physician-parents fell immediately and completely in love with them.

That was fifteen years ago. Our children and we share not one bit more DNA than the 99.9 percent that’s shared by all seven billion humans on the planet. And yet our family is no less real than one formed by the joining of DNA.

Still, that word–real–slips easily from the lips of curious acquaintances and well-meaning loved ones: “Do they ever ask about their real parents?” or “Are they real siblings?” and “Did you ever want real children of your own?”

The unspoken implication, of course, is that genes, or perhaps gestation and childbirth, are the hallmarks of an authentic family. With all due reverence for those things, I assert that it is a daily commitment to muscular love that defines and unites a family. In the midst of calming my children’s sickness or sadness, or sharing meals and a home and heartfelt laughter, or overflowing with a parent’s joy and pride, I wonder at the notion that our life as a family could somehow be unreal.

I have learned what is real for me by creating a space for the curious mixture of joy, imperfection, complexity and awe that is family–that is life itself. Our family’s story began with experiences of loss on two sides of the globe. I do not know my children’s birth parents’ story, but I honor it and will always be grateful to them.

For myself, I can only say that I have found my greatest joy on the other side of loss. I feel thankful for a great deal in my life–including the science that is the basis for my profession and that holds so much potential for improving the health and well-being of humanity and the planet we inhabit. But I am most grateful for the forces that supersede science and biology, reminding us that love is still the most powerful force in the universe.

I hope that my children will always know this–and that they’ll know that their story, and their family, is imperfect and beautiful and evolving and alive.

Because it is, in fact, real.

 

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Anne Jacobson is a family physician in Chicago. After many years working as a clinician and administrator in safety-net health systems, she now works as a writer, editor and consultant on narrative-based health projects, with a particular interest in physician health and well-being, and teaches at Loyola Stritch School of Medicine. Her work has appeared in JAMA, The Examined Life Journal and Hektoen International and in the anthology At the End of Life: True Stories About How We Die and elsewhere. She blogs at thewritetowander.com. “The attached photo is from the day we met our children. We’ve often been told that our expressions tell a story that is probably inadequately captured in words.”

 

Comments

23 thoughts on “A Real Family?”

  1. Dave Mittman, DMSc (hd), PA, DFAAPA

    I am a PA for 48 years, a past national president, and somewhat of an adoption specialist by now. My children are both adults. Have done adoption counseling as a volunteer for years and published in “Chicken Soup For The Expectant Mother’s Soul” about our adoption journey. Agree, the day we met them, touched them, and held them, they were ours forever. Still feel the same decades later.
    Love to talk one day. My email is MittmanPA@gmail.com
    Dave

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  14. Pamela Adelstein

    You have a beautiful family. And your children are blessed to have you as parents.
    I have a friend (also a family physician) who, when asked if her children (multiples conceived using ART) were “real” or “natural”, would say, “No, they are plastic.” That made the inquirer pause!

  15. What a lovely story – thank you for sharing 🙂 One of the parenting books I read while pregnant advised that it takes nine months to make a baby… then nine months to make a mother. I would say a lot longer than nine months, actually! The point being – conception and birth don’t make us parents. That happens at 11pm, 12pm, 2pm and 3pm for endless night feedings. And in aisle nine of Target, when an overwhelmed two-year-old loses her cool. School plays and family movie night and friend breakups and the death of a pet. I’m sorry anyone would use the term “real” to describe biological families. Anyone who’s read “The Velveteen Rabbit” knows that it’s love that makes us real.

  16. My journey, a few years before this one. And we adopted 4 daughters, one at a time. An important thing to do now is to read about adverse childhood experiences so you have the tools to handle what might come later. I didn’t believe that an infant could experience the trauma of the loss of birth family, but it is true that they can, and I am now a believer. Fortunately, I have the tools to deal better with the trauma my children experienced.

  17. Such an engaging bright side read on an early Saturday am Thank you. A true story for a women’s health curriculum for early learners engaging with patients.

  18. Great Story and Congratulations to your entire Family for this wonderful journey ahead, filled with love and gratitude.

    May I suggest some other ways of talking and thinking about what you have described?

    Replace the judgmental term of real family with the scientific term biological family.

    Remove the term of imperfect family. Your children, your husband and you are all blessed to have found this LOVING situation that will enrich all your lives. That sound pretty perfect to me.

    Again, Congratulations!

  19. Henry Schneiderman

    Just a wonderful, insightful, reflective and uplifting story; not only to those of us who have had infertility treatment, but to everybody. So needed and welcomed in this moment when human beings seem not only tormented by COVID, but uniquely rude and intolerant of the 0.1% of DNA that others may have, and in particular of the differences in opinions and loyalties of others. Those children are blessed, and so are Doctor Jacobson and her husband: it is the old “Who rescued whom?” that is so often noted in another context. So beautifully, touchingly, and meaningfully stated. Thank you so much.

    1. As a fellow adoptive mom and physician, your words are not only true but beautifully express such truth about the love between parents and children that comes from choice. I can’t wait to share this story.

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