The other day, the last two appointments on my schedule were “unable to get pregnant, consult” and “pregnant, desires a termination.” Even my medical assistant commented about the timing of those last two patients. Although these are not unusual issues for patients to see me about, the fact I was seeing them back to back, haunted me all day. Why? Why did life deal them these cards? Did fate make a mistake and now, as if to tease them more, have them sit next to each other in my waiting room, anxiously awaiting what comes next? And why at my doorstep, challenging me to be in different mindsets, to support one that cannot get pregnant and one who can but doesn’t want the pregnancy, one right after another?

Life forming when it’s not wanted, when the timing isn’t right; and then not, when the timing is perfect, and the desire is huge. In the beginning, the sources of life approach each other; sometimes cells come together that aren’t normal; sometimes they come together and divide incorrectly; sometimes they just have a mind of their own and make something with no human likeness; and sometimes, they never collide at all.

In the darkness, what forms clings onto the womb for dear life; sometimes it can hold on; sometimes it can’t endure and loses its hold; or sometimes it clings on in a way that will kill its host. Then it unfolds, quiet, unassuming, swaying in the warm fluid. Sometimes it becomes contorted and can’t unfold fully; sometimes it swims with blessed freedom; sometimes it never unfolds. The time passes slowly, passes quickly, with sadness, with hope, with fear, with love. This life knows it can’t stay like this forever — some won’t accept this and will not survive the journey out, some leave with great expectations and joy, and some are so contorted, they must make the journey out a different way.

I think about all these complicated processes and how many times steps can go wrong, how miraculous it is that they ever come out right. I think about all the complicated expectations, disappointments, relationships that go into making life and how all this affects the processes too.

I take a moment before I enter the first room, knowing it is filled with disappointment of life not forming, and knowing I will need to reset myself for the last room which is filled with disappointment of the opposite.

Andrea Eisenberg is a obstetrician-gynecologist who blogs at Secret Life of an OB/GYN.

Image credit: Shutterstock.com