Richard Worth 18th October 2017
I’d never really considered myself as suffering from an overabundance of machismo; I was raised by a single mother who worked full-time so I see strength, fortitude, and the ability to protect others as much a part of what it means to be a woman as it does a man, and as the oldest of three I like to think I adopted some of these qualities in caring for my siblings. I was never told to “be a man” or “act like a boy” but because of our situation, I was the de-facto “man of the house”. Years later I’m now left wondering if building this trait has cut off my ability to feel emotions properly. Boys and young men are told to be strong and deny feelings that appear weak, but without accessing these feelings, how can men fully react to the world around them?
Robert Webb’s book How Not to Be a Boy has recently brought the discussion about toxic masculinity closer to the mainstream. The actor and comedian writes about the idea that traditional male qualities can become dangerous and unhealthy if not well-tempered, peppering the book with his own personal experiences. It’s something I thought my background had allowed me to largely escape. But I was wrong.
Last month my partner and I went through an ectopic pregnancy. An ectopic pregnancy occurs when the egg is fertilised outside of the womb, most commonly in the fallopian tube. It happens in around one in 80 pregnancies and, unless it’s treated, it’s fatal to the mother. As the embryo develops it grows to rupture its surrounding, severing arteries and resulting in rapid internal bleeding. Even though it never came to this, it would feel like a lie to say we were lucky. The process of diagnosing and treating an ectopic pregnancy is fraught with confusion, pain and unhappiness; and the road to recovery is not easy.
Back in mid-July, Beth’s period has stopped and she’s getting pains in her left side. She’d recently been quite ill with what we had assumed was food poisoning, but we still think it best for her to see a doctor just in case. He dismisses her ailments as side effects of the illness and doesn’t see the point in doing a pregnancy test. The pains continue for a week before we decide to take a home test.
The test is positive and within 24 hours the pain increases. We manage to see an out of hours doctor who immediately sends us to A&E. Many hours later, we are admitted to the Early Pregnancy Unit. The gynaecologist heavily suspects an ectopic but the first scan is only available the following day. Beth is kept overnight and I’m sent home – understandably – as it’s a female only ward. This is the first time I feel the full weight of what could be happening to us. I’m forced to leave my girlfriend in a darkened ward, teary-eyed and surrounded by women behind curtains crying for what they’ve lost and what they will lose.
Beth has huge amounts of pain and begins bleeding heavily
Early the next day I’m back for the scan. Neither of us has slept out of a combination of fear and lack of each other’s presence. The scan is incredibly uncomfortable but the result doesn’t show a thing. We’re discharged after being told that the pregnancy is fine, just early. Pain is part and parcel of pregnancy. We have to return for blood tests to monitor Beth’s levels of HCG (a hormone created by pregnancy), the principal indicator of the rate of growth. After two days we’re told not to come back as the levels have risen dramatically.
Another week passes and Beth has huge amounts of pain and begins bleeding heavily. It’s her birthday. The diagnosis is that she’s miscarried. We’ve miscarried. This is incredibly common and many women don’t even realise it’s happened to them, but it’s also no comfort. It’s confirmed with a scan and blood test. Beth begins to grieve and I try my best to support her as the pain continues. After the previous misdiagnosis it feels like we at least know what happened to us – we know what to expect, we know how to move forward. I try to dissociate what happened from Beth’s birthday, attempting to distract her with friends and days out.
But Beth remains unwell, the bleeding and the pain comes and goes. She knows there is something wrong, she can just feel it. For safety’s sake, we go back to the EPU. More scans, more blood tests, more bad news. Beth is still pregnant, it’s ectopic and on her ovary. Whilst her HCG levels are low, indicating the body is attempting to destroy the embryonic tissue, its size is unusually large. A specialist advises us to have Beth kept under observation in the hospital between blood tests. Should the HCG levels rise, Beth will have to undergo surgery, potentially losing her ovary. If they stay the same or continue to drop, she will be given an injection of methotrexate, a chemical used in chemotherapy to destroy cancerous tissue. Beth is terrified. Not for her life, but at the idea of losing her fertility. I’m terrified of losing her.
After two days in limbo, her HCG levels have hardly dropped and the new doctor picking up her case recommends two more days of observation. My confidence that Beth will be okay is suddenly shattered and I react badly. I lose my temper with a doctor, frustrated that he doesn’t seem to know what is happening. At that moment he becomes the incarnation of all the struggles we’ve been through, as if he wants Beth’s pain to continue, and I lash out. After a heated debate with the doctor, Beth and I are left alone. In losing my temper I let her down. But eventually, on the orders of the specialist we’d seen before, Beth is given a shot of methotrexate.
We’re discharged and have to come back five days and seven days later. The drugs cause Beth to feel more pain. On top of the agony of the ectopic, the medicine causes shooting pains. Seven days later, Beth’s levels drop significantly. A fortnight later, with a course of antibiotics to help, Beth is completely better physically. There is no longer any pain or any pregnancy.
I fail frequently at understanding what is happening
Doctors play the odds and you can only hope that they are correct. The NHS does an amazing job and everyone at Leeds St James’s EPU was fantastic in caring for us. I’ve laid out what happened, not to elicit sympathy or tell a sob story, but to demonstrate the confusion and lack of control you feel during an ectopic pregnancy. Our case is like every other case, in that no one is ever quite sure what is happening. People try their best to document their experience on forums and websites to help one another but really there is only one constant: it’s different for everyone. As clued up of the physical aspects of ectopic pregnancy as I try to become, playing the odds myself in attempt to regain control, I can only ever attempt to know what was happening to Beth, I fail frequently at understanding what is happening.
At times during the trauma, we fall completely out of sync with each other. Throughout the treatment, she still feels as though she has a life form in her that she is the steward of. Taking the methotrexate is an abandonment of her duty as a mother and she feels guilt over the loss of a potential life. But where she feels life, I only see pain and ultimately death. Beth feels sorrow for what we could have had while I feel relief, even elation, at knowing it was gone.
I convince myself that I’m being supportive, looking after her physically and asking if she’s okay, but truthfully a tension starts to grow between us. I read every ectopic charity site looking for advice on how to deal with what has happened to us, how I’m supposed to support Beth. The only advice I think I’ve adopted is not to rush her into feeling better but later I realise I had failed at this.
We’ve been through such a hard time, it’s the most difficult thing either of us have ever faced
I know full well that she is in emotional turmoil. I can sympathise but I can’t empathise. All I feel is frustration that this event had dominated our lives for months and now I don’t feel like we can escape it. I also know that I can never tell her this, it would only add to her suffering and remorse. I justify it in part as stoicism – I’m being strong for her – and in part as pragmatic selfishness. I can’t share her emotional journey. I see it as some kind of indulgence. We’ve been through such a hard time, it’s the most difficult thing either of us have ever faced. I have to move on and begin to reassemble our lives.
This translates as silence. I stand on the shore, watching powerful, dark waters engulf the person I love most, unable to help her for fear of drowning. She talks through her emotions to a blank slate, a void who arbitrarily replies in the positive; listening without really engaging. It’s not uncommon for couples to break up after ectopic pregnancies. I don’t want that, I know I’ve stranded Beth alone emotionally, but the thought of being apart is unfathomable. So, we argue.
We argue and argue and things start to become okay again. Addressing our frustrations with one another helps us to understand them. More specifically, Beth understands mine and while I still find it difficult to empathise with Beth’s position, I understand that my attempt at stoicism really just leaves her isolated.
Unable to empathise
Things are beginning to be good again. Every day we both feel a little better and are both so much surer of our strength together. But, I begin to feel a gap in my person take shape. As best I can describe it, it’s a limited range or clumsy apprehension of an emotional language. Every tinge of sorrow or sadness is suppressed and instead replaced with frustration and resentment. What I think is strength is just anger, I’m not getting on with things while emotionally processing what is happening to Beth and me, I’m just holding onto my ire and creating a chasm between us. Why am I unable to empathise and why do I have such a limited and unhelpful range of reactions at my disposal?
I realise later I wasn’t being strong or brave by hiding my emotions from my partner. I was scared at what revealing those emotions would do to our relationship and where it would take me mentally. I couldn’t allow myself to feel what she felt – that we’d lost a child – because it was easier to be angry that this had happened to us than sad. As odd as it is to write, luckily in arguing, these feelings came out. Toxic masculinity is only identifiable in the aftermath, when the denial of delicate emotive states and the replacement of those states with a combative attitude, pushes one into negative actions. Generally low self-esteem, depression and suicide are all linked to toxic masculinity, but in my case, it could have been the destruction of a long-term relationship.
There is a great and cruel irony for men in the idea of thinking that we’re being strong for others
During this time, no-one around us pressurised me to “man up”. At most, people asked us to “be there for each other”, but that’s the real danger of toxic masculinity: eventually, one internalises the pressure as a sort of moral code. That’s what limits your emotional scope. You don’t need anyone to tell you that “it’s not okay to be upset” because you’ve already convinced yourself a long time ago. More than that, you turn away advice that might help. Beth would tell me that she knew I was upset and ask how I was and I’d reply “fine”. Whilst toughening up helped when we were going through it, it hindered recovery. This mindset prohibited any cathartic contemplation of the scale of what I, and more importantly Beth, had gone through.
There is a great and cruel irony for men in the idea of thinking that we’re being strong for others. It doesn’t always help them and we end up endangering ourselves. If we hadn’t had a breakthrough and spoke to one another, if I had been even slightly more stoic, regardless of Beth surviving the ectopic pregnancy, I would have lost her too.
Richard Worth 18th October 2017