What He Left Behind

Kira Martin | Longreads | January 2019 | 13 minutes (3,412 words)

When a woman is pregnant, cells from her baby cross the placenta and enter her bloodstream. From there they sink into the tissue of her body where they live for decades, and perhaps for the rest of her life — they’ve been found in women in their 70s. If you were to capture one of these cells and sequence its DNA, it would be different from the mother’s. It would be half her and half the baby’s father, tangled and assorted in all the complex ways two people come together to make a new person.

When I was 20 weeks pregnant with Max, I had an ultrasound. On the drive there, my husband and I argued about names. I was a fan of traditional names, while he preferred the flamboyant.

“If it’s a girl, how about Krystal?” he suggested. I looked out the window, refusing to dignify that with a response. The landscape scrolled by, trees and houses and the flashes of telephone poles. Then I heard it in my head, and said it aloud like reciting a prayer.

“Maxwell. After my grandfather. His name is Max.”

My husband glanced at me, curious.

“Yeah, okay, I like it. For a boy. But if it’s a girl, you’ll consider Krystal?”

“Sure,” I said, “but his name is Max.”

The function of fetal cells in the mother’s body is not well understood. It is difficult to even find them, but they are there. Even if the fetus dies before viability, the mother will carry these cells forever.

At that ultrasound, we discovered that Max’s blood supply was threatened. A rupture could cause us both to bleed to death. Max could be dead in seconds. I was ordered to immediate bed rest; there was nothing I could do except lie still, wait, and hope. Hour after hour I spoke to the curve of Max rounding out my shirt. Hang in there, Max. Be strong, Max. I can’t wait to see you, Max.

The scientific name for a person whose body is made up of disparate cells with different DNA is chimera, after the Greek mythological creature with the head of a lion, the body of a goat, and the tail of a serpent. The phenomenon of fetal cells rooted in the mother’s body is known as microchimerism. It may bear noting that the mythological chimera breathed fire.

The long weeks of waiting proved successful; bit by bit the danger dissipated. In the third trimester the medical complications resolved, and I was allowed out of bed. I finished the pregnancy in relief.

I awoke the morning Max was born knowing it was his birthday. I was distracted, waiting. The contractions began at 11 a.m., and from the start they gripped me so powerfully that I struggled not to panic. We raced to the hospital, and he was born just after 1 p.m. People think that a fast labor must be easier, but really it’s only faster. I was still in a daze, trying to take a full breath while someone wrapped him up and handed him to me. The weight of him in my arms steadied me. I caught my breath.

We studied each other, silent. His eyes were a deep smoky blue, the darkness of them promising the stained glass brown they would become. He stared back at me, unblinking and somber. He never cried about being born — it just wasn’t that upsetting to him. I realized somewhere, deep in a place without words, that this child needed me in a different way than his older brother. I will always be on your side, I promised him.

A nurse reached between us and loosened the wrapping of his blanket enough to slide a thermometer between the soft folds of skin under his arm. She checked it, and shook her head at the other nurse. She turned to me and said, “Baby is a little colder than we like. We’re going to warm him up.”

“His name is Max,” I said, but she had already scooped him up and turned away. She placed him in a bassinet, under lights. She covered him with warmed blankets. On top of that, she draped what looked like a square of slick black plastic from a heavy trash bag. She checked his temperature again, waited, and checked again. I watched. I was not fooled by this nurse’s studied, calm tone. My flesh itched to hold him and make him better.

“Give him to me.” The bustle in the room all but drowned my voice. There was a pause, and the nurses looked at each other. “Now. Give him to me.” They shrugged. Worth a try, they seemed to say.

They unwrapped Max down to his rustling diaper, tugged open my gown, and laid him down, his chest against mine. They draped the warm blankets over us both. His legs pulled up at his sides like a frog, and he pulled his fists up on either side of his head. His hair was still damp from birth, strands slicked against his head like soft pencil strokes. He rested his ear against me, and we both breathed in relief. Underneath the bundle of his tiny body, my heart pumped blood that was now partly him.

The next time the nurse checked his temperature, she smiled.

I realized somewhere, deep in a place without words, that this child needed me in a different way than his older brother. I will always be on your side, I promised him.

What happens to these fetal cells in the mother’s body is unclear. Researchers have found them clustered at sites of organ damage, such as a heart that has been battered by disease. Some speculate that they serve a protective, possibly healing role.

When Max’s older brother was 6 and Max was 3, I had a third son. I always wanted a lot of kids and was delighted with my puppy pile of boys. Everything seemed perfect to me, but my husband was falling apart. He teetered between paralyzing sorrow and explosive bouts of rage. The escape he chased left him staggering in the door late at night, so drunk he couldn’t untie his shoes, or glassy-eyed with drugs and the drama they invited in. Our home became chaotic and dangerous in the way homes do when someone is sinking under the weight of self-medication and despair.

And then he was gone, his belongings stuffed into a trash bag and the door slammed behind him. The four of us were left behind, huddled together. We would not see him again until the day my oldest son graduated high school.

At night my baby slept on my right, so I could nurse him without fully waking. On my left slept Max, who reacted to the loss of his dad with night terrors. Four or five times a night he stirred in his sleep, reaching into the dark and crying out. The restlessness grew, and he thrashed and screamed and kicked. He clawed at me and once climbed up on my headboard, where he teetered like a high-canopy monkey, shrieking with wordless rage.

I learned to hold him each time he started to fight. I wrapped my arms around him from behind and pinned his arms, crossed over his chest, to stop him from hurting himself or me. I whispered comfort in his ear, but he could not hear me. Max never remembered any of it in the morning.

His doctor said there was nothing to do except wait for him to process his loss. I had never been so tired, but my children needed me. Half of their world had left them, and it was up to me to be the stable and loving remnant. At least I knew I was where I was supposed to be and what I was supposed to do. I could hold him and be the loving restraint he needed.

It would be years before I realized what a luxury that was.

Not all of the effects of these fetal cells seem to be symbiotic. The cells’ presence in the brain might protect against Alzheimer’s disease, but may also increase the risk of Parkinson’s. If they lodge in breast tissue, they may reduce the risk of certain types of cancer, yet increase the odds of others. There is no way to predict if they will help or harm the body they inhabit.

When Max was 7, I met a man. After we’d known each other a while, I introduced him to the boys. Max loved him on sight and with typical Max intensity. One night as we were tucking the boys into their beds, Max grabbed him by the arm and searched his face, his brown eyes bright with longing. “Aren’t you ever going to marry my mama?”

As it turned out, he was going to marry me. A year and a half later, he adopted the boys, and two years after that we had another child, a daughter. Everything seemed perfect.

It wasn’t until Max became a teenager that things started to unravel again. Looking back, I wonder when I should have realized something was wrong. The first time he got suspended from school, for plagiarism? The second time he got suspended, for fighting? The first time he punched a wall? The first time he climbed out his window, jumped off the roof into a snowdrift, and ran away into the night? The second time he ran away, stealing our car? When we picked him up from the juvenile detention center?

In a family, one member never changes alone. As Max sank deeper into his darkness, we all dimmed and weakened. He fought with everyone. The air in the house shimmered with tension. My husband and I turned on each other, frantic for someone to blame. One day I found my youngest son walking down the hall to his room with a pellet gun in his hand. “What are you doing with that in the house?” I asked. “Max said he was going to beat me up,” he replied. “I need some kind of protection.” I took it away and walked him to his room, pretending I could keep him safe.

The crossed-over cells affect the mother to the fetus’ benefit. They might encourage thyroid function in her, which is crucial in maintaining pregnancy. In her breast tissue they help establish lactation, an obvious need for the newborn. However, they can also override the maternal defenses against giving away more resources than the mother’s body can afford. This depletes her and may, over time, spark disease.

Max hated the first therapist we found for him, and refused to talk in his session. We found another one, whom Max liked, but then he decided he didn’t need help. We took him to a psychiatrist, who prescribed medication that was supposed to ease the violence of his emotions. “Max probably feels things very intensely,” the doctor said, “the loss of his father probably overwhelmed him.” I could see Max at 3, his dark eyes huge in his pale face. Max agreed to try the medication, and I filled the prescriptions with hope. Was it my imagination or were things feeling better? Hope can be a dangerous, blinding force.

He arrived home later and later at night. The lies weren’t even partially believable. He stole money from every member of our family. When we asked him questions, he screamed and swore that it was our fault. He punched several holes in the walls. His younger brother was equal parts furious with and afraid of him. While he raged, his 7-year-old sister slipped around corners, silent and learning to hide. His dad and I were so, so tired.

Max came home one night, hours after dinner. My husband and I were sitting at the table, looking up as the door slammed behind him. We asked him to sit with us. We had outlined our minimum expectations — there were four rules written on a single sheet of paper. Pushing it across the table, we said, These are the nonnegotiables.

We didn’t get any farther than You may not threaten your brother or anyone else in this home with violence before he stood up, his chair slamming to the floor. Every muscle was tense, his face alight with savage outrage. “I will threaten him if I want to, and if he deserves it, I will beat the shit out of him,” he promised. These are the rules, we repeated.

“Then I can’t live here,” he said as he turned away. “I’m leaving.” He was barely 18, but the law considered him an adult. I was frozen, watching him stomp up the stairs. My arms reached out, as if I could hold him. I had nothing. He thundered back down the stairs. From his shoulder dangled his duffle bag, a shirt sleeve spilling out. My husband followed him out the door. “This is your home,” he called out. “We love you.” Max didn’t glance back, but grabbed his dad’s bicycle out of the garage and swung one leg over it. Then he was gone, swallowed up by a coal-dark night. “No,” I cried to the empty room. “No, no, no, no.”

There is evidence that sometimes, rarely, these fetal cells can cause an immune system response. Since the cells have become a part of the mother, the attack is turned on the self. The result is autoimmune disease. The chimera becomes its own victim.

The day after Max left, I went to church. The congregation stood to pray. We got to the words “forgive us our trespasses as we forgive those who trespass against us,” and the reality that Max was gone bloomed in my stomach. I folded over, recoiling from the pain. I pressed my forehead against my hands as they gripped the pew in front of me. I tried to be quiet, to trap the sound of crying in my throat. That caused me to gasp squeaky sobs, like a small, wounded animal. Warm hands reached out and rested on my back. People are so kind, I thought as I dropped a mosaic of tears onto the marble floor.

Three days after Max left, I went grocery shopping, because it was Saturday and that is what I do on Saturday. I pushed my cart through the aisles, focusing on my list. I rounded a corner, saw the dairy case, and stopped. There was his yogurt. The thick and creamy kind, with a swirl of jewel-tone raspberry jam at the bottom. I was suddenly blind and dumb with the knowledge that I wasn’t buying it for him. I abandoned my cart in the middle of the aisle and walked out of the store.

There is a grief that is like drunkenness. I was unsteady on my feet, my hands clumsy and slow. I was certain I must be exhaling fumes of it, and I turned my face away from people as though I could conceal it. I lay awake for hours every night, sometimes falling into an unstable sleep, confused by flashes of nightmares. When I woke in the morning, I was unable to remember swaths of the day before. I’m pretty sure blackouts are the sign that it’s time to ask for help.

My doctor gave me a prescription to take at bedtime. It drew sleep over me like a heavy blanket. Each night I tipped a styrofoam-light yellow pill into my hand and stared at it, both grateful for and afraid of the relief it gave. “Do you think this is OK?” I asked my husband one night as I crawled into bed, my limbs already heavy from the pill, “Taking this so I can sleep?”

“I think,” his words were careful, “you wouldn’t want to take it forever. But right now, with the pain you’re in? I think it’s OK.”

I let the weight of the pill press my head to the pillow. I thought of all the drugs Max sought out, the litany of substances he gulped down. It occurred to me that his pain must be proportional. I closed my eyes and sleep claimed me.

Autoimmune disease is not well understood. The phenomenon of fetal cells left behind in mothers is far less understood. Knowledge about where the two intersect is unbelievably small.

Weeks after Max left, I was on another shopping trip, buying clothes for my youngest son. This time instead of yogurt I was taken aback by jackets. It was warm when Max left, and now we were nearing winter. I grabbed the sleeve of a hoodie, feeling its cottony warmth thick between my fingers. I just don’t want him to be cold, I thought. I bought Max the hoodie, leaking tears the whole time, bewildering the young checkout employee.

Then I had to find him. I drove to a parking lot where I’d heard he’d been spending a lot of time with people I didn’t know. It was tucked around the side of a gas station, an oblong of gray with no view except the cars that rolled by and a battered green dumpster in the corner. People I would call kids, who would consider themselves adults, clustered around parked cars and smoked. I stood on the edge of the lot, balanced my feet on the curve where the sidewalk turned down to meet blacktop, and asked for Max. A young woman nodded that she knew where he was and told me to wait. She walked across the lot and stood 10 feet back from an enormous glossy white truck with dark tinted windows. A young man leaned against its side, scanning passing cars with sullen boredom. She called to him.

I let the weight of the pill press my head to the pillow. I thought of all the drugs Max sought out, the litany of substances he gulped down. It occurred to me that his pain must be proportional.

“HEY,” she yelled. “Send Max out! This lady wants to give him something!” He glanced my way, then turned to knock on the window. It opened a few inches, and he had a quiet conversation with someone inside, shooting me sideways looks as he did.

After a few minutes, Max climbed out, tucking his wallet into the back pocket of his jeans. He looked pale. Was he thinner? He walked over to me, his face rigid with shock.

“Mom. What … what are you doing here?”

I stepped down off the sidewalk and held out the hoodie.

“It’s getting cold, and I knew you didn’t have anything warm.” He looked at it like he couldn’t understand what it was.

“Why are you here?”

“I brought you this.” I pushed it closer still. He looked at it, then reached out with shaking hands and took it. We studied each other, silent. Finally I spoke. “I just didn’t want you to be cold.”

“Is that all? Is that why you came here?”

“Yes.”

“OK. Um…bye.”

I nodded and walked away. I made my way home, seeing nothing of the drive there. I found my husband and sobbed into his chest.

“I just didn’t want him to be cold.”

I will always be on your side. That’s what I meant to say.

Some days I am fine. I surround myself with people, preferably ones who don’t know anything about Max. I ask them a lot about their lives. I spend time with the remnant of my family at home. I drown myself in work.

Other days I am not fine, and the pain is so large I cannot get a full breath. I have wept so often in public that I am no longer embarrassed by it. I run over the choices, his and ours, and try to figure out what I could have done differently. But all I can really do is still these thoughts, and wait. In my mind, I talk to Max, pleading with him to find his way home, if not to our house, to his own self. Be strong, Max. Hang in there, Max. I can’t wait to see you, Max.

One of the reasons so little is known about these fetal cells and how they affect a mother’s body is that they are difficult to find. To identify them, each cell in her body would have to have its DNA extracted and sequenced. Not only would this task take a researcher several lifetimes to complete, it would require tearing the mother completely apart.

I leave the porch light on every night since he left. As I prepare for bed, I switch on the light and look past the half circle it illuminates and into the dark beyond. I can feel my cells thrum with the existence of Max. I wonder if it’s actually him I feel, out there somewhere. Or if it’s just what he left behind.

* * *

Kira Martin is a freelance writer who lives in Colorado with her husband and kids and a dog that she refers to as her coworker.

Editor: Katie Kosma