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Alex Lake

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Claire

Dr Singh sat opposite Claire and studied his notes. He looked to be in his sixties and had small, precise features. She had googled him and, as her dad had said, he really was an expert in the field of fertility; he had pioneered a number of treatments with spectacular results, which probably explained the fee her dad was paying.

It was the second time they had met that day; in the morning he had asked her a bunch of questions and discussed her goals, and then he’d sent her into the room next door where a nurse had drawn blood and performed an ultrasound scan, along with some X-rays.

We’ll have the results shortly, he said. But you’ll have to see when Dr Singh is free to take you through them.

Dr Singh was free that afternoon, and Claire had left work to come and meet him. She’d had to move a couple of meetings around, but as a partner she had that flexibility. Besides, she had been thinking about it all day, unable to focus on anything other than what the doctor might tell her.

‘Well …’ He smiled. ‘So far, it’s good news.’

‘What do you mean “so far”?’ Claire said.

‘I mean the tests we did showed no abnormalities, but there are more procedures we can do. However, I’m not sure they’re warranted, at this point. I see nothing wrong.’

He pulled a piece of A4 paper from a file and handed it to her. ‘These are the results of your Hysterosalpingography – that’s the fancy name for the X-ray we took of your uterus and fallopian tubes. As you can see, nothing showed up.’

She studied the paper. There was a lot of text, but her eyes settled on the only words that mattered to her.

Abnormalities: None

‘What about the other test?’ she said. ‘The one about the eggs?’

‘The ovarian reserve test,’ Dr Singh said. ‘That, too, was fine. You have a normal egg supply, and they are of good quality.’ He laced his fingers together and leaned forwards. ‘As far as I can tell, there is no problem with your fertility. We could do further imaging, or even a laparoscopy.’

‘What’s that?’

‘It’s a procedure to take a look inside the uterus. We make an incision in the navel and put a camera in there. If there was anything going on – endometriosis, scarring – it would show up. But, like I said, there’s no reason to believe there is anything.’

Claire met his gaze. ‘Then why can’t I get pregnant?’

‘Sometimes it takes a while,’ Dr Singh said. ‘And the stress caused by worrying about it can make it more difficult. If you can relax, take your time, that would probably help.’

She already knew this. Every one of the myriad of websites about pregnancy and childbirth mentioned it. Make sure you stay relaxed. The body is less likely to conceive when under stress. A relaxed body is a body ready to have a baby. All very well; the problem was that when you tried to relax the trying got in the way of the relaxing. It was like telling somebody not to think of an elephant; as soon as you said it an elephant popped into their mind.

‘It’s hard,’ she said. ‘I can’t stop worrying that something’s wrong.’

‘There’s nothing that I can see.’ Dr Singh twirled his pen in his fingers. ‘At least, not with you. There is, however, one other avenue to explore.’

‘Which is?’

Dr Singh took off his glasses. ‘Has your husband had his sperm tested?’

Claire nodded. ‘A couple of months ago. It was fine.’

When she hadn’t got pregnant after the first few months of trying, Alfie had declared that he was going to take a test.

I don’t want to waste any time, he said. If there’s something wrong, I want to know so I can fix it.

She had asked if he thought she should get tested too.

Not yet. You’ll need to go to a doctor. I can do a home test. It’s easy. And I want peace of mind that everything’s OK with me.

And it was. She was at work when he did it, but when she came home he was beaming: sperm count was normal. She was pleased for him, but it only made her feel worse. If there was a problem then it was with her, and not him.

‘Where did he have it done?’ Dr Singh said. ‘If you don’t mind me asking. You don’t have to say, of course.’

‘It was a home testing kit.’

‘Ah.’ Dr Singh pursed his lips. ‘Those kits are perfectly accurate, if correctly used, but there is scope for error. Do you know if he kept it?’

‘I doubt it. I think he threw it away. I’ve never seen it.’

‘Well, it’s only something to consider, but maybe you could suggest that he come and see me. We can do a more comprehensive fertility test, so we’re absolutely sure.’

‘You think there’s a chance it was wrong?’

‘There’s always a chance. Faulty test, or maybe user error. Think about asking him to come in.’

‘There’s no need to think. He’ll want to do it. Can I book it now?’

‘Are you sure you don’t want to check with him first?’ Dr Singh asked.

Claire shook her head. Alfie would be on board, she had no doubt about that.

Alfie

Alfie turned into their street – they lived in a double-fronted Victorian villa halfway down the street – and walked slowly towards the house. It was a few minutes past seven p.m.; he’d been to a showing in Battersea. He normally tried to avoid showings as much as he could. After he and Claire got married he had felt he needed some kind of job, but he had no idea what to do, so, when Mick suggested becoming an estate agent he had agreed. Mick had helped him to find a post at a different agency – he claimed he didn’t want to mix family and business, but Alfie was convinced it was because Mick thought he was incompetent and didn’t want him near his business. As it was, it had turned out to be an inspired choice of career.

He was, if he did say so himself, fucking good at it. People seemed to want someone with a big smile to convince them that whatever property they were looking at was the perfect place for them, and Alfie was happy to oblige. Even when he knew the neighbours were noisy and annoying and there was a problem with cockroach infestations in the summer he looked them in the eye and said they’d be so happy there. Not giving a shit about them made it easier, of course.

The other benefit – and this was huge – was that he could come and go as he pleased during the day and, even better, the agency had the keys to all kinds of empty properties all over the city which he could use when he met people online.

Claire had texted – Doc says everything OK! – so he had bought a bottle of champagne to celebrate.

‘Hey!’ he called out as he opened the door. ‘Are you home?’

‘In the kitchen,’ Claire replied.

He walked in, making sure there was a wide smile on his face. ‘I got your text. It’s wonderful news. I’m so glad the doctor didn’t find anything.’

‘I know,’ Claire said. ‘In one way it’s a relief, but in another it’s frustrating – and worrying – because if there was a reason then at least the doctors could fix it, and if they couldn’t we’d know for sure and could make other plans. As it is, all I – we – can do is wait.’

‘It’ll happen,’ Alfie said. ‘Eventually. Lots of people have been in this exact situation.’

Claire seemed about to say something but she hesitated. She looked a little sheepish.

‘Everything OK?’ Alfie said.

‘He did ask about one other thing.’

‘Which was?’

‘Your test. The one you took at home.’

‘What about it?’

‘He wondered whether you should take another one.’

Alfie was, for a moment, lost for words. He had not been expecting to hear that. He’d taken his test – or so he’d told Claire – and he’d assumed the whole sperm-count question was settled. The last thing he needed was anyone else interfering. ‘Doesn’t he think they’re accurate?’

‘He didn’t say so. Not exactly, anyway. All he said was, there’s some margin for error. Maybe you didn’t get it right.’

Alfie laughed. ‘It’s not tremendously hard to do. You just – you know, point and shoot – on the test and a line pops up in a window.’

‘Still. He said there are other, more reliable tests he could do.’

‘And get paid for.’

‘I don’t think he was trying to drum up business, Alfie. I think he was making a suggestion. Being helpful.’

Alfie held up his hands. ‘I’m sorry. I was only being cynical.’

‘So will you do it? Go and see him?’

Alfie weighed it up. He could say yes, and then simply put it off. Find reasons to cancel appointments. Eventually she might forget.

‘Sure,’ he said. ‘I don’t think it’ll come to much, but why not? If it helps, I’ll do it.’

‘I knew you wouldn’t mind.’ Claire smiled. ‘So I made the appointment. It’s for seven a.m., this Thursday.’

Seven a.m. this Thursday? The stupid fucking bitch. What had she done now? This was typical of her. She had to fucking interfere. He’d told her his test was OK, but did she believe him? No – she went jabbering on to her private doctor that Daddy paid for because the NHS wasn’t good enough for her and then she went and actually made an appointment for him, an actual goddamn appointment that he would have to attend. There was no way he had something going on at seven a.m., and she knew it.

But he couldn’t attend. Any half-decent doctor would see immediately that he didn’t have a low sperm count; he had no sperm at all. And then they’d see the vasectomy scar – it was small but they’d know exactly what it was – and he’d be screwed.

Totally screwed.

He’d wake up on Thursday and say he was ill. But then she’d reschedule.

He was trapped. Shit. Shit. Shit. He needed a way out. And fast.

‘Are you all right, Alfie?’

He smiled at her and took out his phone – his iPhone, not his Henry Bryant phone, Henry Bryant who would have told her to go to hell, he’d already done the test and she’d better believe what he damn well said – and opened the calendar.

‘What day was it?’ he said, his voice calm and even. He grabbed her glass of wine and took a sip. He fought the urge to chug the whole thing.

‘Thursday at seven a.m. Dr Singh said he’d open early for you.’

He nodded. He’d have to go. He’d simply have to find another way to deal with it. This was a real problem.

Unless. Unless he could find a way to nip it in the bud. He had the beginnings of an idea. Perhaps there was something he could do after all. He felt himself relax.

‘I’ll be there,’ he said.

Claire

Claire swayed as the Tube train pulled out of the station. She glanced at her watch. Alfie should be with Dr Singh now. She’d wanted to go with him but she had a meeting with a client at eight. They were working on the product launch of a new flask, and they still hadn’t settled on the design. It was getting late in the project so they had fired their original designers and come to Claire’s firm. Part of the problem was the brief; they wanted something urban and sleek, but rugged and tough. It wasn’t immediately obvious how to incorporate all those things, but she had some ideas.

She got off at her Tube stop and her phone rang. It was Jodie.

‘Hi,’ she said. ‘What’s up?’

Jodie didn’t answer. Instead she made the sound of someone blowing out their cheeks in frustration.

‘That good?’ Claire said. ‘Fill me in.’

‘It’s Pippa. She’s driving me nuts.’

It took Claire a moment to place the name, but then it came to her. Pippa was the friend whose boyfriend had broken up with her by text. ‘What’s she doing?’

‘She’s moved in. She can’t bear to be alone. And all she talks about is Henry fucking Bryant—’

‘He’s the guy who broke up with her by text?’

‘The very same, and I never want to hear his name again. I didn’t get to bed until one a.m. last night. She was telling me how she loved him and she’d been convinced he was the one and she didn’t know what she’d done wrong, she simply couldn’t understand how he’d changed from one day to the next, and didn’t I think it was weird? And maybe there was something else going on with him because he hadn’t been answering her texts or calls; he could have been taken ill or something bad had happened to him which was the real reason he’d dumped her and so maybe there was a chance they could get back together after all.’ Jodie paused and took a deep breath. ‘I get it, Claire, I really do, and I feel sorry for her. It’s horrible to be dumped – we’ve all been there – and you get trapped in a cycle of wondering if you messed up in some way or other, but this is extreme. I mean, if she’s like this it’s no wonder he wanted out.’

‘Or that he did it by text,’ Claire said. ‘He probably knew how she’d react. Not that it’s an excuse. He should have told her to her face.’

‘Yeah, he should. But that doesn’t help me. She was up at five this morning, which meant I was too, ready for another few hours of speculation about why Henry Bryant had broken up with her. What am I going to do?’

‘It’ll pass. She’ll get over it.’

‘But in the meantime it’s torture.’

‘Take her out. Meet some new guys.’

‘I’d feel bad inflicting her on them.’

Claire laughed. ‘Then you’ll just have to get her to move out in a kind and gentle way. Tell her she’s welcome to stay for a while longer but you’re busy at work and you need your space. Don’t do it by text, though.’

Jodie gave a sardonic laugh. ‘Maybe I should. It might work. Or I’ll tell her I’m going on a business trip and come to stay with you guys.’

‘Sure. Do whatever you need.’ Claire checked the time on her phone. ‘Anyway, I have to run. I have a meeting.’

‘OK. And thanks for the advice, although I’m not sure I’m much closer to a solution. I feel better for venting though. By the way, I’ve got some good photos of us at the party. I’ll send them over.’

They hung up and, a few seconds later, Claire’s phone buzzed. Jodie had sent two photos from her birthday party: one of her and Jodie and Alfie standing together and one of Alfie singing the song he’d written, with her dad in the background looking at him in mild disgust.

Here you go, the message said. Look at your dad! Not sure what he thinks of the song! I’m sure he likes Alfie, but they’re so different. Anyway, thought you’d get a kick out of this.

Claire laughed and walked towards the office. As she turned on to Haymarket there was a busker singing ‘Father and Son’. She stopped to listen. She’d forgotten about Alfie but the song reminded her where he was. It was a good omen, a sign the appointment was going well. She smiled and reached into her bag for some change. All she had was a twenty-pound note. For a second she hesitated, but then she bent down and threw it into the guitar case. She had to. She had a sudden sense that it was all linked and she couldn’t ignore the fact there was a busker singing a song about a father right at the point Alfie was with Dr Singh. She had to give to receive.

The busker looked at the note lying among a scattering of coins. He grinned at her.

‘Thanks,’ he said. ‘And good luck.’

She turned away and headed up the street, smiling so much it was almost painful.

This was it. This was the day it all fell into place.

Alfie

Dr Singh folded his arms and looked at Alfie. He had a puzzled expression on his face.

‘So,’ he said. ‘I have some results. Before we discuss them, I must say I am a little surprised.’

Alfie had no doubt that he was, but he frowned, then widened his eyes as though he was worried. ‘What kind of surprise?’

Dr Singh sat back in his chair. ‘Mr Daniels,’ he said. ‘Your sperm count is zero. There are no sperm.’

Alfie let his mouth drop open. ‘But,’ he stammered, ‘but I took a test. It was OK.’

‘I don’t know how. Unless you read it incorrectly. Tell me, did you refrain from sex and masturbation for forty-eight hours before coming here?’

Alfie nodded. He’d made a big thing of it, telling Claire how hard it was to resist her.

‘Then there can be no doubt. You are not producing sperm.’

‘I can’t believe it,’ Alfie said. ‘I really can’t believe it.’

The doctor’s bedside manner could use some work, Alfie thought. He’d just blurted out the news that a man would never be a father. He wasn’t to know Alfie was perfectly aware of that already. For all Dr Singh knew, Alfie’s devastation was genuine.

‘I want to discuss something else with you,’ Dr Singh said. ‘There are some other avenues we could explore.’

‘Oh?’ Alfie said. ‘Please. Anything.’

‘Normally we would do two or three tests to get a good sense of the quality and quantity of sperm being produced over a period of time, but since there are no sperm at all I’m not sure it makes sense.’

‘I get it,’ Alfie said. ‘If there are none then I have no chance.’ He looked down, focusing on his fingernails. ‘I can’t believe it’s come to this. It seems so hopeless.’

‘Maybe not,’ Dr Singh said. ‘I’d like to do further tests. It’s possible there is a blockage which is stopping the sperm from getting from the testes into the ejaculate. In fact, since there are no sperm at all, I’d like to check for this.’

‘How would you do that?’

‘We could do an ultrasound as a first step. We can do it now, if you like? We’ll have results right away.’

Alfie looked at the doctor. He felt a violent hatred for him but he bit it back. He had to stay calm. If he let the doctor do this then it would be obvious he had had a vasectomy. It would be equally obvious he had lied about it. That said, Dr Singh would have to keep quiet – he couldn’t reveal anything to Claire because of confidentiality. Still, it was better not to have anyone know.

He shook his head. ‘There’s no point,’ he said. ‘I’ll know more about why I have no sperm, but it won’t help.’

‘Oh, it will,’ Dr Singh said. ‘It’ll make all the difference in the world.’

Alfie straightened in his chair. ‘Oh? How so?’

‘Because if there is a blockage then that means you may well be producing plenty of healthy sperm. We can then either fix it, and you’ll be able to get pregnant in the traditional fashion, or we can harvest those sperm and use them for IVF, or other such treatments.’

‘I’m not sure,’ Alfie said. ‘It might be better to let it be. Accept the situation.’

Dr Singh frowned. ‘Mr Daniels! This is a very simple procedure and it could change everything. You should at least discuss it with your wife. I’m sure she would be keen to pursue this option.’

‘She wouldn’t need to know, would she?’ Alfie said. ‘I mean, you can’t tell her any of this, can you?’

Dr Singh did not reply for a long time. When he did, his voice was low and guarded. ‘No,’ he said. ‘I can’t.’

‘Good. Then I’d like it if you didn’t.’

‘May I ask a question, Mr Daniels?’

Alfie nodded.

‘Do you intend to tell your wife that everything is normal with your sperm test?’

Alfie thought for a moment. ‘Yes, I do. But you can’t say anything.’

‘No,’ Dr Singh said. ‘I can’t. But I will have no choice but to stop treating her.’

Alfie looked at him. That could be a problem. ‘Why?’ he said.

‘Because I will know – even though I will say nothing – that the real cause of her not conceiving is your sperm. Knowing that, I cannot continue to act as though the problem might be her, not to mention the ethics of charging for treatment I know will be ineffective.’

‘What will you tell her?’

‘That an ethical concern has arisen and I can no longer be her doctor.’

‘She’ll want to know why.’

‘I’ll tell her I can’t say why.’

Alfie nodded, slowly. He shouldn’t have said he was going to tell Claire his sperm was normal, but then Singh would have felt he could have discussed it with her, since Alfie had already told her. And he had to keep it from her.

So he’d had no choice. And now it was obvious what would happen: when the doctor told her there was some ethical concern, Claire would think something was badly wrong and would go immediately to another doctor. She’d make Alfie go with her, and she’d insist she was there at every appointment. That doctor would discover his zero sperm count and suggest a scan to look for a blockage, at which point the vasectomy would be revealed and his marriage, and the lifestyle that went with it, would be over.

The problems would pile on top of each other until the whole thing came crashing down, and that left him with only one option. The option Henry Bryant would have taken.

‘OK, I’ll tell her the truth. I have no sperm.’ Alfie tapped the desk. ‘Then what will you do?’

‘I’ll say it is true you have no sperm, but I don’t know why, and since you do not want further treatment there is nothing more I can do to help at this point.’

‘Well,’ Alfie said. ‘Let me tell you – patient to doctor – why I have no sperm. It’s because I had a vasectomy. And before you ask, Claire doesn’t know about it, and she’s not going to find out. So here’s what’s going to happen: I’m going to tell her I have no sperm, and then, if she asks you about it, you’re going to say it’s true. And that’s it. You’re not going to say another word.’

Dr Singh’s eyes narrowed, and he pointed his index finger at Alfie’s chest. ‘I’m not intimidated by you, Mr Daniels. I will keep your secrets, but I will not treat—’

Alfie’s hand snapped out and he grabbed the doctor’s finger. He stared at him and slowly bent it back. Dr Singh flinched in pain. ‘Listen to me,’ he said in a low voice. ‘Listen to me, you filthy little Paki. You’re going to tell her there’s nothing more you can do to help me and she’s going to leave here feeling sad, and you’ll never see her again. And if you don’t, you won’t need to worry about breaking doctor–patient confidentiality. You’ll need to worry about me breaking your disgusting brown neck.’

‘I’ll call the police,’ Dr Singh said, through gritted teeth. ‘This is assault.’

Alfie shook his head. ‘No, you won’t,’ he said. ‘There’s no evidence of any assault. And when they get here I’ll say you fondled me when you examined me. I’ll tell everyone. And they’ll believe me, because people believe that kind of thing.’

He tightened his grip and lowered his voice to a whisper. ‘And I will kill you. One night, when you’re all alone, you’ll wake up and wonder what the noise in your house was, whether there even was a noise, and then you’ll look up and I’ll be in your bedroom and it’ll be the last thing you ever see. Understand?’

He could see fear in the doctor’s eyes. He relaxed. This was going his way.

‘I asked you a question,’ he said. ‘Answer it, you piece of immigrant shit. Do. You. Understand?’

Dr Singh nodded, his lips pressed together to suppress the pain.

‘I understand,’ he said.

‘Good,’ Alfie replied, and let go of his finger.