• Erica Rosi Tham

6. Surviving the Medical Appointment: Keep it Minimal

Updated: Mar 6, 2020

Oh, it's frightening when your health could stand between you and your chance to adopt. This is no time to give the doctor free reign on every test covered by insurance.


Four days after our trip to Corry, I was sitting on an airplane, my journal open. It had been a truly inspiring journey that culminated in a dazzling miracle in Mom’s family home. And yet, strangely, I had spent ten days with my elder sister and my mother without telling them that we had decided to adopt.

Why had I concealed it? Before we left for Pennsylvania, I thought, this is her trip, and I don’t want to distract them with our news. During the last days of the trip, I thought, let’s revel in the miracle that has happened—I’ll tell them later.

We drove back to Virginia, and there were many lonely stretches of highway when I asked myself … should I tell them now?

But so much could go wrong. I had read about country-specifications that were surprising—one country excluded people who had been diagnosed with ADHD, for instance. And the statistics were daunting. I had read about international adoptions being in great decline, down from 20,000 a year in 2008 to 4,000 a year in 2018 due to international politics, as well as increasing costs and paperwork requirements. Would we really make it through this process?

One more solid factor stood before me: the medical appointment. Perhaps if my body passed the test, I would be ready to tell my family.

“It looks like you have not had a mammogram this year.”

“That’s true.”

“Still, you are due for one, and I highly recommend it.”

“Is it necessary for the adoption letter that I sent to you?”

Dr. Desai hesitated. Her glowing skin revealed both excellent health and striking youth. I hazard to guess that she was a twenty-eight-year-old who looked about twenty-two. Either that, or she had taken every advanced class in school and managed to attain her medical degree far ahead of the curve. She was of Indian origin, though she must have been raised in the states as she had no accent.

“No,” she admitted, pausing to collect her thoughts. “But at your age, it is recommended to get mammograms frequently. Have you ever had one?”

“Not yet,” I said, and my heartbeat quickened. “Uh, you may not understand the situation. Adoption is very difficult. There is a huge list of documents that I have to complete, including this one, and so right now, all I want to do is finish this. Later on, there will be months of waiting to be approved and then matched and then even for the legal formalities to be done. During that time, I’ll be able to catch up on any extra things I should do.”

Dr. Desai nodded sympathetically yet persisted. “I really think you should get all of the recommended tests for women of your age. If you don’t want to do this today, I can refer you to someone.”

“Sure,” I said, doing my utmost to sound believable. “That works well. Why don’t you refer me to someone?”

Dr. Desai eyed me carefully, logically. “We will have to do the blood test to complete the form. Do you agree to that?”

“Certainly, I expected it.”

“Please lie down. I need to listen to your heart.”

I eased myself back into a reclining position and tried to breathe deeply to relax my heart which was pounding. Soon Dr. Desai’s stethoscope was absorbing my obvious anxiety.

“Heart-beat rate above normal, though that could be due to the exam. Are you nervous?”

“Yes, I’m worried. I really want to adopt.”

“That’s understandable. Breathe in deeply for me. Now breathe out slowly.”

I could feel my heart rate slowing as I breathed.

Dr. Desai pushed on my chest in several places, and then announced my permission to sit up. “I highly recommend you see the specialist and get all of your tests ASAP. Downstairs, you will do your bloodwork.”

“Sounds good.”

“I will call in a few days with your letter.”

“Thanks,” I said, glad to be free.

I had chosen a clinic just over a mile away from my home and walked there for the exercise and peace of mind. Walking and being outdoors is therapeutic for me. My thoughts tend to flow more freely, and simultaneously, I tend to recognize them rather than believing them, though my mind might spin a long story before my meditative side offers a diagnosis.

My thoughts began with tales of relief. In my imagination, I was strolling into the clinic on the day I would retrieve the two copies of my notarized letter indicating my perfect health, and on the way home, I would stop by one of my favorite restaurants to celebrate, and I would eat anything I wanted because the medical appointment would be over and finished, never to happen again—at least not before our adoption. I was smiling at every passerby, even while the fantasy slowly, and without my awareness, began to change. I saw myself at home accepting a phone call and my heart sinking as the doctor told me that my blood tests showed a possibility of cancer. I was returning to the clinic not for the letter, but for additional tests, and I was emailing Jordyn at Nightlight Adoptions to say we would have to postpone the adoption indefinitely.

I was standing at a crosswalk in front of my neighborhood, waking from my nightmarish daydream. My stomach, my heart, and my throat felt tense with fear, and I exhaled slowly to bring myself back to reality. There were not many cars on the street because it was late morning and most people were working. The air was balmy and fine, pleasant for a walk, and there was a light breeze gently shifting the boughs of the trees.

The fear triggered by my fantasy had been so intense, I knew I had not felt it’s like in years. That means, I told myself, that you want this adoption even more than you had thought. It also means that even though paperwork might seem like just fill-in-the-blank forms, the danger here is quite real.

As I walked the rest of the way home, I eased this fear in the one way I could, by asking God to walk with me. It was impossible to know what the morrow would bring. At such times, the only solace for me is to remember that I am walking with the best friend I have in this life. My eyes become open to the amazing qualities of nature, the surprising radiance of flowers, the mathematical symmetry of tree branches, the complexity of the life of every passerby, the majesty of clouds and horizon and everything speaks of God.

Two days later, my blood tests had returned, and my one flaw was high cholesterol, nothing to prevent Dr. Desai from signing. I went to the clinic and discovered that Dr. Desai had signed, but not notarized the letter. Probably, given her youth, she had not realized that the notary had to be present during the signing. I waited while the manager of the clinic reviewed the situation and ultimately told me that there was no notary on staff (initially, I had been told that there was). Gracefully, I thanked the manager and said that I would find the notary myself, make another appointment, and return with new copies of the letter. I was getting accustomed to finding the easiest paths in the flow of paperwork.

Should I tell my family? I asked myself, relieved about the state of my health. But there was the notary to consider, and I wondered if Dr. Desai might now hesitate about signing and insist on more tests. First the notary, I decided; I’ll aim to have the notarized letters in my hand; then I’ll break the news to my family and friends. In fact, we needed five reference letters, two from family members and three from non-relatives who had known us for at least two years. My hesitation was nothing more than a delay of the inevitable.

Erica Rosi Tham

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