Read the ninth instalment in our Fictions series.
Text by Anne Charnock, artwork by Vincent Chong.
Read the associated “Getting Real” blog, exploring the technology, science, policy, and societal implications of the themes from the story here.
Noah peers up into the clear sky from our bay window and cranes his neck to see if clouds are moving in from the west. He announces that he’ll take Alice to the park. “I reckon the worst of the winter is behind us now.” He turns to me and his facial muscles rearrange. His sunny visage dissolves. He mirrors my frown. My head fills with static noise as I anticipate Alice leaving the house. I’m annoyed with myself. Obviously, she’ll be safe with Noah. Words skip through my head—trip, fall, cut, stitches, fracture, siren, ambulance.
He says, “We’ll give you an hour’s break, hey? And you can make that call. While you have the house to yourself.”
In a false show of enthusiasm, I say, “Yes, I’ll do that.” I will make the call.
While picking at my fingernails, I wonder how I’ll cope when Alice starts nursery in the autumn. She is such a sociable child. I know she needs to go, make new friends. Perhaps Noah could do the nursery drop-offs, and I’ll do the pick-ups. The way I am now, I can’t imagine waving her off without having palpitations.
Surely, children suffer from separation anxiety, not parents.
I totally agree with Noah that I should work towards finding a solution, finding help. I told him this morning over breakfast, “If only I could sleep better.” And Noah insisted that when I spoke to the doctor I must explain about the nightmares. I know for sure, one hundred per cent, where they originate. But knowing the cause does not help me in the slightest.
It’s some perverse form of the baby-blues. Perverse because, as far as I know, post-natal depression is linked with natural births, the physical trauma. Whereas I carried Alice for only twenty-two weeks—my pre-emptive caesarean being presented to me as a rational choice given my age and my risk factors. But I never felt happy about it. Alice’s full-term birth, the gentlest of procedures, involved the unzipping of her baby-bag in a sterile gestation ward.
Alice says, “Come on, Mum. Let’s go.”
I kneel before her in the hallway, fasten her coat and help with her gloves, saying, “Spread your fingers, Alice.” And we laugh as we always do. Mittens would be easier. “There. Go and make mischief with your dad. I’ll make hot chocolate when you get back.”
Alice stares at me. Almost incredulous. “You’re not coming?”
“I might catch up with you.”
Noah takes her hand. Alice looks up at Noah and back at me. “You always come to the park.”
“You’ll enjoy yourselves. Now go on.” For once, I don’t say to her, Be careful.
As they close the door, the letterbox rattles, and I roll my shoulders to release the tension.
I log on to the medical consultation platform. As a delaying tactic—because I’m not sure how to start the conversation—I fiddle with the appearance of my avatar, hoping to convey an impression of calm confidence. I replace the avatar’s wavy hairstyle with a straight bob with an angled fringe. Black-framed glasses, which on second thoughts I switch to pale blue frames. I check the avatar options for the doctor and select a female with a round face. All the faces are smiley, and each doctor wears a white coat. A stethoscope is optional. Over-the-top, I reckon. I choose an informal consultation room so that we sit in armchairs on either side of a log fire, and I change the default bland painting over the fireplace to a Tracey Emin bird print. Finally, I select a landscape with cherry trees, which is visible through the floor-to-ceiling windows behind the doctor’s armchair. Cherry blossom quivers in a breeze.
The consultation is prefaced by a number of prompts to confirm my identity and to outline the reason for my call. I speak in clear sentences. “You will see from my notes that I don’t often require a consultation. And my family is well within our annual quota.” I try to sound light-hearted. “And no trips to Accident and Emergency, I’m happy to say. I’m contacting you today because I’m not sleeping well. On average, I have serious sleep problems twice a week and I’m finding it difficult to focus on work commitments.” No doubt, the key phrases—sleep problems and work commitments—will be picked up. The software will also pick up my accent—a northern one, gentle I’d like to think—and apply that accent to the doctor’s speech.
Our session begins. The doctor opens her palm and a sheaf of papers materialise—my virtual medical history—and she leafs through them.
“There is nothing in your notes about a sleep problem.”
These consultations are invariably abrupt. I hoped the relaxed environment of the consulting room might soften the mood. But her clipped tone suggests an interrogation or confrontation rather than a fireside chat.
“I’ve never mentioned this problem before, but it’s been going on for some time. It’s a recurring nightmare, you see. I wake me up in a sweat about twice a week, sometimes three times. When I go to bed, I find I’m nervous about falling to sleep, so all my nights are affected one way or another.”
“Difficult to focus on work commitments. Do you feel stressed?”
“Not as such. I just feel tired. Not as sharp as I should be.”
The doctor’s avatar places a finger on her cheek. “I see. Sleep problems. Nightmares. Tired.”
Evidently, the person behind the avatar is following a protocol. I imagine her reading a decision tree. Sleep problems>Stress. Sleep problems>Nightmares. Sleep problems>Snoring. Sleep problems>Shift worker. She’ll have selected Sleep problems>Nightmares.
Our family health policy is not the best, and I suspect this first point of contact is not with a doctor. Is this an AI triage? Or does the platform employ medical students who work shifts? Do these sessions help them with their studies? I could be speaking to a school-leaver, and this may be their first day on the job, which would be annoying for me. After all, I have my own self-diagnosis app.
“I am sending you advice on how to prepare for sleep, and if you follow the advice you may see some improvement. Don’t read it now. Please read it at the end of our session.”
Again, this must be standard. I mentioned sleep problems so, automatically, she sends me a steps-towards-bedtime advice note. But I’m not stupid. I’ve done my own research already and tried all the usual suggestions.
She continues. “Tell me about your recurring nightmare.”
I walk my avatar to the window of the consulting room and turn to face the doctor who is still seated. I consider aborting the session. In a real-world, face-to-face consultation, I could be confident of a certain level of privacy, but those sessions are exorbitant. What if this so-called ‘doctor’ doesn’t take privacy seriously? Is her supervisor listening in? Will they talk about this session in the pub tonight?
Noah and I should upgrade to a better policy.
I press on. “The dream is always the same. I’m visiting the baby clinic where my daughter is gestating for the second half of her foetal development. I walk along the rows of baby-bags, calmly at first, but I become panicky because Alice isn’t in the place she’s supposed to be. And I start running along the rows, and the nurses are chasing me, shouting, ‘You shouldn’t be in here. You’re unfit. You’re unfit.’ And then I wake up.”
“Is this based on lived experience?”
“Partly. My daughter did gestate remotely.”
“For what reason?”
“It’s in my notes.”
Silence for several moments. The avatar leafs through the papers again.
“Advanced maternal age.”
“In my mid-forties when I became pregnant. The doctors insisted that remote gestation would be safer for the baby.”
“Correct.” A momentary pause. “Older mothers have a greater risk of giving birth super-premature, leading to chronic health complications for the baby.”
“Even so, I didn’t really want Alice to be migrated. I felt pressurised into accepting the procedure. So, the C-section took place at twenty-two weeks. And my husband and I visited the gestation ward as often as we were allowed. Once a week.”
“The nurses in your dream say you are unfit.”
“Well, I can’t stop them saying that, can I? It’s a dream. And it’s not true. I’m confident that I am a good mother. But I remember, one time when I visited the gestation clinic, seeing the other foetuses—the ones rescued from problem families. I felt sorry for them. And it stuck with me.”
“Describe your relationship with Alice.”
“Despite our separation, I bonded well with Alice immediately. In fact, I become agitated if she’s out of my sight. So, it’s not just the nightmares. I want to relax a little more.”
I wonder if she has identified this phrase on another decision tree. “I’m sure it’s a throwback. At the gestation clinic, I worried that the nurses would mix up the babies, and I found it deeply distressing to leave Alice at the end of visiting time. So, I know why I’m having these nightmares. I just want them to stop.”
“I understand.” Silence again for several moments. She begins a monologue about the need for good sleep patterns, a verbal reiteration of the advice she has already sent to me. It’s obvious: she’s keeping me on hold while she hands my session over to another ‘doctor’, perhaps with a specialism. Maybe she keyed in sleep plus gestation clinic plus unreasonable anxiety plus nightmares.
While I’m waiting, I swivel my avatar around to face the blossom trees.
“I’m sorry for the delay,” says the new doctor. “I love the consulting room you’ve chosen. It’s my favourite. And what a lovely view.” A deep female voice with a similar overlay of a light northern accent. There’s a confidence in her informality. She asks me to repeat the details of my nightmare, and I sense that I’m talking to an actual qualified doctor, a real person. I wonder if I’ll be charged extra for a lengthy consultation.
When I finish describing my nightmare, she says, “You mentioned to my colleague that you become agitated when your daughter is out of your sight. Is this a daily worry for you?”
I regret that I described myself as agitated. I should have toned it down by saying, sometimes I feel a little tense. I recall stories of parents who become labelled as over-anxious. I decide to lie. “No, certainly not daily. But I’d like to feel more relaxed, as I told your colleague. Children are so accident prone, aren’t they? But no, it’s not a daily worry.”
“Well, that’s good. I think it would be a good idea for you to embark on a series of visualisation therapies. Nip it in the bud. We’d tailor the scenarios to match those which cause you to worry. For example, if you start to feel anxious when your daughter leaves the house to play in the garden—” I swallow hard as danger words flash again through my mind: rose, thorn, soil, tetanus “—we can recreate the scenario in a 3D animated visual. And I, or one of my colleagues, can lead you through the animation, talk about your physical responses and emotional reactions.”
“Alice starts nursery in a few months time, and I’d like to prepare for taking her there and waving her off. Could you create an animation for that?”
“Yes. I’m sure we have something similar on file, which we can tailor. And we do have a visualisation set in a gestation clinic. For some parents, remote gestation proves to be quite a challenge. Perhaps if you’d told us sooner… It’s a shame you didn’t make your reservations clear at the time.”
Don’t push the blame on me, I say to myself. Remote gestation wasn’t my idea, and I did push back, stated my preference for a natural pregnancy. What did the ante-natal doctor say? “Do you really think that’s the correct attitude?”
But if I get into an argument, here, our contract might be refused next year.
“Maybe I need to work through the clinic scenario too. If it’s not too late to do so.”
“It’s never too late. It might help with your very specific nightmare.”
“Are these visualisations included in my family’s annual policy?”
“Let’s see your account.” She tells me she can allocate three or four of these sessions, “as long as your family has no significant medical needs for the remainder of the contract.” And she concludes, “I strongly advise you to proceed because we don’t want you projecting your anxieties onto your daughter. Much as we need to sort this out for you, we must proceed in order to do what’s best for your child.” Once again, it’s not about me.
I hear Alice and Noah laughing as they reach the garden path, and before I reach the door, Noah pushes it open and I rush forward to help Alice out of her coat and shoes. She holds out her hands, palms down, and I peel off her gloves. She says, “I fell down when Daddy chased me. But it didn’t hurt.” She hugs me hard and I know she’s telling me not to worry.