"There is no such thing as reproduction"

(At least, that's what I'm told this book says). And it's true.

At least once a day, I have the discussion with a pregnant patient about the limitations of prenatal testing and ultrasound. "Let me share with you," I'll say. "I realized, about halfway through my counselling session with the geneticist during my second pregnancy, that what I was really worried about? Was autism."

[Break to explain, especially for readers with an autism-spectrum disorder, or who are raising kids with one: I was worried about autism not because of the diagnosis itself, but because I thought I would be really terrible at parenting an autistic child. This assessment was made with woefully limited information at the time, but regardless I had this whole fear about how it would combine with my native social anxiety and my general impatience in a bad way, and that this kid - my kid - would suffer more because of my particular inadequacies.]



I'll continue: "And you know what we don't have a test for? Autism. And you know what can't be seen on ultrasound? Autism."

I eventually talk about how I ultimately found that loss of reassurance liberating, that it was easier for me to then accept what I could and couldn't know about our Down's syndrome risk (Hint: not a whole bunch. First trimester screening is really iffy for twins). Realizing that I would not know many important things about my pregnancy meant that I could move on.

When I have this talk with patients, I ultimately end up discussing what I can and can't see on ultrasound that day, and how inadequate or misleading some of our tests can be, and eventually end up by comparing parenthood to leaping off a cliff without a parachute blindfolded with your hands tied behind your back. Uphill, both ways! In the snow!

All this came to mind after reading this poetic review, of a book which I haven't read yet (and with which I will probably have some disagreements; isn't some of parenthood creating civilized people out of the barbarians - also known as toddlers - that we start with? Or should I read the book before I start arguing?). Thus, we're in the business of production. Or as I say, less pithily, on a daily basis, mostly to myself: You gotta let your own weird kid be their own weird self.

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Oh, here's such a beautiful and lyrical review of the same book. Well worth reading; thank you to the Bearded Economist for sending it to me. I may never read the book, but the discussion of parenting it is provoking is quite lovely.