I noticed it as we walked out of the exam room. A red piece of card paper, laminated, hanging on the door by frayed white yarn. It had no words on it, because no words can capture what I assume the red card was meant to say. It spoke for everyone.

It was the 12-week ultrasound for our second baby, and I was filled with excitement over seeing our baby again. At my 8-week appointment the midwife had brought in a low-fi portable sonogram machine, and on the grainy black screen I had gotten to see the tiny, fluttering heartbeat. This time I would get that perfect picture to hang on the fridge. I would finally go public with the news tomorrow and make it my profile picture and then watch the congratulatory comments roll in. Maybe we’d even get an early guess at the gender? Our son had been so insistent that he’s getting a baby sister that we’d started referring to the new baby as “her.” I couldn’t wait to see her again.

As soon as the wand swept across my belly, however, I could tell something wasn’t right. The tech got quiet and seemed agitated as she repeatedly measured what looked like a big, black, empty sac. She checked through my paperwork and asked if I was sure about my dates. We were sure. I brought up the 20-second video of the 8-week ultrasound I had taken on my phone and watched it, feeling devastation begin to rise from my core. She asked if I’d had any bleeding or spotting. No. I started to panic. A tear formed at the corner of my eye. Please don’t say what I know you’re going to say, I thought. “I’m so sorry,” was all I heard.

By now tears streamed down my temples and flooded my ears. I stared at the ceiling, at the fake twinkling starlights that at first had looked so cute and calming but now had morphed into a clouded sky of rain. My husband grabbed my hand, and I could tell he was holding back, trying to stay strong. The tech left, and we hugged and mourned together. “This can’t be happening…” I said. “What the hell…?

A high risk obstetrician came in and took a look. On the screen he called out a large placenta, with black holes dotted through it like Swiss cheese. He explained this was consistent with gestational trophoblastic disease, specifically a partial molar pregnancy. It was a rare condition caused by tripled genetic material at the point of conception (two sperm got to the egg at the same exact time; there was nothing we could have done to cause or prevent it, it was just bad luck), and the resulting placenta had grown rapidly out of control, overtaking everything. It was, technically, a tumor. Molar pregnancies can produce abnormally high levels of hCG and grow quickly, which explained why this pregnancy had made me feel a hundred times sicker than I’d ever been with our son and why my belly had been getting so big so fast. At only 3 months I felt as big as I’d been at 5 months with my son. He then outlined the dangers of a molar pregnancy—the biggest of which being that the placental cells could continue to grow after removal or spread into another part of the body as cancer. Fucking cancer! Because the only thing worse than being told you’ve lost a baby is being told you could get cancer from the baby you never had.

They drew my blood to get an hCG reading and said that I’d need to be monitored for the next year with very frequent blood tests to ensure the hCG levels reduced and that no cells continued to replicate. The good news was that if I got the cancer, it was 100% curable with chemotherapy—but it was still awful to consider. They would run a test every week for the next 6 months, and if my hCG level returned to zero I’d need another 6 monthly tests confirming no increase to clear me. That was at least 32 visits to the obstetrician’s office over the next year. I hate needles.

Only then, after a year, could we even consider trying again, but by that point our son would be nearly 5 years old when his sibling was born. We had planned this so that our kids would be just over 3 years apart. The timing had been perfect: I’d have had the baby in April, I was due on the 16th but in my mind I had committed to April 22nd. In my imagination it would have been on Earth Day, and the night of a full moon called the Pink Moon. My son was also born past his due date under a full moon, the Wolf Moon in January, so it just seemed to fit. I’d give her a name that honored her Earth Day arrival, maybe Ruby or Lily. We’d spend the summer outside bonding in the warm sunshine, snugly bundled up with her head to my heart in a sling. Our son would be a protective big brother, teaching her all about the things that matter to him like capes, light sabers, and ninja moves. But now those visions had vanished, like the baby that was once on the screen, to nothing more than an empty, black hole.

“I’m sorry I had to meet you under these circumstances,” the doctor said. “Please, take care.” And it was over. I gathered my things, and we rushed out the door, tissues in hand. No one stopped us on the way out, no one said goodbye. We were the people that got the red card.

Our next stop was to head across the complex to see my midwife. When we got to the clinic the office manager was standing, waiting for us. Her face looked pained. She quickly waved us past the front desk into the first room. It was the same room I had sat in on the final day of my last pregnancy, watching early contractions rise and fall as they were scratched out on the belt monitor’s ticker tape; tiny tremors that had signaled our son would be joining us soon.

I sat on the paper-lined exam table while my husband sat in a chair. When the assistant came in she said I could take a seat in the chair next to my husband instead. The moment I hopped off the table, I was no longer a patient. The table was for patients expecting babies, but I wasn’t carrying a baby anymore, I was carrying a tumor. I was nothing more than a butt-print on the paper, the shell of a mother that used to be.

My midwife arrived and offered her truly heartfelt sympathy, then counseled us about what would happen next. If the hCG blood levels came back low, we had a few options, but if they were high I would require a D&C to surgically remove everything from the pregnancy. I asked how common this was, and she said in their practice they had only seen four molar pregnancies. I was lucky number five. After giving us time for questions and advice, she said she’d call me very soon.

My husband and I had driven separately to the hospital, so we hugged goodbye and I told him I’d be okay. When I got in the driver’s seat and closed the door I felt compelled to let out a high, murderous scream. I didn’t. Instead, I laid my head on the steering wheel and sobbed until I could summon the strength to turn the ignition.

My mom’s office was right across the street, so I navigated there on autopilot. Through my tears I tried to find words but couldn’t. She asked what was wrong, but all I could do was shake my head. She took me back and looked for tissues while I ran through all I knew. “It just isn’t fair,” I kept saying. She tried to find the right words but confessed she was probably saying all the wrong things. (I’ll let you in on a secret: there are no right words. In a moment of fresh grief, nothing anyone can say will take the sting away.) I just needed someone to cry with, someone to listen, someone else’s heart to collect the falling words and tears instead of a silent void. When I felt that my body’s last remaining tear reserves had dried up, I let her get back to work. I drove away with bleary eyes. It was raining.

It didn’t take long for the midwife to call. My hCG level was over 100,000, consistent with a partial molar pregnancy. She referred me to their backup obstetricians and wished me well. The call from the obstetricians’ office came minutes later, and in a whirlwind I was scheduled for surgery with a check-in time of 11:15 the next morning. All that was left to do was eat cake and have a stiff drink for my last meal before surgery.

That night I dreamed that we missed our appointment. I woke up in a panic but realized that it was only 5 am. I tried to fall back asleep, but I couldn’t. On my phone I Googled all the things I shouldn’t have. I cried until my head throbbed from so many tears. My husband rolled over and held me close.

In the morning I showered, put on comfortable clothes, and tied my hair up in a knot. We rode to the hospital in near silence, and after dropping our son off with my mom we headed up to the surgery center. Check-in was somber. The woman at the computer could see tears welling up in my eyes, and my cheeks, without a speck of makeup as the pre-surgery checklist ordered, were blotchy, raw, and puffy from the saltwater that had streamed over them for the past 24 hours. I apologized for my grief, explaining that this had all happened so fast that we were still trying to process it all.

She tagged me with a bracelet and it was real: I was a patient again. We were taken to a room where a revolving door of techs, nurses, anesthesiologists, and finally the doctor I’d never met before came in and out to sign authorizations, take vitals, and answer any questions we had. Finally it was time to go. My husband and I hugged goodbye and I promised him I’d be okay.

The operating room was true white with flecks of blue and a single table in the middle covered by heated blankets. I nervously hopped up on the table and stared up at the large, round lights above me. It all felt so foreign. The anesthesiologists and nurses surrounded me like a Nascar pit crew. They were talking to me, but I wasn’t listening. Wires were attached, a cuff and oxygen monitor were clipped on, and my hand was getting prepped for an intravenous line. I had warned them that my veins are bad—really bad. I would make a terrible heroin addict. They got hot compresses and took their time trying to find one. I stared up at the lights with silent tears once again streaming into my ears. This is really happening, I thought. The needle burned as they fished around for a vein. My damn veins are always a problem. My son must have inherited them from me. I thought back to a surgery he’d had and all the trouble we’d had with his blood draws and intravenous lines. The only person who could catch a vein on him was a large man with a thick Caribbean-sounding accent named Hector. They called him “The Vein Whisperer.” I wondered if I needed Hector right now. After an eternity they got the needle placed, and the injections stung. I couldn’t look. I laid there staring straight up, overcome by fear and grief. A nurse held my hand, and in a few seconds my eyes were getting heavy. Three more blinks and they were closed. Time stopped.

The next thing I knew I was being wheeled down a hallway. Panicked and disoriented, I said, “I’m still awake!” No one responded. It was already over. In the recovery room the nurses buzzed around me. I pleaded with them to take the needle out, and they asked if it was hurting. Still groggy, I said no, I just don’t like it. I told a nurse I never even had an epidural, as if that helped make my case for removing this needle. I felt dizzy and helpless, and the tears began to flow again as I remembered why I was there. The nurses snapped into action—“Are you in pain? What’s wrong? What can we do?” I squeaked out, “I just wanted a baby, not this. I’m just sad.” The nurse who had previously ignored my request to remove the needle took my hand and said only five words: “I know, it’s not fair.” My sobbing must have caused a commotion, because I heard her repeat to several people, “No, she’s just sad.” They decided to call for my husband, probably because no one wanted to watch a grieving mother awaken from anesthesia alone. As soon as I could walk he went with me to the bathroom and helped me get dressed.

In a different recovery room I was given a warm blanket and water. I shivered under the blanket while they finally removed my intravenous line. A nurse ran through all the discharge paperwork with my husband and sent him off to get my prescriptions filled. He brought the car around, and the discharge nurse helped me outside. She told us to take care of each other as we took off for home. I watched the hospital grow smaller in the side mirror as we drove away, leaving a piece of my heart behind.

As I write this now I lay here, bleeding, exhausted, and trying to make sense of what happened. I know with time we’ll be okay, and we’ll learn to appreciate the things we do have once the empty feeling of what we lost has faded away. I know that the sadness will eventually be replaced by small moments of happiness that will grow exponentially as time passes, and that someday my smile will no longer mask a deep pain inside. Life trudges on.

But the tragedy of it all is that I can’t move on, I can’t forget. Not yet. While everyone else has forgotten, I’ll still have to bring myself to the waiting room to face pregnant mothers and crying newborns every week. Maybe one day an excited first-time mother will smile at me and I’ll ask her how far along she is. Maybe she’ll ask me in return, and I’ll say I’m just here for a checkup. It’s an easier answer than burdening her with the real story. I won’t want to tell her that some mothers don’t get a baby at the end of nine months, they get cancer. Because while my body is healing, my heart is still an open wound. And I’m sure it’ll never be easy to talk about the baby we never had. Of the dreams that were dashed. Of that red card on the door.