Restart in the fall

“Autumn is performing a revue outside the hospital window. Sunshine against a park bench. Small breezes in the trees. Thick scarves. Autumn leaves that float softly through the air. I want to be out there. Be my usual me. It’s been a week since the surgery. Nothing as a whole, but an eon of time right now. As if autumn is passing me by. I’m stuck in here. Will it take another week? Two? Nobody knows.

I’m shaking constantly. The whole body is rebelling against medicines and the invasion of it. Have no energy left. Were we wrong? Was all this just a stupid idea? It’s hard to get distance from everything when you’re in the middle of it. The days before. Now that it is done. What to expect in the future. “It’s important that you focus on something else,” the doctors say. Don’t shut myself in. 

The autumn tree outside the window becomes my focal point. I see it age day by day. Pretend to feel the crisp autumn air in my lungs. Listen to Anders’s words in my heart. That we made the right decision. That we would have regretted if we had not done the surgery. I trust in those words. They calm me. He just repeats what I have said.

If the tree out there can let go of all its leaves, so can I. Let go of the control. Stand bare and skinless for the coming winter. Await my time. It’s all gonna be just fine. This is just a short moment in eons of time.”

***

Autumn has always been my favourite season. A rebirth. As if after a long warm summer I can finally breathe and look up and ahead. A time of clear perspectives and a new drive. But also serenity and thoughtfulness. A much needed break from everything that is shorthold and stressful, to embrace the familiar. Unwind. Peel off. Prepare for the oncoming.

The fall of 2012 was the start to a one big preparation. Up until September 15, most of everything had revolved around the operation. The four meter high wall in a long obstacle course. From there, there were tiny little ditches to cross. Slow de-escalations of medicines. Clear goals for when some of them would be completely excluded. Uterine and blood flow checks that went from weekly to monthly…

Coming home to a warm and embedded apartment was a nice step into the familiar. Something firm and reliable in the overthrow. (Putting on your shoes when going home felt literally like being on land again after a long time at sea.) Walk barefoot on a creaky wooden floor. Light lots of scented candles. Take a long hot shower. All over sudden, all the anxiety disappeared. And the sharp scent of antiseptic. Shaving your legs has never felt so liberating. It is hard to feel like a vibrant woman wearing only a shabby hospital gown and knee-long compression stocking with shaggy legs underneath.

I had a big need to cook in the beginning (not so fond of it usually). A tremendous craving for familiar flavours. Longed for rich stews and creamy pasta sauces. The shaking of the legs made it difficult to remain still. So I kept me busy tidying out and cleaning every inch of the home. (As good as possible with bent back and sore stomach.) Tried to get in place. The psychologist of the team once said that I “restored the fluff in the brain”. Soon enough, the shaking faded. To return again when I got pregnant. The shaking in my legs has become a significant expression of when my body is extremely stressed.

The soul played several tricks on me, autumn 2012. As if I was in the middle of some kind of catharsis. For instance, I had difficulty being outdoors and among large crowds. Looked over my shoulder once and twice before crossing the street, well aware of all the dangers. Physically and mentally I carried a precious cargo. I who normally get caught up in every hospital series, had to turn off every time there was a surgical procedure on the TV. When the movie Avatar went one night, I couldn’t watch it. Panicked a little because the main character was strapped into an incubator-like box. (Also, that he was chairbound was too synonymous with my own unreliable legs.) Strange it was. 

Slowly along the autumn, however, I returned to normal. On the other side of the cleansing. Like the season, my soul changed one tiny shade at a time. Prepared itself. Colors got a wider spectrum. Smells and flavours got an additional ingredient. Reassurance.

This autumn I’m going through something similar. A heavy blanket of weariness, compounded by feelings such as inadequacy and frustration (becoming a parent has been the toughest challenge of my life – for several reasons) has been lifted and the struggle to get to know your child and your new self have matured into a confidence and optimism. It’ll be fine. We are a family now. We find our own way.

(Speaking of reboot, I’m looking for new exciting freelance assignments. Feel free to tip me if you know anyone who needs a Swedish writer or virtual assistant ;))

If someone had told my younger self that it would be long before I became a mother and that the road to it would be a long tangled trail, I probably would have been very unhappy. Now I wouldn’t want it any other way. Today, in addition to a time of recovery, autumn is also a stamp of everything wonderful that has happened to me and our family. In the autumn, we think about the day my husband and I once became a couple, and the day we got married. In the autumn, we notice the day my mother and I were operated on and remember the disappointed embryo transfer the year after. In the autumn we celebrate our son’s birthday.

And that I became a mother (almost) in the autumn of age has become a sign of how much I love autumn.

“Mom, why do the trees lose their leaves?”
“They are preparing for what’s coming”

Things that bloom again. Another thing I’ve come to appreciate as I’ve gotten older.

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Something called cancer gets in the way

The cancer came somewhere between breakfast cereals and evening snacks. Between work and house dreams. Between love and … life. I was unsuspecting.

A pap smear in 2002 shows an atypia which is “difficult to interpret”. Something in my vaginal parts differs from the usual. The sample is retaken after a week and it comes back as normal. I think, that sounds quite weird. But buy entirely the explanation that it “sometimes happens”. At age 23, of course nothing bad happens to you. 

Three years later, I have a new appointment with a pap smear. Before the routine check, I have troubles with a stubbornly aching abdominal pain. I have also sought help for bleeding and irritation in my lower abdomen that feels strange. Then I get the answer that I have an “easily annoyed cervix”, which also seems reasonable. The midwife who does the test this time raises her eyebrows a little surprised when I now have pain and bleed heavily. ”Come back if you get a fever”.

(After those words, I still find it difficult to take midwives seriously. With a few exceptions)

A week later, I call the gynecologist reception at the hospital. I get hospitalized and get antibiotics intravenously for a severe infection on the cervix. The doctor’s test also shows cell changes. The general surgeon is called in and examines me. He plans for an operation where the cervix is to be laser irradiated. A psychologist comes into my room, sits on the side of the bed with her head tilted and puts her hand on my leg. The family is visiting, worried. I calmly explain what is about to happen and what has been indited to me by the doctors. “Cell changes are not dangerous”. It is even a little exciting to be sedated for the first time.

On the post-op are other girls who have undergone the same procedure. They go home after a couple of hours, I am being rolled up to the ward again. At that time, an invasive cervical tumor has taken root in the body, but doctors cleverly avoid the word cancer. Afterwards, I have understood that the staff very well knew what was expected and that cell changes were just a small pretext for the operation. The term “happily unaware” is shoved down the throat. When the doctor enters my room after the operation and wants to talk about his findings, I am completely unprepared. I’m being paralyzed.

We sit in a cell-like minimal room, me and my partner. I see the lips of the doctor moving, but do not understand what he is saying. Thoughts wanders off. I am bothered by the psychologist’s red lipstick and aunty hairstyle. And I think to myself that it is a strange thought to be having when the doctor tells me that I have cancer.

My case is taken over by the Sahlgrenska University Hospital in Gothenburg, where the doctor does an examination under anesthesia. The general surgeon at the town hospital is confident and assures me that he has probably removed everything when he did the radiating. “This is just a routine procedure”. Once again, I’m being fooled. The second time in a short while I am lying in a post-op. I see the doctor who examined me walking around to the other women and talking reassuringly to them, they are smiling relieved. Me, she walks just past, without wanting to face me. The fear grabs me, instinctively I know what that means. Quiet tears aches within me. I hold my breath for two days.

I’m back in the hospital on a Wednesday. In an as small room as the last one. In sweeps a storm of disaster, disguised to my doctor. As scaled-down and light-hearted as announsing what´s for dinner, she gives me the information I have feared. “As I suspected, the cancer remains, so we will remove it”. Cervix, lymph nodes, tissue and uterus. Everything will be removed. It takes a while to realize what she says. Within me, an abyss opens. I have hold my breath for so long that I no longer can breathe. Out comes a scream and the beginning of a flood of ​​dammed and uncontrolled crying. The doctor is confused, “I thought you were informed”.

I leave the hospital shocked and mentally turned off. In the car home, me and my partner sit quiet. The tears run down my face, I don’t even care to wipe them. In the luggage there is a drying rack for the bathroom, which we had intended to return at Ikea after the conversation with the doctor. How incredible stupid. It is no longer possible to ignore the problem, this is really happening. On Tuesday I will be operated. For five days I cry constantly, there is not more time. The partner says the right things in the moment, but deep down I know this will not last. Not because I am playing martyrs and feel sorry for myself. Because I just know. Our relationship is not built to cope with this disaster. We have just moved to a house, it is now that life with plans for family should take over. Something called cancer gets in the way. My life will not be the same.

April 12, 2005, at 6.10 am, I am outside the hospital gate. I haven’t slept all night. I do not understand how the body is steered into the hospital when the panic and predator within me scream to run away. I have such anxiety that it feels like I’m going to fall apart. I am 10 minutes late and I get a scolding from a stodgy nurse. I feel like I want to kill her.

With thin drapes in between we are lined up. Like cattle on their way to slaughter. One after the other we are rolled away, sometimes there is a slight traffic jam in the hub into the operating rooms. Someone screams in anxiety – “I don’t want this!”. It could have been me. If it wasn’t because I’m afraid of losing it. Even in the worst time of my life, I am too well behaved to be troublesome.

The surgery goes well. The test results are positive. As quick as I was with cancer, as quick it is removed from me. I never even felt sick. Left is a scar on the stomach, which reminds me the days I wake up and supposedly believe that everything is like it was before. That everything was just a nightmare. And that I could still be a mother. Left is also an indescribable anger that the universe and one of Sweden’s foremost hospitals deprived me of the most sacred. Afterwards, they leave the anxiety of not understanding why I, by a gathering of older women, is the only 25-year-old at the ward. A nurse wants to talk about how I look inside after the surgery, wants to give me the tools to process. But I’m not there. I do not know how to explain that the doctors dug a larger hole within me than the size of a uterus. Surely I will regret that I do not listen, but I just want to go home. Establishe a strategy to cope with the days in the hospital, one minute at a time. I bury the psychological pain in a safe place deep within me where no one can access it. Cancer is gone. Outwards, everything is just fine.

Two months after I first received the diagnosis, I am back at work. Everyone seem relieved that I take everything so well. I talk about everything that has happened and I feel invincible. Feed of the attention I get. I tell myself that I am indeed strong and that I got away lightly. “There are always those who have it worse”. The partner moves out and I bury myself in work. What defined me up to the cancer has been an insatiable energy and demands of performance. I’m not going to stop now. Fight bravely not to change. It works for a while. As people move on from what has happened to me and the everyday is back to normale, the emptiness within me grows larger. At lunch breaks, I pull away from the others. Can’t bear to listen to their talk about families anymore. Can’t bear to keep up the facade for their staring eyes. I’m not the same anymore. My rescue becomes a fatigue depression, one year after the surgery, which is piercing everything. Only then, I let go of the control over my feelings.

Then I will also rejoice

September 2012

I’m not good at being sick. (Is there anyone who is? How do they do?). I close myself. Wear an invisible blanket around me and bite the bullet until I’m capable enough to take the world in again. Being in bed at a hospital and in the hands of healthcare staff do something to me. I feel small and diminished. It all reminds me too much of the past. When I had cancer and they took my uterus. I was the only 25-year-old among a bunch of elderly ladies who sat in the tv room and read gossip newspapers, seemingly untouched. I thought my life was over. Never before have I felt so lonely and devastated.

This time it’s different. The operation is voluntary and not traumatic in that way. Literally, it may give me another life. Yet, it’s hard. I don´t recognize myself. My eyes are blurry and my brain is sluggish and syrupy. I strain myself to formulate words to people around me. The body is stressed. Speeded. The pulse rises to the double as soon as I move. I have never tried drugs but I imagine it’s like this when you are high. I feel chased. Would like to strap on a pair of running shoes and run as fast as I can. Although I’m one of the world’s laziest people. The troublesome shaking does not want to stop, the worst is in the legs. In order to get some rest, I force myself to the bed and firmly press down the legs flat against the sheets. Restless legs have got a whole new meaning.

The doctors are looking for explanations for my and S’s condition. Some symptoms are typical side effects of the drugs and will ease. Others, such as shaking, are puzzling. They consult and give the drug manufacturers a call. The explanation they finally agree on is that we have received a bad batch of the medicine given in high doses at the time of surgery to knock out the immune system.  Mats Brännström, chief of the project, is worried. A whole world has become aware of his life work and the pressure is enormous. And we are worn-out and depressed at the hospital. He has nightmares involving a black lump of organ coming out of us and he tells me ”You have to pull yourself together”. Han calls my partner and asks him to bring magazines and other things that will distract me. And then he sends up the team’s psychologist.

We have talked about this though. What happens to the mind and body when moving from a healthy state to a sick. The other patients at the ward have usually been sick from kidney or liver disease for a long time and usually recover a few days after the transplantation. Often, the donor is worse than the patient. Now it’s the opposite. My mother is a patient at the women’s clinic, but walks relatively unconcerned across the hospital area to visit me a couple of days after the surgery. A day after that she is released from hospital. I continue to vomit and shake.

Against the pain from the surgical wound, I get headache pills. Against the shakes they give me morphine syringes. First intravenously. Then straight into the legs. When that does not work, I do the thing that gives me a fairly relief. I walk. I walk manically in circles, at first in my room and later on in the corridor. Lap after lap, I walk in my Foppa slippers, day and night. Sleeping pills have no effect. Eventually we are allowed to go outside the ward and down to the main entrance. In the hospital area there is a construction site. Building dust and sensitivity of infections are a bad combination for us and we need to wear a mask and a chunky coat over our clothes. S comes back from a trip to 7 eleven, crying. She feels like an alien that everyone is staring at. I don´t have the energy to care. Steeled, on the verge of resigned, I keep my fake smile on and try to do what is expected of me. No nurse likes a grumpy patient. It feels a bit embarrassing to be down and gloomy after an operation like this one. I swallow my medicines, drink a lot from the can and write down how much I pee and eat. Trying to get as much food as possible in me, though only the smell of food makes me nauseous. I avoid the day room for that reason. Also, I do not want to risk having to talk to any of the other patients. It feels extradited and tricky to get me into a discussion that I have a transplanted womb. I let them believe I’m kidney or liver transplanted.

With the uterus it is all good

With the uterus itself however, it’s all good. That’s nice. Every day, Dr. Liza comes in and measures the flow of the uterine arteries. They are the ones who provide the uterus with strength and those which the entire operation is depending on. On the ultrasound scans you can see how my vagina is once again connected with something bigger. A room for a child. Inside the uterus is the endometrium, the layer whose thickness will be decisive for an embryo to get caught. On the ward where we are located, a special examination room has been set up for us. On shaky legs we crawl up in the gynecological chair to do the first biopsies on the uterus. Those who show how the uterus really feels. It looks good. Mats Brännström is relieved. I long for home. I need to get out of my shell and lick my wounds in private. Feel like myself again. Then I can also be happy about the operation.

On the twelfth day, I´m finally released. I go home. I breathe out. Five days later I’m back in the hospital. I have a fever and a diffuse pain in the abdomen. The body shows all signs of a rejection.

 

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Waking up to the news
Day 4. Monitored at hospital.

Waking up to the news

September 19th 2012.

”Are you listening?” My fellow sister in the other end of the room, whom I have not yet talked to, increases the sound to the television. On the news they talk about the uterus transplantation that took place this weekend. Two women in their 30s who got new wombs by their own mothers. An operation that Sahlgrenska University Hospital is first in the world with. One woman (me) has previously got her uterus removed after having undergone treatment for cervical cancer. The other woman (S) is born without uterus. “The operations were successful and all patients are doing well.”

My surgery was Saturday. Today is Wednesday. Sunday, Monday and Tuesday have gone by in a one big blur. First in a recovering room where I disappear in and out of a haze. Each time I wake up, it beeps frenetically in the monitors above me and stressed nurses instruct me to take long breaths in an oxygen mask. They try to put a bigger mask on me, a CPAP, which will remove the fluid in my lungs. But the mask works badly and gives me panic disorder. Ultimately, I refuse.

Somewhere in the same room is my mom. I´m too groggy to register it though. A day after me, S also rolls in. Same frenetic beeping. Our general condition is worse than expected and the original plan to relocate us to the transplant ward is thrown-away. Early Monday morning we roll with blinking monitors and oxygen masks to an intensive care unit. To protect us from potential press and computer hacking, the instructions from the team are to keep records by hand. We go under the radar. When my loved one calls to say good night, they do not know who to give the phone to. I’m not in the system.

In a broader perspective, it´s however soon clear who we are. We are those “complicated” patients who are part of a new research project, which many consider to be “unnecessary”. One of those operations that falls under quality of life and not life saving. Which will take time and money from those who really need care. And we are treated accordingly. When the nurse from the transplant ward comes down to provide us with medications she is faced with skepticism and resistance from the other nurses.

The intensive care unit is neat and modern and the equipment is better than the one in the recovering room. I can´t get away from the CPAP. Even here they come running as soon as I wake up and force the mask on me. I pretend I´m sleeping. S has left the unit before me. The anaesthesiologist from the team prescribes me tranquillizing to endure the sessions in the mask. I close myself mentally and disappear somewhere where I’m not newly operated and fragile. Locked in the mask, I count to 30 as I’m told. I dream that I’m drowning and fight the air fervently so that they do not forget to release me.

On the fourth day

The press conference was yesterday. I wonder what kind of questions the doctors got and how the spirit between them was. Now everything is on the news. I only half listen to it though. I´m having trouble imagining the world outside the hospital window, even less that it’s me they talk about on television. It´s just after eight o´clock and the nurse is messing about in the room. Sets the medicine cup and the canopy with water on the bedside table. Replaces the drip and clears the catheter. Checks the dressing on the stomach. The scar from the navel and down to the pubic hair senses weakly underneath. It crosses the bikini incision from my cancer surgery. I have IV drip for nutrion, catheter, oxygen halter and is connected to a telemetry for increased heart rhythm. I feel queasy and is alternately freezing and sweating. I´m dizzy and breathless. As if I had gone a wrestling match and can´t get the body to rest. The fact that the entire abdomen is numbed and it´s difficult to move, I´m in some way used to. The body and I have been prepared for the pain that would come, the one we remember from before. Same operation, but reversed. I crawl up to a half-seated position to swallow the tablets and lay down again on the side. S calls out from the other side of the room, asking me how I do it. Her body is unable to turn in any direction, and she has slept on her back all night.

Into the room sweeps another nurse. Talking loud and blatant. She seems to have made efforts to ensure that she will be taking care of us today, usually she is not at this ward. Don´t know if I´m delighted or uncomfortable. She flatters and chatters about how big this is, how courageous we are and that she knows a thing or two about involuntary childlessness. I wonder whether the behavior is so professional of her but hummar polite now and then. The effect of the tablets is reminiscent and the increasing nausea makes it difficult to be nice. But this nurse does not seem to notice anything. S walks past the bed, faltering and bent forward, with the IV drip rolling in front of her. The nurse continues to talk. I lean over the bed and vomit in a sick bag. In my head I hear the words from the news broadcast “The women are doing well but are tired after the surgery”. S and I smile of recognition towards each other. It’s all a very strange situation we are in.

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World’s first womb transplantation from mother to daughter
Eyes on surgery.

World’s first womb transplantation from mother to daughter

1998. In a patient room at the Royal Hospital in Adelaide, Australia, a 25-year-old woman has just been told she has cervical cancer – stage 1B. Angela. The prognosis for her survival is good, but doctors Mats Brännström and Ash Hanafy want to remove her uterus. Mats: “That means you can´t have children”. Angela: “But can´t you transplant a uterus the day I want children?” The question is simple and the solution to a large infertility problem should be as simple. Why can´t you transplant a uterus? Bothered by the question Mats is forced to reply: “No, that’s not possible. Maybe in the future”.

2012. The moment they all been waiting and training for, are here. In an operating room at the University Hospital in Gothenburg, a group of surgeons and nurses are gathered for a time out. Customary before an operation is to go around and present themselves. So even today. Main operator Mats Brännström says: “Today we are going to do a uterine transplant. The first.” They nod gravely. Embrace the moment. The patient on the operating table is a Swedish woman who, at age 25, lost her uterus in cervical cancer – stage 1B. Me.

***

The operation

September 15th 2012

The night before the big operation, they meet. Gynecologists, transplant surgeons, everyone who are surgically involved in the project. After 15 years, it´s about 15 people. Now they run everything through one last time – the procedures, who will do what and who will be in each operating room. The one with the donor or the one with the patient. They talk about media. So far, Sahlgrenska and the team have kept a low profile, but they can not be sure that the press has got news about Sweden’s first uterus transplant and that they will be outside the hospital the next morning. Niklas Kvarnström, one of the transplant surgeons, calls the patient and inform her their strategy. If the press is watching the main entrance, she should call one of the nurses who will let her in through the back door.

They arrive early. Some of them change clothes in a building further away and then walk to the operating rooms through the culverts, just in case. It is Saturday and the corridors are empty. Just as planned. The research should in no way interfere with ordinary activities. The staff who work in the aftercare this day have previously notified their interest in working an extra shift.

Gynecologist team one initiates the operation. Well skilled, they lay the first cut. A so-called midline cut that extends two centimeters above the navel. The woman, the patient’s mother, is a 52-year-old healthy woman who has given birth to three children vaginally without complications. An exemplary donor. X-rays and rigorous studies show that uterus and surrounding vessels are equally exemplary – whether that is true or not they won´t know for sure until they open up. Do they hold their breath?

They inspect. The uterus is of normal size and slightly backward. On the left side there is an active ovarian and inside is even an follicle. The right ovarian is somewhat atrophied. Of the relatively common muscular tumor myomy, there are thankfully no signs of.

A grueling work begins. The space in a woman’s pelvis is surgical minimal and the uterus is clamped between urethra, urinary bladder, fallopian tube, ovaries and intestines. Around these weaves a fine mesh of a variety of thin blood vessels. Just as with an archaeological excavation, all this must be carefully distinguished and separated. The longer vessels the better. Vessels that will accompany the uterus to the other body. They divide, dissect and cut.

In the operating room next door, they prepare the patient. The device they use to cut the tissue is slightly malfunction and the device is replaced. Between the bowel and ovaries, the gynecologist team two detects some adhesions, from the patient’s previous surgery. Then when the uterus was removed. The cavity after the first uterus has also caused the bladder and rectum to slightly collapse and the ureters are glued to the pelvic wall. Further down behind the bladder, more adhesions are detected. Thicker ones. They search for the ligaments that the uterus usually is attached to. Stubs that after the removal have been degenerated but is now marked with threads for the new uterus. Two on the side and two back down towards the rectum. Pelvis vessels from before are also picked up. On them they place small rubber bands for easier access later on. In wait of the transplant, the open wound is covered up.

It takes time. Much more time than they expected. The veins in the donor’s abdomen are twisted and collapse easily. A little naive, the team has assumed that the operation should be almost identical to the procedures on the baboons, perhaps even a little shorter because the anatomy of a human being is bigger. It did not. Womb transplantation is an advanced affair. But the surgeons are tough. Concentrated. They talk and laugh. And when it gets critical it becomes dead silent. Three at a time they take turns in the surgical wound, burning and holding. Outside the operating rooms, in a barren waiting room, the patient’s partner waits. Trying to make time pass he watches movies on the phone – first one, then several. He even falls asleep a couple of times.

On the arena, the transplant surgeons finally enter. They stand for a while and reflects the operating wound before they finish the releasing of the vessels. The uterus is taken out. Thoughtfully they place it on a separate table where it is flushed and iced. When it disappears from the room, the donor’s team of gynecologists remains. Closing the wound. From here it’s like any other operation. Gently they place a final hand on the woman’s body. The work of her and the gynecologists has now been completed.

They sew. Ligament. Veins. Arteries. Then the final solemn moment remains. The clamps that block the blood flow during the operation are loosened and the blood is released. The uterus gets a nice pink colour in just a few seconds. On the right side, the flowmeter measures about 15 ml per minute. On the left about 60 ml per minute. The transplant surgeons take a break and the patient’s gynecological team sews the suspension ligament and the vagina. When the transplant team attends once again, the flow reaches approximately 50 ml on the right side and 70 ml on the left side. They are pleased with that.

When the patient is rolled out of surgery, it is night time. The team of around 15 people elected to perform the world’s first womb transplant from mother to daughter has been operating for 18 hours. It’s like a relay race. Methodically and tactically, they run one lap at a time, hour after hour. Like persistent runners they are trained to endure lactic acid and mental stress. The adrenaline that pumps during the long waking hours keeps them alert. Afterwards a wave of exhaustion rinses over them.

A clear September day has passed them by entirely. In the cool autumn darkness, they now pull the jacket close to the body and slowly walk across the parking lot. At the car they stop for a short while gazing out to the horizon where the sun soon will rise. They take a deep breath and sigh satisfied. It is done.

In just a couple of hours, they will gather here again. For the next operation. Tomorrow, another woman will be given a uterus from her mother.

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