When the world seems to vanish

December 2nd, 2013. Maya and Jada Choi are born around 9:52 and 9:53am in Berkeley, CA. The twin girls of my baby brother and his wife.  Beautiful and healthy babies. It was a proud moment for my parents and my brother's wife's parents. But, in a very different way, it was a very proud moment for me. I heard the nurse (on several occasions) call my brother "dad." My little brother, who I played baseball with in the streets of our neighborhood, that always did so much better in school than I ever did, who I literally pushed into a pile of shit when he was in 2nd grade, who I saw get 1st place in track and field when he was in elementary school, who asked me for advice when he had relationship problems,  who delivered an amazing speech at my wedding......my baby brother, was now a father.  He and his wife have made a very good life for themselves and both my wife and I (as well as our entire extended family) are very proud of them. As I said before, sometimes in life, it pays to be a good person.  This is one of those cases.

As my wife and I walked back to our car to drive back home, I began to think of how lucky I was to be married to such a patient and understanding woman.  You see, amongst the many things that come with being infertile and not being able to have biological kid, we also miss out on all the pre-baby and birth-related activities.  No baby showers. No gifts. No visits and cards. No one calling us mom or dad. No bonding experiences. No parties.  No decorations. No baby themes.  No congratulations. No excitement. But God has blessed me enough to at least share out adoption process with my wife. And on the way home, I realized, in the end - it's pretty much just me and her facing this uncertain and difficult adoption.

I know I shouldn't have to feel indebted to my wife - but the fact is, I do. Innately, and permanently. And I don't mind, in fact, sometimes, it makes me a better person. Perhaps, an even more grateful person.  Amongst all the nice aforementioned pleasantries of gifts and congratulations and  celebrations, she will also never look at her new born child. Nor watch her child grow to take their first steps or say their first words. She will miss the first teeth that come in, and many other important firsts. Our first interaction with our child will be inside of a social services department building in Seoul, South Korea where we will have a supervised visit as we try not to scare our child to death with our English-accented Korean.  No one will be there to congratulate us. There'll be no gifts. No hugs.  No celebration.  There'll be a judge that will yap out a verdict, then a few legal items, and then the long flight back home where we suddenly have to adjust to being adoptive parents to a nearly 2 year old toddler.  And in the face of this challenge, my wife stays incredibly strong and her faith in me, in us, never wavers. Ever.

And so for this reason, I try my hardest to be that crowd, the friends, and the person that will always congratulate her and make her feel special. To help her celebrate our life, even when everyone else has so much going on in theirs (especially now that our siblings have multiple children). And so I  take her on trips and see her smile, see her face light up as we share experiences. I try to hold her just a little tighter and longer and make her laugh - its what I should do and just a few of the things I want to do.  I take her to events and places that make her happy.  Try and go to bed early and watch TV with her instead of working.  And take the burden of the immense paperwork and legal hindrance that has become our adoption process.  Try to find time to spend with her family and our niece and nephews to make us remember the family that surrounds us.  I strive to be the support she needs and the husband that I have to be. Because, for the time being, that's all I can do. It's the little that I can do to try to make our lives better and to give my wife something, anything to look forward to. For all that my loving wife has suffered through, in the end, my devotion to her, while somewhat rooted in gratitude for her sacrifices, is more heavily rooted in the depth of our marriage. A marriage which has evolved and grown from the naive, yet meaningful love of our youth in to a resilient and enduring story laced with ardor. So to her I would like to leave this quote:

"I could not tell you if I loved you the first moment I saw you, or if it was the second or third or fourth. But I remember the first moment I looked at you walking toward me and realized that somehow the rest of the world seemed to vanish when I was with you."

Returning the favor

In the fall of 2008, I decided that I was going to ask Jennie to marry me.  I went to her parents house  to ask for her hand in marriage.  I knew it was going to be a non-trivial thing to do, but I had no idea it was going to be so difficult.  It was one of the most enduring and grueling things I've ever experienced. Amongst the many things I was questioned about during what seemed like an interrogation, is her dad asking me (a bit spitefully): "how do you know that if you marry my daughter, your marriage will happy and ever lasting?"

They asked me many questions, some very difficult to answer, some embarrassing, most irrelevant. Of them all, that question was the easiest to answer. I took no time to reply "I don't know, and even if I somehow could, I wouldn't want to."  I knew going in that I was choosing the person to face all the uncertainties of life with. That as selfish and prideful as a person I knew I could be, she was one of the few people I have ever wanted to do more for than myself.  That I would be as strong as I could, so that she could tether herself to me when she felt like the world was spinning out of control. That I would be her rock when she felt fragile, her reassuring husband when she got scared, someone that could brighten her day when things looked broken. The person to restore faith, and possibly hope when things looked their absolute darkest.

What I didn't know, what I didn't expect, was just how much more the favor would be returned by my quiet, timid, and shy wife.  Between 2009 (the year we were married) and 2012, we would encounter the following hindrances: losing nearly our entire savings (late 2009), our credit rating lowered to an embarrassingly low number (2011), and, of course, our struggles with infertility (2012). And while there were moments when my wife would feel overwhelmed, scared, and depressed - she was miraculously strong and steadfast through those years and continues to be an incredibly strong and, therefore, inspiring person.

The funny thing is, she will be the first person to tell you that she is a timid and weak person.  She doesn't like to order in Korean at a Korean restaurant, she hates confrontations, she gets scared asking her boss for time-off or pay raises.  And, yet, she is able to (many times reluctantly) perform some of the bravest things I've ever experienced, among them this short list: zip lining through the mountain side of Puerto Vallarta, scuba diving in off the cost of Aruba, placing large tarantulas on her face and snakes around her body while posing for pictures. She's been stung by a jellyfish, held stingrays off the coast of the Cayman Islands (where she also saw me get bit by a female stingray),  experienced tumultuous floods in Cabo San Lucas where we walked barefoot to get help when our car died in the street. Before doing any of the aforementioned things, she was always very scared, and a few times literally almost backed out at the last second. But she stayed strong, persevering and conquering things that she was fearful of.....for me.

Until very recently, I never really thought about why so many older people at weddings (particularly our parents) cry so much at weddings.  I always assumed it was because they were losing their daughter or son, or because they were so proud of them at that moment.  I'm sure that is part of the reason, but I think the bigger, deeper reason is because after being married (or having experienced the trials of marriage) they know what it means to pick someone to take the roller coaster of a ride with. That venturing into something like marriage means you are taking a humongous gamble. An unpredictable journey that will have you gasping for air during times of laughter and joy, and hurling all kinds of items while yelling hurtful explicatives during times of turmoil and frustration.

The only thing you can do is marry someone that is worth sacrificing for, that makes you strive for things you wouldn't have otherwise by yourself.  A person that makes you want to face the many things that are easier to avoid. In this way, selflessly - we start to (most of the time unbeknownst to us) morph into a person, the person, that will become a better husband or wife, and undoubtedly be one of the main steps in becoming a responsible parent.  I guess in this way, a wedding is (many times) the start of a transformation. A transformation whereby we lose some of our stubborn, uncompromising ways and gain the courage to truly sacrifice and exercise real strength in the face of the grimmest and bleakest of times.  A transformation which likely takes years, that may begin with simple things such as overcoming fears, but ends with the deepest and most devoted acts of love.  Jennie may never know the full depth of inspiration and change that she has brought, nor be aware of  the beautiful, caring and courageous person she has become in the process.  When I think about all that could go wrong and the challenges that come with becoming parents to an adopted child, I can derive comfort and strength from a single thought:  In the midst of the darkest and most trying of times, it was then that Jennie's love and spirit shined brightest.

Smiles and Band-Aids

October 21st, 2013 - it is now nearly 16 months since the start of our adoption journey.  The past 7 weeks have seen Jennie and I go through 3 different fingerprint screenings, including one that took place on the very same day as the baby shower held by my brother and his wife. In a funny way, it was like both of us were taking a small step towards parenthood. The circumstances were a little different, however.

They were showered with gifts and friends rejoiced their pregnancy, and rightfully so.  They are good people, living their life honestly, surrounded by friends they value.  Meanwhile, Jennie and I stood in an old Postal Annex shop in San Jose, being questioned about our integrity to adopt and our worthiness of becoming parents. Another set of fingerprints, the third time in 7 weeks we had to do so. Additionally, we had the exquisite opportunity of re-doing our paperwork and working with not one, but two inefficient and tragically unfocused governments who help us inch towards finalizing our adoption.

Here's something that people outside of buying a home almost never experience: mass document notarization.  In the past 7 weeks alone, we have notarized more than 20 documents, each containing 2 signatures - EACH of which need to be notarized. "Google" notary fees in California and you will find that the average charge is $10 per signature on top of the $150 per fingerprint session. Yes, just another blissful part of adopting a child.  What other joyful events have Jennie and I took part in you ask? There couldn't possible be anything more exciting and convenient, could there?

The last update Jennie and I received regarding our child has been more than 9 weeks ago - that's 73 days without ANY update whatsoever as to the progress or health of our child. No pictures. No letters. Earlier I mentioned that our potential adoptive son (Tae Yeong) seems more like a myth to me than a reality. Nowadays the thoughts of him and his pictures seem like a hazy dream that is fading before it even materialized into something I could remember.

A few days ago I forgot to call my mom to thank her and let her know that I have received the food she left on my doorstep.  We were in a rush to go see my wife's sister and her family (the aforementioned newborn and 19 month old boy) and had forgotten to return her call earlier in the day.  We called back that evening and one of the things she said to me after I thanked her for the food and asked her what she would want for her birthday was "I don't want anything for my birthday, I'm just very sad these days. Having you guys call me back and thank me for the food is what I wish you guys would do in a timely manner."  And she is right, and I'm sure she has had her share of heartbreak and sorrow during this time.  But during this infinite sadness, where was her call after I had a surgical procedure done a year ago? Where was she when I had 30 appointments going from hospitals to clinics to specialists to laboratories?  Where were her calls and condolences when I had court appearances, social workers, and government agencies make feel like I was a criminal trying to adopt a child while dealing with the life-altering diagnosis of azoospermia?  And when I sat in the parking lot of Good Samaritan Hospital and my life felt like it had ended - where was everyone? Where was anyone? In truth, my parents (and friends) are great people and I could care less about my parents going about their lives normally as Jennie and I combat our issues. They have my brother and Helen to help take care of and be excited about, that far outweighs anything Jennie and I deal with.  Being grandparents is the reward for wrinkles and aging bones. But for her to make that statement to me is a bit offensive.  The worst part? That's my own mother telling me something like that without even thinking about the larger picture.  I can only imagine the perspective that my brother and friends must have.

Not everything has been difficult. The past few weeks have been filled with several good things that I am very thankful for. My brother and his wife are progressing very well in their pregnancy - their twin girls seem to be doing very well and they have started to convert a room to a nursery.  My niece was born August 29th. She is beautiful and both her parents are doing well and are an even happier family now that their family has grown by another member. And earlier this month in October, Jennie and I took a memorable trip to Italy.

I saw my wife smile and enjoy herself while walking and taking in the sights of Rome and Florence. And looking back at some of the pictures we took while vacationing, I think you could almost mistake us for a couple taking a honeymoon in Italy.  Almost.

What they wouldn't see is that on some days we can barely hold each other up.  That we try and rejoice when we can with the people that mean the most to us. And when we do share those moments with the people we care about most, we DO lose ourselves and forget our problems and the constant state of coping that comes with infertility and, now, the uncertainty of adoption.  But those smiles and sounds of laughter are fleeting.  After spending time celebrating with our siblings families, even a  simple task of walking back to our car or driving back to our home......our life, can sometimes be like a temporary state of amnesia fading with the realities floating back into our minds.

The truth is, people do care, but they don't really want to hear everything.  They don't have time and they have their own problems and things they need to share. And I have to be willing to listen.  I know that in some way, they see me as the guy that makes jokes, fools around, and laughs loudly.  And only upon returning to that type of personality do they start to think things are okay.  Hanging out with us - with our current issues and depression, can't be an easy thing to experience.  I'm sure it's hard for our family and friends to see us going through these difficulties.  And so I don't bring up our adoption or infertility issues. Ever. And Jennie and I whole heartedly find joy in both our sibling's journey into becoming parents and raising a family.  Sometimes, though, I do find myself indulging and yearning.......in the hopes that some of the people in my life will know this:

Smiles are like Band-aids, they cover up the pain, but it still hurts underneath.

Maybe in another life

Today, I turned 34 years old. In about 2 hours and 40 mins, it'll nearly to the minute. I once went to a delivery room at UCLA's medical center on my birthday and met a roomful of newborns who will all share the same birthday as me.  I guess today I feel grateful, and it was the first time in a very long time that I prayed in the early morning thanking God for the life I have.

I have a lot to be thankful for on this 34th birthday of mine. My friend Paul from my younger days drove out to see me, gave me a $10 lotto ticket, 2 century movie tickets, and took me out to lunch. I can't even remember the last time a friend of mine gave me a birthday gift. And my wife today brought home some korean food (kimbap) from the Korean grocery store, and I was both surprised and excited to eat with my wife. All in all, it was a good day, and its days like this that make me feel like I have things to look forward to. Like I mentioned in the quote from Tuesdays with Morrie, we need to limit our self-pity. And today, on my birthday, I look to a son that I have never met to find strength,  to not only be a better dad one day, but to be a stronger, better, and more optimistic person.

Some 5500 miles away from me lives a 16 month old boy that I have never met, heard the voice of, and long to see. He is our potential adoptive son with whom we have been matched with since the beginning of this year, in early January.  While there lies more than 6-7 months left before we will even be given the opportunity to officially adopt him, my wife and I struggle to imagine the adjustment and awkwardness that will surface upon his arrival. And when he does come home, we will suddenly be parents, of a child that is nearly 2 years of age (if not older).  That horrifies us, but also inspires us.

Sometimes, (admittedly) not very frequently, I wake up in an optimistic mood where I think my infertility is a result of God's grace and infinite mercy. That in a past life I asked God for a second chance to relive my life without children because in that life my wife and child die during childbirth and he has given me the chance to do-over that traumatic event. Or that in some warped or twisted fashion, this scenario where our adoptive son T has become an orphan will have his shitty situation met with our sorrowful endeavor and as a result, we will rise triumphant in this life together. I do find it nice to have those thoughts, but they are usually fleeting and outnumbered by days of depression.  The harsh reality remains: I face the world each and every day with the fact that I am a man that literally can not impregnate my own wife.....who's wife suffers each day as her own fertility starts to wind down as she inches every year closer to 40.....and I watch helplessly unable to take away our pains and suffering no matter my efforts.....and I have to find the courage to persevere through this depression and self-pity. Because in this world, the real world, its becomes my wife and I alone whom face our fate together, and try to salvage the vision of a life we once had for ourselves.

Maybe, in another life, my wife and I had or will have our own biological children.  In that life we don't have the deep and painful sorrow of not being able to reproduce. We don't stress over health issues, international adoptions laws, infertility and fingerprints, doctor's appointments and court dates, immigration and social workers........ and that just maybe the only things that make us cry are the movies we watch on Netflix, and the only things that depress us are the problems our children have at school.  I like to imagine that sometimes. But that's just my imagination running away.....but I will continue to try to make this life one that my wife and I can look back on and feel proud of and one that we truly feel we tried our best at, even if it turned out bumpier than we would've like, and not exactly the way we planned it.

Why we blog, why we read blogs

We all know that parts of life can be very profound and yet, sometimes they can be extremely petty. We know, for instance, friendships can leave us annoyed and while other times they reign triumphant, even inspiring. I guess that's the reason the stories told in books, articles, movies and even blogs can be so meaningful - they help remind us of those instances and sometimes put into perspective the things we so often overlook and take for granted.

Let me put this into a bit of context for clarity. For example, during traumatic events, stressful, and depressing times, its easy to forget about all those around you willing to help, and to view them as neglectful.  Sometimes, during these events when you feel like you've been abandoned by your friends and family, you happen to read an article or watch a movie..... and for a moment, you're hit with the realization that maybe things are different from how they seem in your head.  After all, your friends have their own problems, and while your problems may seem insurmountable in your life at the moment, your friends have their own life to live - their own issues they struggle to look past.

Think about an impressionistic painting: when you are up close to the painting you can see all the strokes and details. Without stepping back and taking the full painting at once, you loose the full effect the artist had in mind when creating the painting. Likewise, when we critique our friends and family on each and every occasion, it is easy to find flaws and shortcomings.  Particularly when things get hard and you need help, it can be all too easy to feel shafted by your friends. And then you watch a movie or read a great blog or hear the perfect song..... it helps you take a mental and psychological step back on the situation and your friendships. It reminds you of the bigger and more complete picture: your friends (the ones that really matter) are the ones that cheer the loudest when you succeed, that suffer with you and feel your pain when you fall, and that act as your foundation when you feel your world is crumbling from underneath you.  After all, the friends that are closest, that know you best, they are the ones that sometimes know you better than you know yourself.

"A friend is someone who can see the truth and pain in you even when you are fooling everyone else."

Trying to Feel Normal Again

Today, I heard a song by Ben Rector that, as songs tend to do from time to time, resonated with me as it spoke to some of the depression I have struggled with on a daily basis.  The song is called "When a Heart Breaks," and while it sounds like a it might be about a broken relationship and love, when I listened to the song carefully, it's about a little more than that. In fact, without speaking to the artist himself, I'm pretty sure the song is about the bigger struggles in life, the ones that are life changing and sudden.  The ones that make you trule re-evaluate life.

The start of the song is somewhat expected: he speaks of waking up and receiving heartbreaking news, but it's the second verse that struck a chord with me:

I heard the doctor
But what did he say
I knew I was fine about this time yesterday
I don't need answers
I just need some peace
I just need someone who could help me get some sleep
Who could help me get some sleep

The world definitely gets the volume turned down and all the little things that you were petty about leading up to a moment that changed your life, such as a life changing diagnosis from your doctor. That is something you can never be prepared for. And you wake up the next morning thinking, for a second, was it all a dream? But you know it wasn't. And all you want to do is sleep. Forever.

These days, my friends and family rarely see me, rarely call me, rarely contact me.  In fact, I can hardly remember that last time any of my "best" friends called me to shoot the shit or ask how I was doing. Nearly every time we have seen or spoken in the past few years has been initiated by me, and I have no problem with that.  But now that I'm in a bit of a depression, it would be nice to have them come around unexpectedly, or call to check up.  But they never do. And it does break my heart.

When we do talk, specifically about my azoospermic condition, most of the time, my friends and family are saying how bad they feel for me, how they wish they could do something. Sometimes, I wish I could respond "how come you guys all sound like a hallmark card for people in the hospital?" I know people are busy, but it would be nice to hear something from someone that, like Ben Rector said - would help me sleep a little better. I guess it'd just be nice to know that someone actually tried to put themselves in my shoes. Not just a fleeting thought, but a real try. But that's not even the best thing they could do.

I remember one time when I was getting punished by my father for something I did, my dog at the time (she was a german shepard-labrador mix) kept sitting next to me. I pushed her away, and then she came back. I yelled at her, moved away from her, and pushed her again and again.  But she was relentless and eventually I put my arm around her and I felt a lot better.  My friend C had similar perseverance when dealing with my depression and hibernating status.  I realize more and more how much my friend C (mentioned before in this blog) really came through for me. As much as I told him not to show up, and as much as I didn't want to go out and see him or anyone else, he'd swing by even if it was only to hang out in my living room. He didn't press any issues, he didn't ask me anything. He would disguise the encounter with saying "let's just get something to eat real quick." And when we did talk about some of the difficult things that I was going through, he just listened. I mean really listened, and responded with genuine responses, not just random statements of positivity or condolences. It was simple, but it made all the difference.

I guess I thought I could just crawl into a lonely hibernation and avoid contact. I was wrong. Depression, guilt, and overall confusion just kept getting worse.  But with the help of my wife and C, and a few other people - it was nice to see that the world was in fact still in tact. That I could still find my way back to being a bit more normal and possibly my old self again.  I have wonderful friends and family, and I know this post reads as if I am angry at them.  I just have always held my friends (especially) to a high standard. One that I thought I could always count on, one that I thought would show how good of friends and how strong a friendship I had with them.  One that I probably don't uphold myself, as much as I try to.  But that was just me being unrealistic. They are just people, good people - with busy lives and too many things to think about. And that's okay. I guess like a little kid, I was just very disappointed, and still am till this day.

The Ben Rector song finishes with this chorus:

This isn't easy
This isn't clear
And you don't need Jesus
Til you're here
Then confusion and the doubts you had
Up and walk away
They walk away
When a heart breaks

It never is easy, and certainly not clear. And while my heart is certainly broken for my wife, my self, the children we will never have, and for the grandkids and nephews we will never share with our family and friends - I think the confusion and doubts are starting to subside. And I'm happy for that.

Random Childhood Regression

When my brother and I were young, we used to have this thing where we would say "we can ask God about that when we go to heaven."  Sometimes it was about something that we couldn't understand, like why our cat got ran over on my 14th birthday. Other times, it would be about things we were curious about such as whether ghosts existed or if there were such things as UFO's. Then there were times when we would add to the list things that were a bit less light-hearted, questions about why certain things would happen, like why a relative died from brain cancer.

Not that I'm angry, in many ways I feel I've been given my diagnosis of azoospermia for past sins and actions. Sometimes I think, in some twisted way, maybe God is looking out for my wife and I by not allowing us to have children. After all, He is infinitely benevolent. But while I'm here on earth, I still feel the need to ask him, since I'm curious to know - I know he'll have the answer, one that I can never find myself, and perhaps one that I will no longer feel the need to find.

As my wife and I continue on our journey towards adoption, I find myself looking at pictures of our adopted son as I would pictures of a beautiful beach or a majestic cathedral: it's something I hope one day to see but until then, it feels more like a concept of mythical proportions than a reality.  From pictures of his birth, to videos of him playing with toys, to seeing pictures of his first birthday. My wife and I feel more like spectators on the outside looking in than prospective parents-to-be. And while we witness nearly every couple in our vicinity welcome their children into the world, my wife and I are left connecting with our adopted son thru 6 degrees of separation, where even sending a care package of toys and clothes are handed between no less than 3-4 people. Even for his first birthday, we could only imagine and guess what kind of toys and clothes he would need and like. It's kind of a sad reality to face, but in the end, it is our reality: the struggle of infertility that has lasted more than 16 months, and an adoption process that has lasted more than 13.

Today my wife turned to me, randomly with a melancholy tone "we're missing some of the best years of raising a child." I agree. When will we ever witness such blatant curiosity and innocence?  How many priceless moments have passed us by?  How many defining moments will I never know of?  I wish I could do something more, and so I try to think about how I can make it up to my wife. I guess I can only hope that the day our child arrives from Korea some of our depression, anxiety, and hopelessness can be replaced by some feelings of joy, purpose, and relief.  I can only hope that when we hear his voice, his laughter and hold him for the first time in our arms that all our waiting and hardship has been met by the certainty of our little miracle. Not the way we always imagined, but in that moment maybe......just maybe, we'll feel like the parents we so desire to be.

It's always the quiet ones.....

When I was a lot younger, my girlfriend at that time came home one day and told me something that I will (and can not) ever forget. In her class, they had a final project where they needed to write something very meaningful and profound about a life experience. During the final week of the semester  they would have to share their story in front of their class on the day they turned in their paper. And while most the stories shared were about struggles with money, neglected relationships, regretful paths, and such, there was one unassuming and (as told by my girlfriend at the time) quiet girl whom surprised everyone. When it was that girl's turn to present and tell her story, no one, not even the teacher knew what was coming. She approached the front of the class clutching a worn teddy bear under her left arm, and with the support of the professor on the right. She said, and I quote (from the words of my girlfriend at the time):

"I grew up in what seemed to be a normal family. My parents were always supportive, involved in the community, and were very hard working. In particular, I adored my father. But on April 2, 1993 I walked into my house and heard some commotion in my brother's room. When I opened the door, I saw my father raping my brother......"

Of course, the story went on and there were other details, but that is the meat of the story. That story has always shocked, impressed and inspired me with how much courage she must've had to share this story, and how she had grown to accept what had happened.  Without knowing her, I feel that in some way, that event, like most traumatic and momentous events, changed her and, furthermore, become part of her. I guess I feel that way too about being an azoospermic......about being infertile.....and about everything my wife has had to go through because of my condition. It is very much a part of me, one that I will have to live with, continue to grow through, and (eventually) learn to share with those around me.  And someday, perhaps, I too can exercise the level of acceptance and courage with which that girl displayed in front of (what I can only assume was) a classroom filled with young, sometimes judgmental, and somewhat immature group of young students whom realized (some for the first time) that the look and power of valor, audaciousness, and heroism can manifest itself at any time and in any form. Even in the form of a quiet, unassuming girl, clutching a teddy bear.

Dreams are relative, misunderstandings are absolute

I can remember about a half dozen times in which I explained my infertility diagnosis as well as the complications that come with it (i.e. low testosterone, depression, etc.) to friends and family members. I think while most were concerned and genuinely cared, the gravity and depth of the disorder never really hit them. After all, it wasn't like I was dying or anything. At least not on the outside.

Even as I the words for this blog I can hear children screaming in my condominium community as they play, their echoes resonating as they run and chatter in the courtyard of our community park just outside my window. Playing, having fun, seeing my friends - it was quite literally the only thing I cared about when I was young. I was never really a great student and, as such, never received good grades. Not until much later in my life (at least much later than most people) did I start really focusing on my future. That is, with the exception of one thing I always knew I wanted in my future: having children and relishing the joys of having a family.

At one point in my life, my father (and possibly the rest of my family) worried very much about the outcome of my future. Would I get a decent job? Who would I grow up to be a responsible person and what kind of job could I get? Admittedly, I always thought I would be an average worker, making average wages, with an average drive. But I knew that I always wanted to become a father. A father that would take time to play with his kids, to listen to their problems, and a father that would, above all, be proud to come home to a family where his mediocrity would be washed away by the faces of his family. And while I know this vision is naive, immature, and likely unrealistic, its just what I said it was in the beginning of the post: it was a dream.

One of my favorite shows every produced was "Band of Brothers," an HBO series which aired during the early 2000's. I remember in the beginning of those shows they would show the actual soldiers depicted in the series tell a story about what they saw and experienced. I can remember one story where one of the veterans spoke about several young men in his town committing suicide because they couldn't serve in the military. I remember thinking how extreme that sounded. But looking back now, I  guess I can understand now how dreams can be a relative thing and how I misunderstood the significance of what they were saying. A desire and a sense of purpose which you can innately feel,  for which you strive for can be an unbearable reality to face when someone or something makes reaching such a dream impossible. And that sense of purpose and innate desire can be hard for people on the outside to understand, especially nowadays where people are so busy with their own lives and problems. Understanding the gravity and depth of someone's lifelong desire takes time, and honest consideration, something that is genuinely rare to find even amongst the people that love you the most (of course I'm guilty of this myself when it comes to the people closest to me).

Upon googling "infertility depression childlessness" I remember how hits I got related to psychological disorders associated with an infertile diagnosis. There were many hundreds of links I read, and I even remember reading cases of individuals whom committed suicide at the thought of not being able to bear children.  The truth is, being infertile and wanting to have biological children has the same magnitude of a cancer diagnosis for those that want children (and most of us do, certainly those that read this blog).    And while those that suffer from cancer or have lost a person close to them receive the comfort, devotion, sympathy and, importantly, time from their loved ones - those with an infertility diagnosis quietly and desperately seek some understanding.  The sight of a pregnant women, the countless commercials which depict families, father's and mother's days, movies which outline the love between children and their parents, co-workers talking about their kids, seeing your relative's families......everywhere you look there seems to be a reminder of what will never be. At times, it seems as if the rest of the fortunate and fertile world thumbs their nose at you. But they're not, they're just living their life and celebrating one of the best joys of living: having children. And the resulting guilt that comes with trying to be as happy for your friends, family, co-workers and everyone else whom you want to celebrate life with. But inside, at least for me, I can feel a deep sadness that engulfs me at times, where I can barely get a grip on life.  Its part depression, but it's also part progression - in the sense the sadness is very much a part of me and who I am and I am learning to recognize it. Not what I envisioned, but for better or worse, my infertility is part of my life that I have to deal with.  I'm not sure where this part of my life will take me, and I'm definitely scared and feel alone most of the time, but I know its a part of my life that I have to accept and a path in my life that I have to take. One that my wife has chosen courageously to take with me, and one that I wish more of the people in my life could one day understand.

[Tangent Thoughts] A club we will never be part of.....

May 7th, 2013.......Mother's day.

Today is a day when motherhood is celebrated.  While celebrating mother's day with my mom and dad, we observe all the families and children around. It certainly is a celebratory day for moms, and their thankful families. During our dinner, unexpectedly, my brother and his wife shared unbelievably exciting and happy news with us today while eating dinner with my mom and dad: he and his wife are expecting twins.  My mother's face lit up like I've seen few times in my life, and for good reason - she was going to be a grandmother, twice over. I've seen this same face in my mother-in-law's face when my wife's sister gave birth to their first child. I also saw the smile and pride which my wife's father gave to my brother-in-law when they announced she was pregnant. The same look I saw on my father today. Looks I so desperately desire to obtain. Words I whole-heartedly wish to hear. And I could see my parents giving those looks to my brother, cautious not to be overly excited as my wife and I were present. I was elated for my brother, but could feel a bit of sadness loom. Let me explain.

Imagine going to a very large celebration, a prom or formal perhaps, and forgetting to wear dress shoes.   Like most nice venues, there is a strict dress code. Those whom dont have the right attire can't be apart of the celebration and, if their lucky, their date stands by their side. Two people paying the price for the mishaps of one of them. In life, there is such a celebration in which nearly everyone is invited and few are left out of: pregnancy and birth. It seems in this life event, I've showed up with sandals while my wife dressed up like she belongs on the red carpet. Imagine how horrible you would feel if you know you kept your wife from having the time of her life at such an event. Imagine how infinitely worse it would be if that event lasted a lifetime. 

How can I ever repay my wife for robbing her of such an important life event?  I work tirelessly with adoption agencies, social workers, lawyers, etc. to make our hopes of becoming parents come true.  And  as hard as I try, and as positive as I try to be, the truth of the matter is this: I fall short. My BEST efforts remain a very distant and lackluster second to becoming a family through pregnancy and birth.  The self-pity and realization with which I find myself feeling at this moment is a cocktail of guilt, depression, and sorrow. My wife, a women whom has such a motherly touch, may never become a biological mother simply because she was unlucky enough to marry a man whom was born infertile. Just yesterday I saw her walking and talking gently, happily, and selflessly with my nephew.  In another life, perhaps that would be our kid she was taking care of so gingerly. But in this life, her husband has primary testicular failure and a piece of him dies each time he thinks of how hard their life has become because of him.

The ephiphanies of an azoospermic.....and the emotions.....

June 6th, 2012. 5:30pm.

My cell phone rings and I recognize the phone number as the doctor's office that performed the FNA mapping one week prior. I have been somewhat bed-ridden, and in a bit of physical discomfort for several days. That said, this is the day that I have been waiting for. I was so nervous picking up the phone call I felt like puking. This is how the phone call went:

"Hello?" I said as I picked up the phone.
"Hi Brian, how are you feeling?" said the doctor.
"I'm doing well, and feeling better."
"Is there anything bothering you?" he continued.
"No, nothing other than a little lingering discomfort when I run or sit down too quickly."
"That's normal, that should subside in a week or so. I'm sure you are anxious to find out the results, but I'm afraid I dont have any good news to share" he stated with a cautious tone.
My heart sank, I could barely breath, and I couldn't get a word out.
He paused and then continued "there was no sperm found at any of the mapped sites in your testes. The  results show that you have less than a 2% chance to retrieve sperm using even the most aggressive micro TESE procedure."
I paused, mustering the little courage I had and finally squeezed out the words "Okay, doctor, thank you for the call and for your help."
"Please let me know if you have any questions, and if you need any counseling. The results and impact of your diagnosis is truly on par with those that have suffered a loss of a very close loved one, or have been given the results of a cancer diagnosis. You don't have to face this alone" he said.
"Thanks for the information, I'll let you know if I need anything."
I never called him, never got counseling, and sunk into the deepest of depressions I have ever felt. It was like I died all over again, and when I told my wife - she died with me, and with it any dreams of our envisioned path to parenthood. That was one of the darkest days of our married life, and I held her a little tighter that night as we fell asleep with swollen eyes and heavy hearts. And when I could hear her breathing slow and knew she had fallen asleep......my tears rolled down my cheeks in a way they haven't in a very, very long time.

The next few days were very blurry, and we were somewhat disoriented. We tried to do normal things: laundry, clean the house, find places to eat. But it was like someone took our tastes buds away, and the color out of the sky and trees. I remember when we first moved into our house, I put up photos of our wedding in nearly every room, so we could each remember that day. Not because our wedding was so unforgettable, but because it was OUR day, and our friends and family shared it with us, our promise to be together. Those same pictures now mocked us. The smiles, the promises, the gifts, the happiness. It was all a faded memory. The things we envisioned while we were at the alter looking at each other: achieving goals, having children, raising children, becoming a family, getting old and seeing grandchildren......were all changed so suddenly. We simply didn't have time to adjust, and maybe we never will.

For my wife and I, the next days, weeks, and months were extremely difficult as we tried to move on with our lives. We tried to stay as strong as possible, but the fact was simple: our life and the path we envisioned towards becoming parents and raising a child had been changed forever.  The depression and fatigue we both felt was unbearable at times, and I could find my wife quietly crying on occasions. I felt like we were paralyzed, and we couldn't talk to people about it and, therefore, there was no one really there to help.


After about a month had gone by and we started to adjust to life again, I (for some random reason) decided to look into adoption. For anyone reading this that is going through or dealing with azoospermia, they have undoubtedly been presented with the idea and option of adoption. It is one that is unfathomable at first, and one that is extremely hard to think about. Raising someone else's child is a tall order. The funny thing is, once I started going to the adoption websites, I could feel a sense of possibility. And for the first time in wait seem like ages, I felt something positive about our future. And so I decided to call an adoption agency which specialized in international adoptions with Korea (since my wife and I are of Korean descent, we wanted a child that our parents could easily communicate with).

When I called the adoption agency, I asked about Korean adoptions and she replied: "The cost will likely be somewhere between $30,000-40,000 and the time to bring a child home will be 18-24 months." The small bit of excitement which had coursed through me had flickered out, and I felt like my heart imploded all over again. After my voice changed to a saddened tone and she replied "I know this is not what you wanted to hear, but unfortunately this is the way the Korean government has decided to implement the adoption process." And with that, I thanked her and we hung up.

It wasn't until a week later that I called again, and this time, I asked for more information. It was daunting. Full medical exams for both my wife and I. Blood tests, urine analysis, vital statistics. 6 letters of recommendations each. Official birth and marriage certificates. Proof of citizenship. 6 hours worth of visits from social workers. Mounds of paperwork describing our childhood, parents, siblings, education.  transcripts from our universities attended. Proof of insurance, proof of employment, proof of salaries, proof of taxes paid, proof of coverage in case of accidental death, proof of tetanus vaccination, proof of hepatitis vaccinations, proof of polio vaccinations. FBI database clearances for legal records. Background checks. Credit score reports. Even proof of our BMI (body mass index). Notarizations on 100+ documents. Let me stress that this is only a partial list. This was a very hard and unconventional way to becoming a parent. But when you have few choices and your life has thrown you into the darkest predicaments, you have little else to do than make the best of your shitty situation. It was our chance to take our infertility combine it with a child's loss of parents with the possibility of making all of our lives a little better. At least that's what I hoped for as I clung to a thread of hope for my wife and I as we looked to our future.

When I went home to speak about things with my wife, I realized one fact. My infertility had robbed us of becoming parents biologically, but it didn't mean we couldn't become parents and have a family in another way. This path, while far from the path we envisioned to parenthood when we got married, was nonetheless a real option towards raising a child together, as a family. I can not even begin to tell you or express the amount of uncertainty and hesitation we felt as we started preparing all the documents and appointments necessary to just qualify to adopt from Korea (let alone all the money we had to prepare to invest in this endeavor). But, for the first time since feeling that infertility had choked the life out of us, we gasped a few breaths of optimism.


“I thought about all the people I knew who spent many of their waking hours feeling sorry for themselves. How useful it would be to put a daily limit on self-pity. Just a few tearful minutes, then on with the day.” 
― Mitch Albom, Tuesdays With Morrie

Sometimes, the little things get you

Here's a short poem that I'd like to share to start the blog. It's not always the monumental things events in our lives that make us break down. Sometimes it's the little things that happen during times of massive stress that solidify out state and make us melt in the spot. They catch us off guard and already worn thin.

Shoelace

it’s not the large things that 
send a man to the 
madhouse. death he’s ready for, or 
murder, incest, robbery, fire, flood… 
no, it’s the continuing series of small tragedies 
that send a man to the 
madhouse… 
not the death of his love 
but a shoelace that snaps 
with no time left … 
The dread of life 
is that swarm of trivialities 
that can kill quicker than cancer 
and which are always there - 
license plates or taxes 
or expired driver’s license....

As my wife and I waited for the test results of the various exams I took in the weeks before, we started to plan the "next steps" of assisted conception through what is known as ICSI-IVF. ICSI-IVF stands for intracytoplasmic sperm injection-in vitro fertilization. What ICSI-IVF essentially amounts to is the extraction of sperm from a male which gets "injected" into harvested eggs from a female. Its a very expensive and complicated procedure which is an amazing process, but one that is also incredibly prone to failure (success rates can be as high as ~50%, but typically are a lot lower and multiple attempts are usually necessary).

So what is ICSI-IVF exactly? To me, it sounded a lot like the doctors were simply impregnating my wife's eggs with the sperm they would extract from me and then implanting them back into her. The physical cost: my wife would have to take large, muscular injections near the back of the pelvis for the better part of 3-4 weeks, as well as hormones and other light injections. My wife, God bless her, was scared as all hell over the idea of taking so many shots and having to go through all the bodily changes that comes with such hormones. But she was a trooper, and I was so proud of how she kept herself composed and positive as we embarked on an endearing and torturous journey.  Even now, as I hear her watching TV in the bedroom as I type, I can see my sweet, playful girl prepping herself like a soldier that is readying to go to battle - telling herself to be strong, be brave. And she was so, throughout this entire debacle. I was and am still so very proud of her.

For me? Testicular sperm exploration and, hopefully, extraction. One such process is Fine Needle Aspiration (FNA) Mapping.  In fine needle aspiration (FNA) mapping, there are roughly 18 aspirations with a needle, surgically pierced into EACH testicle (for a total of 36 "punctures") with an extraction of some intra-testicular medium. Each sample will be examined by two independent labs to determine if there is any sperm being produced in the testes. Then, assuming sperm is found, there are TESE and mTESE procedures. TESE is also known as Testicular Sperm Extraction, where the scrotum is sliced open, and one or both testicles are further sliced "opened" to reveal the inner "tubings" where samples are taken which may or may not yield sperm. mTESE is a variant of TESE were a microscope to aid in the extraction of testicular tissue is done so that less testicular tissue can be taken with a better chance of finding sperm. In other words, both will hurt like shit, and the "balls" are gonna be swollen.

Let's talk about the money. ICSI-IVF would cost about $30k, for 2 attempts. FNA-mapping costs about $6-7k (since we chose to go with one of the best FNA-mapping specialists in the world, who happens to practice in SF). TESE/mTESE would be another $5-10k depending on how little sperm there was (i.e. how hard it would be for them to find the swimmers).  Before subjecting my wife to anything, I decided to get FNA-mapping done on myself to determine if there was even any sperm worth betting ICSI-IVF on. My appointment in San Francisco was on May 31, 2012. That was one day after my wife and my 3-year anniversary.

On the day of my surgery, my friend C picked me up. I was happy that someone could accompany me and that my wife could be spared from having to wait in the waiting room thinking about my surgical discomfort. She would be working until later that day, and my appointment was at 3pm. I arrived at 2:30p, by 2:45p I was a little loopy from the valium they gave me. She really wanted to come, but I thought it was better if she didn't and I would see her at home immediately afterwards. I remember as I was getting prepped for surgery, the thought of most my friends not knowing anything about my surgery nor about my condition made me feel isolated. The nurse left the room for a moment, and I remember how alone I felt - and for a while, I wished I could hear my friends tell me everything was going to be okay, and that they would be there when I got home. Even till this day, most of my friends, even the ones that know of my azoospermic condition and surgery can barely remember the feelings I had, or could care less. But they are still very real to me. Even nearly a year later, I can still feel emotions put a strangle hold on my thoughts when I recollect.

As I lay back on the surgery table, bare naked, the nurse completely shaved my scrotum (rather quickly which was horrifying even with the valium), it became very real that my testicles were about to have a major "attack" happen to them. And then, she applied what felt like really hot water on my scrotum. It was a topical analgesic, and it made my balls feel like they were on fire. Then the real fun began: 6 inch needles filled with local anesthesia. They were injected about 2-3 inches into my groin area and it was very uncomfortable but I didn't budge, I was too scared of what might happen if I did. I barely breathed.  All said, the doctor gave me 4 shots on my left groin, 3 on my right. He was about to delay the surgery as I was not getting fully numb, but I asked him to just proceed. I hadn't come out here and go through all this just to go back home with partially numb testicles. And so with a little discomfort he proceeded. 36 aspirations where he stuck a needle about 1/4-1/2 inch into each testicle, 18 times. When everything was done, I was still a little loopy from the valium, but very happy that the procedure was over.

My friend C was waiting for me in the waiting room and it was great to see him, and thankfully he was able to drive me home. Amongst all the friends that tried to say the right thing, that were absent from it all, that were too busy to come by, and to those that just didn't make an effort to call after not hearing from me for a year.....it was C that came thru the most. He just came by to, well, come by. To watch TV, to eat some food. Not because he felt sorry for me, or because he thought I needed it - but because he just wanted to hang out. To me, that was the sign of a great friend. Even people that don't like you will be there when you are really down (say when a parent passes away), but the ones that come by just because they like being around you and just like seeing you......well, those are the ones worth keeping the most.

One thing I learned from all this was that there are only a handful of times in your life that allow you to define who you are and what you're willing to do.  I think, amongst many things, friendships intersect at such junctures. It's the people that shine in those moments, without necessarily intending to rise to an  occasion,...... those are the ones that define friendships for other people. Other people, like me, that were on the receiving end of an unintended but generous gift. Thanks C, and, of course - thanks to my wife.

Zero, zilch, nada, nil, nothing.....azoo what?

Starting the Summer of 2011, my wife and I tried to get pregnant. By the time Spring of 2012 came around, we figured we should both take some fertility tests. Since a fertility test for a guy is pretty simple (basically semen analysis performed in a lab) I decided to go to the doctors first near the end of March 2012. By early April 2012, my life felt very different.

When my doctor called me to discuss the results of my semen analysis, he admitted that he was confused by the sperm count. He was a fairly young general practitioner (GP) and, as such, he had never encountered someone with a sperm count of 0. Zero, as in zilch, as in nada, as in none, as in no sperm whatsoever in the ejaculate that I supplied the lab.

I can still remember very clearly the feeling I had as I was walking from the building housing the urology department to the large parking structure at Good Samaritan Hospital in San Jose. I could feel the sun on my face, the cars passing me, people chatting......and I felt as though my life had come to an end, while the world kept turning. I didn't even know what to think as I made the drive home after my doctor's appointment. What would I tell me wife? How would I tell my parents? My brother? My in-laws?

One week later I went in for an appointment with a urologist (also known as an andrologist to some). He further educated me on what I had scoured the internet over in the days leading to my appointment. He gave me what seemed like an overwhelming battery of tests and analyses that needed to be performed on me. A short list includes:
1. Blood sample analysis for FSH (follicle stimulating hormone) levels
2. Blood sample analysis for LH
3. Blood sample analysis for prolactin
4. Micro-deletion testing
5. Karyotyping for any chromosomal or genetic disorders
6. Doppler Ultrasound for analysis of my testes
7. Specialized Semen Analysis with pelleting
8. Urine Analysis

It seemed like there was a never ending string of tests that required me to go to 3-4 different test centers.  All the while, I could barely get a grip of my life.  Holding a thought became challenging. These tests were essential to determine the extent of my diagnosis known as non-obstructive azoospermia (NOA). It is a form of infertility in men which is extremely rare, and results in zero sperm count due to primary testicular failure.

Several weeks after all the tests had been completed, my wife and I were dealt another extremely devastating blow as we learned my condition was looking more and more irreversible, and less and less likely that we could have biological children.

The next step, as it turned out, was also the last line in the hopes of bearing our own biological children: surgical procedures to determine if there was ANY sperm being produced at all, and in vitro fertilization (IVF) for my wife. In the next post I will discuss the procedures and follow-up medical examines we undertook, but for the remainder of this post, I would like to focus on some of the feeling (perhaps you are feeling yourself) that my wife and I experienced.

During this battery of medical tests, there was something else happening inside of me that was far worse than the stress induced by the idea of not being able to have biological children. I started to become massively depressed. Embarrassed by my medical condition of azoospermia, I could hardly look myself in the mirror, felt guilty each and every time I watched my wife sleep next to me. I shut down socially as I hardly interacted with anyone I didn't absolutely have to. I isolated myself from my family. And in the late night hours, watching my wife sleep next to me, I could feel the guilt overtake me to the point where I could hardly breath. For those of you that are fortunate enough to have married a woman as patient, loving, kind, caring, sweet, and beautiful as mine - you can understand the feeling of inadequacy that can result when you aren't able to get pregnant together. Where because of a condition that you have now discovered, the path to parenthood and a family has and could forever change.  Till this day I feel indebted to my wife for having chose to marry me, and to endure this painful and life-altering diagnosis.

Then there was the whole idea of sharing and dealing with telling my condition to my family and friends. This took nothing short of 8-10 months, and even till this day the majority of my friends are in the dark about this. I felt no one would understand, no one would say the right things, and that people would view it as something short of what it actually was. I remember my doctor saying "azoospermia and infertility as a whole has the same stress and emotional patterns as those that are diagnosed with cancer or for someone that has just loved a very close loved one." It sure didn't seem like that as I started telling a few of my closest friends, as they soon forgot about my condition, never came around to hang out, and basically left me feeling like I had told them about something that was at the level of gossip rather than something extremely personal with a topic that is possibly one of the hardest to discuss as a man.

However, those that came thru, and did hang in there and checked in on me, not just to see how my infertility progress was coming but just to see how I was holding up and would just sit next to me and keep me company knowing I wasn't in the mood to talk......that made ALL the difference in the world.

It is because of those friends and my wife, as well as the some support from my family that I was able to gain enough zeal and courage to continue on in pursuit of a better life for my wife and I. It was a dark 6 months, and the 2-4 months following when I started to open up was just as difficult. But I got through it, and my wife got through it with me. And in the middle of that shitty mess, we somehow came out together with the ability to still smile at one another and feel a genuine sense of love. We were forever changed. And our smiles, while nowhere near as bright and carefree as those on our wedding photos, remained. I knew that things would get hard (though I had NO idea how hard they would get), but I now knew that we could persevere....and that even in the worst of scenarios we would find comfort in each other: our small silver lining.

The adaptability of humans......such a time-dependent phenomena

Humans, generally speaking, are very adaptive creatures. We live in all sorts of climates, deal with changing environments, can adjust our demeanor and even our expectations (for better or worse) when the situation calls for it. However, the one thing to consider here is that our adaptability is not instantaneous nor infinite. In fact, the time needed to adapt is somewhat (if not directly) proportional to the degree or depth of change we expect to tackle. For instance, if I was to tell you that you were to lose your job in 2 years due to outsourcing, you would likely be upset but, as painstaking and unfair as it may be, you would adapt. You would update your resume, adjust your budget, manage expectations. You would do what you have to in order to get your next job and ensure you get back on track with your life . On the other hand, if I were to tell you that you were to lose your job in the next 24 hours, it would be massively more difficult to come to terms with. You would be, to a some (perhaps large) extent, paralyzed in what to do next. The immediacy of the change and the ripple that it caused in your life and outlook would be much harder to deal with. And the loss of confidence and optimism, while not irreversible, would take a disproportionate blow. There simply wasn't enough time, and things changed too fast to allow for a manageable adaptation.

The thing is, we all have dreams. I'm not talking about fairy tales, but very real, achievable things that we strive for and expect from our future. A good job, good friends and family, financial security, traveling the world, retirement, getting married, growing older, having kids. Some of these things would seem impossibly hard to deal with if someone took the option away. Many people deal with such scenarios. I'm one of those people. If you're reading this blog, chances are you're probably one of those people too (or have someone very close to you that is).

This past year (actually the past 2 years) have been trying times for my wife and I. An unfortunate string of events has changed us from the bright eyed, optimistic kids we were just a few years back. Yet we are also light years from where we were just 10 months ago. This is my not-so-easy to tell story about azoospermia, and the perils that come being infertile (or sterile). Indubitably, the worst of such perils being that my wife and I will never have our own biological children.

Thank you for finding this blog, I hope you find at least the tiniest bit of comfort in knowing someone else knows how hard things are or have been for you, and how much harder and seemingly (for lack of a better word) embarrassing it is to open up to others about azoospermia. Feel free to comment, send an email, or contact me in anyway.