Page 24 of Scarlet Thorns

“Is it…?” I clear my throat, try again. “Is it treatable?”

“Absolutely. We have several options— hormonal therapy to slow the progression, pain management strategies, surgical intervention if necessary. Many women with endometriosis live full, normal lives.”

Normal.

What’s normal about taking medication forever? What’s normal about surgeries and treatments and managing a condition that turns your own body against you?

“What about…?” The question sticks in my throat like glass. “What about having children?”

Dr. Khan’s expression softens, and I know before he speaks that this is the part he dreads discussing.

“Endometriosis can impact fertility, yes. The scar tissue can interfere with ovulation and implantation. But it’s important to understand that difficult doesn’t mean impossible. Many women with endometriosis conceive naturally, and there are assisted reproductive technologies if needed.”

Difficult.

Assisted technologies.

The clinical language can’t soften the brutal truth underneath— my dream of easy pregnancy, of carrying my future husband’s child without medical intervention, of the natural progression I’ve imagined since childhood, is probably gone.

“I need to emphasize that every case is different,” he continues gently. “Your condition appears to be moderate, which means early intervention can be very effective. You’re young, you’re otherwise healthy. There’s every reason for optimism.”

I nod because that’s what you do when your doctor offers hope. But inside, I’m drowning. The future I’ve carried in my head since I was a little girl playing with dolls— marriage, pregnancy, babies, the whole beautiful sequence— feels like it’s disintegrating.

“I’d like to start you on hormone therapy to help manage the pain and slow progression. We’ll monitor your response and adjust as needed. In the meantime, I want you to know that this diagnosis doesn’t define you or limit what you can achieve.”

He hands me pamphlets, prescriptions, follow-up appointment cards. Information to help me navigate this new reality. I take everything with hands that feel disconnected from my body, still struggling to process that this conversation is actually happening.

“Do you have any other questions right now?”

I shake my head, not trusting my voice. Questions will come later, probably hundreds of them. Right now, I just need to escape before I fall apart completely.

“Thank you,” I manage.

Dr. Khan stands when I do, his expression compassionate but professional.

“Ilona, I know this feels overwhelming right now. That’s completely normal. But you’re not facing this alone, and this doesn’t change who you are.”

Except it does. Everything’s changed. I just don’t know how to explain that to someone who deals with these conversations every day.

The walk to the parking lot passes in a fog. My feet carry me through automatic doors, across asphalt that shimmers with heat, to my car sitting under the relentless July sun. The metal handle burns my palm when I open the door, but the pain barely registers against the numbness spreading through my chest.

I slide into the driver’s seat and close the door, sealing myself into privacy. That’s when it hits.

The sob comes from somewhere deep, wrenching through my chest like it’s being torn from my bones. Then another. And another. Until I’m gasping, doubled over, tears streaming down my face as everything I’ve been holding back for weeks pours out.

Endometriosis.

The word echoes in my head, heavy with implications I’m only beginning to understand. This isn’t something I’ll recover from. This is something I’ll carry forever, managing and medicating and accommodating until it becomes a part of my identity.

The woman who can’t have children easily.

The woman whose body betrayed her.

The woman who’s broken in ways that can’t be fixed.

I think about all the times I’ve imagined holding my own baby, feeling life growing inside me, sharing that miracle with someone I love. The nursery I’ve designed in my head, the names I’ve considered, the future I’ve built around motherhood. None of it feels possible anymore.

What if I’m unlovable now?