I never imagined that IVF might kill me.

This is how Nadine Kenney Johnstone begins what is ultimately a heartfelt charting of her experiences when facing adversity. Maternal deaths resulting from IVF are relatively rare, but they do occur. And Nadine Kenny Johnstone had no idea that she would be facing the little-known horrors of IVF when a procedure caused severe internal bleeding, and she woke up from emergency surgery with a six-inch scar instead of a baby bump. There are many accounts of couples struggling to create a family. Johnstone’s is unique insofar that her story has a happy ending, but not one that you will anticipate in the beginnings of the memoir. I’m not going to spoil the story; I’m just going to say, it’s a good one and I highly recommend it.

Johnstone’s candid memoir is for everyone. It’s for people who have had no problem conceiving and for those who know the challenges of IVF (no matter the results). Ultimately, it’s the story of a woman who, once married, begins trying for a baby without knowing how hard that road will become.

Maribel Garcia: Nadine, thank you so much for being with us today. In Hourglass: Time, Memory, Marriage, Dani Shapiro wrote, “To write memoir is to find the shape in something shapeless—to understand and make use of the raw and chaotic stuff of life.”

You did a remarkable job finding form to the “raw and chaotic” stuff of life in this memoir. The anxiety caused by complicated and stressful IVF procedures and additional failed fertility treatments threatened not just your marriage, but also your mental state. Did writing about the experiences keep you sane? Do you journal? Did you feel that writing would help you to make sense of so many senseless ordeals?

Nadine Kenney Johnstone: I journaled a lot during the second half of our IVF journey. I have 54 single-spaced typed pages that chronicled my thoughts during that time. (During the first half, I was obliviously optimistic, so I wasn’t really journaling, and after my near-death experience, I was so traumatized that I wasn’t able to write much).

I try to set aside two-hour writing chunks. At the beginning of every session, I set my phone time for 10 minutes, open up my “diary” doc, and I speed-type everything that is on my mind. Then, usually, the 10-minute buzzer goes off, and I’m only halfway through brain dump, so I set it for another 10 minutes. I always feel better after because it helps me get an outsider’s perspective.Time truly is the best editor and healer, because when I wrote my book, I reread those entries. Because by then, years had passed and I’d processed some of the pain, reading those entries was a great way to tap back in and remind myself what I was feeling so I could recreate the scenes for my memoir.

MG: What are you hoping that your book contributes to the public conversations that we should be having about infertility?

NKJ: This week is National Infertility Awareness Week. I am so happy that this issue is gaining more exposure because so many people are affected (1 in every 8 couples). At least one person you know has probably experienced infertility, whether they’ve opened up about it or not. Infertility is beyond isolating. Jamie and I felt like we were living a lie. Going through IVF was like living a double life. During business hours, I was an English professor in Massachusetts, but before work, I’d be at the blood and ultrasound lab at six-thirty in the morning. Then, in the afternoon, I talked on the phone to the nurses about my results. In the evening, I gave myself injections. It was all-consuming. My husband and I told no one besides a couple of family members. But then, when I almost bled to death after my egg retrieval procedure, I needed to talk about it because I was fighting for my life. I stayed in the hospital for five days and was out of work for two and a half weeks. I could have lied about why I was out of commission, but suddenly realized that our infertility struggles were nothing to be secretive about. Was I not allowed to talk about our story because, god forbid, it involved reproductive organs?

It has been incredibly rewarding to hear from so many readers who have emailed me to say “thank you” for capturing the isolation that one feels from infertility. Most people don’t share their struggles because they’re afraid of the reactions they will get from others to “stay strong” or “look on the bright side” or to try this new drug or that popular adoption agency. None of this is helpful. The most important thing to do is listen and hug.

Infertility treatments can be very emotionally, mentally, physically, and financially risky and it is important to interview many different clinics and doctors before moving ahead. Most people think of IVF as a “sure thing.” They don’t realize that it can put one’s health and relationship at stake.

MG: There are many of us who believe that every person who wants to, and who has the capabilities, should enjoy the gift of parenthood. For this, many are grateful for the science and technology that has made it possible for families to exist. That said, the stigma surrounding infertility is real. Can you tell us a little bit more about this?

NKJ: There’s so much shame associated with infertility. I’ll never forget the night that I was complaining about the IVF injections I had to do, and Jamie said, “Sorry I have shitty sperm.” I could feel his shame from across the room, and I felt awful that he felt like he was to blame. People feel that their bodies, naturally, should be able to produce offspring, and when that doesn’t happen, there is blame and shame. People feel that their bodies have failed or betrayed them. The infertile member of a couple feels guilty for not being able to procreate. Though it is not their “fault” and they did not “choose” to be infertile, they feel responsible that their partner cannot have a dreamed-of baby. This guilt can wreak havoc on self-esteem and relationships. Men do not like to say that there is a problem with their semen and women do not like to admit to having “old eggs.” They feel that it tarnishes their gender and self-identity. But infertility is nobody’s fault, and it is not something to be ashamed of. That’s why I HIGHLY recommend talking to an individual and couple’s counselor about the feelings that arise.

MG: Your husband Jamie was diagnosed with cancer (and subsequently beat it) before you were married. That meant that he had to take the necessary precautions if he ever wanted to have a family, like freezing his sperm to preserve his chance of having a family in the future. It seemed such a cruel twist of fate that on top of this cancer diagnosis and the steps that he had to take, you two would then have to face one obstacle after another to have a baby. The way you write about all of this adversity is so raw; it makes you want to scream. And I will not tell our readers what happens (it’s not anything you would expect at the beginning of the narrative), but even though you are a bit critical (and who wouldn’t be) about the saying “Everything happens for a reason,” did that change after you finished writing the book? What are your thoughts on that saying after writing the book?

NKJ: I think that I still have a problem with “Everything happens for a reason” because when it is said to a person who has experienced trauma or loss, it feels infuriating. I’ve talked to so many individuals who’ve suffered through some form of trauma, and they’ve said that “Look on the bright side” and “Everything happens for a reason” are the worst reactions they’ve gotten. I think that those sayings hurt because, even if our losses do lead to lessons, “Everything happens for a reason” refuses to acknowledge the deep pain that leads to those learning opportunities. Now, 5.5 years after our IVF experiences, I can see the “education” I gained from life’s schooling, but it also hurt like hell!

MG: You teach writing, what did you learn about writing after finishing this particular book that you didn’t know before?

NKJ: It’s a LOT of freaking work!!! No, but really, I learned many things: You can get a lot done when you write in the morning BEFORE you answer emails. Routine is everything. I wrote and revised much of this book between 9 and 11 am while standing at a Starbucks high-top and rocking out to Eric Church and Fleetwood Mac. That was my routine almost every morning. Like many other writers, I’m not an amazing first-drafter, but I am a diligent and ruthless reviser, and that makes all the difference. I always say to my students, “There are a million fabulous writers out there, but the good majority of them are unpublished because they don’t have the endurance to keep going. Perseverance in the face of adversity will set you apart.” When I graduated with an MFA in creative writing, I naively thought I’d have a book out soon after. That was nine years ago, and the book that was my thesis is still on my hard drive. But, I kept writing past plenty of rejection and different book ideas. With Of This Much I’m Sure, I just refused to give up. The title of the book came from Jamie’s cousin, Amy, who is a birth coach. At our lowest in our infertility journey, she said, “You will have your baby. Of This Much I’m Sure.” She said it with such assurance that I had to believe her, and I had a similar mantra when writing: “You will publish your book. Of This Much I’m Sure.”

MG: Nadine, thank you so much for being with us today.

Nadine Kenney Johnstone teaches English at Loyola University and received her MFA from Columbia College in Chicago. Her work has been featured in Chicago magazine, The MothPANK, and various anthologies including The Magic of Memoir. Nadine is a writing coach who presents at conferences internationally. She lives near Chicago with her family. You can check out her website here.