Wednesday, October 3, 2018

Waiting

I go into your room periodically. I look around. I run my palm over the changing table and often there is a cat there, purring for a pat. The only thing missing are curtains, which I have ordered, but have not arrived yet. Hopefully you don't come out demanding curtains, but if you do, you are outta luck.

I know you'll spend approximately zero time in your room at first, except to have your diaper changed. That's okay. I mostly set the room up for me. I look into your crib (which looks enormous, by the way, I feel like I could sleep in it if I weren't so hugely pregnant) and I can hardly fathom when you'll be a chunky toddler, sprawled out from corner to corner with your bum in the air. 

I tap your bum a lot these days. It's one of my favorite parts of you. When you're shoving it into my ribs, I call it your squishy tushie and your dad laughs at me.

These last thirty-nine weeks have (mostly) flown by. I can't believe you will be here so soon! (Incidentally, any time you want to come out would be just fine. I'm getting a little tired of hefting you around, and having heartburn, and not sleeping, and peeing every hour.)

I watch you move inside me, and it never fails to make me smile. My belly jumps and bulges from your little knees and I'm not going to lie, it's not always comfortable. I told your dad that babies don't have kneecaps and it blew his mind. Don't be surprised if he inspects your knees when you come out.

I have dreams that you'll never be born. 
The other night I dreamed I was a very tired bird who couldn't take off from the lake where I'd landed, and instead flapped and flailed in the water, waiting for some hungry creature to come make lunch out of me.
I texted your auntie about it the next day and she told me I was breaking her heart. I wish you could see what everyone who loves you sees. You're going to birth your baby, I swear it. Have some faith in yourself.

I try to visualize you settling into my pelvis and labor starting and progressing and me not needing an induction and you eventually making your way into the world and despite my extremely overactive imagination, there are some things I just can't fathom. Maybe that's how everyone feels before they do it for the first time.

So I eat my dates every day, and drink my tea, and gently quell the anxious thoughts about induction and Cesareans, and I press my palms into your knobby bits when you're trying to stretch out in there and there's just not room for that.

You'll come out eventually, I tell myself. And then the real adventure begins.


Saturday, June 9, 2018

The Before

I waited weeks to feel you move. Weeks turned into months. I thought I didn't love you enough to feel you move. I thought it made some sort of cosmic sense, that I was too self-involved to be a mother, that I couldn't even know you were there.
I didn't know you were there.
I took a blood test at work before my period was even due, because I thought I had the flu and would make my decision about medication use accordingly.
I called your dad from an empty patient room, told him quietly. We both were cautiously, measuredly happy. yay, we said, in lower case. No exclamation points. A month earlier I'd been bleeding your brother or sister into my pants at a Bon Iver concert. Life had marked us, casually, with one of its petty cruelties.
I saw you on the ultrasound at six weeks, a tiny pulsing blob. I felt like I was watching someone else. I heard your heartbeat at ten weeks. I knew the risk of miscarriage was still 2.5%.
At twelve weeks, I considered trying to love you, to believe you were real. I said a few words to you in the bathtub. I told some people at work about you.
The next day, a patient came in at fifteen weeks along with her own baby dead inside her, and I pushed you out of my mind again.
There is nothing there. It rang in my head as I'd try to fall asleep.
I had to buy new clothes and borrow my friend's hand-me-downs. I told everyone else at work because I couldn't hide you anymore. It still felt like a lie.
Are you excited?! people would say, Yes, yes, so excited, of course, I'd answer robotically with a fixed smile on my face.
There is nothing there, there is nothing there, there is nothing there.
At seventeen weeks, I started expectantly laying with my hands on my belly at night. Well-meaning people at work insisted I "must" be feeling you by now. I felt nothing.
We saw you on our ultrasound at nineteen weeks and your nose looks like mine. You tucked your arm behind your head, lounging.
I let it go. I tried to stop worrying about you.
Instead I worried about work, and my awful boss, and I argued with your dad about getting the living room painted.
At twenty-two weeks exactly, I lay on the couch moping, and suddenly there you were. Unmistakably. Poking me from every which way. I laughed to myself. Watched my belly jump as you did one more spin, then settled down again.
I texted your dad, and your aunties. I almost convinced myself I'd made it up, but you seem to enjoy your acrobatics now, so I don't stay convinced for long.

I love you enough, by the way. I love you more than you'll ever know what to do with. I will go to the ends of the earth for you, turn myself inside out and break my heart in two for you. Just like every mother before me, and every mother since.

Hang on, little boy. We can't wait to meet you.


Friday, January 26, 2018

January

I have a crack on my thumb, by the nail, on the right side, it radiates pain like a just-bumped bruise. In and out of lukewarm water, I wash my hands ten, fifteen, twenty times a day. Put lotion on, it starts to heal, wash my hands again, it opens up. It is miniscule. The tiniest annoyance. It feels enormous. I cradle my hand against my chest, thumb in, while I sleep. By morning it has healed. By lunchtime, it is red and oozing again.

He lifts the electric kettle off before it has boiled. You know, it shuts itself off when it's boiling, I tell him. Isn't water for coffee better just before it has boiled? he asks. I look back blankly, a beat, two beats. I don't know, I tell him. Do whatever you want.

The patient starts yelling at me the second I open the door - I saw what's written in my fucking chart! What the hell do you people know? You think you know me?! You don't fucking know me. I'm going to sue whoever fucking wrote that.
My heart pounds. I oscillate - fear, rage, panic, despair. Hi, I say calmly, same as I always do. My name is Caitlin, I'm one of the midwives.
Nice to fucking meet you, she says. Get that fucking thing out of my chart.
This continues for five minutes. I stand up. I'm the picture of serenity. Inside, I am seething.
You can either reschedule this appointment, or you can work on calming down. I understand you're upset, but it's not okay for you to scream and swear at me.
Miraculously, it works. She takes a breath. Apologizes. We listen to her baby. I'm forty minutes behind now. Later, her therapist calls our office - what happened in her appointment? The patient is threatening to sue.

I wake up every few hours all night long. Everything aches. By morning, my nose is running like a faucet, my lymph nodes are tender, and my throat is so sore I can't swallow. He gives me a hug as he leaves for work, kisses my forehead, tells me to feel better. Don't leave, I whisper. Stay with me. The lock clicks on his way out.

My dad is sick. Again. An infection gone haywire. IV medications at home for two weeks. Something wrong with his left kidney, nobody knows why. Each day, a new complication and a change in plan. I walk the dog in the freezing cold, my words garbled because my cheeks are numb, I talk to my mom, What can I do? Do you want me to come home? Seven hours away is too far. There's nothing I can do. I shiver in the bath, my heart pounding while I grit my teeth and will it to slow down. Fear, rage, panic, despair, rinse, repeat.

January is the longest month.


Thursday, December 7, 2017

Eight Days

My period is two days late, I texted my friend, late last Monday night.

I took the test in her farmhouse bathroom, the door pushed open wide by the two-year-old grinning madly, saying, "Auntie peeing. Auntie pants off."

Two lines. One faint, but definitely there. I smiled and felt tears at the same time. "Fuck," I said out loud, and then laughed. She hugged me hard enough I lost my breath. Cried too. Laughed. Our kids will be little together. You're going to be such a good mom.

I ached with the fear of how to tell him. This man I love so much. So much that I want nothing more than to have his accidental baby, and so much that I quake from the thought of thrusting this upon him, too soon, four months in, we barely know some things about each other. Other things, we know so well I can't remember a time before we were an us.

We have to talk, I texted him.

He brought my Christmas present with him. Thought I was breaking up with him. Wanted to give me my present even if I was.

Said, wow. Said, Seriously? Said, That's amazing. A baby. Our baby.

I cried again. Told him I didn't want to ruin his life. That I didn't want him to stay because he felt like he had to. That I knew how complicated his life was and that I was so sorry this happened. He stopped me. Firmly. Held my face in his two hands so I had to look him in the eye. Told me not to ever say that about our baby. Told me we would figure it out. Said we'd work even harder to make things work because it wasn't just for us anymore. Took me out for ice cream. Kissed my belly.

* * *

It was the barest sweep of brown when I wiped. I used my midwife voice on myself, told myself everything I tell my patients.
Drove myself to the hospital while I cried on the phone with my friend and she sweet talked the lab technician into doing stat labs on me after hours.
Crawled under the covers. Hit refresh on my computer screen over and over again. Felt the taste of vomit in my throat when I saw the result. Is that bad? he asked me. I nodded. Too low. Way too low.

We went to the concert anyway. My Christmas present - tickets to my favorite band, a sold-out show. Excited, raucous voices all around us, a hush falling as they start to play. I felt it start, felt the dark wet between my legs like it was my aching, gasping heart sloughing off instead of a uterine lining, a minuscule placenta, a cluster of cells. My baby. Our baby.

I can't stop the tears. He wipes my face with calloused hands, over and over. Tells me, It's okay, it's okay, it's okay, it's going to be okay. Clots oozing out of me, cramps doubling me over, leaving me breathless. Cracks in my shell spreading, joining, my liquid insides uncontained and spilling out, blurring into a wet ocean of despair. 

The singalong portion of the evening. The words are easy, the artist says. The audience laughs. Here, try it:

What might have been lost? 
Louder. A chorus around us. His arms around me, holding my shattered shell together.
What might have been lost?
The happiest eight days of my life.
What might have been lost?
A cell cluster. 
A baby.
Everything.

Tuesday, August 29, 2017

Details

I stood outside the bar, my heart beating shallow rapid pats beneath my sternum. The sky was gray and heavy, threatening rain. I was on the phone with my best friend's little sister, and I was very, very late. She had just been dumped, unceremoniously and casually, by her partner of five years only a week or so prior. So lately, we had been on the phone a lot, sometimes urgently as she cried, and sometimes in comfortable silence while we ate dinner and browsed the internet, separate but together even hundreds of miles apart. I say my best friend's little sister because it is factually accurate, but for all intents and purposes she is also my little sister and I love her fiercely. Given half an opportunity, I would unceremoniously and casually crush her ex's pinky fingers beneath my SUV before sitting him down for a good long chat. Unfortunately, time was not what I had to spare that night. She had called me when I was leaving my house, which meant I had thirty-three minutes to talk with her before arriving at my destination. At minute forty-four, my heart jogging along in my anxious chest, I tried to gently end the conversation.
"Sweets, I'm so sorry, but I have to go. I have a...thing I have to go to." (In my head, I chanted - don't say date, don't say date, don't say date. Nothing says "fuck you and your broken heart" quite like someone else going on a first date.) "How about I call you after, if you're still awake, okay?" She agreed, and I hung up.
I barreled into the bar. I was officially almost twenty minutes late. I was not fashionably late. I was inconsiderate-bitch late. The bar was crowded and yet I found his face in seconds. I remember thinking, Whoah, and then, Shit, I wish I hadn't ruined this by being late.

I apologized and flashed my most winning smile. He accepted, more graciously than I deserved, confidently ordered a water while I ordered a beer, and proceeded to enthrall me for the next two hours. In the car on my way home, I texted my best friend, Call your sister. I was supposed to call her back but I'm busy ;)

* * *

In the dark last night, I held our palms together, carefully lining up the fingers. I tell him how my brain is like a library card catalog, each drawer filled with hundreds of carefully printed white cards, all containing detailed information (much of it useless): here is one with all the lyrics to the Backstreet Boys song, "I Want It That Way;" here's one with a brownie recipe, here's one with the terrible things a nursing school preceptor said to me one dark Tuesday night in med-surg clinical in October 2012, etc, etc. I imagine either the vast swaths of more useful information I could hold, or the oasis of calm that might exist in there if I could stop remembering every little thing. He tells me his brain is like a 3-D web of ideas that connect to each other in complex ways, that the small clusters connect to bigger ones, and he can see how they all relate but when he zooms in close, it's like an impressionist painting that only makes sense from far away.
I don't remember details, he tells me. 
I can't remember anything but details, I reply. 
He drops his hand to my belly and I roll over, eyes heavy. I think, he says softly, that between the two of us, we'll figure it out.

Saturday, July 15, 2017

The Dream

Gonna pack up and set aside maternity clothes for you...
reads the text from my midwife friend and my heart does a swooping leap and dive that leaves me a little sick.

I delivered her second baby a week ago yesterday. She is my anchor here, our friendship having grown like a sturdy little tree over the last two years, slowly but steadily, tiny leaves of vulnerability opening up between us over the weeks and months. Her first-born can say "Auntie" now, and then grins with pride, waiting for my reaction. He is mischievous and tow-headed and I love him fiercely. He rolled over on my yellow rug at four months old when she told me, We're going to have another one, after swearing up and down that she only wanted one child. I smiled, unsurprised. And waited another six months with her until they started trying again, consoling her gently when periods came and went. We would laugh, saying ruefully, We know too much, and it's true, we do - it is both agonizing and utterly unremarkable to be an expert in all things obstetrics and women's health and then to be a pawn of fate just like everybody else. It didn't take long. That sturdy toddler is twenty months old now, learned to say "baby" and kiss her belly, not a clue what was coming. She came in at 3 AM, I didn't remember it hurt this fucking much, got in the tub, held my hand, walked and rested and swore, tried to manage her own labor, stopped when I snapped at her, watched her baby's heart rate on the monitor till I turned it away, smiled at me in between contractions, said quietly, just once, Don't leave, and eventually, laughing, pushed for all of fifteen minutes and I wept, tears coursing down my face as I lifted up her second little tow-headed boy.

We were walking in the woods near her house three months ago, the dogs skipping ahead. I want to have a baby, I said. Maybe I'll just do it alone. The words hung there, terrifying and raw. She didn't miss a beat. I think that's great. Then our kids can be little together.

It's not what I pictured. I wanted the guy (or the girl) and the dog and the house and the chickens and the babies. It's not what I got, though. Cheryl Strayed gets it:

"Oh, the dream. The goddamned man + baby dream....
But please remember that the dream you have of finding a long-term romantic partner and having a baby is not just one dream. It's two. The partner dream and the baby dream are so intricately woven that you can be forgiven for thinking they're one. It's lovely if it is rolled up into one. It's more than lovely. It's convenient. It's conventional. It's economically advantageous. It's hella good when it's good.
But it isn't what you have."

* * *

I don't have it all worked out. I still don't know most of the answers to only some of the questions. But I'm starting to think that unconventional and inconvenient might be what I've got. Because I've also got friends like her, helping me along.

Saturday, May 20, 2017

Solitude

I decorated the porch for this apartment. It's on the third floor, and it faces south and west and the sun slants in, warm and quiet as the days grow steadily longer. It faces a tiny patch of grass and an alley and several other apartment buildings from which I can fairly often overhear people fighting, so it's nice, but, you know, it's also the kind of porch you get off the back wall of an affordable apartment. I put up twinkle lights and chairs and a little metal side table. I filled three pots with herbs and hung a planter and a thermometer with a cheery red needle. I almost never go out there. I don't sit in the chairs except briefly, sometimes, when I get back from a run. I have never, not once, plugged in the twinkle lights. I water the herbs and the planter out of habit. The porch feels like so many other things in my life - like a stupid naive field-of-dreams-type fantasy where I imagined that if I built it, they would come - "they" being someone to share this with. Someone to sit on the porch with me. Someone with whom to install a carseat safely into my sturdy, family-friendly SUV. Someone to eat the pile of leftovers sitting in my fridge until they rot.

And yes, through it all, I am fine. Painfully so. I am really good at being alone. I cook healthy food and I pay all my bills and I work my ass off and never call in sick. I'm open and friendly to cashiers and patients and coworkers. I take the dog for hikes and I go to concerts and I go out to dinner and I go see movies in the theater and I read epic novels from the library and watch interesting shows on Netflix and I talk to my parents and I nurture my friendships and contemplate relearning Spanish - and I do it all alone.

A colleague and I made small talk last night at a going away party. He asked me about why I take my dog to daycare thirty minutes away when I'm at work. I looked at him steadily. We've been friends for almost two years now. Because there's no one else to take care of her for twenty-four hours at a time, I said. He blushed. My perpetual singleness embarrassed him.  He had married (way above his station) and had two beautiful children by the time he was my age.

I told my therapist about Richard. About our relationship and how tumultuous it was, how I felt like I was always guessing at what to do and how to be. Why did you stay with him for so long? she asked me. For a lot of reasons, some of which I mentioned. But mostly because I worried - rightly, as it turned out - that he was my last shot at having a partner and a family on the approximate timeline I'd envisioned.

I change the radio station in the car when love songs come on. I drag my dog into the bed with me most nights, bending myself around her warmth. I cry, briefly and hard and then stop, telling myself savagely, The world doesn't owe you a partner. The world doesn't owe you a single fucking thing.

Sunday, September 25, 2016

Moments

We look good together, he says, laying his arm next to mine. His is like copper and milky coffee. I thought I was a little tan after this summer, but next to him, my skin practically glows, its luminescence seems to pulse.
I feel his hand on my belly, and I think idly about how flat it used to be and isn't anymore. I ask him about the work he has to do tomorrow, we joke about the cat calmly sitting at the end of the bed, taking a bath. Privacy is hard to come by around here, I tell him. He doesn't seem to mind.
I like you, he says, and bites my neck, just until it hurts, and then stops.
I like you too, I tell him.
He goes home. I go to sleep.

The chlorine makes my nose twitch. It takes a total suspension of disbelief to get in, every time. It is good practice for work. I know how awful it will feel to get in, and still, I snap on my goggles and push off from the pool wall into the freezing cold. It is the worst thing I've ever felt and it lasts less than ten seconds, I'm already warmer as I stroke down the pool. Nothing feels as good as the first lap, slicing through the water, the fastest I'll be all day. Except maybe the last lap, worn out, my lungs raw, my mind blank but for stroke, kick, breathe; stroke, kick, breathe. It takes all my concentration to remember what lap I'm on, there is no room for anything else. Eleven....eleven...eleven, I chant with each out-breath, the bubbles streaming from my mouth and nose. And then, twelve...twelve....twelve. I am so tired when I get home, I fall into bed, my legs feel leaden and hollow and delicious.

My midwife friend and I, we go to a festival today. It is the most New England affair - the sun is like whiskey and a few leaves fall. In the shade, I'm glad I wore a sweater. We wander through vendors selling handmade wool blankets, delicate watercolor paintings of local flora and fauna, we step over hula hoops left on the lawn for anyone to use. A ragtag group of dreadlocked people play something vaguely bluegrass-sounding, and all of a sudden, she remembers the massage slot she signed up for in the shiatsu tent. She hands me the baby and runs off. He sinks into my shoulder, gums his thumb, and hooks the other hand around my neck. We wander like this for twenty minutes, he is sleepy, sun-warmed, and content. It's been ten months like this, him and me. Auntie Caitlin is here! they cry to him when I come over and he grins, reaches for me, scoops out my beaten down heart and offers it back.

Saturday, July 9, 2016

Anywhere but here

It is so hot, the air is like a blanket over the house, this town, this lush green valley. The fan whirs dully and the lurid, waxy dreams cling to me like sticky cobwebs as my mind tries to surface from sleep. My limbs are heavy and damp, there are hot animal bodies pressed into me as I fight to open my eyes against the effects of the sleeping pills that blur the shift from night to day. It feels like giving up, admitting to my doctor that I can't sleep, that the sounds of fetal heartbeats, bump....bump.....bump-ing along at sixty beats per minute, half the rate it should be, that this is the soundtrack of my nightmares, playing on repeat over a looping reel of blue, slick, flopping babies pulled from bodies, silent. 
She listens calmly, makes a case for therapy and hands me a prescription for Ambien, which I fill, defeated but exhausted.

*  *  *

She'd just gone to the bathroom and as she climbed back into bed, the anesthesiologist was on his way, she wanted an epidural for this fourth baby's labor which was speeding along and leaving her breathless in its wake.
The nurse moved the fetal monitor all over her belly, her eyes found mine and time started its elastic stretching and pulling. 
Seconds that lasted hours of silence and then occasional beats heard, way, way too slow. 
She's on her hands and knees now, head into the bed, the oxygen is cranking at 10L a minute, I hear the angry hiss and I feel like I'm floating as I hear my voice ask for gloves, I apologize as I fit my whole hand inside her, feeling for a cord and all I can feel is the baby, her cervix, fluid.
Call the team, page the OB, open the OR, I hear my voice saying and there are four nurses now, we're wheeling the patient down the hall, she's on her back now, I pull her gown over her belly and feel silly for caring that the construction workers don't see her exposed because it will be the last thing she cares about if her baby is dead.
Her eyes find mine and I tell her calmly that she needs to keep taking deep breaths and that she's being very cooperative and I'm so sorry that this is happening but that her baby is telling us he needs to be born this very moment and so that is what we're going to do. 
I scrub for half the suggested time, the OB is here, her eyes are piercing as she checks the patient and the scrub tech dumps an operating kit onto the table with a crashing clang, someone slops half a bottle of iodine on her belly and it splashes the floor and stains dark brown. She's fully now, the OB says and makes a split second decision and I'm holding her legs back, I put my arm under her head and say, Now, you need to push like you've never pushed before. 
Deep breath in, that's right, chin to your chest, push with everything you've got. 
That's right, again, big breath in, no you're not contracting, we can't wait for the contractions, you've just got to push. 
They're putting a vacuum on the baby's head to help you, come on, one more time, yes you can do this, I know you can. 
Big breath in again, and now, GO, PUSH, NOW.

The baby takes a few tentative breaths and whimpers. I hold her hand and tell her calmly and quietly, Can you hear that? That's your baby starting to cry. The pediatrician is making sure he's okay. You need a few stitches, so the doctor is going to give you some numbing medicine first. That's right, deep breaths, it's over now, you did it. You did such a good job.
She looks up at me and the tears start in both eyes, running backwards into her ears on the operating table, she tells me with her words in a rush, I am so glad you were here.
I hug her, hard, her sister weeps into my shoulder and all I can think but would never say is, I want to be anywhere but here.

*  *  *

It's not entirely true, of course.
I love being a midwife. Most of the time.
But I wait, every time, for the time it doesn't end like this. 



DISCLAIMER: whenever I tell work stories here, they are conglomerations of multiple patients and I change details such that the actual stories no longer resemble any one patient's individual story. Yeah, HIPAA.

Wednesday, May 11, 2016

If it gets any worse

I am awoken from a feverish dream regarding field hockey and a girl I worked with at camp two years ago whose photos I was stalking on Facebook the other day. The pager is unconcerned, it BEEP BEEP BEEPs with cheery insistence while I blink my scratchy eyes and read the text: She's thirty-nine weeks pregnant and wants to talk about some cramping she's having. I sigh a little internally, but note with relief that the migraine I've been nursing all day has retreated to a dull roar by my nap, which has also left me with damp cheeks and sweaty hair stuck to the side of my face. It's gotta be eighty degrees in here with the sun peeking under the shade, I think. I gulp water while I pull up the patient's chart and dial her number.
She answers, breathless and tells me about having cramps "a few times an hour" for the past few hours and she doesn't know what that means, and it feels different than the cramps she was having the other day, and she doesn't think her water has broken, and most importantly - what should she do?!

I speak slowly and calmly and we talk about all the things that are reassuring about her situation - about how she's not bleeding, and her bag of water is almost certainly intact, and it can be very, very normal to have some cramping and some contractions at thirty-nine weeks pregnant and the best thing she can do is drink fluids, and maybe take a bath, try to sleep, and wait for real labor to start.

So...you're telling me to just...wait? Wait for things to get worse? She asks me, a little incredulous.
Yes, I tell her gently. You can call me back at any point if you feel worse or if you have questions. I'll be here all night.

*  *  *

She hangs up and immediately my phone rings and it's my mom, telling me that the worst I had feared is true, that my dad's infection is not getting better, it's actually getting worse and that he's going to be admitted to the hospital for stronger antibiotics and so they can try to figure out what's going on.

 I was just there, I drove fourteen hours round-trip for a two day visit and it was worth every second and yet now I sit, three hundred miles away, feeling utterly helpless and missing them both so much that a lump rises in my throat even as I tell myself - calmly and rationally - that it's just a UTI gone haywire and ceftriaxone is a wonderful and effective drug and that the chances of him being fine and the chances my patient is not in labor are roughly equal (i.e., approaching one hundred percent).

So...I just need to be here. And wait. Hopefully for things to get better, not worse, I tell myself, and I feel paralyzed. Stuck too far away from the people I love, but in a job I adore and a life that is starting to feel like a soft t-shirt that fits just right.

The words are easy, I've already said them once today, to my patient earlier, and now to my dear mama - I'll be here all night. Call me if it gets any worse.

It feels like the most useless thing I've ever said.