Wednesday, February 18, 2015

Coping

When a woman is in hard, heavy labor, asking her what her pain level is is the equivalent of asking to be slapped. It's high. Really fucking high, and your stupid zero to ten pain scale doesn't really work for me, thanks very much. Instead, we ask her how she feels she is coping with her pain. It's the same idea, and yet the complete antithesis. Usually, people can tell you very genuinely how they feel they're coping, and it almost never has very much to do with how much objective pain they're experiencing. As a midwife, I spend a lot of time explaining labor pain prenatally, and trying to encourage women to let go of our evolutionarily honed reaction to pain (Run! Fight! Escape!) because this pain is different, and productive, and is bringing their baby closer to being in their arms. We talk about being in the moment, about being only in this contraction and then letting it go. Don't think about the ones that have already happened, or the ones ahead of you. Just be here now. And then sometimes, none of that works and a patient can't or won't push because it hurts just too, too much and I have to put on my no bullshit voice and say, "Yep, you're right. It does hurt. It hurts so, so much and you still need to push because that's the only way it's ever going to end." Sometimes it works, sometimes it doesn't.

When people ask how I'm doing out here, it feels like the "what's your pain level" question and I don't know how to answer. Shitty, I think, or It's fine if I'm feeling polite. Some days, I'm too anxious to eat and my stomach is in knots until I walk out of the hospital and the knot loosens slightly, until I walk into this house that is not mine and so far from anything familiar and a new knot forms and I fall into bed, exhausted, at 8:00. My patient last week bled a bucket of blood while we watched, rivers pouring out of her while we tried everything we could to make it stop. A different patient had a baby after being raped by a friend and had a panic attack about going home because she couldn't wrap her head around loving this baby while hating how she came to be. A third patient spent forty-five minutes of her first prenatal appointment telling me why she hadn't presented for care until she was twenty-three weeks along, why none of her other five kids live with her, and why oxycodone is the only thing that works for her sciatica and how she really, really needed some more.

So I come home, after days like this, and I watch Netflix movies, and apply to jobs, and drink endless cups of hot tea. On my days off I drive to the canyon so I can lay in the sun on the warm rocks and read in the total silence but for bird calls. I drive with the window open and I take pictures of cows. I drink more tea. I make biscuits to go with my vegetable stew and then eat two bites of stew and two giant biscuits and then I'm full and have to wrap up the stew and tell myself I'll eat it tomorrow. I look for puppies on shelter websites and reread the cards and letters I've been sent, and feel them like warm hugs wrapped around me.

The pain is still there. The loneliness, the isolation, the unknowns, and the anxiety. But the coping is there too. I'm breathing through it all. I'm doing okay. Just don't ask me to rate it from zero to ten.


Sunday, February 8, 2015

Gaining Ground

I turned 27 the other day. I told my sister on Skype the night before that there was no going back now, that "late twenties" is almost thirty and I just don't know how I feel about that. When do you stop having existential crises on your birthday? I'm genuinely curious.


I was trying to be very calm and matter of fact about being alone on my birthday which was all well and good until I just absolutely fell apart about it the night before and sobbed myself into a snotty mess for twenty minutes. Washing my face after and peeling my contacts off my red eyes, I knew that it wasn't really about my birthday at all, it was about being more deeply and achingly lonely than I've ever felt before, and something about the supposed significance of the following day was just clanging that particular bell.


It's an interesting space, existing in this loneliness. It's just here. It is here, and I am here, and we exist together, my loneliness and I. All that said, I am glad I am here. I am fiercely proud of taking this leap. Most days, I feel brave for doing this. Sometimes, I just feel like an idiot. And then I see things like mountains and the sky and I learn about a plant called "Mormon tea" and my mind unfolds a little bit more and the loneliness backs off just a touch.


I caught a baby girl on my birthday. I campaigned hard for them to name her after me, but no dice. I told her mama it was a good day to be born while she laughed as she saw my whole right leg was soaked in the wave of amniotic fluid that had followed her baby girl into the world. The next day in clinic, one of the midwives, upon hearing it had been my birthday the day before, began dissecting my personality via my star chart. Patients walked by the open door, charts piled up around us while she told me matter of factly that I was a chatterbox, that I had strong friendships, that while I was meant for a career in "birth, death, and transformations" (duh), I was also aloof and way too analytical. My loneliness makes me feel raw most of the time. I've lost a layer of buffering between me and subtle cruelties, and the tears welled in my eyes when she said I was aloof. Am I? I wondered. Probably, I mean, she said so.


I tried to tell the story like it was a funny little lark of a tale the next day, while I helped a different midwife pack up her UHaul to leave this place. I tried to say it all lightly, like I didn't care what she had said about me. "Aloof?" this other one asked skeptically. "I don't think you're aloof, if anything, I thought you were way too forward when I met you."

How do I keep forgetting how raw my edges are, before I open my mouth?


I slept, finally, last night. Today I spent a day doing homework in a sunshine-filled coffee shop, bought myself a scarf, ate pizza with a med student who leaves on Monday, but whose company has been a tiny anchor in this sandstorm. She sent me a 12-minute read about how to not give a fuck and I felt a weight lift from me when I read it tonight. I'm being more careful about where my fucks are given. Not to people who don't know me who say things that cut my tender edges. Not to this house that doesn't feel like home, but is ultimately temporary.
To my patients, battling through their darkest moments in front of me - yes.
To the puppy I might take home from this desert land - yes.
To trying to find a job that pushes me and also respects me - fuck yes.
To the people who love me from so far away, but whose kind words and gestures and gifts reach me even here - always yes.


Because this is all that I am.
I exist in the space where it all bleeds together, the sand running in my bones, my edges sharp and raw, tender and bruised, healing back together stronger than before. I proudly own my thousands of imperfections and trace the seams of where I have put myself back together over and over again, badly broken by things much worse than idle words. Getting up, stubborn, coming here and ignoring their words, reserving my fucks to be given with care. This is 27.

Saturday, January 24, 2015

Trust

The dogs here are teaching me. They are teaching me that dogs are descendants of wolves and that until knowing these dogs, I have not really known dogs at all. They wander the Rez, in twos and threes, with dirty sandy fur and mats around the burrs stuck in their ruffled necks, their keen brown and blue eyes calculating me coolly, warily. We communicate through a series of agreed upon movements and gestures; words are meaningless. I squat down, turn my palms up and wait. They crawl towards me on dusty bellies and I rub under their chin and over their ears and they lick my chin and roll over in almost aggressive displays of submission. A few of them join me on my runs, usually. They find me on the trails, often so quiet behind me that they make me start when I look down and see their dark noses pushing into the backs of my knees. They run ahead of me, their white-tipped tails leading the way. They circle back around me when I have to walk, exhausted by the sandy, slippery trails and the 5,000 feet of elevation that my lungs are still protesting fiercely. If they are strays, they are smart ones, but mostly they are pets in the Navajo way of thinking. Only we crazy white people invite animals into our homes and into our beds. These dogs are animals. They are fed, and watered, and cared for, but they are not furniture-shredding, barking, insolent creatures. They are a self-sufficient pack, and they are teaching me a whole new order to the universe that depends sorely on paying attention. One wrong move, one tiny lip curl, one uplifted ear, and I could be seriously bitten out on the dark sandy trails. So I pay attention. And I learn body language like I've never learned it before.


I walk into clinic rooms and hospital rooms and feel my whiteness like I'm naked, like a brand on my face, like a sign around my neck. I am so cautious, I am constantly second-guessing what I say. I take deep breaths and speak quietly and try to tell myself that if I can figure out dog body language, I can do this too. The words feel strange in my mouth as I learn new ways to counsel and consent people that are all in the passive and third person voice. "A woman might ovulate and conceive a baby before her period returns. It can be difficult for a woman's body to become pregnant again so soon after she has had a baby. Would you like to hear about options a woman might have for birth control?" No, she would not. Not her body, and not her baby, certainly, because that's as good as inviting it to happen. So I shut up. And I give her condoms and Plan B and talk about lactational amenorrhea and do a breast exam without lifting her gown, learning to trust my hands more than my eyes in order to protect her modesty. I watch her face when I ask her, barely above a whisper, if she feels safe at home. Her husband is on the other side of the curtain, silent, holding their new baby. I look for the slightest twitch. "Yes," she says quietly and I move to the other breast. "What a beautiful baby," I say when we're done. Her husband smiles at me and nods. "Yes," she says simply.

I am learning to trust. I trust the dogs not to bite me. I trust my hands to find suspicious lumps without the aid of my eyes. I trust my voice to convey my intentions, even when my words are clumsy and wrong. Above all, I trust my patients and their deep and abiding ability to survive in this desolate and barren desert, their children loved and adorable, their hands worn and calloused, their eyes still bright and happy.

And the more I trust, the more I can see.

Monday, January 12, 2015

From East to West

Do you know how big the continental United States is? Because I'm learning. And it's enormous. It feels oceanic, glacial, expansive - I've run out of adjectives. The bigger it feels, the safer my car interior and my nightly hotel room boxes begin to seem. I sit for whole minutes in my car, the engine off, gathering my courage and my wits in order to get out and move my tiny insignificant self from one safe port to another and then back again. I have never filled and emptied my gas tank so much before (it feels). I'm still shocked every time that the nozzle clicks off and the total reads $19.01, $18.49, $15.12. The last time I remember seeing gas for $1.79/gallon, I was in high school.


Indiana and Illinois are the flattest things I have ever seen. I felt like an ant in a gymnasium. The horizon never seemed to move, and had my gas tank not been steadily emptying, I would have thought I was suspended in a floating, unmoving bubble rather than covering miles of ground.

Outside St. Louis, Missouri, I got into a fight with Siri. She was so calmly telling me to exit at an exit that wasn't there until, whoops, suddenly there it was and her crystal clear self telling me to "Exit now," was too much for me and I told her she was an idiot and that she needs to warn people before the exit, because that is literally the point of having Google Maps with navigation features. She told me to drive six miles further and get on I-44W another way and it worked so I calmed down and felt badly for yelling at her so I and asked her to tell me about the St. Louis arch and she placidly read me the (entire) Wikipedia page about it. (Dear Tom Hanks in Castaway, with Wilson - I understand you now.)


Illinois is home to the world's largest wind chimes. Betcha didn't know that was even a thing. Oh, but it is. And across the street from this gem - which, by the way, I pulled the rope for and made it chime and it was the single best moment of my day - is this other gem:


Coming soon! Maybe I'll catch it on my way back through.

The further south and west I go, the less and less variety there is on the radio. Christian music, country music, and Christian country music are my three options. The commercials are for tractor sales and during the news breaks, DJs discuss the price of soybean seed at the local auction house. I feel sometimes intensely foreign, like my bright blue Connecticut license plate is a kind of nakedness that I can't cover up. Other times, it just feels like a flatter, more expansive version of the farmland I grew up in. Then I'll see a hand-painted sign that says, "OBAMA LIES," or two billboards stacked on top of each other, the top demanding, "DO YOU KNOW JESUS?" with a phone number to call (Hello, Jesus? Yes, I have some things I'd like to discuss with you...), and the bottom directing me to the closest "ADULT SUPERCENTER STORE, 2 EXITS AHEAD." And then I feel naked again, with my HRC magnet and my Coexist bumper sticker, and I have to take deep breaths before leaving my car and remind myself sternly that by and large, people are good and kind and wish me no harm, and the dead bolt is locked, and my phone is charged, and I am safe, I am safe, I am safe.


Thursday, January 1, 2015

New Year's 2015

New Year's 2015

1.  What did you do in 2014 that you'd never done before?
 
Caught babies.
Camp nursing.
Was more kind to myself than unkind (I probably was capable of this pre-adolescence, but it's been a long time, so I'm calling it a new development.)

2. Did you keep your new year’s resolutions, and will you make more for next year?  
 
Last year, I said I would...
1.  Be consistent with fitness. Short answer = no. Long answer = let's be honest, I'll always be working on this. I have a plan for 2015 that I'm not writing about because it'll jinx it. I'll write about it once it happens.
2.  Nurture the relationships and friendships I am blessed with - stop being lazy about Skype, phone calls, and emails to the people I care about. I think I did better with this. Communication is hard, but god if loneliness isn't harder. I had some rough times this summer, feeling so cut off and alone. But then I'd write a letter and inevitably, get something awesome in return. Richard, Hallie, my mom - they all wrote me fantastic, loving, hilarious letters and cards that brightened my days.
3.  Less screen time.  Books are awesome, even my textbooks. I was definitely more proactive about turning screens off this year. I've been reading a bunch this break.
 
I need to give myself credit for other things I did this year that I never planned to:
1. My dentist scolded me, so now I consistently brush my teeth twice a day. And I floss every day (I've been doing that since I was a kid, but I know a lot of people don't, so I'm taking credit for that one, so there.)
2. My midwife scolded me, so now I take calcium every day. I also take magnesium, zinc, and melatonin to help me sleep and whether it's the placebo effect or not, it works more often than not.
3. I take my contacts out every night. Boom. No exceptions. My eyes love me.
 
Resolutions for 2015:
1. This running thing I can't tell you about.
2. Keep reading for fun, even when I'm busy.
3. Be patient. With Richard, with myself, with the world.

3. Did anyone close to you give birth?
 
Yes! My oldest friend had a baby in April and it was magical. Another close friend is due in July and I am all of the happy (and also all of the when-is-it-my-turn).

4. Did anyone close to you die?

No, and for that I am grateful.

5. What countries did you visit?

Not a damn one.

6. What would you like to have in 2015 that you lacked in 2014?

I would really, really like (nay, need) to be working as a full-time midwife and be done with school. I would also like to live in the same place as my boyfriend. The long-distance thing is wearing me down.

7. What dates from 2014 will remain etched upon your memory, and why?
 
March - went to a good college friend's wedding (the first from our friend group)
April 10 - Bailey was born
July - Bailey's mom - my oldest friend - gave me a week's notice about her wedding that I flew home to go to, and I am so glad I did.
November - had the shift I've been waiting for, left the hospital and cried happy tears in my car and remembered why I wanted to be a midwife in the first place

8. What was your biggest achievement of the year?
 
Keeping going.

9. What was your biggest failure?

Doubt. Scary, gut-swallowing, soul-eating doubt.

10. Did you suffer illness or injury?

I had a bad cold over Thanksgiving. That was it.

11. What was the best thing you bought?
 
Plane tickets to be with the people I loved - last-minute, planned, cross-country, whatever. My people matter.

12. Whose behavior merited celebration?

Richard, always. He keeps the faith when the floor falls out from beneath me.
H., again. She knows the soggy rotting bottom of my hollowed-out heart.
My parents, forever. They love me not in spite of my imperfections, but because of them.
My patients, no matter their circumstances. Birthing babies is hard. Every one of them made it to the other side.

13. Whose behavior made you appalled and depressed?

I quietly unfriended a lot of people on FB this year.
 
14. Where did most of your money go?

Yale.  Until I die.

15. What did you get really, really, really excited about?

Catching babies.
Working as a nurse.
Being done with classes.
Looking ahead - with terror - to integration.

16. What song will always remind you of 2014?

"Middle Distance Runner," by Sea Wolf

17. Compared to this time last year, are you: a) happier or sadder?

Little of both. I'm happy about the possibilities the future holds, but I am sad to be moving so quickly away from the past that I know and love.

b) thinner or fatter?

Maybe a little fatter? Don't really know.

c) richer or poorer?

Poorer. Always.

18. What do you wish you’d done more of?

Breathing very slowly. Running very fast. Sleeping. Swimming. Loving without expectations.
 
19. What do you wish you’d done less of?

Getting angry. Doubting. Eating takeout. Worrying about the future.

20. How did you spend Christmas?
 
Here on the lake at my parents'. Richard came for a few days, and I remembered that home is how his chin fits on my shoulder, not in an empty room in New Haven.

21. Did you fall in love in 2014?

Every day, for the rest of my life.

22. What was your favorite TV program?
 
I watched a lot of Gilmore Girls with H., some Grey's Anatomy, and some Biggest Loser. I also went on a 2-week SVU binge that gave me nightmares every night so I had to stop.
 
23. Do you hate anyone now that you didn’t hate this time last year?

No, but I did have someone tell me this year that I was a terrible, cruel person. I consider it a personal accomplishment that I don't hate them.

24. What was the best book you read?

Being Mortal, by Atul Gawande
Still Points North, by Leigh Newman
Far From the Tree, by Andrew Solomon

25. What was your greatest musical discovery?

Radical Face

26. What did you want and get?
 
Being almost done with this grad school thing.
Another year with the one I love.
My parents' health.

27. What did you want and not get?

A baby, still.

28. What was your favorite film of this year?

Mockingjay, Part 1 was fun.
The Fault in Our Stars left me gasping through sobs. But in a good way!

29. What did you do on your birthday, and how old were you?
 
I turned 26 and skipped clinical, flush with the knowledge that this is the last year of my life that I can even remotely do something like that. My mom and aunt came to visit the next weekend and I loved showing them around New Haven. I felt exactly the same as 25 and I missed Richard in a way that felt like a bitter taste in my mouth.

30. What one thing would have made your year immeasurably more satisfying?

Seeing Richard more.

31. How would you describe your personal fashion concept in 2014?
 
This was the summer of blue camp shirts and wearing the same pair of shorts for four days in a row. The rest of the time, I wore a lot of sweaters and boots and scarves.

32. What kept you sane?
 
The cats. Richard. Hallie. My family. When babies cry right away. Sleep.

33. Which celebrity/public figure did you fancy the most?

The new NICE guidelines that recommend out-of-hospital, midwife-attended birth for healthy women! (So I know this is a stretch, but I'm admiring the National Institute for Health and Care Excellence and calling it a celebrity/public figure.)

34. What political issue stirred you the most?

I was stirred, in multiple and complex ways, by the deaths and court cases this year (Michael Brown, Eric Garner).

35. Who did you miss?

Richard, every damn day.

36. Who was the best new person you met?

Bailey. She was so brand new, we were all thrilled to meet her.

37. Tell us a valuable life lesson you learned in 2014.
 
The perineum is sometimes shorter than you think it is.
If you think a mom sounds grunty and like she's pushing, you should trust yourself.
Babies come out. Big babies, little moms, crazy midwives - doesn't matter. Babies come out.
You'll know when it's a hemorrhage.
Exercise helps with bad feelings.
There are unknowable depths to the people we love. This is a good thing.
Never underestimate the power of an ice pack.
How we die matters just as much as how we are born.
It's okay to be scared.

38. Quote a song lyric that sums up your year.

Ships are launching from my chest
Some have names but most do not
If you find one, please let me know what piece I've lost.
 

Long post!  Congrats if you got through it all!

Here's to a happy, healthy 2015 for us all!

New Year's 2014
New Year's 2013
New Year's 2012

Wednesday, December 31, 2014

A Year in Pictures

I didn't write very much this year. I think I was busy doing other things. Looking back on it, I really wish I had written about those things because some of them were really hard and it probably would have helped. I wish I had written about the time I caught a baby for a woman who was so high that she couldn't tell me her name as her uterus contracted nonstop and she started pushing at six centimeters. A baby boy slid out, gray and silent and she wouldn't look at him while the pediatric PA worked for fifteen minutes to get him pink and breathing. I watched the sweat drip off my forehead onto her thigh as I stuck my entire hand in her uterus and pressed down on her belly, hard, I knew it hurt but she didn't react and that scared me more than if she'd reared up yelling and screaming in my face. I could feel her uterus pouring blood into the bag between my knees and I knew there was cocaine in her blood and I imagined I could smell it, like its acrid, putrid scent was burning the inside of my nose as she bled and bled and her silent baby would not cry. Cry, I screamed in my head at the baby, and Stop fucking bleeding, I screamed in my head at her, and finally they both did, and I said to myself, This is not what I thought it'd be like, even though, by now, of course, I should know.

All of the studying. With Tucker, of course.
I should have written about packing up all of my worldly possessions - which meant getting rid of a good percentage of them. Boxes of books, clothes, jewelry, kitchen castoffs and other detritus sat on our sidewalk in the cold drizzle and I caught glimpses of passersby rifling through it. It felt like a tiny rejection when they walked away empty-handed. I sorted through memory boxes, recycling an avalanche of notes, birthday cards, love letters. I was relentless, told myself none of it mattered, it was all trash and then staring up at me would be a birthday card from my grandmother, the last one she wrote me before she died, her handwriting delicate, her cursive perfect. I'd crack open, it was like digging again and again at a barely healing scab. Apology notes after knock-down, drag-out fights over a topic I've long since forgotten. Sweet nothings from lovers I've half convinced myself never even existed, so complete is their vanishing act. I woke up the last morning in my room, emptied of everything that made it mine, and felt hollowed out and raw. This place was home, and the things that filled it, my things, were part of an anchor, holding me steady. And just like that, they're gone.

My room.

Campers, doing art.

Summer camp tie-dye.

Campfire cooking. Closed-toe shoes required.
I wrote about camp, some. It consumed me, consumed my entire summer and all my energy and left me wrung out at the end of every day. It was exhausting and doable and eternally frustrating and oftentimes completely fun. I remembered how important the outdoors are to my soul while I simultaneously grew an appreciation for buildings with insulation and electricity and the capacity for bath towels to dry in between showers. I learned what loons sound like, how to identify a white sycamore, the superiority of lake swimming over daily bathing, and how to talk to nine excited teenage girls at once. I saw my tortured teenage self in so many of them, and longed to bundle them all up in my arms and reassure them that good lord, life gets so much better than what it is at 15 but for pity's sake, stop being so frightfully mean to one another. Babies are so much simpler.


And this girl. Always this girl. I can't think too much about not living with her anymore because it makes me want to cry. Our friendship has not always been easy. We have fought, we have grown apart (then grown back together again), and we have said terrible things to each other. But our capacity to return to each other, to try again (and again, and again), to hold each other up and know one another inside and out - it is the truest thing I know and probably the only thing I really believe in.

Another year gone. Bring it on, 2015.

Tuesday, August 12, 2014

Drumbeats

The rain is coming down in sheets. I drive, mind either blank or racing, extremes being the obvious choice for comfort zones.
NPR drones, a voice is describing the surface of the earth being like the surface of a drum, showing and broadcasting the turmoil that occurs deep within its core, things like earthquakes and volcanoes and eruptions.
I think of my core erupting, over and over again in twenty-six and a half years, my drum surface struggling to broadcast what's underneath.
A week before the end of camp, we sat in the pine grove, idly chatting before Sunday meeting. My legs stretched out in front of me, tanner than I've ever seen them, despite copious amounts of SPF 30. A sort-of friend asks me, nonchalantly, about the scars on my left thigh. What happened?
I don't blame her for asking. They stand out in sharp relief, white and puckered against the darkened expanse of skin.
The moment stretches to an infinity in my mind. I feel my drum surface caving inward, the volcano of years ago smoldering now. 
I think of days spent only in bed, alternating between crying and sleeping.
I think of hiding in shower stalls, in closets, in empty classrooms. Digging my nails into my palms until bloody half moons appeared, biting my tongue until my mouth tasted of metal, feeling like I was drowning under the lava flow of unwarranted grief.
I think of how I let hunger carve a void into which I placed every emotion I ever felt, one by one.
Anger, sadness, contentment, loneliness, excitement, despair.
My drum's surface, cracked and silent, reverberating nothing. 
Now, though, my tattoos curve over flesh instead of bone. I catch glimpses of myself in mirrors and no longer startle in fear. 
I take vitamins and only cry maybe not that much more often than anyone else.
I still don't sleep, deeply, almost ever. 
The waves of paralyzing, terrifying grief ebb at my sweaty palms and rabbit mind in the dark hours of the night but they retreat with the sunrise.
I name emotions for myself, like flashcards in my mind. This is contentment, this is joy, this is exhaustion, this is frustration, this is fear.
The names are a drumbeat, tentative.
The meals, a drumbeat too. Steady in the background, three times a day, it is so boring I could die. This is gallows humor. This is laughing. This is fun.
Meanwhile, there are meds to pass and charts to write, and in the fall, there are babies to catch and exams to take and it occurs to me that this ebb and flow, the emotions I name to ground my drumming heart into the lava hot core of myself, that this is normality, that anxious and lonely and sad are not just my drumbeats, but everyone's, sometimes.
The moment snaps back and only half a second has passed.
Self-inflicted, I say calmly, with a half smile and an almost apologetic shrug, as if to say, Oh, you know - a little self-mutilation. Haven't we all been there?
And no, we haven't, that's obvious. But in other ways, yes we have.
She gives me a half-smile back and nods.
Someone rings the bell to start.
Oh Camp Arcadia, when we are with you…

* * *

These words have been brewing inside me for weeks, but they have new meaning for me in light of Robin Williams' death. Many, many people know the pain of depression and have felt - and answered - the siren song of suicide. I often quake in the enormity of my fortune that I made it through my bad years with nothing worse than a few scars and a propensity to write long-winded blog posts on the subject. My heart aches for the families of all those who never saw their waves of despair ebb away and leave something brighter in its wake.

Tuesday, July 22, 2014

Four Tiny Cups

Her chin is quivering before she even walks in the door.

"Hi there, lovey. What's going on?"

"My toe hurts." Her words are barely perceptible, save for me watching her lips move.

"Your toe hurts? That's no good. Let's do your ibuprofen and see if that helps."

She's nine, but the size of a seven-year-old, and she ripped her toe open on the beach the other day. I will grant her that it probably hurts, but the quivering chin and brimming eyes seem to be about more than a banged-up toe. She takes her medicine like a champ, but the minute I brush her hair away from her face, the tears overflow.

We sit, my arms around her as she sobs on my lap. She nods emphatically when I say things like, "It's hard to be away from home, isn't it?" and "Camp is fun, but the first few days are really tough to get used to."

Eventually, she sips some ice water and we listen to three Bruno Mars songs on my phone until she's humming along the tiniest bit. We agree to write a letter to her parents this afternoon, and we talk about how much fun swimming will be tomorrow when we take the bandage off her toe. I piggyback her to her cabin and tell her I'll see her in three hours for some Tylenol.


This time, she's limp-running in through the door.

"I need four tiny cups! Please!"

"Well, sure you do. What are you guys doing in arts and crafts?"

"We're making a moose out of leaves and twigs and the cups will be his feet okay thanks for the cups bye!"

And she's off. And the Tylenol is long forgotten, and I can't wait to see this moose-creation with cups for hooves and twigs for antlers and leaves for fur.




Sometimes I miss midwifery, but all day every day, I love this job. Even in the moments when I hate it, I still love it (I know that makes no sense.). Being a camp nurse is like nothing I could have ever imagined, but so much better than I could have ever predicted.

Tuesday, April 22, 2014

When It's Someone You Love

I thought I knew what it's like to be with someone in labor. And I did, in a sense. With my patients. My patients are lovely and amusing and sometimes frustrating but brave and powerful and utterly remarkable. But I am their midwife, and they are my patients, and those are our roles.  

Two weeks ago, my oldest friend had a baby. She is brave and powerful and amazing, just like my patients are, but I am not her midwife and so I was a wreck. I was a wreck because I love her so much and I loved her baby even before she was born and I didn't know how different it was to be with someone, really with someone in that space, someone that you love. 

I drove the six hours to be with her because I couldn't imagine missing it. I met her boyfriend for the first time when I got there, and gladly accepted hugs from her mother, who I've called "Mom" for as long as I can remember.

I made her walk the halls with me for four hours and we caught up on life as it is now, and reminisced about our high school antics until she couldn't talk during her contractions and we were running out of ice chips. I tried very hard not to hover over her when the midwife would check her cervix, and I tried to be helpful to her nurses who were, every one of them, so kind. I listened carefully to everything every doctor and midwife said and then explained it all again to her family, drawing little diagrams in the air when the baby turned out to be OP, and explaining what the fetal monitor meant with all its squiggly lines.

I held her hand and dozed in between her contractions, because her epidural only took the edge off and she woke up with every one. Twice, through a haze of Nubain and Benadryl, she woke up and looked at me and told me, "I'm so glad you're here. I couldn't do this without you," and I smiled and told her there was nowhere I'd rather be. She closed her eyes again and I felt like breaking open as a tear leaked down my nose because I wanted to take all her pain and hold it inside me and bury it deep but I couldn't.

I changed the pad under her every time she felt wet, and I made her open her eyes and look at me when she couldn't stop saying, I can't, I can't, I can't, and I told her that yes she could, she already was, and to squeeze my hand as hard as it hurt and to push through the pain even though it felt impossible.

And in the end, after the consent had been signed and her epidural was bolused, I pulled the curtain around us and sat on her bed and told her that it wasn't her fault, that the baby wasn't moving down because of how her head was positioned and that she did such a good job, the best job ever, and that everything was going to be okay. I told her how brave she was, and how strong she had been, and how after 48 hours of labor, the doctors were right, it was time for a Cesarean.

They wheeled her away and I fell apart. I felt like I'd failed her, like I'd let down my oldest and dearest friend by not being able to doula her out of an OP, asynclitic and unflexed baby's head. I am blessed to have midwifery friends who very gently and matter-of-factly pointed out how ridiculous that was.

So I waited till she was out of surgery, and helped her get the baby latched on, and stayed just a tiny bit longer and then drove all the way back to Connecticut in the wee hours of the night, already missing her sweet face and the baby's soft downy hair. 

I couldn't be her midwife, but that was okay. Because I am so lucky to be her friend.


Thursday, March 27, 2014

The First

The first birth was awful.

I wanted it to be amazing. I wanted it to make me feel like a real midwife, like I could be good at this thing that I am both in love with and utterly terrified of. Instead, this woman I was with, she was only a couple of years younger than me and she did not trust me. In hindsight, this does not faze me. I get it. I'm 26, I was doing a less than spectacular job at faking any semblance of aptitude or confidence, and she was just done. Done with her contractions, done with the baby's father talking on his phone while she was racked with pain, done with her mother-in-law asking loudly when the hospital was going to do paternity testing because she was sure, she was positive that this baby was not her son's, and of course, done with the student midwife even being in the same room as her. So I did my best and offered to my preceptor to sit this one out and merely observe, in a genuine attempt to respect this woman's wishes, and was met with deaf ears.

"This is a teaching hospital. She needs to get over it."

Um, okay. Wow.

So in the end, no one was happy. My preceptor was annoyed that I dropped my hands away from the baby's head when the mother screamed, "No!! Don't touch me!" I was done trying to walk a fine line between respecting a person's body integrity and right to refuse whatever the hell they want to refuse - including having a student catch your baby - and trying to please whichever random "teacher" I'm spending a given 12 hours with. I was shaken by being so despised, in that moment, by someone who didn't know me at all, and - I'll admit - I was hurt and upset and took the whole thing far too personally. I grazed the baby's ears as they emerged and then, a few minutes later, managed to very messily deliver the placenta with shaking hands, waiting to be screamed at again by someone (anyone, really).

Ten minutes later, we were sitting in the chart room and my preceptor says matter-of-factly, "Okay, great. So that was your first catch. Here's the birth certificate, can you fill this out? Front and back."

I nodded, smiled, and excused myself to the bathroom where I sat on the floor, shivering uncontrollably, and took deep cleansing breaths until I'd breathed out all the adrenaline and guilt and fear and disappointment and anger and confusion until I was an empty shell of somebody calm and detached and wholly unlike me. That night, in the dark of my bedroom, I finally gave in to the sharp stab of hurt at being unwanted, of being terrible at something I so badly want to be excellent at, but mostly, at feeling such overwhelming sadness and guilt that I had been a part of something awful. Of a woman having a birth that was not her own, and not what she wanted. I hated everything about my implicitness in that.

If I've learned anything so far in school, it's that resiliency is far more important than aptitude. I still hate that school is a place where I am not the midwife I will be one day. Where I jump at the chance to perform amniotomies and place intrauterine pressure catheters because if I don't do those things now, I'll never learn how. Where I'm at the mercy and whims of every single preceptor, all of whom want different things, and none of whom are wrong. Where I spend 12 exhausting hours doing labor support for a primip only to be told to walk away at 7 PM so that the ER resident can catch her baby at 7:15. But - and this is a big but - the moments of wet squalling babies whooshing out on a wave of fluid, the pulsing cords, the reaching hands, and the tears that cross every language barrier in the room, those moments remind me why I'm here.

And they're what have finally brought me back to writing, after far too long.