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


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.

Wednesday, February 12, 2014

Birthday Shenanigans

The night before my 26th birthday last week, there was a snowstorm and I gave myself a snow day from clinical.  It was heavenly.  Made more heavenly by coffee and breakfast.

 And this was Tucker's birthday gift to me.  Isn't it special?  The artist and his masterpiece.

And this is the birthday vlog, version 3.0.  Mostly for my own posterity's sake, so that when I'm 95 and decrepit, I can remember what I thought about when I was a wee 26.  But also for your viewing entertainment, if you have nothing better to do.

Movie on 2-12-14 at 8.29 PM from Caitlin on Vimeo.

Thursday, January 30, 2014

Repeated Exposure

It's very subtle, how it begins.  It's like a twitch, in the back of my brain.  A flare of activity in a place that's long laid dormant but somehow, once triggered, feels instantly and sharply familiar.  There is frustration and impatience at first - I do not have time to feel like this now, thanks very much.  I hastily push it aside and move on.  Then, because it is so familiar and because it has never been nearly long enough to forget how it feels, there is slow acceptance.  I am a little older now, and a little wiser, and a little better at recognizing it when it comes - the rising tide of anxiety has found its way back to me.

I check myself, all the time.  I try to step back and assess whether this is actually stressful or difficult, or if I'm oversensitive and magnifying it to be so.  A psych lecturer the other day was discussing the roots of anxiety (free self-diagnosis is always an entertaining part of provider education).  In her world, everyone who is anxious is a war veteran, a victim of child abuse or rape, a closet drug addict and alcoholic - or all of the above.  Stupidly, perhaps, I asked her about those people who are anxious and depressed and none of those things.  She assured me that some people are just "extremely oversensitive individuals" and just don't know "how to handle stress."  Ah.  Got it.  Thanks a bunch.

It's January.  I know this.  It is dark, and the very most typical time of the year to feel this way.  It's cold, bitterly cold, every single day.  I haven't seen the boy since break and I miss him with an ache that is barely touched by Skype conversations and text messages.  I know all these things, and yet when I stand paralyzed in the middle of my kitchen, half-dressed and already panicking about the day ahead, it doesn't help to know those things.  It doesn't help when I feel my chest tightening around the knowledge that I have a quiz, four lectures, about a thousand pages of reading I'm behind on, twenty-four hours of clinical a week, and an empty gas tank facing me when I walk out the door.

I cry at the slightest thing.  I can feel my nerves that are exposed, like raw wires sparking in the sub-zero New England air.  The slightest thing - an insensitive comment from a friend, the way my preceptor spends two minutes with each OB patient - will set me off and I'll be leaking tears in a matter of moments.

The raw familiarity of these feelings is always the worst.  I think, forever, there is a part of me that hopes to be free from a history of mental illness.  That wishes if I could run far enough or fast enough away from it all that it will never catch me.

In my more rational moments, I know that familiarity, and education, and privilege also make me that much more able to access help, if I could only find the time to do it.

Wednesday, January 1, 2014

New Year's 2014

1.  What did you do in 2013 that you'd never done before?

Became a nurse!  And pelvic exams.  Lots and lots of pelvics.

2. Did you keep your new year’s resolutions, and will you make more for next year?  

I had to look back and here's the rundown:
1.  Keep running -- sort of, I did for several months, and then took several months off, and now I'm trying to start up again.
2.  Keep doing well in school -- yes, in so much as I'm passing and happy and learning as much as I can.
3.  Pass the NCLEX/become an RN -- yes!  Currently applying for summer camp nurse jobs with my fancy new license.
4.  "…move from loathing to loving your own skin." -- a never-ending process, but this is the first year I can remember where I spent more time appreciating my body and its capabilities than I spent wishing it were different and hurting myself to change it.  So that's pretty huge.
For this coming year, I strive to:
1.  Be consistent with fitness.
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.
3.  Less screen time.  Books are awesome, even my textbooks.

3. Did anyone close to you give birth?

No, but someone very dear to me is due in April.

4. Did anyone close to you die?

No, and I'm very grateful for that.

5. What countries did you visit?


6. What would you like to have in 2014 that you lacked in 2013?

A better balance between school and life - a lot of times this past year, I felt like I was either burning the candle on both ends, or slacking so utterly that it made my stomach clench.  I'm not sure either was true, but if I am consistently more balanced, then if helps me not feel like a swinging pendulum all the time.

7. What dates from 2013 will remain etched upon your memory, and why?

August 20th - took (and passed) the NCLEX
November 9th - my boy moved away

8. What was your biggest achievement of the year?

Becoming a nurse.  Being halfway done with grad school.  Sticking through the shitty times and finding that on the other side of those times, is the best/safest/most loving relationship I could have ever imagined.

9. What was your biggest failure?

I tried very hard to find an RN job after I got my license and didn't.  That still stings.  I also left many a patient visit this fall feeling like I had failed them, that I couldn't do nearly enough.

10. Did you suffer illness or injury?

Definitely sore after the half-marathon in April, my first ever UTI in July, and some fun GI stuff this fall that is now greatly improved.

11. What was the best thing you bought?

The solid beginning of a professional wardrobe. 

12. Whose behavior merited celebration?

The boy's (again), my parents' (always), and - perhaps most importantly - H. and I worked really freaking hard on our friendship and it shows.  And that makes me happy.

13. Whose behavior made you appalled and depressed?

I had some, um, interesting patients this fall.  I whipped out my very-serious-very-calm-but-very-intimidating clinician voice to good effect a few times.

14. Where did most of your money go?

Yale.  Always and forever.

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

Finishing my GEPN year, becoming a nurse, feeling like a real midwife, planning a future with the one I love.

16. What song will always remind you of 2013?

"Half Acre" by Hem.

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

Happier.  Onward and upward.

b) thinner or fatter?

Maybe a little thinner?  I don't really know.

c) richer or poorer?

Poorer.  Those emails from FedLoan Servicing are like punches to the gut.

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

Listening.  Sitting still.  Reading.  Running very fast.

19. What do you wish you’d done less of?

Overthinking.  Being defensive.  Feeling angry.  Facebook.

20. How did you spend Christmas?

With Richard's family in Ohio.  It was really hard being away from my family.

21. Did you fall in love in 2013?

Every single day, over and over again.

22. What was your favorite TV program?

I liked watching New Girl with the boy, and H. and I liked watching NY Med on Hulu during dinner.

23. Do you hate anyone now that you didn’t hate this time last year?

I don't hate anyone.  I hope that nobody hates me.

24. What was the best book you read?

I'm really enjoying The Golem and the Jinni by Helene Wecker.

25. What was your greatest musical discovery?

Hem, but mostly I listened to podcasts during my drives.  I fell in love with This American Life, Radiolab, The TED Radio Hour, and The Moth.

26. What did you want and get?

A relationship that lasts through the tough times, another year to grow and develop, and some truly amazing friendships that I didn't have before.

27. What did you want and not get?

A baby.

28. What was your favorite film of this year?

The boy and I watched "We're the Millers" the other day and it was, by far, the funniest thing I have seen in a very long time.

29. What did you do on your birthday, and how old were you?

I turned 25, and felt suddenly very, very old.  I had a test that day, and two more that week, but in between a very stressful school workload, Richard and I went out for dinner and saw a monster truck show.

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

Again, easing this loan stress would be nice.

31. How would you describe your personal fashion concept in 2013?

Adulthood!  I wear dresses and slacks and flats and blouses to clinical now, and jeans and scarves and sweaters to school.  And plenty of old scrubs and stolen boyfriend t-shirts the rest of the time.

32. What kept you sane?

Richard.  My parents.  Hallie.  My garden.   Cooking.  Sleep.

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

Pope Francis, without question.  He is a leader and a revolutionary, and I admire him.

34. What political issue stirred you the most?

Healthcare, again.  I am extremely disappointed in how the ACA is going so far.  I lost count of the number of patients I saw this year who attempted, and failed, to get healthcare for themselves and their families and were left with no good options.

35. Who did you miss?

I missed Richard so, so much when he moved (it's nice being here with him on break, but that is ending soon).  I miss my parents, always, and especially this Christmas.

36. Who was the best new person you met?

I have two amazing school friends that I only knew peripherally last year.

37. Tell us a valuable life lesson you learned in 2013.

You don't have to have all of the answers.  You just have to be willing to listen to the stories.

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

All my life is arm in arm with you
When you've got trouble I've got trouble, too.

Long post!  Congrats if you got through it all!

Here's to a happy, healthy 2014 for us all!

New Year's 2013
New Year's 2012