Wednesday, February 18, 2015


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.