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.

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