This One's Not About Midwifery

Most of midwifing is about joy, whether subtle or overt – the excitement of a new pregnancy, the welcoming of a new life into the world, the beauty of a woman as she blossoms throughout the stages of life. The days when things aren’t so easy – long, drawn-out labors, difficult clients, or struggles to understand vague symptoms and nagging ailments – pale in comparison to the wonder of a mother gazing into her firstborn’s wide eyes.

This post, though, is about those days, few and (thankfully) far in between… as a nurse, a friend, and a family member, I’ve seen grief. Grief that sneaks up alongside you, taps you on the shoulder, and then takes you out at the knees; finally helping you up and keeping pace with you, step for step, until you feel as though you can no longer take it. I’ve worked with families who’ve had babies born still – babies born fully developed, perfect in every way; other babies have been lost far too early, months before they were expected to arrive, yet already eagerly anticipated and much loved. I’ve known and cried with families as they mourn the loss of babies diagnosed with terminal illnesses, not compatible with life, and supported them as they honored their loved, tiny infants the best way they knew how. As a midwife – remember, I have only been able to claim that title for two weeks – I have yet to embrace women and their families in those desperate, dark hours… but I will be there.

My grandpa died.

When it comes down to it, that’s what this post is really about. Barely two months ago, my grandpa – my Mini’s “Puppa” – was diagnosed with Acute Myelogenous Leukemia – and given a prognosis ranging from moderate to poor (depending on the treatment regime chosen and the response of the disease to it, of course). One dose of chemotherapy didn’t significantly improve Puppa’s counts, but didn’t drag him down at all, either; he still fought like hell. Even a nasty, raging infection to his IV port didn’t take the fight out – it was only when his oncologist really explained why he had recommended hospice care (rather than continued chemo treatments) that he just gave in, and let go… within a week, he was gone.

To me, Puppa was larger than life – he wore Brut cologne, farmed his entire working life, fished and hunted like a “real man” in the Midwest would, and ate headcheese and liverwurst (ewww). My memory is flooded with treasures from my childhood; this is the man who taught me how to bait a fish hook (and get a fish off the hook, once caught), climb up on a tractor to ride beside him, play cribbage, and to open a glass bottle of Sun-Drop with a bottle opener. I could go on and on – like any good granddaughter – but I’ll keep those memories as seeds to plant for the Mini’s, or if nothing else, for a day when I’m a little more awake, and it’s a little earlier. Memories that they may lose (or have never experienced) like how Puppa always had a teeny Tupperware container in his shirt pocket for them, with just two jelly beans or marshmallows in for them, or how on birthdays, he had a special card just for the birthday kid with exactly the number of crumpled dollar bills as years old you were turning, the envelope and card addressed in his loopy writing… his love of Diet Sun-Drop – but *only* in the old glass bottles, not in cans, and not in the ‘new’ glass bottles. And the dimes – always the dimes…

When death comes, it’s amazing how fast/slow things move. I swear it was just yesterday that my grandpa walked into my living room, showed me the lab results from his recent hospital stay, and asked me what I thought of them (as my heart dropped to the floor). And, just a few days before that – it had to have been – we were all out on the pontoon boat, with everyone healthy and happy. But it seems like it’s been months and months of watching him slowly fade away….

I can’t imagine the pain of losing a child, or a spouse, or a parent… yet I can’t fathom thinking that I’ve “only” lost my grandpa. How do you compare this hurt? I feel selfishly grateful that this is really the first time in my memory that I have lost someone close to death; I’m also so grateful that my family is so close to begin with, and that the Mini’s know their greatgrandparents so well. The very last words that my grandpa really said to me, a few days before he passed away – looking me right in the eye, with a squeeze of his hand – were, “Thank you.” When I asked what he was thanking me for, he said, “For it all.”

To everyone who has gone through this grief, whether the loss of a parent, grandparent, spouse, a sweet child, or the whisper of a child yet to be --- let yourself be embraced by the open arms of those who care. Open yourself to the friends who can offer words of comfort, hope, and love; to the family that shares your memories and knows stories outside of your own. Realize the true beauty of the people who will forgive you when you 'disappear' for a few days or weeks, lost in your own world of clouded thoughts and reminiscences. I feel so blessed and have so much appreciation for everyone who made the last few weeks, especially the last few days, easier than they might ever have been otherwise.

Thank you… for it all. XOXO

~*~*~*~*~*~*~

(P.S. This post formed in my head as I finally took a hot, hot shower, letting the past few days and weeks rinse over me; as I got out and wrapped myself in warm pajamas, I was overwhelmed with the scent of Brut…. *tear* Things always end up all right, don't they?)

And what goes around... (on depression and stress, too)

As they say.

Ebb and flow, yin and yang, yadda yadda. After my little meltdown Friday, things eventually lightened up. (If you've followed the blog at all, or know me, I'm sure you know this is nothing new... or maybe this isn't just me personally, but something that is a natural phenomenon of this thing called life. Maybe it's not unique to mothers, or women, or grad school, or th

ose of us who deal with depression. Maybe it is. Does it matter? Not really.)

Anyway. I posted a similar cry for help, bemoaning my situation on Facebook; basically, that the Warm One was at work, I was at the end of my rope with the girls and had no idea what happened to my patience, and the end of the weekend (the Warm One works a weekend program - Fri/Sat/Sun only, therefore leaving the girls and I to our own devices all weekend) seemed ages away. I was desperate.

And out of nowhere, a good friend came to my rescue. She invited the girls and I over, to visit, to play, to stay. It took us hours and hours to get moving and get packed, but eventually, we got there. She opened her home to us, the girls played (she has a daughter the same age as the Mini-est), and we were able to catch up. We spent Saturday together, just hanging out. Was I the most fun and exciting person to be around? No - but I hope I was a better mother and friend than I felt like I had been earlier that week. Little by little, I am crawling out of this miserable, stress-filled hole.

Before the girls and I left, I managed to pull myself up out of my funk enough to send a copy of my resume/cover letter to the physicians I work with as a labor/delivery nurse, simply to introduce the idea of adding a nurse-midwife to their practice (I've been hoping to have the 'right' moment to talk to some of them about this over the past year or so, but it just hasn't happened); I also emailed my nurse-manager to touch base. My fingers are crossed - even though my breath is far from held - that good things could grow from this tiny seed being planted.

The Warm One also came home last night and shared that another doctor, an incredibly sweet family physician working for a nearby tribal clinic, had asked where I was at with my job hunt; she mentioned that the tribal clinic had been trying to fill an open physician spot for the past year, and she was willing to bring up my name at the next physician's meeting to see what the interest there would be. Again, fingers crossed... I've worked at another nearby tribal health organization in the past, and love working with Native populations. The culture and history, combined with the deep relationships between families, make it a community I would be honored to be invited to work within. (I've requested information from the IHS about their loan repayment program, but have yet to complete the application process; it's on my radar as yet another thought...)

*And, if nothing else - this again cements to me the fact that I cannot - at least at this point in my life - function without antidepressants. I know that there are many different viewpoints on this and whether or not medication is something that is "right" or "necessary" but until I have one or two fewer things going on ... I can't let myself - and my family - go down this road. It never fails that when I manage to go without taking the pills for a short period of time - whether because I fail to get a refill in a timely manner, or because I miss one or two, and then tell myself I still feel "great!" - I find myself in a similar murky fog within a matter of days or a week. Someday, I will be able to truly dedicate the time to find other positive

lifestyle changes to experiment against this headgame, but as for now... I'm gonna take the easy way. I need to be able to accept sweet love notes from the Mini and appreciate them; I need to be able to have patience with my girls when they are being kids, instead of being over-anxious and stressed... I can't see the confusion and hurt in their eyes when they look to me for comfort, and don't get it; this parenting thing is hard. I feel like I hardly see the Mini's lately... and when I do, they're not my sweet little girls anymore! They don't listen... they're sassy... they fight. I don't know if it's a stage, or if it's related to not seeing me, or if it's how it's always been (and I'm just seeing things differently because I'm stressed), or if their actions are feeding off of me, or ...?!

When my mind wanders, this is where it goes...

Today I had lunch with a great friend. We don't do it often enough... and we really, really should do it more often. Hmmm... how to 'dub' this friend? She is full of awesomeness, a truly free spirit, a little bit flighty (like all free spirits should be), and just all-around fun, fun, fun. Let's call her, simply... Friend.

Friend and I have worked together for years... I was a new nurse, and she was the "seasoned" nurse (albeit, still a newer nurse --- but, she had a few years on me, so it all worked out!). She had a little guy who was a year or so older than my oldest Mini, and it seemed as we always had some common interests. Over the years - and many snacks, deliveries, and desserts - I like to think we've become pretty good friends.

(I'll interrupt myself here to say that I don't really have many close friends... or maybe I do. I don't know... what is a 'friend', really?? I think in the past year or two, this has changed a lot... I don't know. Anyway, where were we?!)

So, moving on. Friend and I are both moving towards the common goal of midwifery, but via different paths. While I am pursuing a degree in nurse-midwifery (CNM), Friend is going a slightly different route to earn a Certified Professional Midwife license. Basically - from my understanding (and I would love to be further educated, so please let me know if I have this wrong!) - Friend is learning from "the best", a very well-known and well-respected CPM or "lay" midwife in the area. This midwife has been doing births in our area for the past 30 years, and has welcomed hundreds (if not more) of healthy, beautiful lives into this world in the warmth and love of their own homes. She is active in the midwifery community and - I can only imagine - a wonderful source of perspective and learning for Friend. So while my education is coming from a variety of sources, primarily distance-based (online) until my clinical rotation finally started a few months ago... Friend has been immersed in midwifery since deciding to take the leap into apprenticeship.

There's pro's and con's, certainly, to each method. She's been able to attend births as a midwife - and get her hands (and her brain) - on those delicious, slippery babes from the beginning; I have had to wait until getting successfully past all of the theory behind the birthing. I've had a large community of support from fellow classmates and those who've come before me via my school's online forums; Friend has been cocooned in the intimate circle of the two CPMs that she has been apprenticing with. Friend's coursework is self-paced, whereas my program has traditional terms - with equally traditional (and stressful) deadlines, midterms, and headaches.

Our paths will also determine our future course (as is so often true). As a certified nurse-midwife, I will be - in theory - eligible to deliver clients in a hospital, birth center, or home setting; in my state, though, over 90% of CNMs attend patients in the hospital setting. Friend, however, will be limited to seeing clients in out-of-hospital settings (at least in our state).

This is where my mind starts to wander... I don't know that I am courageous enough to catch out-of-hospital births (that's a topic for another day) - but I like to think that someday I may be. When my mind wanders, though, I think about a modest clinic site offering prenatal and well-woman care, just outside of 'town' (our small town is around pop. 8500); a few exam rooms, a space for education, perhaps room to have a lovely display to sell some "nice" stuff that the kind of mamas that might seek out a midwife may be interested in - cloth diapers, breastfeeding supplies, etc. We could offer childbirth classes, breastfeeding support groups, and - possibly? - one or two birth suites adjacent to the main space; while (in my wandering self) I imagine most women opting for hospital births, Friend would also be available to attend home births, and the birth suites would be available for a birth center birth.

I don't know the logistics of any of this. I have no clue on the feasibility of it. In all honesty, it really is just a mind-fantasy, but such a sweet one. I don't know if Friend would seriously consider "joining the fun" - in the past, we have joked about starting such a venture... but how much was seriousness, and how much was jest is hard to say.

If nothing else... this all gives me a nice bit of something to start with for a lovely, 60-odd page paper that I need to write (and have yet to even start thinking about, by the way) this term, so that I can graduate this spring. Happy trails, on that happy note!