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

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(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?)

I have been blessed...

I started to write this post last week, and never got around to finishing it. The title was different, and the whole tone of it - it was a little more playful, with an undercurrent theme that mirrored Tigger's theme from the classic Pooh cartoons (for those of you familiar with Pooh's adventures... and aren't we all??) - was meant to be a light-hearted-yet-deep reflection of the wonderful thing about blessings in life.

And I have. Truly, in so many ways, my life and my family, are lucky. As I (finally) sit down to type this, though, I just don't quite have the same levity as I did a week or so ago when I started composing this in my head. I was going to recite the list of changes that have happened over the past two months (comps, graduation, etc, etc...). Instead, I'm quiet; the Warm One is battling a fierce cold, the Littles are runny-nosed and cranky, and I've passed my boards exam. I am, officially and with no holds barred, a certified nurse-midwife.

The colds will clear up, and the Kleenexes and textbooks (and highlighters and scattered notepages) that have overtaken our home will eventually be cleared away as well. Some will be recycled, or tossed; others may be stored in the office "just in case" - who knows if I'll need that text again, or maybe I'll decide to 'recycle' it to an incoming student?

The other blessings in my life are just as clear: my family, who have been so close and willing to step in whenever needed during this journey. The Midwife, even when things became rocky, was a blessing in disguise; I learned things, personally and as a midwife, that I needed to know, from her. From D, and from all of the women and families along the way. From so many close, wonderful friends - some nearby, and some far away... women who I may never have met in person, and yet who I can (and have) shared so many of my deepest fears and funniest moments; these are my sisters and peers, both fellow students and mothers.

And, of course, the Warm One and the Littles (one of my proudest moments so far? When the Bigger Little 'corrected' the younger, who had thought that "Dimbo's" - Dumbo - mommy was being 'naughty' in the movie. The elder of my daughters explained that Dumbo's mother was upset that the other elephants were being mean to the baby elephant and making fun and picking on him because of his ears; that sometimes mommies had to stand up for their babies. It was a touching conversation for a mother to overhear between a 5 and a 3...)

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Some blessings are a little harder to understand... in the months since my last post, my family has been stretched apart, and pulled together in an even stronger way. My grandfather, the "boss" of the family, was diagnosed with an aggressive leukemia just before Labor Day, underwent one round of chemotherapy, and has become progressively weaker since then. After a bout with a massive infection and complications due to the infection and its treatment, hospice - and the care that goes along with it - nurses are a daily reminder of the change. It's so hard to see the difference between the strong, capable man that taught me how to bait a fish hook and tossed hay bales into a barn loft, and the saddened man that cancer has made my grandpa. The thought of saying goodbye - along with the pain of seeing my grandfather this way, as well as how it hurts my grandmother - is only soothed by the idea that the time we are gifted by this allows for storytelling, memories, "I love you's".... my family has been together much more in these past few weeks than in the past years (we've always been close), although I don't know if this outweighs the pain that my grandparents are feeling. At this point, all we can do is "Let go and Let God..."

Hurts

"Never ruin an apology with an excuse." ~Kimberly Johnson

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My heart hurts. My brain hurts. My ego hurts. My body hurts. My checkbook hurts. From my eyeballs down to my left big toe (specifically) I hurt. This nurse-midwifery thing is trying - but I have so much faith that it will b

e worth it.

Where to start?! I'll try going from the top and go down... on a light note (looking back now), I had the embarrassment of walking in on the husband of one of my mama's as he was, um, using the bathroom facilities. I had peeked in her bathroom to see if there were pads and lovely mesh undies set out for her, and - seeing that there were none - headed to her closet to grab some. This apparently took a few minutes longer than I expected, because in the very brief time that I thought it took me to turn around and head back to the bathroom... he snuck in. Surprise!!

(Well, that's what she gets for coming in at 4:00 a.m... right? These people should know I'm no good before 10 a.m.!! Ha, let's see how far that excuse ever gets me!)

So, that was the first bruising of my ego in recent memory. I'm sure there has been others, and there will be many more. Patients who do not like me, or prefer not to have a student working with them; personality conflicts, and, of course, staff/physician/etc conflicts.

Moving on. My checkbook. Oh. My. Heavens. I'm not going to go into details here, since I think my very last post spent a little time talking about this --- but it's not pretty. Thoughts of LAC ("life after clinicals") are really becoming time-consuming, including some pretty in-depth fantasies of where I can find or create a CNM position in the local area. More on that topic soon, I think.

My brain. Oh, yes, the brain... or what's left of it. There are days when it is just a-reelin', if you will. Between the ego-beating and financial stressing just mentioned, and then the mind-trips about future career possibilities, I feel like I'm stretching myself pretty thin when it comes time to actually focus on life and clinical critical thinking. While I know I need to push all of that nonsense to the side and get down to business - that knowledge certainly fits in the "easier said than done" category. Distraction has always been a strong suit of mine, and continues to be so...

Where was I??? Oooh, how about my body next? It is sore as heck, many days. I'm loving what I'm doing, don't get me wrong. L-O-V-E. But, as they say (I think I'm hitting every cliche in the book here) --- love hurts. In this case, it's some of the twisting and maneuvering that I do - usually during births - that gives me some aches and pains. Nothing that I think is going to cause any lingering damage (it's already much better than the first few weeks of clinical, and usually is just a little bit of muscle pain for a bit after a looooong second stage); enough to mention in this somewhat-related post, but not worth changing the way I deliver. (The Midwife doesn't break down the bed; she drapes the foot of the bed, and takes her place sitting on the side of it... this is how I catch, as well, and don't think I would have it any other way... sore back be damned). But, there is al

so my bum toe - my left great toe, to be exact. I broke the S.O.B. four years or so ago tripping on my grandparent's step in my trusty flip-flops, and it's given me a fair amount of grief ever since. I'm still looking for the "right" pair of shoes for clinical/L&D; so far, everything I've been wearing (and maybe it's partially due to the nasty, cold winter weather we've been having --- and the fact that I'm getting to be one of those old fogies that blames the weather for everything) seems to aggravate this darn toe. But, cute shoes are worth the pain, right?

And here we are, at the heart of this post. Pain. My pain, really, is not an issue. I can deal with that. I like to think that I can handle pain, as much as I need to. When "my" mama's are in pain, I help them through it as best as I am able and as best to the plan that they had wanted to follow - whether than means using medications, a shower, or screaming obscenities at passersby. (Well, maybe less-violent forms of vocalization are encouraged, depending on the situation... anyway...)

What kills me, though, is pain that I can't "fix". A mama who has desperately lost sight of what's going on, or feels as though her birth experience is being taken away from her. A baby, who may have suffered an injury during a birth. I have felt these types of aching moments as a nurse, and am beginning to see them now as a student nurse-midwife; fellow students are also sharing their experiences in the same way. A rapid second stage; quick birth of a head with massive cheeks - and then apparent progression of the shoulders. Mama's legs repositioned to open the pelvis further, strong encouragment to PUSH! along with gentle traction as the anterior shoulder finally delivers... and a soft but clear pop is heard/felt. The rest of the baby delivers easily, stunned for a moment, then recovers beautifully and transitions to life on mama's chest.

As a student, this kind of scenario fills me with so many questions and so much guilt (just as a laceration has in the past) - Did I cause this? Could I have prevented it? How could this baby - not "big" by any means, and delivered over an intact perineum - be an innocent victim of trauma?

The sinking pit in my stomach, of course, is only stirred up a bit further by the babe, consistently irritable and refusing to eat; moving both arms but certainly favoring one. Though the Midwife - whose hands guided mine, whose hands guided the baby's head into this world - is reassuring that the injury was not "mine" (but rather a part of the delivery) and the prognosis of a fractured clavicle is excellent... my heart aches at the pain that little soul (and the mother) will bear. However this happened, there are no excuses and no reasons why. Little one... I'm sorry.