Born of Dust and Silence

Several months of silence have elapsed since I last showed up to pour my thoughts into this space. Much has been unfolding that is more personal than I am able to explore in this format at this time, and I trust that as stories arise that want to be shared, words will accompany them. For now, know that much is shifting beneath the surface, and perhaps the surface itself is shifting, the landscape of my life changing shape a little, taking on new elements of beauty and fascination and curiosity to marvel at.

I have wondered on and off if it is time to retire from blogging for now. It seems I have less to say here than when I was a student, and it is at least as much personal as it is about midwifery. And then, at the ACNM Annual Convention last week, I spoke with no less than a dozen people (many current midwifery students, or new midwives) who told me that my blog was instrumental to them choosing this profession, or helped them through the rough waters of school, or reminded them that they were not alone. And I realized that I could still do that, even though I am in a very different place now than six years ago when I first sat down to write about my excitement about becoming a midwife and explore my journey towards this career, this calling of mine. Six-years-ago me could not have imagined that I would be sitting down during a lull on a call shift (I didn’t say the “q-word…” I learned never to say the “q-word!”) after a busy day in clinic to blog about being a midwife and becoming myself. Or, perhaps, could have imagined it, but not what it would be like from here.

But six-years-ago me isn’t the part of myself I’ve recently been most strongly connecting with. Ten years ago this summer, I was ill to the point of bordering on death. I look back at the photos of my emaciated body, hollow eyes staring at me through a decade of time, and I have so much I want to tell the person I was then. Last week, I went back to my childhood home (one of them) to visit my parents and my sister, and I spent some time connecting with myself. It felt like a deep healing sort of magic, to be able to send love back through time to myself when I desperately needed it.

Brene Brown put it this way:

A deep sense of love and belonging is an irreducible need of all people. We are biologically, cognitively, physically, and spiritually wired to love, to be loved, and to belong. When those needs are not met, we don’t function as we were meant to. We break. We fall apart. We numb. We ache. We hurt others. We get sick.

A number of those things happened to me a decade ago. I was newly out as queer, and newly in love with the person who would become my wife. I was living in a place where I did not get to express my queerness with a sense of safety or acceptance of who I was, and I managed to internalize the unspoken message that I needed to be small and take up less space. Combined with some undiagnosed physical health issues that spiraled together with anxiety and systemic oppression and not feeling a sense of belonging or knowing where home was, I made myself small. I lost 70 pounds in a year, dropping from an average weight to one that I still cannot believe I could survive at. I broke. I fell apart. I got sick.

I didn’t know if I would get better, or if I could, or even if I wanted to. I could not conceive of a life where I got to be my whole self and was loved exactly as I was and where delight was a theme woven through my days alongside the complexities of sadness and beauty and loss and heartbreaking joy.

I remember a singular moment that felt like a tipping point, where I sat alone in my room, my stomach raging in pain and nausea, gnawingly empty. I watched the pulsations of my aorta through my gaunt belly as I sat staring at a banana and trying to decide if I could eat it. I sat with that banana for hours, feeling like choosing to eat it despite how ill I knew I would feel was an affirmation of my intent to stay alive in the world, and uncertain if I had it in me to say yes. I journaled about this inner chaos. On July 1, 2007, I wrote of how “frighteningly low” my weight was (below 100 pounds), and described all the medical interventions that were on the horizon if I couldn’t force myself to eat, and what my choices were there. And then three small words at the very bottom of the page: “I choose life.”

I ate the banana. I somehow pushed through walls of pain and mountains of fear and kept eating. I left home and built a little family and fell in love with my life again. I didn’t die. I dreamed big dreams and from the depths of myself found the courage to follow them. I moved again, by myself, went to school, got divorced, became a nurse, became a midwife. And here I am on my couch at 11 p.m., pager clipped to the waistband of my shorts, hundreds of babies later, blogging about it.

In my grand tradition of writing letters to my past selves, here’s one specifically to me in that moment when I was sitting there with that banana:

Dear Rob (yep, that’s your name now; hang on),

I see you. Where you are at right now SUCKS. You feel sick constantly. Your body is wracked with pain and your mind with terror. You can’t imagine ever feeling alive again. You are eating your own flesh to stave off death for a bit longer, uncertain how much more you have to give. You are possibly the loneliest you’ve ever been, there in the solitude of your descent into illness.

I know, trust me I know, how much you don’t want to do this. You know how sick you will feel if you eat. You know what it will cost you. But just for a minute, I want to plant the seed of the idea that you not eating will cost me everything I now have. I need you to survive. I need you to do whatever it takes to keep your body alive. I can go back and repair anything else, can return with new perspectives and skills and coping strategies and will happily clean up any messes left behind. I just need you to feed yourself.

If I could, I would give you a glimpse into what lies in store for you on the other side of not dying. In the way that time is not as linear as we think it is and magic is weird and knowing that I went back last week with the intention of reconnecting with you, I’ll give it a shot. If you eat that banana, and keep eating, and keep doing whatever you need to do to stay in the land of the living, I promise you on everything you know to be holy and good that you will come alive again. This is not where your story ends. Far from it. You will keep writing.

In a couple of months, you will move to California, and you will meet people who won’t bat an eye at your queerness. A year from now, you will be married. You will put on a dress (sorry, next time it can be pants) on International Women’s Day and say “for today, and for the days to come” to a woman you love, and you will mean every word of it. You will explore together to the end of your exploring, and your paths will diverge, and you will be sad, and you will feel broken, and you will crochet and write and cry and study your way to feeling whole again.

During this time you will have moved again, to Seattle, on to one of the biggest challenges you’ve ever given yourself. You will dream a seemingly impossible dream, and you will have no idea until you’ve actually done it whether you can. From where your emaciated body sits, banana in hand, you can’t fathom being able to take on the role of caring for anyone but yourself, but you will do it. You will kick ass at one of the most accelerated intensive nurse-midwifery programs in the country. You will rise to the challenge of the dream your grandmother offered you. You will sit in a session at a midwifery conference ten years from now and hear her whisper, from somewhere, that you are her wildest dream, and you’ll realize that she gave you yours as well.

You will get a job that will stretch you and teach you a lot about how to be and how not to be a midwife. You will stay there until you need to leave it, and then you will go to a new place. You will bring your whole self to your work. You will receive babies into your hands and stories into your heart. Your presence with your patients is being cultivated by the quality of the ways in which you are showing up for yourself right now. So keep showing up. Keep doing the hard work of staying alive in the world.

Know that you are not alone. I promise that I will come back for you. Ten years from now, I will return. I will sit in the bedroom you spent your adolescence in, and I will bring all of my accumulated love and wisdom and magic with me. I will sit in the living room eating an apple (because I can’t stand bananas anymore), and I will feel the weight of your frail body sitting there with me, and I will reach out a hand to you from across the decade and lend you all of the strength I have built in the 80 extra pounds of muscle and fat and blood and bone and life I hold in this body you now occupy, and through our collective tears I will call you home again. I must leave home to stay alive, and I promise I will come back for you and through some time-warp magic I will reach back through the past and whisper courage to your palpitating heart, the courage you need to stay alive so you can grow into me and I can go back for you.

Your (my? our?) pager will go off while you write this, and you will go catch a baby and not come back to finish blogging for another week. What will remind you is a sunset that is so astonishing in its simple brilliance that it will move you to tears. You will stand in a spot a block away from where you now live, the fading light of day dropping down over the Olympics before you, and the way the sky makes a perfect silhouette of a sprig of Queen Anne’s Lace will flood your cheeks with saltwater because you are alive to see it.

You will be listening to “Turning Wake” by Ayla Nereo right then, and you will stand still with the cool evening breeze caressing your face as she croons,

I’ll be dancing’ with the ones who remind me
we are born of dust and silence
we are made of ancient songs
and there are ones who’ll keep us sleeping
and there are ones who bring the dawn
put your back to the birch and your mind to the matter of a
listening kind of way
we are born of dust and silence
we are made of ancient songs…

I will stare into the lens of my camera in that moment as if I could look through ten years of history and catch your eye.

I will gaze unblinkingly at the memory of your dying body as tears pour down my cheeks, and I will smile because (spoiler alert!) I know you made it out alive. You can’t know that now, and that is terrifying. Your body will indeed die one day, love, and you will return to the dust and silence you were born of. But not yet. This is not where your story ends.

 

I will stare back across a decade and hold you with limitless compassion, borne out of all of the precious life I’ve lived in the 3644 days between these two photographs. I will grieve with the embodied memory of what happens when I try to take up as little space as possible. You have no idea what you are capable of, how you will proceed to gleefully and unapologetically refuse to fit into anyone’s boxes, how in claiming your authentic wholeness and all the space that is yours to occupy you will create for yourself a life that you can thrive in.

I imagine myself with you in my lap. I would kiss the top of your head and stroke your bony cheek and tell you stories of the life you will live if you eat that banana. I would whisper in your ear the names of every single baby your hands will catch. I would sing you songs you have yet to learn and recite to you some of the poems you will write. You have to stay alive, love, because the world’s best cat has yet to be born, and yours are going to be his favorite shoulders to sit on.

Oh, my love, the tales I have to tell you of who you are becoming! You have so much life left to live. I wish I could tuck you in at night with stories of how brave you are, how resilient, how you will create a home and a life and a chosen family for yourself. It will be a long, tough rode; I won’t lie and tell you otherwise. Dozens of healthcare providers, well over a hundred appointments, several surgeries, and countless medications and treatments of a variety of kinds will be required to keep your body alive. You will do so much inner work, filling journal after journal with your thoughts and reflections. You will come face to face with your own shadow and welcome it. The journey of a lifetime is to integrate all that you have seen and done and experienced and been in the world, and I promise you that you have within you a seemingly endless well of courage that you will draw from again and again to show up and do the work.

Your beautiful queer self belongs in this world, Rob. Despite what you grew up hearing and what you still hear: there is a place for you at this table. You will discover, as you do the work of staying alive, just how much the world is in love with you. Oh, I wish you could take just a tiny glimpse into my bank of memories from the past decade! You have no idea what a ridiculous life I’ve built for you to come home to. I need you not to give up on living just yet, because there are full moons to admire and queer humans to kiss and mountains to hike up and songs to dance to and heart-shaped rocks to discover in all of the places you go. There are books to read and baths to take and poems to take your breath away. There is love to give and receive and make and fall into and fall out of and do it all over again. There is so much delicious food to eat (I promise that nourishing yourself won’t always be as hard and painful and scary as it is now). There is this incredible body that you get to inhabit, and as you put in one of your poems, “to live in this skin and come alive here.”

And so you will, dear one. You were born of dust and silence, and one day you will return to the same. But not yet. I came back for you. I came to bring you home with me, to carry you to a life you’ve made for yourself to thrive in. I left a heart-shaped stone behind so that you can find your way back to me. I’ll take care of you; I’ve learned how.

Come home with me.

All my love and magic,

Rob (roughly 5,247,360 minutes later)

The Love of Thousands

Yesterday, these hands of mine had the honor of welcoming three new people into the world, and last week, I caught my 200th baby. It felt like a terribly ordinary moment but one with an extra measure of delight added in. Counting c-sections I’ve assisted in, homebirths I’ve attended, births I’ve attended but not as midwife, and all of my doula babies, I figure that I’ve seen at least 350 births. This is probably already more than my grandmother witnessed in her whole career as a nurse and a midwife, which is hard for me to grasp.

I went to Seward Park this afternoon, just as the afternoon sun was beginning to sink low into the sky. The fall leaves were rustling in the tree branches above my head. A gaggle of geese huddled together in the water. Red, orange, yellow, and brown leaves littered the grass. I saw my breath in the crisp air as I exhaled.

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Just bringing myself back into nature, I felt my energy quicken. As I began my walk around the circumference of the park, capturing the sights through the lens of my camera, I noticed tears running down my cheeks. I paused, trying to make space in my mind and body for the immense beauty that surrounded me. A stiff breeze kicked up, causing the leaves to whisper their secrets to me. I felt the incredible aliveness of the world around me. As I stood still, I recalled the time I felt the trees breathing me in the redwood forest in northern California. I felt these trees breathing too, and reaching up to touch a branch, a gentle, “Hello,” escaped my lips, a greeting, a recognition of our kinship.

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I walked through the damp grass, my breath catching in my chest as if anticipating a lover’s kiss. I fell terribly in love with the world again, a sensation which surprised me given the various transitions that are occurring in my life at the moment. I expected maybe to be sad that I was walking in the park alone, when the last time I was there I was with a partner. This time, the whole park was my partner, and was showing me its beauty in ways I might not have seen had I been holding someone’s hand.

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Tears again came as I felt love coursing through my veins, and they come now as I find words to describe the immense gratitude I feel to have found myself again in the magic of the world. I think back to all of the people I have been throughout my life, all of the various iterations of me, and I am just so delighted that each one of them made the choices they did that brought me here. I am thankful to them for not giving up, for finding a way through some very difficult times and places, for continuing to believe in the idea of home.

The cold wind kissed my cheeks as I sat on a damp log on the shoreline, looking at rocks on the beach. Anytime I am around rocks, I look for any that are remotely heart-shaped; these make their way into my pockets and come home with me. Sometimes it is a stretch to see a heart in a rock, but if you look closely enough, you can find love everywhere. I look closely.

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I took my time wandering, and the sun quickly faded beneath the horizon. I found myself on a path in the dark, and was momentarily struck with the various and sundry fears that arise in the dark. But then my breath came back to me, and I stood still, watching leaves tumble from their branches down to the forest floor. I must have witnessed this for five or ten minutes, just soaking up the wisdom that allows the trees to release without fear what they no longer need to hold onto and trust in the cycles of life. These giants towered above me, and they’ve stood in this park for far longer than I’ve stood on this planet. They have seen countless seasons come and go. Millions, billions of leaves have been shed onto this ground.

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I thought of the following quote as I walked back to my car:

“Walking, I can almost hear the redwoods beating. And the oceans are above me here, rolling clouds, heavy and dark. It is winter and there is smoke from the fires. It is a world of elemental attention, of all things working together, listening to what speaks in the blood. Whichever road I follow, I walk in the land of many gods, and they love and eat one another. Suddenly all my ancestors are behind me. Be still, they say. Watch and listen. You are the result of the love of thousands.”

–Linda Hogan, from Dwellings: A Spiritual History of the Living World

I am the result of the love of thousands. The babies that I have welcomed are the result of the love of thousands. You, you my dear, are the result of the love of thousands. Watch and listen.

She Said Yes

I am leaving for Haiti in a week.

Holy moly, it’s happening. I’m going, along with my love, to a new place. We will be serving the cause of promoting maternal and child health in whatever ways they need us. We will undoubtedly come back different people.

I wish the Robin that I was five years ago could know that this would happen. That person, who had yet to begin midwifery school, had no idea what she was capable of. She was filled with fear, yet her courage was potent and fierce. She wanted to see if it was possible, this journey out of herself and into the world. She had, for such a long time, been containing her life inside the boundaries of what felt safe, because safety had been an elusive concept. She built firm walls around everything, and as long as each facet of her existence was controlled, the panic remained at bay.

But there was, deep inside of her, an undeniable voice that called her to bigger things. She began dreaming of catching babies, as her grandmother had done when she was alive. She had a huge road ahead of her to tackle both physical and mental roadblocks that easily could have kept her from pursuing the intensive program of study that her dream required to become a reality.

And she said yes.

She carved that “yes” onto her wrist in black ink and dove headfirst into the work of finding herself. She left the only home she knew. She took the risk of claiming her authentic selfhood, even though it cost her relationships with friends and family. She married her first love, and ultimately allowed space for her heart to be broken so they could both be more whole. One by one, she stared down her debilitating anxieties, reclaiming ownership over her life a single deep breath at a time. She left home again, moving to a city where she knew no one, to live alone and become what she dreamed of being.

She felt the sharp terror of utter groundlessness and made her way through it. She survived cold, lonely nights in a too-big bed. She learned how to be alone with herself, and little by little, she fell in love with her life. She realized that she was strong and she was capable of taking good care of herself as well as caring for the people she served.

She learned how to stay present when everything inside of her wanted to run away. She realized that she was capable of having challenging conversations and holding space for people who are in the most intense moments of their lives. She learned how to stare into the abyss and not back away.

She opened her heart and found herself falling in love with everything. Delight swept through her days, even in moments that were overshadowed by tragedy.

Her open heart one day found another person to love, and she continued in the work and the joy of sharing her life with a partner. She found herself living in a home full of animals and books and half-completed craft projects and gluten-free snacks. She remembered, little by little, that wholeness is always worth pursuing, even if the cost is high.

She and her partner talked about traveling. They both had wanted to volunteer as midwives in an international setting. Everything came together, in time, and they found themselves packing for a trip that would take them 3,419 miles from the home they were building together. Neither knew what to expect, exactly, and both were simultaneously excited and nervous. They felt the support of countless friends and loved ones, and they listened to the undeniable calling that brought them to the work that lay before them. They waded through the piles of supplies in their living room for weeks, packing and attempting to prepare for the unknown.

They are ready, and not ready. They are ready enough.

 

I haven’t written much for the past few months. I have been doing a lot more internal work and a lot less writing, and to be honest, I have been exhausted from the long hours I have been putting in at my clinic and on call. Internal shifts are happening, and I am excited and grateful to be back here in my virtual writing space.

 

To the Robin who always wanted to do what I am about to do but never thought it would be possible because there was so much she was afraid of, I say this:

You’re going to do it. All of it.

You’re going to find your way through the anxiety that currently paralyzes you. You will do things that sound impossible to you right now. One day, you will wake up and realize that you are no longer living in fear. The work you invest in healing yourself will come back to help you be healing to the wounds that exist in the world around you.

You will take on the risk of facing the things that most terrified you, because the thought of not doing what your life asks of you is scarier than your other fears coming true.

You will realize that being authentically yourself in a world that wants you to fit into a not-you-shaped-box is worth risking everything. You will risk everything, and you will lose some of it. But what you will gain is worth it. I promise.

Thank you for being willing to do that hard work that brought me here. Thank you for the hours you spent writing in your journal, processing your history, breathing through tough emotions, dealing with the intensity that held you captive. Thank you for doing that work so I can be here doing this work that I love so much.

I write a lot less now, but I live a lot more.

Your hands that once spent so many hours holding your pen and journal now spend their days welcoming new souls into the world. They put on gloves and insert IUDs and hold the hands of tiny babies and wipe the sweaty brows of people in labor. They help newborns latch on to breastfeed. They do what you always dreamed they would do.

You will feel sad about the limited time and energy you have for writing, but know this: You are still a writer. And you will write. You are currently collecting the stories that will fill the pages of your books in the future. Live the hell out of your life as it is in this moment. Be here now. Soak it all up. Write when you can.

Know that you are making a difference in the world. Know that your claiming your inherent wholeness gives permission for others to do the same. Dream your big dreams, and chase them down. Make them come true. Know that you are deeply, truly loved.

So go to Haiti. Go with an open heart and hands willing to work. Learn from everyone. Let this journey open you, break you if need be, and rekindle in you a passion to leave the world better than you found it.

Then take that passion and run with it. See where else your journey takes you.

All my love,

Robin

How Women Die

I sat on a stool between her legs, blood up to the elbows of my surgical gown. Her husband sat in the corner, holding his new baby, silent and worried. The nurses looked at me with concern, alternating their gaze from my face to the ever-growing pile of saturated chux pads we were weighing to more accurately assess the extent of the hemorrhage. I went through the Four T’s of postpartum hemorrhage (tone, tissue, trauma, and thrombin), and was quite certain we were dealing with a tone issue. The placenta had come out smoothly, all in one piece, and appeared intact. She had had no lacerations–I just double-checked. Coagulopathy was possible, but unlikely. Her uterine tone kept going from firm to boggy. Her bladder was empty. She hadn’t had excessive amniotic fluid or a big baby, so her uterus wasn’t over-distended; of the three babies I had caught that shift, all to third- or fourth-time mothers, this one was the smallest.

I sat there, in the middle of the night, massaging her fundus, willing the methergine to kick in and give me a nice contraction, debating whether I should call in my OB backup for help. A fresh gush of blood answered that question for me, and with one request and a quick phone call, surgical help was on the way, should it become needed.

I sat there, blood dripping onto the blue drape on the floor, in that sleepy haze where the veil is thin, and I thought, “This is how women die.”

I realized that even as I was audacious enough to know with almost certainty that my patient would survive her hemorrhage, many women around the world at that very moment were not surviving their own. They had given birth without access to the extravagant amount of resources I had at my fingertips: pitocin, cytotec, methergine, even Hemabate (which makes for a terrible day, but can indeed save a life!); Bakri balloons to inflate in the uterus and stop the hemorrhage from the inside, OB-GYNs capable of performing emergency D&Cs (or even a hysterectomy if necessary) in the operating rooms down the hall staffed by nurses and an anesthesiologist and equipped with all of the requisite supplies to save my patient’s life. And blood, and a lab to test it safely, and protocols and equipment to safely transfuse it.

I wondered what would have happened if this patient had delivered in her hometown in the country where her older children were born.

I thought of the hospital in Haiti where I will be in two months’ time, and of the way they had gotten down to their last vial of pitocin a few months ago, how sometimes there is no electricity or running water and they have to make do. I thought of the mothers in that country, 75% of them, who have their babies at home without a skilled attendant present.

I looked at the blood on my gloves, and on the pads in the corner, and on my shoes. I saw how pale my patient was, pale but with stable vital signs despite losing a third of her blood supply over the past couple of hours. By the time my backup OB-GYN arrived, the meds had kicked in and her bleeding was scant. He praised my work and went to the call room to lay down, just in case his help was needed later on. The baby’s father thanked me profusely in his native language for saving his wife–he had understood how uncertain the situation was. Seeing that much blood flowing from the body of a person you love leaves little question.

I thought of my grandmother, and how she had little to draw on but a few medications, her skills, her hands, and her faith. I remembered the story of the night that her gut told her to stay longer after a birth than she normally would, and the mother began to hemorrhage later, and she was there to stop it and save her life because she trusted her intuition. I whispered gratitude for the legacy of inheriting her wisdom.

My patient went home with her baby a couple of days later. But I could not help but reflect on how things could have been different, and what I would–no, what I will–do when I am faced with this same scenario in a setting where I don’t have access to everything I am used to that helps me intervene when interventions are necessary and life-saving.

My partner Teresa and I are going to Haiti in September to volunteer with Midwives for Haiti, a non-profit organization that trains skilled birth attendants who are making a difference in the lives of countless mothers and babies. If anyone would like to join us in spirit, we would be grateful for your partnership! We are seeking to raise funds for our travel expenses, program fees (which all go to Midwives for Haiti and help support their programs), and donations of medical supplies we will bring with us. Links to our websites and how you can get involved are below. I will continue to update my blog with my experiences and photos throughout the trip and afterward.

I am going into this trip with my eyes and my heart wide open. I have no illusions of saving anyone or fixing anything; my aim is to offer what I have to the larger goal of helping to train more midwives for a country in desperate need of them. They are the ones who will make the difference for the women dying of hemorrhage, sepsis, eclampsia–all treatable issues that don’t have to be fatal. Local midwives, providing compassionate care to their own people: this is how we will change the world. That is how women will survive childbirth.

Our Trip Website

Our Fundraising Page

Midwives for Haiti’s website

 

 

Enough (A Year in Review)

It is hard for me to believe, but I have finished (survived!) my first year of practice as a nurse-midwife. In school, everyone told me that the first year is intense, and I expected that, but I had no idea just how much I would learn and grow and more fully become the midwife that I am.

I have caught 80+ babies born vaginally in the past 12 months, and assisted on 40+ c-sections (some scheduled, some urgent, some emergent), and managed dozens of other labors, and seen goodness-knows-how many patients in triage (for everything from UTI and pyelonephritis, to appendicitis/abdominal pain/gallstones/nausea/vomiting/dehydration, to pre-eclampsia, to threatened preterm labor and actual preterm labor, to vaginal bleeding in pregnancy [from abruption or previa or having had sex the night before], to possible ruptured membranes, to vaginal discharge [pick your favorite reason for it, and I’ve seen it in triage!]).

I’ve had 1500+ individual patient encounters in the past year. Each time, that involves me reading through a patient’s chart, coming up with an idea what’s going on, making a plan in my head of what I might do, knocking on the door to the clinic room the patient is in, introducing myself (if we don’t already know each other) and my role as a midwife, asking about their health and any concerns they have, going through their medical history, allergies, current problems, medications, smoking status, sexual history, screening for warning signs, performing a physical exam, prescribing medications, discussing the plan with the patient, washing my hands, and going back to my desk to chart on everything I just did. Often I do all of this in 15-30 minutes or less, 15-25+ times per day. Holy moly, is that exhausting!

I have all of these incredible stories that I have collected inside my head over the past year. An aggregate of the specific issues I managed or helped to manage does not begin to delve into the full intensity of connecting with each individual and their loved ones during each of these events, but sometimes it is the best I can do here on my blog when I am so done after telling a patient’s story in their chart that I don’t have the creative energy left over to extract its essence in a form in which I can share it publicly without compromising my patient’s privacy.

Also, it’s been quite a year for me personally. I moved to a new city for a job, not terribly far away from my friends in Seattle but far enough that commuting back after work just never happened. I started that job, and fell in love with my work. I met an amazing person who became my partner, and we just recently moved in together, in an epic process of combining all of our stuff and our excessive quantity of animals into a single living space. Which necessitated another move, back to Seattle. Less than a month in our new home, and we had a break-in, in which a lot was stolen and my sense of safety was shaken. I developed a fistula and had surgery for it, and I was in the most pain I’ve ever felt in my life (which is saying something!). I am working on healing from that, still, and am reconnecting with myself and my body in very profound and important ways.

As a midwife, in the past year, I have gotten a rich variety of exposure to almost every condition I could imagine. (I say that now, and just watch–next week, something entirely new will show up on my schedule!) I have had the immense privilege of being present with people during incredible transition periods in their lives, as well as caring for them during the normal times.

I have sat with dozens of women as they labored to bring their babies into the world. I’ve held their hands, wiped their brows, held their puke bags, supported their perineums, welcomed their babies, delivered their placentas, sutured their lacerations, congratulated their families, and went to bed a tired and happy midwife.

I have slow-danced through contractions with tired mamas eager to meet their little ones, their babies in utero kicking me as we swayed.

I have caught babies coming at me from all sort of pushing positions: squatting, supine, side-lying, and hands and knees.

I’ve supported the use of hydrotherapy, birth balls, peanut balls, and birth stools in a hospital system, not to mention skin-to-skin, intermittent fetal monitoring, and early initiation of breastfeeding.

I have assisted surgeons in dozens of cesarean births and a few other surgical cases. I feel it is my job to make the OR feel a little less cold, more comforting. These hands of mine have touched skin, subcutaneous tissue, fascia, muscle, peritoneum, and organs. I have suctioned blood to keep the surgical field clear. My strength, from the outside, has pushed these babies out of their mothers’ bodies. I have gripped their now-empty uteruses, massaging them firm to minimize blood loss, then holding them in their outside-the-body position so they can be sutured closed. I have helped suture and staple bodies shut after surgery. I have assisted in tying Fallopian tubes when the time for baby-having is over. My feet feel grounded in the OR, and I consciously breathe in the antiseptic air, grateful that I can play this role, though surgery is not at all why I went into midwifery. (I really like the low risk, normal patients!)

I have seen hundreds of people in clinic for routine annual exams, and I feel the weight of holding their health in my hands. I have assessed their health risks, asked about their sexual well-being, screened for domestic violence, examined their breasts for masses, Papped their cervixes, and palpated their pelvic organs. I listened to their fears about their health and helped promote their well-being in as holistic a way as I can, recognizing that wellness neither begins nor ends exclusively in the body but involves the entire person (mind/body/spirit) embedded in their sociocultural framework. Individual wellness cannot be separated from social justice.

I have performed hundreds of vaginal exams, and I have gotten consent every.single.time. No exceptions.

Three sets of twins gave me the honor of helping to welcome them.

I caught two babies born in the caul. Lucky little kiddos, those ones.

Fetal heart tones in the twenties is without a doubt one of the worst sounds I can recall.

I have seen what happens to fetal heart tones when the placenta halfway detaches from the uterine wall during labor and blood flow to the baby drops drastically. Can I just say…YUCK!

Numerous women with scars on their uteruses victoriously pushed their babies out into my hands.

I know what a true crash c-section looks like, and what it means when every second counts. I have shed happy tears when a baby we were very worried about came out screaming and peed all over me.

I have witnessed a severely hypertensive woman’s mental status change just before she began seizing from eclampsia, and I rushed to help the team save her life and that of her baby.

I have seen many women before, during, and after their miscarriages. I have held a tiny pregnancy sac in my hands, and have gently extracted retained placental tissue that was causing bleeding after an incomplete miscarriage. I have sat with devastated clients who lost much-desired pregnancies, as well as with confused or relieved clients, or people feeling many things at once. Loss is complex, and heart-wrenching, and it evolves on its own timeline. Early pregnancy loss is very common, and despite the fact that I know my clients will very likely be able to have a healthy pregnancy in the future, I can sit with them in the intensity of losing this unique and irreplaceable pregnancy and hold space around that with them. And I do, usually at least once or twice per week.

I’ve worked with folks who wanted to be pregnant and were not. I’ve worked with folks who were pregnant and did not want to be. I worked with folks who were not pregnant and wanted to stay that way. And I worked with folks who were pregnant and were delighted about it. My job was to support all of them, and provide them the highest quality reproductive health care possible, regardless of which category they fell into. I’ve helped folks prevent pregnancy as well as plan for it as well as navigate the ins and outs of it once they had a positive test. And I feel honored every time.

I have seen placentas do all kinds of normal and funky things, from velamentous insertions to true knots in umbilical cords, to retained placentas requiring surgery or manual removal, to bits of membrane left behind causing too much bleeding, to cords avulsing (snapping off). I have a profound respect for this phenomenal creature, the only organ in our bodies that was intended to be truly temporary!

I’ve felt the presence of my midwife grandmother standing in the corner when a baby came out with terrible APGAR scores and I found myself running my first neonatal code blue.

I have inserted dozens of long-acting reversible contraceptives for people who want a highly-effective form of birth control for now and still to reserve the option of future fertility. The flip side of that is that I have counseled numerous women on contraception and have had quite a few come in to me for prenatal care a few months after I gave them birth control pills, but none of my patients (so far) have gotten pregnant with IUDs or Nexplanon. I am passionate about educating everyone that comes to me about effective contraception!

A young woman came in laboring only to discover that her baby was no longer alive. She still had to do the arduous work of giving birth, compounded by the enormity of grief. She pushed her stillborn baby into my hands, hands which had never touched a dead body until that moment. I came to visit her the next morning and she asked me to hold her baby, who had been in the room with her all night. I cradled the infant in my arms, marveling at the tremendous beauty of this child and at the utter wrongness of babies and death coexisting.

I have worked with numerous sexual abuse survivors in the clinic and in labor, and I do my best to ground myself first (knowing that with my own rather extensive sexual trauma history, I could get triggered and need to focus on good self-care) and then to be as aware of the special needs of this population as I can. I am able to show up and hold space for someone who comes to me in clinic for STI testing shortly after an assault, or to help give control back to someone in labor who feels out of control of her body. I feel very proud of this work that I do.

I have helped folks in abusive domestic relationships find resources to help them with whichever stage of the process they are at, whether they need a safe place to stay immediately, or a listening ear to talk about previous abuse.

I have learned that cancer is a hard thing to tell someone that they have. It doesn’t matter whether it is in their breast, their cervix, their uterus, their ovaries, or their vulva–saying, “The tests came back positive for cancer” never gets easier.

I have seen what an entire blood volume looks like on the outside of someone’s body. I would like to never see that again, but I know that my career will (hopefully!) span another few decades, and any number of things can happen in this time. Including postpartum hemorrhages.

I have seen almost every STI that exists, most within my first month of practice. I have encountered people with syphilis, gonorrhea, chlamydia (so much chlamydia!), herpes, trichomonas (so squirmy under the microscope!), hepatitis B and C, HIV, HPV, scabies, and molluscum contagiosum. I have treated pelvic inflammatory disease, cervicitis, vulvar abscesses, and more.

Oh, and BV and yeast–pretty much every day.

I have watched a strong young woman push out a gorgeous baby into my hands and then placed in the hands of the adoptive mother, who had dreamed of this moment for years. I have cried with both of them and sat in the midst of such intensity.

I have had to step aside from work for weeks, focusing my attention on my own body and my own healing. I have endured the most excruciating pain I have ever known, and have marveled at my body and its ability to heal. I have had to put on hospital gowns and identification bracelets and be a patient in my own hospital system. I’ve been wheeled down the hall into an operating room and given permission to someone else to cut me open so that I could work on putting myself back together. Healing is still a work in progress, always in progress, with ups and downs, but I am so grateful to be precisely where I am.

I am coming to understand in a deeper way that I need to clearly define where I end and where my patients begin. I am so empathetic that I can too easily take on someone else’s experience, especially when it resonates with mine, but this is exhausting for me. I am learning how to draw invisible lines around myself and say, “This is my body. This is her body. This experience is happening to her and not to me,” and this saves me a tremendous amount of emotional and physical energy.

These hands of mine routinely are the first contact a new person makes with the outside world. I have the privilege of, in the words of my friend Simon (who wrote an amazing poem on his becoming a midwife), “touching people inside people and calling them out.”

I have been a little hard on myself for not blogging more often like I did when I was in school. Then, last week, during a call with my amazing life coach, I had a moment of realizing that maybe being exactly where I am is just fine. Maybe just going to work, doing a great job caring for my patients, and coming home to my partner is enough. Maybe I don’t have to have extra creative energy right now. Maybe it is okay for it to feel different as a provider than it did as a student. Maybe I can be flexible and compassionate with myself in this time of transition, just as I was before I became a midwife. Maybe all that I’ve done over the past year, collecting these stories in my mind and body (if not very often on my blog), is sufficient for now. Maybe I am enough, exactly as I am now.

Another Day of Loving

“Wake at dawn with a winged heart and give thanks for another day of loving.”

–Kahlil Gibran

This blog has been an incredible outlet for me over the past three years. I have turned to this virtual space time and again to chronicle my personal and professional journey towards becoming more and more myself. I have written my way through a cross-country move, an intense immersion program for nursing and nurse-midwifery school, a broken/mending heart, a drawn-out job search, a local move, and the beginnings of a new career as a midwife.

As my life is changing, so to is the way in which I approach this space. I continue to be vigilant, as always, of protecting the privacy of the stories entrusted to me by my clients by compiling them into stories that are true to the spirit of what I have experienced while still maintaining my patients’ anonymity. My goal has been to document my life and reflect on the process of becoming a midwife in a mindful and compassionate way. I believe I have achieved this goal, and I am proud of the insights that have poured forth into these posts.

I have never been shy about documenting my adventures, and as I begin a new chapter in my personal life, I have the desire to explore that experience here as well. So, on that note, I am excited to share that the Mindful Midwife is in love. With another mindful midwife, no less!

The experience of mindfully falling in love has been unlike anything I’ve ever done before, and at the same time it is the natural progression of all of the work I have been doing over the past few years. It is simultaneously intense and gentle, and the depth of connection I feel with this amazing person in a relatively short period of time has caught me by surprise. We keep showing up for each other on a soul level and doing the hard and beautiful work of being our authentic selves in the presence of another.

I feel so overwhelmingly grateful and blessed to be here now. I love that I have a job that calls me out of bed at 3 in the morning to hear an owl’s haunting call from the top of a towering pine as I walk through the fog towards my car so that I can welcome a new life into the world. I love that I get to spend my days doing work that feeds my soul as well as my belly. I love that my work helps improve the lives and wellness of people in my community. I love knowing that my life is making a difference to others. I love my community. And now, I love having a person to share that love with.

My heart is full and brimming over. My life is magical, even on the long days after long nights of little sleep and many babies and pregnancy complications. Even after helping someone through urgent/emergent surgery for fill-in-the-blank reason (hemorrhage from placenta previa, non-reassuring fetal heart tones, fetal malpresentation in labor, arrest of dilation or descent in labor…). Even when the babies don’t do well after birth and my heart breaks open over and over again. Even when much-desired pregnancies end without a baby to hold onto and it is my job to hold the space around the lack of answers. Even when partners cheat and unsuspecting lovers contract sexually transmitted infections as a result and come to me with their grief as well as their need for treatment. Even when Pap smears or mammograms or blood tests are abnormal in potentially life-changing or life-ending ways. Much of my work is joyful, but even in the parts that can threaten to sink me in intensity for a while, I still end my days crawling under my covers flooded with gratitude that I get to be here, living this one wild and precious life. I love my work as a midwife, and learning to love it mindfully has been a tremendous journey.

Exploring mindful love in a romantic relationship has been similarly wonderful. We are both showing up as two whole people, vulnerable and honest and willing to be raw and authentic and unpretentious. We are here, doing the work, breathing into the emotions that arise, the intensity, the challenge of being real when much of what we see modeled are relationships that are founded on pretense and hiding our gorgeous true selves behind masks of propriety in order to make ourselves appear more acceptable. I feel seen and heard and understood and deeply cared for in my raw, imperfect wholeness.

I am aware that opening myself up to love also puts me at risk for loss, for disappointment, for sorrow. But I am willing to take the chance that my heart might be broken in order to experience a life lived as wide awake and full of joy as possible. Let my heart break open. Let my love bleed out all over this world in need of compassion and healing.

I’ve got more where that came from.

If a Seed Can Grow into a Tree

“If a seed can grow into a tree
And if that tree can grow leaves,
I ask, how is that different than me?
Because we both breathe and we come from the dirt
And that’s where we will return
When both of our seasons fade.
We’re entitled to change because we grow
Like one into two.
Like the eleventh hour turning to noon,
Then May slow fades into June,
Then you’re a grownup in your childhood room–
The change is gonna happen real slow
But not a day goes by we don’t grow.”

–Tyler Stenson, “We Grow”

I was at a birth recently. The woman in labor had several children at home. She was hoping to labor this time without pain medication, but left the idea open just in case things got too intense for her. Once her water broke, things went quickly, as they often do for multips, and she hit that wall that many (if not most) women in labor do, usually around transition, where they feel that they cannot possibly do it anymore. I checked her cervix, and she was still about 8 cm dilated, but she had an enormous urge to push, and got a wild-eyed look that people get when they feel their babies moving down through their bodies, and then there was a baby’s head in my hands, before I even had time to think about getting gowned and gloved up (I had gloves on, just not my fancy sterile pair yet!). I got a lovely amniotic fluid shower as I welcomed a brand-new life into the world.

As I made my way home after helping the new family settle in, the lyrics of the song I quoted above played themselves over and over in my head. The birth I had just witnessed felt so terribly ordinary. There was nothing unusual about what I had just been a part of. It seemed so… normal. (Which, indeed, birth is!)

“We grow like one into two,” the song states. I saw that one becoming two. I was the partera, literally the “one who brings forth.” I was one (of several) in the room who held the life and health of that pair in my hands. I got a few new gray hairs in the process, but as I walked away from the hospital and looked up at the sliver of moon smiling down at me, my breath frosty in the winter chill, tears pricked at the corners of my eyes.

I felt like I had just been a part of something. This birth was so very ordinary, and yet I felt different leaving the hospital than I had when I walked in a few hours earlier. I’ve seen hundreds of babies enter the world, and still each one is its own glorious event.

I am realizing more and more that I am a part of all that is. I do not stand outside of the rest of life, looking in through the window. I’m right here in the middle of it, getting dirty, feeling the palpitations of anxiety and the sweat beading on my brow during yet another deceleration, sighing with elation and relief when the baby emerges with a lusty cry. I am growing along with everyone else.

If a seed can grow into a tree, I ask, how is that different than me?

Just like the seeds have already within them the trees they will grow into, I have embedded within every double-coiled strand of my DNA the pattern of the individual I am becoming. And as trees are shaped by their environments, so am I.

We both breathe, and we come from the dirt, and that’s where we will return when both of our seasons fade.

Every time I hear a newborn baby cry, I am deeply aware that I am welcoming people onto the planet who will outlive me. These babies will be walking around, hopefully as middle-aged or near-elderly folks by the time my last breath arrives, but it is impossible to know. None of us have any idea when our season will fade. So we keep growing in the meantime. We keep digging our roots deep into the soil in search of nourishment. We keep reaching our arms up to the sky. We keep following the blueprints inside of us that guide us as we become who we already are.

We keep on doing the ordinary, miraculous work of walking around in meat-suits made of stardust on a tiny rock whirling through through the universe at dizzying speeds. We work at being human. We listen to the echoes that call us home, knowing that each of us is on our own journey.

Speaking of home, someone posted on Facebook today a picture of what my childhood home in Colombia, South America, looks like today. It is a much brighter blue than it was when I lived there twenty years ago, as seen in the first photo (which seems impossible that it was that long!), but it is still my house. And now I am “grown up in [my] childhood room,” remembering who I was when I lived there and thinking of the journey I’ve taken to get from there to here.

In the pictures below (which are from about 1990 and 2014, respectively), the window to the far right was my bedroom. It was right underneath a mango tree that terrified me every time a storm would dump ripe mangoes onto our corrugated asbestos roof in the middle of the night. The stretch of windows along the left was my playroom. I learned to ride my bike on that dirt path out front. My dogs used to run around in that yard. I made lemonade from the lemons in the tree out back. I grew from a baby into a child in this home, and then, abruptly, I had to leave my home, and have been looking for my way back ever since.

I believe in seeds. I believe that one mango seed grew into that tree that fed me fruit, that tree that appears to be growing still. I believe that one egg and one sperm can grow inside one body into one brand-new tiny person, and that people in labor are strong and courageous and resilient, and they can get their babies out (with whatever degree of assistance may be necessary, or not). I believe in each one of my clients, in their inherent goodness, in the beauty and dignity and love that defines them, whether they can see it or not.

My question for myself tonight is whether I believe in the seeds within myself.

Do I believe in the longings I felt, even as a young child, to be a part of helping people as they grow their families? Do I trust that those seeds nestled in the depths of my heart will grow into exactly what they are meant to be? Can I trust my deepest desires for wholeness and connection to guide me home?

The change is gonna happen real slow, but not a day goes by we don’t grow.

Robin Time

I went on an incredible retreat this weekend [note: it has taken me a week to write this, so two weekends ago now!] with eight pretty phenomenal LGBTQ women in the middle of the North Cascades. We slept under the stars (and the rain!), dreaming to the sounds of the rushing river and waking to birds chirping. We shared delicious, healthy meals (half of the other folks were either gluten free or vegetarian/vegan, so there was a lot I could eat!), spent time hiking some challenging trails with breathtaking views, and relaxed around the campfire at the end of the day, singing and laughing and telling stories. I bathed in only slightly-melted glacier water in the river (you seriously feel a whole lot warmer the second you get out; I convinced five other people to follow suit and everyone was in agreement that this was true!). I went without modern plumbing. I got used to feeling perpetually wet and slightly cold and miserable and had the time of my life doing it. When I took a hot shower upon my return home, I smelled the unmistakable scent of campfire smoke in my hair.

I shook up a lot this weekend, wiggled things loose in my body that have been sitting stagnant for a while. I pushed myself pretty hard, physically and interpersonally and spiritually and mentally. I broke a bunch of “rules” that made me feel safe and practiced sitting with feeling outside of my comfort zone (sometimes waaaay outside it, such as when I had to traipse into the woods in the middle of the first night with my head lamp the only thing illuminating my path as I went in search of the pit toilet and hoped a bear wasn’t hanging out nearby!).

The first night, we went around and wrote down things on index cards that might keep us from being fully present over the weekend. I scrawled down, among other things, “fear of breaking open,” uncertain precisely where that sentiment was coming from. We took our cards and placed them into the campfire, allowing flames licking at heart-shaped logs to turn these roadblocks into ash. We then came up with ideas of what might help us to be fully present, and I stated, “The willingness to see myself as whole, and to let myself get lost in hopes of finding something.”

Get lost, I did.

Not in the woods, per se. Rather, I went down deep into the hurting places in my body and felt the intensity that was buried there. I still have a lot of energy that I am holding onto around remembering how sick I got several years ago, how close this very body was to not being able to stay alive anymore. In some ways, ever since I lived in a very fragile shell that felt like the smallest stressor could break it, I have been guarded. I am cautious not to push myself too hard physically. I don’t go to the gym. I walk places, but I don’t usually run. The closest I get to extreme physical challenges involves staying up all night and burning through all my glycogen stores rushing from a birth to a c-section assist and back to another birth with a dozen triages thrown in.

 

Somewhere in my psyche, I am afraid that if I push myself too hard, I will break open, even though I weigh a good sixty pounds more now than I did at my most emaciated and am overall quite healthy. This anxiety came up for me on the trip most notably during the hikes. I enjoyed them for the first little while, until I started running out of steam and began getting cranky. Out of breath, I stopped being able to carry on conversations and had to focus on putting one foot in front of the other and ensuring that I placed it on solid ground. Especially on the second hike, which was at a higher elevation on a much colder day, my asthma began to flare up, and I had to take a couple of albuterol breaks. By the time our group stopped for lunch, my chest was killing me and I wasn’t able to catch my breath enough to keep going up the mountain any further.

Wheezy selfie in the woods

I sat there with my friends, on a huge rock overlooking a waterfall, and I sank down deep into frustration with my body’s limitations. All I could see was the fact that I would have to separate from my group and go back down because “my body was broken.” I had a private pity party for a little while until something caught my eye and drew me out of my mental stuck-ness and into the present moment. I looked around and saw the amazing sights before me: an enormous glacier, a waterfall, millions of trees, and the clouds that began to envelop us. The question in my head shifted from, “Why won’t my body let me go any further?” to “Look how far my body has brought me!” Instead of being stuck on the things I could not do, I was able to truly see how far I had come, not just that day on that hike but on the larger journey of my life.

I saw my path spread out before me: the missionary childhood, the sexual violence that shattered it, the traumatic loss of my first home when we had to evacuate the country due to security issues, the health issues that took years to properly diagnose, the multiple surgeries and countless doctor’s appointments, gaining and losing an entire person’s worth of weight in the span of a couple of years, the realization that I was gay in an environment that was not too enthusiastic about me being my whole self, the sexual assault in college, my coming out process, the social justice trip that changed my life, meeting my (now ex-)wife, getting extremely sick and nearly dying, putting my bodymindspirit back together on a diet of brown rice and vegetables from the farmer’s market, dreaming over and over of my midwife grandmother extending her hand to me, deciding to follow her path but being completely unsure if it would be possible for me, working as a doula and lactation consultant, diving in and dealing with my trauma history that was in my way of being able to become a midwife, moving up to Seattle all by myself to start graduate school, living alone for the first time in my life, getting divorced while working my ass off in nursing school, catching babies for the first time, achieving this dream of mine, finding a job, and doing the work I have been called to do. My whole life in all its complexity was with me there on that trail, and I was offered a choice: fix my gaze on my limitations, or focus instead on all of the myriad ways that my life is amazing. I could get stuck on the parts of the mountain I would never see, or I could open my eyes and take in the beauty that was all around me.

I chose to go back down the mountain slowly and let this enormous lesson sink in. I alternated crying, laughing, humming happy tunes to myself, snapping pictures, and being present with the sensation of my body in motion. It was a hard-won prize, and I will never forget that moment on that rock when my life reminded me to see where I am, right here and now.

I came home and had a fantastic coaching session with one of the organizers of the retreat, who asked me a question which I cannot remember but the answer that came to me very clearly was that I want from myself the same quality of attention that I give my patients. At the end of the day, I have been tired from constantly giving away my attention, and I haven’t been focusing on self-care to the extent that I need. She helped me to see that this is something I desperately want from myself, and that it is vital to my well-being (as well as to the longevity of my practice as a midwife and to the care that I am able to give to my clients) to meet this need.

I sat down with some art paper and markers after the phone call and came up with a poster that I hung up on my wall detailing dozens of different activities that could constitute “Robin Time.” My plan is to make a concerted effort to take time for myself every day, whether that is through journaling, stretching, reading a book, baking something delicious, cuddling with my kitties, taking a bath, engaging in social justice work that feeds my spirit, going for a walk, or any number of other activities. Hopefully, this will help me to reconnect with myself and my sense of purpose in the work that I do.

Tiny Sapling, Mighty Roots

I’ve been MIA from blogging for a bit, not because I lack things to say but rather because I’m not sure where to even begin.

It is different being a provider than being a student. Different in some really nice ways (you get paid for work you do, rather than paying for the privilege of learning, for one). Different in some hard ways (you’re on your own, with appropriate back-up, and judgment calls you make are your responsibility, rather than always having to report what you do to a preceptor who will approve it or not). It is amazing work and I am grateful beyond words to be here doing it, but it is still sometimes harder than I would like it to be.

And that’s okay.

Hiking is harder than I want it to be, but I’m signed up for a lesbian camping/hiking trip this weekend that I fully expect to kick my butt. I went on a hike with the group on Sunday and by 2/3rds of the way up, I was very grumpy. I felt like I imagine women in labor feel when they hit their wall. If it had just been me hiking, or even with folks I knew well, I would have asked to slow down the pace, to take more rest breaks. I would have stopped to enjoy the scenery and taken more pictures. My asthma would likely have bugged me a little less. I might have even given up and turned back around before getting to the top. But I huffed and puffed my way up the mountain, giving up on trying to converse with the group and focusing solely on what I was doing. Each step became intentional. My legs ached and my muscles begged me to stop moving them. I was desperately thirsty despite chugging lemon water. I kept wondering how much longer until it was over and how I would possibly make it. I started thinking about backing out of the weekend hikes to come. I was very, very cranky. I wanted out, but I pushed through.

And then the sunlight broke through the trees, and the view became clear. I saw the lake in all its glory. We had reached our destination. The group stopped for lunch and we had the chance to regroup. I caught my breath and found my second wind. I went for a walk all the way around the gorgeous Heather Lake, and then was the first one down the mountain. Downhill felt easy. I knew I could do it. I felt happy, and made conversation with others. Endorphins coursed through my bloodstream. My feet were killing me, but I didn’t really care. I logged more than 24,000 steps that day (more than 3-4 average days for me!).

What a trip, and what a perfect metaphor.

I’m always comparing my life to the stages of labor, which only makes sense given my line of work. Climbing up that hill felt like the first stage of labor, easy at first and getting progressively harder, until I hit my wall and didn’t want to do it anymore. Seeing the lake felt like reaching second stage, and I knew I could do the rest. Downhill/pushing was hard work still, but it felt different and good. And the feeling at the end was simply delightful.

I also had a moment in the forest that brought me to tears. There were numerous large-growth stumps left over from the giant trees that were cut down, and from these remains, new trees were sprouting. Someone referred to the whole area as a nursery for new growth. I saw one particular giant stump with trees growing from its base, reaching heavenward, and it instantly made me think of my grandmother and her legacy as a midwife. She gave me such a rich gift, and though her life ended before I really had a chance to know her well, I feel solidly rooted. I feel her smiling at me in the birthing rooms at the hospital. I sit there, sometimes for hours, holding the hand of a woman in labor, breathing with her, helping her focus, and I swear that Grandma is there. This sense was so vivid last week that I opened my eyes and looked around, and like a lightning bolt I realized that she wasn’t outside of me but inside. I bring her with me into those rooms. I carry in my DNA all of her wisdom. She may be gone from the physical world, but she is alive and well in my memory. I am proud to be the baby tree sprouting from her magnificent stump.

In the grand scheme of things, I am a tiny sapling. If life allows me the time, I aspire to add many dozens more rings to my trunk. It takes much patience to become part of the old-growth forest. It takes putting down roots and reaching up branches and following the whims of one’s DNA and just growing. Thankfully, I’ve got some powerful examples to follow.

I decided not to give up on the weekend of camping (complete with even more butt-kicking hikes!), so keep your eyes peeled for more pictures and stories after my retreat. I look forward to returning to the world, renewed and ready for more.

Lost and Found

Stand still. The trees ahead and bushes beside you
Are not lost. Wherever you are is called Here,
And you must treat it as a powerful stranger,
Must ask permission to know it and be known.
The forest breathes. Listen. It answers,
I have made this place around you.
If you leave it, you may come back again, saying Here.
No two trees are the same to Raven.
No two branches are the same to Wren.
If what a tree or a bush does is lost on you,
You are surely lost. Stand still. The forest knows
Where you are. You must let it find you.
–David Wagoner, “Lost”

I have been feeling a bit lost lately. I am settling into the daily routine at my new job, which is to say that I am becoming accustomed to how different each day is from the one before, and how the same. Each clinic schedule lays out before me a list of names, a brief word or two about their reason for coming to see me that day (routine OB visit, new OB intake, GYN problem of almost innumerable variety, breastfeeding issue, etc.), their estimated due date (if applicable), and how much time I am allotted to see them. But nothing ever plays out that way. I may start the day with a certain number of patients on my schedule (hopefully, never again will I have seven new OB intakes in a single day, because dear God is that a lot of talking!), but some of those will cancel, or will be in labor, or will have given birth over the weekend, and others will call in with a problem and want to be seen that day, and at this point the midwives are the only ones in clinic with same-day availability, so we get to absorb these visits as well (for UTIs, suspected pregnancies, vaginal infections and STIs, and pregnancy-related or postpartum problems). Each day is so very different, and I truly enjoy (for the most part) the interaction with clients and their families, the intellectual stimulation I get from having such unique permutations of issues, and the challenge of having to think on my feet in every clinic visit. I never know what questions people will throw at me, but thankfully I have lots of resources at my fingertips. I can see my confidence in myself as a provider increasing even over the past couple of months that I’ve been in this role. I don’t really feel all that new at it anymore.

The sensation of being lost that I have been feeling lately is not so much work-related but rather in my personal sphere. I had set this enormous goal for myself almost seven years ago, having no idea whether my body or my mind or my psyche would allow me to achieve it. I had this dream of becoming a midwife, and through an amalgamation of fortitude, sleeplessness, self-care, community support, unwillingness to give up, and not a small amount of unearned privilege, I now can sign the letters “CNM, ARNP” after my name.

I am really proud of myself for this accomplishment. But I also don’t quite know what to do now. My road map of steps to take to accomplish this goal ended with certification. I added a bullet point at the end that said “apply for all the jobs” which involved its own nine-month process of tweaking my resume and cover letter, looking up jobs to apply to, personalizing my applications for each one, completing precisely one hundred applications all over the country and in a couple of international locations, keeping data on the status of all of these applications (if I knew it) in a spreadsheet, interviewing at least a dozen times, eating a lot of potato chips and watching way too many episodes of Grey’s Anatomy to appease my angst about not having a job yet (I haven’t watched a single episode in MONTHS now!), freaking out a little, wondering where my life would take me next, and trying to stay grounded in the midst of incredible uncertainty. Now that I’m here and those days are, to my endless gratitude, behind me, I feel a significant gap in my mental space where all of this future-focused energy used to go.

This void has left me with a near-rabid desire to come up with big new goals to achieve. The emptiness is hard to sit with. I am so used to having something to move towards, that now to be precisely where I’ve been heading is disorienting, to say the least. It is incredible to look back on everything it has taken to get me here, all I have sacrificed, all it has cost me. I can honestly say that it was all worth it.

And yet.

Now that I’m here, I feel lost. I don’t know where I’m going next or how I will know when I’ve gotten there. I am trying to stuff other ideas into the gap (I should find a partner! have a baby! buy a house! pay off my student loans! go on medical missions! write a memoir! finally get my apartment settled into!), but more and more I am finding that lost is exactly where I should be. Rather than run from the discomfort, I need to practice moving towards the places that scare me. I need to sit in the unpleasantness of the void, dig my toes into its richness, breathe in its scent, and open my heart to all it has to teach me.

I realized recently that I have not been as effective in caring for myself, especially my physical body, as I need to be if I want to maintain a certain level of well-being and not burn out in this physically intense job. I have started working on moving my body more, and on being present to the sensations of moving in my own skin, as well as being more mindful about the food I choose to put into my body and whether that is what really feeds me. I have been trying to stuff the emptiness down with food, and not the food that my body truly enjoys, either. I haven’t been listening to what I need, and while I can have compassion for the part of me who is feeling unsettled by all of the upheaval in my life recently, I also can choose how to respond to it.

One thing I’ve been more diligent about doing recently is walking. When I lived in the city, I walked a lot more as a mode of transportation. Here, I am a bit more isolated and find myself driving more. So I started walking to work more often (I’m about a mile away from my clinic), and walking around the neighborhood or to the local nature preserve. I went there yesterday and was engrossed with the delight of being one small part of one very large interconnected whole.

I wrote previously about this forest whispering to me, “Let yourself be moved,” during a time when I really needed to hear it. These woods were where I took solace after attending my first stillbirth as a midwife. I had no idea what to do with the intensity I had experienced, but the trees welcomed me in and showed me how even death is embraced in the natural world, how fallen trees are reclaimed and recycled and the whole forest goes on. I felt a deep stillness there that soothed my grieving midwife soul.

I went back again the other day, feeling lost. I walked to the end of the path and saw this log, fallen over, with mushrooms sprouting off it and moss on one side. I stepped off the trail and immediately took a seat on its bark to breathe in the silence of the forest. I remembered the poem I quoted above, and meditated on it as I sat. “The forest breathes. Listen… The forest knows where you are. You must let it find you.”

I sat in the spot in the above photo that was illuminated by the light of the setting sun. The brilliance broke through the trees and danced on my face, and I soaked it all up. In one split second, I opened my eyes and noticed that there were tiny rainbows on my eyelashes where the light landed on them, and I burst out laughing this delighted belly laugh in the middle of the stillness. The forest had found me with its rainbows and its magic. I was no longer lost, not in that moment. All of the larger questions I had brought with me into the woods remained unanswered, but I had gotten what I came for. The trees breathed me and graced me with their sacredness. I walked back out of the woods with a lightness in my step that was very different than when I had gone in.


I am grateful every time my life offers me an opportunity to awaken, just for a moment, and see everything so clearly. I know that I will continue to feel lost from time to time. That is part of engaging fully in the intensity of this work. But I also know where to go to be found, there among the everyday miracles of the forest, where the richness of the earth meets the cool breeze of the air, the fire of the sun, and the vitality of the water. My spirit is refreshed and renewed after time spent in the presence of such beauty. I am ready to rejoin the world, not necessarily with a clear sense of what my future steps will be but with a renewed energy to commit myself to the work I’ve been called to do and a faith that all will be well, and all will be well, and every manner of thing will be well.