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)

All the Robins

I woke up in the middle of the Hoh Rainforest at 5:00 this morning, realizing I had completed what I set out five days ago to do. With that sure knowledge settled deeply into my bones, I packed up my campsite and was on my way ultimately back home. It seems I am always on my way home.

The past week has been one marvelous adventure after another, starting with staying up terribly late after ecstatic dance to go with a dear friend to see the Perseids meteor shower at its peak. We lay out in the middle of an open field, giddy with excitement every time we saw a meteor arcing its way through the night sky. In between gasps of delight, we shared deeply with one another and continued to build on a connection that has been so nourishing to me.

The next morning, bright and early, after a counseling appointment to set me off on the right foot, and running on only 3 1/2 hours of sleep (from staying up so late watching pyrotechnics displays in the sky), I packed up way more than I needed and headed out into the woods in search of something. I had not made any firm plans about where I would go or whether I was car camping or backpacking or what precisely I would do when I got there. Being a planner by nature, this was a stretch for me, and it put me in precisely the frame of mind I needed to be in to do the work I went to do, namely, to get lost in search of myself.

Which is exactly what I did. I let myself get lost, alone and far away from home and from the people I love, away from the creatures that keep me warm at night and the food I’m used to eating and the bed I sleep in and the routines that make me feel safe. Dropping the facade of safety was key to the work I had planned, which was to dig deep into the stories I carry in my body and in my psyche that want out, that want to be written in a form beyond the limits of my journal or this blog.

I allowed myself to deeply face my fears. I sat with myself, my selves, all of the Robins I have been throughout my life, and I greeted each of them–regardless of how difficult I find it to love them–and welcomed them back to me. Over and over again, I allowed memories of all that I have been and done and experienced to wash over me, and gently, with courage and grace and dignity, called them home.

As I have done repeatedly over the years, sometimes what I need to say can best be expressed only by directly addressing myself in a letter.

Dearest Robins,

I usually write to one particular memory of you, one time or place in the past where I think of you and recall you needing to know that you are loved and that you are going to make it. Usually, I take this one at a time, and focus in as with a zoom lens on my camera onto one particular area, but today I want to take a step back and look with a curious eye over the entire landscape of my days.

I love you, each and every one of you. I love the scared child about to undergo surgery not understanding why. I love the creative, curious kid who loved climbing trees and swimming in the lake. I love the terrified little one who learned about violence way too soon, and I love every last creative thing you did to survive and live through it so you could become me. I love the sick teenager whose body grew and shrank at almost unbelievable rates, disappearing nearly before our eyes until birth defects were discovered and lifesaving surgery was carried out and more trauma and healing could happen, and did. I love the person who grew so focused on coming alive and living well. I love that, despite further trauma from multiple complex sources, that person found ways to make it through. I love the person who lived in the sick body that again nearly died, and again, fought to remain in the land of the living. I love the queer one who declared their autonomy from all of the oppressive messages that said they weren’t worthy. I love the lover, who has in their heart an enormous capacity to love, and the ability to continue to love again even when it doesn’t work out sometimes. I love the midwife who helps others create their families, even as family is a tricky thing to define for oneself. I love the one who has lived through fractures in mind and body and has nevertheless pursued wholeness. I love the one who creates their way out of the darkness with any means available: words, poems, art, music, crafts, connections with humans and animals, dance, photography, time in nature, cooking, and physical activity.

To sit with every last thing about my life I could remember and accept myself fully in every aspect of my wholeness took me to some of the hardest places I’ve ever been. I chose to go there alone, to be physically and emotionally and psychically and spiritually in solitude, with the natural world as my anchor, always calling me back home to myself.

To the Robin who is so sick she is terrified to leave her house, I say this: You will travel out into the wilderness with courage in a body that is as strong as it has ever been.

To the Robin who is so terrified she cannot believe she will ever feel better, I say this: You will learn skills to help you hold all of the enormity of your feelings, and you will learn to reset your brain so it can be calm, and you will not always be afraid.

To the Robin who needs constant reassurance that you will be okay, I say this: You ARE okay. You belong to the Everything. You are a part of the world, and you belong to the trees and the mountains and the waterfalls and the wind and the rising moon.

To the Robins who have done things they are not proud of, I say this: You are worthy of love and acceptance and belonging. There is forgiveness for you. You have hurt yourself, and you have hurt other people, and there is yet healing and reconciliation for both.

To the Robin who doesn’t know what the next step is, I say this: Stand still. Let the forest breathe you. Listen to the winds beckoning you forward. The way will open. Let yourself be guided gently forward. Your passion will continually call you home to yourself and to your work in the world.

To the Robins who feel permanently broken, I say this: Brokenness and wholeness are not opposites. They exist in dynamic tension with each other. I would not be able to be this whole if I had not been this broken.

To the Robins who feel lost, who long again and again to go home, I say this: Home is inside you. It is as close as your breath. Home is the presence you bring with you to any given moment, the attention you give to the elements that make up your life. You will find your way home again. And again. And ever always again.

To the Robins who strive for safety through some very creative means, I say this: I see you wanting to structure your world in such a way that you make it predictable, and controllable, and solid. But hear me when I say this: You will wake up one night in your car in the middle of the Olympic National Forest with a black bear trying to get inside, and you will know deep down what safety is. None of the mental structures you create can give you the sense of security in the world that you can get from standing firm in your truest wholeness, and in the knowledge of how inordinately fragile a thing life is, and how out of reach it is to control.

To the Robin who is afraid of germs (and I mean, seriously afraid of them), I say this: You’re going to wake up one day not having properly washed your hands in a while. You will be filthy. You will swim in bodies of water that may contain giardia, and you will poop in holes you dig in the woods, and you will laugh at the reality that a germaphobe grew up to be a healthcare provider with a job in a hospital, and you will delight in the irony that is your life.

To the Robin who is afraid to be whole because claiming their authentic self in the world has some degree of unpredictable loss inherent in that process of selfhood, I say this: Be wholly you anyway. Yes, you will lose people you love who cannot create space for you to be you. You will lose dear friends and family members and casual social relationships, and your vulnerable authenticity will make people uncomfortable. Be you anyway. Be the most Robin-ful Robin you can be. Nobody else can do that for you, kiddo. Nobody else can go on this journey to the places that scare you (both inside of yourself and out into the world) and come back with 2200+ photos and 200+ heart-shaped stones and dozens of stories of encounters with nature that took your breath away. You are it, love. You have it in you to go on this journey and to do this big thing, and I believe in you.

You are coming home to yourself love, loves. Every last one of you is a part of me, and I am so beyond grateful that each of you existed, and engaged with whatever your challenge or struggle in all the ways you did, and that you did everything you could to survive and to become the Robin I am now. You each had a part in helping me create this life that I can honestly say that I love living. And I give you my word that I will do my best to honor the work you have done by bearing witness to the stories you have lived.

So that’s where I end, and where I also begin: In the storytelling. I went out into the wilderness in search of myself, in search of the inspiration I needed to start writing again, and I found it in measures that astounded me.

I found it in the moonrise over the Hoh River:


I found it in Lake Crescent:


I found it at Sol Duc Falls:


I found it in the Hall of Mosses at the Hoh Rainforest:




I found it at Kalaloch:





I found it at Rialto Beach:


I found it at Ruby Beach:



I found it in the presence of the world’s largest western red cedar, near which I had unwittingly camped the night before:


And I found it in the pages of my journal, and in the pages of my history:


Greet Yourself Arriving

The time will come
when, with elation
you will greet yourself arriving
at your own door, in your own mirror
and each will smile at the other’s welcome,

and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you

all your life, whom you ignored
for another, who knows you by heart.
Take down the love letters from the bookshelf,

the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.
–Derek Wolcott, “Love After Love”

The time will come, and for me, is soon coming. I am leaving this weekend for a week-long solo trip to the Olympic Peninsula, to get lost and find myself in the woods, or something. I’m going to write, to explore what is inside of me that wants to exist in the world, to explore both my inner world as well as the world around me. I am taking my camera, and my journal, and my curiosity and anxiety and courage and authentic wholeness.

Nine years ago exactly, I was really sick. This body I live in now was eating itself for food; I weighed 70 pounds less than my current (very average) weight. I had a BMI of 13.7. I was aware that I was actively dying. I said goodbye to my life, and detached from everything that I loved and that gave meaning to my existence. I was ready. I remember vividly what death tastes like. I can feel the coldness of her shadow on my skin. I didn’t know what to expect, but I certainly didn’t expect to survive.

But I survived. Thanks to exquisitely-timed interventions from loved ones that involved leaving my parents’ home, moving across the country to seek specialty treatment for the leading expert and researcher in my particular condition in a place I’d never lived before, and being welcomed in my wholeness into a loving and accepting community, little by little over the next year I started getting better. And in my process of healing, I realized that I had the opportunity to rebuild my life in whatever ways I chose. I launched into an exhausting process of exploring every last piece of my life as I decided whether I wanted it to be part of what existed for me now. After not dying when I fully expected to, everything since that time has felt like bonus time, moments that I never thought I would get to experience. It was during that exploration that I realized I didn’t want to study childbirth academically as I had planned, but that I wanted to have a more hands-on role. And a year later, I was enrolled in prerequisites for midwifery school.

That period was a turning point in my life, setting me on a path that has led me to a place where I get to be my most whole self, doing work that I love, in a place I feel welcome and accepted, belonging to a community of people who see me, creating a family for myself out of chosen friends and loved ones. I have gone to the very depths of myself, digging into the deepest awfulness of human experience, and come back with fists full of unearthed treasures.

Some of what I’ve done doesn’t seem like it should be humanly possible, and when I look back, I wonder how I did it. I have so many stories of survival, of not just getting by but of actively thriving. I never thought I would be able to say that I love being alive, but I truly do, and getting here was a journey so full of rich stories that now want to be told. So I am going, in large part, to explore my stories. I did, after all, pick “storytelling” as my word for the year, and it is kicking my butt in all the best ways.

I am simultaneously terrified and fearless to go on this trip, to pay attention to every last bit of me that has stories to tell, to sit down with myself and “feast on my life.” I feel strong (hopefully strong enough to haul my pack on the trail!), both in body and in spirit, probably as strong as I’ve ever felt. I have no idea exactly where I’m going, other than that I’m taking myself to the woods to get lost and found again, and that I’m going away so that I can call every last part of me home.

It is time to greet myself arriving at my own door, after all the work I did to heal from my illness, and to address all of the physical and mental and emotional and psychosocial challenges that got me that sick in the first place. It is time now, after the intense work I did to heal, and to prepare myself for becoming a midwife, and actually studying and learning how to be a midwife, and becoming a midwife, and then working fiercely as a midwife for my first years in practice, and now finding myself settled in my second job and with more free time and energy to be able to bring some attention and gentleness back to myself.

Who am I now after that long journey? What do I want to do next in the world? What writing do I need to do? What stories want to be told? What further healing wants to happen in my mind and body? Where am I going, and what do I need to support myself on the journey?

These questions and more will follow me to the coast this week. I don’t know what I will bring back with me, but I can guess that there will be stories, and photographs, and likely more than a few heart-shaped stones. I’m ready to let the meteor shower make me feel exquisitely small, and for the trees to breathe me, and for the ocean to call my name and the ground to give me a place to rest. I’m ready to “give back my heart to itself.”

I will love again this stranger. I will find my way home.


For those of you who have been following my blog for a while (some since I wrote my very first post as I was starting nursing school!), it is not a big secret that I am something of an open book. I was having a conversation with someone recently who was surprised at the level of vulnerability I share in such a public space, and they were curious how I came to the place where I decided I wanted to write this deeply about my life.

I can think of no better answer than Nayyirah Waheed’s beautiful words:

it is being honest
my pain
that makes me invincible.

I spent nearly a decade of my life swallowing down pain so deep it threatened to drown me and could have succeeded. I fought hard to claim ownership of the voice that allows me to find the words to speak of the pain and joy that have made up this delicious beautiful mess I call my life. This body and mind I live in has survived an enormous range of experiences, some which should not have been survivable. The very fact that I am still breathing sometimes takes my breath away, and the exquisite poetic irony of this truth teases the corners of my mouth into a smile.

Finding words to attach to the experiences I have had as a member of the human race alive in this body on this planet at this particular juncture of time and space has given me a sense of delicious freedom, as if by writing something into being I am simultaneously creating it and acknowledging my utter lack of control over anything.

I had a moment of piercing clarity in a clinic visit a while back, during which time I was working with a client who was struggling with health concerns that I have had as well. I saw myself in her suffering. I remember the despair, and the longing to be seen. I did not go into detail with her about my story–it was time to focus on her own wellbeing, not to shine the spotlight on me–but something in what I said alluded to the fact that I knew on a very deep level what she was experiencing, and that gave her a measure of relief in itself. She was not alone. I understood and believed her. Isolation gave way to validation, and her pain abated, if only for a moment.

When I was lost in the despair of the closet that trapped me, that I had no idea how I would ever find my way out of, hearing the stories of others who had been there gave me strength to keep going .Through witnessing their bravery, I found my own. What I discovered is that I am made of ferocity beyond my wildest dreams, and that some measure of that courage is borrowed from others who came before me and, in the raw sharing of their stories, pointed me towards my own north star.

It is being honest about her pain that makes Nayyirah Waheed invincible. It is being radically vulnerable with my life story that revealed to me the expansive magnitude of my courage. I know that by owning every aspect of my life, I am risking loss: I have lost dear friends, family members, and social relationships because of it. I am potentially risking my safety (because queer folks still face violence for existing) and my employability (in states I would not choose to live in because my human rights can be legally discarded), among many other things. Because me being me is more than some folks can handle. But me not being me is more than I can bear.


Case in point: my hair is a little more queer this week than last, and there’s a lot less of it. One of my lovely people cut it for me, and I’m rather delighted by it. I had briefly forgotten the vulnerability that comes from instantly being recognizable as being a little too much, too “out there,” until I twice yesterday got called out on why I cut my hair the way I did. I cut my hair because it’s my body and I get to do with it what I damn well please. And because it’s adorable this way. And I really don’t even need to give that much of an explanation, because I don’t exist to make anyone comfortable. If anything, hang out with me for a minute and I’ll be sure to ask you a question that will take you to an edge that makes you wince a little and think a lot. It’s what I do.

I have already given up way too much of my life to fear. I let anxiety about what other people would think of me and what I stood to lose hold me back from all that living from my authentic wholeness would open for me. I played small for too long. I made myself palatable. But I’m not easy to swallow. I am a fireball of healed trauma wrapped in non-conformity with sprinkles of compassion and a heaping side of mindfulness. I am incapable of moderation. I love with abandon because I know how desperately short everything can be and I have no idea how much time I have left to soak up what the world has to offer me and to splash my own magic around liberally. I’m okay if that’s messy, and I hope you are too, because I hope that my wholeness can interact with yours in ways that makes each of us more ourselves.

So I choose in this period of transition to step out of all of the closets that have held me captive, and pry back the lids of every box I have ever tried to conform my queer little self to fit into. I embrace my wholeness as a person whose interlocking identities defy easy categorization, whose gender and sexuality don’t resonate with binaries, and whose heart has longings that don’t always make logical sense but always, always point me towards home. I say yes to loving wholeheartedly, to seeing deeply, to creating glorious messes, to arriving wherever I am in any given moment and finding myself ever only always here now. I am willing to sacrifice the illusion of connectedness with people who are incapable of loving me in my authenticity so that I can see and be seen by those who want to play in the richness that vulnerability has to offer.

At a workshop a couple of weeks ago, I stood in a circle with other folks and spoke my deepest fear and my greatest desire into the center. I learned in doing this that what I fear and what I long for are light and shadow to each other. I am most afraid not of being vulnerable, but that in my vulnerability, folks will see my true self and find me either inadequate or excessive, not enough or too much. I won’t be good enough, and therefore I won’t be lovable. The flip side of that is that my greatest desire is to belong, both to belong deeply to myself as well as finding a home in a community of family, friends, and lovelies who see me in my authenticity and love me precisely in my too-muchness.

I am taking steps towards creating space in my life for my greatest desire to be possible. One of those steps is telling my story, making myself visible, taking up space and giving others permission to do the same. I do this with a fair bit of trepidation, and also with great courage, remembering the words of Albert Schweitzer, who asked for divine help to “fling my life like a flaming firebrand into the gathering darkness of the world.”

This is me. This is what I have to offer the world. This is who I am, in my broken, unapologetic openness. This is my queer body that defies any attempts to categorize it. This is my immoderate heart that loves with abandon. Here are my stories of pain and brokenness and violence and healing and discovering that I am made of exquisite magic that wants to do big things in the world. This is the space I take up. This is me becoming invincible.

If I could send any message back to my closeted self, I would say this:


I wish you could see how much you would fall in love with your life, how much love you would give and receive, how free you would feel on the other side of that closet door and with a good decade or so to work through all of the shit that put you in that confined space to begin with. I wish it was possible to give you a glimpse, in just a few words or photographs, of how much you would come alive.

I think of you daily, and am grateful to the point of tears that you didn’t give up. You could have, and I wouldn’t be here doing the work that I love (catching babies that share my birthday!) and loving the people that I love and sleeping snuggled next to the cats that I love and wandering through the forest just to be caught completely off guard by the incredible beauty of the world.

“I wish I could show you when you are lonely or in darkness the astonishing light of your own being,” Hafiz said, and this could not be more true of how I feel about you. I wish I could help you see how deeply worthy you are of love. I wish I could reassure you that you will find it, and that it will knock your socks off. I can’t go back in time, but I can share your story moving forward, and I will.

Thank you for holding on. Thank you for putting one foot in front of the other on the days that you wanted to die. Thank you for choosing to do the hard work of healing so that I can do the hard work of being healing in a wounded world. I am fiercely in love with my life now, and if any tiny bit of this message were to make it back in time to where you sit, I wish it would be this: you will come home again. You will discover what your name is, and you will live your way into it. You will never be without family, though it may not look anything like what you expect. I promise you: you’re going home.

In the meantime, keep doing the hard work of being a whole person. I love you more than words can ever say.



Dare to be Powerful

Sometimes things don’t go as planned.

I talk about this as a midwife, in prenatal visits and birthing rooms. Labor might have different plans than I do, might choose a different path. Sometimes a GBS test comes back positive and antibiotics are added to the plan. Sometimes a breech baby won’t turn and a cesarean birth is now up for discussion. Sometimes waters break and labor doesn’t start and augmentation becomes the plan. Sometimes, despite every trick in my book, babies won’t come out vaginally without help, or at all, and operative interventions become the plan. Sometimes uteruses won’t stop bleeding and lots of rapid interventions are added to the plan. Sometimes babies are born sick, and need treatment, or surgery, or a decision when enough is enough. Sometimes labor starts before babies can survive and saying goodbye becomes the most terrible plan ever.

The majority of pregnancies are healthy, and most labors can and do go smoothly. Most pregnant people do well with encouragement to put healthy things in their bodies and stay active, and we can expect them to have mostly-normal labors as well. As a midwife, that is my plan. But, as a midwife, I am also ready for when things don’t go as planned. I train for those moments, not for the normal babies that would essentially deliver themselves and the parents that would recover well on their own. I learn how to have difficult conversations quickly, expressing necessary information and getting consent to perform an intervention. I am flexible, and I know how to respond when plans need to change.

So, then, when I’m not in scrubs anymore, and my badge is no longer clipped to my chest, one might assume that I would be similarly flexible when my personal life takes unexpected turns. After all, I’m good at responding to new information and acting quickly. And sometimes, this is true.

And sometimes, it is not.

Sometimes, I want my life to follow the plan I have set out in my head. Sometimes, I don’t want to have to be flexible. Sometimes, I wish that I could snap my fingers and turn the image of “my perfect life” that I carry in my head into reality. But I’ve tried that before, and even when I was on track to achieve what it was that I thought I wanted, I was miserable. My life felt solid but I was not whole. And it took me a bit, but I realized that more than anything, I needed to be allowed to be whole.

Sometimes, just sometimes, when curiosity and self-compassion settle into my heart, filling in the cracks where worry threatens to submerge me, I feel the deliciousness of having no solid ground to stand on. For brief moments, I rest in the stillness in between thoughts. I remember that my life today looks nothing like the plans I had laid out for myself a decade ago, and that it is ever the more beautiful for every time I have shouted or sobbed or whispered “yes” to the offering of a new adventure.

Transition is hard. It is a hard part of labor and it is a hard part of life. That liminal in-between space that links before and after, here and there, past and future and right now–that space is home to me. My queer little self exists outside of the binary world of easy opposites. I have never found a box into which I easily fit. It would stand to reason that I would spend much of my life in in-between spaces. Sitting in a labor room, pregnant with anticipation, holding the intensity of a new person crossing over into this realm and guarding their passage, I feel this liminality. Sitting in my bedroom late at night, trying to remember what I am doing with my life, I feel it too.

What I am doing is telling stories. And I learned this weekend, in a conversation with a delightful new friend, that I am also un-telling stories that I have been told and been telling myself for a long time. I am rewriting my narratives, tracing a trail of breadcrumbs back to myself, back to a body I am constantly trying to belong in, back to a life that I am making that feels like mine, back to a family I am assembling for myself, back to the fire at the center of my being that drives me to be more fully myself in the world, as terrifying and vulnerable a thing as that is. I am ever and always making my way home.

Like all explorers, we are drawn to discover what’s waiting out there without knowing yet if we have the courage to face it.
–Pema Chodron

Recently, doors to new adventures have been offering themselves to me, asking me if I have the courage to open them. And I don’t yet know what my answer is, other than that my curiosity about where these invitations will take me is stronger than my fear of everything changing. And everything is always changing. The times that I feel solid ground beneath my feet are little more than an illusion.

When I dare to be powerful, to use my strength in the service of my vision, then it becomes less and less important whether I am afraid.
–Audre Lorde

I am afraid. Of course I am. I want desperately to know what is going to happen and how it all works out. I want to know what my life will look like in six months or five years or three decades. I love stories, and I want to already know how this one ends. But it is so far from ending, and if I knew, I think I would shrink back. I think through all of the moments of my life where I would have run away if I knew what was in store, and how much I would have missed out on by not showing up. So I dare to be powerful. I feel the pounding in my chest and the clenching in my gut and I move forward anyway. I find my strength and hold clearly my vision of who I am called to be in this world and how I am being asked to serve, and my fear, though still powerful, becomes less relevant.

New people have joined the planet today, and others have left us. Cells are dividing inside me at a dizzying rate, going on about their processes without so much as a guiding thought on my part. Winter has left, for now, and spring has squarely taken hold here in the Pacific Northwest. The days are longer than the nights again, and the sun shines through my window to wake me. Doors are opening and closing before me, before all of us. Ground is illusory. The best-intended plans are constantly in flux. We are only ever always in transition.

Burying Sadness

But if you bury your sadness under your skin instead of letting it out, what else can it do but grow in your veins, to your heart?

–Nikita Gill

My life is full of joy. I have spent delightful hours over the past couple of weeks at my new job, getting to know a new population of clients, most of whom are expecting to welcome babies into their families in the near future. I have had the immense honor of catching their babies in my hands and whispering a blessing of welcome into this big world. Witnessing contractions opening bodies so new members of growing families can come through never ceases to amaze me. I have no doubt that I am doing my work in the world. I am lucky that my job is also my vocation and my calling.

Mixed in with that joy is now and always a fair bit of sorrow. Sometimes my experienced hands cannot guide the Doppler to a heartbeat. Sometimes a scan shows worrisome findings. Sometimes the lying bastard known as depression tries to steal away the happiness of welcoming a new little love into one’s home. Sometimes a partner unexpectedly turns violent, or cheats, or leaves, and my client is left with a mess on their hands. Always, always, there is fallout, and often this bubbles up in my clinic room.

And my life, too, has its measure of sadness. It is not easy to be a healthcare provider and simultaneously the adult child of a mother with cancer. It intense to live in a body that so regularly reminds me that I am made of flesh that aches and bleeds and can sometimes break open. I have not hidden the fact that my mind has myriad reasons for big feelings to arise from time to time, and when I am in periods of transition, everything in my history tends to ask for my loving attention again, which I am willing to give, and which offers me insights into deep and beautiful things when I slow down and show up for myself.

It takes its toll being queer in a world that doesn’t have a box to check that easily defines me, always being “other.” No part of me easily fits into a box, and while I would not trade in my queerness if I could (though I did spend the bulk of my teens trying, without success and with plenty of damage to my wellbeing), the idea of being understandable and understood by more than just other misfits and weirdos has its appeal every once in a while. Coming home to an empty house after a long call shift spent helping other folks create their families doesn’t always touch that place in my heart that aches, but today it did. Being a wounded healer is a privilege with a heavy price tag attached.

So on nights like tonight, I feel my sadness instead of letting it settle in my flesh unexamined. I notice the ache in my sternum where my awareness of mortality lies. I feel my ovaries begging me to use their eggs. I feel my belly (always), chugging along, painfully digesting my life as it so diligently tries to do. I sense the vast empty places in my bed that for now will be filled with feline companions. Sinking into my body, I remember that sadness is a universal experience, one which links me to the whole world. Catching my breath, I feel the ice around my heart melting. Tendrils of compassion wrap themselves around me and extend outwards to hold the shared sadness of others. I feel all the feelings at once. It is not possible to feel so alone when I remember that I am a part of everything.

So much is shifting for me, and so quickly, that it is easy to get lost in what is different. And also, in the groundlessness, there is space to rest as well.

We are always in transition. If you can relax with that, you’ll have no problem.

–Chogyam Trungpa Rinpoche

Transition is hard. In labor, it’s when many people hit a wall and feel like they can’t do it anymore. In life, it’s when the maps that used to prescribe where I should go next no longer show me the road ahead, and I must wander through and trust that the way will open before me.

Choosing “storytelling” as my word of the year is kicking my butt. I didn’t realize that such a word would call me to more deeply question and explore who I am as a storyteller. This year is not even a quarter over, and already I am not the same as when it began. My life is dynamic just now, and while all that is changing leaves me feeling like I have no solid ground on which to rest my feet, relaxing into that reality is bringing me comfort. Not long ago, I felt very stuck, and while I had solid plans for what direction I would be going, I wasn’t happy. Now, I am most definitely not stuck, and I have no idea where I will be in six months or a year, but I feel free in a way that I didn’t before. Free not only to tell stories that have been holding me back, but also to release their power over me.

For me, I have found that in my vulnerability and acceptance and willingness to face the things I haven’t wanted to write down or speak aloud, they lose their power over me. As I claim all of my life experiences and actions as mine, I become free from them. Integrating every last bit of my life into one complicated whole has been some of the hardest and most rewarding work I’ve ever done, and there is certainly plenty left to do.

Sometimes, when I remember to pause in the midst of chaos, I ask myself, “What is the work of this moment?” And then I do that. Tonight, my work has involved rearranging furniture, answering pages from clients, remembering to feed myself, having a good cry, reaching out to friends to break my isolation, and writing a blog post under the warmth of a snuggly purring cat-friend. And now, the work of this moment is to rest (until morning or the pager goes off again, whichever comes first!). Much love to anyone and everyone who has ever felt sadness, and may the willingness to feel it deeply open you to greater joy as well.

The Word Beyond Home

what is the word beyond.
after home.
where is it. this word.
why can i not remember
how to say this
thing. this feeling that is
my whole body.
–nayyirah waheed

This is my first blog post this year. I have sat down many times to write and have found myself in a state where I am too full of stories to tell any one of them.

I am in transition. That is a story in itself. I am in an in-between place, where I am becoming more fully myself but not entirely sure what it is that I am becoming, where I am going, who I am in the world. I know I am a midwife; this part of my identity is solid and lovely to me in its reassurance that I know this much of who I am, at least. The rest of it feels like it is up for grabs.

In my last blog post, I wrote about the word that I chose to represent this year for me. I was anxious about choosing “storytelling” as my word, because I knew that it would ask big things of me and I wasn’t sure if I was ready. I was not wrong about either of those things. “Home,” my word for 2015, took me to some incredible places. This is a new year, a year for storytelling. This, for me, is the word beyond home.

This word, in under two months, has already called me to rise in ways that I cannot fully describe in language (ironic, given the word I chose). Committing to tell my stories this year is a radical, political act as well as an intensely personal one. I am making the intention of owning my whole self, every facet of my being, without shame. This authenticity and vulnerability is game-changing. For me to stand up and say, “This is who I am in the world,” and to be that person, involves a depth of wholeness and integration that is revolutionizing the way I walk through my days and show up in my interactions with other people.

You need only claim the events of your life to make yourself yours. When you truly possess all you have been and done… you are fierce with reality.
–Florida Scott-Maxwell, “The Measure of My Days”

That is what storytelling means to me: claiming the events of my life, making myself mine. Being fierce with reality. And my reality has been fierce with me, to say the least. Those of you that know me in person or have followed my blog for a while know that my life has been full of some not-so-easy stories to tell. As, likely, has yours. I feel compelled to tell my stories, even the seemingly shitty ones, because I have found that my vulnerability bridges a divide that exists when we walk around in the world trying to pretend like we have it all together.

So I sit here not for the first time this year, but for the first time that I have been able to put words together in a form I can share publicly. I am taking Nayyirah Waheed’s advice and writing “the thing you are most afraid to write.” Almost. I’m not quite ready to share that one. Close, but not quite.

But I am ready to sit down with myself and write me a letter. I think of my fifteen-year-old self, closeted and lost in a mire of depression and shame, with unresolved trauma and a sense of never belonging. I think that person that I was needs to hear from the person that I am now.

Dear Robin (the 1999 version of you),

Oh, honey. Just to think of you brings tears to my eyes. I see you trying so very hard to make it, to make a place for yourself. You invented crushes (on boys who grew up to be gay–good gaydar you had!) because all of your friends were dating and you wanted to fit in. You went to church and Bible study and missionary kid youth groups, and you did your best to fit into the molds you were presented as the only possible good way to be. You sat and studied your Bible for hours a day, highlighting verses and taping them up around your room, and tried desperately to pray away parts of yourself that were becoming undeniably true for you. Parts that you knew, if you invited them into the open, would possibly cost you your friendships and family relationships.

I also see you desperately trying to stuff down secrets that wanted to come out of your body, stories you’ve held inside for too long, words you’ve told no one. I see you struggling to fight off the demons of shame and a sense of doubt in your value that comes from the violence you experienced at the hands of people who should have been safe for you. I see you holding these secrets inside you, piling food on top of them to choke them down. I see you gaining weight rapidly (a hundred pounds last year alone) in an unconscious attempt to be invisible. I still see you, and Robin: You are a lovely human. I know that the size of your body feels to you like it will make you safer. You have already internalized the sense that fat bodies are not seen the way that slender ones are, and the safest thing to you seems to be being unseen and unseeable. So your creative self, the you that desperately wants to stay alive in the world despite how hard and painful it is for you, came up with a solution. You survived, and I am proud of you. You did what you needed to do to make it.

Nothing about your body needs to change, though it will, and drastically, and soon. Over the next 11 months, you’ll lose more than half your body weight, as you lose your appetite for life and your ability to stuff anything down anymore. Your guts will literally turn on you (you were born with them tangled and “defective,” though you don’t quite know this yet), and you will have a long struggle ahead of you that will involve many invasive tests, a surgery that will take three times as long to heal from as anticipated, and a lot of pain and anxiety. And you will pull through it, and at the end, you will finally come up with the courage to tell someone about the violence you suffered through as a young child.

Sometimes the pain will feel like too much for you to hold. Sometimes it will burst out through lines traced in your skin, the blood leaking out a reminder that you are alive. There will be a time you “put the sharpness back,” as Mary Lambert so beautifully says.

Fathers and uncles are not claiming your knife anymore
Are not your razor, no
Put the sharpness back
Lay your hands flat and feel the surface of scarred skin
I once touched a tree with charred limbs
The stump was still breathing
But the tops were just ashy remains
I wonder what it’s like to come back from that because
Because sometimes I feel forest fires erupting from my wrists
And the smoke signals sent out are the most beautiful things I’ve ever seen

You will not have to wonder what it’s like to come back from that. You will come back. Do you hear me, love?

You. Will. Come. Back.

You will come home to yourself, in new ways, again and again and again. You will find words to attach to the deafening silence you’ve choked down for years. You will cling to stories of other survivors like life preservers. You will read Alice Sebold saying of her rape, “You must save yourself or you remain unsaved,” and you will set about the work of saving yourself. You will reach for the doorknob on the closet door, and you will come home to your queer self. You will find yourself with a new name and a new body. You will come to a place where you feel the permafrost in your muscles melting in dance class, and you will move in your skin and learn–little by ever so little–that you belong here.

You will do thousands of hours of hard work and self care that make it possible for me to do what I do now. Had you not invested so much into your healing, there is no question that I would not exist, either on this planet anymore or in my current role as a midwife. Death would have taken me ages ago if you hadn’t worked to keep her at bay. So you worked. You wrote. You put your pain into words on paper in dozens of journals that now fill boxes in my room. Your words pour off the lines into my memory and I send so much love back to you, back in time. I think of how much you despised yourself, how lost you were in shame and loneliness and grief. I think of the body that you hated and treated with such contempt, yet managed to keep alive. Here’s a secret: You will love this body one day. Joy and pleasure and happiness will show up beside pain and sorrow and loss, not taking their place but coexisting with them. You will expand your capacity to feel all of these things.

From where I stand, 17 years later, I am so grateful to you for your courage, and your strength, and your creative tenacity. You could have taken your life, and by extension, mine. You certainly thought about it. Your childhood friend did, last year, hanged in her closet full of despair after holding onto life as long as she could. Your closet reeks of pain, too, my love, and nevertheless somehow you held on. Thank you for holding on.

Thank you for somehow believing that there was a world with room for all of you in it. Thank you for making your way out of oppressive spaces and finding a path to a city and a community where you could be big. Thank you for following your passion to a profession where you get to do work that you love and make a difference in the world. Thank you for claiming your authentic self and wholeness in an environment that wanted you to be small and normal and ordinary. Thank you for the immense work you put into becoming me. I am in love with my life today because you did the heavy lifting and taught me how.

You are a goddamn tree stump with leaves sprouting out of it, reborn, my love.

And tomorrow, you will start your second job as a nurse-midwife, at a new hospital, with a new group of colleagues, in this city that is becoming home. You will continue to show up for your life and tell your stories. Day by day, year after year, you will become ever more yourself.

And so I send love back to you, in hopes that somehow it reaches some part of your psyche. I think of you with fondness and gentle compassion, in the complexity of the person you were and are. I think of the wars you fought and the bravery you showed just by showing up.

I have tried for a long time to escape you, because who you were at 15 is not who I am or want to be now, is not the life I want to live. I never want to return to your closet of death again. But I see now that running away from you is just running away from the person who would become me, and showing you kindness is cultivating self-care. In every way, you are me. You learn how to become an ever-closer approximation of your whole self. You live your way into you. Into me. You find your way home.

You find the word beyond home.


You Burn

“You burn because you carry fire.”

–Rune Lazuli

I know that I am not alone in this sensation of burning from the inside out, this intensity that has called my name since I was a child and has compelled me to follow a tough path with many opportunities to give up and choose something easier. I know that I take up more space than is “ladylike” or comfortable or easy to witness. I speak openly about some very difficult topics and don’t hesitate to move in the direction of big feelings. My dinner table conversations are likely to make some people squeamish. If I take a liking to you, I will probably ask to see your soul and show you mine in return. I believe in and practice radical vulnerability. As Brené Brown says:

“Owning our story can be hard but not nearly as difficult as spending our lives running from it. Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy—the experiences that make us the most vulnerable. Only when we are brave enough to explore the darkness will we discover the infinite power of our light.”

Sometimes this is scary. Not everyone can hold this much fire, at least not without practice. I have felt lately in certain relationships like I might be too much, too big, too intense, and have contemplated how to go about being just a little bit smaller. I would fit so much better in the world as it is now, in my family of origin, in polite company, if I could contain some of this potent energy, if I asked less of the people I love and showed them less of the harder-to-love parts of myself. But the thought of making my magic smaller hurts me. I feel like I would be less whole, less authentically me, if I worked to fashion myself into something more acceptable. I feel that burning, and lately, I’ve been struggling with what to do with it.

“You burn because you carry fire.” What a simple and potent statement! The ardent heat in my chest that put me on the path that has led me to becoming an ever-closer approximation of myself is not an anomaly. It is not a symptom to be treated, a burning to be extinguished. I burn because I have spent my life chasing down my demons and reclaiming their power over me, and this has made me brave, if not exactly fearless. I have gone to many dark places, some with company and some alone. I have made space in my chest for the enormity of grief, the agony of loss, the ugliness of shame, deep waves of sadness, isolating loneliness, and the bitterness of rejection, and in turn this has carved more room inside me for deeper joy than I could have ever imagined. I live in a body that I have only really known in a semi-broken form, and I invest much time and energy working to understand what level of wholeness is possible for me. I am a broken healer, burning because the fire I carry is not something I can put out.

I do not exist to make anyone comfortable, not even (especially not) myself. I am here to invite you to go to the scary places where you will meet yourself. If I extend a hand to you, it is inviting you to come with me to the edges and peer over to see what lies beyond them, to discover what wholeness you might claim from going to the places that scare you. I am here to hold up a mirror to show you the most beautiful things about you that you’ve never let yourself love. I am happy to love them with you.

This will likely be unpleasant. Big feelings will come up, and along with them all of the things we do to avoid feeling those big feelings. But if you can breathe, and stay at that edge, and not run away, I promise you that something valuable will be there to explore, something that will deepen your understanding of yourself and your life and your purpose.

I am at that edge now. I am breathing. I am wanting to run away, wanting to quiet the feelings with chocolate or mindless chatter or anything but actually feeling my way into them. So much in my life is shifting, and with these transitions come both the finality of closed doors and the invitation of open ones. In this period of liminality, I invite my whole self to show up and remind me who I am and what my life wants me to be. “Let your life speak,” the Quakers say, and I am working to create the stillness necessary for the quiet voice to come forward and beckon me into deeper wholeness.

Paying attention to the voice of the whole self is dangerous, because often it asks for what it needs, and these requests require action. I have been offered invitations to make some big changes in my life this year that are pointing me in the direction, ultimately I believe, of greater authenticity and wellbeing, but for the time being, I also feel a certain degree of chaos surrounding them. I am making changes in my personal life, in my most important relationships, in my work life, and in my home, and I anticipate that while I feel destabilized temporarily, I will settle into a place of greater stability in the long run. All of these choices presented themselves to me initially as a sense of unease, whether in my mind or body, and only as I explored them was I able to mine their deeper messages.

2015 has been a big year for me. I have had several major health issues to deal with (including needing surgery and having a couple of procedures under general anesthesia), an important relationship that grew as much as it could but ultimately was not sustainable, my first international midwifery volunteer experience, many dozens of babies caught and hundreds of encounters with pregnant folks as well as those seeking general reproductive health care or contraception, some lovely new friendships and relationships built, and the beginnings of transition from one place of employment as a midwife to another (which will officially happen in February 2016).

I am making choices that will stoke this fire that I carry, that will help me guard it and use it well and help it keep burning strongly for as long as I live in a body to carry fire in. It is not easy to stand up and say, “I need this to change for me to be my best self,” especially when claiming one’s wholeness risks disappointing others. But self-care is the least selfish act I know of, especially for those whose job it is to care for others. It took guts for me to recognize that the work situation I was in was not sustainable if I wanted to remain healthy and balanced, and to take steps to orchestrate the changes necessary to create that balance. The same goes for relationships, and for my interactions with family. Ultimately, I am only responsible for myself, and if I do not love myself fiercely and protect this spark inside of me, I risk it going out.

Robin Williams said, “You’re only given a little spark of madness. You mustn’t lose it.” He’s right. We just have that one spark. But if we care for it, that one spark is enough.

You burn. You burn because you carry fire. So carry that fire. Merge it with other flames, dance on dry twigs, and stoke smoldering embers. Let the fire inside you burn whatever does not make you your most whole self. Let it remind you who you are in the world to be, and then go be that.

That Long Journey

“And you?

When will you begin

That long journey

Into yourself?”


I am aware of the silence that has permeated my blog lately. I have been very mindfully (sometimes) sitting with the intensity of the words I can’t find to describe where exactly I am.

I know my posts in Haiti ended abruptly. So did our trip there. I got sick (likely with dengue fever), and we had to come home a few days early. That is the short story, the one I can put words on.

What I have been having trouble describing is the day and night I spent as a patient in a Haitian hospital while I waited for transportation back to the States. I was pretty sick, and feeling pretty darn awful, and pretty good and dehydrated. I had no idea whether to expect to get better or suddenly worse (dengue can go either way), and I knew that if I got worse, I was in a place where there was no medical care that could help stabilize me to the level that I might require. To say I was nervous is an understatement.

I watched two people die in front of me in the hospital ward I was in that night, and listened to the agonal breathing of a third all night long. I watched no one rushing to save them. I watched a soon-to-be-widow swat flies away from her dying husband and bring the sheet further and further up towards his face, ready to cover him once he gave his last gasping breath. I heard the keening of a family member at the bedside of another patient who died during the night. I sat up from my restless attempts at sleep dozens of times when there were gaps in the gasping sounds, wondering if this poor man’s suffering was finally over. I watched exhausted family members hold buckets for their sick loved ones to vomit or poop or pee into, right in the middle of everyone, without any privacy.

I laid there on my bed which was covered by a sheet someone scrounged up, without a pillow (as I hadn’t known I was supposed to bring my own pillow and linens), sweating in the heat even at midnight, swatting away flies and those damned mosquitoes that got me into this predicament in the first place. The front door to the hospital (and the “intensive care unit” I was in, as it was the only inpatient unit at the hospital) was kept open all night due to the immense heat, and at one point I saw the rain pouring down, which provided a small amount of relief from the heat.

There was a bucket under my bed, but I refused to use it. I was so dehydrated, I barely had to pee after the liter of fluid they gave me before my poorly-placed IV fell out, and I chose instead to use the filthy bathroom where family members dumped out the contents of the buckets.

That night that I was alone in that bed, trying to advocate for my well-being in French and Creole–that night changed me. Watching people die while I was trying very hard to stay alive changed me. Seeing how hard it is to be a patient in a foreign healthcare system that you do not understand changed me.

I had a moment there, when I was alone in a sea of other sick people, when I remember having a choice. I wanted desperately to allow myself to go into full-blown panic mode, but I felt like I had to hold it all together. So I stayed with my breaths, one at a time, purposely slowing down my inhalations, as the phrase, “I want to go home,” settled in my mind.

I want to go home.

I didn’t just want to be in my own bed, in proximity to my own healthcare system, not surrounded by dying people, and speaking a language I could better understand, though all of those things were certainly true.

I wanted to come home to myself. I wanted to feel like I belonged in my body again.

I made a choice on that hospital bed to feel everything. I decided that I had the courage to climb into my own skin and find myself at home there. “If I can feel at home here,” I remember thinking as I looked around the crowded ward, “I can be at home anywhere.”

And, for fleeting moments in between waves of panic, I felt myself fully alive in the present moment, in my body, in the space I was inhabiting. I felt the raging headache and the brutal bone and muscle aches and the gripping pain in my belly. I felt the flies settling on my sweaty skin. I felt the shifting sheet barely covering the plastic-covered gurney beneath me. I heard the sounds of caregivers soothing sick family members in Creole. I watched people leave their bodies forever, and I realized how desperately I want to be alive in mine for the time I have left in it.

That night moved me more than the rest of the trip combined, though I have other stories of midwifery care to tell at some point, and I will tell them as I wade through the layers of what that trip meant to me. Being a patient changed me more than being a healthcare provider.

Last December, I chose the word “home” to meditate on for 2015. I thought I had a pretty good idea in mind of what home would mean to me and where that process would take me. I am discovering that I might not have left enough room for my life to surprise me, as it is wont to do.

A good friend reminded me last night that my whole experience with my fistula earlier this year asked of me, “Let this open you.” And indeed it did. And, once opened, and shaken, and with eyes wide open to how harsh and fragile and gorgeous life can be, I am finding myself with a renewed sense of urgency to really live the hell out of my days, to strive for more balance in my life, to take better care of myself (noting that the majority of my energy goes towards taking care of others), and to really explore what my soul is calling me to do.

I feel like that has the potential to disrupt my status quo, which is unnerving to me. But transition is rarely easy.

Home is calling me. That long journey into myself continues.

And you…when will you begin?

Packing It All In

Yesterday (Monday) was Teresa’s and my first day to go out on the mobile clinic. We went to an area called Ceramon and set up our clinic in a building established on a concrete slab with corrugated metal roofing. It was quite an adventure to get there and back in the Land Rover! Due to several days of recent heavy rainfall, the roads were even less accessible than usual. Getting out of the town of Hinche was also an issue, as police were diverting traffic due to some sort of parade of schoolchildren through the streets. We ended up going down a back road that was barely wide enough for our “machine” (Creole for vehicle) and the crowds of people and their animals and motorcycles that were arriving for market. Driving is an art form in Haiti, and the horn is a well-utilized form of communication. Drivers use it to express anger or frustration at other drivers, as we do in the States, but it is also used whenever going around a corner or over a hill when the people/animals/vehicles that might be ahead would not be able to see you coming. People often drive in the middle of the road, including right down the middle of the “do not cross” line (when it happens to be painted on the road). Our driver quipped that if he didn’t have a horn, he would kill people every day! The horn is also used to claim the right of way (which seems to follow the same rules as I saw in Colombia, where the largest of the vehicles arriving gets the right of way, regardless of who arrived first; a Jeep will always claim the right to go before a motorcycle, for example).

So the roads were sloppy with mud, and the rains had carved deep channels and ruts in parts of the road out to our remote destination. It was a very bumpy drive, and I found myself turning a little green by the end. We had to snuggle up really close to some nearby trees to avoid the most treacherous spots on the road, and our driver would quickly warn us to close our windows so the tree branches wouldn’t reach inside and slap us in the face! (I still ended up with bits of leaves all over my backpack and clothing!) But we made it without getting stuck in a rut or a deep mud puddle.

It took a bit to set up the clinic from the suitcases of supplies we brought along. First was a song and a prayer in Creole, followed by an educational session led by one of the midwives. She asked everyone who had been there before to name the warning signs of pregnancy problems, and they remembered everything except decreased fetal movement. She then used a poster to teach them about nutrition. After that, charts were handed out to the 20 women who had been there before, and the 5 people who were there for their OB intake and physical exam got new charts established.

Teresa and I helped with vital signs at first, all of which took place on the outside porch, with the women sitting on benches. Vitals included temperature, respirations, BP, pulse, weight (which happened on an analog scale which we had a bit of trouble finding a level part of the concrete porch to place it on so we could get accurate readings), and one that is not part of my vitals in the States but is important here: upper arm circumference in centimeters, which is a good approximation of nutritional status. I helped mostly with taking weights, climbing down on the ground in front of the woman on the scale to read the number upside down and translate the reading from the red needle into a French number which I called out to my translator who wrote it in the patient’s chart. Our translators were a lot more involved in the clinic than they would be in the States–I even saw one of them (a young mom herself, with a 6-month-old son at home) helping a mother of a newborn position her baby to breastfeed.

After vitals, it was time for the prenatal exams, which happened inside the building. The exam table for speculum exams was a massage table covered in a sheet and a piece of plastic shower curtain (more for the muddy feet that would be planted on the corners of the table, because there were no stirrups, and less for an impermeable barrier underneath the women, because they all had their skirts underneath them; the sheet was not changed between exams). The midwife performing pelvic exams had a wonderful system of not contaminating the specula: She brought them in a plastic tub, all wrapped in a clean towel. She had a pair of ring forceps that she kept on the lid of the tub, and whenever she needed a speculum, she used the ring forceps to push back the towel and grab a clean speculum and cover up the others still in the bin. She collected the used specs (most of which were the pediatric size today, as we had a lot of teenage primips) on the lid of a bucket to be transferred later into a container to be taken home and sterilized.

The exams happened behind a curtain that separated the exam table from the outside, but there was no other curtain dividing the exam table from the side room where two other Haitian midwives plus Teresa took histories, gave out medications (folic acid, a prenatal vitamin, and iron tablets to every woman; anemia is endemic here), and Teresa did belly checks (Leopold’s for fetal position, fundal height, and fetal heart tones). So, the women getting speculum exams (covered with a lavender sheet as a drape) were having conversations with the women waiting in line to hear their baby’s heartbeat and to get their medications for the next month. Nobody seemed fazed by this, and indeed, for several of the girls this was their first pelvic exam and the others in the room helped to talk them through it, encouraging them to relax their legs, or laughing with them at what a strange feeling it was.

Somehow, squatting on my haunches in this small, dark cement building for over an hour, lit only by a headlamp and whatever sun streamed in through the windows, helping a midwife perform gonorrhea and chlamydia tests (with only a massage table and a rickety chair as exam furniture) was a better leg workout than I’ve had in recent memory. (My quads are speaking their mind this morning.) Far more rewarding, too! I learned how to perform the rapid GC/CT tests, which required separate swabs, tubes, test media, number of drops, number of times of swirling the swab in the test media, number of minutes to wait (if any) prior to adding the media to the cassette (which looked like the pregnancy tests we use at my office), and number of minutes to wait to read the results. I counted out the drops of test media and swirls of the swab in Creole (thank goodness I paid attention in French class over a decade ago–I still remember how to count!). It was interesting that the packets said “not for use in the United States”–I’m not sure why that is, except that we have a system of labs that can perform the tests for us, and that infrastructure does not exist in Haiti.

After all of the pregnant women and the three postpartum clients and their babies had been evaluated, we packed up our supplies back into their suitcases, tied them back onto the top of the Land Cruiser along with the benches the clients sat on while waiting, and started the bumpy journey back to our home base.

Today, bright and early, we got up to prepare for our separate morning and early afternoon projects. I was in the classroom with the 30 new midwifery students, and Teresa went to the hospital with a translator where she worked with a few people in labor, including people who were being induced preterm with pre-eclampsia.

My role in the class was to teach GTPAL, which is a system of categorizing pregnancy numbers and outcomes. The acronym in Creole is a little different, GPTPAV, standing for gravida (total number of pregnancies), para (number of births after 20 weeks), term (births at or after 37 weeks), preterm (births from 20-37 weeks), abortions/miscarriages (prior to 20 weeks), and number of living children (enfants vivants in French). The students, for the most part, listened carefully and one asked 95% of the questions in class. She tried to stump me with a great hypothetical question: if a woman was pregnant with twins, and she delivered the first twin at 11:59 p.m. on week 36+6, and then had the second twin 10 minutes later, at 37 weeks exactly, and a twin birth only counts as one in the “para” category (because it is one single pregnancy that is ending, and we are not counting the number of babies until the last category), then which slot do you put it into? Term or preterm? I heard this question explained to me through my fabulous interpreter, and I loved the question and its asker dearly. (The long answer I gave her is, it depends, and you get to use your clinical judgment, and thankfully situations like this don’t happen super often, and when you are interviewing a woman about her pregnancy and birth history, she might not know the exact number of weeks she was when she gave birth, and logically we know that ten minutes’ difference doesn’t make much of a difference in terms of whether a baby is term or preterm, so use your clinical judgment in whether the babies seem term or preterm if you have to decide.)

I also taught how to determine due date based on factors other than last menstrual period. I told them the story of my own birth, where my mom was breastfeeding my 6-month-old sister when she got pregnant with me, and had not had a period yet so had no LMP to go off of. Ultrasound dating was similarly not available, especially in rural Colombia. She had a scheduled repeat c-section (I told the students how I was born via surgery during a power outage in Bogota, and the surgeon continued by flashlight–blackouts are quite common here, and they all looked at each other in surprise that this white midwife would have a birth story that they could relate to!), and when the doctor pulled me out, he noted in my birth record that I looked to be about 36 weeks’ gestation. I weighed just a little over 2.5 kilos at birth (I was a tiny little peanut!). They loved this story and I think it helped to underscore how you need to use all of the available data to make the best estimate of due date possible, because otherwise you might cause problems further down the line.

Teresa has her own stories from her time in the hospital today (her close Doppler monitoring of a mom who was being induced for pre-eclampsia at 35+ weeks, and noticing that the baby was having late decels down to the 60s-80s after every contraction, and her insistence that the baby was not doing well, likely encouraged the staff to move towards a cesarean birth sooner than they otherwise would have, and may well have saved this baby’s life, if indeed the baby survived its birth–I will check on them tomorrow), and I will let her tell those in as much details as she desires to share.

After returning from the hospital, and after my class was over, we ate a quick lunch of rice and beans and vegetables, and then hopped onto a moto-taxi to spend a few hours at Azil, a feeding center for starving children and a hospice center run by the Sisters of Charity (Mother Teresa’s order). The nuns there wear the traditional white robe and head cover with blue stripes. Teresa and I found our way upstairs to a series of connected rooms on the second floor of the compound. About thirty or forty toddlers and young children sat in small plastic chairs against the walls in the hallway, having just eaten their 3:00 meal (likely protein porridge). There was a mixture of emaciated-appearing children and those who were extremely bloated with huge, round, firm bellies (indications of kwashiorkor, or protein calorie malnutrition). Some were so edematous that their eyes were almost swollen shut. The children were all sitting quietly and patiently in their chairs in the hallway, which is atypical behavior for children this age but common in institutionalized children. Most of these kids had families who had brought them here for care and feeding for a temporary period of time, and once they were well again, they would return home. The families are allowed to visit once per week on Mondays, and the children who are well enough return home on those days. This being Tuesday, new children were being brought in, and they were all lined up in chairs waiting for an examination by the doctor. Some of them had wild looks of confusion in their huge eyes.

We moved on into the room with the youngest babies and sickest children. About twenty old wire cribs filled the room in rows. Each crib was lined with a plastic square covered in a cloth the size of a pillowcase, for easy changing throughout the day when the babies wet through the cloth diapers most of them wore without plastic covers (though a few tiny babies were in huge disposable diapers many sizes too big), or when they had diarrhea and got their clothes and sheets dirty. Several of the babies had thick, chesty coughs. The nuns invited us to sit down in short chairs they pulled aside for us, and pointed towards the cribs encouraging us to pick up a baby to cuddle. We each scooped up a little one and sat down. The first baby Teresa held was somewhere between nine and 18 months old (difficult to guess because of the malnutrition), and she kept trying to nurse at Teresa’s breasts. She appeared blind with some cognitive and motor delays, and she was covered in burn scars. It was heartbreaking. I held several babies, and when one fell asleep, I would put her down and pick up another. I held a four-year-old girl named Marielil the longest. She was the size of a young toddler, and she reached up her rail-thin arms to me from her chair and begged to be held. When I cuddled her, she kept calling me “Mama, Papa,” and when it came time to put her down, she would not stop crying. Walking away from her in her crib, reaching out for me with tears running down her cheeks, nearly ripped my heart out of my chest. Teresa and I also both held a young infant who seemed to be less than a month old.

There was minimal stimulation in the room, and some serious attachment issues. A lot of the babies didn’t want to be touched or picked up when I offered, though one enjoyed playing games with me (copying facial expressions, and giggling hysterically when I told her my name in Creole–I guess she didn’t expect the blan to speak her language!) but refused to let me pick her up, and I didn’t push it.

There were no toys in the cribs, but there were a random assortment of toys and religious artifacts on the walls, including a shelf with a statue of the Virgin Mary beside one of those giant plastic baby bottles used to give baby shower favors in. Curious.

I am not sure how I will go to sleep tonight thinking of that little girl in her crib begging me to come back for her. I have so many feelings about the experience. Those babies are there because of poverty, malnutrition, disease, because of political corruption and historical occupation of their country, because of war and greed, because of everything that is at the root of all of the problems in the country. I know there are such babies in Seattle, as well. This is not an isolated problem. But to see about 80 babies and young children separated from their families for weeks to months at a time during critical periods in their development is just heartbreaking. And the problem is so much bigger than anything I could possibly to do fix it. So I go, and I bear witness, and I get dirty, and I snuggle the hell out of those babies, and I leave when I must, but I leave changed at a molecular level. I cannot unsee what I saw there. Some of those babies will die, and some will survive and return home to families who cannot feed them food that helps their minds and bodies grow, and the cycle may repeat itself.

I had such a strong sense of being in a place when Teresa and I were on the motorcycle on our way to Azil. I saw the beautiful landscape in front of me, felt the breeze on my face, held tightly to the waist of the moto driver and felt Teresa holding tightly to me, saw the people and the goats and pigs and chickens wandering the streets, felt every bump as we drove over it, and noticed the warmth of the sun causing hot beads of sweat to trickle down my back. I was so very present, so very HERE. It is a moment captured in my memory that I plan to return to again and again.

So much of what is here is not up to me to change. I had another profound moment in the classroom this morning, sweating bullets in front of the class. I realized in a deep way that I was here for them, for the students who will become midwives and will scatter throughout their country and do more good here than I could ever hope to do. I am here to support this program, whose mission is to make more midwives for Haiti. I will go back home in 12 days, and I will continue this mission long after I return to my own practice with my own patients in my own hospital where I do not have to bring whatever equipment I need for that day.

Tomorrow, though, I will spend my first day at the hospital. Anything I plan to want to use, I need to bring. I packed a backpack and a fanny pack full of supplies. I am impressed with how much I could fit into a medium-sized fanny pack! From memory, I know I had the following in there:

  • A doppler
  • Doppler gel
  • Several pairs of sterile gloves
  • Sterile lube in packets
  • A blood pressure cuff
  • A stethoscope
  • A full-sized bottle of Purell (as water for handwashing is unpredictable)
  • Misoprostol tablets in a ziplock baggie in case of hemorrhage
  • A bottle of lidocaine
  • Suture packets
  • Gauze
  • A couple of needles and syringes
  • Tubes of erythromycin eye ointment
  • A cord clamp
  • A watch
  • Alcohol swabs
  • Three drapes to go under women for deliveries (cut from unused delivery gowns)
  • A gestational wheel
  • A tape measure
  • Some cash (a $5 and a few $1s)

All of this fit into my fanny pack! In addition, in my backpack, I have some blankets, a breast pump I assembled yesterday from random pieces of donated pump parts (to take to the woman who delivered preterm by cesarean section today), a box of gloves, and a number of other supplies.

I am nervous, because I don’t know what I will face or if I will know what to do. But I believe in myself, in my skills, in my knowledge, in my ability to stay present in intense situations. I know that much of what I will encounter will be outside of my control. But what I can offer, I will give wholeheartedly.

I feel like that list of items in a small bag is a metaphor for how this trip is “packing it all in.” I am cramming so many different experiences into such a short period of time, wedging them down, to be lived now and accessed later as memories that will serve me for a lifetime.

I have no photos to share today; it seemed most respectful to the children and the nuns not to document our presence there, and photos are not allowed in the hospital compound. But my heart is full of images that it will never forget, and hopefully I have transmitted some of them to you. They say a picture is worth a thousand words, so hopefully these 3500 or so words will give you a few pictures’ worth. 

If not, you might just have to come here and see it for yourself.