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My Dead Branches

December 7, 2020

By Kayleigh Shuler

It was an overcast and particularly taxing morning in May of 2020, dealing with my fear of the unknown and my frustration with the uncontrollable. Going on New York City’s third month of quarantine, things had shifted from “Ah – an opportunity to bake!” to “When will this end?!” rather drastically in the last week or two. I decided to get myself moving by hand-washing one of my favorite sweaters, making myself some tea and going to look at the (still) nearly-barren tree outside my window. It was May, and all of the other trees around were dressed in green, full bloom. My poor tree was adorned with the occasional bud and leaf, but otherwise looked lifeless and tired. I felt rather lifeless, too, most days. It felt like we watched one another everyday and were saying, “You’re still here. I’m still here. We’re still here. That’s all we need to know.”

Her roots live in cement between a parking lot and a sidewalk where drunk men “play” at night. She has been spat, peed, and thrown up upon. The base of her body has been doused in beer. And despite all that… there she stands, day after day, outside my window. During the day she’d let her green baby buds sway in the wind. Her branches are café tables for chatty birds that I loved listening to. She was bare, but she was more than enough for me.

I was in the kitchen when loud sounds from outside brought me into my living room holding a sopping wet sweater, a cup of tea and what felt like the weight of the world. I looked out the window at the tree, and watched as one of her branches came crashing down. My eyes darted to a man with an electric saw standing on a roof behind her. Then, another branch came crashing down. They were disposing of her because she couldn’t bloom like the rest, I suspected. She had been deemed useless; a waste of space in a potential construction zone. I thought how selfish they were… how unfair it was… how empty she was, now. She never had a chance. They had violated her, only to cut her down and leave her to rot. They left her looking even more naked and kind of lop-sided. I figured all of her buds would be dead by morning.

My eyes welled up with tears and my face got hot. My throat and chest constricted and my hands went a little numb. I was so angry. Anger, rage and sadness welled up inside me and came out, finally, as I let myself and the sopping wet sweater and the still hot cup of tea fall to the floor and feel loss, for a while. Of course, I realize now that I was grieving much more than tree branches. Seeing the tree branches fall was just the trigger I needed for release. I let myself feel and cry, and eventually got myself up and trudged through the rest of my day, loathing all of mankind and feeling helpless in a cruel, unjust, and out of control world.

Not a week later, she started blooming green like I had never seen in two years here. She began growing, expanding, getting so full of life, now. I thought something was being taken from her and that she’d be left to rot, but it was actually just what she needed: to trim the dead parts of herself and grow. A couple weeks later, there was a full moon in Capricorn during a Lunar Eclipse. I don’t claim to know much about astrology, but everything I read about it in the days leading up indicated that this was a time of… wait for it: shedding what no longer serves us. Letting go. Leaving or re-evaluating relationships that we have outgrown. Trimming the dead parts of ourselves, so that we can grow and be full of life.

I’m looking at her outside my window, now. She and I look at each other all day long as I work; my desk is purposefully positioned that way. In a place like Brooklyn where the view outside my bedroom window is a wall, a big, beautiful tree outside one of my windows is a luxury not to be underappreciated. It makes me smile to look at her and write about her triumph; I feel proud. She’s beautiful: full of dark, green leaves and even those little bright green things that always fall on the sidewalk. My dad taught me to peel back the edges and stick them on my nose so I would look like a rhinoceros. I still do it all the time. That may have been the only thing my dad taught me to do that I still do (on purpose). I do plenty of the things he didn’t mean to teach me all the time.

My memory of life with my father is not “mostly good with a few bad moments”. I remember it as mostly bad with a few good moments. I can probably count the number of times I felt true love from my father on one hand. That’s okay, though, because I’ve learned not to need it. I’ve learned not to expect, or feel I deserve, a lot from him. He learned that from his father, as well. Many people find ways to avoid the hand life dealt them. For my father, it was music, first and foremost. A master of the art, he could get lost playing, dissecting or writing a piece for hours at a time. When music wouldn’t cut it, however, he turned to something stronger. Eventually, music fell by the wayside, and so did the artist and man he could have been.

******

One night in early February of 2020, I found myself in a delightful martini bar in the West Village of Manhattan. I had been at work all day and wasn’t feeling ready to go home, quite yet. I had been obsessed with martinis at the time. Reading about them, looking at pictures, comparing reviews and recipes of different variations. I felt, now that I was 25, it was time to sample New York’s finest and try my first real martini.

So, there I sat in the dimly lit and (now unthinkably) packed bar on a weekday evening, sipping my first martini and pretending I enjoyed it. It tasted salty, nutty and like rubbing alcohol. It must have been excellent,  just not my thing. I finished it and talked to the bar tender about a different option for my next. He suggested a gimlet, saying that it was lime based and a little sweet, and I was sold. So sold, in fact, that I had four.

I sat there, becoming woozy and soft in my mind, like a massage to my brain. It felt so good, like I was melting into the corner I had tucked myself away in. I was a fly on the wall, people-watching and invisible. I overanalyzed interactions betweens guests, tried to guess what people did for work, created backstories for everyone there. I began writing on my phone and was, honestly, overcome with emotion at the sheer brilliance of my creative genius while intoxicated with all of this lovely gin. I sat there, thinking: This is what he must have felt.

After a while I became bored and lonely, and those are not good things to be when you are highly intoxicated. I went to write again, but the high had left and the low had entered. Writing was no longer an escape from loneliness; it was accentuating it. I looked at what I had written before. It didn’t make sense. It was all just a bunch of fancy words and ideas. No through line, no purpose, no direction. Just spatterings of what felt like creative genius just fifteen minutes ago. I suppose a lot of people would be able to laugh at this, their silly drunken writing. Maybe I could have, too. Except I was bored and lonely and highly intoxicated, so instead, I sat there thinking: This is what he must have felt.

When the thing that gave me creative genius tricked me like that, I felt so embarrassed, because I had deceived myself. In my experience, alcohol taunts what’s already there. It brings the shadows to light but doesn’t make me feel strong enough to face them. So, I’d drink more and a little more “genius” would strike, and then fade. So, I’d drink more and a little more “genius” would strike… etc. The thing that always troubled me with alcohol was that it seemed to have no positive lasting effects, only bad ones.

The morning after the four gimlets, I had a rehearsal for a very exciting project, for which I was hungover. Getting up that morning was laborious. Being at rehearsal would have been great, except, I wasn’t fully there. I was tending to a hangover and, worse than that, my guilt. I felt so guilty for arriving in this professional environment feeling sick and unworthy. I was not up to the task. I left that day feeling ashamed and tired.

I began to think about my relationship with alcohol in a more critical way. How do I feel before drinking alcohol? Impatient, excited and fiery. How do I feel while drinking alcohol? Subdued, relaxed, and happy, at first. Second drink I’m feeling good, buckling in, and I start “saying it like it is”. Then around the third drink, I begin second guessing everything I say,  and I start getting emotional. If I make it to the fourth, I become very analytical, and dark thoughts and reasons why I shouldn’t feel good start filling my brain. My brain always, inevitably, leads me to something that doesn’t feel good, because I think that the most hurt parts of me still believe I don’t deserve to be happy. Truly happy with no exceptions.

When I realized that alcohol was a gatekeeper to dark thoughts and inhibited my ability to defend myself from them, I began to question whether or not this could be a long term relationship for me. I always felt like I couldn’t go to battle with the dark thoughts; I’d just wave my white flag and have another drink.

When I say “go to battle”, I don’t mean telling myself things like, “Go away bad thoughts! Stop! Stop!”. That wouldn’t help because I wouldn’t be addressing it, just commanding it. Dark thoughts and, especially, trauma don’t work like that. Dark thoughts need to be told that they are not allowed in the driver’s seat and why; they stem from our childhood and are as reckless, naive and irrational as the children we were when we first formed them. They don’t respond well to panic. They need calm and clear direction. Direction can look like asking these dark thoughts questions, such as: Why does this keep coming up for me? Why do I always feel angry when X happens? How could what I’ve been through in the past be showing up in my life now? What would make me feel better right now?

I’ve worked on this piece slowly over four months. In that time I have shed old parts of myself so that I can grow, but not without many tears and the digging up of old, rotting roots. Like that tree, losing half of her arms at a moment’s notice, the changes I have undergone have left me feeling stripped and shell-shocked. The unknown became something I didn’t need an answer to, only something worth exploring. I haven’t had a drink since that last gimlet.

And here I stand: blooming. Not fully there, yet. Not like some of the other trees around me, who’ve weathered this storm and stand taller because of it. But my baby buds are swaying in the wind and I am on my way. Growth lies in the unknown, the uncomfortable and the, sometimes, terrifying. Everything that most of us were taught to avoid or control is unavoidable and out of our control. Perhaps it’s best, then, to make peace with this fact, shed the old parts of ourselves and grow. Why not me? Why not you?

Kayleigh Shuler is a writer/screenwriter living in Boston, MA. Kayleigh writes and directs custom scenes for actors and loves being a part of anyone’s creative and spiritual journey. Follow Kayleigh on Instagram at @kayleigh_shuler.

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Health, Women

We Must End Period Poverty For All Women And Girls

September 10, 2020
period

By Rita Serra

I chose to backpack around the world as a 22-year-old, pierced-nosed, May You Stay Forever Young-tattooed, Hubba-Bubba pink, blue and purple-haired, flower child. Equipped with a degree in US history and ample youthful exuberance, I was ready to feel the unparalleled freedom of solo travel. My only armor for this eight -month endeavor was my blind faith in good vibes. What could go wrong?

Four months into my wanderlust pilgrimage, airport security procedures had become a mundane chore rather than a cause for stress. With off-handed indifference, I referred to the time spent waiting in lengthy passport control lines as, “the traveler’s tax.” As I stood in the diminutive security line of Lombok International Airport (LOP,) I was pleased to pay these meager taxes that evening.

Measuring forty-seven miles across, the tranquil island of Lombok, Indonesia is relatively untraveled by tourists compared to its neighboring island of Bali, allowing the landscape and pace of life to remain much closer to its organic form. The majority of Lombok consists of rural villages separated by large swatches of undeveloped land. Although LOP is the only airport on Lombok, a single terminal is apt for receiving all domestic and international fights.

I stood in line with a placid smile as I watched the female agents check every pocket of every traveler’s bag with a Swiss watch-maker’s precision. But then, like Isaac Newton and the infamous apple he took to the head, I was struck with a sudden realization that overtook my idle thoughts. In the top pocket of my backpack was a plastic bag that contained; a brick-sized stack of Laotian currency, US dollars, Euros, Cambodian Riels, anti-malaria medication, traveler’s diarrhea pills, and a smaller zip lock bag containing off-brand Advil. The lack of original packaging making it seem as if the Advil could be any drug. In my effort to maximize packing efficiency, I set myself up to look like a suspicious character while attempting to enter a country that regularly applies capital punishment to drug traffickers and drug dealers.

Light-headed, my mind went into a hazardous spin. I oscillated between berating myself for committing such a blunder and conjuring ill-fated visions of myself sitting in an Indonesian jail cell. Stress-induced sweat droplets rose to a beady line of attention along my brow. I pushed past these negative thoughts and began to practice my explanation. Yes ma’am I know this looks weird, but I purchased all of the Laotian money from a friend to save him from a bad exchange rate, as if my inherent altruism would help me out of this situation without issue.

My turn came and an Indonesian woman with soft brown eyes and dark hair pulled into a tight bun, started to rummage through my bag with silent diligence. Standing at 5 foot 10, I towered over this woman by nearly a foot, yet I felt as if I was small enough to fit in a front shirt pocket standing in her authoritative presence. I attempted to hold a pleasant, unsuspecting smile as I wondered if this agent would believe the reason for this money and various pills, some unmarked, was due to my naiveté and not because I was a drug dealer.

The agent used her thumb and right index finger as a pair of tweezers to pluck a tampon out of my bag. Mystified, she raised the tampon until it was even with her eyes and after a few moments of greater inspection, she inquired in English, “What is this?”

I surmised that it must have been unfamiliar packaging throwing her off, so I gave what I though was a simply yet efficient answer, “a tampon.”

The bewildered expression remained suspended across her caramel-toned face. I wondered if my bluntness had been misinterpreted as curt, but then it hit me; she had never seen or heard of a tampon before. A piece of my innocence expired as I explained to this woman, who was at least ten years my senior, what a tampon was and how it is used. Her cheeks pulled back like an accordion, forming elongated, vertical smile lines and the austere formality of her uniformed appearance melted away. With an enlightened sounding, “ahh” the woman placed the tampon back in my bag, forgetting to check the final pocket, and sent me on my way.

I walked through the sliding glass doors and was greeted by the hot, sticky, humid night air like an impassioned lovers kiss. I breathed out a sigh of relief, and inhaled sharply making my lips form a tight O as my mind unpacked what just transpired. What did this woman use while on her menses? Will this woman tell her friends about what she just learned? Her mother? Her sisters? Her daughter?

 I had never considered that a tampon was not basic knowledge for all women. I sat with this profound knowledge for some time, not knowing what to do with it. But the unanswered questions remained, so I launched into conducting research on women’s reproductive health among different countries. In doing so I came across the topic of period poverty.

“Period poverty” refers to the estimated 500 million women and girls around the world who lack the monetary funds and /or access to menstrual products each month. For a myriad of these females, the root causes and devastating effects of period poverty extend much deeper. In developing regions of Africa, Asia, Central, and South America there is a substantial lack of education about women’s reproductive health, what sanitary products are, and how to use them. This issue is often compounded by the absence of hand washing stations and other sanitation facilities, leading women and girls to not be able to manage their menses in a safe, dignified manner. Extending deeper for many women and girls, the crux of period poverty is caused by the long-standing cultural stigma that menstruating women are dirty.

Within numerous communities around the world, the topic of menstruation is taboo. Women in rural India are perceived as impure and unholy, leading to them being treated as lepers and banned from entering temples and participating in prayer during their menses. Considering that the overwhelming majority of India’s population are either devout Hindus or Muslims, two religions based upon praying multiple times a day, the act of menstruating is debilitating to Indian women’s daily lives. In Nepal, woman and girls are forced to undergo the custom of “Chhaupadi” in which females are ostracized from their family homes and made to live and sleep in cramped, window-less huts because they are seen as unclean while on their menses. Due to poor ventilation and snake bits, this practice has claimed the lives of many. Chhaupadi continues today, in defiance of a 2018 law forbidding the dangerous practice. For young ladies in Uganda, they feel they must hide their periods from their brothers and fathers for fear of crippling shame and utter embarrassment.

The disempowerment millions of females suffer through every month is marked by bitter irony because without the act of menstruating, the creation of life would halt all together.

Adding to the gravity of this gender inequality issue, is the fact that period poverty impedes girls’ educational endeavors and constricts their future prospects. Worldwide, millions of girls stay home from because they lack sanitary products and/ or fear becoming a social outcast. One in five American girls have reported staying home from school due to the inability to afford sanitary products. Across Africa, it is estimated that at least one in every ten girls will miss up to fifty days of school a year because of menstruation. These habitual absences cause girl’s grades to suffer and for them to fall behind their male counterparts. Even more damning is the fact that a multitude of girls will drop out of school because they are not able to adequately manage their menses. This is the case for at least twenty percent of girls in India.

Navigating the dust-kissed, stone streets of Morocco, I often happened upon a group of school children walking in their uniforms of white coats, casting the illusion that every one of them was a young scientist on the verge of discovery. In Luang Prabang, Laos I was always tickled to see a young lady zipping through traffic on motorbike with two of her female compadres riding side-saddle, (a feat much more difficult than they made it look.) Their long ponytails waved wildly like streamers in the wind, making them seem so free, despite their school attire of navy-blue jackets, knee-length grey skirts, and nylons.

Of all my carefree experiences interacting with locals, I most fondly reminisce on a day spent in Koh Rong, Cambodia on the beach with a cohort of travelers. Three Khmer children, two boys and one girl, stopped by our blankets after spotting our idol tennis ball. The kids ushered us to our feet by means of animated hand gestures and arranged us in a large circle. Captivated by the childlike-wonderment that marks the lighthearted days of travel, we played a laugh-filled game of catch for nearly an hour.

I occasionally look back with concern at the array of silly-faced selfies of myself and the little girl on the beach in Koh Rong. It is disheartening to imagine her, the girls on the motorbike, or the young ladies in Morocco, who bubbled with life and were free from inhibition, are now routinely filled with shame for simply menstruating. I cannot help but think about all the bright, young ladies around the world whose academic standings have slipped due to the constricting realities of womanhood imposed by their cultures.

Before traveling to Indonesia, I had never equated a tampon with freedom. Awareness is the first step in bridging inequality. From my experience in the airport, I became aware that hygienic products allow women the ability to play sports, receive a full education, work a steady job, participate in religious events, go about their daily life unencumbered, and to rise to the same playing field as male counterparts.

We have made great strides in America in the field of women’s equality and reproductive health thanks to the activism of Margaret Sanger and our other feminine predecessors. In 1960, the FDA approved the use of the pill as contraceptive which was a divisive issue at the time. Many women took the pill in secrecy, afraid of being outcast or labeled as promiscuous. After decades of continued activism, these same women now lead women’s gatherings with pride and conduct ceremonies that celebrate young ladies’ menstruation, and empower them as they cross the threshold into womanhood. Today young girls are taught about menstruation health in school and women have access to an array of contraceptives and sanitary products. Furthermore, there is a Red Tent movement sweeping the nation, where menstruating women and girls are invited to come together and celebrate their menses on a monthly basis. Nevertheless, we still have ground to cover in America when it comes to eliminating period poverty.

Ending period poverty is a matter of accepting and normalizing female biology.

One way to get involved in the movement is to vote. In recent years there has been a large push to remove the “tampon tax.” Although the FDA considers tampons and other menstrual products as medical devices, in forty states they are still subject to sales tax unlike other medical devices. For the women who live in poverty or work low income jobs, removing taxes on sanitary products would make managing their menses less of a struggle. Georgia House of Representative member Debbie Buckner, presented a bill in January 2019 that would make Georgia the eleventh state to remove the “tampon tax,” As of today, activists in Georgia are still working to have this bill passed. Scotland made history in February 2020 by becoming the first country to make period products free to all women.

Supporting organizations such as, Alliance for Period Supplies, is another way to get involved in this movement. This organization was founded by U by Kotex and aims at ending period poverty in the US. Support can be a simple as shopping for your own sanitary products. For every U by Kotex purchase, sanitary products are donated to women and girls in need through Alliance for Period Supplies. For people who want to go a step beyond, consider hosting a period supply drive. This is done by linking with your local allied program, (which can be found online through allianceforperiodsupplies.org) food bank or women’s shelter to distribute the collected products. This might be of particular interest to women who have stopped menstruating, but still have unnecessary sanitary products.

On the international level, donating to organizations such as WASH United or the World Bank is a way to help end period poverty. These organization partner with groups such as UNICEF, UN agencies, the Global Water Security and Sanitation Partnership, and other NGO’s to promote advocacy and provide menstrual hygienic management (MHM) education designed to empower woman and remove cultural taboo. They also provide woman and girls with hygienic products and improve conditions for women to manage their menses in a safer, more dignified manor such as providing clean water, constructing hand washing stations, and sanitary facilities.

Finally, spreading the word is a way to promote advocacy and transform period poverty into “period positivity.” Since writing this piece, I have begun discussing period poverty with my male roommates who have all been receptive to discussing the topic. May 25th – 31st 2020 is period poverty awareness week, by sharing stories on social media and using hashtags such as, #EndPeriodPoverty #EndPeriodStigma #WithUSheCan #eachforequal #NoMoreLimits and #MenstruationMatters, we can normalize the topic of menstruation.

As the torch is carried forward in the women’s health and equality movement, we must ensure some women are not getting left in the dark.

Rita Serra graduated from the University of North Carolina Chapel Hill with a degree in US history with a special interest on the social and political moments of 21st century America. For two and a half years, Rita backpacked around the world, often solo, on a quest for human connection, cultural enlightenment, historical intrigue and natures wonderment. After her period of Rolling Stone Embodiment, Rita found herself in Northern California where she currently spends her days writing prose & poetry and farming.

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Guest Posts, Health, motherhood

Promises

January 28, 2020
blood

CW: Stillbirth

By Whitney Lee

Four years ago, the Friday before Mother’s Day, a team of Emergency Department nurses barreled through the double doors of my Labor and Delivery Unit with a term-pregnant woman. It was just before dawn and I had been the physician on call overnight. In anticipation of this woman’s arrival, I’d already shed my white coat and removed my wedding rings––prepared to transport her to the operating room. As the gurney clattered across the linoleum floor, the woman twisted her body and clutched the dome of her abdomen gathering the fabric of a blue hospital gown into her fists.

Throughout the night, bleeding, adhesions, and brand-new babies had stolen my sleep. After twelve hours of standing, gravity pulled blood into the veins of my feet, my ankles, my calves. I felt as if there were weights in my shoes­­––I was tired.

The windows on Labor and Delivery glowed gold. It was a typical Southern California morning––a city with gorgeous yet monotonous weather. Soon, the sun would warm the air, the asphalt, and the enormous seals lethargic on the La Jolla shore. Light would illuminate brilliant fuchsia bougainvillea and the wings of hummingbirds, osprey, and lanky blue heron. All night, I had anticipated the sunrise that would signal the end of my shift and my escape from the hospital.

As the Labor and Delivery nurses rolled the woman into a triage room, the emergency department team explained that her name was Lisa. She was thirty-eight weeks pregnant with two prior cesarean deliveries. Severe pain started at home along with vaginal bleeding.

***

The week before I met Lisa, I’d promised my five-year-old son, Zachary, and my three-year-old daughter, Esmae, I would attend their school’s “Muffins with Mom” breakfast in celebration of Mother’s Day. I am an obstetrician and Obstetrics is a conspicuous thief. It has stolen weekends, my husband’s birthdays, Sundays at church, family dinners, at least two Christmas mornings, Zachary’s first day of kindergarten, and my grandfather’s funeral.

In truth, missing those events and navigating the interruptions was a nuisance but not a burden. I found meaning in my job and possessed a physician’s arrogance: I served a unique role. I felt necessary in a hospital, which provided instant gratification. A baby delivered, a family consoled, a diagnosis made, all justified my absence from home and validated the story I worked to build around my value as a physician and a person.

But the December before my life intersected with Lisa’s, when I came home from work, Zachary asked, “Where were you? All the mommies and daddies were at the Christmas Party but you. Esmae and I had to sit with Jonathon’s mommy.” I imagined my children in a neat, sparse, yet beautiful Montessori classroom filled with tiny versions of common adult items––china tea cups, a blue metal pitcher, glass bowls, a short countertop with a sink. I pictured them still and sad as they both waited for me to stroll through the classroom door. I imagined Zachary and Esmae sitting beside Jonathon’s mother––a woman I’d never met. But I pictured her lovely like calla lilies, ballerina skirts, ivory cashmere, soufflé, ribbons, and monarch butterflies. She wasn’t a woman who wore a pair of bloody scrubs and missed Christmas parties.

I’d sent a plastic container of store-bought oatmeal cookies with Zachary and Esmae that morning––my children’s contribution to the potluck lunch––price tag stuck to the side. The package of cookies was reflection of my approach toward many traditional maternal tasks. I found little value in baking cookies, cakes, or brownies.

***

Lisa twisted her body like a fish on a line. She pulled her knees to her abdomen, and shifted her legs right and left. I leaned over the metal rails of her bed and asked if she had any medical problems. Was her pregnancy complicated? Did she have a surgical history? When was her due date? She provided fractured breathless answers. She asked me to save her baby. She called him Jonah.

Nurses held down Lisa’s arms so they could thread needles into her veins, draw labs, and start intravenous lines. An obstetrics resident quickly rolled an ultrasound machine next to Lisa’s bed. I positioned the probe on her abdomen then gazed at the black and white image on the screen.

A baby’s heart pumps twice as fast as an adult’s. In a healthy baby, on ultrasound, the mitral and tricuspid valves, the flaps of tissue that separate the chambers of the heart, open and close in rapid succession like the wings of a starling. Rapidity offers reassurance. But the myocytes, the cells that coordinated the muscle of Jonah’s heart, were starving for oxygen. They had lost the energy and strength to beat, thus they failed to pump blood through his body. His heart contracted then fell open in a slow and labored motion. Jonah was dying.

With the tone and intensity of a drill sergeant, I instructed the charge nurse to call a Code Purple. In our hospital, like a Code Blue, Code Purple meant a life was at risk––that someone, in this case Jonah, may die without immediate intervention. The code alerts anesthesiologists, pediatricians, nurses, and scrub techs, to hustle, run, dash through corridors and up the stairs, toward the operating room.

I maneuvered the foot of Lisa’s gurney out of the triage room toward the operating room. The resident ran next to me and a nurse sprinted ahead of us opening three sets of double doors at various points along the path to our destination. As we rushed through the corridors, I directed the nurse to call the blood bank, call the NICU, explain to them that Lisa was abrupting­­.

An abruption meant that inside Lisa’s body, the arteries that connected her uterus and her placenta, the source of oxygen, to her baby, were shearing apart. Blood surged from both maternal and fetal vessels and spilled into her uterus, which clamped down like a vice in protest. This contraction was the source in Lisa’s unrelenting pain. Like all pregnant women, a half a liter of blood flowed through Lisa’s uterine vessels per minute. The bleeding was torrential. She and Jonah were hemorrhaging to death.

***

I had planned to leave the hospital at 8 o’clock that Friday morning. I would get to Esmae and Zachary’s school by 8:30 a.m., when the Mother’s Day celebration would begin. At that time, Zachary and Esmae would be choosing chocolate chip or blueberry muffins, opening their cartons of milk, and taking their seats at short square tables.

Every day that week, my children reminded me of the event and every day I promised them I had not forgotten. They excitedly described the details of all the presents they made for me: popsicle stick picture frames, ceramic necklaces, cards, and painted boxes.

***

Outside the operating room, the obstetrics resident handed me a surgical cap and mask. As I tugged the gauzy blue bouffant over my hair and tied the mask behind my head and the nape of the neck, I pushed through doors and passed the scrub sinks. Those sinks would remain silent––no hum of the plumbing, no water spraying on steel. We would not wash our hands. In emergent cases, sterility transforms from a necessity to a luxury.

Inside the operating room, a team of anesthesiologists and nurses moved Lisa onto the operating table. The pediatrics team set up equipment needed to resuscitate Jonah. A scrub tech opened a rectangular metal box, removed instruments and laid them on a sterile blue table––a scalpel handle, Kelly and Alice clamps, hemostats, Richardson retractors, bladder blade, Debakey forceps, Ferris-Smith forceps, Russian forceps, Adson forceps, Bovie tip, needle drivers, Metzenbaum and Mayo scissors.

I ignored Lisa’s cries and questions. There was no time to address them and I had no answers. I ran through a surgical checklist in my mind. I asked if we had antibiotics in the room. I positioned huge circular lights over Lisa. Then I picked my surgical gown off the back table, stretched my arms through the sleeves, and pulled gloves over my hands. There was no time to count instruments and no time to scrub Lisa’s abdomen. Lisa and Jonah’s condition forced us to start the case without performing the rehearsed rituals associated with almost every surgery.

A nurse tied the back of my gown. Another nurse opened two bottles of betadine and squeezed them onto Lisa’s abdomen––a crude, rapid, and likely ineffective way of sterilizing her skin before I cut through it. The brown liquid pooled in her umbilicus, spilled over her belly, then dripped down her pale flanks like a massive ink blot. The scrub tech passed me the blue surgical drape. In a synchronous motion the resident and I unfolded it over Lisa’s abdomen.

Then I paused. I could not start the surgery––I could not slice into Lisa’s skin––until medications rendered her unconscious. It took energy to alter the inertia I had set into motion. I shivered because a cold sensation grew and spread across my body––the sort of cold that comes when wind pulls sweat from your skin. I shivered because adrenaline zipped through my blood vessels teasing the muscles I worked to keep still. The commotion in the operating room had ceased. I heard Lisa’s cardiac monitor chirp. I folded my arms across my chest and bent my right leg then my left to the rhythm of her heartbeat––a subtle sway.

The anesthesiologist pushed Propofol, a thick white anesthetic, into intravenous tubing that snaked into Lisa’s arm. When her body relaxed, I peered over the blue surgical drape. He slipped a tube into her throat. “Go,” he said.

The resident pulled a scalpel over Lisa’s skin, cutting down to her fascia with one clean swipe, then handed the instrument back to the scrub tech. We hooked our fingers through two small nicks in the silver and white fibrous tissue that held Lisa’s abdomen together. We leaned back with all of our weight bending at the knees like water skiers. The force ripped open her abdomen. I split Lisa’s rectus muscles then felt the warmth of her abdominal cavity as I pushed my index finger through her peritoneum––a thin glistening membrane that draped over her organs.

The swirling muscle of Lisa’s uterus should have been pink. Instead, like India ink, shades of purple and black spread and diffused across its surface. Blood had seeped from her placenta into the centimeter of muscle that separated Jonah from me. The scrub tech placed a scalpel back into the resident’s open hand. Then he incised the lower portion of Lisa’s uterus entering the space where Jonah had thrived and grown for thirty-eight weeks. A tide of blood tinged amniotic fluid spilled from the incision, over Lisa’s abdomen, splashed onto the floor, soaked the bottom of my scrubs, shoes, and socks. The resident grasped each side of the uterine incision then pulled it open.

A blood clot, the size of a cantaloupe, erupted from Lisa’s uterus. I reached down into her pelvis, wrapped my hand around the top of Jonah’s head and pulled it up to the incision. The remainder of his slippery body followed with ease. Sixty seconds had passed from the time of Lisa’s skin incision to Jonah’s delivery.

Jonah’s dusky arms and chubby legs hung from his body motionless. He did not cry or gasp. His face did not grimace, his mouth remained still, gaping, and blue. I held his flaccid body in my hands. “Oh God,” I thought. “He’s dead.”

The resident clamped Jonah’s thick rubbery umbilical cord with two Kelly clamps and cut it with a pair of heavy scissors. Then I placed Jonah into the arms of the pediatrician. She carried him to the neonatal warmer, rested a stethoscope on his chest, and announced, “No heart beat.” Meanwhile Lisa’s uterus was failing to contract and the thousands of the spiral arterials that supplied her uterine muscle gaped open spilling blood into her pelvis, turning the surgical field into an opaque red lake. The resident sewed and stitched with a swift mechanical motion while I soaked up and swept away blood with white laparotomy sponges. Lisa had already bled enough to consume most of her clotting factors––proteins that achieve hemostasis. The more she bled, the more her body consumed the factors, and the less her blood clotted. In this situation, the only treatment is transfusion. Unless we replaced Lisa blood faster than she lost it, she would never stop hemorrhaging.

In the corner of the room, the pediatricians worked to save Jonah. They pushed epinephrine, performed chest compressions, and announced time, “One minute, no heart rate. Five minutes, no heart rate. Ten minutes, no heart rate. Fifteen minutes, no heart rate. Twenty-five minutes, no heart rate. Time of death, 7:10.”

Lisa continued to hemorrhage. I compressed her uterus in my hands slowing the bleeding while we repleted her blood and clotting factors. With my hands in Lisa’s pelvis, I asked one of the nurses to contact my husband, “Tell him my kids cannot go to school today.” I would not leave the operating room in time to make it to their school. I could not bear the thought of Zachary and Esmae waiting for me.

The morning Jonah died, no one reached my husband. Zachary and Esmae waited in their classroom. They waited with ceramic necklaces, popsicle stick picture frames, handmade cards, and homemade boxes. They each picked a muffin for themselves and they picked one for me. My kids did not know I saved a woman’s life. They did not know that Jonah died. And to them, those truths did not matter.

When I finally finished the case and stabilized Lisa, she woke, then asked about Jonah. I said nothing. Though I knew the inside of her body, though I had worked to keep her alive, though I held her son as he died, I did not know Lisa and she did not know me. We were strangers. She deserved to have someone else, someone closer to her, unveil the devastation.

As the anesthesiologist transferred Lisa to the Intensive Care Unit, I lumbered out of the operating room. My back hurt. My jaws were tired from clenching my teeth. My eyes had grown heavy.

Outside, the morning was ablaze and dust sparkled in the sunlight as it stretched through windows and across the hospital floor. The day-shift obstetrician, a colleague, had taken over the unit. He met me at the nurses’ station. As I approached, he opened his arms to hug me. I rested my forehead on his shoulder, then cried. We were not close friends. We did not confide in each other. We did not eat lunch together. But the pain we experience as obstetricians in the midst of losing a baby is universal.

After I settled, I collapsed in a chair. The rest of the world moved as it would any other Friday morning. Residents managed the laboring patients––flitting in out of rooms. Nurses wove through the unit. Pregnant women waited at the front desk to check into triage. Someone had abandoned a travel mug on the counter next to me. My white coat draped over the back of the chair where I sat. Monitors tweeted as they recorded fetal heart rates. Like a culture shock, I reeled from the contrast of the mundane world outside the operating room with what I had just experienced inside of it.

A social worker called from the Intensive Care Unit and informed me that Lisa knew Jonah had died. I made my way through the corridors of the hospital to Lisa. Through the glass doors of her room, she saw my pink scrubs, and panicked. I heard her say, “Don’t let her in here. She killed my baby.”

I bent over, put my hands on my knees and worked to catch my breath. I neglected my children who waited at an oak table with a muffin at an empty seat intended for me. I failed to keep my promise to them. For what? A dead baby? A critically ill mother? Painful accusations? This was an excruciating trinity. I found no solace or explanation for that morning. I dissolved into despair while Lisa suffered and grieved.

***

Four years after I delivered Jonah, on Mother’s Day, I wore a bracelet Esmae constructed out of clunky foam geometric beads and a pipe cleaner. She had asked me to promise I’d wear it all day, even to work. With great joy, I wore the bracelet. But after Jonah died, I quit making promises to my children because I break them. They forgive me. But I fail to offer that grace to myself. So, I don’t make promises.

But on that Mother’s Day, with Esmae’s awkward bracelet dangling from my wrist, I opened my laptop. Lisa’s name was in my email inbox. She had found me and sent a message. With reluctance, I opened it.

What waited for me was a great deal of peace. Lisa explained that she now had solace on Mother’s Day. The memories of Jonah were more of a celebration than a source of pain. I have always loved Lisa and Jonah in my own way. I bore witness to Jonah’s life and then death. I knew Lisa in the midst of excruciating pain. But I believed she would never understand how her story affected me as a mother and a physician. Yet, in her message, she acknowledged my pain and thanked me for enduring it so I could continue to take care of women like her. She shared that she only had to face the death of a baby once but knew as long as I practiced obstetrics, the tragedy would not end for me. Then, she wished me a Happy Mother’s Day.

Names have been changed. This essay first appeared in The Rumpus.

Whitney Lee is Maternal Fetal Medicine physician, an Assistant Professor of Obstetrics and Gynecology at Northwestern University, former OpEd Public Voices fellow, and veteran. She received her MFA from Vermont College of Fine Arts. Her work has appeared or is forthcoming in Ninth Letter, Booth, Typehouse, Lunch Ticket, The Rumpus, Crack the Spine, Gravel, Numéro Cinq, Huffington Post, and Women’s eNews. She lives in Chicago with her husband and four children. Currently, she is working on a memoir about a physician’s experience with death.

 

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exercise, Guest Posts, Health

Getting Up Offa That Thing

March 11, 2019
trainer

By Nina Gaby

Before we start, the trainer asks me if I can get up and down off the floor. We are standing in front of a contraption known as PF360. As I am devoted to the idea of changing my life right now and keeping the dark shadows of my mood on the periphery, I force a good-natured laugh. “Now why are you asking me that? Do I look like someone who can’t get off the floor?”

Well yes I probably do. My white hair flies out from its clip, my left arm trembles a bit from the exertion of the Matrix machine that I’ve just done again for the first time in a year, and my numb right hand can be pretty worthless as evidenced by having just dropped my iPhone again. I’m pale from insomnia and worry and disappointment. And then there’s the belly, an appendage with a life of its own. I’ve already been called “hon” and “dear” by staff twice today. No one ever called me “hon” or “dear” until I hit sixty-five and now I rue every condescending sweetness I ever bestowed on any old person in my life. It’s a micro-aggression, I want to tell them, but off course I don’t. At least they are trying to sprinkle a little kindness in an inhospitable world.

Dexterity and stamina suspect, I surprise the trainer by holding plank for 45 seconds and being able to synchronize “dead bug” and move on to the ropes and pulleys without incident. “I do yoga” I tell her. “Not well,” I add. “I used to exercise all the time…” I trail off. She is glancing out over the football field sized Planet Fitness and worries that if anyone else shows up for the training she won’t make it out in time to pick up her kids from day care. She is a working mom who doesn’t have time for my reminiscing. We move on to the kettle bells. Continue Reading…

Guest Posts, Health, The Body

Why We Must Remain Vigilant: An Affordable Care Act Story

April 3, 2017
vigilant

By Jenny Giering

For me, the repeal of the Affordable Care Act is a life and death issue.

I used to define myself in various ways: a musician, a mother, a wife, a yoga devotee, a cook. Some friends (and my husband) called me the Energizer Bunny. Now: I am the poster child for Universal Health care.

The day I got my breast cancer diagnosis, I was in the process of re-certifying through the Massachusetts Health Connector (Massachusetts’ version of the state health insurance exchanges) for the following calendar year. My local Navigator, a local public health official trained to help with the application process, told me about Massachusetts’ Breast and Cervical Cancer Treatment Program, a Medicaid initiative designed to cover middle and low-income women through their treatments. We were relieved to discover I qualified. Our two children were simultaneously enrolled in MassHealth (Massachusetts’ Medicaid program) and their care became free as well. This was what saved our family from financial ruin. Continue Reading…

Guest Posts, Health, Women

Endo

June 21, 2016
pain

By Janet Frishberg

Age 12: In the afternoons when I’m bleeding, I double over as I stagger home up the hill. I hold onto a telephone pole on the way to the white-walled apartment where my mom and I live, where I can sit on the toilet and cry, trying to imagine myself out of my body, writhing on the carpeted floor, wanting to find a place of comfort. I slouch at the computer console, my feet resting on its grey plastic side, crying and playing games to distract me from the pain. It feels like my insides are a room and someone is peeling off the wallpaper very slowly, with a straight-edge razor. In the quiet apartment, alone, I know I can scream or groan as loud as I want; everyone is at work. My mom and I go to doctors, more than two, less than five. They say, “That’s part of being a woman.” And, “Sometimes menstruation is painful. You’ll get used to it.”

The pain overwrites the past. It becomes difficult to remember my body from before my body is in pain. Continue Reading…