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promises

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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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Promises & Lies.

January 8, 2013
beauty-hunting-jen-logo-blackBy Jen Pastiloff.

Promise. The word itself is sleazy. Hard at first, then sizzling out at the end like something that can’t last. A snake. A word that can’t get up off the ground.

You promised though.

You promised.

I promise you.

We promise.

I promise. 

Hsssssssss. Promisssssse.

**

In 1983 we lived in Pennsauken, New Jersey, after having moved from Philadelphia a couple years earlier. Across the street from our house was a little store called Kirk’s Newsroom. The store itself a tiny animal, nestled next to an appliance repair shop and a Jersey highway called Route 38.

There was nothing pretty about it. We bought American cheese there, thinly sliced, and egg nog in December. Kools for my dad, Almond Joys, sometimes a newspaper. I played PacMan in the back in the dark little room where there were two video games shoved against a wall.

We had a “house account” at Kirk’s Newsroom. My dad would send me across the street to get him a hard pack of Kools, cheese, and half-n-half. I don’t remember what Kirk looked like besides having a mustache and a thin face, he was always behind the counter. Put it on my dad’s account I’d say like a lady to the mustache behind the counter. And can I get a hard pack of Kools?

I think about that now and how a child could never walk into a store and get a pack of cigarettes and also, do house accounts even exist anymore? It was the early 80’s however and most things were possible until they weren’t.

I hated that store. It felt dirty and old and every time I was sent there to retrieve things I’d felt as if I was being delivered into the arms of a rat. Go, my child! Go straight into the den of vermin! Be gone now! Come back with cigarettes and cheese. Don’t let the snakes eat you!

Kirk was nice enough, I guess. He’d leave egg nog on our doorstep around the holidays. We’d wake up and a frozen carton would be there waiting for us or we’d open the door and step on it, not knowing it had been there. Either way, I hated the place like I knew it would kill us in the end.

And it did.

I’d flushed a pack down the toilet because I’d been so angry that he’d promised to quit smoking and hadn’t. He’d promised! I was ballsy and triumphant at 8 years old. I’ll show him! Flush.

He smoked 4 packs of menthol cigarettes a day. Now that so much time has passed, I often wondered what has turned to myth, as so much does, but, nonetheless, he chain-smoked a shitload of very-bad-for-you cigarettes daily. He was not happy with the flushing incident, he did not think it was cute. You are being bad and making me not feel good. Now, please go get me a pack of cigarettes across the street.

Did he really say that?

You’re asking me? As if. As if our minds can be relied upon. As if history doesn’t fold in upon itself and change over time. As if our memories are safe. As if Time hasn’t ravished them and then polished them before putting them back into the wrong compartment.

You always break your promises! I hate you.

The end.

He died that night, and yes, that was the last thing I ever said to him. I. Hate. You.

Things and people I have tried to blame it on: Kirk: the bastard who sold cigarettes and newspapers. Myself: I killed him with my words. I was bad and made him not feel good. Speed: his heart, his poor heart racing to keep up, a fist in his chest, pumping five times faster. Downers: the confusion his heart must have felt daily, up and down, up and down. My mother: why couldn’t she save him? God: God hated me and this was proof. The woman he’d had an affair with: if he’d never met her this would never have happened. Promises: if he’d never promised to quit smoking, I would never have told him I hated him and the night would have played out differently. He would not die. I would not walk 17 times around the block in an effort to not cry. We would not pick up and move to California. We would be safe.

Fucking promises.

There is a promise when a baby comes into the world as you hold them for the first time. I will care for you. I will be here. You are safe. We are safe. But how can you know that?

How dare you promise anything?

 

When I lived in NYC I used to promise myself nightly that if I didn’t die during the night I would stop abusing laxatives. I didn’t die and I would do it the next night and the next and the next in my little single apartment owned by NYU Housing. I would take 10 laxative tea bags and put them in a few ounces of water until it was  brown sludge. Sometime in the middle of the night as my eyes were wildly dilated from the diet pills I was taking, my stomach would begin to gurgle and I would rush to the bathroom and pray Don’t let me die.

I couldn’t even keep a promise to myself.

I promise I will do better.

Can you remember all the promises you’ve made to yourself? I can’t.

What is a promise called when you don’t really mean it? When you just say it to get you to the next tier? Is it a lie?

I lied to myself over and over.

Maybe you’re cringing or maybe you pity me. Maybe you don’t care at all since promises to ourselves are the worst kinds of promises because no one is holding us accountable. Or perhaps you’d pick up your own coffee cup, the one right after you’ve sworn off coffee, and nod with I promise I will do better before you put it back down and go off to brew another pot. The newer lies I tell myself stacked on top of the old ones all along the edges of my life in places nobody would care to look. All the years I lied to myself about not wanting to be a writer. The lies I told myself about who I was. The lies themselves innumerable and ugly. What’s most scary about these lies we tell to ourselves is their proximity to the truth.

Such a strange sense of satisfaction being so close to the truth. Holding it in your hands like a thing with weight, until you realize that lies are slippery and wet, unholdable at best, and that they have no weight. They carry nothing but themselves.

They will not carry you.

I couldn’t keep up with the promises I told myself.

Every year that I stayed at my waitressing job was another year I had promised and failed to: go back to school, to try and get acting work, to do something, to get out finally from waitressing, to make a change, to stop hating myself so much, to stop starving myself all day and only eating at night. There were so many promises, all as empty as I wanted to feel at night when I would lie in bed and make sure my ribs were protruding by pressing into them hard like something I wanted to make disappear.

I had lost faith in promises, their meanings slippery as the years I had stayed at the restaurant. All through my 20’s and I couldn’t tell you one year from the next until all of a sudden I was 30 and then 31 and then Oh My God, I promised myself I would be Something by now. I would be Somebody.

Who was I promising anyway? It sure wasn’t God. I’d mutter the promises to myself or write them down on random slips of paper and then scribble them out and throw them away so nobody would see. After my father died, I had decided that God hated me. I constantly searched for evidence of this. Bad things happen to me, I’d think. I walked around waiting for that fact to shake up my life, to turn up at a street corner and snatch me away.

Bad things happen to everyone sometimes.

That is what I now know. This too is innumerable and ugly, as so many things often are. But it is also a testament to life, one that we are born into whether we like it or not. As soon as we are held for the first time by our parents, as soon as they whisper into our new soft baby heads: I will care for you. I will be here. You are safe. We are safe.

Promises are tricky: when they break, when their shells crack and they fall all over the kitchen floor like a fallen glass, your heart goes along with it. Be careful when you pick up the glass to throw it away that you don’t throw a little bit of your heart away. It can happen like that. And then the digging and searching through garbage to find what remains.

I spent years digging through crap to find my missing parts.

Don’t make a promise you can’t, or (don’t intend to) keep. I say this to myself as well as to you. I write it here, and instead of secretly scribbling it out and crumpling it up so nobody can read it, I share it with you. Stop lying to myself I write, on my mirror in red lipstick. Don’t make promises to yourself that you know you won’t keep just so that you can  slump yourself on the floor validating how rotten you are and how bad you suck, yet again and yet again and yet again.

Don’t do it.

I always know when I am lying to myself, that’s the thing. Always. I always knew I wouldn’t stop taking the laxatives even as I promised that if I didn’t die on the toilet, I would never ever do it again. 

I knew I would do it again.

So, what is the point of the promises that know themselves so well, that know they are untrue things?

I think they actually think they are keeping us safe.

My father thought if he told me he’d promised to quit smoking he’d be safer than if he said I never want to stop. I love smoking. It makes me happy and I don’t want to quit now.

We all want to be safe.

If I didn’t tell myself all those lies I would have easily sank to the bottom of the ocean. By telling myself the lies, I became equipped with a temporary life jacket. I am safe in the world right now because starting tomorrow I will stop abusing myself. Starting tomorrow I will ______. Starting tomorrow I will not _______. 

Tomorrow would never come. I would carry on doing what I did until I finally did sink to the bottom of the ocean. I finally had my breakdown. There weren’t any more promises I could think of that hadn’t broken me.

I got up and took off the platform shoes I had been wearing for over ten years to pretend I was tall. I waitressed on concrete for over ten years in really really bad platform shoes. I picked myself up, dusted myself off, and put on some nice supportive sneakers. It took a while to get used to my frame of reference being 5 inches shorter but I did it and when people balked at me You are a midget! I had no idea you were so short I just smiled and fought every urge that said Dig those shoes out of the trash and put them back on as soon as possible. 

I didn’t ever put the platforms back on.

Eventually I stopped taking the laxatives and abusing myself. Eventually, after over 13 years, I left the restaurant. Eventually I admitted that I did not want to be an actress.

It wasn’t because I promised myself. It was because I finally woke up one day and realized that lying was harder. That who I am was far more beautiful than who I was pretending to be or promising I would become. I woke up and said Enough. And then I said it over and over and over Enough Enough Enough.

I didn’t want any more promises or lies. I wanted what was rightfully mine, my birthright, as it were, and that was the knowledge that I was whole. That I wasn’t missing any parts.

It’s true that there are many things in life that are innumerable and ugly and inconceivable. But it is also true that what is on the other side is a whole world of glittering NOW.

There is nothing to promise NOW. You and I are here now. I am writing this now and you are reading this now and we are here and alive and what else could matter? What future based promise could possibly touch that irrevocable fact?

The Manifestation Workshop in Vancouver. Jan 17th. Book here. No yoga experience required. Only requirement is to  be a human being.

The Manifestation Workshop in Vancouver. Jan 17th. Book here. No yoga experience required. Only requirement is to be a human being.

Jen Pastiloff is the founder of The Manifest-Station. Join her in Tuscany for her annual Manifestation Retreat. Click the Tuscan hills above. No yoga experience required. Only requirement: Just be a human being.

Jen Pastiloff is the founder of The Manifest-Station. Join her in Tuscany for her annual Manifestation Retreat. Click the Tuscan hills above. No yoga experience required. Only requirement: Just be a human being.

 

Join Jen Pastiloff, the founder of The Manifest-Station, in The Berkshires of Western Massachusetts in Feb of 2015 for a weekend on being human. It involves writing and some yoga. In a word: it's magical.

Join Jen Pastiloff, the founder of The Manifest-Station, in The Berkshires of Western Massachusetts in Feb of 2015 for a weekend on being human. It involves writing and some yoga. In a word: it’s magical.

 

 

Contact Rachel for health coaching, weight loss, strategies, recipes, detoxes, cleanses or help getting off sugar. Click here.

Contact Rachel for health coaching, weight loss, strategies, recipes, detoxes, cleanses or help getting off sugar. Click here.

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