Reading, writing...that's what I do.

Love for the printed word, love and belief in ideas.

A Gentle Reminder on the L&D Unit…(Labor and Delivery)

Go placidly amid the laboring patients, and remember what peace there may be in coffee breaks. As far as possible and without surrender, be on good terms with the unit secretary, for she controls everything. Speak Lamaze quietly and clearly; and listen to others, even coaches who sit watching TV, occasionally mumbling “breathe honey, breathe”; they too have their story.

Take not the words of loud and aggressive patients to heart; an apology often follows delivery. If you compare yourself with others, you may become vain and bitter; for always there will be those who mistake a patient for complete when she’s really only two centimeters! Enjoy each delivery as if it were your first. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of the modern health care system. (So true)

Exercise caution in your charting; for the world is full of lawyers! But let this not blind you to what virtue there is; many persons strive to successfully VBAC (vaginal birth after cesarean) and everywhere life is full of heroism.

Be yourself. Especially do not feign knowledge. It is better to ask a stupid question than to make a stupid mistake. And do not be cynical about screaming primips (first baby) at one centimeter; for in the face of all pain and disenchantment they are as perennial as nursing students.

Take kindly the counsel of the unit manager, for she is just doing her job. Nurture the accumulation of overtime to shield you in times of low census. But do not distress yourself with imaginings. Many fears are born of the prospect of not getting your patient delivered in time to watch Star Trek (or substitute something else)! Beyond a wholesome firmness, be gentle with your patients. You are a labor and delivery nurse, no less than the obstetricians and the midwives. You have a right to be here!

And whether or not it is clear to you, no doubt the universe will fall apart as soon as you sign out. Therefore, be at peace with God, whatever you conceive Him or Her to be, and whatever labors and aspirations, in the noisy confusion of shift change, keep peace with your soul.

Because with all its sham, drudgery, and popcorn trodden in the carpet, this is still a beautiful unit. So be careful. Strive to be happy, and don’t go home with the narc keys in your pocket! 

THANKS TO THE AUTHOR, RAY SPOONER

PS Yes I love this. And though I haven’t worked on an L&D unit for a very long time, it still speaks to me. And… ALWAYS BE KIND TO YOUR NURSE.

I’M SORRY FOR MY LOSS Part Two

 

THE STORIES WE TELL: The Authors Refer to it as: A QUIET RIOT

When should a woman reveal that she is pregnant? Kate Watson writes in Scarlet A: Ethics, Law and Politics of Ordinary Abortion, referred to the silence that often accompanies the realization that one is pregnant…the “cultural confinement period” …a version of the Victorian rule that women could not go out in public when visibly pregnant.

Wow, what would they say today? In our culture, we might guess that keeping a new pregnancy a secret until it is established and visible, means either the woman is making sure all is well, or she is admitting, “I didn’t want this, I don’t know what to do.”

The authors also stress that pregnancy loss is not uncommon: between ½ and 1/3 of women will experience a pregnancy loss; one in four women will have an abortion.

Misunderstanding as to what causes a miscarriage is also widespread. Lifting a heavy object, using an IUD or birth control were once popular explanations for a miscarriage. But at least half of miscarriages are due to chromosomal issues, a genetic mismatch…that cannot be controlled. The authors then underline that it is comical, that many pregnant women wait until their first trimester to move the fridge to the basement. Really?? But maybe this is a joke I have not encountered!

What readers do need to know, is that there is a bounty of information, advice and expertly-presented research in I’m Sorry for My Loss. As a former Labor and Delivery RN, I applaud not only the authors personal strength and positivity, but also their excellent and thorough research. This book required belief in the project, persistence in doing research, asking questions, and getting answers: the latter not easy when questioning some doctors!

Long and Little are to be applauded for their openness, honesty, and the ability to share their own experiences, their own pain. The book is beautifully organized and well-researched, truly a handbook for all women, accessible and easy to read, a guide proving that personal revelations help support female understanding and female hope.

The book also provides a clear message: women, no matter their age, background or connection to doctors and other medical staff, will often need to rely on personal strength. And more importantly, they must rely on and USE their ability to ASK questions. Medical people are people. Don’t hesitate. Ask questions, any question, especially if you are experiencing sorrow and anxiety. And after reading this guide, I hope there will be a voice in your head, one urging you to ask questions, to not hold back. When visiting with a doctor, midwife or doula, you might carry with you a copy of the chapter: PULL YOURSELF UP BY YOUR OVARIES…just as a reminder!

And remember: this is book of warmth and encouragement. It is also a book of the realities of loss…as the title emphasizes. I encourage every woman of child-bearing age to read this well researched and honest look at Women’s Healthcare. Whether you have just started to menstruate, want to be pregnant, have already given birth or are going through “the change”, information about your female body, your ability to reproduce, must be part of you. This book can act like a shield: because with information, your ability to understand reproduction, pregnancy and birth is enhanced. You have always had the strength to make you own choices…now you have more tools. Now you will agree: your female strengths MUST BE PROTECTED.

THANK SO MUCH FOR READING.  And PS  If you have a daughter or daughters, surely there are parts of this book you will want them to read. 

I’m Sorry for My Loss PART ONE

Review:  Elizabeth A. Havey

The cover of this amazing, well-researched, open-hearted book, written by Rebecca Little and Collen Long, acts as a preview for the reader…but only if you take your time, look carefully, and open both heart and mind.

The book’s title, I’M SORRY FOR MY….LOSS, indicates that this is a serious, well-researched work, one that discusses women’s health and pregnancy. This well-researched book focuses on things that can go wrong,  and thus permanently affecting a woman’s life and her reproductive future. The writers intent, which they have definitely achieved, is to take a hard, well-researched look at women’s health and a women’s physiology, both of which are known to NOT always deliver the longed-for child.

I’M SORRY FOR MY LOSS examines the specific health needs of women, but also the lack of CARE that women in these changing times often experience at the hands of both male and female gynecologists. If you saw this book online or in a bookstore…and if you were hesitating, don’t! Or maybe you are uncertain as to the approach of these authors. If so, keep reading. Knowledge is power, this being 400 plus pages of research and personal experience that examines and presents in detail: Miscarriage, Stillbirth, Abortion, Patient Rights, even Grief— all amazing information that EVERY woman of reproductive age needs.

LONG AND LITTLE: We Write from Experience

There is one major difference that makes this book extraordinary in content and readability: the writers aren’t summarizing research and interviews. They’re writing from painful and difficult personal experience, in addition to doing research before, during and after pregnancy. In our current cultural climate, the work of these two writers and its resultant statements emphasize and inform us of the dead ends, the outright ignorance and arrogance that we women have endured, are still enduring and might once again encounter, when seeking healthcare for our female bodies.

Example: Pregnancy Loss. It is hard to believe, that in the wealthy United States of America, we still have an embarrassingly high rate of infant mortality, and that this rate is expected to rise in the aftermath of the Supreme Court reversing abortion protection. Little and Long write that the United States has 32.9 maternal deaths per 100,000 live births, a shocking rate. The United Kingdom is the next closest, their numbers being much lower:10.9 per 100,000 births. And for Black women in the United States…a frightening 69.9 deaths per 100,00 births. Little and Long: “This data of Black women…makes them nearly three times more likely to die than white women during pregnancy or within a year of the end of the pregnancy. Black women are also far more likely to suffer miscarriage, stillbirth, and other complications.”

The authors write that NONE of this reflects well on our healthcare system. Anushay Hossain, in her book Pain Gap, makes a strong case as to how women of color are treated: “Maternal mortality ratios tell us how well a country’s healthcare system in general is functioning. In America, our maternal mortality rates are a stark reminder of how little we actually value women’s health.”

Little and Long quote Dr. Sarah Prager, an ob-gyn and professor at the University of Washington: “It’s really under-appreciated that pregnancy is dangerous.” Prager stresses that this danger includes all women, but especially women of color. A recent study of Black women in the U.S. revealed that impact: “Research on obstetric health inequities is notable, with Black communities experiencing higher rates of preterm birth, low birth weight, infant mortality, and maternal mortality.”

RACISM and WOMEN’S HEALTHCARE

The authors also quote Jamila Taylor, a reproductive rights advocate. “Dealing with racism in our daily lives is a major factor in our health and well-being. The experience of racism makes Black people sick, whether it’s mental and emotional health or even physical health.”

Taylor states that many Black women have approached her, admitting they are afraid to get pregnant, they worry they will not survive it. This fear dates back to historically mistrusting white doctors: the Tuskegee Institute promoting forced sterilizations; Henrietta Lacks, her family not knowing for years that her blood and tissues were being used for experimentation. And the most frightening…statistics revealing that the infant mortality rate of Black infants is only cut in half when women are cared for by Black doctors.

And please consider Tori Bowie, an Olympic gold medal sprinter, who died while pregnant, her white doctors refusing to truly listen to her. They just needed to do simple testing, thus finding: elevated blood pressure, protein in her urine. They needed to listen to her complaints: headaches, shortness of breath—all classic symptoms of pre-eclampsia. Bowie was eight months pregnant when she died. Other black athletes have admitted that their doctors ignored physical complaints. Thus, Little and Long conclude: “If doctors won’t pay attention to Black athletes, then Black women in general don’t stand a chance.”

WOMEN’S RIGHTS AND GRIEF

Now, because of DOBBS, there are more women seeking abortions, the authors providing research concerning what some might call, THE DOBBS EFFECT.

The “gold standard” in medical miscarriage management is the abortion regimen—mifepristone combined with misoprostol. But due to the FDA’s extra regulation of mifepristone (and numerous lawsuits), many patients are now offered only misoprostol. There is also disagreement in timing. The FDA: use allowed up to 9 weeks. The World Health Organization: use allowed up to 12 weeks. The writers believe that in states where a procedure is not available, more pregnant woman will be forced to rely on medication even later in a pregnancy. But after Row fell, and because of rape, Morgan Nuzzo, who is trained in all-trimester abortions, created a clinic in Maryland. She now reports a heart-breaking reality: seeing children every week, some as young as nine. Her clinic also takes care of people who have developed disabilities and/or are nonverbal. The clinic keeps tissue samples for pathology, so detectives can try to locate these rapists.                                         

ABORTION, STILLBIRTH

Many restrictive laws have been heavily influenced by Evangelical Christianity, and that includes the doctrine stating that women should suffer punishment for original sin. If you die in childbirth or because of an abortion, it’s God’s will. Don’t blame them, blame Eve, ye old original bitch. 

Jen Klein, director of the White House Gender Policy Council under President Biden, told authors Long and Little: “There is a strong contingent of extreme, mostly politicians, but also judges, who either don’t see or don’t want to see the effect these laws are having on women’s health care more generally.” Klein then added: “Pregnancy loss of very wanted pregnancies is one example at the heart of the problem.”

Yes, it is. The authors have also explored another aspect of women, pregnancy and THE LAW, citing a case in 1999, when Regina McKnight became the first woman in the U.S. to be prosecuted and convicted for having a stillborn…this according to a legal scholar, Michele Goodwin. Knight served a decade in prison before her conviction was overturned, the prosecutor saying he wanted to make her an example: “If you kill a child by showing extreme indifference to human life, then you’re guilty of homicide by child abuse…”

McKnight’s conviction was eventually overturned in 2008, due to faulty scientific evidence presented at the trial…though by then, she had already served a decade in prison. This, because many people in power are ignorant concerning pregnancy, birth and postpartum. They are literally harming pregnant and postpartum women with laws created out of ignorance…laws made by men who know how to get a woman pregnant, but who truly do not understand the biology of pregnancy and birth. (My note: Please read that again, that last sentence.)

Because of intense research, and personal experience, Little and Long have written a book that presents facts, history related to pregnancy, loss, and other elements subsumed in those categories. It is a personal work, a book of knowledge, but also great caring. The authors stress that many women who have lost a pregnancy go on to help with charity events, their work done in their baby’s name. Women also lobby for changes in the system. Little and Long beautifully refer to their efforts as “parenting a legacy”.

Part Two next week

EUDORA WELTY….A Curtain of Green

When we moved back to Chicago, leaving our wonderful years in California, my daughter Christie sent me a book of collected short stories to read in those infrequent moments when I would not be unpacking, setting up a new household.

She sent me the work of Eudora Welty, a southern writer whose name I knew, but whose work I had not explored. But in time, I was able to quietly turn the pages of this author’s work, and thus be transported to her southern world.

Ann Patchett writes in her intro to the book: “When I first read THE COLLECTED STORIES , I thought Welty was a fabulist, a writer endowed with a superior imagination and love of tall tales. Those things are true, of course, but Welty, who spent most of her life in Jackson, Mississippi, in the house her father built when she was a child, was also telling the TRUTH.” (caps are mine)

Also, the amazing writer Donna Tartt wrote: “The reason it’s so impossible to write about Mississippi is that everyone thinks you’re exaggerating.” I LOVE THIS!

And thus, Patchett adds: “In the last 25 years in which I have been going to Mississippi regularly, I’ve come to believe that Welty was to her state what Joan Didion was to California: the clear eye of verisimilitude….There is no writer I know who tells the truth of the landscape like Welty.” 

LITERATURE RECORDS REAL LIFE 

So, if you want to take a trip to America’s south, keep reading. 

In the collection, A CURTAIN OF GREEN is the story of a southern garden. “To the neighbors gazing down from their upstairs windows it had the appearance of a sort of jungle, in which the slight, headless form of its owner lost itself….”  Foreshadowing? 

No neighbor dared go into this garden…

“Early that morning they had heard whistling in the Larkin garden. They had recognized Jamey’s tune, and had seen him kneeling in the flowers at Mrs. Larkin’s side. He was only the colored boy who worked in the neighborhood by day. Even Jamey, it was said, Mrs. Larkin would tolerate only now and then…”

BECAUSE…Mrs. Larkin’s husband had died the summer before, in an accident that echoes the fearful love of a southern garden: a tree, “a fragrant chinaberry suddenly tilting dark and slow, like a cloud leaning down to her husband, ” but crashing down on his car as he was arriving home.

And Mrs. Larkin had seen this happening, had strongly believed her love for her husband would save him. But it did not.

THUS, WELTY MUST ASK A QUESTION 

Why would a woman who loved flowers, trees, all growing things, why did she have to lose her husband this way? And what is Welty telling us? 

Then later  in the story, while the other women of the town sit inside “fanning and sighing, waiting for the rain,” Mrs Larkin is once again in her garden, where she chooses to be consistently, as again we feel the rules of the south having their say: “…since the accident in which her husband had been killed, she had never once been seen anywhere else.”

Yet hers is a fertile garden that needs “cutting, separating, thinning and tying back” to keep the plants from “overreaching their boundaries and multiplying out of all reason”. Yet Mrs Larkin in her deranged grief does none of this, instead she works incessantly, obsessively, planting more and more. 

And there is Jamey, a Black man who has helped her in this garden. Jamey kneeling in the soil and working, though the sight of him makes her so angry, that she finds herself lifting the hoe. “Life and death, she thought gripping the heavy hoe, life and death which now meant nothing to her…” And in then in this story Welty asks: “Was it not possible to compensate? to punish? to protect?”

“Pale darkness turned for a moment through the sunlight, like a narrow leaf blown through the garden in a wind. In that moment, the rain came. The first drop touched her upraised arm. Small close sounds and coolness touched her. 

Sighing, Mrs. Larkin lowered the hoe to the ground and laid it carefully among the growing plants. She stood still where she was, close to Jamey, and listened to the rain falling. It was so gentle. It was so full–the sound of the end of waiting.

One critic wrote: “A curtain of green” is a great read, for its exploration of how grief can derail you, making you, temporarily at least, a little mad.”  

THANKS FOR READING. 

 

GENERATIVITY WHAT IT IS & WHY IT IS Good FOR YOU.

This time of year we remember things we are grateful for, and families often top the list.  And our children, if we are fortunate to have some, are certainly most important.  Looking at them seated at the Thanksgiving table or hearing their voices on the phone, consciously or unconsciously reminds us: children are our legacy.  They satisfy at some level our desire for generativity: In the middle years of adult life we come to realize: “I am what survives me.”  We have the gift of creating and leaving in our culture, good people and their positive thoughts, ideas and even their art…books, paintings, films…. 

Psychoanalyst Erik Erikson wrote, that in the middle years of adult life we come to realize: “I am what survives me.”  Though giving birth is the ultimate act of generativity, it’s the parent’s follow-through, his and her commitment to nurturing and growing this person, that truly counts. 

And it is comforting to know that we all can experience generativity by giving birth or by creating something: a business, a song, a piece of sculpture, a resolution of a problem, a scientific theory, a recipe, an article, a novel, a hybrid rose.  Generativity also means creating the very future itself…through teaching, nursing, volunteering, voting, forming and helping social institutions, like community centers, churches, schools and health centers.  In each of these created endeavors reside a part of us, the good in us. Bottom line: what we generate moves into the future and provides for those coming after us.  I am what survives me.

Psychologists confirm, that people who want to generate and create experience feelings of well-being and low levels of depression.  Once again, if you are feeling sad or lonely, the best cure is reaching out to help someone else. Though there might be some ego or need for power in our acts of creation, when we generate for future generations we cover over that power with love. Dan P. McAdams in his article about generativity, quotes an African Proverb to underline the positive aspects of our desires to leave something behind:

The world was not left to us by our parents. It was lent to us by our children.

Erik Erikson further states that in order to create and have children and build societies, we indicate a “belief in the species.”  We daily know the horrific things that can happen on our planet, but we also forge ahead believing in our own generative powers, the goodness that can still exist on our earth for the generations to come.

In McAdams’ article he includes a Self-Test. The items below are from the Loyola Generativity Scale (LGS).

Read the following six items and mark:

O if the statement never applies to you;

1 if the statement sometimes applies to you;

2 if the statement often applies to you;

3 if the statement always applies to you;

Then add up your score.  Men, women in their 30s, 40s and 50s usually score 11.  Younger adults and adults in their 60s and older usually score slightly lower.

___ I try to pass along knowledge I have gained through my experience.

____I have made and created things that have had an impact on other people.

____I have important skills that I try to teach others.

____If I were unable to have children of my own, I would adopt children.

____I have a responsibility to improve the neighborhood in which I live.

____I feel that my contribution will exist after I die.

Thanks to Dan P. McAdams for the inspiration from his article GENERATIVITY:The New Definition of Success

 

THE MOON DOCTOR: Memories That Help Us Change

She listened to the steady pounding of her feet along the roads. And after a while, she could feel it running in her veins, something that turned backward to rituals of spring–Lent, events of her childhood, painting rain-washed colors on hard boiled eggs. The sky would scuttle from grey to blue to grey, rain spitting just as intermittently. But the air was becoming velvet, enveloping, warming the skin, and when she walked now, crunching spring detritus, a hollowness opened inside her, a sweet opening as if she were also ready to suffer, to feel pain, to live and embrace it all. (from The MOON DOCTOR)

When the son of a very close friend (I will refer to him as David) was severely burned in a house fire, I wrote a novel, THE MOON DOCTOR, to deal with my emotions concerning this horrific event. Watching how this child suffered and how THE FIRE changed all their lives…sent me to the keyboard to make some sense of it. But I struggled with the story, with the characters. And THE MOON DOCTOR has never been published. What started as a tight story, began to wander, as if I could not pin it down…too many characters, too many plot points, all that sorrow. Today, it sits in a drawer. (I did enter a hospital scene in a contest, but heard nothing. I guess no one was ready for a burn victim and his doctor, who simply appeared at his bedside to help him accept his changed life.)

But I glad that I wrote that novel, found empathy in my characters, and that in real life, David and I forged an even closer friendship when we both went through Nursing School… together. Being in a house fire and surviving, can make you intensely aware of the human body…its strengths and weaknesses. David’s empathy was unmatched, he calmed his patients, explained his scars, shared his life. 

WE LIVE OUR STORIES

But much later, as an RN in an inner city Chicago hospital, I had the privilege of working on the maternity unit with doctors, nurses, interns and patients of many different religious and racial backgrounds. We were a team, and there was NEVER a provoking incident due to racial or physical differences…until….

One Sunday, I received a patient, worked up her chart, drew blood, assessed the fetus, helping her through early stages of  labor. THIS, before her husband arrived at the hospital. He took one look at me and left the room. Moments later the charge nurse called me out, telling me I had been relieved of my duties with this patient. The husband had requested another nurse.

I learned that if he had his choice, no one would have been able to help birth his child, but now, faced with being in a hospital and having to choose the personnel available, he wanted an African American nurse. At first I didn’t understand, later being told that his choice had more to do with his Muslim faith, than whether I was a capable RN. The nurse who took my place was excellent. She had been in the trenches for years. My patient was in good hands.

ANOTHER DOCTOR…No Matter Our Skin Color, We All Need CARE.  

I had a wonderful friend, a doctor from South Africa, who worked during the time Black doctors couldn’t take care of white women. This made me remember a college text that dealt with racism. The author said right out that racism messes up our brains, and that how we are raised contributes greatly to racist feelings and reactions–locking a car door, avoiding getting in an elevator because of who is occupying it, the unaccounted for fear that lurks somewhere in the brain, because of a newspaper headlines or the words of some people you meet during life. 

Jim Grimsley, a white man, wrote a book about his own experiences: HOW I SHED MY SKIN. The Amazon Book Blurb read in part: What Jim did not realize, until he began to meet these new students, was just how deeply ingrained his own prejudices were and how those prejudices had developed in him despite the fact that prior to starting sixth grade, he had actually never known any Black people. Jim writes that the first time he saw Ebony magazine, he was astounded: “I had never seen Black people depicted in this way before, as if they were just like white people.”  Ah yes, they are!! We can be very slow learners. 

The Bill Cosby Show was genius. It showed us white folks that the Black family was not unlike the white family or the Latino or Asian etc etc. We all have struggles raising children, working and being there for our kids, knowing when and how to deal with various problems as they become adults. (So sad that Cosby’s mistakes pushed that show back into the film can.)

But the best thing I can take from thinking and writing about these issues is to always remind myself that empathy and understanding can fill up the heart. Fear, anger will only make a person hard and mean–and in the end, probably shorten that person’s life. Watch out for the stress that messes with your heart and makes your brain believe things that just aren’t true. Despite his scars, my friend David lives his life and now has children and grandchildren.

Final thought: Consider that one to one relationship wherever you go. Make a new friendships –HE or SHE just might be from the another country…but we learn and understand more, every time we meet.

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