birth

Reading about drugs

LSD
and that people re-experience the terrible trauma of birth

but wait: terrible trauma…

I had the grace and delight and sometimes terror
of catching babies, new and slippery and surprised
for nineteen years

they do not arrive traumatized

an older obstetrician
always gentle
when I would ask for help
deep calm and sometimes
he would wait for the newborn
and not rush us to the operating room

and if the child emerged
he would say “girl ears”
or “boy ears”
he always guessed
frequently wrong
his small tickle of humor
and the mother too busy at that moment
to notice at all
except that his voice was calm

I think of the one forming
in the womb
the sounds of mother’s heart and guts
dark and sounds
of father brother sister other

the first time I see
the new baby in clinic
I imitate the sound of the doppler
swish swish swish
and the newborn alerts, and knows my voice too

I think of the one forming
in the womb
and my daughter
who tried to come early
confining me to bed for three months
and adrenaline-like terbutaline
continuously
my hands tremble
my heart rate at one hundred
I knit to channel the figdets
six sweaters
and my daughter is worth it

I think of the one forming
in the womb
out of room
the space is too tight
can no longer stretch or kick
head down
ready

I think of the one forming
in the womb
saying now
I need more room
now and the cascade starts

we don’t know what starts labor
the baby or the mother
or both

now
I need more room
and the infant pushes towards the door
towards more room

and I have had
the grace and delight and sometimes terror
of catching them
slick and messy and bloody
as they emerge
into the light

open their eyes
and breathe
startled
at light and room and air

Rock trail

My daughter and I spent four nights at Larrabee State Park this week and hiked down the Rock Trail and back up: http://www.wta.org/go-hiking/hikes/rock-trail

When birds chirp at me, I often talk back. Sometimes we have conversations. They think I have a terrible accent and also just talk nonsense. This Pacific wren was very vocal and right by the path. My young adult children are used to this, so my daughter just rolled her eyes and waited. After a while I got this photograph, hooray for zoom lenses and for delightful wrens.

End of Life Plan

My End of Life Plan and Wishes are as follows:

1. My plan is that my life should end after a half day of skiing for free at age 125 or 126.
2. My wish is to ski quite brilliantly, smoothly and gracefully, though not as aggressively as at age 110 and below.
3. My plan is that other skiers will ask who that brilliant skier is and that all the lift operators will know.
4. My plan is that I will have a delicious lunch, with a glass of champagne, in a condo overlooking the slopes.
5. I plan to have a hot tub and then a massage from one of the many handsome men who flirt with me.
6. My plan is that I will sit in a comfortable leather armchair with my feet on a foot stool, while three of my male friends vie to be the one to bring me the second glass of champagne.
7. My wish is that I will not need any cosmetic surgery or false eyes or ears or teeth or joints or heart valves and will retain my spleen, teeth, gall bladder, appendix and brain in full operating order.
8. My plan is that I will not be on prescriptions, medicines, vitamins, supplements, medical foods, or nutraceuticals nor under the care of any quacks of any sort.
9. My wish is that my male flirts will all think that I am not a day over 75.
10. My wish is that I will be listening to live music, a woodwind quartet or string quartet, just dropped in to say hello, along with three of my great grandchildren, showing off their olympic ski medals, summa cum laude graduation documents, or Nobel prizes.
11. My plan is that after the quartet leaves, I will fall asleep….
12. ….and not wake up, and that though my attendants are sad, none of them throws themselves off the balcony over the cliff and are all surprised at my true age and at the bountiful gifts I have left to each of them with proof that a long life and compounded interest have excellent results. My children, grandchildren and great grandchildren will live long and prosper as well.

death in childbirth

When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”

We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….

Preeclampsia? No. Not that common. Eclampsia? Ditto.

“What if a woman is in labor and the baby is stuck? What do they die of?”

Ick. “Bleeding?”

“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”

We were all silent.

When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.

We would like to think this is in the past, but it isn’t. It still is going on, right now, inΒ  poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…

When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….

http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-43

http://www.msf.org/en/article/perils-childbirth-democratic-republic-congo

http://www.who.int/maternal_child_adolescent/documents/childbirth/en/

http://www.who.int/mediacentre/factsheets/fs348/en/

Donate:Β  http://www.doctorswithoutborders.org/

The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.

 

Frail

I wrote this two years before my father died. I did find him…..

Frail
We are going sailing
My partner says to me
β€œInvite him if you want.”

Then I am busy for a while

I think of calling, then forget

He was not at chorus on Monday

At last I say,
β€œI haven’t called. We’ll just sail.
Just us today.”

I haven’t called
because he was not at chorus on Monday

He is frail
55 years of camels
two packs a day
as if each cigarette
destroyed one alveolus
in his lungs
one tiny air/blood interface
built to exchange oxygen
and carbon dioxide
the loss is cumulative
He is frail
he is proud that the choral director
says, β€œI need you.”
He can’t sustain
but his entrances and time
are the best
among the basses.
They need him.

Chorus
is our winter link
two introverts
we hug at the start of chorus
sing for two hours
and talk for a few minutes at the end

Occasionally we go for a beer
I invite him for dinner
but he comes less and less
he often does not feel well at night

He looks smaller at chorus
this season
this is normal in emphysema
the body sheds weight
too much tissue to oxygenate
too hard for the lungs
and the heart, working overtime
to make up the difference
he is blessed with low blood pressure
genetic, from his father,
tough English stock,
otherwise I think he’d be dead

I didn’t call
before we went sailing
because I am afraid

I’ve driven out before
when he has not answered the phone
for a day or two
wondering if I would find him dead

I didn’t call
before we went sailing
because he was not at chorus on Monday
because if he didn’t answer today
I would not go

 
I took the photograph in 2009