Brave Woman

Adventures of a future nurse-midwife

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Sexuality and Birth

Posted by Lucille on October 3, 2011 at 3:15 AM Comments comments (0)

Here's something I encountered in Africa that I didn't write on the blog, or reflect on much while I was there, I think just because there was so much else going on. A lot of the women would touch themselves during birth. For background information I think it's important to note that birth is inherently sexual. There are so many physical systems that connect them: breast stimulation releases oxytocin, which stimulates uterine contractions, semen contains prostaglandins that soften and open the uterus, and arousal releases endorphins that make you feel relaxed and block your perception of pain. Plus, creating an intimate and loving environment will do a lot for assuaging fear and making the experience enjoyable (thus minimizing complications and medical interventions). Masturbation has its role, too: as one mother in Ina May's book described, "The baby was ready to be born, and I massaged my gates of life instinctively to help them open." Ina May tells mothers, "It's that loving, smoochy vibe that put that baby in there, and it's that loving smoochy vibe that will help her out." A lot of birth attendants, including both midwives and OB/GYNs, are starting to promote the sexuality of birth, and offering to leave couples alone for a while so they can enjoy the birth together.

Personally, I like this approach, but I acknowledge that open celebration of the sexuality of birth is not for everyone. However, when a woman is giving birth on a table with no medical assistance, I think she's got a right to as many endorphins as she can get.

I noticed that there was a pattern related to genital mutilation. The women whose clitorises had been removed seemed much more comfortable touching themselves in public, whereas the women that hadn't been subjected to that procedure seemed to experience a lot more shame: they would glance around frequently, and stop immediately if they felt someone might be watching them. I can only assume that this is the result of cultural messaging that genital mutilation makes a woman clean, and separates pleasure from the 'dirtiness' of sexuality, whereas the women with clitorises had no illusion that their pleasure wasn't sexual, and thus in their culture, shameful.

At one point I was cleaning in the birth room while a woman labored on a table at the other end of the room. She was clearly having some significant labor pain, and then started massaging herself, and within a few minutes relaxed, and closed her eyes, and rolled easily through the next contraction. I turned back around as though I hadn't seen and went about my business. A few minutes later, a midwife came in, saw what the woman was doing, and immediately started yelling. I couldn't understand what she said, but she lit into her, and the woman immediately sat up and curled defensively against the wall until the midwife left. She tensed and moaned a little through another contraction, then looked up at me almost shyly, to see what I would do. I nodded to her and smiled, and left to give her privacy. She smiled gratefully and resumed her former position as I rounded the corner. Over the rest of the day, we developed a non-verbal system. Any time the midwife headed into the labor room, I got up and entered just before her, giving the women time to change into more ‘acceptable’ positions.

I expected to form random connections with people I encountered, but I never imagined I'd connect with someone for giving her privacy to masturbate during labor. But then, that was sort of the point: to have experiences I never could have imagined.

Wealth and Cultures

Posted by Lucille on October 2, 2011 at 3:45 PM Comments comments (0)

The down time I had this week gave me some time to reflect on my trip to Africa and the process of reintegrating here. One of the most common responses from people who travel in third world countries is a sense of guilt over the resources we have. I really haven't experienced that. I think a large part of it is the paradox of how the resources are used: we have so much, but we value using it sparingly, whereas they have so little and value using all of it.

       We hear a lot of statistics about how many children starve every day. The thing is, birth and death rates have to be in balance. You can have a high birth rate and a high death rate, or, a low birth rate (which usually requires reliable access to family planning). It doesn't work when people in developed countries decide to mail developing countries extra food without putting equal emphasis on reproductive health to try to sustain a lack of balance. It can't result in anything but a crash (and it's sustaining an unhealthy food system in the US through subsidies). From what I can tell, the white flour, white rice, oil, and sugar shipped in by the UN and WHO has mostly led to a baby boom and an epidemic of diabetes, moving people away from their culture and natural diet, furthering hegemony, and competing with native farmers. It may be naive optimism, but I tend to think that if people are left without interference, over time their culture will adapt to whatever works best for them. I have more resources here than they will ever have, and I enjoy using them responsibly. I don't think there's any reason to feel guilty about that.

       This isn't to say that I'm against globalization or think that industrialized and non-industrialized countries should remain inherently separate. I chose to travel to Africa, I loved it, and without a doubt I'm planning on doing it again (just not anytime soon). But I think I had a sense that I was leaning toward this view because I chose a program that didn't involve handouts. It should be possible to facilitate relationships between countries that are built on exchanges of ideas, not material. I guess you could say I'm in favor of the globalization of information and the localization of resources. From an economic perspective, localization does a lot toward minimizing the tragedy of the commons. In any case, I don't feel guilty about coming from this culture. I feel empowered every time I learn how to live in a new culture, and I enjoy finding ways to bring aspects from them into my own life. What I want to bring into my life from Gambia is their emphasis on community, their skill in living with less, and their wisdom in recognizing the continuity of life.

It Turns Out

Posted by Lucille on October 2, 2011 at 12:15 PM Comments comments (0)

I had a staph infection.

       Because my mom is a microbiologist, I actually got to go into the lab and look at my plates. The staph made these big white blotches. It was pretty cool. The especially cool thing was that I got one of the few strains of staph that is sensitive to penicillin, so the penicillin worked its magic, and by the end of the week I was better. I watched in the mirror in my parents' room as the pus went away and my tonsils gradually return to twice their normal size.

       Getting better so fast really emphasized the contrast for me. I was SICK. I can't believe I was so stubborn about coming home. It also left me with some anger for the doctors that failed to help me, and an irrational affection for the doctor that finally got me the medicine I needed. One thing I wasn't prepared for, and I don't know how much of this was from being sick by myself for three weeks or leftover from Africa, but I was emotionally needy. This struck me when my mom got up and went in the kitchen, and I felt a momentary panic as she stepped out of sight and a strong desire to be held. "Hey, Mom?" I said.

      "Yes, hon?" She stuck her head into the room, her hands full, clearly in the middle of a million things.

       "I feel like a two year old!" I laughed. (I can laugh now, isn't that neat?)

       "Because you're so needy?" she said. Whoops, busted.

       "Yes...I want to be so small you can just pick me up and carry me around with you!"

       She laughed and came back to the couch, and let me curl up in her lap for a little while. I love my mommy. She kept making me crushed ice, which felt amazing on my throat, but had the side effect of making my tongue numb so that I talked like a two year old, too. I felt ridiculous.

       My brother agreed, and decided to eat crushed ice with me in solidarity. The mispronunciations were an endless source of amusement. I hadn't realized how much I missed him. It feels so weird, not having him around, not always having a child in the back of my mind. I wondered idly if that was why I signed up to work in the childcare center, not because it's a fun way to earn money, but out of my own emotional need. Both, probably. And when I finally came home, he was the one taking care of me! He was thrilled to get to 'be the boss of an eighteen year old' and was put in charge of making sure I drank water and stayed on the couch. He practically tackled me when I got up to go to the bathroom. I somewhat regret having so little energy that I didn't get to play with him much. We'll have to fix that over winter break. His school pictures were yesterday, and he decided to surprise me by wearing the necklace I brought him from Africa. I smiled and told him that was sweet, but I'm going to remember that for the rest of my life.

       This week has been pretty low key. I enjoyed watching Untold Stories of the ER and I Didn't Know I Was Pregnant with my mom, Firefly and Harry Potter with my dad, and persuading them to play family uno games with my brother. Mostly I reveled in being surrounded by people who love me and know me better than anyone in the world. Something about that is just good for the soul.

       I even got to see a few of my friends while I was here. It was great to see them, catch up, and hug them and have them be tangible and solidly there. Skype can't replace hugs. It was strange, though, being in Portland with so many people gone. This is completely hypocritical of me, of course--they were here all summer while I was gone--but it was the first time I'd experienced it. Oh well, there's always winter break. And facebook.

       Right now I'm focusing on taking my last doses of penicillin, resting, and eating food. The last time I checked, I was fifteen pounds underweight (by my standards, not theirs). By itself, I don't think going to Africa would have been a problem, but getting mono and then a staph infection so soon afterwards just compounded it. It was so gradual that I might not even have noticed that anything was wrong, but of course my parents noticed the second I got off the plane. I didn't get my period. So, eating food. Lots, and lots, of eating food. Eating anything I want and without pain is fairly pleasurable, so I'm not expecting that to be a problem.

       It might actually have been a good thing I got sick. Maybe not overall, but at least in some ways. I think that, emotionally, I needed more time at home to recoup between Africa and college, and I would have been too proud to come home on my own. So in that sense everything worked out. And you can imagine my surprise yesterday when I realized that I maybesortofalittle miss college. A couple of my new friends even emailed me to check that I was okay. What do you know, college missed me too. I'm flying back tomorrow.

I'm in Portland!

Posted by Lucille on September 27, 2011 at 6:00 PM Comments comments (0)

Three hours later I walked out of security and straight into my Dad's arms.

       One of the huge flaws with the 1-10 pain scale doctors use (despite the fact that, since 10 is defined as 'worst pain imaginable', it completely depends on the patient's imagination) is that it ignores psychology. For example, imagine that a person with a sore throat swallows. It hurts a lot. Fast-forward 400 swallows. The physical level of pain is the same, but emotionally, it's going to be a lot harder to deal with. If we accept, then, that psychology plays a role in pain, it might explain why I'm feeling awesome.

       It is so wonderful to be home. Seeing my parents, sleeping in my own bed, being able to go into the kitchen without running into drunken strangers, and just being somewhere familiar, my home, my stuff, my family, is more wonderful than I can tell you.

       I went to the doctor this morning. She peeked in my mouth and told me my tonsils were huge. Just having it validated, that yes, I'm really sick, felt so nice. Then she got a light and tongue depressant and got down to do the actual exam, looked for two seconds and said, "That's bacterial."

       "But I thought I had mono?"

       "That I can't tell you, it's possible that this is a secondary infection, but it's bacterial. You've got green mucus running down the back of your throat and open sores on your tonsils. Mono doesn't do that. I'm putting you on penicillin." She paused and looked again, then sat back and looked at me with concern. "Have you been able to eat and drink okay?"

      I shook my head. "No. It's really hard."

       "Yeah, I bet. Don't worry, we'll get you something to help with that."

       A half hour after I'd taken my first dose of pain meds, I was working on my computer, and it occurred to me that my throat didn't hurt. I could swallow, and it barely hurt at all, and suddenly I was so hungry I couldn't believe it. Mom made french toast and we ate together, and I ate more in that hour than I'd had in the last day. I feel fabulous.

Pause.

Posted by Lucille on September 27, 2011 at 12:20 PM Comments comments (0)

       Life happens. I'll get back to blood mysteries later.

       I woke up feeling like I couldn't breathe. I could get air- but it was hard, I had to consciously suck it in. I went to urgent care. They told me my tonsils were partially blocking my airway.

       "It's not bad, though," the doctor said, "We have a scale we measure this by, and it's really not that bad. You have more than enough room to breathe."

       I sucked another slow breath in and looked at her, hoping to communicate, "Don't just tell me I can get air so it's okay. It shouldn't be this hard to breathe. I woke up thinking I was suffocating, and it was terrifying, and I need you to tell me there's something we can do."

       "You have a lot of pus and mucus draining down your throat, though. That's probably what's making you feel like you can't breathe."

       "Mmm?" I said, hoping she would understand.

       "Let's see, what can we do about that..."

       Yes!

       "You're pretty dehydrated. That's probably why everything is so thick. You need to drink a lot more fluids."

       My heart sank. "But how cab I dreek more fluids wheb I cat swallow?" I said, wincing because talking hurt. I can actually talk pretty well in the afternoons, but I think the blood not having to work against gravity makes everything more swollen at night, so for the first two hours it's really hard.

       "Why can't you swallow?" she said, looking confused.

       "Becub it hurts!"

       "Oh," she said, making a note on her computer. I could feel tears coming and blinked them back. You looked at it! You just told me that my tonsils are partially blocking my airway and there's pus draining down my throat, and you're surprised that it hurts? "One other thing," she said, "Dairy can sometimes make you more congested, so don't eat any ice cream, cereal with milk, or yogurt."

       My gut clenched in desperation. You just went through the list of everything I've managed to eat in the last three days." Tears came again. Don't cry. Just get what you need. I braced myself for the pain of speaking.

       "I'm underweight, and I'm dehydrated. Since this is a virus, the most important thing I can do is help my body by getting it the food and liquid that it needs. I haven't been able to drink or eat enough because it hurts so much to swallow. Is there anything we can do to fix that?" I could hear my voice getting desperate toward the end, as she watched me silently. "I need to eat," I said again, watching her and hoping she'd understand.

       "Well, have you tried ibuprofen?"

       I started crying. I hadn't cried the whole time I'd been sick, but tears just started silently slipping down my face. She was looking at her computer and didn't see. "Yes," I said, "Yes, I've tried ibuprofen, I'm taking the maximum dose, and it doesn't make a difference, it's still so hard to swallow anything, much less eat..."

       She looked up then, and her eyes widened a little, and for a second you could see the flicker of fear, "Oh god my patient is crying. What am I supposed to do?" And then she covered it, passed me a tissue, and said, "I'll write a recommendation for Aleve in your note. It's technically the same strength, but some people think it works better. You can see what you think and come back in a few days if you're not improving." She handed me the stack of paperwork and opened the door.

       I got a few blocks away and collapsed on the side of the road, struggling to breathe through sobs. It had been three weeks since I first got sick, I was hungry, and exhausted, and every time I swallowed it felt like someone had stabbed me in the throat. Every time I went to the doctor they told me to hang on because it would get better, and every time it got worse. Meanwhile I was missing more and more class and feeling like I was losing my grip on this new world around me. 

And somewhere in the back of my mind I knew it was time to let go. It felt like failing. But I didn't know what else to do.

I called my parents back and told them I wanted to come home.

I guess that's all they were waiting for, because they told me my uncle would pick me up in an hour.

Conference! (For Real This Time)

Posted by Lucille on September 26, 2011 at 8:00 PM Comments comments (0)

 The first presentation I'd wanted to go to was on the Sacred Androgyny, "From the All that is God Hirself, come seeming polarities: Light and Dark, masculine and feminine, heat and cold, hope and fear. World traditions hold sacred the Divine Twins who share the forces of emergence and creation. We have the power to re-unite them, birthing the Holy Androgyny who reconciles all division, and walks between the worlds." Regardless of your spiritual beliefs, I hope you'll agree that this is hugely powerful symbolism.

Unfortunately I missed most of this presentation. When I got there, the presenter had invited some guest speakers, most of whom were intersex, to talk about their experiences and the controversial practice of doing 'gender reassignment surgery' on intersex babies at birth. (They were unanimously against it.) I won't give a full description because I came in in the middle of it, but their main reasons seemed to be that:

1. There's no medical benefit, the practice exists to maintain our culture's dependence on the system of gender binary

2. 20-50% of the time it results in loss of sexual sensation. I guess views on this would differ, but in my mind, conformity is not worth that.

3. They can always do it later if the individual decides that's what they want, but if you choose for them, it can't be undone.

Then they pulled out a twister mat and talked about how masculine and feminine qualities (your feet and hands) should support each other instead of being in conflict. I gathered that this was an analogy they'd been building up through the presentation, but I got a little lost. I don't feel like I can do this presentation justice having just been there for the end. They concluded with the idea that the remembrance of the divine feminine that our culture is experiencing is part of the eventual recognition of the divine androgyny.

The next one I went to was called Blood Mysteries: Women in Tantra. The blood mysteries consist of menstruation and birth, and are inclusive of all females (inclusion of transgender and intersex people varies by group), including crones (post menopausal women, a title of honor), and virgins (premenarchal girls). Maybe it would help to tell you a little about why I decided to go to this presentation. Or maybe not...I can tell this could get pretty philosophical. But hey, I'm stuck in bed and it's not like I'd rather be doing homework. You willing to go along for the ride? Okay, here we go.

Gender: Pagan Alliance Conference

Posted by Lucille on September 25, 2011 at 11:45 AM Comments comments (0)

The 1st Annual Conference on Earth-Based, Nature-Centered, Polytheistic & Indigenous Faiths, is what it's technically called.

       I know, I know. I'm supposed to be staying home and getting better. But I'd already bought my ticket, and it's only once a year, and yeah there'd be one next year but it would have a different theme making this the only time EVER to hear these speakers on these topics...so I went.

       Basically, everything that could go wrong did. I'd left my ID card (which functions as my bus pass) in the pants I wore yesterday, so I dug up the change for a bus ticket, and then asked for a transfer receipt. I guess in California you have to pay extra for a transfer receipt. And you can only use it once: the next time you get on a bus, even if you get off after one stop, they take it from you and you have to buy a new transfer. It turned out my transfer was not actually to another bus, it was to BART (Bay Area Rapid Transit) so I didn't get to use it anyway, and had to go around looking for an ATM and then a restaurant that could give me change. But I made it onto BART.

       Going in the wrong direction. Stop, cross sides, now we're going in the right direction. Running late, but it's okay, we're going the right way now.

       I got off when it was time to transfer to another bus (my transfer had expired). I wasn't feeling like giving the bus driver more money at this point. Besides, I'd looked at the map, and it was only around four blocks in a straight line. I decided to walk. Only, it was actually more than ten blocks, and wasn't in a straight line. I got lost.

       I've learned from experience that, especially when you're in a tourist town like San Francisco, the best people to ask for directions are the homeless. As long as you choose someone that isn't crazy (and do it in public just in case you're wrong and they are crazy), they'll know the city like the back of their hand. I came across this place that looked exactly like Pioneer Square, and there were a bunch of homeless people sitting in a circle on the steps, so I went over to introduce myself and ask for help. They were very friendly. Two of them started debating the best route and another asked me how I got lost, and then the others started commenting.

       "Tut-tut, taking a young woman's bus transfer!"

       "There ain't no grace in this world."

       "No grace!"

       "Amaaa-zing graaaace..."

       And one by one the whole group burst out singing. Everyone stopped what they were doing and joined in. I took the harmony line. A young guy that had been sitting on another part of the steps with his guitar came over and started accompanying it, and then a woman walking by with a violin case stopped and joined in, and a family that was sitting at the bus stop got up and started dancing, until we had around twenty people, and yeah I was late and rather needed to know where I was going, but it was the most freaking amazing thing I'd been a part of in a while and it was worth it. Eventually we ended on a last drawn out chord, and everyone laughed and waved as they headed on their way, and someone remembered that I was still in need of directions and showed me where I needed to go.

       I know, I haven't even gotten to the conference yet, but this is a long post so I'm going to start a new one. Scroll up!

Zzz

Posted by Lucille on September 24, 2011 at 12:05 AM Comments comments (1)

I went to bed at 8:30. My first class starts at noon. I slept through class. (WTF.) And the crazy thing is, I'm still tired!

Follow Up Appt

Posted by Lucille on September 23, 2011 at 10:35 PM Comments comments (0)

I went in for my follow up appointment, and the nurse practitioner was running behind, so I curled up on the patient bed and went to sleep. I woke up when she came in, apologized for being late, and started signing in to the computer. "Okay, let's go over your lab results. No TB, no hepatitis, no HIV...good...and your blood work, high lymph, low hemo, high white count... Oh my god, you must feel like shit!"

       She looked over at me then, as I was slowly sitting up and watching her blearily from the hood of my sweatshirt. I blinked my assent. The lines in her face suddenly relaxed as her maternal instincts kicked in and she came over to me. "Oh, you poor thing!"

       I relaxed too and fully enjoyed being fussed over for a little while. "Dr. Harris said I have mono."

       She tapped something into her computer. "Yes, there it is. The problem is the blood pattern they use to diagnose that can be caused by some other viruses, and you did just get back from Africa...I wonder if I should forward this o the travel clinic...Can I look at your throat really quick?" I opened my mouth, and she winced and said, "Well, I'm believing the mono story now. That can't feel very good."

       She took me into the hallway to weigh me. I actually lost weight since last week. I'm in the states now and eating as much as I please, that is definitely not supposed to happen. Because it kills your appetite and gives you a sore throat, mono's been known to make people drop twenty pounds in one month. I really don't have that much to lose, and since eating when I'm hungry clearly isn't going to cut it when I have a lowered appetite, she had my attention now. "Low weight and a sore throat...Hmm...Okay, here's what I want you to do. I want you to go to the store and get milk and your favorite flavor of ice cream, and make yourself a milkshake whenever you feel like it, okay?"

        Best medical advice I've ever received. She also suggested putting olive oil on my pasta, and it turns out that makes it a lot easier to swallow.

       Going to the store was an ordeal. It's normally a twenty-minute walk, but I don't have a lot of energy right now, and it ended up being a three-hour adventure. I got there and decided to treat myself by buying juice and cereal and other things I normally don't get that looked amazing. In my excitement I forgot to only get as much as I could carry. I was going to bus back, but it turned out the bus was on a detour that completely skipped my section of the route, so I ended up walking. (It's uphill.) Halfway there I stopped to rest and there was a group of freshmen nearby talking about how awesome independence is. "Isn't this great? We can stay up as late as we want and get drunk and nobody cares!" And I kept thinking, no, I miss my home! Parents are wonderful, they buy you ice cream when you're sick, and give you a ride when you miss the bus... I felt pathetic, but there you go. Independence is a lot cooler when you're not sick. I made it back with all my groceries intact and felt cool for proving my self-sufficiency. I think I'll celebrate by making myself a milkshake and going to sleep.

But I Haven't Kissed Anyone, Really!

Posted by Lucille on September 23, 2011 at 10:10 PM Comments comments (0)

In the bathroom this morning it occurred to me that the mirror was at the right angle to the light for me to be able to look at the back of my throat. I thought it'd be cool to see it while it was all red and inflamed and stuff, so I took a look, and was shocked to see it was covered in white blisters. Ow. I used my meager medical skills (and a call home to Mom) to diagnose myself with strep.

       The follow up appointment I never got around to cancelling was the next day, so I thought I'd just wait until then, but over the next few hours (during which I passed the 24 hour mark for cancelling the appointment) my throat got a lot worse and I started wanting to go in right away. But that put me in a double bind financially, because an urgent care appointment is more expensive, and since I'd passed the 24 hour mark, I'd have to pay for both. My wonderful parents (thank you, Dad!) assured me that getting my penicillin 24 hours earlier was worth it and told me to go in, so I dragged myself into the urgent care room, and felt some amount of satisfaction when the nurse took one peek and said, "Yep, that looks like strep." They took a swab test and sent me to the lobby to wait while I tried to contact my work-shift coordinator to let her know I couldn't make dinner tonight. I ended up dictating an email over the phone to my mom. (Love you, Mom.)

       The strep test was negative. They called me in to see the doctor, who was very nice, gave me free cough drops, and asked mostly yes or no questions so I didn't have to talk. He felt my lymph nodes (ow) and said that by process of elimination, they were diagnosing me with mono. :(

       So here's what I know about mono. There's no treatment. It lasts about a month, makes you really, really tired, makes your throat blister and your appetite go away, and makes your liver swell. This means that taking DayQuil was a really, really bad idea and could have caused my liver to rupture (don't worry, I'm using ibuprofen now) and I can't work out for a month, so I guess my doctor gets her wish after all. And I can't be around children, so no going to work. The doctor was really sweet and when I thanked him on my way out he laughed and said, "I just told you you have mono, and you're thanking me? Sweet girls like you shouldn't get sick. Take care of yourself and let me know if you need anything."

       The good news is that the info sheet he gave me said to email all your teachers and let them know because most of them will make arrangements for missed class and late work. (And if they don't, it said to call social services.)

       I missed my French class but made it in time to catch my teacher, and before I even said anything, she said, "You don't look well. Go get some sleep, you can send me an email to tell me what's going on." But I was already there so I went ahead and explained that I have mono, and she was really sympathetic and said that she can make an exception for the missed class and late work policies and that I shouldn't worry about it, just focus on getting better. I'm really relieved. Even if there's no treatment, knowing what I have, and having it be something that other people recognize, is going to make not falling behind a lot easier.


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Sometimes I have the privilege of being a part of intimate, powerful moments in other people’s lives. I cannot and would not share these stories, because they are not mine to tell. However, they touch my life and become part of my own story. When I share these moments here, you can trust that I have not broken anyone’s confidentiality. The characters are invented. They are not real, but could be. I take creative license to communicate the essence of my experience while respecting the privacy of others.