Brave Woman

Adventures of a future nurse-midwife


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Mystery In My Pocket

Posted by Lucille on October 18, 2015 at 11:25 PM Comments comments (0)

I have a mystery in my pocket. A slip of paper with a single name.

I'm on my way back to campus at 8 o'clock at night to prep for the next day, so that I will be able to anticipate my patient's needs less than 12 hours from now.

Everyone I've talked to says they remember their first patient.

As soon as I sit down at that computer, my first patient will stop being a mystery. I'll start taking in a story that will be part of me forever.

I walk slowly, admiring the street lights, my hand clasped around the slip of paper. I dally so that I can sit with the mystery just a few minutes more.

First Day Freakout

Posted by Lucille on October 10, 2015 at 2:00 AM Comments comments (0)

I started at my clinical placement for this term, on an abdominal transplant floor (though they have other patients, as well). I woke up at five and raced the sunrise up the hill.

Because it was the first day, instead of doing patient care I was assigned to a nurse to shadow. It was a good way to get oriented to the flow of the unit and get an idea of the sorts of cases we are likely to see. The nurse I was shadowing had a really high patient load, so mostly I sprinted after her and tried to absorb as much as I could without getting in the way.

I had my learning cap on.

Later, the delayed emotional reaction kicked in.

I got home, warned Travis not to touch me, went straight to the bathroom and started taking off my scrubs and dropping them directly into the laundry bin.

"So?" Travis said, "How was your first day?"

I took a deep breath. "It was a good learning experience and it's going to be a great term but I'm having a First Day Freakout. Capitalized. I think it's to be expected, and it will pass pretty soon, but right now I would really love to just say everything that's going through my head even if some of it sounds crazy. Is that okay?"

He gave me a loving, exasperated smile, said, "Of course," and listened.

"There were sick people, Travis," I said as I started the shower.


"At the hospital. There were sick people."

"Well, yes."

"See?" I said, "I know! I knew that! But I didn't really get it. For as much as we talked about what to expect in clinical, I didn't really get that I was going to be taking care of actual sick people in actual pain with actual diseases. And some of the diseases are infectious! My first hour on the unit, I'd already gone into rooms with MRSA and C.diff. The plastic gown, gloves, and mask we have to wear seemed like a fun costume in class, but all of a sudden those little pieces of plastic were all that stood between me and some seriously scary microbes. I wasn't as scared about myself, necessarily, because I know I'm about as healthy as I'll ever be, but what about Pollux? We have a kitty that needs massive amounts of prednisone to keep his face from falling off! What if I give him MRSA? Or something else? I know I sound crazy right now but I really want someone to promise me that our cats aren't going to die the first time I forget to scrub under my watch!"

He tried to hug me through the shower curtain, which was cold but made me laugh. Then he thought for a moment while I rubbed a soapy nail brush all over my arms and hands.

"Lucille, you're on an abdominal transplant floor."

"I know!" I said, sticking my head around the shower curtain, "What are they thinking?! They have nurses running back and forth between patients on contact precautions and patients who are being medically immunosuppressed. Who came up with this? More importantly, who thought this could possibly be a good idea?!"

"What I meant," he said, "Is that if those 'little pieces of plastic' you're talking about didn't work, people would die left and right and the whole hospital would be shut down. That's not ordinary plastic, Lucille. The holes in it are so small that not even viruses can get through. Viruses. Remember how small viruses are?"

Oh. Right.

I stayed in the shower until I felt really, really clean, hugged Travis and the kitties, and then snuggled in with homework so I can be ready to be back on the floor next week.

I think having a First Day Freakout is a good thing. This is really serious stuff I'm doing. Yes, it will probably seem routine at some point, but I think it's important (especially now when I'm building safety habits that I'll need to rely on for the rest of my career) to realize just how crucial those safety steps are. The soap, hand sanitizer, gown, gloves, mask, etc., are not just there for procedure. They are my tools for keeping me, my family, and my patients safe.

Job Shadow

Posted by Lucille on October 9, 2015 at 1:00 PM Comments comments (0)

There was a student last year who did what I am trying to do (applied to the midwifery program while in the AccBacc program) and got in. I got in touch with her and one of the things she suggested was trying to set up a job shadow.

That turned out to be a lot harder than expected. Most places turned me down because of liability, or sent me through a bureaucratic runaround that led to dead-ends.

I cold-called midwifery practices. I called hospitals I'd been to as a doula and mentioned the specific midwives I'd worked with. I reached out to nurses I knew and asked them to pass my number along to any midwives at their hospitals.

It was exhausting and scary to keep reaching out again and again and again, but finally, I heard back, from a wonderful midwife who remembered how much her mentors had meant to her as a student and had resolved to always try to be that person for the next generation.

It was such an amazing experience. I was bright-eyed, bushy-tailed, and about as green as they come, but all the midwives seemed really excited to have me there. They wanted me to get to see as many things as possible, so they passed me around to whoever had the most going on, and always took the time to answer my (many) questions even though I'm pretty sure it put them behind. I was blown away by how invested everyone seemed in my experience and learning that I started considering ways I could someday have this mentorship role myself, and help welcome others into this work behind me. I'm not sure teaching in a classroom would be quite for me, but there's always a need for preceptors!

I was especially excited to shadow in clinic, because this was the side of a nurse-midwife's job that I hadn't been able to see as a doula. A part of me was nervous. What if working in the clinic didn't grab me the way that birth did?

I need not have worried. It was amazing. Every appointment was so different, and yet each time, the midwives met the family exactly where they were at, connected with them, and walked with them into the next step of whatever was happening. There was a tugging in my chest when I left, the kind that says, "This. Yes. I want to do this."

At the hospital, I got to observe a few postpartum discharges. I'd never seen a labor and delivery floor that wasn't busy, so it surprised me that there was no one in labor on any of the days I was there. Thanks to me having the guts to be more assertive than I'm usually comfortable with, and the generous advocacy of the midwives I'd been working with, I got my shadow extended and transferred to a different midwife so that I could observe a scheduled cesarean the next day. This would be my first surgery and 20th birth. I was so nervous/excited the night before that I could barely sleep.

There was confusion about when I should arrive vs. what time the surgery was scheduled to start, so I got there after baby was out, but I got to watch the repair. Later the midwives helped me transfer my shadow to an OB so I could observe a high risk cesarean (though I can't share specifics because: HIPAA). It was absolutely amazing watching a whole team of healthcare providers join in a careful dance to get everyone through the procedure safely. It was also strange to be a part of someone's birth without ever learning their name.

So far my break has not been remotely restful, but it has definitely been restorative, in the sense of reminding me why I'm working so hard to go into this work. I have one more week of break before the start of fall term, and no plans except to rest, recoup, and spend some quality time with my family and Travis, before the nursing school train takes off again!

Old People Are Outstanding

Posted by Lucille on October 2, 2015 at 12:45 PM Comments comments (0)

One of our assignments this term is a group poster project on a health promotion topic, to be presented to members at a local community for older adults. My topic was healthy intimacy. Of course it was, right? At first I was a bit dubious about handing out condoms, lube, and dental dams to senior citizens, but it turned out to be one of the best community outreach experiences I've ever had. There is something about standing by a poster on STIs and consent that invites people to share their most sincere stories with you, in a way that a poster on vision changes or insomnia just doesn't.

And share they did. People came right up to us, glanced at the poster, and then offered us their stories: how thrilled they are to see the progress in acceptance of LGBT relationships over their lifetime, how it makes them proud that people now talk openly about consent and abuse, how privileged they feel to be sharing these last years with their partners, how they grieve for their partners, how they find joy in seeing the loving partnerships of their neighbors, how they found love here in the later chapters of their life. I confronted some of my own preconceptions when an adorable little old lady came up. I wanted to give her a hug. She immediately reminded me of my grandmother, and I related to her as I related to my grandmother: not so much as a whole person but as a trusted caregiver, who I imagined liked knitting and baking cookies. Within a few moments of conversation, I had to scrap these preconceived images completely as she told us about her career (changed for privacy, but the concept still applies) as an advocate for victims of domestic violence. Part of our presentation was on normalizing that older adults are often sexually active. More people took condoms and lube than we expected, and once we explained what they were, the dental dams were a huge hit!

Every single person that I met blew me away with their stories, their love, and their authenticity. I think I set a record for the number of new life goals adopted in just a few hours. For the first time in my life, I considered the possibility of emulating many birth workers by transitioning to working with older adults at some later point in my career. Perhaps. For now I'll stick with planning to be an outstanding little old lady when I get there.

Do No Harm

Posted by Lucille on September 13, 2015 at 5:50 PM Comments comments (4)

Learning about rare but serious side effects shook me up a bit. For some reason, our unit on preventing medical errors (did you know nurses kill 90000 people in the US a year?) didn't scare me as much, perhaps because of the illusion of control. But it was hard to learn about the many serious, adverse reactions to medications that can be almost impossible to predict. The knowledge that I could be absolutely perfect, and despite my best efforts the care I provided would still sometimes hurt people, was both comforting and terrifying.

Looking back, I probably should have anticipated that starting nursing school would trigger memories from Berkeley. The emotions came back with steaming intensity.

I still feel a a hot twist of anger in my stomach when I think about the many well-intentioned clinicians in the urgent care center who looked at my chart, saw that it said I had something viral, and then sent me back home saying there was nothing they could do.  I still feel a gratitude that borders on irrational when I think of the doctor in Portland who looked at my throat first and said, "This is bacterial."

I take partial responsibility for the communication failure between me and the Berkeley clinicians. There was information that didn't get relayed, and this was a shared responsibility. They didn't ask and I didn't tell. I was exhausted and talking was agony. I could have asked for pen and paper, but I didn't. And they didn't offer.

They asked me how many ibuprofen I was taking. They said it was okay for me to take more, and took this to mean that I didn't need to talk about other pain management options. They didn't ask me why I wasn't taking more already. I could have told them that I was sleeping 18 hours at a time, so anything I took had worn off by the time I woke up. I couldn't take more on an empty stomach and I couldn't eat without taking more. So I didn't eat. I could have told them, but I didn't, because it hurt so much. They didn't ask.

Until the doctor in Portland. She was going through a list of questions as prompted by the computer to check for complications. Any pain in my abdomen? Any changes in my vision? She kept having to turn back and forth between me and the computer to see if I was nodding or shaking my head, because I refused to speak. And then she stopped what she was doing, looked at me with concern, and went off script. "Can you eat?"

I shook my head and started crying, and then stopped quickly because that made it hard to breathe. I felt such an intense rush of gratitude. I wanted to hug her. I would have married her then and there. By the time she handed me liquid lidocane and a paintbrush so that I could eat pain-free without forcing down enough food to take pills first, I would have sold her my soul in a heartbeat if she'd asked.

The emotions of that experience have not dulled one bit. But I found that now, I was looking at the experience through a different lens. I was not just remembering myself as the patient. I was imagining myself as the clinician, looking for things that went well, looking for things that needed to change.

And the emotions came through that new lens as well.

I was suddenly acutely afraid of being the Berkeley clinician, of being the one who missed something, who failed to ask the right questions, whose good intentions couldn't stop the situation from progressing to the level of an emergency. I wanted, fiercely, to be the Portland doctor, the one who knew what questions to ask, caught what others had missed, and, ultimately, saved my life, or at least spared me a great deal of potential further suffering.

I pondered this intertwined fear and craving. There are things I can incorporate into my practice, certainly. I can offer pen and paper to patients with sore throats. I can strive to listen to each patient, view them as whole people, and question diagnoses that no longer seem to fit, no matter how rushed or stressed I am. But realistically, I know that won't cover everything.

I will miss things. I will ask the wrong questions. I will be remembered poorly by some patients, and mostly I will probably never know why or what I can change. And sometimes, I will go off script and get things exactly right. I'll see something others missed. I'll question something that needs questioning, or advocate for someone who needs advocating, and I'll be the bridge that gets someone needed care.

"Who will I be, the Berkeley or Portland clinician?" is a false dichotomy.

I will be both.

I have been asking our faculty about their experiences. These are expert nurses I admire greatly. Every single one has a story of a patient they failed, and suspects that they failed many more but never knew it. Every single one of them has stories, many, of being the one to see the missing piece of the puzzle and move a patient from the road to disaster to the road to recovery. Every single one of them has been both.

There are more and less competent clinicians, certainly. I will always strive to show up fully for every single patient I meet. And yet, every clinician, no matter how well-intentioned or hard-working, has strengths and weaknesses.

For the first time, I considered that the Berkeley clinicians probably have patients who remember them with the same gratitude and admiration I remember the Portland doctor. And the Portland doctor, my savior I would have married if she'd only asked, probably has patients who remember her as the one who let them down. Their ratios of satisfied and unsatisfied patients may differ, I can't know. The point is, at some point or another, every clinician is both.

I will be both.

I had tried, before, to rationalize the way the Berkeley clinicians had failed me. I knew they had nothing but good intentions. I knew they worked in a system that gave them too little time with too many patients and too few breaks. But this was the first time I remembered them with true empathy. For the first time, the knot of anger in my stomach softened.

I remember how part of my fear was that I would let patients down and never know what I could change to keep it from happening again. I would truly and honestly want to know. So just now, I looked up the website of the Berkeley student health center and found a link where you can leave feedback. I don't know why it never occurred to me to do this before. Probably for the same reason it never occurred to me to ask for pen and paper.

I'm going to write the Berkeley clinicians a letter and imagine I am a patient writing to my future self, the practicing nurse (or midwife). I will include as much compassion and as many concrete suggestions as I can muster. And I will hope that someday, the patients I let down will find the same compassion and courage, even if it's years down the road, to contact me and let me know how I can do better. That way the next time a similar patient comes in, I will know the right questions to ask.

I Am Here

Posted by Lucille on September 13, 2015 at 2:55 AM Comments comments (0)

I got swept up in nursing school so fast that I'm writing this post-finals week. What a term! I don't even know how to sum it up. The first week, the faculty devoted an entire class session to talking about the shift we could expect in starting the program. "Getting into this program is competitive. We know, because you are here, that everyone of you is capable of finding that competitive edge, pushing through the extra mile, committing yourself to academic excellence above all else. We applaud you for that. But the time for competition is over. We implore you to take that competitive edge that helped get you here, sit with it for a moment, and, gently, set it down. YOU ARE HERE. You are worthy of being here. You were personally selected for this program, and what this means is that we expect every single one of you to finish it. You will have to work hard, absolutely-- but so long as you are applying yourself, if there is something you don't understand or need more help to master, we will work with you to make sure you get there. You are all in this together. Count on each other. All of us are here with the goal of helping every single one of you become the best nurse you can be. I spoke earlier of committing yourself to academic excellence. Lay that aside. From now on, the only person you need to be better than is the person you were yesterday. I would say that the goal now is to commit yourself to learning-- but there are so many different kinds of learning (academic, kinesthetic, personal, social, spiritual...) you will experience in this program that even that is inaccurate. Commit yourself to the existential journey that is nursing school."

I listened to all of this thinking, "Yes. Yes. YES. This is exactly what I have been looking for. I am so ready."

Over the first weeks, I learned new names and new things every single day. We regularly came back to the subject of self care, as the faculty wanted to encourage us to build self care into our new routines from the beginning. I was on cloud nine.

About halfway through the term, the honeymoon phase ebbed. We covered medication errors, opioid overdoses, and adolescent suicide all in one week and I had a chance to put my self care practices to the test. Travis buried me in a pile of all the blankets, pillows, and stuffed animals we own. I feel loved.

All term long, I pushed myself to extrovert as much as I comfortably could. It was quite a jump, going from working alone by myself for ten hours a day to being surrounded by 25 other people most of the time. It helped that every single person I met was outstanding. There is something really magical about being surrounded by people who are passionate about the same things you are. Instead of feeling split between the people who care about science and the people who care about social justice, as I had in college, I was surrounded by other people who emphatically cared about both. I could talk about complex experiences like Gambia and SARC, and even though I am still learning how to articulate those journeys, I had the immediate sense that the people around me understood what I am still learning how to put into words. I felt home.

I was so excited to meet these incredible people that my joy sometimes took the form of impatience. Can't we just skip the awkward getting-to-know-you phase and be lifelong besties already?! Hasn't happened yet, but I'm going to try to do what our teachers repeat at least once every single day and 'trust the process'.

At first I had the strangest sense that almost everyone I met was in the midwifery program. I knew it should be about 1/5 of us, but when I started asking people about their long term goals, it seemed like everyone I had most connected with in the first few weeks was on the road to being a midwife. With the exception of a couple outstanding people destined for other fields, the midwifery crowd were the people I felt most organically drawn to, and I took this as one more piece of evidence that, despite not getting in the first time, I am right about where I am meant to be.

Talking about how I will be reapplying to the midwifery program was the only time I felt my competitive edge surface. I would feel that primal need to defend my own worth. I would start talking about my past experiences as though I were narrating a resume, instead of talking from the heart. Frankly, it felt icky. (I think it made the midwifery students feel icky, too, to hear me talk about desperately wanting something they had.)

So I sat with that and pondered it. I knew well enough that the ickyness came from insecurity. I'm pretty sure I'm the youngest person in our class, and I worried at times that this would keep me from truly belonging. I spent a lot of time alone last year (and all through college). Learning how to make friends as an adult, and without being mama hen, is new. I got awkward or competitive or put my foot in my mouth with some regularity. And yet day after day, my new classmates welcomed me back, waved me over to sit with them. The "will they like me?" voice in my head calmed, and I started remembering to help make other people feel welcome, too. Sometimes they got awkward or put their feet in their mouths, and when they did I wanted to hug them. When I talked about wanting to be a midwife, it was with passion and longing, but without the same desperation as before. People started opening up about their own journeys to midwifery school. Some people had to reapply. Some were waitlisted at first. Some had gotten in here, but been rejected from other schools. We connected over this passion for reproductive health and how scary it is to have to prove yourself worthy of following your calling.

I remembered something I wrote in my first letter to myself, "You will dream of being part of a community of midwives, blending science and advocacy in every aspect of your work." I may not carry the title 'student midwife', but I am here. I am part of a community of students, nurses, and midwives, and the work I do every single day is turning me into the person I want to be and bringing me toward the work I want to do. I have not 'arrived' because there is no point of arrival. But I'm on the path I want to be on, whether I get into the midwifery program sooner or later. I am here.

Shortly before finals week, as I was practicing with my pharmacology flash cards (with help from the cats), I made a remark to Travis about what a tremendous amount of work this program is. He said, "I trust you on that, but I have to be honest that I feel a little confused on that front. Except for maybe right now, right before finals, you've been so much less stressed than last year. You have energy, you wake up smiling... Don't get me wrong, I love seeing you this way. I just heard so much about how rigorous this program is that I braced myself for you being really stressed and I feel like that hasn't happened."

We reflected on it together and explored how, despite the dominant narrative that equates amount of work with amount of stress, the two don't necessarily have to have anything to do with each other. I am working way harder than I was last year, in terms of academic productivity. But I am not having to work to fit a routine that is wrong for me. I am not working in isolation. I am not working under the paralyzing fear that if I am not enough, I will be turned loose after college and not find my way to a meaningful career that is right for me. I am working way harder than last year, but my work FITS. It fits me, my strengths, my goals. It is stressful. I think every beautiful human being on this planet is struggling for something, all the time. There's no such thing as stress level zero. But this is my kind of stress.

I identify as a spiritual atheist, but I've been stumped for some time about how I define that. In nursing, spirituality is defined as having to do with your place in the universe. This definition suits me. I am working really, really hard. But I feel like I'm right where I need to be.


Posted by Lucille on September 13, 2015 at 2:50 AM Comments comments (0)

In the week between graduating from college and me starting nursing school, Travis and I took a road trip with his family to Utah to see Bryce and Zion National Parks. It was hot, wild, and beautiful. My favorite parts were riding in the back of the RV, communing with a wild raven, hiking the Narrows (where a river that runs through a small canyon IS the trail, and is probably the only place with shade in the entire park!), trying rabbit and rattlesnake sausage, and pulling over at midnight in the middle of Nowhere, Utah to gape at the stars.

Graduation Party

Posted by Lucille on August 12, 2015 at 5:05 PM Comments comments (0)

It occurred to me, in the last leg of writing my thesis when I really, REALLY needed a distraction, that it was about time I throw a party. I don't think we'd thrown a party as a family for at least five years. And suddenly I REALLY wanted to. I wanted a way to mark this life transition besides making my parents sit through hours of speeches in a stadium full of strangers just to see my 60 seconds on stage. I wanted to celebrate with the people that mattered.

So I got the okay from my parents and started inviting people. I figured most people probably wouldn't be able to come, so I invited a lot. And then most people came. It was packed. Loved ones drove in from three different states to celebrate with us. Travis's people got to meet my people. My school friends got to meet my family friends. We had an impromptu dance party with our neighbors. Pascal made little foam graduation caps and put them on all the plastic pink flamingoes in the yard. I moved around trying to make sure I talked with everyone. At the end of the party, Dad surprised Travis, Pascal, and I with Hogwarts robes. My cheeks hurt from smiling. It was absolutely magical.

In all the logistics of graduating, throwing a party, and leaving for California with Travis's family all in a few short days, it took a while for things to settle down enough for me to really reflect on the party. When I did, I started crying the best tears. Having our people all in one place at this turning point in our lives was so special.

In the chaos of cleanup and packing, all the cards people gave us got scrambled around, so I wasn't able to write thank you notes. I'm filing that lesson away for next time. But if you were there and are reading this, I am sincerely grateful. And if you weren't there and are reading this, thank you for celebrating with us here if not in person.

Thank you for being our people.

See, now I'm crying again. I should buy stock in tissues.

Coming of Age

Posted by Lucille on July 20, 2015 at 9:55 PM Comments comments (0)

My mom re-read my first letter to myself, linked from my last post. The next time I came over, she scooped me into a tight hug. "Oh, if I had only known...if I had any idea, I wouldn't have waited, I would have moved heaven and earth to get you out of there..."

It was one of those amazing hugs that only your mom can give, but I pulled away because I had to interrupt her.

"Mom. No. Absolutely not. I love you so much and I can only imagine how hard it must have been to have me be sick and far away, and to wait until I asked you to help me. But I am so, so glad you did."

I ended up having to pull up my post and read a quote from it to her.

"For some people, their coming-of-age experience is one of self-discovery. For you, it is learning when to call for help. And just now, here on the side of the road, you have done it."

"That was my moment, Mom. In the whole fiasco that was Berkeley, that is the moment I am most proud of. It didn't feel that way at the time, but that was my VICTORY. That was my coming of age moment. I'm so glad that you waited even though you knew I needed help. I hadn't figured it out yet. And because you waited, I got to figure it out for myself. I was caught up in this whole idea of who I was supposed to be, and instead of just having that taken away, I got to sit with it and make a conscious choice to set it down. I was trying to be independent, and I ultimately had to conclude that was unrealistic and unhealthy-- but I had AGENCY in my choice to step away from that. Instead of just needing help, I learned to ask for it. I really wish I hadn't needed to be so sick before I learned that lesson, but I'm glad I got to learn it for myself. I know that was probably one of the hardest things I ever asked of you. Thank you for waiting until I asked to come home. I'm glad you did."

That really wasn't what mom was expecting. After a while she said she could understand it intellectually, but that emotionally, even knowing everything I'd just said, all she wanted to do was fly down to go get me and hold me and make me well. And if I try to imagine my baby being sick and far away, I'm in the same boat. My babies are going to be lucky if I ever let them out of my sight. 

Did you know my parents let me go to Africa? Just weeks after graduating from high school? I mean seriously. My parents are some of the most courageous people I know.

Another Letter to Lucille

Posted by Lucille on July 10, 2015 at 2:35 AM Comments comments (1)

A year ago, I wrote a letter to my younger self at the time I was most afraid. (Which you can find here.) Today, I want to write a letter to the Lucille I was then, one year ago.

Hi, love.

I am writing again, just like I promised, with your own glimpse through the fog. You are on the edge of a really exciting year. You are jumping into a lot of brand new things, you brave girl, and you will learn so much.

Here is your spoiler. You will spend a LOT of time this next year feeling anxious.

And now I have another spoiler for you: that is okay. You are okay. There is nothing wrong with you.

The last time you leapt into a brand new adventure that was outside of your control, you took on a lot more than you thought you'd signed up for. You pushed your mind, heart, and body to their absolute limits. You were sick and scared, and it took a lot of time, love, and healing to get back on solid ground.

Now you are jumping again. I don't care that the adventure you're heading off on this time might objectively sound more mundane. Of COURSE you're scared. There is nothing weird about that. It would be downright weird for you NOT to be scared. All this means is that your mind and body are looking out for you, letting you know that you are taking risks, and reminding you to take care of yourself.

Anxiety is there for a reason. By the end of this year, you two will be old friends. You will go from either acting on anxiety or begging it to shut up, to saying, "Hi, friend. I hear you. Thanks for looking out for me, but I'm pretty sure I've got this right now."

It will take a lot of wisdom and courage to get to that point.

One last spoiler: you are wise and brave, and you've got this.

This year you will write a thesis, apply to grad school, and attend nine births. You are going to learn so much. Man, I'm excited for you. That doesn't mean it will be easy. One of the things you're going to learn is that working from home while being on-call 24/7 is emphatically NOT YOUR THING. That's okay. What a great thing to learn, right? I'm so glad you're learning this now. That lesson will not cancel out all the others, because you know that this is temporary. You can push yourself outside your zone for a year, learn a lot about yourself and the world, and be stronger for it. Learn as much as you can that is useful to you, and leave the rest.

You're going to learn that writing a thesis is not really your thing either. That's okay. You've got this, babe. Take a break to process life-news as you need to. Then come back and get it done.

One thing this year WILL be your thing: BIRTH. Oh man, do you love supporting families through all kinds of different birth experiences. You'll put your foot in your mouth sometimes, but overall, you're going to be great. Trust me. You know your calling. Now, being constantly on-call...that's going to be hard. That is not for you in the long term. But this is not the long term. This is the point in your life where you can actually make it work, and one day you're going to REALLY miss offering that continuity of care, getting to know families ahead of time and then being there through the whole story. It's going to be hard AND awesome. Soak in every drop of it while you can, and remember to nurture yourself as much as others.

Working from home will take a toll on your body. To the pound, you're going to gain as much weight as you lost last time. (And I'm a turtle if you think that's coincidence.) Here's the thing, though. Your body talks to you in lots of ways, and you're the only one that knows where your priorities need to be. If your body says that you need to spend that hour every week with a therapist instead of at the gym, listen. If your body tells you that right now buying bigger clothes will be a healthier choice than adding one more stress to your plate, listen. Do what you need to do. Keep tending the balance, knowing that this particular balance is temporary and that soon enough it will change again.

This next year, you will have a lot of big projects due nine months out, with no daily structure and no feedback along the way. That's going to be hard. You are used to accomplishing things and getting regular guidance. You're going to feel lost, chronically behind, maybe even ashamed. I know I can't actually give you this spoiler, but I want you to know anyway. You are going to get EVERYTHING done. Every single thing. Your thesis, grduating college, certifying as a doula, finishing your work at SARC, figuring out a plan for next year... It will all happen. You will spend so much time worrying that you haven't finished yet that by the time you finish it will feel less like a celebration and more like a contented sigh at the end of a nine-month long day. But you will do it. I'm cheering you on.

I know that you feel isolated right now. That's not going to get better quite yet, but you will get better at reaching out. I know it's scary. Keep practicing. Extroverting is hard, but it will keep getting easier.

Isolation, uncertainty, and anxiety will all challenge you this year. You are up for the challenge. And a year from now, you will look back and laugh at life's serendipity, marveling at how the lessons you learned this year may turn out to be EXACTLY what you needed for your next adventure.

The last time you were in an accelerated program, it ended badly. You were on fire: you accomplished more than you ever thought was possible, but in the end you were seriously burnt out and alone. You want nursing school to be different. I think the work you do this year will be exactly what you need to ensure that. You will start nursing school ready for a busy routine, ready to lay aside competitiveness and build strong connections with others, and knowing a lot more about how to take care of yourself than you ever have before.

I can't tell you how this part ends. I bet it's going to be awesome. And I promise to write you again with all the juicy details when I find out.

What I can tell you is that I'm really, really grateful for all the hard work you did this year. You rose to the challenge, pushed yourself while taking care of yourself, and changed more than you thought you could. Thank you. I don't know how nursing school is going to go, but I feel more ready to get what I want to out of this experience than I ever imagined. If I could give you a giant hug right now, I would. This year is going to be hard, wild, and worth it. It's okay to be scared. Thank you for taking it on.

One last time: you've got this.





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HIPAA Disclaimer

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.