What Can Be Given?

That has been the question of my hiatus. Hello everyone, I apologize for my continued absence, and my non response to both emails and comments. The truth of the matter is that after I passed C&C my physician recommended that I take a medical leave from the program. So here I am. On sabbatical.

I have grown up with an increasing feeling of responsibility to those around me. It was never as much as many, but has dictated much of my adult life. What can I give to those around me? Who can I help? What is expected of me? For me it’s been very all or nothing, which is a philosophy that I’m sure all midwifery students have run into. We’ve all read the article on what must be sacrificed on the atlar of midwifery. The imagery has a martyrdom appeal which is something that has long been tied to women’s professions and selves.

What can be given? This is a question that has stricken close to home at this point, when, due to some pesky problems with my back, I’ve been immobile for almost a week. Standing is painful, sitting is painful, and lying down is the best option because it’s only slightly painful. I am physically prevented from my modus operandi.

The impulse is to run the other way. Skirt the responsibilities. Encourage your own passivity. Give 0%. That’s no good either.

I felt very responsible to this blog, and to those who sent their letters in asking for help, because I remembered that feeling of desperate hope. But it’s been hard for me to work up the mental energy when I have so many other things going on my life that are tired of being pushed onto the back burner. What can be given?

It can be hard to decide how many stories are the ones that need to be told, and told to how wide a circle. What is my responsibility to future students? I had people to lean on every step of the way. I need to be a person for others to lean on. It’s only fair. The stories that other people tell make us feel less alone. Then there’s the question of ego. Why do I think it has to be me, anyway? What do I have to offer? Impostor syndrome. As you can see, the navel gazing goes on in a tangle forever.

Stupid really, I wrote my undergraduate thesis about how silences effect history telling. You never think things apply to you until they kick you in the shins.

The classic midwifery trap is burnout. It’s almost a cliché. B for Balance right? But my honest answer is that I don’t think it’s possible to be balanced in this program.* It’s too demanding. There’s a reason for this, of course. Our responsibility as care givers. The things we give now are on a larger, weightier scale. Someone pointed out to me the other day that there’s a very good reason that not everyone chooses a profession with responsibilities like ours.

Who wouldn’t want to be a midwife? Well almost everyone, you know, statiscally.

I’m planning on returning to school in the fall of 2015, when I will be more able to satisfy the demands of the program. What can be given? Quite a lot, actually. I believe in midwifery. I’ve had the most amazing teachers along the way, of the professor and preceptor and client varieties. It is a profession that I think has tremendous value. I hope that will be understood.

I’m not sure about this blog. I think about it a lot. I’ve been composing this piece in my head for weeks now, honestly. So I probably will write again. But I can’t offer a schedule or an idea of a deadline at this time. I also can’t offer to proofread letters right now. I’m on sabbatical.

I hope you are all well. I am sending you my very warm regards.

*That is not the gospel of midwifery school, only of Maija.

Great things that I am doing on my sabbatical:

READING! Nonstop. Some of the best so far:

A Tale for the Time Being by Ruth Ozeki
The Faraway Nearby by Rebecca Solnit
The Inheritance Triology by N.K. Jemisin
I’ll be Right There By Kyung-sook Shin
The Signature of All Things – Elizabeth Gilbert
What I Loved – Siri Hustvedt
Saga by Brian K. Vaughan and Fiona Staples.

Fairy Tale Logic

“Last night, as I was sleeping,
I dreamt – marvelous error! –
that I had a beehive
here inside my heart.
And the golden bees
were making white combs
and sweet honey

from all my old failures.

– Antonio Machado, translated by Robert Bly

If I am going to be truly honest this needs to be said. Two weeks ago I came extremely close to taking a leave from the program. It was any number of things – I’d had a hard placement, my anxiety was starting to cloud my belief and trust in normal birth, I was worried that I am not yet ready to step into the role of responsibility that is being a primary health care provider. Most of all, I couldn’t be gentle with myself. Every small failing was further proof that I was unworthy. Everything was a disaster. I would spend days home alone, crying. I don’t know where all those tears came. But I was in a deep, dark well and I could not get out.

It is easier to retreat. I don’t doubt that taking time off from the program is sometimes completely necessary for our physical, emotional, or mental health. But I’m not sure taking a break would have been that needed pause for me. I was running away. It hurt too much to keep going, it scared me too much to think about, so I opted out. Which, of course, just compounded the problem. Closing our eyes does not mean that the dragon is no longer out there. It does mean that you won’t be properly able to size that dragon up. The task becomes impossible. Everything became impossible for me. Even checking my school email would have my heart pounding my throat and make me break out into a nervous sweat. I couldn’t take care of myself. How was I supposed to care for others? Every day I would present myself with further proof that I was not good enough. Look at how little I’ve reviewed things before this placement. Look at how terrible many of my clinical skills still are. Look at how often I miss something that is obvious to other people. I wanted to stop midwifery school because it was too hard. It was too painful. I couldn’t think about being a midwife with anything other than fear.

“Some periods of our growth are so confusing that we don’t even recognize that growth is happening. We may feel hostile or angry or weepy and hysterical, or we may feel depressed. It would never occur to us, unless we stumbled on a book or a person who explained to us, that we in fact in the process of change, of actually becoming larger, spiritually, than we were before. Whenever we grow, we tend to feel it, as a young seed must feel the weight and inertia of the earth as it seeks to break out of its shell on its way to becoming a plant. Often the feeling is anything but pleasant. But what is most unpleasant is the not knowing what is happening[…]Those long periods when something inside ourselves seems to be waiting, holding its breath, unsure about what the next step should be, eventually become the periods we wait for, for it is in those periods that we realize that we are being prepared for the next phase of our life and that, in all probability, a new level of the personality is about to be revealed.”

— Alice Walker

I wish I could say that I am now unafraid. That would be a lie. I am still deeply afraid that I am not worthy. I am deeply afraid that I am not up to the task. But I can’t let this fear talk me into becoming small. What would I get from a year off? I’d be further away from the skills I need to practice, I would be further away from a philosophy that trusts in what is normal about birth, I would be further away from my dream of being a midwife. Would that mountain get higher the longer I put it off? And would a year without these challenging situations really result in me being kinder to myself? Or would I just find new ways to disappoint myself? My brain has become very good at pointing out my flaws. Taking time off would maybe just leave more space for that mean, unforgiving, cruel voice within me.

I am still afraid. The mountain still seems awfully steep. I don’t know what reserves I have within me. But at this point I have come to see that not being willing to find out – not being willing to take that risk – will stunt me in a way that will continue to drive my unhappiness. I’m not planning on doing this alone – I reached out to family, to my friends, my classmates, a counsellor. I’m surrounding myself with people who will look after me. But I’m also making it clear to myself that I, and I alone, must walk the path. No video study montages, no one to make the mistakes for me. The poem I’ve left below this paragraph has become a talisman. I have a magic within me that will help me defeat the impossible task of my final year of midwifery school. Somewhere there is a will within me that my fear is keeping me from accessing. The poem recognizes that accessing that will might have high costs, but the rewards are worth it. I have to believe.

“Fairy-tale Logic”

Fairy tales are full of impossible tasks:
Gather the chin hairs of a man-eating goat,
Or cross a sulphuric lake in a leaky boat,
Select the prince from a row of identical masks,
Tiptoe up to a dragon where it basks
And snatch its bone; count dust specks, mote by mote,
Or learn the phone directory by rote.
Always it’s impossible what someone asks—

You have to fight magic with magic. You have to believe
That you have something impossible up your sleeve,
The language of snakes, perhaps, an invisible cloak,
An army of ants at your beck, or a lethal joke,
The will to do whatever must be done:
Marry a monster. Hand over your firstborn son.

–A.E. Stallings

Medwife

A friend of my ex came over for dinner one night during my first year of midwifery school. She was very nice – and interested in midwifery. When I asked her if she had thought about applying for school she told me that she wouldn’t want to go the MEP route because all it did was produce medwives. For those of you who don’t know the slang – a medwife is a derogatory name for a midwife who’s gotten ‘too close’ to the medical system, who no longer practices radical outlaw midwifery, and is part of the technocratic, high intervention system of birth in Canada. Or more simply, a medwife is a midwife who has lost her ‘trust’ in childbirth. Now this was still in my bright-eyed, bushy tailed MEP existence, so I got very defensive, very quickly. Midwives provide safer care when they are well integrated into the health care system, I argued. Didn’t she believe in the space for change within a system? Besides, she had never met some of the radical midwife powerhouses in the MEP, to dismiss them with the word ‘medwife’ was incredibly insulting to them and to their legacy. My feathers were very ruffled.

But I used that word too before I got into the program. I told everyone that I wanted to go to Ryerson because I had heard that they focused more on social justice, and that I had heard that one of the other schools really produced too many ‘medwives’. Spiritual Midwifery was my jam. I look back at myself then and have to roll my eyes a little.  If I am honest with myself, I have some of the characteristics that people would call “med-wifey”. I don’t care that much for homeopathy, though I don’t have any feelings of vitriol towards it either. And I am 100% pro-vaccination, something I can get quite irate about (although never with clients). And although I really do believe and trust in the process of birth, it is clear to me that the ability for midwives to quickly and smoothly intervene in birth is a vital skill.

This is not really an essay about medwives vs. midwives. (But if you do take one thing away from this it should be: STOP SAYING MEDWIFE PLEASE.) But it’s important set up for what I do want to talk about – my experience of third year in the MEP. For those who don’t know, third year is a series of interprofessional placements. My year has been: NICU for two weeks, Lactation Consultant for two weeks, Labour and Delivery Nurse for a month, a research placement, a virtual placement mostly about pharmacotherapy and clinical management, one month with a Family Physician, and one month, my last, on an Obstetrical rotation in a big Toronto hospital. In many ways, third year has been really relaxing. I’ve never been on call. When I’m at home, I’m really at home to stay. Which means if I want to drink a couple of beers with my sister and watch silly movies I can. It means that I don’t live in dread of my phone going off, and that when I’m not doing overnight shifts at the hospital, I’m guaranteed to sleep through the night. I’ve been clinging to my sleep the most, especially because I know that this is the last period in my life besides time off that I am guaranteed it. School itself has sometimes been an annoyance. Forced discussion board talk is not my favourite thing in the world. And some of the assignments we’ve received have felt like a waste of my time. I really don’t like feeling like I’m wasting my time when I still have SO MUCH to learn. But I am settling into my groove, and really starting to feel that I have knowledge that other people can use, which is great. And although I still make lots of fumbling student mistakes, actual health care procedures freak me out less, even the ones I have less competency in.

Placing midwifery students interprofessionallly would probably be considered the height of medwifery. Here I am – following someone who thinks home births are dangerous and that midwives are ‘cowboys’ for wanting to do them. And it’s true that sometimes in an interprofessional placement you are going to hear some unflattering, and sometimes downright nasty, things about midwifery. But I’ve found that most of the people I’ve worked with are incredibly giving with their time, and curious about the things they don’t know about midwives. I’ve had fantastic conversations with OB residents, with NICU nurses, with Lactation Consultants, and with women who I might not ever get to meet doing midwifery care. I’ve been taught how to do things that I might never do again. This ended up actually helping my other clinical skills – simply by demystifying the work of healthcare. There have been some bad moments, but I think on the whole I made a lot of really friendly connections that will hopefully create goodwill towards other midwifery students, and other midwives.

Isolationalism is a form of professional pride that can often work against what we are actually trying to achieve. I’m a firm believer in midwifery care, and I genuinely believe that some of the ways in which we do things are superior to some of the more traditional models of care. But I really don’t believe in letting that cloud my judgement about what people in allied health professions can teach me, and how they can help me. I want my future interprofessional colleagues on my team. I don’t want to be playing against them. That’s not fun, and it does not make care safer.

There is one last thing about interprofessional placements that I’d like to say. It can be intensely stressful to be a student ambassador for midwifery. As a classmate of mine put it “Imagine you are a yoga instructor, and you meet someone who’s only idea of yoga is riddled with misinformation, distrust, and scorn. You’re meeting with them is going to inform how they might think about yoga going forward. You will be their yoga experience.” That’s a lot of pressure, right? There is still a tendency to put the entirety of midwifery on trial based on the actions of one midwife, or the interactions with one student. It can be hard to handle that pressure – especially because we are learners and we will make mistakes. I think midwifery students on the whole are incredibly hard on themselves, and in this context, we are almost invited to be hard on ourselves if we feel like we don’t measure up to the ambassadors we’re supposed to be.

Finally I do have to say – as much as I’m nervous about being a senior student, I am incredibly excited about getting back in midwifery care. I’ve missed it a lot.

I’m in the middle of a second intensive at school but I’m hoping to be back soon with another post. I hope everyone is doing well.

****

In case anyone has been wondering,  I managed to get an Ottawa area placement! It’s a bit of a commute but it’s not moving to Guelph so yay! I obviously made the right move sacrificing those pure white bulls to the trade gods. Also it starts in a week and a half. Gulp. 

Role Models

I’ve been thinking a lot about what to write about my third year placements for everyone. I’ve been working on a post about interprofessional work and how I feel it’s been helpful for me but I also wanted to be honest about what’s been hard for me. I’ve definitely had a couple of really great placements, and a couple of just okay ones. But I’ve been having a hard time lately, and it’s because I’ve been feeling incompetent and inadequate. I preach a lot about being kind and gentle with yourself but I’m less good at practicing it. Nobody is harsher about me than myself. And it’s not healthy. And I’ve been feeling very burnt out because of it.

At one of my placements, I had a first day where I was literally the queen of cockups. I was incompetent in basically every way it is possible to be incompetent – I messed up getting my ID badge, I lived with my foot in my mouth, I didn’t take complete histories, I missed learning opportunities, I didn’t take the initiative, I FAILED TO CUT THINGS WITH SCISSORS, I accidentally de-sterilised myself and had to dress twice for a section, I filled forms out wrong…basically I was a mess. These people have no frame of reference for me. I am the disaster of a midwifery student who was around that day. And I will never be anybody different to them. Some ambassador for midwifery I turn out to be.

I don’t know about you, but I have a really hard time forgiving myself for having an off day. And having on off day on a first day is the worst. It feels like you’ve messed the whole placement up. It feels like dread in the pit of your stomach when you thinking about having to go back and smile and learn and find completely new ways to eff up. It means a bunch of days of feeling like a complete tool.

So what now?

Well, the honest answer is I had no clue how to keep going, other than to cry about it. Crying is cathartic, but it doesn’t get me out of bed in the morning. So I started thinking about a couple of characters that I relate to:  Bridget Jones from Bridget Jones’ Diary and Chummy from Call the Midwife.

bridget-jones-drunk“I mean, you seem to go out of your way to try to make me feel like a complete idiot every time I see you, and you really needn’t bother. I already feel like an idiot most of the time anyway – with or without a fireman’s pole.” (This might be a Bridget Jones quote but it is also, coincidentally, a look inside of my brain).

What did Bridget Jones do on her first day at that silly news network? Become a national laughingstock. In fact, that movie is about how Bridget Jones makes silly, and sometimes terrible decisions, and pays the price for them constantly. And almost everyone around her is mean to her, or they dismiss her, or they take advantage of her.

Chummy

One has so many horrific memories.” (Chummy, also reading my brain)

Chummy is the laughingstock at Nonnatus for a while. She can’t ride a bike, she’s clumsy, she says the wrong thing, she knocks things over. People doubt her ability, and doubt her staying power. She has to work twice as hard to prove herself.

I’ve never been one for Schadenfreude, when embarrassing or awkward things happen to other people I’m all sympathy. Sometimes I get so embarrassed for them that I have to run out of the room. Even though it’s just a fictional embarrassment. One of the reasons I do that is because I see so much of myself in these characters. I make an ass of myself on a daily basis, and it can be completely exhausting. And it can be hard to keep your chin up when you’re trying but both fate and your own mistakes mean that you don’t get there. You end up in a bunny prostitute costume at a garden party. It’s no wonder I want to hide in my apartment all day every day.

But there’s something else I want to channel from those two women. Which is that despite the fact that a lot of people laugh at them, and not that many people take them seriously, they find ways to get up out of bed every day and keep trucking.  They make new mistakes, and find multiple ways to laugh at themselves gently. I love them because despite everything they have dignity as whole human beings and they learn to demand respect from other people. They continuously find ways to keep trying after they make mistakes. Which I find is one of the hardest things to do in the world.  I have an easier time laughing at myself than I do forgiving myself. Which means I only got part of the lesson that these characters are trying to teach me.

Despite everything, despite all of their mistakes, they deserve nice things. They deserve to have people laugh with them with love, and not at them with scorn. They deserve to be happy. And I have to find ways to remind myself that I do too.

And hey, if I could also find a way to make out with Colin Firth too, that would be awesome.  Bridget, hook me up.

Scurvy Lemonade

When life gives you scurvy, make lemonade.*

So. How am I doing after my very public VERY SAD, VERY MAD feels post? I’m doing okay. I’m participating in the trading process in terms of final placement, so we shall see how that goes. I’m very dedicated currently to not getting my hopes up, and instead dealing with this hand fate, or a random number selector, dealt me.

So how does one deal with this kind of crummy news?

1) Have a good cry.

Really allow yourself to feel how much this sucks. Because it does suck – as my friend Megan says “We all might have signed that paper understanding that we’d have to move, but none of us really thinks it’ll happen to us.” Until it does. And it is really, really hard to handle. Cry, beat your pillow, drink a lot of wine, these are all valid feelings options. I also distracted myself – it just so happens that my sister and boyfriend and I had planned an amazing road trip to New York to see Patrick Stewart and Ian Mckellen in No Man’s Land and Waiting for Godot for that weekend. I ate amazing food, hung out with two of my favourite people in the world, and saw Ian Mckellen in the flesh and lemme tell you, JUST as adorable as you might think. Also, chocolate.

2) Don’t compare yourself.

One of the hardest things to hear is that other people have it tougher. Undoubtedly people do. I am so sorry for the classmates of mine who have kids who fell out of the lottery. I can’t even imagine what they are going through. Their shitty sandwich, however, doesn’t invalidate your shitty sandwich. You are allowed to feel sad. Having to pay to move to a city you didn’t want to move to is really hard, no matter what. Don’t let people tell you that “at least you don’t have x”. It may be true but that kind of comparison game doesn’t help anyone handle what happened.

3) The lottery information parade is long.

Be prepared. You’ll have to deal with the second run of the lottery, which takes a while. Be prepared to get your final choice there, too. (Which I did – because, of course.) The trade process also takes a while. You have to live with the uncertainty and unhappiness for a while before you can even begin a new plan for what your life is going to be the next year. The nebulous waiting is one of the hardest things to do. Plan nice things, and go easy on yourself. Understand if school stops being your top priority for a while. That’s totally fine.

4) Reach out.

There have been a bunch of people who have gotten me through these last ten days or so. They let me cry on the phone to them. They let me rant to them on Facebook. They put up with my endless whiny texts. Basically they were amazing, and I probably wouldn’t be as okay as I am without them. People who give you the space to be as sad/mad as you need to be are necessary. There’s no immediate fix for how much this sucks, and so that kind of ongoing support is really, really important.

5) Know that not everyone is going to be helpful.

Some people are not good with big emotions. And that’s okay, but know that it’s possible that some people are going to let you down. It doesn’t mean that they don’t care, or that they’re horrible people. Rely on the people who are the right support for you at this time, and be cool with the people who, for whatever reason, just can’t be there for you right now.

6) Know that you’re going to get through.

This is the hardest one for me. I can know that I’m a self-sufficient person who is going to make it all work. I know that I can handle what’s coming, and I know that I’m going to be so busy I’m not going to have space to be totally miserable. Objectively, I know that a year is peanuts. It can be really hard to find that silver lining right away. Don’t pressure yourself to be okay with the news. But do know that despite the news, you will be okay.

To present people who fell out of the lottery, and to all your future ones, I send many jedi hugs. It sucks. It really, really does.

I’ll see you on the other side.

*Cause who doesn’t enjoy a little pirate and vitamin c deficiency related humour?

That One Thing

So there’s one thing every midwifery student dreads: falling out of the lottery. I was totally prepared for it (maybe) for Normal Childbearing. If I had to move away from my loved ones, four months isn’t so bad. It’s been my own personal nightmare since I started the program that I would fall out of the senior lottery. Which I did. Yay for me. Is this like the reverse of The Secret? You dread something, and your dread manifests itself?

So what does it feel like?

It really fucking sucks. I cried for about 3 hours yesterday. I cried when I woke up this morning. No matter what happens, I have to move away from my support network. All the options that are left are 5 or more hours away from my family, and my boyfriend, who can’t move with me. I have to find a subletter for my apartment in Ottawa, and I have to find the money to move to a new city. Again. The very worst part is the knowledge that the next year is probably going to be one of the hardest years in my life. And I’m going to have to do it alone.

What does it feel like?

I sorta hate the program right now, and don’t feel like doing anything for it. I can’t stand to think about homework. I resent all of the students, anonymous and (I’m sure) lovely, that got the placements in and near Ottawa. It’s really not fair of me but there you go.

What does it feel like?

You watch (most) of your classmates count their lucky stars and you resent them. They try to make you feel better but it’s hard to accept their help. I don’t want to feel better. There is no silver fucking lining.  I want to wallow. I have to spend a year, after all, making the best of it. Let me be miserable now.

Things like the fact that I still don’t know when my obstetrical placement will be (sometime next month, and in Toronto) are harder to bear. Knowing I’ll have to go to Toronto for the intensive is harder to bear. Now it’s not just short trips away. It’s eating away the time I have left. Everything is subtraction. It’s knowing that yet again my lover and I will have to rely on text messages, Skype, and a once a month visit when I’m off call and too tired to be anything other than sleepy and grumpy.

It’s really fucking dramatic. I don’t have the particular desire to be fair, or reasonable. I’m angry. I’m really fucking sad. But I’m resigned to the fact that I don’t have as much control over my life as I would like. I signed that control over to this program. Insert something here about how it will probably be worth it maybe. Right now, I got nothing. 

My Personal Letter

Hi all, 

I’m in the middle of reading the personal letters that got sent to me. If you sent one to me, you should get an email back tonight with my notes. If you didn’t, it was lost in the recesses of my email, and please resend it. I’m still accepting them until Jan. 10. 

Because I’m in the middle of this I’m thinking a lot about the questions from the personal letter. So I thought it might be fun to answer them as a (almost) senior (wait…what?) midwifery student. Please don’t actually use these in your own personal letters. A) Some of the MEP people read this blog and they will know B) they be jokes. 

1. Describe the attributes and personal qualities which you believe make you suited to the Ryerson Midwifery Program and the midwifery profession. 

I have a great sense of humour, and am quite able to laugh at all the absurdity around me all the time. I can laugh at myself, I can laugh-cry at something I said in clinic, I can laugh-cry at something one of my preceptors said to me, I can laugh when I look at the amount of material I have to memorize in one semester, I chortle every time I even think about my Pharmacology class, I giggle when I inevitably drop things like babies, and I guffaw when I think about using Illuminate, Learnlink, and Adobe Meeting Centre thing. This sense of humour will protect me from committing hari-kari. 

I’ve worked hard to develop my medical poker face. 

My naps are like the pros. 

I’ve got so much respect for this profession and the people who do it that I will totally just go with any curveballs this program will continually throw at me in order to become part of it. This shall be done with minimal bouts of public swearing. 

2. Describe what your bring to midwifery from your academic background, work, and/or life experience that is relevant to a career in midwifery. 

I’ve got a degree in philosophy and I’ll work really hard to make forced discussion board conversations less painful than getting a tooth pulled. Instead they will be loud drilling noises outside of your apartment at 6am level painful. 

I worked at a law firm and will be able argue people in circles to defend the honour of the midwifery education program when people start to worry about the state of my emotional, mental, and physical health. 

I worked as an actor which means I’m totally prepared to do informed choice discussions when I can’t remember the information I’m supposed to be imparting.

I used powerpoint once and I won’t again, this program’s obsession with it be damned.*

I watched a whole lot of Call the Midwife and my classmate Whitney told me that counts as studying. 

3. Describe the demands, as you understand them, of being a midwifery student. How will you cope with these demands?

The demand is that you’ll continually feel like you’re scrambling for information and skills that everybody thinks that you should know. As soon as you feel like you know one thing you have a whole new huge pile of things you don’t know or can’t do. This will be forever, until suddenly it’s still like that and you have to think about medico-legal responsibility. 

I will cope with this by eating ice cream and laugh-crying. 

Also you have to fax a lot of evaluation sheets and faxing things from the post office is expensive. I have found no coping mechanism for this.

4. Describe the contribution you hope to make to the midwifery profession. 

I will gently rib the school and the program that is training me for a profession that I love in a public blog that they can find and castigate me for. 

Also I will keep the chocolate drawer at the midwifery office where I eventually work full of chocolate. 

 

 

Well?

Do you think I’d get in now?

*Powerpoint sucks.