Remembrance

April 19, 1995....You know, some say you'll always remember where you were when national tragedy struck. I think that's quite true. On this date, people in Oklahoma City had awakened to a normal day of just going to work, going to school, going to pay bills, attend meetings...any one of a number of things in the daily grind.

Then came 9:01 AM...time stood still and the world came crashing down.




I was in music history class at Oral Roberts University in Tulsa, quite unaware of anything that was going on. However, a friend who was working 6 miles away felt the hospital she was working in shake, and my current midwifery preceptor remembers looking out the window in labor and delivery, no doubt seeing and perhaps feeling some of what was going on, since this hospital is only a 5-minute drive from the site.

It was Wednesday, and when I went to chapel that day, we were asked to pray for the people in Oklahoma City, because someone had blown up a day care center. That's all I knew until I went back to my apartment for lunch and turned on the midday TV news...and I couldn't believe what I was seeing. I felt conflicted, because I had already heard of medical professionals driving into Oklahoma City from all over the state to offer help. I seriously considered going there, but realized I couldn't leave because of my school responsibilities. I spent many days consumed with keeping up via television and newspapers the unbelievable events as they unfolded. I didn't realize how long our flags in Oklahoma had been at half staff until I went home to North Carolina in June and saw the flags at full staff.

And Jesus wept....



Fast forward to April 19, 2009...Now, a quiet field of 168 chairs sits where the massive federal building was bombed, one chair for each person who was killed in the blast...smaller chairs for children who were lost to us and large chairs for the adults. The gates of time, the survivor tree (that refused to die though it was only a few feet from the blast), and a museum that tells the story of those tragic days...they're all there. People were lined up around the outside of the building waiting to gain admission.

"We come here to remember those who were killed, those who survived, and those changed forever. May all who leave here know the impact of violence. May this memorial offer comfort, strength, peace, hope, and serenity."

On this date, I caught baby #37 at 2 AM...I'm sure it was no accident that her name was Liberty, though I don't really think that her parents named her that because of anything connected with this day. I just think that liberty was to be the theme of this day, and this little girl's arrival was the dawn of this new day.

I had the privilege of playing harp on this date at the church that sits across from the memorial. The windows in the building were blown out that day, and ultimately, the church replaced the windows and built a beautiful new sanctuary joined to the old sanctuary. The church celebrated their 120th anniversary! It was a remembrance of joy incorporated into a day set aside to remember those who were lost to us on earth 14 years ago.

May God be strength and grant His healing power to those who lost their innocence and their loved ones on that dark day.

Well...Poo-ee on You-ee!

Last Monday, while I was awaiting the arrival of baby #32, I learned not to ever turn my back on a laboring woman...not even to put on sterile gloves!

I have always been amazed how many times labor nurses and midwives can say the word "push" in a single breath when coaching a laboring woman to push. It usually sounds like "push-push-push-push-push-push-push-push" and then starts again and continues through the contraction in the same fashion. Verbal coaching has always been something of a challenge to me, simply because I'm not naturally the cheerleader type, so I'm still working on finding my style in encouraging pushing.

This particular woman was Latina, so the pushing rules took on a bit of a new twist. The word for "push" is "empuje" (pronounced "em-POO-hay"). Obviously, you sure can't say that word 50 times really fast when coaching, so the labor nurse that was with us shortened the word to something sounding like "pui" (pronounced "POO-ee"). You can say that word lots of times in a single breath, so I heard, "pui-pui-pui-pui-pui-pui-pui-pui" again and again. In no time at all, I saw about a nickel-sized spot of baby scalp, and I turned to the delivery table behind me and started putting on my sterile gloves hurriedly while the preceptor of the day was on her way across the room to the bedside. I turned around on a dime and the baby was half-way out!! Shades of "Cannonball" (my first catch) -- this kid was in a hurry! I'm very thankful that the labor nurse was there to catch while I took only a few seconds to put on my gloves!

So...poo-ee on you-ee...lesson learned -- don't ever turn your back to a pushing woman!

Time for a Laugh: The Middle Wife

When I was a kid, I loved show-and-tell. So I always have a few sessions with my students. It helps them get over shyness and usually, show-and-tell is pretty tame. Kids bring in pet turtles, model airplanes, pictures of fish they catch, stuff like that. And I never, ever place any boundaries or limitations on them. If they want to lug it in to school and talk about it, they're welcome.

Well, one day this little girl, Erica, a very bright, very outgoing kid, takes her turn and waddles up to the front of the class with a pillow stuffed under her sweater. She holds up a snapshot of an infant. "This is Luke, my baby brother, and I'm going to tell you about his birthday. First, Mom and Dad made him as a symbol of their love, and then Dad put a seed in my Mom's stomach, and Luke grew in there. He ate for nine months through an umbrella cord." She's standing there with her hands on the pillow, and I'm trying not to laugh and wishing I had my camcorder with me. The kids are watching her in amazement.

"Then, about two Saturdays ago, my Mom starts going, 'Oh, Oh, Oh, Oh!'" Erica puts a hand behind her back and groans. "She walked around the house for, like an hour, 'Oh, oh, oh!'" (Now this kid is doing a hysterical duck walk and groaning.) "My Dad called the middle wife. She delivers babies, but she doesn't have a sign on the car like the Domino's man. They got my Mom to lie down in bed like this." (Then Erica lies down with her back against the wall.) "And then, pop! My Mom had this bag of water she kept in there in case he got thirsty, and it just blew up and spilled all over the bed, like psshhheew!" (This kid has her legs spread with her little hands miming water flowing away. It was too much!) "Then the middle wife starts saying 'push, push,' and 'breathe, breathe'! They started counting, but never even got past ten. Then, all of a sudden, out comes my brother. He was covered in yucky stuff that they all said was from Mom's play-center (placenta), so there must be a lot of toys inside there. When he got out, the middlewife spanked him for crawling up in there.

Then Erica stood up, took a big theatrical bow and returned to her seat. I'm sure I applauded the loudest. Ever since then, when it's show-and-tell day, I bring my camcorder, just in case another 'Middle Wife' comes along.

...And the Stork Just Laughed!!!

It's raining babies here in Oklahoma! Because of that, I've been doing my part to re-populate this state. Since Tuesday at midnight (until Thursday about 4PM), I've caught 3 more boys and 3 more girls...now I'm up to 26! Also, since Tuesday morning, I've had about 9 1/2 hours of sleep, but amazingly (for someone who really likes her sleep), I've been able to keep going.

Something happened today that made this young stork laugh out loud...of course, outside the patient's room. I had gone in to check on one of my young patients. As we chatted briefly, she asked me the dreaded question...the one I really hate to be asked..."Have you got any children?"

Now, I feel a little explanation is in order. You should know I haven't always hated that question. The fact of the matter is that when I worked in labor and delivery some years ago, my patients would look at me with this quizzical look, ask me that question, and when I responded that I didn't have any children (yet), the follow-up question would come..."Do you mean you can watch me in labor and still want to have children"? I could honestly say I did want children, especially since I had names for 8 children in an old journal. Now I don't know if I really wanted 8 children, but I was fascinated with the concept of names and their meanings (and still am....), so I had very meaningful names selected for any children that I and my future husband might have.

However, Mr. Right hasn't come along (yet), and now time has marched along, and I can no longer have children. The suggestion has been made several times over the years that I adopt (by myself), but as much as I think I would have been a good mom, I don't want to voluntarily become a single mom...single parenting is too challenging in my mind to volunteer for the job. I can honestly say that I'm happy simply helping women become moms and men become dads...I always have been, and especially with my new role, I expect I always will be.

The thing that makes me not like the question when it is posed now is that I sense that it's often a way that women 'size me up' as to whether I know what I'm doing while I help them give birth. Women do this to each other all the time...checking up to see if other women live up to a particular standard of womanhood, especially as it relates to childbearing and choices related to that process. I trust they aren't intentionally trying to make me feel uncomfortable, but since I know my situation far better than they can, it does 'dig' a little. I wish they could understand that even if I had given birth, I would know only what my experiences were and still couldn't know exactly what their experiences are.

So now...back to the story. When the question came, I gulped and said, "No, I didn't get to have that experience". My young patient (who by then had received an epidural) said, "Well, girl, you don't want to be havin' no children. This hurts too much!" It was all I could do to get outside her room before laughing...not at her, but at the way she advised me and how the conversation took a totally different direction than I had expected. She went on to deliver a healthy baby boy this afternoon, but I think her friends will get a seriously large earful of advice when she goes back to school!

...and the stork just laughed!

The Way to a Midwifery Student's Heart....

Oh, yes, there are three ways to a midwifery student's heart...actually, maybe more, but these are the ones that come quickly to mind.

1) Be excited that the student is coming to be with you at your birth! I have a school project that requires that I see at least 5 clients in the office for prenatal visits 3-5 visits, then come to their births, and follow-up by phone call and/or visits after the baby arrives. I've selected 6, and have now been through visits and birth with 3 of them. But this week was the best! I told two of them that I was making a list of women that I wanted to follow through birth and afterward. One of the women asked, "Can I be on your list?" The other asked me (before I could tell her about the list) if I was coming to her birth. When I told her I was planning to, she seemed so happy! I felt like I was going to shed happy tears! I think it's a huge compliment when a woman actually wants a student at her birth!

2) Ask for the student to be there and help you during your birth! I was attending one of the four births I tell about in the next post, and the mom reached out and asked me to hold her hand. Something so simple, yet something I hadn't had time to do when I was a staff nurse. I think that anything I can do to convey that she can do what she's trying to do when birthing her baby is bound to bring necessary confidence and strength to help her through the process.

3) Realize what you've done and lay claim to your power after you give birth! Birth can be a very empowering experience, and once you've brought your child into the world, you're a very powerful woman. You see, it's really women who deliver their babies, we midwives simply catch! Twice at this clinical site, I've heard it....on my first day, we told a young mom, "You did it!", and she responded, "YES, I did!". During the long, long day (next post), the mom who was able to avoid a Cesarean, said, somewhat in disbelief, "I really did it! I can't believe it, but I did it!"

What a joy it is to help empower women and help babies into the world! It makes this midwifery student's heart sing!

The Long, Long Day (and Night and Next Day....)

Four more bundles of joy were born into my hands this week...a girl and three boys! In the process, I found out how great God's grace is and how He can keep a body marching on when it's wa-a-a-y past bedtime!

I got up at 7:45AM to prepare to go to work with two of my mentors in the office. I saw 4 clients with one midwife, 3 of whom I had attended when they gave birth about two weeks ago, and another whom I hope to attend in the coming weeks. Two of them even brought their babies with them; they're all growing and thriving! I saw several others with another of the midwives; one who had given birth 6 weeks ago, and others that will deliver months after I move on from here. After completing my paperwork, I went back to my room, where I took care of bills, exercised, and ate dinner.

While I was making my dinner, I missed a phone call from the midwife on call that night, so I paged her to find out what was happening. She said one of our patients who had planned to have a Cesarean on Thursday was coming in and said she was in labor. This patient had wanted to avoid a Cesarean this time, but on Tuesday had decided that she would go ahead and have surgery after all. However, when labor started and she was progressing, she decided to give it a good try and continue on with labor. I left my room about 10:30PM to collect that patient's history and physical exam.

In the meantime, another patient came in who had been scheduled for labor induction on Thursday, but unbeknownst to us, had arranged to come in the night before to begin the induction early. After the department found her orders and prenatal records, they began the labor induction about 11PM.

Then a couple of others came into the department, one of them due soon thinking she was in labor (but wasn't yet), and the other having lots of contractions, but who had only completed 27 weeks of her pregnancy. The one who wasn't yet in labor was treated and released; the other (early) one ultimately went home after we ran lots of tests, confirmed she didn't have an infection that might have started preterm labor, and stopped her contractions with medicine. The challenge was in thinking about the possible causation of her preterm labor long after my brain had decided it was time for bed when my mentor quizzed me.

However, the midwife on call and I had this continuous circuit between low-risk labor, high-risk labor, and triage all night long. (Our two laboring patients were both low-risk, but the one being induced was transferred from antepartum to the high-risk side when the other side of the unit filled up.) Thoroughly confused yet??? (Me too....sigh!)

I saw my mentor jog out of the low-risk side toward the high-risk side, and I knew I'd better go find out what was going on, because when people run in the hospital, it's never something to be ignored. The one who was being induced progressed rapidly, and she gave birth to a baby girl just before 2AM; the mom only needed 2 stitches. After we finished our paperwork for that birth, we moved on to the triage unit and discharged the two patients there.

After that, we were able to turn our attention to the remaining patient in labor. We had to keep a close eye on the baby's heartbeat, because he kept doing funny business. Finally, with oxygen and IV fluids, the baby decided he would behave himself, and a sweet little boy was born around 5:30AM. His parents and midwives have already decided that he looks like his brother. One of the neatest things ever was when his mom, right after birth, said three beautiful words -- "I did it"! She said then that she had decided to schedule the repeat Cesarean thinking she couldn't give birth any other way; it was evident from the way she worked with her labor that she really had not wanted to proceed with surgery, but she didn't see any other way. In some ways, I think that for her, avoiding a Cesarean provided a bit of emotional healing from her previous experience, and I was so happy that I could help her fulfill her heart's desire. She only had to have 3 stitches...this recovery period should be comparatively a breeze, and I told her so!

By the time the paperwork for that birth was done, my primary mentor arrived for our regular 10-hour day on the unit, and I had already been up 23 hours! On our regular day on the unit, we not only care for the midwifery patients; we care for the patients who have been seeing the residents and med students in the clinic. There was one that was almost ready to push about that time, so we went in to help her get ready. After a little more time, she began to push; even with an epidural, she pushed very nicely, but it still took a long time since she was a first-time mom. Ingredients for woozy feelings for a midwifery student...1) Sleepiness; 2) Dim lights; 3) Baby's heartbeat...oh so rhythmic; and 4) No food and very little water since the night before...yep, it's a set-up! I could feel myself getting dizzy and started weaving. Quietly, I looked up and prayed for God's help, because I couldn't leave. I decided to try something, and I closed my eyes between the contractions, and just that tiny bit of rest seemed to help just enough to get me through each of the remaining contractions. It was exactly what the mom-to-be was doing, and it worked perfectly for me too. A baby boy with lots of dark hair was born just after 10:30AM. (First-time mom...no stitches needed!)

I'm sure my primary mentor saw my closed eyes and knew what was going on, because after we came out of the room, she asked me if I needed to go to bed, and though I did, I learned that the mom isn't the only one who gets a burst of energy when the baby is born...so does the midwife! So I told her I was fine...just needed something to nibble on. It really wouldn't have taken me longer than about 5 minutes to get to the room where I was staying to get something to eat, but we had another mom in labor who had already had 2 children, and I know better than to trust them not to deliver quickly. So my mentor dug through her lunch bag and produced a cheese stick; I grabbed some saltines from the unit stock. It's amazing what a feast cheese, crackers, and water can be!

I actually figured this mom would deliver faster than she did, but this baby boy wasn't born until around 2PM. Again...another mom who needed no stitches! After she and her family spent some time with the baby, I went in to do a newborn exam on the baby, as I had done on 2 of the others. When I came out, my mentor wanted to know if I'd examined the baby yet, and when I told her I had, she said, "Go to bed"! It was 2 hours before I was expecting to be off that day, but she didn't have to tell me twice! I went back to my room, ate almost anything that didn't eat me first, and finally gave in to sleep a little after 5PM...33 1/2 hours after I had gotten up!

Except for one very brief awakening at 8:15 PM when I wondered if I had overslept (and missed rounds at 6:30AM) and it was actually 8:15AM, I slept until the alarm woke me at 5:45AM. I was dreaming I had missed rounds...OK, there's a theme here, so I dragged my body out of bed and joined my mentor (who had been up during the night catching yet another baby) to go and see our two midwifery moms who delivered during my long stretch. They both wanted to go home and we discharged them so they would be ready to go when the pediatrician discharged the babies. Moms and babies were doing well!

When I returned to my room this time, it was tempting to climb back into bed for another nap, but I stayed up, had breakfast, packed up, and drove back 2 hours to my friend's house in Broken Arrow. I'm still a little tired, but I'm almost back up to par. Thanks be to God for His grace and keeping power!

Hey, What Happened Next?? Don't Leave Me Hangin' Here!

Well, this is the way things looked when I left the storage locker at the end of January. I'm still so thankful for my 5 friends who at various points in the process came alongside me to help me get everything packed up, and the 8 friends who helped get everything loaded into a U-Haul truck and 4 cars. It was a huge job, and if it had all depended upon me, I might still be packing! Never underestimate the gift of practical help, especially when it's offered to a single person. The gift of time is a present valuable beyond words!

It still took me until the evening of January 31st to completely clear out everything and finish cleaning the apartment. Even though I had planned to be finished and out a week earlier, it was obvious that it wasn't going to happen quite so quickly. I was really glad that my lease didn't actually expire until the 31st!

The delay gave me a chance to play harp at church one last time before leaving, and though the parts were more complex than usual, I thoroughly enjoyed playing them. I said my goodbyes again, and left to finish getting ready to leave for Oklahoma the following day.

You know what's funny? The week before, when I was saying goodbye to my worship pastor, he asked me if I was taking I-20 to Oklahoma. I had no idea where I-20 was; I was planning to travel all the way on I-40. I learned in the next few days that wintry precipitation was expected along I-40 in Tennessee on the day I was planning to leave, and the temperature the next day wasn't supposed to be above freezing. Besides, Arkansas and Oklahoma were in recovery mode after an ice storm the week I had expected to travel; one of my friends in Oklahoma didn't recommend traveling on I-40. So I decided I'd better find out where I-20 was, and how I might get to Oklahoma that way. That was a decision that would prove to be providential.



This is what my car looked like from the back the morning of February 2, 2009. I did manage to leave myself a place to see out the back of the car as I traveled, but precious little space otherwise. There was no floor space left anywhere in the car. I had hoped to get going by 10AM that day, but loading took time, and after that, I was sitting in the car, frantically trying to make my GPS software work. I ended up making a call to tech support and the problem had a simple fix to it, so off I went by about 11:30AM...oh well!!

I don't mind saying it...I knew my path would take me through Atlanta on I-85, and even though I haven't been there since I was a child, I wasn't really relishing the idea of navigating traffic there. OK...so now I'm a veteran of Atlanta traffic! It wasn't anything I would like to do regularly, but as I've heard and said many times before, "That which does not kill me will make me stronger!" Atlanta was definitely a strength-builder...6-7 lanes in each direction! But I made it to I-20, and kept on going west...

I planned to cross the Alabama state border and place a call to my former nurse manager who had recently moved to the Montgomery area from Austin, TX. I had planned to stay overnight in Tuscaloosa, but I was invited to stay with her and her husband in their new home. I started to turn down her offer, because I wasn't sure when I could get there, how far off course I'd be, and I knew she would have to be at work early the next day. I ultimately took her offer, and I'm so glad I did, because it was so enjoyable spending time with them and getting a tour of their new home. She hastened to tell me that boxes were everywhere, but since boxes had filled my apartment until a few days prior to my leaving, I didn't see that as a problem. A friend of mine once told me, "If you're coming to see me, come anytime, but if you're coming to see my house, call ahead."

I arrived in her town about 7PM and we enjoyed a meal together, catching up for the last four years. We moved on to their home after that, and visited late into the night. The next morning, we were on the road by about 7:30AM, but it was really a refreshing visit. The next two pictures are from our time together.

There was a welcome here at George and Aggie's house!

Notice in the above picture that Aggie's awake...but I'm not! (Oh, I know it looks like I am, but I'm not...it was too early!)

It turned out that even though it was too early to suit me, it was a good thing...because I had a reservation at a hotel in Tyler, Texas for that night, and counting stops for food and driving breaks, I was on the road 12 hours that day before I saw my hotel. I was so tired...but I had supper before checking in. After unloading part of my cargo, I quickly went to the spa pool, because my shoulder was aching and I needed the whirlpool! I enjoyed traveling through places I'd never been -- Mississippi and Louisiana, and seeing the countryside. Frankly, it's a good thing I love to travel...if not for that, my entire clinical practicum would have been a disaster!

On Wednesday, I traveled from Tyler, TX to my friend's house in Broken Arrow, OK to unload the majority of my cargo by the afternoon. I then turned around and traveled to Oklahoma City, OK and moved into a hospital room at OU Medical Center to spend the night. I've already heard people say, "You're staying in a hospital room?" I figure that as long as I'm not a patient, it's all right.

I met my new preceptor the next morning at 6:45AM...bright and early...at least early, if not so bright! That day, by mid-morning, I caught 2 more babies, one after the other. Back to back catches helped cement the method of helping the mom birth her baby. Later that day, there was an emergency, but even that was good for me to participate in, because there will be emergencies that I'll need to know how to handle. The majority of the time, birth is normal, but on occasion, something happens.... Mom and baby did well, though, and they went home together a few days later. After my 10-hour shift with my preceptor, I drove back to Broken Arrow to stay there until the next Sunday.

So...now that's my routine. I stay in the hospital room Sunday night through Thursday after work, then drive back to Broken Arrow (a couple of hours away) to stay with my friend Thursday night through Sunday afternoon. I've caught 12 babies since I've been in Oklahoma City, so my current total is 14 -- 5 boys and 9 girls! It's fun working in the cabbage patch!

I've finished up peri- and post-menopausal office visits with two gynecologists in the practice; unfortunately, there aren't a whole lot of women past childbearing age that have been going to the midwives I've worked with. I'm making progress in finishing my prenatal visits with the midwives. I've gone on hospital rounds with the midwives, and last week, I survived an unexpected 23-hour-long shift, during which I caught 2 more babies...2 of the 5 born in that time frame. I've never been drunk before, but I do believe that the way I felt after that long shift must be what drunk feels like...pretty rough!! It took me until the evening of the following day to feel like a human being again!

I'm back on Weight Watchers as of March 1st, and my first week, I lost 2.4 of the 17 pounds that sneaked back on while I wasn't looking! I've been walking 30 minutes most days, either in the hospital hallways or on the treadmill...exercising for free...gotta love it! I'm also practicing harp an hour or more each day when I'm at my friend's house in Broken Arrow, and I'm getting reacquainted with Tulsa friends I left behind over 4 years ago when I moved back to Charlotte.

Slowly but surely, I am becoming who I believe God wants me to become. Ultimately, it will be so exciting to see where He wants me to fit and function!

Movin' On...

I knew that packing day was coming this month...but it seemed so far away. I hadn't really planned to move until grad school was over and the "just right" job appeared...wherever it appears. However, the clinical phase of my degree is taking far longer to complete than I ever dreamed and is requiring that I be away from home more than at home. No matter how hard I tried, I could no longer rationalize paying bills at home and living all over the country for the remainder of my school time. (My home has become a very expensive storage locker!) So, I'm not renewing my lease at the apartment I've really enjoyed living in for the past 4+ years, and I'm movin' on....

I've usually had the luxury of time when I've decided to move and I could take my time packing, but since I have to be out by the end of the month, time is not on my side. I am so grateful that four of my friends came last Saturday to help me pack, and I'm guessing that by the time we finished, the five of us had gotten about 50-60% of the packing done! Pretty good, considering we worked at it hard for about 6 hours! I now have just under 2 weeks to get the remainder packed, along with some remaining schoolwork, and then I can resume clinicals. Because I don't know where the "just right" job will be when this journey is over, I'm storing everything (that I don't either take with me or keep at my mom's house) at a U-Haul facility. Then, off I'll go to Oklahoma City!

Yesterday, I was reading Joshua 1:9 in the Complete Jewish Bible. In this translation, the verse reads as follows: "Haven't I ordered you, 'Be strong, be bold"? So don't be afraid or downhearted, because ADONAI your God is with you wherever you go." The following was my reflection on this Scripture....

"The word 'ordered' in the verse above surprised me, but on thinking back, I remembered the word I'm familiar with (in that spot -- different translation) is 'commanded'. Same difference...but it made me stop and think a bit. I have been...well, not so much afraid as downhearted about leaving my apartment. I never did get to organize it and decorate it as I really wanted to and always pictured in my mind's eye. Maybe it will happen the next time around...but now I see I have orders...any good nurse knows what to do with orders! I believe God will go (is going) before me and will be with me wherever I go...."