“The terrible thing, the almost impossible thing, is to hand over your whole self—all your wishes and precautions—to Christ. But it is far easier than what we are all trying to do instead. For what we are trying to do is to remain what we call “ourselves,” to keep personal happiness as our great aim in life, and yet at the same time be “good.” We are all trying to let our mind and heart go their own way… and hoping, in spite of this, to behave honestly and chastely and humbly. And that is exactly what Christ warned us you could not do.” -“Is Christianity Hard or Easy?”, Mere Christianity, C.S. Lewis
Birth is an unexpectedly messy, notoriously unpredictable, unimaginably painful process. With each rock-hard contraction, the baby asphyxiates as the walls of its heretofore insulated, filtered world come crushing in. The mother focuses on not hyperventilating, grabbing walls or rails or hands, contorting and sometimes screaming or crying. One woman told me it felt like she was being run over by a truck; another that her bottom half was being amputated. And the whole thing, contractions every 2-5 min, can last the entire day, taking so long the baby’s head gets squeezed into a cone shape in the birth canal.
After the placenta is delivered, I put my hand into its warm, bloody sac and think: what a harsh world it must seem at first. So glaringly bright, desert dry, arctic cold. No cushion against the steady pull of gravity. Instead of the steady pulsation of mom’s heartbeat, the harsh cacophony of voices, scissors, suctions. I think about how hard it is for me to live in the new life God offers me every day—how easy it is to stay on the old track, to lapse into self-reliance and nurse old habits.
What does staying in the old world mean for you? For me, it’s the myth of believing I can succumb in little ways—to habits, indulgences, thoughts—without consequence. It’s figuring I can do things on my own. It’s always thinking I’ll be better tomorrow without changing the present. It’s not accounting for the things I feed my mind, spirit, and body. It’s coming to take things for granted.
Inevitably it’s a losing battle. The walls start to close in, and somehow the freedom and truth and betterness of new life is pushed into view. If I only listen, God is speaking it to me all the time, in His word, and through people who love me into beauty and speak to me in truth. And to take that new life—it is a marvelous and somehow effortless thing. Marvelous, effortless. Just like the slippery baby that slides out in a gush of fluid and blood, and in moments opens its crinkly eyes and fills the air with its cries.
Written February 4, 2005 during ob-gyn rotation
Wednesday, September 30, 2009
Tuesday, September 29, 2009
Small Joys
God’s joy moves from unmarked box to unmarked box,
from cell to cell. As rainwater, down into flowerbed.
As roses, up from ground.
Now it looks like a plate of rice and fish,
now a cliff covered with vines,
now a horse being saddled.
It hides within these,
Till one day it cracks them open.
- Rumi
Tonight E fell asleep on my chest. She had just finished feeding, and I had propped her on her side between my breasts to burp her a bit. She curled both hands up near her chin, tucked her face down into the shadows next to a fold in my shirt, and closed her eyes. I felt the weight of her warm, milk-tinged softness slowly relax. The two cats were dozing next to each other on the bed, one pressed against my legs with her head on outstretched paws, the other curled into a black ball of fur facing the opposite direction. It was one of those moments I wanted to freeze in time.
Life at home is outwardly uneventful. Today I did not perform an operation, write a prescription, attend a meeting. I barely even held a two-way conversation. Today I marveled at small things. A cat’s eyes squinted shut in sleep. The turn of phrase in a book, savored deliciously in my mind. The fresh water and folded laundry left by D near the bed. The baby’s hilarious looks of concentration while pooping; the smile she gives in mid-feed, mouth still full. Like her, I see at close range. It’s a world of microcosmic wonder.
These are the small, private joys. Not the kind that makes you go dance in the street, but the kind that burrows quietly inside, that is slowly and unexpectedly unwrapped. Each heart knows its own bitterness, and no one else can share its joy (Proverbs 14). These are joys in the things I see and feel, though not much is said. It’s the same sense I have in nature, a sense of deep happiness and wonder that cannot be taken away, that seems a sign of the Spirit within and a promise of the eternity to come. This is what I’m delighting in most about her, this sense of wonder and promise she brings into my life.
from cell to cell. As rainwater, down into flowerbed.
As roses, up from ground.
Now it looks like a plate of rice and fish,
now a cliff covered with vines,
now a horse being saddled.
It hides within these,
Till one day it cracks them open.
- Rumi
Tonight E fell asleep on my chest. She had just finished feeding, and I had propped her on her side between my breasts to burp her a bit. She curled both hands up near her chin, tucked her face down into the shadows next to a fold in my shirt, and closed her eyes. I felt the weight of her warm, milk-tinged softness slowly relax. The two cats were dozing next to each other on the bed, one pressed against my legs with her head on outstretched paws, the other curled into a black ball of fur facing the opposite direction. It was one of those moments I wanted to freeze in time.
Life at home is outwardly uneventful. Today I did not perform an operation, write a prescription, attend a meeting. I barely even held a two-way conversation. Today I marveled at small things. A cat’s eyes squinted shut in sleep. The turn of phrase in a book, savored deliciously in my mind. The fresh water and folded laundry left by D near the bed. The baby’s hilarious looks of concentration while pooping; the smile she gives in mid-feed, mouth still full. Like her, I see at close range. It’s a world of microcosmic wonder.
These are the small, private joys. Not the kind that makes you go dance in the street, but the kind that burrows quietly inside, that is slowly and unexpectedly unwrapped. Each heart knows its own bitterness, and no one else can share its joy (Proverbs 14). These are joys in the things I see and feel, though not much is said. It’s the same sense I have in nature, a sense of deep happiness and wonder that cannot be taken away, that seems a sign of the Spirit within and a promise of the eternity to come. This is what I’m delighting in most about her, this sense of wonder and promise she brings into my life.
Thursday, September 24, 2009
Medicine
“Now, in my fiftieth year, I venerate the sight of the abdomen or chest laid open. I’m ashamed of our human capacity to hurt and maim one another, to desecrate the body. Yet it allows me to see the cabalistic harmony of the heart peeking out behind the lung, of liver and spleen consulting each other under the dome of the diaphragm—these things leave me speechless. My fingers ‘run the bowel’ looking for holes that a blade or bullet might have created, coil after glistening coil, twenty-three feet of it compacted into such a small space. The gut that has slithered past my fingers like this in the African night would by now reach the Cape of Good Hope, and I have yet to see the serpent’s head. But I do see the ordinary miracles under skin and rib and muscle, visions concealed from their owner. Is there a greater privilege on earth?” - prologue, Cutting for Stone, Abraham Verghese
D and I entertain ourselves by talking about getting venous access, mostly because it’s the procedure we can both relate to the most. The other things he does as a medicine resident—lumbar punctures, tapping the lungs or abdomen—are only things I’ve done overseas, without anesthesia and with the barest of instruments; I wouldn’t even know how to set up for those things here. The other procedures I did as a surgical intern he obviously doesn’t have to bother with, to his relief. He proverbially rolls his eyes when I recall the glory days of chest tubes and emergency appendectomies.
And so we discuss lines. I talk about the time I practiced by putting an intravenous line in every patient that walked into the MGH emergency room. He talks about the central line he threaded blindly into the neck of a bleeding and hysterical young girl. We talk about quadruple jugular lines and femoral lines. I talk about a procedure more familiar to surgeons than internists—the saphenous vein cut-down—which he scoffs at. Do people really do those? So I had to smile when I read about it in Verghese’s novel. Ha ha! They did in the 1900’s on cargo ships going to Africa!
It feels good to read good writing. And it feels good to read about medicine. It’s a way to return to myself, to remember part of who I was before I turned into a milk-making machine governed by feeding cycles. D has gone back to work now, thankfully at a relatively normal schedule, and I see that it makes him a better parent. He has greater perspective, more love and patience to lavish upon the baby at the end of the day.
This is the longest I have been away from clinical medicine for three years. Seeing medicine through its absence in my life and influence upon D’s tempers the exhausted and increasingly cynical view that came from its taking so much of my earlier life. It’s good to remember again, why I do this, what it can mean for a balanced life and future ministry.
D and I entertain ourselves by talking about getting venous access, mostly because it’s the procedure we can both relate to the most. The other things he does as a medicine resident—lumbar punctures, tapping the lungs or abdomen—are only things I’ve done overseas, without anesthesia and with the barest of instruments; I wouldn’t even know how to set up for those things here. The other procedures I did as a surgical intern he obviously doesn’t have to bother with, to his relief. He proverbially rolls his eyes when I recall the glory days of chest tubes and emergency appendectomies.
And so we discuss lines. I talk about the time I practiced by putting an intravenous line in every patient that walked into the MGH emergency room. He talks about the central line he threaded blindly into the neck of a bleeding and hysterical young girl. We talk about quadruple jugular lines and femoral lines. I talk about a procedure more familiar to surgeons than internists—the saphenous vein cut-down—which he scoffs at. Do people really do those? So I had to smile when I read about it in Verghese’s novel. Ha ha! They did in the 1900’s on cargo ships going to Africa!
It feels good to read good writing. And it feels good to read about medicine. It’s a way to return to myself, to remember part of who I was before I turned into a milk-making machine governed by feeding cycles. D has gone back to work now, thankfully at a relatively normal schedule, and I see that it makes him a better parent. He has greater perspective, more love and patience to lavish upon the baby at the end of the day.
This is the longest I have been away from clinical medicine for three years. Seeing medicine through its absence in my life and influence upon D’s tempers the exhausted and increasingly cynical view that came from its taking so much of my earlier life. It’s good to remember again, why I do this, what it can mean for a balanced life and future ministry.
Saturday, September 19, 2009
The Real Thing
I feel a bit guilty confessing this, but sometimes it is difficult to love the real E, not the baby I thought she would be. Nine months of unconscious projection is a hard thing to reinvent at one go. I realize now that my idea of what a baby would be like was a hopeful amalgam of various impressions. I wanted her to be the soft thing couched in an orange cloth carrier on the chest of the woman next to me on the airplane, soundless during the entire trip. I wanted her to be the smiling infant in the strollers we passed during our walks. I wanted her to be the type of baby that makes other people want to have babies.
But that’s not always who she is right now. She cries going to sleep and cries waking up; she cries a bunch in between. She doesn’t conform easily to any type of schedule. She can be stubborn and gets fussy. She can’t be willed into being a certain way, which is oddly difficult after a pregnancy and labor that seemed almost too easily conformed to what I had hoped it would be.
I can be exhaustingly efficient, endlessly patient, unmovingly firm, and she will still be at times difficult, unpredictable, demanding. Sometimes that is difficult to accept, and the endlessness of it all, and the degree to which it has so suddenly changed our lives, can be overwhelming. In this way, being with her is unlike any other endeavor I’ve undertaken. It is unlike going into medicine, unlike getting married. It demands instant, blind unconditionality.
But I guess that’s the challenge, the calling. It’s not judging her, according to my own selfish standards or society’s standards. It’s not caring too much how other people see her. It’s literally laying aside my training, my old body, my sleep, to meet her needs. Motherhood in that sense does not come naturally. It is not something I can will myself into; I need God’s help as much as with anything else. Sometimes that is relieving to admit.
But that’s not always who she is right now. She cries going to sleep and cries waking up; she cries a bunch in between. She doesn’t conform easily to any type of schedule. She can be stubborn and gets fussy. She can’t be willed into being a certain way, which is oddly difficult after a pregnancy and labor that seemed almost too easily conformed to what I had hoped it would be.
I can be exhaustingly efficient, endlessly patient, unmovingly firm, and she will still be at times difficult, unpredictable, demanding. Sometimes that is difficult to accept, and the endlessness of it all, and the degree to which it has so suddenly changed our lives, can be overwhelming. In this way, being with her is unlike any other endeavor I’ve undertaken. It is unlike going into medicine, unlike getting married. It demands instant, blind unconditionality.
But I guess that’s the challenge, the calling. It’s not judging her, according to my own selfish standards or society’s standards. It’s not caring too much how other people see her. It’s literally laying aside my training, my old body, my sleep, to meet her needs. Motherhood in that sense does not come naturally. It is not something I can will myself into; I need God’s help as much as with anything else. Sometimes that is relieving to admit.
Wednesday, September 16, 2009
Uncertainty
The most stressful thing about parenting is the uncertainty. All it takes is one book or piece of advice to make us question ourselves all over again—and it seems like no two of them agree. You should never let your baby cry alone in her crib. Crying is good for the lungs; crying is not good for the lungs. You should breastfeed both sides equally; better to drain one breast first. Never hesitate to wake her from sleep; let her sleep when she can. Keep to a schedule; follow her cues and demands. Always put her to sleep on her back; sleeping on the stomach is better. And all of these dictums come with judgments: you are good parents or bad parents; you are causing this or that effect upon your child.
The reality of it is that nothing tells you what to do in that moment when she’s crying again in her crib and you have to decide whether to go in and what to do. You make some type of decision based on your personality as parents, your knowledge of her personality, the context, and other general principles. You keep track of her habits, you learn her cues, you try to set a few rules, you find things that work and things that don’t. The reality is, it all still feels like a huge step in the dark. You hold your breath and mutter prayers.
The glorious thing about having my mom here for now is how it gives D and I the ability to go out occasionally. Yesterday we went to a favorite park, green meadows and blue coastline. It’s good to get out, get some perspective. I think about all the babies around the world who are raised in different situations and cultures. I think about the single moms and dads who have far less resources than we do. I think about E, the person we are getting to know, not some object in a book, and how far we have come.
I think about the times my parents apologized to me in the past—I don’t even remember what for, just my surprise then at their vulnerability—and I understand a little better. We are bound to make mistakes, and that is okay. It goes without saying we will do our best, read and talk and listen and pray, but in all this too is a letting go, a rediscovery of faith. We are stewards; God is no less sovereign. That is good to remember.
The reality of it is that nothing tells you what to do in that moment when she’s crying again in her crib and you have to decide whether to go in and what to do. You make some type of decision based on your personality as parents, your knowledge of her personality, the context, and other general principles. You keep track of her habits, you learn her cues, you try to set a few rules, you find things that work and things that don’t. The reality is, it all still feels like a huge step in the dark. You hold your breath and mutter prayers.
The glorious thing about having my mom here for now is how it gives D and I the ability to go out occasionally. Yesterday we went to a favorite park, green meadows and blue coastline. It’s good to get out, get some perspective. I think about all the babies around the world who are raised in different situations and cultures. I think about the single moms and dads who have far less resources than we do. I think about E, the person we are getting to know, not some object in a book, and how far we have come.
I think about the times my parents apologized to me in the past—I don’t even remember what for, just my surprise then at their vulnerability—and I understand a little better. We are bound to make mistakes, and that is okay. It goes without saying we will do our best, read and talk and listen and pray, but in all this too is a letting go, a rediscovery of faith. We are stewards; God is no less sovereign. That is good to remember.
Tuesday, September 8, 2009
Suffering and Joy
Life is completely different. People ask how I still have time to write, but I think it’s something I do to feel normal for a few moments. Everything else is haywire.
For the record, caring for a newborn is harder than taking call, because it never ends. Sleeping feels like that moment at two A.M. when you’ve finished your to-do list and wonder if it’s worth trying to get some shut-eye before being paged with the next admission or question from the needy night nurse. D and I lie in bed wondering, will she stay asleep this time? Will she cry in ten minutes, and if so, should we let her cry to sleep or check again to see if she needs to be burped, diapered, or fed?
My day passes in a sleep-deprived litany of breastfeeding. It feels like that’s all I do with my life, though I console myself with the fact that I’m essentially running five miles a day. Then again, working out doesn’t leave you with breasts so hard and engorged you can’t sleep (sorry for those I just grossed out). My mom once said you just can’t imagine the kind of changes your body goes through after birth, and she’s pretty much right.
But then there’s the totally amazing experience of being with E. Coming to realize I love her has been less a moment of ecstasy and more a sure, gradual feeling. Holding her just after giving birth simply felt surreal, foreign. No tearful, emotional climax. But every day since then I’ve marveled more, laughed more, just felt more. Part of it is the product of constantly serving her, part of it is coming to know her more. Touching, smelling, watching her face contort when she poops or swallows or sits in her post-feed high, limp and happy.
Suffering and joy. Both deeper than I might have thought or been prepared for, but I suppose God gives the strength to receive both, each never-ending cycle of feeding and sleeping. There are the little breaks, the moments of grace, like D holding my hand at night, the green trees outside the nursery window and the cooling breeze, my mom’s carefully prepared meals, and the moments I get a little more sleep and am able to feel more lucidly myself. Things will be okay.
For the record, caring for a newborn is harder than taking call, because it never ends. Sleeping feels like that moment at two A.M. when you’ve finished your to-do list and wonder if it’s worth trying to get some shut-eye before being paged with the next admission or question from the needy night nurse. D and I lie in bed wondering, will she stay asleep this time? Will she cry in ten minutes, and if so, should we let her cry to sleep or check again to see if she needs to be burped, diapered, or fed?
My day passes in a sleep-deprived litany of breastfeeding. It feels like that’s all I do with my life, though I console myself with the fact that I’m essentially running five miles a day. Then again, working out doesn’t leave you with breasts so hard and engorged you can’t sleep (sorry for those I just grossed out). My mom once said you just can’t imagine the kind of changes your body goes through after birth, and she’s pretty much right.
But then there’s the totally amazing experience of being with E. Coming to realize I love her has been less a moment of ecstasy and more a sure, gradual feeling. Holding her just after giving birth simply felt surreal, foreign. No tearful, emotional climax. But every day since then I’ve marveled more, laughed more, just felt more. Part of it is the product of constantly serving her, part of it is coming to know her more. Touching, smelling, watching her face contort when she poops or swallows or sits in her post-feed high, limp and happy.
Suffering and joy. Both deeper than I might have thought or been prepared for, but I suppose God gives the strength to receive both, each never-ending cycle of feeding and sleeping. There are the little breaks, the moments of grace, like D holding my hand at night, the green trees outside the nursery window and the cooling breeze, my mom’s carefully prepared meals, and the moments I get a little more sleep and am able to feel more lucidly myself. Things will be okay.
Friday, September 4, 2009
The Labor Story
So it started with deciding to try to labor naturally, without any drugs. Not that I have anything against an epidural and wouldn’t have judged myself or anyone else for getting one, but I think going through the process of deciding to do it that way was good. It made me think about trusting both in God’s purpose for pain and in His not giving me more than I could bear, of trusting my body’s ability, and of trusting in the support of community. I listened to a lot of birth stories, asked for a lot of prayer, and tried to leave the rest to God.
I think pregnancy is designed on purpose so that by the end you want the pain to start so you can stop being pregnant. That was my first thought when I woke up one morning two days after the due date, with the gut feeling that labor would start that day: relief and excitement. Throughout the day I had crampier versions of the practice contractions I’d had all week, and D and I enjoyed our last day of childlessness doing our favorite things: worshipped in church, ate out, got candy and fruit at Wegman’s, hiked around a lake and park, watched a movie at home.
By eight that night the cramps were regular and uncomfortable enough that I had to get up and walk each off, and started coming every ten to twenty minutes. I think that’s when it hit us both that this was for real. By eleven they were every six to seven minutes and felt like a hyperbolic wave of painful pressure. D labored with me for the next four hours at home. As each contraction came, we breathed and walked together as he told me I could do it, I was doing great. I focused on relaxing through each as much as I could. In between we rested, I drank. D kept a string of our favorite music going and timed each contraction.
Sometime towards the end of those four hours we called the hospital and were told it was up to us to come in, or wait until the frequency increased to three to five minutes. At that point D asked me how I felt about an epidural, and I remember saying, I think I can do this. I much would rather be at home with him than lying in a hospital bed with nothing to think about but the pain, so we opted to stay home a little longer.
D worried I was getting tired, and suggested a bath, which was wonderful. The hot water was relaxing. I listened to All the Way My Saviour Leads Me on repeat on my headphones, holding D’s hand and counting through each contraction. They were becoming more intense, but it was bearable because I knew by the time I counted to twenty they would start to ease up.
They sped up quickly—within the hour, contractions were intense, coming every few minutes, not letting up completely in between. I remember with shock feeling like I wanted to push, at which point D was already rushing to get the car. The next four contractions were a blur; when they hit I’d curl up on the ground wherever I was—sidewalk by the car, backseat of the car, hall of the hospital waiting for the elevator—and focus on not pushing and counting through it. After the fourth I had arrived in the hospital; I counted through two more while lying in bed, amid a flurry of activity. The doctors were paged stat to the room, they said I was fully dilated, the sterile field was being set up, and by the next contraction I started to push. I remember gripping D and a nurse’s hand on either side, surrounded by a ring of nurses and doctors, everyone cheering me on with each push. You can do this! I can see the head! Keep going!
An hour and fifteen minutes later, she was born. I could feel her coming out, burning then something slippery. Someone asked how it felt, and I kept saying, weird. I looked over and there she was, small and pink with two big open eyes.
Good memories: D walking and breathing with me, holding my hand in the tub. The songs I listened to. The circle of people cheering me on with each push. D’s look of excitement when he told me he could see the head. His look of relief afterwards when he said, “we did it!” Most of all, knowing that something elevated as such a negative, painful experience can be in part positive, redemptive; that the prayer, positive thinking, and preparation made a difference. And now she’s here!
I think pregnancy is designed on purpose so that by the end you want the pain to start so you can stop being pregnant. That was my first thought when I woke up one morning two days after the due date, with the gut feeling that labor would start that day: relief and excitement. Throughout the day I had crampier versions of the practice contractions I’d had all week, and D and I enjoyed our last day of childlessness doing our favorite things: worshipped in church, ate out, got candy and fruit at Wegman’s, hiked around a lake and park, watched a movie at home.
By eight that night the cramps were regular and uncomfortable enough that I had to get up and walk each off, and started coming every ten to twenty minutes. I think that’s when it hit us both that this was for real. By eleven they were every six to seven minutes and felt like a hyperbolic wave of painful pressure. D labored with me for the next four hours at home. As each contraction came, we breathed and walked together as he told me I could do it, I was doing great. I focused on relaxing through each as much as I could. In between we rested, I drank. D kept a string of our favorite music going and timed each contraction.
Sometime towards the end of those four hours we called the hospital and were told it was up to us to come in, or wait until the frequency increased to three to five minutes. At that point D asked me how I felt about an epidural, and I remember saying, I think I can do this. I much would rather be at home with him than lying in a hospital bed with nothing to think about but the pain, so we opted to stay home a little longer.
D worried I was getting tired, and suggested a bath, which was wonderful. The hot water was relaxing. I listened to All the Way My Saviour Leads Me on repeat on my headphones, holding D’s hand and counting through each contraction. They were becoming more intense, but it was bearable because I knew by the time I counted to twenty they would start to ease up.
They sped up quickly—within the hour, contractions were intense, coming every few minutes, not letting up completely in between. I remember with shock feeling like I wanted to push, at which point D was already rushing to get the car. The next four contractions were a blur; when they hit I’d curl up on the ground wherever I was—sidewalk by the car, backseat of the car, hall of the hospital waiting for the elevator—and focus on not pushing and counting through it. After the fourth I had arrived in the hospital; I counted through two more while lying in bed, amid a flurry of activity. The doctors were paged stat to the room, they said I was fully dilated, the sterile field was being set up, and by the next contraction I started to push. I remember gripping D and a nurse’s hand on either side, surrounded by a ring of nurses and doctors, everyone cheering me on with each push. You can do this! I can see the head! Keep going!
An hour and fifteen minutes later, she was born. I could feel her coming out, burning then something slippery. Someone asked how it felt, and I kept saying, weird. I looked over and there she was, small and pink with two big open eyes.
Good memories: D walking and breathing with me, holding my hand in the tub. The songs I listened to. The circle of people cheering me on with each push. D’s look of excitement when he told me he could see the head. His look of relief afterwards when he said, “we did it!” Most of all, knowing that something elevated as such a negative, painful experience can be in part positive, redemptive; that the prayer, positive thinking, and preparation made a difference. And now she’s here!
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