Several conversations over the last few days have made me think about what life should be like, who I want to be, who Alex wants to be, who we want to be together. My mom was making a "bucket" list (I made one a while back, you can see it in my July post from last year). But as I was looking over it just now, and talking to Alex, I was realizing that what I want is not to neccessarily accomplish this certain list of tasks. What I'm going for is a lifestyle, which I can kind of get a picture of from looking at those tasks.
I want my life to be a little bit like a Nikki McLure print, I guess. I want my life to be oriented towards adventure, enjoying the small things, being together with Alex and growing our relationship over the decades, learning from life and other people and growing spiritually, appreciating the passage of the seasons, communing with friends, building community, giving service to others-loving life and sucking the marrow out of it. I've always told people that I am a very visual person. I have to be able to actually see myself doing something or being someone in order to make it happen or to feel that it's right. So when I look at my life list I see myself riding my bike to the farmer's market in Columbia City, having coffee on the porch with Alex, making dinner with a crowd of friends, picking raspberries and sweet peas in the garden, being an excellent and compassionate midwife, going stargazing with Alex and making out on the beach.
Having the life list is helpful because it helps me see what the vision is, and maybe it will help me check in with how I'm doing. Since there will no doubt be hard days in any life (how else would we learn, and deepen connections with our loved ones), knowing that I am generally on the right track will be good. Here is my somewhat updated life list. It's scary to let go of the old one, becuause I worry it means I'm never going to accomplish anything with this everchanging goal. Ain't that life, though?
Near Future:
1) Keep fresh flowers in my house
2) Shop at the farmer's market
3) Grow our own food, and preserve for the winter
4) Remember to send cards and little gifts on people's birthdays
5) Kill my TV for good!
6) Learn to play the cello and/or the fiddle
7) Host a Love Feast
8) Go ice skating every winter, pick berries and fruit every summer, bake cookies and press leaves in the fall, cut our own tree and decorate like crazy for Christmas, dress up and hand out candy at Halloween, go all out for Thanksgiving Dinner with lots of family and friends, make Valentines cards and cookies for friends and family...
9) Try rock climbing
10) Be a trail runner
11) Make a budget and stick to it for a year
12) Hike a National Scenic Trail with Alex
13) Do yoga at least once a week for a year
14) Use my bike for 90% of my transportation
15) Fulfill my wedding vows every day
16) Go on a date once a month
17) Bake our own bread
18) Make out with Alex at a drive in movie
19) Go on a weekend road trip with Alex
20) Maintain close friendships and let my friends know how much I value them
21) Go stargazing with Alex and make out under the stars
22) Camp on a beach in the Fall with friends
Long Term
1) Be a kind, loving and faithful wife
2) Be an excellent, compassionate, skilled midwife
3) Be a foster parent
4) See Alex hold our baby
5) Volunteer at a hospice
6) Have my babies and grow old in one single house
Tuesday, July 14, 2009
Sunday, July 12, 2009
Standard Issue Nurse
I bought my UW purple scrubs a few weeks ago. And a white coat. Oh, the white coat. That symbol of authority and knowledge, of professional solidarity . I am at once proud that I will soon be wearing the uniform of a health care professional, and extremely cautious about it's meaning. I just want to be clear with myself about what kind of provider I'm going to be. I think I need to be pretty solid about my core beliefs and values before I start the standardizing process of nursing school.
There are advantages to standardization. It's nice to know that no matter where you get your care your privacy is protected by HIPPA, and your physician is somewhat bounded by standards of care. On the other hand, our health care system is not as uniform as one might think. There are huge variations in policy and treatment from one hospital to another, and even from one provider to another in the same institution. One week at Evergreen, moms with epidurals can use a squat bar and eat popsicles. The next week they're flat on their back for the duration, and it's ice chips only. One Group Health provider says 4cm and contracting every 5min is not even active labor. Another says if you do this for more than 12 hours you need a cesarean for failure to progress. So, standardization is at once a blessing, a curse, and an illusion.
Nursing school and medical school seem to be designed not only to teach providers the physical and mental skills, the facts, figures and flowcharts of their professions, but to teach them a certain belief system about their profession and about patients. It involves a little bit of de-humanization. Maybe you have to be a tad arrogant and a bit emotionally removed to take people's lives into your hands. I guess all I know is this, that I want to keep a few things about my beliefs and my humanity intact, regardless of what I learn in school. Even if I look like everyone else, in my purple scrubs and white coat, I want to hold onto what makes me human, and passionate about health care in the first place, and what grounds me. So I think I better write it down before I even start school.
1) We all, every one of us, deserve compassion, dignity and respect.
2) Just because I know some things about the human body does not mean I know more about my patient than they know about themselves, and does not make me superior in any way.
3) An ounce of prevention is worth a pound of cure.
4) People make good decisions for themselves, when provided with the information and resources they need to make those decisions. If it's not the choice I would make, that's Ok because it's not my choice to make and I'm not the one who lives with the consequences.
5) Most of the time, people need you to listen long and hard before you speak.
6) It's OK to say you're sorry.
There are advantages to standardization. It's nice to know that no matter where you get your care your privacy is protected by HIPPA, and your physician is somewhat bounded by standards of care. On the other hand, our health care system is not as uniform as one might think. There are huge variations in policy and treatment from one hospital to another, and even from one provider to another in the same institution. One week at Evergreen, moms with epidurals can use a squat bar and eat popsicles. The next week they're flat on their back for the duration, and it's ice chips only. One Group Health provider says 4cm and contracting every 5min is not even active labor. Another says if you do this for more than 12 hours you need a cesarean for failure to progress. So, standardization is at once a blessing, a curse, and an illusion.
Nursing school and medical school seem to be designed not only to teach providers the physical and mental skills, the facts, figures and flowcharts of their professions, but to teach them a certain belief system about their profession and about patients. It involves a little bit of de-humanization. Maybe you have to be a tad arrogant and a bit emotionally removed to take people's lives into your hands. I guess all I know is this, that I want to keep a few things about my beliefs and my humanity intact, regardless of what I learn in school. Even if I look like everyone else, in my purple scrubs and white coat, I want to hold onto what makes me human, and passionate about health care in the first place, and what grounds me. So I think I better write it down before I even start school.
1) We all, every one of us, deserve compassion, dignity and respect.
2) Just because I know some things about the human body does not mean I know more about my patient than they know about themselves, and does not make me superior in any way.
3) An ounce of prevention is worth a pound of cure.
4) People make good decisions for themselves, when provided with the information and resources they need to make those decisions. If it's not the choice I would make, that's Ok because it's not my choice to make and I'm not the one who lives with the consequences.
5) Most of the time, people need you to listen long and hard before you speak.
6) It's OK to say you're sorry.
Wednesday, July 1, 2009
Defensive Doula
You often hear about "defensive medicine." Providers who at the very least, chart every possible interaction and occurance with their patients so they are somewhat protected if the patient later sues for a bad outcome. At worst, providers use an intervention just to say they did something, which is thought to be better than doing nothing. Lately I feel like I've been practicing defensive doulaing.
I've begun to feel like, when I attend a hospital birth, the doctors and staff very much assume that my client will have an epidural, pitocin, and very possibly a cesarean. They are justified in the assumption: at one local hospital, 90% of women have an epidural, adn 36% have cesareans. When 90% of your patients have an extremely abnormal birth, abnormality becomes the new paradigm. The staff at the hospital with the highest epidural rate is clearly uncomfortable with normal birth. All the moaning, all the pesky position changes, the sheer duration of a normal birth. They are uncomfortable with women in pain, women who are tired, women who need emotional interaction and support. They are so used to an immobilized, chatty, TV watching laboring mom that when my sweaty, moaning, vomiting and shaking, hip rocking, crying, squatting, normal birthing mom is in the room they feel they must DO something. And what do they know how to do? For a while they might sit next to a bed (where many women assume they must stay during labor, or are stuck with a routine IV and fetal monitors) and tell a woman to "just relax, breath it out." But, they have other things to do, and I really get the feeling that many of them think the idea of unmedicated birth is just heinous, an unnecessary cruelty. And if you offer a woman in that much pain an epidural, they have an awfully hard time saying no.
Anyway, lately I've been feeling like I need to prepare my clients, really, really prepare them, to defend themselves from the new normal. Wait to go to the hospital until the last possible moment in labor. To say no (repeatedly, confidently, and assertively) to pretty much everything the staff tells them they 'have' to do. To close their ears to the innumerable discouraging comments, and to close their legs to the innumerable, discouraging, and pointless-unless-you're-in-a-hurry vaginal exams. I've even resorted to encouraging the use of very defensive, almost legal language in birth plans, to put the fear of god and litigation into the staff. "I DO NOT CONSENT to any cesarean that is not an emergency." Telling patients they might want to cross out the section of the admitting paperwork where they sign a general consent for a cesarean. This is not stuff that encourages the team spirit, mutual respect, and collegial vibe that I have always worked for in my relationships with staff.
Although I'm not happy about these ways in which I've changed my practice, I'm not ashamed of them. There are changes, however, that I am more worried about. These are where I am truly taking on a practice similar to defensive medicine: I'm doing something (something I don't even believe in) just to do something, to change my clients behavior because I can't change the providers' behavior. I'm ashamed to admit that I've used directed, purple pushing with unmedicated moms, because I know we have 3 hours to get the baby out before the staff start to move for a cesarean or if we're lucky, a vacuum. An unmedicated mom with a good urge to push may take 4-5 hours to push her baby out, both mom and babe are perfectly healthy, and she pushes when and how she feels she needs to. Lately I've told moms that they're better off to flat out lie to staff about their pain, frustration, or fatigue. Of course the mom is tired. That is NOT a valid reason for major abdominal surgery. Even worse, telling women you think they are too tired to push at all, before they even try, and before they have said boo about being tired. I feel terrible encouraging my women to change their normal birth to save them from an abnormal birth. Wait forever to go to the hospital so that you have to practically crawl down the hall in transition. Furitively sneak gulps of apple juice when the nurse is out of the room. Outright deny your perfectly normal feelings of fatigue, frustration, uncertainty. Lie when they ask you to put your (level unspeakable) pain on a 1-10 scale and say it's not too, too bad, maybe a 7. Lie and say you aren't at all tired when it's time to push, say you have all the energy in the world. Because the staff has 0 faith in women's ability to give birth, they latch onto the slightest indication that she too is doubtful, and exploit it to push intervention.
All of this bugs me on the obvious level that it is unjust for the laboring woman. But it bugs me in a more insideous way too. Because I am not a rule breaker. I am a rule maker, a rule follower, a research and science and fact junkie. I'm the kid who cried when I was even mildly scolded for breaking a rule. I'm not one of those fanatical, radical, 'use nothing but your intuition to make decisions about your birth' people. I believe firmly that there is a time and a place for everything, including epidurals, pitocin, and cesarean birth. I believe that we should base medical recommendations on good research, and that clients should base their decisions on solid, honest information about the recommendation, the alternatives, and the risks and benefits of each. It bothers me that sometimes I hear myself talk about birth, and I hear the voice of a frustrated fanatic, not the logical, down to earth, pragmatic person I am. Of course it bothers me that believing a woman in labor has the right to full informed decision making makes me sound radical.
Moreover, I have to walk a very fine ethical line between my scope of practice and standards of care as a doula, and doing what the situation demands to defend my clients from ridiculous hospital policies and bad provider attitudes. It's hard on my self image; it's hard on me emotionally to go to births where I feel like the woman is truly treated unjustly, and it's hard on me to feel like I'm constantly toeing a line between actually helping my clients get good, healthy outcomes, and stepping outside of my very restricted scope as a doula. Technically as a doula I am supposed to "protect the woman's memory of her birth, recognizing that birth is a peak life experience." But I am quite sick of trying to protect women's memory of their unneccessary cesarean. And it's hard to qualify an afternoon spent napping, doing cross-words, and watching TV as a peak life experience, even though it does end in a new human being.
I'm doing my best, and I'm not sure I'm doing enough. That sucks, because I care. A lot. About birth as a peak life experience. About the health of moms and babies. About the way a woman remembers her birth and perceives her strength in birthing, and takes that memory and knowledge of how strong she is, and uses it to get through sleepless nights, teething, smarty pants eight year olds, snotty teenagers, sending her baby to college, supporting her daughter when she has a baby of her own. It really, really matters.
I've begun to feel like, when I attend a hospital birth, the doctors and staff very much assume that my client will have an epidural, pitocin, and very possibly a cesarean. They are justified in the assumption: at one local hospital, 90% of women have an epidural, adn 36% have cesareans. When 90% of your patients have an extremely abnormal birth, abnormality becomes the new paradigm. The staff at the hospital with the highest epidural rate is clearly uncomfortable with normal birth. All the moaning, all the pesky position changes, the sheer duration of a normal birth. They are uncomfortable with women in pain, women who are tired, women who need emotional interaction and support. They are so used to an immobilized, chatty, TV watching laboring mom that when my sweaty, moaning, vomiting and shaking, hip rocking, crying, squatting, normal birthing mom is in the room they feel they must DO something. And what do they know how to do? For a while they might sit next to a bed (where many women assume they must stay during labor, or are stuck with a routine IV and fetal monitors) and tell a woman to "just relax, breath it out." But, they have other things to do, and I really get the feeling that many of them think the idea of unmedicated birth is just heinous, an unnecessary cruelty. And if you offer a woman in that much pain an epidural, they have an awfully hard time saying no.
Anyway, lately I've been feeling like I need to prepare my clients, really, really prepare them, to defend themselves from the new normal. Wait to go to the hospital until the last possible moment in labor. To say no (repeatedly, confidently, and assertively) to pretty much everything the staff tells them they 'have' to do. To close their ears to the innumerable discouraging comments, and to close their legs to the innumerable, discouraging, and pointless-unless-you're-in-a-hurry vaginal exams. I've even resorted to encouraging the use of very defensive, almost legal language in birth plans, to put the fear of god and litigation into the staff. "I DO NOT CONSENT to any cesarean that is not an emergency." Telling patients they might want to cross out the section of the admitting paperwork where they sign a general consent for a cesarean. This is not stuff that encourages the team spirit, mutual respect, and collegial vibe that I have always worked for in my relationships with staff.
Although I'm not happy about these ways in which I've changed my practice, I'm not ashamed of them. There are changes, however, that I am more worried about. These are where I am truly taking on a practice similar to defensive medicine: I'm doing something (something I don't even believe in) just to do something, to change my clients behavior because I can't change the providers' behavior. I'm ashamed to admit that I've used directed, purple pushing with unmedicated moms, because I know we have 3 hours to get the baby out before the staff start to move for a cesarean or if we're lucky, a vacuum. An unmedicated mom with a good urge to push may take 4-5 hours to push her baby out, both mom and babe are perfectly healthy, and she pushes when and how she feels she needs to. Lately I've told moms that they're better off to flat out lie to staff about their pain, frustration, or fatigue. Of course the mom is tired. That is NOT a valid reason for major abdominal surgery. Even worse, telling women you think they are too tired to push at all, before they even try, and before they have said boo about being tired. I feel terrible encouraging my women to change their normal birth to save them from an abnormal birth. Wait forever to go to the hospital so that you have to practically crawl down the hall in transition. Furitively sneak gulps of apple juice when the nurse is out of the room. Outright deny your perfectly normal feelings of fatigue, frustration, uncertainty. Lie when they ask you to put your (level unspeakable) pain on a 1-10 scale and say it's not too, too bad, maybe a 7. Lie and say you aren't at all tired when it's time to push, say you have all the energy in the world. Because the staff has 0 faith in women's ability to give birth, they latch onto the slightest indication that she too is doubtful, and exploit it to push intervention.
All of this bugs me on the obvious level that it is unjust for the laboring woman. But it bugs me in a more insideous way too. Because I am not a rule breaker. I am a rule maker, a rule follower, a research and science and fact junkie. I'm the kid who cried when I was even mildly scolded for breaking a rule. I'm not one of those fanatical, radical, 'use nothing but your intuition to make decisions about your birth' people. I believe firmly that there is a time and a place for everything, including epidurals, pitocin, and cesarean birth. I believe that we should base medical recommendations on good research, and that clients should base their decisions on solid, honest information about the recommendation, the alternatives, and the risks and benefits of each. It bothers me that sometimes I hear myself talk about birth, and I hear the voice of a frustrated fanatic, not the logical, down to earth, pragmatic person I am. Of course it bothers me that believing a woman in labor has the right to full informed decision making makes me sound radical.
Moreover, I have to walk a very fine ethical line between my scope of practice and standards of care as a doula, and doing what the situation demands to defend my clients from ridiculous hospital policies and bad provider attitudes. It's hard on my self image; it's hard on me emotionally to go to births where I feel like the woman is truly treated unjustly, and it's hard on me to feel like I'm constantly toeing a line between actually helping my clients get good, healthy outcomes, and stepping outside of my very restricted scope as a doula. Technically as a doula I am supposed to "protect the woman's memory of her birth, recognizing that birth is a peak life experience." But I am quite sick of trying to protect women's memory of their unneccessary cesarean. And it's hard to qualify an afternoon spent napping, doing cross-words, and watching TV as a peak life experience, even though it does end in a new human being.
I'm doing my best, and I'm not sure I'm doing enough. That sucks, because I care. A lot. About birth as a peak life experience. About the health of moms and babies. About the way a woman remembers her birth and perceives her strength in birthing, and takes that memory and knowledge of how strong she is, and uses it to get through sleepless nights, teething, smarty pants eight year olds, snotty teenagers, sending her baby to college, supporting her daughter when she has a baby of her own. It really, really matters.
Tuesday, October 14, 2008
Obit Reader
Reading the obituary page is definitely my favorite part of the whole paper. The rest of the paper is all passing news, the scandal of the hour, and no matter how horrifying that particular hour is-well, as someone once said (the Bible?), "This too shall pass." But not the Obits. The Obits will stay the same way forever, and the lives of the people they memorialize are now static. How much easier it is to get a handle on something when you're pretty sure that no new information will be dropped on you at the last minute. Of course that isn't uniformly true. God bless the family that finds out years after a death about some unsavory aspect of the deceased (Grandma's S&M buddy memorializes her as such in his obit), and also those who find out about a heretofore unknown aspect of their loved one's good character (the janitor who saved millions to donate to charity). However, these are probably the exception to the rule. For the most folks, the obit is the final summary of what you did or did not do.
When I scan the obits, I look first for the tragedy. The birth and death dates that aren't far enough apart, the "died suddenly and unexpectedly," the ones that mention the memorial service being held at a high school. Tragedy wakes you up like no cup of coffee ever could, readying you for a day of making sure you get a few things taken care of, telling some folks how much you love (or despise) them, and doing something worth noting for chris'sake! It seems like a mistake to me to think that because I am 23 I have plenty of time to make my death noteworthy and my obit interesting. I've seen many 17-25 year olds in the paper, whose families were obviously struggling to come up with something notable about them without resorting to their remarkable ability to be an ass to their parents, their outrageous acne, their record breaking SAT scores, etc. They end up with something like, "Jessica/Kevin was a friend to everyone she/he met." No, they weren't. Why would they want to be? I much prefer the families who choose to acknowledge what may have been truly remarkable about their kid, but maybe they're the only ones who knew or appreciated it. "Epiphany Asteroid Jones once told her 2nd grade teacher to kiss off, and maintained that attitude ever since, applying it especially vigorously to her cancer." The lucky ones are those whose kids actually did do something that they would have wanted written about. "Mary volunteered as a Ski-for-All guide, helping people who were blind or had no legs to ski." It seems almost more tragic than a premature death when the parents can't think of anything to say about their kid. I don't want to be mean. The last place anyone hopes or plans to spend their creative writing energy is on their child's obit, and unlike the elderly, few teenagers pre-write the obit or mention what they want said. I guess I just hope that if I died right now, no one would censor themselves. Just pour out all the grief and humor you can find in my life and death, and publish it for posterity to dig up in a geneology library some day.
The next set of folks I look for are those who were married for 50+ years. Remarkable. That's something that, if I am hardworking, lucky, and dogged enough to accomplish, I damn sure want noted in my obit. If the spouse is surviving, I am forced to think about them. I have shared a bed with Alex for seven years, and I don't sleep well without his twitches and snorts, and the occasional, precious half-awake declaration of love. It's unimaginable how one would feel after 65 years, whether they were spectacular years or not. I guess for some it could be a sense of relief, but I have to think that for most it's more like losing three of your limbs, all at a go. "John leaves behind his wife of 67 years," is going to be a rarer and rarer sighting on the obit page. Those I read about who reached the 50 year mark were married when they were around 20, sometime in the 1940's. I know very few people now who are married before they're 30, if they marry at all. Those that do eventually marry proceed to get divorced in fairly short order. It seems like 20-25 years is the longest one can hope to be married these days. I certainly hope it's a trend that turns around, that some miracle of good communication skills and loving respect will present itself out of the depths of a nation immersed in bad examples on reality TV. In the meantime, I pay my respects to these hardworking and loyal spouses.
After premature deaths and long-time spouses, I read everyone else. A few minutes spent in meditation on people with no obit, just death notices. A few admiring thoughts for folks who did quirky things they must have caught flack for (collecting 150 antique vacuum cleaners comes to mind), and people who suffered the extraordinary and lived on (a child abducted and never heard from again, a holocaust survivor, any combat vets). I know there are lots of things not said in the obits that might be lovable or despicable, and I spend a minute contemplating what those things might be.
Then I close the paper, and having been reminded of the important stuff, live my life.
When I scan the obits, I look first for the tragedy. The birth and death dates that aren't far enough apart, the "died suddenly and unexpectedly," the ones that mention the memorial service being held at a high school. Tragedy wakes you up like no cup of coffee ever could, readying you for a day of making sure you get a few things taken care of, telling some folks how much you love (or despise) them, and doing something worth noting for chris'sake! It seems like a mistake to me to think that because I am 23 I have plenty of time to make my death noteworthy and my obit interesting. I've seen many 17-25 year olds in the paper, whose families were obviously struggling to come up with something notable about them without resorting to their remarkable ability to be an ass to their parents, their outrageous acne, their record breaking SAT scores, etc. They end up with something like, "Jessica/Kevin was a friend to everyone she/he met." No, they weren't. Why would they want to be? I much prefer the families who choose to acknowledge what may have been truly remarkable about their kid, but maybe they're the only ones who knew or appreciated it. "Epiphany Asteroid Jones once told her 2nd grade teacher to kiss off, and maintained that attitude ever since, applying it especially vigorously to her cancer." The lucky ones are those whose kids actually did do something that they would have wanted written about. "Mary volunteered as a Ski-for-All guide, helping people who were blind or had no legs to ski." It seems almost more tragic than a premature death when the parents can't think of anything to say about their kid. I don't want to be mean. The last place anyone hopes or plans to spend their creative writing energy is on their child's obit, and unlike the elderly, few teenagers pre-write the obit or mention what they want said. I guess I just hope that if I died right now, no one would censor themselves. Just pour out all the grief and humor you can find in my life and death, and publish it for posterity to dig up in a geneology library some day.
The next set of folks I look for are those who were married for 50+ years. Remarkable. That's something that, if I am hardworking, lucky, and dogged enough to accomplish, I damn sure want noted in my obit. If the spouse is surviving, I am forced to think about them. I have shared a bed with Alex for seven years, and I don't sleep well without his twitches and snorts, and the occasional, precious half-awake declaration of love. It's unimaginable how one would feel after 65 years, whether they were spectacular years or not. I guess for some it could be a sense of relief, but I have to think that for most it's more like losing three of your limbs, all at a go. "John leaves behind his wife of 67 years," is going to be a rarer and rarer sighting on the obit page. Those I read about who reached the 50 year mark were married when they were around 20, sometime in the 1940's. I know very few people now who are married before they're 30, if they marry at all. Those that do eventually marry proceed to get divorced in fairly short order. It seems like 20-25 years is the longest one can hope to be married these days. I certainly hope it's a trend that turns around, that some miracle of good communication skills and loving respect will present itself out of the depths of a nation immersed in bad examples on reality TV. In the meantime, I pay my respects to these hardworking and loyal spouses.
After premature deaths and long-time spouses, I read everyone else. A few minutes spent in meditation on people with no obit, just death notices. A few admiring thoughts for folks who did quirky things they must have caught flack for (collecting 150 antique vacuum cleaners comes to mind), and people who suffered the extraordinary and lived on (a child abducted and never heard from again, a holocaust survivor, any combat vets). I know there are lots of things not said in the obits that might be lovable or despicable, and I spend a minute contemplating what those things might be.
Then I close the paper, and having been reminded of the important stuff, live my life.
Saturday, October 11, 2008
Not Much Cookin'
Not much to report at all today. I rode the bus to the shelter, which was great. Buses are fantastic when you have all the time in the world to get where you're going, and a good book to entertain you and keep the weirdos away. It was a perfect fall day here: cool, crisp, blue skies, and a breeze.
The shelter was quiet, and all I did was update obselete forms in an obselete word processing program. I worked with T., my favorite advocate. She is hardworking, up front, and knowledgeable. What more could anyone ask for.
I just finished a pretty good book, called The Beautiful Things that Heaven Bears. And, after spending a few minutes thinking about it, I decided to add a reading list to this blog. I always appreciate a lead on a good book, and my mom has always (really, always-like since 2nd grade) encouraged me to start a reading list. Like many things my mom has encouraged me to do over the years, I regret not having done this sooner. Just trying to remember what I've read over the last few weeks was hard, let alone 2nd grade. I'll always remember Ramona, Nancy Drew, Zel, and unfortuantely and embarrassingly, the Babysitters Club series. Beyond that it's a long, mostly happy blur. The public library doesn't keep a list of what you check out, which is quaint, since I'm sure Homeland Security does.
Maybe I'll have more exciting things to say soon. If anyone actually reads this blog, post comments now or forever hold your peace when I start posting gory details of my cat's life because I think no one else is reading this....
The shelter was quiet, and all I did was update obselete forms in an obselete word processing program. I worked with T., my favorite advocate. She is hardworking, up front, and knowledgeable. What more could anyone ask for.
I just finished a pretty good book, called The Beautiful Things that Heaven Bears. And, after spending a few minutes thinking about it, I decided to add a reading list to this blog. I always appreciate a lead on a good book, and my mom has always (really, always-like since 2nd grade) encouraged me to start a reading list. Like many things my mom has encouraged me to do over the years, I regret not having done this sooner. Just trying to remember what I've read over the last few weeks was hard, let alone 2nd grade. I'll always remember Ramona, Nancy Drew, Zel, and unfortuantely and embarrassingly, the Babysitters Club series. Beyond that it's a long, mostly happy blur. The public library doesn't keep a list of what you check out, which is quaint, since I'm sure Homeland Security does.
Maybe I'll have more exciting things to say soon. If anyone actually reads this blog, post comments now or forever hold your peace when I start posting gory details of my cat's life because I think no one else is reading this....
Thursday, October 9, 2008
Workaholics, relax-o-matics
I've been thinking a lot about work lately. Some would say I have time to think about it because I haven't been doing that much of it. I think it's part of my lifelong process of self-acceptance. Also, living with and loving the people I do, work is like a 7th house mate, a family member, the juicy friend that's great to gossip about around the dinner table.
Some people work a lot because they must in order to make ends meet. Other people genuinely love what they do for a living. Some feel obligated to work because their work is important to the world. But I've found that the people I know, regardless of their motivation for working or whether they take pride in the work itself, take pride in working a lot.
I'm not so sure working more than necessary is a good thing. Everyone seems to have a rebellious viewpoint on at least one generally excepted socio-cultural norm. My friend Ben thinks that lard is good for you, and damn the surgeon general. Several friends think that monogamy is a terrible and oppressive practice. A few disbelieve in the existence of most mental illness. I take issue with the moral value of work, specifically working a lot.
These work-a-lot types aren't the people I'd think they would be. It's not like they're stock brokers, day traders, ER residents, miners. They're union organizers, teachers, bar tenders, students, retail clerks. Alex, as some of you might know, is definitely a work-a-lot type, and he has so far come up with the best (and most damning) explanation of work-a-lots for me. "If everyone else would just work more, just do their share, I wouldn't have to work so hard." He told me this a few years ago, and I was overcome with guilt. I, through my relaxation, was working him to death. I immediately started a student group, joined a board, started volunteering at a shelter and a hospital. By God, I was going to do my part to save the hard working work-a-lot types from perishing for my relaxation sins. Of course, that is the vastly oversimplified version of events. I really did and still do care about the organizations and projects I am involved in.
Nothing changed except for my level of anxiety and self-loathing. I'm bad at being overworked, and for a long time that has been a source of shame for me. I have an irresistable urge to slack when I am overwhelmed, and it's not as pleasant as it sounds. At my breaking point, it happens like this: I lay down to sleep, at last, around 1am. I have nightmares all night, that make me cry out, thrash, and generally disrupt my own and Alex's sleep (recently, my spine was torn out by an alligator). After weeks of sleep that is basically more exhausting than it is restful, I wake up one morning, crack my eyes, and can't get out of bed. My heart is beating so fast I fear that I will have a heart attack. I know, from various failed attempts at athletic training, what my maximum heart rate is, and I know that I must me approaching it as I lay there sweating and panting, exhausted and unable to do the 8 bazillion things I have promised various committees, the homeless, the abused, my family, my friends, myself, that I will do. It goes on like this, until I close my eyes and wait, submit to the panic, and eventually it passes. If I have any sense, I go climb into the guest bed and go back to sleep. If not, I go get started on the 8 bazillion things, but the truth, I've learned from so many repeats of this episode, is that it's all over at this point. My relax-o-matic kicks in. I can't focus enough to get anything done. In my shame, I don't call or email or text anyone to let them know that I'll be dropping out of society for a few days or weeks. I just stop. Recently, I stopped as I have before, but this time I tried something different. I tried not to hate myself for stopping. The nightmares and the heart attacks continued for a while, but over the last few weeks they've been on the decline.
It's hard not to think of my inability to handle overwork as one of my greatest moral failings. There are all kinds of derogatory labels for people like me, but I know they're others out there. Partly because Alex is not one of them, and he complains frequently about people who all of a sudden, after a period of good work, stop returning his calls and emails, miss deadlines without warning, blow off important meetings. He is mystified, but I know. They're me. It doesn't help a lot on my mission of self-love that these people drive Alex crazy, but whether out of unconditional love or out of ignorance of my true relaxing nature, he loves me. I prefer to think it's the latter that gets us through.
One option that I've considered in the past is that other people only pretend to work harder than I find possible, unkindly fibbing me into attempting the unreasonable. Sadly, that theory has been disproved my my current acquaintances. In the interest of their privacy, I won't go into specifics of their schedules, but suffice to say that no one works merely 40 hours a week. Relaxation is a priority for no one. Reading the paper leisurely while drinking a hot cup of coffee, contemplatively staring out the window for a few minutes, browsing dusty corners of the local public library-none of this is penciled into their schedules. Some of them try, sometimes subtly, sometimes cuttingly, to make me feel like a bit of a loser for partaking in these activities. Lately, I refuse. I refuse to feel guilty. Not that I have reached Buddha-like peace with myself on this issue. I'm still just a little jealous of other people's capacity for work, but lately I've been hoping that they are a tad jealous of my capacity for doing nothing.
Some people work a lot because they must in order to make ends meet. Other people genuinely love what they do for a living. Some feel obligated to work because their work is important to the world. But I've found that the people I know, regardless of their motivation for working or whether they take pride in the work itself, take pride in working a lot.
I'm not so sure working more than necessary is a good thing. Everyone seems to have a rebellious viewpoint on at least one generally excepted socio-cultural norm. My friend Ben thinks that lard is good for you, and damn the surgeon general. Several friends think that monogamy is a terrible and oppressive practice. A few disbelieve in the existence of most mental illness. I take issue with the moral value of work, specifically working a lot.
These work-a-lot types aren't the people I'd think they would be. It's not like they're stock brokers, day traders, ER residents, miners. They're union organizers, teachers, bar tenders, students, retail clerks. Alex, as some of you might know, is definitely a work-a-lot type, and he has so far come up with the best (and most damning) explanation of work-a-lots for me. "If everyone else would just work more, just do their share, I wouldn't have to work so hard." He told me this a few years ago, and I was overcome with guilt. I, through my relaxation, was working him to death. I immediately started a student group, joined a board, started volunteering at a shelter and a hospital. By God, I was going to do my part to save the hard working work-a-lot types from perishing for my relaxation sins. Of course, that is the vastly oversimplified version of events. I really did and still do care about the organizations and projects I am involved in.
Nothing changed except for my level of anxiety and self-loathing. I'm bad at being overworked, and for a long time that has been a source of shame for me. I have an irresistable urge to slack when I am overwhelmed, and it's not as pleasant as it sounds. At my breaking point, it happens like this: I lay down to sleep, at last, around 1am. I have nightmares all night, that make me cry out, thrash, and generally disrupt my own and Alex's sleep (recently, my spine was torn out by an alligator). After weeks of sleep that is basically more exhausting than it is restful, I wake up one morning, crack my eyes, and can't get out of bed. My heart is beating so fast I fear that I will have a heart attack. I know, from various failed attempts at athletic training, what my maximum heart rate is, and I know that I must me approaching it as I lay there sweating and panting, exhausted and unable to do the 8 bazillion things I have promised various committees, the homeless, the abused, my family, my friends, myself, that I will do. It goes on like this, until I close my eyes and wait, submit to the panic, and eventually it passes. If I have any sense, I go climb into the guest bed and go back to sleep. If not, I go get started on the 8 bazillion things, but the truth, I've learned from so many repeats of this episode, is that it's all over at this point. My relax-o-matic kicks in. I can't focus enough to get anything done. In my shame, I don't call or email or text anyone to let them know that I'll be dropping out of society for a few days or weeks. I just stop. Recently, I stopped as I have before, but this time I tried something different. I tried not to hate myself for stopping. The nightmares and the heart attacks continued for a while, but over the last few weeks they've been on the decline.
It's hard not to think of my inability to handle overwork as one of my greatest moral failings. There are all kinds of derogatory labels for people like me, but I know they're others out there. Partly because Alex is not one of them, and he complains frequently about people who all of a sudden, after a period of good work, stop returning his calls and emails, miss deadlines without warning, blow off important meetings. He is mystified, but I know. They're me. It doesn't help a lot on my mission of self-love that these people drive Alex crazy, but whether out of unconditional love or out of ignorance of my true relaxing nature, he loves me. I prefer to think it's the latter that gets us through.
One option that I've considered in the past is that other people only pretend to work harder than I find possible, unkindly fibbing me into attempting the unreasonable. Sadly, that theory has been disproved my my current acquaintances. In the interest of their privacy, I won't go into specifics of their schedules, but suffice to say that no one works merely 40 hours a week. Relaxation is a priority for no one. Reading the paper leisurely while drinking a hot cup of coffee, contemplatively staring out the window for a few minutes, browsing dusty corners of the local public library-none of this is penciled into their schedules. Some of them try, sometimes subtly, sometimes cuttingly, to make me feel like a bit of a loser for partaking in these activities. Lately, I refuse. I refuse to feel guilty. Not that I have reached Buddha-like peace with myself on this issue. I'm still just a little jealous of other people's capacity for work, but lately I've been hoping that they are a tad jealous of my capacity for doing nothing.
Friday, August 8, 2008
Oi! The guilt!
Song o' the day: http://www.xtreak.com/go/carenott/130533/Trinity_Roots_-_Little_Things.m
I just called in sick to my postpartum job today, because I am so overwhelmed with other things I need to get done. In the longterm, it's a good decision because I'm working on my longterm, big picture plan today, but in the short term...Oh the guilt! I just need to be organized enough to work full time AND get nursing school stuff knocked out. But we all know that's not how I am, at least not at this stage of my self-improvement.
Things I'll be doing today:
1) Writing three birth stories and emailing them to clients
2) Calling to check in on postpartum mamas
3) Calling to check in on pregnant mamas
4) Emailing out birth plan forms/examples and homebirth supply lists to two clients
5) Rough drafting two essays and finishing the form part of the common application
6) Volunteering at the DV shelter
7) Mailing off some care packages
8) Deciding who to ask for letters of rec
9) Catching up on SMS board stuff....ugh
10) Updating my appointment book
Things I need to do tomorrow:
1) Take a float test for rowing (yep, I can tread water for 10 minutes!)
2) Study for GRE
3) Pick out some cologne for Alex (cause it's really for me...)
Alex is being incredibly wonderful helping me stay motivated and enthusiastic about nursing school applications. We daydreamed last night about how great it'll be to get acceptance letters (please, please, please!) and actually get to go somewhere new and do something new. The world is so wide! Staying focused on the outcome is definitely important, when it's so easy to get dragged down in the annoying details of applications.
I'm trying to think about any updates I haven't included since I last posted. Went to a great volunteer birth at the UWMC last week. Early in the labor I really didn't feel like I was connecting with the mama. The differences between us were so huge: she was African, already a mother, much older than me, probably not someone who would've chosen me had we interviewed. But I was the only volunteer available when she got to the hospital, and she was stuck with me-or at least I felt like she felt stuck with my cheerful, young, white, childless, English-speaking self. But as usual, when hard labor really set in, the walls came down, we connected, and afterward we felt like sisters for the 45 minutes or so I could stick around. It is wonderful and amazing what labor does to social boundaries and divisions.
I also got a kick in the pants from watching the new resident, and (I know this is totally prideful and arrogant) realizing that I know a bit more about normal labor and birth than he did, and possibly am even more familiar with the common drugs and interventions. To cut the guy some slack, all the newbies just started July 1st, so he hasn't had a whole lot of time yet, and maybe he doesn't even want to work in OB. But still-it made me realize how much I really have learned from going to all these births over the last couple of years. The interrupted sleep has paid off!
My twins moms had their babies yesterday-they are HUGE for twins, and so healthy! Yea!
Alex has a stress fracture and tendonitis in his wrist, probably from his bike trip. Poor guy can't ride his bike now, but he is quitting his job effective late September. That's soothing the wound of being bike-less.
As you can see from the To-Do list above, I need to go actually get things done.
Love ya's!
Caren
I just called in sick to my postpartum job today, because I am so overwhelmed with other things I need to get done. In the longterm, it's a good decision because I'm working on my longterm, big picture plan today, but in the short term...Oh the guilt! I just need to be organized enough to work full time AND get nursing school stuff knocked out. But we all know that's not how I am, at least not at this stage of my self-improvement.
Things I'll be doing today:
1) Writing three birth stories and emailing them to clients
2) Calling to check in on postpartum mamas
3) Calling to check in on pregnant mamas
4) Emailing out birth plan forms/examples and homebirth supply lists to two clients
5) Rough drafting two essays and finishing the form part of the common application
6) Volunteering at the DV shelter
7) Mailing off some care packages
8) Deciding who to ask for letters of rec
9) Catching up on SMS board stuff....ugh
10) Updating my appointment book
Things I need to do tomorrow:
1) Take a float test for rowing (yep, I can tread water for 10 minutes!)
2) Study for GRE
3) Pick out some cologne for Alex (cause it's really for me...)
Alex is being incredibly wonderful helping me stay motivated and enthusiastic about nursing school applications. We daydreamed last night about how great it'll be to get acceptance letters (please, please, please!) and actually get to go somewhere new and do something new. The world is so wide! Staying focused on the outcome is definitely important, when it's so easy to get dragged down in the annoying details of applications.
I'm trying to think about any updates I haven't included since I last posted. Went to a great volunteer birth at the UWMC last week. Early in the labor I really didn't feel like I was connecting with the mama. The differences between us were so huge: she was African, already a mother, much older than me, probably not someone who would've chosen me had we interviewed. But I was the only volunteer available when she got to the hospital, and she was stuck with me-or at least I felt like she felt stuck with my cheerful, young, white, childless, English-speaking self. But as usual, when hard labor really set in, the walls came down, we connected, and afterward we felt like sisters for the 45 minutes or so I could stick around. It is wonderful and amazing what labor does to social boundaries and divisions.
I also got a kick in the pants from watching the new resident, and (I know this is totally prideful and arrogant) realizing that I know a bit more about normal labor and birth than he did, and possibly am even more familiar with the common drugs and interventions. To cut the guy some slack, all the newbies just started July 1st, so he hasn't had a whole lot of time yet, and maybe he doesn't even want to work in OB. But still-it made me realize how much I really have learned from going to all these births over the last couple of years. The interrupted sleep has paid off!
My twins moms had their babies yesterday-they are HUGE for twins, and so healthy! Yea!
Alex has a stress fracture and tendonitis in his wrist, probably from his bike trip. Poor guy can't ride his bike now, but he is quitting his job effective late September. That's soothing the wound of being bike-less.
As you can see from the To-Do list above, I need to go actually get things done.
Love ya's!
Caren
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