Friday, July 10, 2009

the home stretch

I don't know about you, but I find myself forever wishing for something I don't have. Sometimes, I'm even wishing for something I had yesterday; yesterday I was wishing for today. You would think that at the age I am, I would be a little bit better at appreciating the moment. I'm working on it.

So I spent the first half of my stay here missing my family, my friends, my home, my irises. And while I'm definitely looking forward to coming home to all of those things (except for the irises, which are done now), I'm feeling sad to be leaving the people I've bonded with while I've been here. I like the midwives here, and the secretaries. Last year I was sad to leave them, too, but we all knew I would be back. This time I know that I won't be back here anytime soon, so it makes going home bittersweet.

The other interns are also a joy to be with. Its been fun getting to know them, and hear about their homes and lives, and know that we're all missing that together helps to make bonds. This has been a fun group of people. KD, from Wyomying/Oregon, has been a delight to meet. She's planning on going to grad school to become a Certified Nurse Midwife. She'll be a great, caring midwife. Dianna is from Puerto Rico. We're all envious of her beautiful Spanish, but she also speaks fluent English and so we've had a chance to get to learn about her home, family and traditions. Chana Luba is the newest intern, hailing from Massachusettes. Chana is Orthodox Jewish, so we've all learned some things about her faith and her lifestyle in the short time that she's been here. Brenda is here from Georgia, and knows my friend Judy who was here with me last year. She's missing her kids and grandkids at home, but has taken her time to share lots of support and information with us. It's so great to be here with such a cool diverse group of women--working, living, and learning together.

So while I'm happily making prepartions to come home, I'm aware that my new friendships will take on a different shape. Conversations over long distance, facebook entries and the like aren't quite the same as living and working together. Hopefully, we'll meet up at some other midwifery gatherng--a conference or another training opportunity. Definitely, these women will leave here and be a blessing to the birthing community with all of their knowledge and compassion.

So I've shipped some of my items home, and I'm planning when I'll pack my things up, and gathering things from all little corners of the house that are mine so I don't leave anything behind. I made my last trip to the grocery store today, trying to make sure to buy only what I will use before I leave, so as not to contribute to the growing pile of "community" food. And the family back home has the heads' up that Mom is coming home, so we better start cleaning up the house!

Thursday, July 9, 2009


Strangely, the schedule last week offered me a whole 48 continuous hours off this weekend. Knowing that my family was playing in the sun, swimming, having a picnic with good friends, and enjoying a family reunion made for an acute case of homesickness. Hanging around the intern house during a holiday weekend seemed like a bummer. With KD's car still in the shop, leaving the intern house meant either walking or a bus trip.

So KD and I ventured out on Sun Metro Route 50 to the movie theater. Public Enemies was playing, and given that my dad had quite an interest in outlaws, and our family had toured Little Bohemia when we were kids, it seemed like the movie of choice for the day. It was enjoyable, and fun to try to pick out the Wisconsin locales where some of the scenes were filmed. And a trip out of the intern house always brings an opportunity to flush the toilet paper, which we all do with great delight when we're away.

But a movie, even a movie that you get to on a bus ride, only kills about 4 hours. We knew when we left that we would probably miss one birth, because the mom was not a first timer, and she was already at 6 cm dilation when we left. Sure enough, she had birthed by the time we got back. Two more women were in labor by then, and seemingly neck and neck to the finish line. So, even though I wasn't scheduled to work, I put on my lab coat and hung around the clinic. There's always something to do if you're a willing body.

Because the two women were really birthing quite close to each other, I ended up assisting at the second birth. Then, because I really didn't have much else to do, I helped with the clean-up. Then I helped package tools for sterilizing. Then I attempted to sterilize. Then I hung out and talked with the 1st on (KD), and the staff midwife. Until 2:20. In the morning. What was I thinking?

So the next day, I was up only an hour or two later than my normal. I ended up spending most of Sunday on the couch. Literally. A total couch potato. I've read the books I came with, I've knitted some things, I've done my laundry. I've looked up a lot of random things, much to my roommates' chagrin because I always share the information with them. And while the intern house could use a little cleaning, I was really not that motivated for that kind of activity. Oh, yes, and the internet at the house/clinic is still non-functioning. Computers really aren't that fun without the internet.

Along comes an innocent enough FaceBook challenge from my sister, Juj. She got 63 words out of Charlotte, and could anyone beat it. Honestly, I really only wanted to get 64 words--sibling rivalry and all. I spent about an hour, and had 65 acceptable words. So I posted my count, and even my list. It's turned into a pretty funny interchange among Juj and her friend Toni and me. And it served to help me kill another 1 1/2 to 2 hours.

There were no births on Sunday, but seeing that there are 54 clients scheduled to birth sometime this month, something tells me that there won't be much leisure time for me between now and the time I leave. Which, by the way, is only a little more than a week away!

Wednesday, July 8, 2009

hard lessons

In a previous post, I alluded to needing to do some processing. A lot of processing has gone on over the last year and a half. Learning skills and judgement, figuring out how to work with each client and her family, acquiring enough Spanish to talk like a five-year-old midwife to the clients here at Casa (actually, I think I'm not as good as a five-year-old), learning about the business and politics of midwifery all have worked on my brain. Clearly, any kind of important work also works on your soul, and last week was my opportunity for this kind of processing.

Out of respect for the privacy of staff, interns, and clients here, I can only speak in generalities. When you work in the world of birth, you know in your brain that gestation, labor, and birth are unpredictable, that things can happen that you don't expect, that you might make mistakes even. You say this to your clients, your students and yourself in an effort to be somehow prepared for this certain eventuality. You read, learn, practice, drill so that you can react if and when you need to. Then an experience happens so that your heart learns this lesson. You realize that even though your hands and your brain knew what to do, all the work you've done in your brain did not in any way prepare you for how it would feel.

Always with the birthing there is a dying. A pregnancy dies as a baby is born, a young woman dies as a mother is born, a baby leaves his aquatic environment and makes the change to breath, to life. Transformation and change, birth and death inextricably intertwined. Sometimes even when everyone is healthy, we experience the events of birth as loss--loss of a lifestyle now changed forever, loss of the fantasy of what having a baby will be like, loss of who we used to be before we became parents. We work through these changes and losses, slowly but surely, and we are re-birthed as parents.

Sometimes, the losses are bigger than this, doing bigger work, making bigger transformations. I don't think I've heard anything so mournful and heartbreaking as the wail of a mother who's baby is no longer numbered among the living. I understand in a new way that as a midwife, I stand with a family on a narrow divide between one world and another, between water and land, between heaven and earth. I hope to shepherd many babies safely to this world, to land and earth and breath. But for the ones who don't make the journey, I pray that I will still be a blessing to their families, that somehow I could offer some comfort in their loss. And that all of us involved will be re-birthed, re-committed to doing this work, re-invented to continue to work for the glory of God.

where we hang out

The exterior of the clinic.

The exterior of the intern house.

The lab in the clinic. This counter is always contaminated with blood, urine, and various and sundry other things. We look at placentas, do urine dips, measure blood loss, and clean all tools here. We are constantly "green soaping" this counter and the sink.
This is the clean counter in the lab. We work on charts and paperwork here, and keep our coffee cups and water bottles here. Only clean stuff can go here--no blood, urine, etc.

Part of the staff office. Interns and staff can hang out here.

This is the staff desk, and the couch where we hang out a lot. I push the two "couch" chairs up to the single chair and sleep here for my overnight shift.

This is the back office of the clinic. The secretaries work here and also interns can hang out here and work on their computers, etc.

The community intern bike that's parked in our "back yard."
This is our back patio. You can't see that the glider has both seats punched through, so it's not really usable.
This is our big walk-in closet. It's nice because you can shut the door and turn on the light so to not wake any sleeping roommates while you're getting dressed.
This is my bedroom, the bed that I sleep in. Sorry, I didn't clean for you all. That's the way it is when people are working so hard.
This is the front intern bedroom. They didn't clean for you either. Their bedroom has a window, but it's always covered with the blanket because people need to sleep at all hours of the day. And you can hear the traffic from I10 here pretty clearly. At all times of day.
This is our dining area and our sitting area. there is a tv here, too. And lots of videos of past births from Casa. In case we can't get enough of the real thing.
The intern kitchen. We really didn't clean for you. There's a lot of stuff in the kitchen that is "community" food. Meaning that former interns left and didn't deal with their stuff. It's getting pretty ridiculous. I did clean out the refrigerator I'm using when I arrived. Seriously, who do they think is going to eat their 2 (or more) week old egg salad after they've gone?
The rest of the kitchen. I guess the dishes are at least clean.
Another sitting area near the front of the intern house. Almost no one spends time here. It's far away from the TV and the kitchen, and all of the lights are burned out. So we'd have to open the front door for some light, but then we would get yelled at for air conditioning the whole neighborhood. Just like my parents used to say.
The view outside the front door. Lest you think it be picturesque. . .
I'm really not kidding when I say that we live across the street from Interstate 10. There's also a fairly busy freight train line in the neighborhood as well. Not a whole lot of peace and quiet here. And each bedroom has a clinic phone in it, so that we can hear when we get called to a birth. I have to say that was one thing that was nice about the phone and DSL lines being down; we had a nice break from the phones ringing 24/7.

If you want a little layout perspective that the pics don't give you, you can see that here. Hope you enjoyed the tour!

Tuesday, July 7, 2009


The rule here is that whoever discharges a client in the immediate postpartum gets to do the laundry from the birth. If you've ever been at a birth, you know that the laundry is messy, and you might be inclined to throw items in the trash rather than attempt to wash them. I've done this at births. I'm not usually one to throw things away, but when you birth on your bath mat, I'm thinking that's $12 well spent to replace it.

So, I'm the laundry rebel. The laundry protocol here is two and one half typed pages. It's long. It includes soaking, scrubbing by hand, washing in cold, washing in hot, sorting, re-washing, and using bleach. It is typed in bold. You have to be able to speak the protocol to a staff midwife before you get scheduled for a first on shift. The last thing I am hoping to do after a 12 to 14 hour shift on my feet is work this hard at getting things clean.

The protocol has changed a bit since I was here last year. It's typed up prettier, and laminated now, and hangs right over the utility sink in which we're supposed to do all this soaking and scrubbing in the various pails and buckets provided.

On my first trek into the laundry room, I read the whole protocol while holding a large garbage bag full of yucky laundry. "I'm so not doing this," I said to myself. I dumped the whole sack of laundry into the washing machine, poured about 1/2 cup of hydrogen peroxide in along with some detergent and a scoop of oxyclean and set the whole mess on "hot." Seriously, I'm exhausted and someone else is in labor, and we're going to need these sheets before too long, so let's just get this done, shall we?

I know, I know. You're thinking you can't wash stains in hot water, it will set the stain. We all learned that from our mothers, and it's all over the internet as truth, I know because I just looked. Here's the deal: you need to wash your fabric in the hottest water it will tolerate to get a stain out. If you poked yourself and bled on your silk tie, you should wash it in cold water. However, if you bleed on your cotton sheets, hot water will do the trick. And you should never dry your item, or iron it before the stain is out. So if you try this trick at home, you should examine your laundry before you apply any kind of dry heat to it, lest you set the stain.

Hydrogen peroxide is the best cure for blood stains. It's amazing to watch it all bubble and foam, and it just pulls the stain right out. And I love an oxygen bleach--environmentally friendly, gets things clean and bright, what could be better?

I eat my dinner while the load is washing. The look through each item in the washer carefully. If you dry a stain, that's when it will be set, so I really don't want to do that. I know you're wondering how my laundry load turned out. Perfecta
as we say in Spanish. Pure white, no stains, and all without any pre-soaking, scrubbing or bleach. Then we just bake it in the dryer for 70 minutes on hot, and everything is good for the next girl. It's quick and efficient and gets the job done.

Just don't mention it to anyone until after I leave for home.

Monday, July 6, 2009

a day of rest

I've been silent on the blog for a while now due to a random convergence of reasons. First, a garbage truck took out the phone and dsl lines at the clinic last week Tuesday. It's just been fixed today, Monday, a whole week later despite many calls to the provider about how we're an emergency medical clinic and we REALLY need our phones.

Second, the car that I had been using belongs to KD, a very sweet and generous intern with whom I am blessed to spend this time with at Casa. Her car went into the shop on Wednesday and won't be back until Thursday or later this week. So going someplace else to use WiFi suddenly became more complicated as it required a bus trip, and probably the purchase of a cup of tea or something to justify sitting at a coffee shop to use the internet.

Third, I had a lot of processing to do after a pretty hard weekend here. More about this in another post.

Right after the hard weekend and before the garbage truck mishap and the car going to the shop, I had a chance to go to La Mesilla, New Mexico for a little r & r. It was just the ticket for some quiet processing away from El Paso and the clinic. La Mesilla is a historic little southwestern town. There was a cute coffee shop with wireless so that I could use the computer. It had lovely gardens, and I was enjoying sitting outside and sipping my iced coffee.

Here are the pics from La Mesilla.The mountains near Las Cruces and La Mesilla, NM.

Pretty little church on the square in La Mesilla.

The sign makes this pic self-explanatory, and made me nostalgic for a trip my family took when I was about age 10. We traveled out west and my Dad was very interested in the places where famous outlaws frequented and their gravesites.
Of all these picturesque buildings here, The Potteries was very attractive to me. I love pottery, and wanted to go in, and found that it's a working studio, with a wee bit of showroom space at the front of the building. The potter was a very nice lady who chatted a bit with me.

In the gardens at Josephina's Cafe. Love the fireplace.
The rest of Josephina's gardens.

Wednesday, June 24, 2009

counting days

This is starting to feel long to me. I've been here exactly 15 days, and I have 22 days left. There are four interns here right now, which is barely enough bodies to cover the shifts. So, we're all working hard, and taking our time off seriously.

Since we don't live in a very enchanting neighborhood, we have to walk, bus, or beg a ride to somewhere else when we're not working. Popular outings have included shopping (mostly for groceries, but also trips to various malls in El Paso), church, the movies, and exercising (walking, running or taking the community bike out for a spin). One of the interns, KD, has been very generous with her car, so I've been able to get out farther than I could go walking or on the bike that doesn't exactly fit me. I have 24 hours off starting tomorrow morning at 6 am, so I'm already plotting what to do during that time.

We had a flurry of babies when I first got here, and they've been trickling in ever since. We all feel a little like we're in the calm before the storm. We've had some late registrations (people coming in late in their pregnancy to register for care for the first time), so the numbers that are due are kind of building. We had such a late registration, that by the time she finished all the paperwork, the interview with the secretaries, and the exam with the intern, she was in active labor. So she came in to register, and ended up staying to have her baby. Pretty crazy, but also fun.

I do like that there's always something unexpected happening. There's never a "regular" day, really; there's plenty of opportunity to learn, to see and do, and to stretch and grow. I really shouldn't be counting days, but here I am doing so anyway.

What I'm going to do tomorrow depends a little bit at least on what happens tonight. I'm second on tonight. When you're second in the night, you can be in the intern house, but you have to be in scrubs the whole night so that if someone comes in laboring, you can head over to the clinic immediately when you're called. If nothing happens in the evening, you get to sleep. The duties for the second on person are rather limited, so once the birth happens and your chores are done you can go back to bed. All in all, you might end up being up for a couple of hours at most, but depending on when it happens, you could be needing some sleep the next day. So, I'm thinking that tomorrow may bring some sleep, some studying, some knitting, and a walk. Hopefully, I'll feel re-charged in case the storm of babies hits this weekend when I'm on for another 24 hour stint.