Tuesday, April 21, 2009

Blessed Art Thou Among Women

We have been taking some blows here in DBL. Women who have lost once have lost again. New members are appearing daily. My heart has been heavy, and it started about 3 weeks ago when one of my on-line friends Andrea lost one of her triplets after she hung on for 6 1/2 months.

I have known, in my utmost core, that life is not fair. It is random and messy and it is easy to shake your fists and wish that you were living a charmed life, still stuck in the cocoon where things like children dying don't happen.

The charmed life--the life that we think the other girl is leading.

On the surface it looks perfect. Perfect husband, job, life. Dammit, you think....if only I could have a life like her....

When Ronan died, I thumbed through the leaflets that accompanied my DBL Mom package, the pamphlets that emphatically stated it was not my fault, the ones that talked about how I should deal with my grief. There were numbers for local bereavement groups, and a link for MISS. When I went to that website, I was welcomed into a world of ‘Holy Crap! It could be so much fucking worse’.

One of the first stories I read was of Amy, who lost her boy Liam 1 hour after he was born and they didn’t know why. I was reading stories of how babies were lost at 34, 37, 40 weeks, and some while pushing the babies out. My loss at 28 weeks felt like small potatoes. I felt lucky in a way.

And I have had and read a lot of this line of thinking as I have maneuvered through DBL in the last 15 months. In the last 3 months alone, I have been told over and over again that I am blessed. I have a baby girl now, I am blessed. I have a husband who stuck around. I am blessed. I didn’t have to spend $$$ to try to get pregnant again. I am blessed. My baby girl made it through a healthy pregnancy and she was born healthy. I am blessed.

And it's not to say that I do not feel blessed. Of course I feel blessed, but I feel that these statements are coming at me through the undercurrent of comparison. If we compare, (which is fucking retarded to do in the first place, but hey, women are notorious for it) of course someone always has it worse. I think about all of the women who cannot get pregnant, or the women who keep having recurrent miscarriages after their loss. I think, so what if you had a stillbirth, after reading about a poor woman who had 12 miscarriages and finally had a healthy baby on #13. At least you had good doctors who delivered Ronan, I thought when I read about a girl's sister who delivered her son stillborn on the floor of a county ER--who made her wait for 8 hours as she slowly almost bled to death.

And so on, and so on. It's like I try to be grateful for my pile of shit, grateful it was small, or not so bloody, so completely downplaying the glaring fact that it is, in fact, a pile of shit.

I know I am not alone in these feelings of comparisons of blessings. We do the sign of the cross when we read about tragedy, grateful that we were not caught in THAT particular statistic. If we think hard about it, we are the charmed ones to several women who are alone, feel they will die alone, and never get their chance to even try for a baby.

Bizzare, I know.

Charmed lives are a Red Herring. No one can really know what is beyond the polished exterior. For every beautiful, charmed woman, there is a story of anorexia, self-loathing, debt up to their eyeballs, gay husbands, and so forth. The stone cold reality is that we live in a world where someone always has it worse. But I keep trying to tell myself that someone else's tragedy doesn't mean that any of us were dealt something any less devastating than the next woman.

My friend H came to visit me after Radha was born. She had started volunteering at Legal Aid, helping the unfortunate with their legal problems. She told me that she felt guilty that she felt bad about her daughter dying when so many people had it worse off than her. It was right then that I saw the utter heartbreak in that statement. H's daughter had just DIED a couple of months earlier. After she carried her to term with Trisomy 18! She had every right to grieve for what she lost.

And I believe that for everyone out here. We should not feel guilt because we are where we are now when others are on a completely different path. We should not downplay the feelings we have about our losses or our joys, or make someone else's tragedy worse than our own. We should acknowledge that we were all robbed, that we are all dealing the best way that we can, and that we all are living this new life the best to our ability, trying to find the blessings when and if they come.

We should...but even in writing this down, it feels like a weak battle cry.

Wednesday, April 15, 2009

Out of Africa

He grasped my hand and smiled a brilliant white smile. “Pleasure to meet you Dr. S,” he said in the perfect African English. If you have ever met an African, you grow to love the accent—proper British slangs with a hint of tribal dialect. He was a General from Tanzania, interested in becoming partners with Global Epidemiology to aid in the effort to stop the flu outbreak, if there ever was to be one. I was asked to sit in on this meeting, just in case he had questions about the science. I watched the plump man partake in a pastry, sip his tea and was immediately reminded of my trip to Nigeria. It was during the Summer of 1997 and I was 22 years old, mouthy, such a typical Texan---thought I knew everything, even though I had barely set foot outside of the state. When I landed in Kano, I was immediately thrown into another world. Men guarded the airport with machine guns. In a sea of black, we were the minority white. We were hustled into a long line where one rather large, unfriendly Nigerian examined our passports, asked gruffly what we were doing there and laughed a bitter laugh as we fumbled unsuccessfully for an answer.

We were no longer in Texas anymore, Toto.

The drive to Maidugurri from Kano was long---6 hours in a van that felt every pothole in the poorly kept road. Our overseas mentor, Dr. Shatima, a young pediatrician (32) who was slated to work with us in the hospitals, sat in the front seat. He was very tall, rail thin, and pensive. The quiet type. I realized early on he was an observer and he did not like to make a lot of conversation. He initially struck me as a bit of a snob, frustrated that he was stuck with some bratty American kids. Weeks later I would learn that he was not a snob, but rather quite shy, a hard worker who was very good at carrying out orders, no matter how ridiculous and demeaning they were to him. Twelve years later he would become an important pediatric consultant, run his own clinic, and work for the higher ups in government. He would also become my trusted friend and colleague, travelling all the way from Nigeria to Michigan in the dead of winter to witness the hooding ceremony for my doctorate, establishing his place in my adopted family circle of friends. When I wrote to tell him I was pregnant with Ronan, he was so excited, glad that I was finally to become a mother, thrilled to be his 'Nigerian Pediatrician'. When I sent an e-mail last February to tell of Ronan’s stillbirth, he sent back a letter stating he was heartbroken to hear about the death of ‘our son’. He did not write ‘your son’ but ‘our son’, because in his heart, Ronan belonged to him as much as he belonged to us, and his death resonated all the way across the Atlantic, ignoring all religions, tribes and creeds.

I am amazed, even to this day, how a baby only 28 weeks old could bring with him so much love and emotion.

While in Nigeria we stayed at the medical school hostel and my roommate Lisa and I also became fast friends with 3 boys---Jacob, Yakubu (affectionately known as Yaks), and Aliyu. We spent the entire summer with them, playing cards, talking, eating, hanging out like we had known each other forever.

Jacob was the youngest at 20, and very inquisitive. I must have answered 1,000 questions he asked about the United States. Yaks was a cut-up, the class clown but deeply loyal and smart. And there was Aliyu—the class president, a born leader, razor sharp wit and intellect. Aliyu and I would talk for hours like long lost friends, but not about the simple things Jacob was interested in (like if all Texans rode horses like in John Wayne movies), but more philosophical things---like God, and the right to let women lead their own lives. We shared such similar ideas and values, as if we were raised together and not half a world apart. He spoke often about his younger sister Awa, about how hard it was for his mother to raise all the children alone, and how he worked hard now so that someday Awa would have the chance to have adventures like me.

There was an honesty and a friendship that I had with Aliyu that I have not had with anyone else. I could tell him anything, anything at all, and it would be accepted unconditionally. Everything was so easy with him. When I left Africa, I felt incredibly sad that I would not interact with him on a daily basis. We tried writing, but it was never the same as it was that summer. Perhaps it was the situation, much like Lost in Translation, of how you find someone in an unusual place and feel bound to them forever. I knew what I experienced with him was special, and even if I lived to be 100, I would not find that kind of connection with a human being again.

In April of 2002, Dr. Shatima wrote me an e-mail to inform me that Aliyu and his younger sister Awa were travelling back home for Easter when their car struck a truck head-on. They died instantly. Aliyu had just turned 28, Awa was barely 14. I cried for days when I read the news, wept for the injustice of it all---the recently promoted Aliyu, the young Awa and her quest for adulthood and Reese-like adventures. Most of all, I wept for the memory of 2 young kids in Africa in 1997 that sat around contemplating the meaning of life. A couple of years later I was taking a walk one summer evening in Michigan, and I saw a young black man, dressed in a light blue button-down shirt and white pants walking towards me. In the dusk of night, I saw Aliyu’s face, smiling at me and it took my breath away. I stared at that poor man so intensely that he eventually crossed the street, but it was the first time that I truly believed in angels.

A month after Ronan died, I lay awake in the middle of the night and stared at the blank walls of our bedroom. I was still reeling from grief, fighting the horrible thoughts crashing into my poor, weak mind (exacerbated by hormones). I was startled awake that particular night with a question. Who was taking care of Ronan in heaven, if there was a heaven?

The question left me with a new rub of salt in my still bleeding heart. The vision of my poor child alone up there was enough to bring on a fresh, new set of hysterics. All I could do was imagine my son alone. I was panicked, and damn near hysterical to the point of waking up Peyton. I tried to recall those who had passed before me. Who did I know? Who would be there to show Ronan the way?

I saw my grandfather who died when I was a young girl. He couldn’t take care of him. I saw my godfather, Bole, a good, funny man, but I still felt that he was not the one. My mind was burning and the grief was washing over me. Who? Who?

And then I saw Aliyu’s face.

I stopped crying.

I knew Ronan would be safe with him.

Tuesday, April 7, 2009

How about them transparent dangling carrots...

April 7, 2009

Dr. S,

I wish there were words to adequately describe the overwhelmingly tragic scene that we were living January 24, 2008 when we first met you. That day had started out with an underlying sense that something was wrong, and transitioned into what would be the worst day of our lives. When we were in L&D that night and it was determined that our son had in fact died, the nurse asked me again who my doctor was, and all I could do was blurt out your name. But, even as I uttered it, it felt like a lie. That was because we had not yet met you. 2 weeks earlier an office slip up resulted in us going to the office for our first appointment when you had canceled your appointments (because you fell out of a deer lease and broke some ribs). The staff frantically shuffled us in to see Dr. C, and we had made an appointment to see you 2 weeks later. As fate would have it, we would meet 2 weeks later, but not in the traditional way.

While we waited for you in that delivery room last January, we were all in a sort of suspended animation. Peyton and I went through the horrible motions of contacting our parents to tell them that their first grandchild, a son everyone was eagerly waiting for, had just died. I don’t recall a lot about that first night, except for the stinging memories of what Peyton’s voice sounded like as he called his father and how my father cried silently as he hugged me when he arrived to the hospital 2 hours later, never remembering a time in my life when I saw him cry. In all that tragedy, I remember you. You came in wearing those damn green scrubs you always wear, said you were so very sorry, grasped mine and Peyton’s hands and said you would take care of us—your patients that you had never met.

It took a whole year to fully appreciate the power of that statement. After Ronan was born and the testing came back for Trisomy 18 three months later, I told Peyton I didn’t know when and if I would ever want to try again. The pain of living in this new world, this Dead Baby Land as we affectionately call it in Cyberspace, was still too much. I was angry, lost, and damning the god(s) who took away our child. But for all my rebellion came a dream one night of a baby wrapped in pink and a positive pregnancy test 1 week later. Little did I know the fear and damning would come in full earnest as I was about to embark on a journey that had an unknown ending. You were happy for us when you saw me again in June, shook my hand, assured me it would be different this time, but all I felt was complete numbness and a growing whispering in my ear of what the hell have you just gotten yourself into?

I know that as a doctor you see the caution and the hesitation-to-be-happy-until-the-baby-arrives-screaming-9-months-later in your patients who have had previous losses. But I would like you to know that the emotion a woman feels carrying another child is deeper than just caution. It is caution mixed in with everything else in the spectrum of emotion, good and bad. But, in that caution there is also hope flickering ever so small, like a single ember still lit after a campfire has been doused with water. It takes several people to help fan it to set it on fire again---family, friends, and of course, the medical staff that is overseeing the pregnancy. The fire lights, and then it putters out, and it is truly one of the most exhausting and frustrating courses, those long 9 months of constantly fanning a flame--sometimes without the help of the mother, who sometimes just wants to lie down, let the fire die, and let her fate come.

Thank you for fanning the flame, for answering every stinkin’ question that came to my mind, for seeing me every week 4 weeks earlier than you would any other patient, for understanding that this journey was difficult and taking the punches when I had lost my mind and my patience. Thank you for being patient, for being strong when I was weak, and for lighting a candle of hope in my darkness. For all your efforts, our daughter Radha (Row-ah) Elise came safely, albeit 3 weeks early. She had her brother’s birth date as her original due date, but I think she wanted January 26th to remain his special day. Her name holds 2 meanings--in Sanskrit it means ‘success’, but in Irish, it means ‘a vision’, an affectionate reminder that she announced her presence to me in a dream before I knew she was coming.

I don’t know if I have it in me to try this journey again. The fear and anxiety is almost too much for me (read: my husband) to carry again. But, I do know this---if we do decide we are crazy enough to try for another, I know I want you by my side.