Getting Back into the Routine

Let me go back to telling my story. Where I left off three posts ago, Joe and I had just gotten home from lunch after my procedure...

Aside from going to the pharmacy and answering the door when flowers were delivered, I didn't want to allow much to happen over the next few days. We were still recovering from the screeching halt we'd just come to, and I really didn't know what we could or should do at that point. I didn't even answer when the phone rang. I just let it go to voicemail.

But we did have two visitors on the afternoon of the surgery. Joe's parents stopped at our house on their way home from a winter in Florida. When my mother-in-law hugged me, I cried a little bit, but that was all I could muster. And I felt as though someone else was speaking as I asked them if they wanted to know what had happened and I explained the probable causes of our loss (intellectualization).

My mom and sisters came to visit the next day, and they got me to join them for lunch at a Mexican restaurant (it was Cinco de Mayo). It was such a beautiful, sunny day, and such a big part of me wanted to enjoy it, but there was also a part of me that was dying to go back home and be alone with my husband. The restaurant was so happy and noisy. And there I was with tired eyes from lack of sleep, making an effort to smile at the waiter as I placed my order. I felt like an intruder.

We rented a movie that afternoon, and it was so hard to pay any attention to what was happening with the characters. Who cared if this couple had to move to the middle of nowhere and deal with hicks and bears and whatever else? I went back to my room and laid down for a while. I couldn't stand that actress anyway.

When the movie was over and we sat quietly looking at each other, I asked my mom and sisters if I could just talk. I showed them the poem I'd written and the information I'd printed about cystic hygromas, and they listened for as long as I needed them to. I felt like a wounded animal on the side of the road, limping along in order to demonstrate that I would run again. But then I remembered that they had sadness as well--the loss of a grandchild and a niece or a nephew. We were all wounded.

When they left, it was quiet again, and Joe and I did whatever it was that we did during those first few days for the rest of the evening. I can't even remember what that was. But we both knew that it couldn't go on for much longer. Joe had missed three days of work, and I hadn't been to the VA since Saturday morning (it was Wednesday night). We agreed that we would both go back to work the next day. We were looking for a distraction.

I found out when the team was rounding with the attending that next morning, and I arrived then. The attending and the other med student were the same, but the residents had rotated while I was gone. I introduced myself to the new team, and I could tell that they were trying to decide for themselves what my role would be for the next few weeks. What could I do? What could they say to me?

Fortunately, my attending was aware of everything that had happened. Without going into too much detail, I will tell you that she was able to understand me in a way that I would have never expected. She was surprised to see me back so soon, and she told me to go at my own pace. There would be no pressure from her or anyone else on the team.

I did go slow for the rest of that week. I saw one patient the next morning, and then only two each morning after that. By the next week, I was interviewing some new admits, but I cancelled my ER shift and I left early on most days. I only did what I could, and I was so grateful to know that that was all that was expected of me.

I tried to avoid down time, but the VA was unusually slow for several days after I came back, and I often found myself wandering around the internet or just sitting with my thoughts. This happened one morning, and the thoughts were too sad. Tears started to fall, and I didn't even wipe them away. I just sat there like nothing was happening. One of the residents could see me from across the work room, though, and she waited until I was done crying before she asked me if I wanted to talk. She knew part of my story, and I told her a little bit more. She asked me questions, and I was surprised to find out how much I wanted to answer them. Talking about myself was exactly what I needed, not all of the time, but at least at that moment.

It turns out, a lot of the residents at the VA knew part of my story. The word must have gotten around. I found this out after morning report one day. I remember that I had sat slumped down in my chair with a particularly grumpy scowl on my face that morning, and I had felt bad for disrespecting the chief resident afterwards. As everyone was leaving, he approached me and I was sure that he was going to demand to know why I had not participated in that morning's discussion. But instead, he put his arm around me and asked if I was doing okay. I never ceased to be amazed by how supported I really was by these people that I barely knew.

That was at the VA, though. Soon I was done there, and I discovered that I was afraid to go back to my school for the remaining outpatient half of my Internal Medicine rotation. First of all, no one there really knew what had happened. Second, my pregnant classmates were there. My pregnant classmates whose plans were still in place, whose babies were still on the way. And moving on to the second half of the rotation meant new stressors and challenges that I was not ready to face, namely the OSCE (standardized patient exam) and the shelf exam.

On my first day back on campus, we started with a brief orientation to the outpatient clinic and the OSCE. Maybe I was completely overwhelmed, or maybe it was just a bad morning, but it started with a sniffle and quickly progressed to snot and tears running down my face. I was bawling in front of everyone, and no one knew why, at least I don't think they did. This continued until the orientation was over. At that time, I was supposed to leave for clinic, but I couldn't move. Then I was asked to leave, and I looked up from my box of kleenexes. I had caused such a scene. My classmates were speechless. I finally got up and left the room.

One of my classmates who had been more successful than I in leaving the classroom was waiting for me in the hall. He just looked at me and said, "Here... You sit in this room, and I'll go talk to them in clinic. I'll just tell them you're going to be late." I dutifully sat in the classroom adjacent to where we had just been and covered my face with my hands. Our clinic supervisor came in shortly after. She was calm, and her voice was kind, but she wanted to know why I was going to be late. I hated the words "I had a miscarriage" as I forced them out between sniffles and sobs. She talked me through it. Miraculously, I was seeing patients twenty minutes later.

Things went better after that, but I missed the fact that no one at the VA had been pregnant. There aren't many Vietnam vets going into labor these days. And somehow the VA nurses weren't drinking the same water that they were at the University Hospital. Pregnant women were suddenly everywhere around me. And who could forget that poster in the radiology department asking "Are You Pregnant?" I walked by it every day.

Some days it was too much, but I did find some people in this new setting that I could talk to. This was so important. I can remember more than one afternoon when I arrived early to lecture to find one of my chosen confidants there. All I had to do was ask if we could go talk for a minute, and she would follow me to the student room where I could cry behind the closed door.

That is my biggest piece of advice for anyone who has miscarried and is now faced with returning to school or the workplace. Find the people you can trust, and let them be there for you. I found that people were more than willing to listen, even if they weren't sure what else they could offer. When you're enlisting these people, remember to include someone in a supervisory role, if at all possible. It is so important to have someone who can go to bat for you that knows your situation. They can really help you when you're struggling.

Don't push yourself too hard or too fast. Go back to work only when you're ready, and don't go back at full speed. Don't throw yourself too deep into the old routine too quickly. Remember to allow your feelings to come to the surface every once and a while, and have an outlet that's readily accessible. If certain things are making it harder for you to be at work, identify exactly what those things are and talk to someone about how you can adapt.

And just know this. As with all other challenges that follow a miscarriage, this too will eventually get easier.

(What I'm listening to right now...)
 Paramore Brand New Eyes

Taking Care of Yourself

After the miscarriage, I wanted to take care of myself. I wanted to find my own strength and my own ways to heal. So when Joe recommended that I make an appointment with a counselor one tearful night, I rejected the idea. I could handle this.

But two weeks went by, and it was clear that I was not handling it. I was becoming so easily overwhelmed, having meltdowns that the people around me couldn't understand. It was time to do something else.

I finally contacted Student Counseling and scheduled an appointment, and I'm so glad I did. It was a chance to talk to someone about my specific needs without feeling like a burden. It was a chance to hear someone else's take on the situation instead of trying to analyze it on my own. And it allowed me to recognize and label what I was going through as grief.

Instead of concentrating on what happened, my counselor chose to focus on how to move forward. We talked about the resources that were available, and he helped me to think of new ways to help myself.

He gave me this advice:

Pay attention to the things that make you happy. When you find something, enjoy it and remember it. Don't be afraid to let yourself be happy.

I took his advice, and I started to pay attention, not only to my sadness, but to my happiness as well. Here's what I found:

I found a way to spoil myself, simple and just a little bit extravagant. At the hospital, there's a Starbucks coffee cart where I learned to order the raspberry white chocolate mocha (or a "red and white" if you want to sound more savvy). This is the sweetest, best thing I've found, and it's surprisingly pink for coffee. It's also one of the highest calorie items on the menu, but I did mention that I was trying to spoil myself.

I found something that made me laugh, and I found it on TV. Two shows--America's Funniest Videos and the more adult version, Tosh.O. There's just something about watching people hurt themselves. When I'm laughing at their expense, I try to take a second to feel bad, but who doesn't laugh when a grown man gets run over by his toddler in a Big Wheels convertible? I was even able to laugh at the giggling babies.

Lastly, I found something that made me feel good. It wasn't until four months after the miscarriage, but I eventually started going to the gym. One of my favorite things became listening to my iPod while running on the treadmill. This provided me with time to think, but my thoughts were usually more positive when I was working out. Sometimes the music I listened to was too sad or too happy, and I would tear up, but running was cathartic that way.

If you are grieving, I encourage you to look for the things that make you happy too. Let your happiness be guilt-free if you can. There will be plenty of opportunities to be sad.

And I encourage you to seek out your equivalent to my Student Counseling. Grief counseling helps, and grief is not something you should try to take care of by yourself.

(What I'm listening to right now...)
 Sia "I'm In Here"

Not Pregnant

Most of the changes that happen to us are gradual, barely visible. In fact, many important milestones in our lives happen without our even noticing. Can you remember the morning when you woke up and you were suddenly an adult? It probably didn't happen that way.

But there are also life-changing events, specific moments after which nothing can ever be the same. Everyone has a few of these... their first step, first day of school, first car, first date, their wedding day, the death of a loved one. These events become so important that all others are defined by them ("that happened after you started kindergarten... before you were married... right before your grandmother died...").

Finding out that I was pregnant was one such event. One Sunday morning, everything changed. Even as my baby was only the size of a poppy seed, I was already its mother.

What did this mean to me at four weeks pregnant? First of all, it wasn't just "me" anymore. I was responsible for someone else, and it was suddenly very important that I take vitamins, avoid alcohol, wear my seatbelt, wash my hands, drink plenty of water, try to gain a little weight. Making decisions about even the smallest things became a new challenge as an expectant mother... deciding for two. There could be no selfishness. And this was only the beginning.

I fell so madly in love with our baby, too. Just thinking about the little life inside me could bring the silliest grin to my face. I became so eager to meet my son or daughter, and I would write it little love notes in my Belly Book. "You and Mom were scrubbed in for a four hour surgery today!" On the day of our first ultrasound: "Mom and Dad were so excited to see you for the very first time today!"

I couldn't bear the thought of remaining detached, holding back for a little while, and I was willing to accept the vulnerable position I was in, head over heels. By eight weeks, when my lab results came back abnormal, I felt something that I couldn't put into words until I found them in a book: "The human heart was not designed to beat outside the human body, and yet each child represented just that--a parent's heart bared, beating forever outside its chest." My baby, an extension of my self and my body. Even when it was still inside of me, I couldn't protect it from everything.

What I could do was hope and pray and dream about the future, envision myself as a mother. One evening, I begged Joe to drive me past the hospital's main entrance and I could picture it--me in a wheelchair, baby in my arms, a cart full of flowers and balloons. At church, I watched the moms hold their babies, walk their toddlers to the front during communion, sniff dirty diapers and sneak out through the back door during the sermon--that would be me soon enough. And when Joe and I went on walks, I could see the stroller in front of us, our dog stuck in between. I could picture our little family.

These visions were frequent, and it was becoming harder to picture myself without a baby, pregnant or otherwise. Everyday I fell more in love, and everyday I believed more and more in the idea that I was no longer just "me." I loved the responsibility. I ignored my vulnerability.

And then everything changed again, as you know. But more suddenly this time. Another moment with a clear before and after, another very specific point in time. A discovery in a dark ultrasound room. A feeling of things being taken away...

People have asked me why I left the doctor's office through the back door that day. As I approached the waiting room, I pictured the women that would be waiting there. What did I have in common with them anymore? How could I face them and their round bellies, their swollen ankles? I had tried to be like them and failed. I wasn't like them. I couldn't stand the idea of them seeing me and knowing my emptiness, my failure. My bloodshot eyes and tear-streaked face would surely give me away. They were women, but I was just a girl. It was easier to avoid their stares.

Until my procedure the next day, I found myself floating somewhere between pregnant and not pregnant. I was surprised to find out how important it became for me to identify exactly what I "was." What could I call myself? Who was I supposed to be now? But it wasn't until the surgery, walking away without my baby... that's when I became lost in the identity of "not pregnant" again.

Physically "not pregnant." But in the mirror, I still looked pregnant. What was I going to do with this weight I'd put on? I still felt pregnant. There was still enough blood circulating through my veins for the both of us. I hated the thought of watching this all fade away.

Mentally "not pregnant." How could I go back to before? Who had I even been? I couldn't remember that person anymore. And who was I responsible for now that it was just me? I wanted that back. I wanted it to matter what I ate and what I drank.

Emotionally "not pregnant." Could I really be a mother one day, and not a mother the next? And what about my broken heart? My husband's? How could God let us fall so in love with this baby, only to take it away? What about those dreams of myself as a mother, dreams of us as a family--had those also been a lie?

When all of this was happening, I didn't know where to find the answers. And I still don't really have the answers, but I can tell you how I learned to deal with the questions.

When I avoided the waiting room: What did I have in common with those pregnant women? I've talked to lots of people about my miscarriage now, and I've learned how common it really is. And I've also learned that you can't tell by looking at a person if they know that pain. I don't think that many people could guess that I've miscarried by looking at me now. My point is that at least a third of the women in that room probably would have seen my tears and understood my pain, having felt it themselves.

When I thought that I wasn't a woman like they were, I couldn't have been more wrong. To know the pain of miscarriage is something uniquely "woman." To love a child and have to let it go is something uniquely "mother." As for those pregnant women and mothers who have been fortunate to avoid such a loss, they still know what it means to be in love and to be completely vulnerable. We have more in common with eachother than we know.

After the surgery: How could I go back to who I was before? I couldn't. It didn't matter that I couldn't remember the "just me" from before, because that person was gone. Just because the pregnancy was over didn't mean that I hadn't been permanently changed by it. I wouldn't ever be the same again--I didn't have to be.

And who was I supposed to be responsible for now? It was hard for me to accept that I was now the only one walking around in my body. I had a new task at hand, though. Taking care of myself would become very important over the next few months. Taking care of my husband, too. Taking care of myself for his sake. Working hard to keep my head above water.

The hardest question for me was the next one: Could I really be a mother one day, and not a mother the next? The answer was and is no. I am still that baby's mother. I have this advice now for people who have recently miscarried:

You're still a mom, even after your baby has died. You are the most important person that that baby ever knew, and you always will be. Your baby is still right there with you, and it always will be. Because you'll always be it's mom.

Always.

(What I'm listening to right now...)
 Incubus Morning View