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
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