FRECTIS

Today the kids went back to school and so did I.  I am taking a 20-day course in intermediate algebra the last prerequisite ahead of “college algebra”.  The class is Monday through Friday, 9am to 1:05pm.  Yes, we will be using that five minutes after the hour on a daily basis.  Don’t even think of getting up out your seats before then– even if she instructs you to go have lunch, get your homework done, and be on time tomorrow.  A few of us tried to get up with that send off and were quickly barked back into our seats so that she could use the remaining three minutes to show us around the school website and other helpful places online.  The average age of the students has to be about 20 so the chances they’ve actually seen Google are pretty damn good.   But thanks for the tip.

I finished off last semester, which seems like eons ago, with two Bs.  My GPA right now is 3.24 thanks to the C grades of anatomy and physiology I and II.  I’d like to repeat them for better grades but the rules to the game of getting in nursing school around here don’t allow for that unless they’ve expired their 5-7 year eligibility.  If I am still trying to get into nursing school in 2011 when I am allowed to repeat them, please just kill me.

When the actual Spring term starts I will be taking chemistry (a combo biochem, organic, and inorganic class), college algebra, ethics (geared toward bioethics; I hear if you can breathe, you will get an A).  Somehow a yoga class got slipped in there.  If I can survive this I will be completely finished with all the entrance general education required of the two state school systems we have.  Surely I can make it into at least one of them.  If not, see last portion of last sentence of previous paragraph.

Happy new year!

Just about everyone that I used to hang out with during those delicate, formative years is now on Facebook.  We are having a crazy, riotous time daily chatting, laughing, and driving each other nuts with tales from the past and plans for the future.  There was one guy from our group missing and no one had heard from him in years.  I last heard from him around 1990 when he was in the navy.  He’d call from the ship, usually drunk, eventually leading to crying, and late at night.  After he drove my housemates crazy with the calls, I had to ask him to stop calling at that hour.  Instead he never called again.  I didn’t mean for that to happen.

His name kept coming up as people would add pictures to their Facebook profiles asking, “Whatever happened to…?”  I was determined to find him and I did by periodically checking MySpace.  I sent him a note and he replied with disbelief that I figured him out.  His name is along the lines of Elmo Dietrich, not exactly one of the many Mike Smiths we went to school with so it was a relative no-brainer.  That was it though.  Nothing for a month, until tonight when I got the juicy Elmo Dietrich added you as a friend on Facebook message.  I clicked on over to his profile to find I was the only friend he had yet so I suggested others to him.  Then came the Elmo wants to be friends on MySpace! email.  I clicked quickly over there so I could see if he had any pictures of what he looked like now.

Shock doesn’t even describe it completely.  There was the guy who I’d last seen in a baseball cap and letterman jacket wearing a wife-beater shirt with guns down his waistband, throwing gang signs.  I hoped they were joke pictures but by the time I got back to his Facebook page I saw he’d added all our friends, uploaded all those pictures and more!  Our friends started posting a mixture of welcomes! and WTF with the guns dude? posts.

I hope he says it’s a joke and he’s a hot Hollywood gang extra.  Or that he was just trying to see if all us crazy small towners freak.  I will feel really bad if that is indeed his life and I dragged him out of obscurity to answer to it.  I think this is the part of the ’social experiment’ that goes awry.  I didn’t count on the gangsta variable.

A client once came to me late in care and left me about two months later.  She left the first practice because it was hospital-based and she wanted a home birth.  She left the next practice because they rushed her through and didn’t answer her questions.  She left me because I answered them all.  Or so it seems.

In the few, but lengthy visits we had, she presented me with myriad of scenarios of concerns from mild to major and I did my best to address them all.  They were questions that normally get asked and answered at the consultation prior to signing up where couples decide (or not) if I am the midwife for them.  Instead the questions continued past the consultation because of the late date of signing.  It’s my job to reassure the client she has picked a competent provider of care, not to candy-coat or to pet her on the head telling her not to worry her pretty little self.  It’s the hallmark of midwifery to educate the client because without education there is no chance for informed consent or denial of care.  And It’s my style to make sure the question or concern has been addressed in a fashion of asking straight up:  Does that answer your question? If it does, I move on and if it doesn’t I invite the opportunity to find out where I lost her understanding.  If the conversation was directed back to the spot we’d already handled it raises a flag to me that the issue REALLY concerns the client and demands redress, not that she is unable to comprehend my information or that she just likes talking about anatomy and physiology or as some midwives might think, an unstable disaster waiting to happen therefore she should be referred out ASAP.  Mostly I respect the need for the woman to get the concerns out of her head and be assured she can leave them in my hands so she can move ahead.

In this case I thought I was doing a good job judging by the smiles, laughter, and hugs I got.  Not so apparently.  I was dumped unceremoniously a week after our last visit via email and later told that I was scaring the client to death with everything we’d discussed.  Of course I was hurt as I really enjoyed this woman on a personal level and professionally hurt because it’s embarrassing to get canned for what I believed was “doing a good job”.  The community I work in is very small and people talk.  I suppose it isn’t the worst thing to be accused of knowing my medical and emergency shit, but when unassisted births are en vogue and paraprofessionals in the childbirth field (doulas, childbirth educators) blast interventive practitioners and glorify the ones who rely good intentions, I’m sort of between a rock and a hard place.

One evening I had a consultation for a couple whose husband was an emergency medical services provider.  I was fresh from an appointment from the hair salon and feeling quite cute with my bouncy new cut and blonde streaks and dressed fancy to celebrate my feeling.  My home office was mid-construction so I had a quasi-office set up in the room next to it and the doors weren’t yet on the closet.  Inside the closet was my birth kit bag (a red EMT bag) and two oxygen tank cases.  The husband proceeded to share the many scenarios he’d come across with regard to childbirth in the field and asked my experiences.  Now and again there was a glance toward the closet.  I had a really good feeling I’d be hearing from them again but they didn’t hire me.  They hired a colleague and she gave me the feedback:  I looked too made up (I don’t look like a midwife).  I spoke too much medicalese.  And I had a lot of nerve flaunting my medical equipment for all to see.

It’s really simple folks:  If you don’t want to know how your midwife will handle postpartum hemorrhage and shock, don’t ask.  If you don’t want to know how she will resuscitate your newborn in respiratory distress, don’t ask.  If you don’t want to know what a fourth degree tear is and why it requires surgical repair, don’t ask.  If you don’t want to know what makes a breech delivery dangerous, don’t ask.  If you don’t want to know about shoulder dystocia, don’t ask.  I don’t volunteer that info spontaneously because I’d rather discuss with you how we are going optimize a normal birth without complications.  But if you do ask, don’t assume that knowledge of these situation is equal to psychic creation of them or that they are standard operating procedure.  It’s not reflective of some weird midwifery bravado to regurgitate the skills on oral examination.  This is just stuff I am required by degree and law to know and rarely have to recall in actual practice.  Just ask my assistant because she gets tired of resterilizing unused instruments, of setting up and tearing down unused equipment all the time.  It’s tedious and I get cranky when the heating pads are folded up wrong.