Saturday, December 16, 2017

Life as a House

Sixteen years ago, with my first child incubating in my warm belly, my husband and I bought the house that I'd grown up in. We were newly married and my parents were moving out of the home and kindly offered us a very good deal on the house if we wanted it. We eagerly said yes, this offer giving us a way out of the tiny apartment that we shared in small-town Iowa that had no room for the baby on the way.

When we moved in I was entering my third trimester and wasn't allowed much lifting. I carefully directed the friends and family that were helping us to move in, firmly resolved to place everything where it had been when I lived there-- the silverware placed in the same drawer, the beds and dressers matching up with the lines on the carpeting where there successors had once lain. It felt like moving home.

As the years passed, the sameness of the home seemed as much a burden as a comfort. With the birth of my second child, a beautiful daughter, I struggled with postpartum depression and anxiety. With this new mental health condition also came a resurgence of the PTSD that I had struggled with since being raped at seventeen. Memories began to percolate up, haunting replaying of the violence that long ago night.

This house, my current home and the one of my childhood, became a reminder of the bedroom that I'd come home to the morning after the rape, of the bathtub in which I'd cleaned up the blood in the aftermath. Other ugly childhood memories also resurfaced and the house that I'd spent so many hours carefully making a home became my prison. I was constantly redirecting my thoughts away from the memories that haunted me like demons in the night.

Later that year, I jumped upon plans to remodel our home as if changing paint colors and removing old carpeting could wipe clean my memories. We added an addition on to the home which allowed my husband and I to move out of the room that had been my childhood bedroom and into a new master suite. I felt a sudden and sweeping worry the day that we moved my daughter into that room as if her presence in the same room that held so many wicked memories would taint her in some way. I calmed this worry by choosing one good childhood story per night to tell her as I tucked her in. She came alight in the memories that had happened in this bedroom, in this home and in her own backyard. I came to remember myself, as well.

Over the years, I have taken care to make this home my own. It is nearly unrecognizable from both the outside and inside to those who knew it years ago. We have added many memories within these walls in this years, in the best years of my life as I raise my three amazing children with my loving husband. This home is so full of love that sometimes I wonder if the windows will burst with the pressure of holding it all in.

I am still sometimes haunted by the memories of this home. Just a few weeks ago as I scrubbed my kitchen floor, I was reminded of scrubbing my own vomit off of the same spot the morning after my nearly successful suicide attempt in the weeks following my rape. I was thankful in that moment that we had long ago replaced the worn and stained linoleum with the current hardwood flooring. That fact made it easier for me to redirect my things to better thoughts, like when my son took his first faltering steps on these same floors.

Much like my own body, this house has endured violence and anger, love and compassion. I think of this home in the same way that I imagine my life-- as if it were an old journal, beaten and used but still with many blank pages remaining.  I remind myself that what truly matters isn't the old stained pages, unable to be erased, but the crisp pages that await the story waiting to be told there.

If my life were, indeed, a house I wouldn't want my story to be told anywhere else.

Thursday, November 16, 2017

Reclaiming My Birthday

Today is my birthday. I am 39 years old. I haven't celebrated my birthday for the past twenty-two years and that has nothing to do with a fear of getting older.

Twenty-two years ago, on the night of the celebration of my seventeenth birthday, I was raped. This means that this week is both a celebration of the day of my birth and the anniversary of the night that my life was changed forever.

For years I've been asked why I don't make a big deal about my birthday. It's fairly easy as an introvert to deflect those questions by saying that I don't want attention on myself. The truth isn't one that comes out easily in polite conversation.

Over the past year as I wrote my memoir, I realized just how many things were taken from me the night of my rape-- my own feelings of safety, my self-confidence, the ability to listen to songs or watch movies from that time(as it brings back memories) and so many more things. In many ways, I buried my seventeen year old self that night and had to start over as a new person.

This year, I am reclaiming my birthday. I am celebrating my life and all of the accomplishments in it, unabashedly. I am also determined to reclaim some of the other things that the rape and the PTSD that followed it has stolen from me. And, with each and every reclamation and celebration, I'll been sending a big fuck you out into the Universe to the man who tried to take everything from me.

Happy Birthday to me!

Wednesday, July 12, 2017

Why I Don't Want to Hear Your Scary Story About My Diagnosis

A couple of weeks ago my son was diagnosed with Lyme Disease. He came home from Scout camp and several days later had the trademark bullseye rash so we immediately took him in and had him started on treatment, hopefully soon enough that he will not have ongoing symptoms.

I posted publicly about his rash and diagnosis in hopes to spread awareness and help others notice if they find a similar rash on their bodies this summer. (You can find that post on Facebook here if you are interested). Within minutes of making that post, I began to be bombarded with people's comments, messages, texts and phone calls. It seemed that everyone that I had ever met had a scary Lyme story to tell me.

It was awful and inappropriate, however well-meaning the comments were. As a nurse, I well know how bad Lyme Disease can be. I certainly didn't need the reminders, again and again, while my son was being treated. It honestly set off a terrible anxiety that we did not need.

In order to set boundaries and let people know that the stories were overwhelming me, I made a post on my private Facebook page asking that people stop sharing the scary stories. The responses to that post were of even more people telling me all about the awful Lyme Disease experiences that they have had, as though they had not even bothered to read my status or, worse, that they did read it and still felt compelled to share the story of their sister's boyfriend's cousin who is has now been bed bound and is in constant pain due to Lyme Disease.


It's oddly as if people are so conditioned to tell us their sad and scary medical stories that they cannot help themselves. Any woman who has been pregnant knows this phenomenon all too well. From the moment we tell the world about our pregnancy, we are bombarded by horrific birth stories as though the stories themselves will strengthen us for childbirth. They do no such thing, of course. Instead, many women become utterly terrified of giving birth instead of feeling empowered by the women around them.

As a nurse, I have also experienced the frustration of my patients as their loved ones tell them about the essential oils that can "cure their cancer," the alkaline diets that "chase away dementia" and vitamin d drops that "work better than therapy and medication for severe depression". For many with chronic illness, it becomes damn near a full time job just listening to all of the suggestions that seem benign or helpful on the surface, but are often exhausting and simply confusing to the patient, not to mention often lead them to buy unnecessary and sometimes expensive "therapies" that most often do nothing at all to help. I've even had patients stop much needed therapies in favor of essential oils or expensive vitamins only to lose progress on fighting their illness. It seems that everyone is an expert these days, proudly bearing degrees from the College of Google Searches.

What is this compulsion? Why do we do it?

I don't have an answer to that. What I do know is that it must stop. We may have a story that we'd like to tell or a therapy that we hope might help. However, we must first ask ourselves if it is helpful and ask the permission of those suffering first. A simple, 'Would you like to hear about my "insert loved one here" 's experience with your illness?' or a 'I've heard about a treatment that may be helpful, would you be interested in hearing about it?' would suffice. It's quite likely that they've heard enough "experts" spout off on the subject for the time being.

Maybe in the sea of "experts" desperate to unload their experiences, they've been waiting all this time for a single, listening ear.

I often say that if being a nurse has taught me anything, it is that at the core of who we are, inside and underneath all of the bravado, each of us is just a scared little kid begging the world not to be alone in our darkest hour.

 If we are to be a true friend, maybe we can find it in ourselves to shine light onto our loved ones instead of throwing them into a deeper darkness. This is the time to keep our ears open and our mouths shut. 

Saturday, June 17, 2017

A Nurse's Truth: In Healing You, I Healed Myself

I have had a life-long struggle with self-worth. I remember, even as a young child, feeling ever so different from those around me. It felt deeply lonely and it forced me to wonder if I had a place in this world.

This feeling of lack persisted into my adulthood. It became so strong in my teen years that I heavily contemplated suicide and wondered if I were even worthy enough for life itself. I felt empty, drifting through life with no reason at all.

As college approached, I mulled over many different careers: writing, teaching and nursing among the many choices. There were many things that attracted me to nursing, but the sticking point was that I wanted to make a difference. I desperately just wanted to be worthy of life, worthy of existence and helping others seemed the only way to find that.

I received my degree and my license as a Registered Nurse and set out to help others, wishing desperately to help others. In this past decade I believe that I have helped many, although I had been naive about how many there would be that I would not be able to help. What I did not expect is how serving others would help myself. That my helping others would go far beyond giving me a feeling of worth-- it would make me whole.

Nursing gave me a way to make a living by helping others and has allowed me to live beyond existing only for myself and my family. It has given me many things: confidence, knowledge, connection, purpose. 

However, my patients themselves have given me ever so much more. Getting to know and care for my patients, even the challenging ones, has been one of the greatest blessings in my life. Nurses and other health care professionals see patients on their very worst of days and it is astonishing how quickly you bond with people and the stories they tell you. My patients have honored me with their honesty, with their shortcomings, with their vulnerability, with their pain. Making a space within myself to carry their stories inside me has made me a better person. My heart and the depth of my compassion has grown each and every year of my practice.  

I still feel lonely often. My heart often feels broken open at the injustices of this world. Everyday I wonder if my work has been enough to truly help my patients.

The knowledge that I do have, the knowing that pushes me through each day, is that I am not alone in my suffering, in my loneliness. This is a lonely world full of imperfect people like myself. Separately we are imperfect, with jagged edges and voids of space looking to be filled. Together we fit together as puzzle pieces, our jagged edges fitting perfectly with the broken edges of another.

My dear patients: In embracing your imperfections, I have embraced my own. In honoring your stories, I have honored my own. In loving you, I have found a way to love myself.

There is a parable from the bible that is oft quoted in healthcare- “Physician, heal thyself.” I say, with complete honesty and gratitude, that in healing you, I have healed myself.

And, for that I will be forever grateful.


Wednesday, June 14, 2017

American Dreams

As a public health nurse I spend my days visiting low-income housing complexes to see my clients, many of whom are refugees or immigrants. At one of these apartment buildings, I struck up an unlikely friendship with a young Burmese woman who was a fairly recent refugee and spoke little English. She wasn’t a patient of mine but she often sat on the broken concrete front steps as her young daughter played nearby and we developed a budding, if awkward, friendship. Over a year or so we would have hesitant talks as we each stumbled and tried to understand each other with no common language. She was taking an English as a Second Language class(ESL) and delighted in the opportunity to try out her skills with me each week as I walked into the building to serve her neighbors.  As the year passed, her English became better soon she was telling me about her family and I was telling her about mine.

Her favorite topic to speak about was her  “American dream”. She told me that in the refugee camp, she and her family(the few that were still living) would sit around and pass the time by dreaming of which country they may get chosen to go to. The years passed slowly in the camp and they thought up many dreams. They imagined that if they were able to go to America, they would live in a home of their own with green grass in the front yard and a pool in the backyard.

Now, here she was in America, living in a dilapidated apartment crawling with cockroaches and rodents and surrounded by people who did not want to employ her or form a relationship with her because of her lack of English and unusual dress. Yet, she never seemed disheartened. She would often have a folded up picture carefully torn of a magazine that showed a house with a bright green yard or of a sparking blue pool. Her dreams were alive even amidst the bleakness of her current residence.

One morning as I arrived, she came running out of her apartment-calling Nurse! Nurse!(I introduced myself as Mandi, but still she insisted on calling me Nurse). She proudly came over to me and pulled out her tiny, outdated flip phone. She said that she was still saving for her own home but would soon go live with her sister until she could afford her own. Her chest puffed up proudly as she said that her sister and her husband had purchased their very own home. She was so incredibly proud that she her smile was ear-to-ear.

Her happiness was contagious and I couldn’t help but smile as she found the blurry, poor-quality photo inside her old phone. We both squinted at the screen and I saw a tiny blue home with a green yard. I told her what a lovely home it was.

She continued to grin as she told me, “Nurse,  you haven’t seen the best part yet!” She scrolled to the next picture and again we squinted at the screen. The photo showed a tiny plastic, purple pool in the small backyard. Inside the pool a young girl sat proudly in a blue bathing suit and surrounding her were the feet of many adults, dipping their hot feet into the cool pool.

At first, with my jaded American eyes that are used to opulence, I admit to being saddened at the meager sight of this miniscule, plastic pool-- the kind of pool that could be purchased at the local big box store for less that the pay of a single hour’s work. But my heart opened as I heard the sweet woman next to me exclaiming that her sister had her very own pool. I realized that what I was seeing was not a kiddie pool at all. It was the very manifestation of a simple and beautiful American dream.  

Tuesday, May 23, 2017

Are Funny Memes Damaging to the Profession of Nursing?

I'm incredibly proud to be a nurse. Being a nurse has been one of the greatest joys of my life.

Not long ago I was attending to a patient and she asked me if I liked my job. I answered her with a fervent 'yes!' and told her that my job challenges me every day and that I get to meet the most amazing people. I told her that I can't imagine doing any other job.

She very honestly opened up to me and told me that after seeing what nurses post on Facebook, it seemed like we hated our patients. I was a bit speechless but assured her that I love my patients and think of them often even while not at work. She further admitted that she has avoided going to the hospital in the past because she didn't want to be cared for by a nurse that didn't like her job or her patients. I was horrified that someone that may have seriously been in need of medical care did not seek it because of my fellow nurses' social media posts.

Her frank confession changed the way that I viewed my colleagues posting of humorous(and often rude)memes on social media. I know that nursing is a very stressful job and that those in medicine often compensate for the stress by coping with humor that can be very inappropriate. Break rooms at hospitals are full of jokes that would surely be deemed unacceptable on the floor where our patients can hear them.  Social media, however, is an entirely different beast. The jokes and memes put out by medical professionals do not only come before those inside medicine, they are seen by everyone on your friends list.

So, I'm asking with honesty-- are these jokes and memes harming the profession of nursing, a profession often regarded in the past as the most honest of all professions? I fear that it is.

I follow a blogger that happens to be a physician and he recently shared a meme from a nursing blog's social media feed. It was relatively harmless, but indirectly inferred that nurses may not care about their patients. The comments on the meme ranged from nurses mocking their patients to non-nurses commenting that it seemed like nurses no longer care.

I felt sick. I care every, single day. My co-workers care every, single day. I work for a non-profit and make a very low wage and bust my ass every hour of every shift and often work unpaid hours so that I can finish my charting and communicate with other agencies working with my patients. I think of my patients often in my non-working hours and am often brainstorming ways to help make their lives better. I know that I'm not alone. The vast majority of nurses care so very, very much for our patients even when we become jaded and are exhausted physically and emotionally.

I've shared some memes here that my nurse friends have shared on their public social media feeds. I admit that I shared the more mild memes because the more offensive messages made my stomach hurt. We're publicly implying with each of these memes and messages that our patient's pain isn't real, that our patients are stupid and that we don't really want to care for them. 

I know that I'm going to be lambasted by the jaded nurses who will accuse me of not having a sense of humor. That's fine. I can deal with that. I do understand how years on the job can jade you and how humor can get you through the toughest day. I actually happen to have a wicked sense of humor and a raging potty mouth. However, there is a time and place for everything. 

I can't help but think about the most vulnerable of patients out there. Those who already have a fear of hospitals. Those are are sick but are afraid of being shamed for their weight, or drug use, or lifestyle. Those who have already had a poor experience with medicine of whatever kind. 

Is there a chance that these posts may increase their fear so that they may not seek out help? 

Is there a chance that patients may not trust their nurses during their hospitalization? 

I believe there is a strong chance of that happening for some patients, even if the number is small. And, if that is so, isn't that enough reason for us to stop publicly posting memes that make our patients feel shamed, even in the smallest way? 

I promise you that I will do my best to think in the future before I make a public post, both about what the post may make others feel about my beloved profession and how it may impact the psyche of a future patient. My profession deserves such a pause of thought, as do my patients. 

Sunday, May 14, 2017

Birth and Mothering in America: Mothers Deserve More

Working as a public health nurse with low-income, high-risk families has opened my eyes to the world in so many ways. The person that I am today and the person that I was seven years ago(before embarking on this area of nursing) are so very different and for that I am so thankful.

In all(or nearly all) nursing jobs, nurses are privileged to work with people of all colors, cultures, languages and personalities. The uniqueness of my current job is that I work with my families in their own homes and, thus, am immersed in their cultures while we work. The majority of my clients are refugees or immigrants and it is not unusual for me in one work day to visit a myriad of homes-- all of which may speak a different language and have a completely different culture(many thanks to the amazing interpreters who help me in my work). I believe that I have grown more as a person in these past years than at any other time in my life.

As I learn from these new Americans about the cultures that they have come from, I've been shocked many times over to find the disservice of our U. S. culture, medicine and politics on mothers and families.

One of my first expecting clients was a woman from a small African village(I know that Africa is a continent and am being intentionally vague in order to protect my client's identity) and she, a brand new refugee in America, was ready to have her baby any day. I remember during our education about what to expect from a birth in an American hospital, looking at her and realizing that she looked terrified. When I asked her what she was feeling, she said that she was scared and asked me where all of the other mothers would be? She said that in her former home, all of the mothers in the village would come and support her during both the labor and the weeks after. Every need would be met and she was treated like a queen during labor. After the baby was born, the baby would be cared for while the mother rested. The entire village would celebrate the birth and the mother. New motherhood had previously been such a joyous time and now she feared that it would simply be lonely and exhausting. 

Here, she said, she'd never felt more alone. Pregnancy seemed to be treated like a contagious illness and the birth like a surgery to correct it. Everything seemed so clinical and cold. She wished that she were back in the refugee camp, she said.  I remember freezing in place at those words from a woman that was so proud to be a new American and had otherwise completely embraced our culture and traditions.

Another client of mine, who had birthed another child in another small village and now had a newborn in America was suffering from Postpartum Depression. She was struggling each day to simply keep her head above water. I asked her if she had experience Postpartum Depression with her last pregnancy. She looked at me,eyes heavy with sorrow, and replied, "There was no such thing as postpartum depression in my country." I assured her that there must have been, that mental illness permeates everywhere, but she was adamant. She said to me, "I was supported by my entire village every moment of my pregnancy and the baby's first months. I was never alone. Here I am always alone. No one asks to help me. My neighbors don't even reply to my hellos in the hallway and seem to not even have noticed that I now have a new child. This is the loneliest place that I have ever known. It surprises me that all women here don't suffer from depression."

Yet another beautiful client took me aback at her response when I asked her how her first American birth experience was.  She responded that the birth that she had in the refugee camp was a far better experience. She hoped to never experience an American hospital again in her life. Her response held the theme that many clients before her had shared-- the birthing experience here was cold, clinical and lonely. 

I can't help but wonder-- as a mother, a nurse and a human being-- if we are doing a grave disservice to our mothers here. For all of our focus on a medical-based, clinical birth, studies show that the U.S. has the worst rate of maternal deaths in the developed world and that 60% of the maternal deaths each year are preventable(Source here). The U. S. is one of only two countries that don't mandate any paid maternity leave(source here).

We are giving mothers a cold, clinical birth that may not even save them from death in preventable situations, providing little to no support after the birth and forcing many mothers back to work before healing their bodies or bonding well with their children.  Our communities don't rally around new mothers to offer assistance. Other mothers often offer only criticism of the new mother, even strangers in the grocery store feeling compelled to offer unneeded advice without compassion or real assistance. New motherhood is terribly lonely and exhausting here. I cannot help but know, with a sickening pit in my stomach, that we could do so much better here in America.

This Mother's Day I wish for a better future for the mothers in America and around the world. We celebrate our moms one day per year, but the truth is that babies are being born into the world by mothers each day and they deserve so much better than the current American experience of new motherhood.

Wednesday, May 10, 2017

An Open Letter To the Teacher Who Taught me How to Live

 I have always loved school. As a child, I greeted every summer with a bit of sadness to have to leave the classroom for three months. I have many beloved former teachers. However, I only have one favorite teacher-- a woman that reached into her soul to teach me far more than the Language Arts lessons that she was paid to teach every day.

A bit of backstory before I tell you about the teacher that changed my life-- when I was in seventh grade my best friend, Jacki, died in a car accident.  I was brought to my knees with crushing grief and sadness. As a junior high student that had never experienced the death of someone my own age, I was frozen in my grief and unable to cry or work through her death. When thoughts of Jacki would come bubbling up, I would push them immediately back down. No one had taught me how to mourn and so I simply moved on with my life with all of my feelings bottled up inside me, the pressure rising with each passing week. That year passed in a blur and I went on to my eighth grade year still frozen in grief and with a torrent of unshed tears inside.

Language Arts was always my favorite class as I was (and am) a voracious reader and persistent writer. Mrs. Wood was my teacher that year and we bonded immediately over a shared love of the written word. I did not know in those first days that we would end up sharing so much more.

On the first day of class, Mrs. Wood handed us each a journal that we would write in and she would periodically read. Some days we would write about simple, everyday topics and other days we were allowed to write about whatever we wanted. I loved journaling and felt a sense of freedom with every word that passed from my pen onto the page. As the months passed, my trust with her grew, as I felt connected with her through her kind written responses to me in the margins, scribbled in red pen. I began to look forward to the days that we would pass our journals back to her in her wire basket, knowing that I was passing what was in my soul over to a teacher that would treat my words with respect.

After a few months I began, finally, to write about Jacki—how much I missed her, my memories of her and my sadness at the great loss.  There was a rush of emotions that began to flow out of me onto the page. I was voicing for the very fist time the pain of losing my friend, a pain that I had not yet begin to work through. I struggled not to cry in the classroom as I allowed the pain to flow onto the page. 

Days after I submitted my journal with my writing about Jacki inside,  I arrived to find the other students being shuffled out of the classroom for an assembly. Mrs. Wood kindly asked me to stay behind with her. I was flummoxed and was a bit worried that I was in trouble. I was a good student and had never been in trouble before and my mind swum with all the imagined things that I could have done.

She sat down facing me, our knees nearly touching as we sat on the tiny student chairs. She shared with me her own deep pain from when she had lost her young and beloved son Jonathan years ago. She did not hide the depths of her pain and cried -- tears soaking her clothing until she was left damp and disheveled.  I was humbled and in shock as she shared the story of her great loss, speechless to be in the presence of such pain. I was honored that an adult would trust me, a child, with such powerful emotions. 

Then, her story complete, she asked me to share the story of my own loss. I know now that if she hadn't shared her own story first, I would never have been brave enough to tell her the depths of my own pain.  I told her of my sweet friend and my memories of her, of how much I missed her. For the very first time since her death, I found the tears shake loose inside of me. I broke down and I wept while Mrs. Wood held me and assured me that it was okay to cry. I do not know how long we sat there, intertwined as my tears fell on her shoulder and hers fell on mine—it seemed, at once, like only a second and many years had passed.

After we cried together, we sat quietly and she talked softly of the things that I could do to help manage my grief. She asked me if I would promise to come to her if I was ever struggling in any way. I promised her and knew that I could trust her with anything, for she had shared with me the deepest pain of her soul with me.

That fall day(and all of the days after in that school year), I was taught how to mourn, a skill that should be innate in a human soul but somehow is not. She taught me how to manage uncomfortable emotions and the coping skills that I found that day are still used today. I still journal, allow myself to cry, scream into my pillows, run at breakneck speed until the anger is spent and seek help when I need it. Life is full of suffering and the mourning of loss and those lessons, the knowledge of how to simply survive great heartache, have served me again and again in my life. I know today that I would not have been able to undertake a career in pediatric nursing if I had not been given the tools to cope with my own suffering and the suffering of those around me.  I had been given a firm foundation to set my life upon.

I left that day feeling lighter than I had for a year, on a path of healing. What I had realized that day is that many teachers can teach knowledge, but the true teachers are those who use their lives to teach us how to live. I am thankful everyday that I was given Mrs. Wood to teach me how to share my life with others and live a life of meaning. I will never forget her and remain forever changed by the depth and courage of her teachings.

That day my teacher lit a lamp for me, a lamp lit with the fire of her own suffering, so that she could light the way for me to find my way out of the darkness. I am forever grateful.