Sunday, May 14, 2006

Nurse Margaret's Magic Words

This year we have a harmonic convergence of Nurses Week with Mothers Day, an event that brought to mind a certain nurse who eased my passage to motherhood.

Nurse Margaret's Magic Words

"Dr. Spencer! Peggy! Please, sit down! Please! We do NOT want to have this baby in the tunnels!"

"Wait! I can't. Hoooo. Just wait a minute! Hoooo. Hoooo." I was contracting and panting, standing in front of the wheelchair, hanging onto my husband. My face was red, my breathing fast and strained, my hold on hubby just short of a vice grip.

Nurse Patty was not happy. She was a clinic nurse, temporarily relegated to transport duty. Not a delivery nurse. She had been assigned to wheel me from the clinic, where I had measured a mere 4cm twenty minutes ago, to the hospital, via the underground tunnel system, more direct and warmer than overground in November, but still quite a trek. She wanted to get there, pass me off, and get away.

This was our second baby. The first one, almost 5 years earlier, had taken her sweet time making her grand entrance, with several hours of labor at home and several hours more at the hospital. Plenty of time for everyone to be at their appointed places on cue. More about her another time. She deserves her own story.

They say every child is different from the get go, and they are right. This second baby rocked and rolled for 9 months, making me feel more like a private gymnasium than a holy vessel of life. I never forgot for one minute that I wasn't alone in my body. And when the time came, man, that kid wanted OUT. My labor changed from frequent but mild squeezes to out and out hard labor the instant my water broke as we pulled into the lot outside the clinic. Good thing we had gone there when we did. I had called the doc in confusion minutes before, asking, "How am I going to know when to come in? The contractions have been a minute and a half apart since I first felt them a few hours ago and they've never been strong." He wisely advised me to come on in, taking the fact of my phone call as evidence of a change in the labor progress, whether I was aware of it or not (I wasn't). He'd been there before.

After anointing the Honda seat, we made our way from the parkng lot into the clinic. I had to stop twice on the 50 yard trip, put my arms around my husband's patient neck, and pant through what were suddenly much more intense contractions. The patients in the clinic waiting room looked at us in alarm as we passed, and one nurse wondered aloud if this was the right place for us at this stage. Perhaps we should be at the hospital.

Our beloved and highly competent family doctor took us calmly into an exam room to "check" me, making reassuring noises to everyone. Getting up on the exam table and lying on my back was about as appealing as standing on my head in a tar pit, but I managed somehow, and he did his thing. "Four centimeters" he announced.

No way! Four?! Only four? That's out of ten, in case you didn't know. Four is the beginning of the beginning. It's usually not even considered active labor at four. I could have been at four for days. After four is when it gets serious, when the contractions get effective and start to do their work. Well, mine were feeling effective, all right. I thought he was going to say at least six. I was going to have six more centimeters of this? "Yep, looks that way. No, don't go home. Let's have you go over to the hospital. I'll meet you there after I finish my charting."

So here we were, making our halting way through the lonely concrete maze, me balking, Patty urging, my husband trying both to support my labor needs and get me to the delivery suite ASAP. "Stop!" I'd demand. "Here's another one!" I couldn't take them sitting down. I had to stand. There just was no question about it. So I stood. He held me. I panted. I breathed. Patty begged. I sat. We went on. The tunnel seemed endless.

Finally we made it to the elevators, none too soon for Patty. Pushed the button for the 3rd floor. Stopped on one, to take on several visitors and staff. Stood to pant between 1 and 3, not caring what the other riders thought. Out at 3 and into Testing and Triage, where Patty took her grateful leave.

Testing and Triage, or "T &T", is where women come to be evaluated when they're pregnant and have any kind of problem, from a bladder infection to labor. It's staffed by nurses and interns, and is usually a pretty controlled place, where things move at a reasonable pace. The typical pregnant woman at term will present to T &T in early labor and either be sent home to progress or admitted to Labor and Delivery ("L& D", naturally) to, well, labor and deliver.

I was not the typical T &T patient. I was really laboring hard by this point. Internally, I was struggling to find a rhythm, to settle in for the long haul, to pace my breathing and stay calm and all that other crap you read about that doesn't apply to real life. I felt totally out of control. It was like a giant hand would reach down, pluck me up, squeeze the livin' breath out of me and drop me like a spent sponge, only to wring me out again a minute later. I was only partly present, dimly aware of a triage nurse asking me for a urine sample (There was no friggin way I could sit on a toilet, much less manage a sample collection), of my husband answering the questions I couldn't. I wanted everything to slow down, so I could hang on, so I could catch up. I heard fragments of conversation. "They said she was four." "She doesn't act like four." "Can we check you?" "We better just get her out of here." "Can you walk?"

I could walk. It was a matter of feet from T &T to L &D. I knew that. I had worked in both places, had collected the urine samples, had examined the cervices, had coached the labor and caught the babies. In another life. Now I felt like a stranger, a frantic, out-of-control instrument of someone else's design. I had been taken over, occupied, shoved aside for the crew. My cervix had gone from 4 to 9 during our subterranean voyage, unbeknownst to me. I was already in Transition, that wild-eyed no-woman's land that causes many of us to declare absurdly that we're "not doing this any more", as if we had a choice. All I knew was that this was moving a lot faster than I was ready for. Life had taken over and left me hanging onto the back, just hoping not to fall off. I wasn't sure I could handle it.

Next thing I knew, a cool hand was on my neck , a steady arm around my waist. "Let's go." I stood and started to walk, with this cool stranger helping me. She looked familiar. Long dark hair, cat glasses, untroubled face. We started to move, and made it a few feet before the giant hand came down again. There's got to be a stronger word than "squeeze". SQUEEZE! My mind closed in, focusing on the sensation, struggling, fighting. Then Margaret's two strong arms wrapped around me, and her calm voice spoke low in my ear. "You can do this."

"You can do this."

Four simple words. One simple concept. It sunk right into me, all the way down. From top to bottom, her gentle confidence became mine, and I felt my breath slow, my shoulders soften, my body relax. Her words settled into my womb, and I felt it, too, relax and open. The last centimeter gave way, the gates were wide open, it was time. And I believed her. I believed her.

The last minutes of labor are a bit of a blur. A nurse telling me to go ahead and push. Me insisting I'd wait for my doctor, while I panted and held off. Doctor arriving just in time to throw on gloves. Husband right there, touching and encouraging me. Two gigantic, wrenching pushes, mostly involuntary and entirely effective, and here came Derek, diving headlong into life.

I fell back exhausted, bathed in sweat and grateful tears, holding my slimy baby on my slimy belly. Taking what felt like my first voluntary breath in days, I understood that what had just happened was done TO me more than BY me. If I had passed out in the tunnels, my body would still have done its job, and this boy would have been born. It's a natural process, unescapable, inevitable. Maybe "through me" is a more apt phrase. "They come through you; they are not from you," cautions Khalil Gibran.

So maybe I didn't do much. Maybe the Universe picked me up and squeezed me like a grape until the tender flesh inside popped out. Maybe I was just a tool, the skin of the grape, a holding tank. But, as I gazed down at this wild child who had taken me on a wild ride, as I felt the love bloom inside me, I heard again the magic words of Margaret the nurse, "You can do this" and felt the rise of gratitude and pride. It couldn't, after all, have happened without me. And, though logic tells me otherwise, I don't think I could have done it without Margaret.

I ran into Margaret (and this IS her real name) in the supermarket one day, when wild child was about three years old. I reminded her who I was, and thanked her for her magic words and her steady hands. She just smiled and nodded. All in a day's work. Last I heard, she had gone on to become a midwife, a perfect move. She'll be smoothing the passage for many fortunate women.

And she'll never know how often, even now, I think of those magic words and say them to myself. In times of struggle, when the task seems impossibly huge, when life's pain threatens to overwhelm me, I remind myself.

I can do this.

24 comments:

D.P. said...

Thanks for sharing--your story made me cry! You should receive an award for the best Mother's Day post!

connery said...

WOW!!!!!!!

THIS was powerful. Gripping. Traumatic. Fight & flight. Frightening. Full of maximum strength Adrenaline. Compelling. Loving. Beautiful (by the end).

I'm a man, but I felt something vivid in my Uterus, and all over my body, I swear.

I agree with d.p.--That was a powerful, gripping, special, and award-winning Mother's Day (and Nurses' Week) article.

What an incredible story, and an incredible storyteller.

Happy Mother's Day, you.

--Connery

Jo said...

Gorgeous story! Thank you.

anafaran said...

Another hit out of the ballpark, Dr. Peg! I was fighting for air myself up until your nurse coached you with those four words. My advice: start your book now. You can do this. I'd like to be one of the proof-readers.

peg said...

dp, connery, jo and anafaran - Thank you all for your kind feedback.

Connery, maybe you oughtta see your Gyn about the uterus thing. ;)

anafaran - My dad keeps saying that about a book too, but I'm not ready. These essays are my forays into new and wild territory. Maybe one day I'll camp out there, but not today.

connery said...

Let me once again second anafaran's suggestion.

Once you collect a bunch of these essays, you might as well turn the "collected works" into a book.

You're doing that now, just, like a bird building a nest, one twig at a time. Before you realize it, you'll have a full and beautiful "nest" to bring to an author friend/colleague/publisher. Certainly less self-induced pressure doing it one twig at a time, than being a bird wondering about this big compex nest.

I'll put in an advanced order (waaay advanced, I guess) for a copy.

--Connery, flyin' around, lookin' for twigs lately

Charity Doc said...

Beautiful story!

FL said...

A long time ago, relative to the age of Tivo, a friend told me that one day I would write "my" book. I don't think I want to write a book about me. One, because I think it would be a big downer and two, because I didn't think I had anything to contribute. So maybe it's true. Maybe some books aren't meant to be written, but among friends, we know what should be written and what we would like to read. We're doing it right here, aren't we now?

Barbados Butterfly said...

A beautiful post, thank you.

Moof said...

That is the absolute best description of "labor out of control" I've ever read!

You have a definite gift! :o)

Allison said...

Beautiful. My daughter was born at home, and I think I (vaguely) recall my midwife saying those exact words. At that point, I was starting to question whether I could (first child, went from 4 to 10 within about an hour), so it was exactly what I needed to hear.

Thanks for reminding me of the words to tell myself next weekend while I take the GRE!

Peg Spencer said...

Charity doc and Barbados Butterfly - Thanks for your kind words.

FL - "Downer" books sell great sometimes, doncha know? Seriously. Everyone has pain, and reading about someone else's can feel validating.

Moof - Sounds like you've experienced something similar - wild, isn't it?

allison - You, too. First baby!? Wow. Hey, good luck with the GRE, and do remember to tell yourself, because I'm sure you can.

BarnGoddess said...

great story! I remember both of my delivery nurses, not what they said, but the kindness in thier eyes...

Heather said...

That was awesome!!!

Carole said...

Awesome story! I have been using those same words on a daily basis to continue to cope with the loss of my 17 y/o daughter 4 months ago in a car accident. "I Can Do This" is something that I need to convince myself of on a daily basis. I did not believe it at first for about 2 weeks, but my family and friends kept telling my husband and I that we can do this. They told us to eat, they told us to breathe. They told us we had to for the sake of our other two children. We also have no choice. There is no going back. I miss her every minute of every day. As a mother, I am struck by the similiarity in these pieces of the life and death cycle.

connery said...

Carole--

"You Can Do This." Thanks for showing us all a different use for this strong and versatile phrase of inner strength. I can't begin to imagine the pain you must have felt and be feeling. Thanks for sharing your emotions here also.

I wish there were better words of comfort one could offer to you. I wish only the best for you and your family. As the prayer says, "May the Father of Peace send Peace to all who mourn, and comfort all the bereaved among us."

And, I mean that as sincerely and earnestly as anyone can.

Dr. Peg has built a special emotional sanctuary here, that's for sure. It's always very moving and spiritual around here, Dr. P.: A reflection of, and a tribute to you, for sure.

dr peg said...

barngoddess (great tag) - Amazing what a difference those nurses can make, isn't it?

heather - hi! Thanks for stopping by and for your kind comment.

dr peg said...

carole - My heart hurts for you. I cannot even imagine your pain.

Thank you so much for sharing a bit about your terrible experience. I will be "holding you and your family in the light" (how Quakers, my birth religion, pray for others)

I'm sure you can, you can do this.

Big cyberhugs to you,

Peg

Kim said...

Dr. Peg, that post gave me goosebumps....and cramps! LOL!

I'm embarrassed to tell you that I told my first Ob/Gyn how much I hated him after I had been dilated to ten for two hours and pushing, only to have him walk in and tell the nurse he'd do the C-section after his dinner.

Once I lost the goal, the rhythm and the hope, I lost all control...it was an amazing, horrible feeling that it was out of my control...

(The thing is, I really did hate him!)

Shame on me!

anafaran said...

Carole, reading Dr. Peg's post and then your comments have me contemplating just how from birth to death these children of ours bring us pain. We hope to avoid pain every step of the way and yet it's just the consistency of life that without pain, no joy and without joy, no pain. Our children bring or have brought both pain and joy into our lives with the fact of their existence. My hope for you is that you will gather all of your daughter's memories and images and feel JOY emanate from them and the beautiful life that you gave her. Her beautiful journey on earth is over but she may be on one more beautiful than this, nobody knows for sure, and you are a blessed mother to have her as your daughter and she has a treasure of a mother in you. You'll always be her mother and she'll always be your daughter and that is the kind of bond that can never ever be broken.
My niece died last April, also in a car accident, 6 weeks before graduation from high school. Her parents, three sisters, one a twin, suffered through this same experience that you are now having to endure. I wish we had been closer to the family because I felt awkward that I appeared at her service after being so distant. But I love those girls because at one point in our lives we weren't so distant. My sister-in-law and I carried our babies at the same time, and at the time we lived in the same little town and we went swimming together and we watched each other grow bigger around the middle and we guessed what we were each having, and what the names might me and how miserable we felt in the oppressive Maryland heat and humidity in the last trimestre. In my heart, there was this bond in time that nothing could diminish: not time, not events, not even death. So for me it meant a great deal to be present at her funeral. No, not much can be done to console the family I guess but to try ones' best anyway and hope somehow or another a splinter of compassion touches those closest to the loved one who has left. I think because we all experience grief in our life one time or another just being near is comforting. It would be for me I think if I lost one of my girls. Yes, I've been feeling a dull ache for you since I read your comments the other day. It's the most unimaginable thing all parents dread. I still think sharing the story of your personal experience helps others who are unable to express themselves as well to cope a little bit better. It's harder than the hardest thing I could ever imagine happening and I'm truly sorry. I will be keeping you and your family close in my thoughts and prayers now having heard from you on Dr. Peg's site. Dr. Peg is one neat lady to know and you will enjoy hearing more from her I'm sure. Thanks for sharing such a difficult personal experience. It has moved me to see the necessity of digging into myself daily to keep on being courageous, even if somedays it feels like it's only an act to be courageous. Life is so fragile and I always need to be reminded. I sense you are one very strong and special person. I'm up too late to try to understand if this is making sense. I hope you know this is from my heart to yours.

Giovanni said...

What a great post! Especially appreciated "a holy vessel of life". Great story!

Giovanni

dr peg said...

Kim - I hate your OB too! I mean, gollLEE, couldn't he have ASKED you if a C-section was okay with you? And, if the answer was yes, why not NOW?! Or at least he could have said something else besides "after my dinner". He could have made up an emergency surgery or something, rather than make you labor hard while he's enjoying a meal. The shame, IMHO, is on HIM!

anafaran - I'm so sorry for the loss of your cousin. I'm SURE the family was honored and pleased to have you at the service. Goodness, why not? You were honoring her memory and offering support in a time of need.

giovanni - Hey, good to see you again! Thanks for visiting. I'll be over at your "place" soon!

wolfbaby said...

Breath taking post.

TC said...

Peg, that was the best account of what it's like to give birth I have ever read. Do the book.

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