A Changing Perspective

Sunday, February 23, 2014

Over the past week we’ve been caring for one of our teenage moms who delivered this past month.  She’s young and the condition we’ve been seeing her daily for is heartbreaking.  Today as I waited in the quiet clinic for her to show up I became discouraged. The time we’d agreed for her to come came and went.  She didn’t show.  I was frustrated.  Frustration turned to a little anger.  Doesn’t she know we’re trying to help her? Why can’t she just show up here?! She can’t do anything else until she heals…she can’t possibly be too busy!

My frustration and little bit of anger melted into sadness as I thought about the injustice and effects of poverty.  It has been life-long for her.  She wasn’t a middle class citizen who one day had a date with misfortune.  No, she was born into poverty and that’s all she knows.  It’s a culture within a culture and one I really know little of.  Perhaps she doesn’t know how to tell time.  Maybe she does, but even then she likely doesn’t have a clock hanging in her house.  She probably has a phone, but she likely has no power source in her house and the sporadic electricity in the area lately may have left it uncharged.  She doesn’t live far, but walking the distance from her house to the MC would be terribly painful with her condition. Perhaps she doesn’t have the Haitian Gourde equivalent of $0.13USD to climb into a crowded taptap that could bring her the short distance.  It could be she just really doesn’t want to come, but even a lifetime of poverty plays into that scenario.  Could it be, regardless of how much we’ve told her, the importance of daily care just doesn’t make sense in her mind? After all, she does feel much better than the first day we treated her. Surely that means she doesn’t still need care every day.  

My melting frustration and anger turned me into a puddle of tears…for the sadness of this reality that is all around me, for my initial response of frustration and lack of grace.  And I wonder how many times my frustration, anger and lack of grace have been because of my inability to see and understand? Lack of grace can only be a fault on my part. Only I am responsible for opening my eyes to see the world around me for what it is and not what I think it should be. Only I am responsible for my response, be it one of grace or the lack thereof. 

May we have eyes to see, hearts to understand, and responses of grace. 

Thoughts on Pain

Friday, February 14, 2014

She knelt next to the bed and laid her head in her mother’s lap. The cry coming from her was not the cry of a woman stretching to give birth to life.  It was a sound coming deep from within her broken and hurting soul.  I knelt behind her, heart pounding, breathing with the feeling of a ton of bricks on my chest.  I breathed the name of Jesus and willed myself steady as a lifeless body was born into my hands.
Sirens blaring, bumpy roads…the seventeen year old girl trembled under my own unsteady hands. She came to us, but not in time. The cord that gave life, flowing with oxygen, gave way before birth to life could win. Furious with a world of medicine in a culture not my own, the managements calls left me helpless and small.  I ran from that small OB emergency room heaving and crying. My mind unable to grasp the horrific scene, my heart refusing to accept, and anger the only feeling I could find. 
The door to the bathroom opened and she asked me, “Beth is this normal?” I looked to find the floor no longer white, but red.  I placed the Doppler on her round, swollen middle only to find the time between beats far too long. The slow beats became slower and I felt my soul being beaten again. We rushed her to the OR, but it was full. No room in the inn. She had no time to wait. Life inside her was no longer.

I left two years in the Philippines feeling emotionally behind, angry and unsure of how to handle the pain of these things and more. For fear of finding myself 10 years down the road and a total basket case of unresolved painful experiences and the emotions that go along with them, I took time to write, to process, to grieve.  It was good. I cried, grieved and moved on.  But in the back of my mind, I wondered if it would be enough.  Would it be enough for these hard things?  Would it be enough if I move to practice midwifery in a place where circumstances are different, risk of complications are higher, medical systems operate in a world all their own, and death is a common occurrence?  Could I walk through hard things and come out without feeling bitter, angry, confused and hardened? 

I’ve known and seen so little pain.  I’m sure there will be more.  I’ll probably grieve and be angry, but I’ve wanted something to grasp; some assurance that in the end I’ll still be sane, soft, compassionate, loving, and graceful.  Maybe what I have really wanted is a way to avoid the pain altogether.  
I ask the compassionate, loving, passionate, and gracious woman sitting across the room from me how she has done it all these years.  How has she seen so much, been witness to so much pain and yet still possess all the qualities I hope to retain in spite of what might come?  Her response…real. It’s raw in every way.  It’s not what I expected her to stay, but it strikes deep within me and I know she’s right.  

Her response, at least what I took from it, was something like this: We have to come to terms with the truth that God uses the pain in our lives.  Those who know and accept that God can use the pain we experience to teach us and shape us have a depth to them not everyone has.  We do have to grieve and move on, but until we accept that God can and does use the pain to change us and shape us, it’s difficult to move on.

Maybe it sounds a little cliché or too religious. My pain changes me for His Glory. I’ll be all nice and shiny, refined like gold, as one of my friends likes to say with a little sarcasm.  But I think the truth, the experience, and the heart behind her words pulled more weight for me as she answered the question that has been stirring in me for a long time now. Her answer was so real and vulnerable.  I think I’ve fought the acceptance of that truth…it’s such a messy thing. Does He cause pain? I don’t think so. Does God really use pain? Can He use the pain of this broken and messy world we live in? Yes, I think He can and does…now I have only to accept it.

Ann Voskamp writes it in such a striking way, “The only way to stop your heart from breaking is to stop your heart from loving. You always get to choose: either a hard heart or a broken heart. A broken heart is always the abundant heart — all those many beautiful pieces only evidence of an abundant life." 

Call the Midwife

Wednesday, February 5, 2014

Every midwife knows about PBS’ hit entertainment show set in London’s East End in the 1950s. It’s the closest thing entertainment has to what we do here.  We don’t do births in homes here. Goodness. We’d flood little houses with sweat dripping from our face for lack of electricity and no fans.  The baby would never know it made the transition earth side.  We’d have no lights and miss births because we got lost ten times on the way to a birth. I’m thankful for this clean little clinic with running water and electricity. I’m thankful our ladies can come here and it’s a familiar place where they feel welcome and comfortable. I’m thankful we get to use fans when our adrenaline is pumping!

When a lady delivers with us she usually stays in our postpartum area anywhere from a few days to a few weeks depending on their situation; how mom and baby are doing.  After their stay they pack up their small bag of toiletries and baby clothes we’ve given them and load up in the ambulance.  We ask the ladies to show us the route to their houses. Left turns, right turns, continue straights sometimes get mixed up and miscommunication happens, but eventually we make to a place on the road where they say, “konpe la.”  We park the ambulance and climb out. What happens next is a series of humbling, sad, eye opening events in which I feel like I’m living a surreal Haiti version of Call the Midwife.  We follow the once pregnant mother through winding alleys and rocky paths.  “Houses” made of tin, left over earthquake tent pieces, and sticks and/or concrete which line the three feet wide paths.  I take mental notes to try to remember how to get back out of this maze.  I think about our ladies walking this path as they come every Thursday to prenatal class, their swollen bodies making the trek to our clean maternity center. As we follow the new mother to her house we are greeted by neighbors, mocked by some, welcomed by others.  Finally we arrive at the house.  Their house is always humbling to me.  Sad glances are usually subtly passed between midwives as we swallow hard trying to grasp, once again, the reality our ladies live in. 

Shortly after entering one of the houses, where an instant heat wave of 15 degrees hotter meets us, a young barefoot girl bends low to get through the small door of the house. When she stands up I can see the fullness of her frame. The buttons on her dress are pulling from her swollen belly bulging beneath the material and my heart sinks.  Knowing in the next month she’ll give birth, likely in a small hut with a dirt floor, and no train professional in attendance gives me overwhelming sadness.  What will her story be?  I can’t resist. I reach out and touch her swollen belly and breathe a prayer of protection. 

We climb back into the ambulance with heavy hearts. This is a favorite activity; taking ladies home.  It’s also a space in time where the reality of our world sets in just a little deeper. And I am thankful there’s such a thing as heaven.  Thankful that Heaven can come to earth now and that one day all things will be made new. 

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