Countdown

DAYS UNTIL MY MAMA ARRIVES!

Tying Up Loose Ends

Just a hodge podge of all what's flying through my mind...trying to organize thoughts, check boxes marked as "return to," fill in empty spaces, and answer a few questions before I dive deeper back into my head (and hopefully the page)...

[::] There's been discussion going on in the comments section of this post. You should read it. I think what just happened was that moment when you get right up on something...but then stop because of the blow up that might occur afterwards...even though the blowup is what moves people (some people) toward growth. I've been thinking about why I didn't respond with as much enthusiasm/anger/frustration/energy on the page/in the comments as I did in the house as I was discussing it all with the man. He said, "why didn't you write that?" Meaning, what I said, in the way that I said it, to him. Great question. I don't have a good answer, except that maybe that moment was coming, full steam, where I was going to "go off" and then there would be aftermath. Ironically, I had just said that I wasn't afraid of confrontation. Hm. I don't think I am afraid of confrontation...at least not in person I'm not, so what's going on? Maybe it's about not wanting to feel like I have to defend myself on this blog because I do that so often everywhere else. It's also because I can obviously talk much faster than I can type, and while bouncing all of this off of the man, I am able to flush out what the hell I'm thinking because his questions come in real time, not the next day...and I'm just tired of explaining to others. Especially when they don't wanna hear/understand it enough to go do their own thinking about it. But when the dialog is honest, I love the interaction. There was one thing I wanted to respond to though, and that's whether I always bring it (whatever it is) back to race when talking or asking a question in class. The short answer is NO because, believe it or not, I rarely speak in class...I don't have the patience for it. But when people ask my opinion, I give it to them. And I try not to hold back. A lot of times that opinion includes race, how could it not? Ask a stay at home mother to never talk about their children, a midwife to not talk about birth, a CEO to not talk about money, a volunteer to not talk about purpose. Almost impossible, why? Because it's part of their identity. I'm walking around in this skin. It's part of me. How do I...why would I, walk, talk, and act as though it's not? Furthermore, in class, when I have the energy, why say what everyone else is saying? I know you want to talk about eating right...but when I mention the cost of eating right in my neighborhood, how do I do that without the lens of race when your next question is "why is what is sold in your grocery store different than what's in my grocery story?" I can try to explain that without saying because my life/my needs/my health is not valued as much as yours is....but then you ask "why not?" Why in the hell am I supposed to refrain from saying because I'm black and therefore devalued and not worth meat that doesn't say "use or freeze by (today's date.)" What you want is for me to avoid talking about race because it makes you uncomfortable. Fuck what is happening to me, let's make it easy for you.


NO.


Or, you want me to stay focused on the fact that there are poor white people, poor people of every color, and so let's just talk about poor people in general...not poor black people specifically. Or that those in Africa are even poorer than we are here in America. I'll leave it to you to talk about poor white people...in my community there were very few poor white people. Maybe I should talk about that one day, because I know that people who grow up in places that are "diverse" are sometimes shocked that in other parts of the country segregation is still very much alive and functioning. But I also refuse because even poor white people have the protection (although I should think of something else to call it) of white privilege, and therefore, even if we eat the same thing, go to the same community centers, or frequent the same theaters....when the police arrive, we are not just poor people....we are black people and white people, and when you reach for your wallet to prove your identity, they aren't going to shoot you, but me? Maybe 42 times.

moving on.

[::] A while ago I mentioned that I was blogsided by a dean at the university. I never emailed her back. But she approached me one day and we ended up talking about it. She wanted to know so that they could use one of the posts during black history month. I told her she could use whatever she wanted...anonymously. She then told me that she had already told the lady who's coordinating the events that she thought the blog belonged to me, and that the lady is supposed to contact me. I told her that when she does, I will deny being the blog's owner because for now I wish to remain anonymous. I also asked her if there was any chance that she could forget that she found me....she laughed.

[::] I mentioned yesterday that someone tried to dissuade me from getting a PhD. I understand. My best friend just had this conversation with me before I left home last year. (Hi H!) And I get where it comes from. Believe me I think about it. I even think about it in terms of the impact that it will have on my understanding of my community...the longer you're away, the farther removed you become...but I also believe that you can take the girl outta the hood, but you can't take the hood outta the girl, so there's hope ;o) What it comes down to for me is that while I think there's a good chance that I would regret not getting one, I know I will not regret getting it. I also know that it's now-ish or never. It takes something to be in school, and once I leave I never want to come back. I don't mean that I don't want to learn anything else, just that I want to learn it on my own terms. I'm also ready to have kids, yes, that means I made a decision to have children, and that they are welcome at any time from now, this moment, to 2012ish. This was a monumental decision in our household ;o) Grad school would be as good a time as any to have them. What meeting with the current nursing PhD student did do for me was get me thinking about a different kind of PhD. That is, to expand my thinking from only earning a PhD in nursing, to considering public health, social policy, sociology, anthropology, etc. I wanted a nursing PhD because I feel like nursing needs more people to bring interdisciplinary ideas to it, but I am also ADAMANT that my PhD is about *me* as much as it is about funding and other people's ideas, so that's something I've been looking into. It's exciting to have the opportunities opened up a little in my mind.

[::] Midwife-to-be asked, in the comments, about doing a study on why more women of color don't have children at home [in this country] and whether it would be offensive (in my opinion) if a white woman were to conduct such a study and whether it would be useful. The short answer is *I* don't think it would be offensive, but do you? Why or why not? Yes, it's irritating to me, that we're always being researched on by others because there aren't enough of us to go around, and it doesn't seem like there's a real push to change this...but offensive is probably a stretch. (And there's the fact that those who are available simply might not be interested in doing this work, and you are...) Compassion, honesty with yourself and the women, awareness about their lives, clear expectations about what they should expect/might get/not get out of it...etc are what I suggest you proceed with....anyone else want to weigh in on this?

[::] Lastly, I want to set something straight: I never said that midwives should never work outside their race and class. What I suggested was a withdrawal of care to see what the community itself would/could come up with. I ALSO said that if one considers herself a member of said community, then I don't expect them to withdraw. I said I do not want to be served by providers to felt like it was their obligation to bring me the care, without considering teaching me how to care for myself so that I wouldn't be dependent on them. I also clarified that this was about me and my community, and that what I wanted was more midwives of color from communities like mine available to provide care. It is not that I do not believe white women should provide care to black women, and it's so sad to see it reduced down to that by others. But what I do believe is that a black impoverished community could benefit from black midwives who come from their environments. I stand by what I said then, and now, 100%.

Brain Spasm

Stewing in old stuff. Racing with new stuff. Too jumbled to write down, really.

Gave the man the week off from dish duty because I felt like he should have a "break" of some kind, like I do. (I do the cookin, he does the cleanin - every time X 7 years and 5o more to come) But I really do HATE washing dishes. Ugh.

Read a chapter of Rock My Soul at the book store today while having coffee, then met with a PhD student from my school to discuss getting a PhD, which was interesting because she pretty calmly discouraged me from doing so...

So much going on.

I'm practicing my knots (for suturing)...which is a kind of cool thing to do as my mind is racing...

Drawing Parallels

I've been thinking about why it's so hard for other people to understand the centralness of race in my life. I was up last night thinking about parallels. Immediately fat came to mind, because fat is also something that I think about daily. It's like this. When you're fat, you think of the world differently...an amusement park takes on a different meaning...will you fit in the ride? Will your seatbelt on the airplane fit? Will you weigh more the recommended maximum for a particular ride? Just how wet will I get if I ride the white water raft ride? Are my clothes going to be completely soaked and therefore clinging to me...how long before I'm dry again? What about the restraunt seats...is there going to be enough space between the bench and the table, or are my breasts going to be in my plate? Sure, I want to go shopping, but going to the mall really isn't as fun if you can only fit the clothes in Lane Bryant or Torrid or Ashley Stewart or Avenue...and of course they NEVER EVER put all of these stores in one mall, or even two of them...so yeah, I'll come but I'm thinking about how long I can stand to watch you try on clothes as I spend all my time in accessories or shoes. And when I'm trying on the shoes I'm wondering if the heel can support my weight and not make me break my ankle. And when we do go to "my" store, I'm paying extra attention to patterns and colors, less I walk out of the store with something that makes me look pregnant (cause for some reason they love, love, love to put bows, and flowers and back ties on "plus size" clothes.) And when I'm on my 5th "lifestyle change" of the year, every time I go out to eat I gotta make sure they have something suitable for whatever the rules of such life style change are. Then every commercial is some skinny ass woman telling me how she lost her hips or breasts or gut or bowels by using the next big thing, and I should call to get some for myself. I could go on and on and on, the point is I think fat people think about these things so often that they might not even realize just how much they think about them. It's a part of their identity.

Here's another: when a woman is going through infertility, all she ever thinks about is infertility. every commercial is a pregnancy test, a pampers commercial, thermometers, a baby story, a fake family selling a car, a cleaning company, grape juice. She reads books about it, she talks about it, cries about it, writes about it. Wants to kind somebody else, anybody else, who's going through it so she doesn't bother those who don't understand with her stress about it. She can pretend that it only has a small impact on her life, but the relaity is that it's probably her whole life in that moment. It affects her interactions with other women, other people. It places her in the realm of "other." It's a part of her identity.

There are many facets of identity that, I think, manifest this way. Sure you're a person with a complex personality, but there are always salient aspects of identity. Women whose conversations/lives center around their children. Or their professions. Whose identities are shaped by motherhood...or midwifery. At our best we attempt to address all of the parts of ourselves...doing the work to identify on multiple layered levels...ie: I am not only someone's partner, a midwife, a mother...I am also a writer, a dancer, a knitter, a woman, transgender, gay, queer, lesbian, none of these, all of these. Bit even when I am tuning it to all that/who I am, there are some things with which I more strongly identify...when I'm

A Day of Rest

The man and I

Homesick

Creepin up on me.

Today is my brother's 13th birthday.

Happy Birthday, boonness.

We're a Christmas family.

The next few days will be hard.

Tonight I'm watchin Beloved again because it's new on the free movies channel.

I Realize

In the comments of my post about stress and race and health disparities, dark daughta said this:

"I'm going back up to read some more. But I wanted to stop here for a quick sec:"maybe the reality is that they don’t want to"It's hard to ground in the reality that white domination IS about giving certain people a disproportionte amount of stress so that others may experience joy and well being.People of colour and poor people carry the burden so that white people and affluent people don't have to.That's the point of this sick little game we call domination.This is a screaming affair when we think that all the helping professions are peopled overwhelmingly with white people and with affluent people.This is the reason why things don't seem to get any better. This is the reason why it seems like such an awful struggle for those who try to make change from within these power structures.Most governing structures aren't designed to make change. They're designed to uphold it while maintaining the appearance that they are trying to make things better.So, they do their "research", they write their documents, their papers, they publish what they've "found". But that's as far as it goes because that's as far as it's supposed to go.This is where the dance happens. People with good hearts and some politics who understand that there is power inside certain helping structures, inside certain service professions try to utilize these papers to make change.But it's like trying to shoe horn a whales fin into a man's shoe. One wasn't meant to fit into the other. It just isn't supposed to happen.It's a ritual dance. An energy absorbing dance. An emotion screaming, hair pulling out dance.And when it gets to be enough, when the crying and struggling and hoping for some sort of substantial change inside any given system or profession gets to be enough for those who struggle, when enough is enough, they say you're burnt out.They never say, the system was designed in such a way so as to wear your resolve down, to grind you down until nothing remains and until you blame yourself for not being smart enough, strategic enough, enough of a player of the game. It's your fault you, not the system buckled.Don't buckle. But I think you realize what you're dealing with as you study midwifery, no?"

What you’re talking about is what I call one of my conspiracy theories. I do realize it…what I’m up against…the situation as it stands. I realize it’s not supposed to get better…it’s not supposed to change…it is my opinion that this is why we have committees in institutions, to keep track of how much “progress” is being made so that if at any point there is a threat of changing the balance, it can be stopped dead in its tracks. I realize that the illusion is that by working hard and playing by the rules (most times :O) things will begin to change. I realize that the master’s tools are not supposed to be able to dismantle the master’s house. I would love to create change by stepping completely out of the preset world of academic midwifery…in my dreams I am a homebirth midwife warrior who works with teenage women in my community…not just to catch their babies…but to talk…to listen…to teach…to learn…to live out my days surrounded by life and death and love…and then I would go to those places where the academics gather and say whatever it is I need them to hear and then turn around and walk right back out…home to my family, where I’m home schooling 5 kids with the man, and peeling yams, and then locking myself into a room of my own to write until I fall asleep with the pen in my hand until the phone rings and it’s LaCreshia on the other end saying can you come now? But alas, I am not that girl, that woman, just yet…and truthfully, maybe never. Right now I am still enchanted by a real size paycheck that will pay everything on time and leave a little for world travel…by owning a home of my own…by king crab and good steak…because I’m tired of quiet hours and no smoking and cars that break down and loans and ramen noodles. It’s a step up from roaches and slum lords and section 8, but, still, it aint. Even if I believe that you can never escape your class because it’s learned and it’s your teeth, and your speak, and the way you hold your silverware, your book…wait, if you’re holding a book at all…I still want it…because I’m tired of not having it. I want to know what it’s like to paint my walls without fear. To pick out my own refrigerator. To buy what I like when I like, even if I do see the lack of discipline it encourages.

Even in my frustration at myself for whatever I feel like I don’t do…I still realize that the system, this country, has failed me. Better, that it was never for me in the first place. That all I was ever meant to do was work for it, for them, until I could no longer work or lost my mind. I know that I’m supposed to break my back for it, and then be grateful that I was allowed to do so. And, I realize that what I’m doing can be considered just that. I realize it, and it hurts. I’m trying not to buckle, but it’s hard. I’m trying to play the game, but I’m tired. I’m trying to do the dance, but it’s not my kind of beat. And it becomes more and more obvious as time goes on, which is why midwifery in this place is so hard.

Yes, I realize what I’m dealing with, dark daughta, and it keeps me up at night. I am supposed to want all of this because that’s what it means to be a first generation college student. I’m supposed to want it because they never had it…because our car was always worth more than the house we lived in…because the schools never intended to prepare me for it… I am supposed to want it because I’ve just paid $100,000 to have it. And most days I do want it.

But there are days. Days when I think…but this isn’t even what you want…this isn’t what’s going to help the people you keep saying you want to help. How many black girls are gonna make it to the schools I’ll end up teaching at? Already they tell me my research interests won’t earn any funding, and until I have position in hand, I should read/write about this instead, because this is where the money is…so, really, what do I think I’m doing? It’s all swirling and I’ve been struggling with what to do and when to do it and why. About whether I really can make change from the inside, or if I really do have to do the work of creating a way of midwifing that speaks to me, specifically...and if I'm willing to give up the security of academia to do so.

Day Two

First: *SO* irritated that I missed the next "grade" level in Patho by 1 point. Literally 1 point. As in 1 more point on the exam and I would have made it to the next level for my final grade. I've come a long way since coming this close to failing the hard core sciences last year. LOL! Seriously.

New from the ACNM

The ACNM has issued a brief:

In America the burden of disease and premature, preventable deaths is borne disproportionately by politically disfranchised and economically disadvantaged communities. In all leading public health mortality and morbidity indices, there is a persistent gap between the privileged and the deprived that is euphemistically referred to as “health disparities.” Health disparities are “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.”1 Even when access-related factors are controlled, such as insurance status and income, minorities still receive a lesser quality of healthcare.2 For African American women, the lifetime and generational exposure to institutional and interpersonal racism have been shown to affect pregnancy outcomes such as birth weight,3 as well as other health conditions.4

Read it in its entirety.

According to my Pathophysiology textbook,

"A person experiences stress when a demand exceeds a person’s coping abilities, resulting in reactions such as disturbances of cognition, emotion, and behavior that can adversely affect well-being....In the past decade, for the first time in history, it has been demonstrated that the interactions among social, psychologic, biologic, and behavioral factors are inherent in the causes and courses of many diseases...Physiologic stress may cause or exacerbate several disease states, including many of the diseases implicated as leading causes of death in the United States."

Here are a few of the diseases listed in a chart as being “Stress-Related Diseases and Conditions:”

Coronary Artery Disease
Hypertension
Stroke
Asthma
Ulcers
Type II Diabetes
Amenorrhea
Fatigue and Lethargy
Depression

And not in the chart, but in the ACNM document, PREGNANCY OUTCOMES.

These are only a few of many listed. Why did I pick these? Do they look familiar? They should. A lot of them are diseases for which black people disproportionately suffer morbidity and mortality. This is not new information. In fact my professors are quick to point these stats out at the institution. They will show and quote power points like this one from the CDC which tells of all the disparities. But what's always missing is context. Well here’s some: STRESS. Why doesn’t anyone say this? Why don’t they/haven’t they made the connection? It’s right here in the same damn textbook that they have been making us memorize for everything else. I want to say it as plainly as possible:

Experiencing RACISM, whether, overt, internalized, institutionalized, forgotten, ignored, debated, denied, or otherwise, is STRESSFUL. That stress manifests itself in many ways, one of which is poor health outcomes. THIS is one reason why it is so damn frustrating to be sitting in a classroom where we are supposedly discussing these inequalities in health care, incidence of disease, and health outcomes and NOT ONCE discuss racism as a factor.

I’m screaming at this point. I can’t help it. I thought that the reason they weren’t providing context was because they couldn’t, and that’s why I was trying so hard to provide it myself. But maybe the reality is that they don’t want to. It’s here. They’ve read it. You mean to tell me that my professors who are leaders in the field of nursing and midwifery have not read the 1999 article implicating the lived experience of discrimination and racism as having a direct effect on health outcomes for black women? Seriously? Not one of 'em? I don’t buy it. They read it, and chose, at the time of delivering the statistics to our class, to not mention it. Why? Because it’s easier to say “it’s lifestyle choices…poverty…living in congested spaces without fresh air, parks to play in, or safe food in the grocery store” than it is to say it is our history of oppression, racism, discrimination, abuse, brainwashing, disregard, disrespect, denial of humaneness, and good old fashioned hatred that created/perpetuated this. The lack of parks, clean air, and fresh food sounds more like an external “that’s just the way it is” or “we all need more of that” or “commercialism has ruined our society” factor…on the other hand, you suffer more heart attacks, maternal mortality, and type II diabetes because I raped your mother, stole your father, and worked your child into the dirt is just too damn hard to come to terms with…especially for those who can’t even come to admit to themselves that white privilege exists.

For those who wnat more details (I would, too) here's an example of how, physiologically, this thing thing plays out:

Obesity and Type II Diabetes: Cortisol (aka hydrocortisone) is a hormone of the body that inhibits the uptake and oxidation of glucose so that one has more glucose in the blood. Why would we need that? Because glucose is energy...energy needed to combat stress...the more stress you have, the more cortisol you produce, the more glucose you hold on to which leads to obesity...specifically, "cortisol-induced obesity," which they now think leads to Type II Diabetes. (p317)

I remember on another post emjaybe (no blog) asked something to the effect of “now what?”

I’m sitting here thinking about that. OK. You read the brief, looked up some of the articles, and are outraged. I’m crying and typing and trying to make a point. Now what? “Now what” is that the ACNM claims it’s ”striving to increase now underrepresented racial and ethnic groups among the ranks of our Profession” (I'm glad they said "now") Yeah ok. So let’s tell the truth about that right quick. What kind of midwife do you have to be to belong to the ACNM? Bellytales talked about it here. Ok, now exactly how many people who look like me meet these requirements? We have to get our children through high school first. Then undergrad. Then a friggin master’s degree. Who in the hell are you kiddin? Yeah, we’re coming but it’s a mighty slooooooow process, and honestly, by the time you get done beating me up and robbing me of my mind, I might not even have anything constructive to contribute to your damn Midwives of Color Committee. And by the time I get done experiencing the profession at my place of learning, honestly, the ACNM is probably the last place I’m trying to go…hmmm…more like the ICTC. Furthermore I think it’s safe to say that a lot of people who meet the requirements are already members of the ACNM…but acknowledging that CNMs to do not = the profession, the real question is do you want us in the profession, or in your academy? And is just any brown face you're looking for, or one who has had certain life circumstances or one who is committed to working on these disparities or one who is willing to be the poster child for your campaign? What exactly do you want from me?

“Now what” is more people talking about the shit that somehow stays buried. Stress. Stress from racism. Stress from invisibility, or in the case of crime prevention and the so-called war on drugs, stress from microscopic monitoring and existing while black. Stress. Talk about it. That’s what’s next. But more than that, write about it. Leave behind some proof that you acknowledged it and thought about it. Then what? (cuz I already did that) Scream about it. Don’t stop. Work through the fatigue. Type through the cramping. Make it your thesis, loving pecola. Your fuckin dissertation if necessary. One of a million platforms.

Now what?

Sleep. Sweet release, at last.

Day One of Freedom

A million things to say and no idea where to start. I feel like my head is going to explode with all of my thoughts. Common sense says "one thought at a time" but my thoughts don't emerge that way. My thoughts bounce around my skull, then they fight for my attention and the right to be first. My book list is long and overwhelming. I'm taking the pressure off of myself by saying even if I only read one book...one book chosen completely and entirely by me...I will have accomplished something. It's frustrating because after being crammed with junk from other people, it's harder to think for myself. It's like what do I say? About what? Why that? What can I possibly say that everybody else hasn't already said? That's what I would want to start with, but there's little of that left, I think?! What's for certain is that there should be no pressure involved in this undertaking of three weeks of freedom.

With that in mind, I've been tagged! I think already this tag before, but I'll do it again as an entry into my new found freedom!

I believe the rules are to post 7 random things and then tag folks.

1. My brother calls me "sister." I mean really. Like "mama" or "papa," but sister. As in never by my first name. Sometimes when I read characters in books who are called "sister" it seems so strange to think that that's what I'm called, too. I miss my brother. He's turning 13 on Sunday. I feel like I'm missing his whole life right now.

2. I love that navelgazing, and sagefemme, and darkdaughta post so many pics/videos on their websites. I'm jealous. I've been weighing my anonymity (what's left of it...which is very, very little) with putting it all out there so I can be creative, too. So far all I've convinced myself of is that I can post anonymous type photos, LOL. *sigh*

3. I watched Harry Potter last night and was disappointed with Hermione's character. I always liked her. She could be unappologetically smart and bold. But this time she had almost no role at all, except for a minute moment of critical thinking when she asked Harry "but what if that's what they want you to see?" Other than that, flat. So disappointed. But I did appreciate the whole "don't let the 'darkness' take over your mind, you must revenge against mind domination" plot of the movie, especially in light of my recent thoughts on the topic.

4. I am at the library and I am about to leave with "Growing Up Fast" by Joanna Lipper, "Promises I Can Keep" by Edin and Kefalas, and "Women, Race, and Class" by Angela Davis from the library.

5. My mama is coming to visit us in a week! I am *so* excited. Even if we don't do anything. Just to have her here. Just to lay around. Just to know that for almost week she will not have to lift a finger. Not cook. Not clean. Not even answer to "mama" if she doesn't want to.

6. I'm struggling with how I'm going to make a change in the world through midwifery. I worry that all of the things I want to do (teaching, clinical practice, and research) are not physically possible in the way I imagine them to be...at least not without taking a considerable (ie: unacceptable) amount of time away from my family. I know I can't plan for everything, but I'm thinking about it all.

7. My blog has been boring me.

End of the Semester

A WHNP classmate came into the room today where we were all about to take our Stats exam (the last final of the semester) and said:

"I just spoke to [our professor]; we all passed GYN."

You can imagine the excitement that produced. And the shock.

We took the Stats exam which was hard but not impossible, and then I went to find my teacher to ask her if I passed the primary care exam. I was thinking there's no way I want to leave here without knowing whether I'm done or not. She said yes you passed, everyone passed, and you can tell them so.

It's over.

Thank Gawd.

I can't believe I survived another semester.

I did it.

I did it.

Yes, uh huh, I did it.

GYN Final Exam

Usually I go through and mark the questions I don't know the answer to.

Today I marked the questions that I did know the answers to.

17.

Out of 58.

There was a massive vent session after the exam, which I did not participate in because I just didn't have the energy. I did look my questions though, which I don't always do after exams because it drives me crazy, but after a while I stopped looking them up because the answers were all wrong by some minor point. The general consensus is "well they can't fail everybody" but I don't trust my classmates. They always say this and then ace the damn exams. Right now I am venting because I have to get it out so that I can switch gears and study for Stats tomorrow...especially since I failed the last exam...after everyone swore they did so poorly and pulled in 100s, thereby fucking up the curve. After yesterday's questionable Primary Care exam, and today's joke of a GYN exam, I am stressed beyond words. I just wanna get it over with so I can hug the man, cook a good meal, and go to sleep.

1 more day.

1/2 Way...

through finals week.

2 down, 2 to go.

Patho yesterday was ok.

Primary Care today was scary.

GYN tomorrow is...is just...overwhelming? That doesn't seem to do it justice. I can. not. believe. how much material we've covered over this last semester...and now I have to take a test on all of it?

I dunno.

*sigh*

It's That Time Again

Finals are here, and I'm stressin, just a lil bit.

Deep breathing isn't really helping...but I guess it could be worse. I had my first ever panic attack last year, in nursing school. It was textbook; my heart was beating out of my chest, I couldn't breathe, my chest was hurting...I thought I was having a heart attack and that I was really going to die...shaking/trembling and feeling like I was going to faint. Yeah. It was bad. It was the day I received the "you're not cut out for nursing school" letter, which happened to be the night before a huge exam. That was my first and only attack, and really it has kept me from getting as stressed as I used to get about these exams because nursing school is not going to kill me. Nu uhn. I'm not having it.

I missed out on 4 hours of studying today because I had to take the shift of someone who had a final today. I usually get to study at work, but for some reason they gave me 3 hours and 20mins worth of work today. I could not believe it. Usually, when you are kind enough to fill in for someone...on a Saturday, they don't give you much to do and you can study. But not today. I wish I hadn't of taken this shift, but it's over in 15 blessed minutes. I have never had this much work to do at this job, it only takes me 45mins-1hr at the most. I'm working of my stress levels. It doesn't help that I have four finals this week, 3 of which are cumulative.

I will get through this week.

I will get through this week.

I will. Yes uh hun, I will.

My Commercial

Primary Care for Midwives textbook: $67

Salary of Primary Care professor: approximately $60,000

Food and drink each night while studying for Primary Care final exam: $4

Fighting hegemony by changing the name of the patient in your assigned case presentation for Primary Care class from Sarah to Keisha: PRICELESS.

There are some things that money can't buy, for everything else, there's Sallie Mae.

Random Bloggin on a Study Break

The list of things to do over winter "break" is piling up. As the emails come, and the advice and suggestions that are always contradictory is given out more often, I am trying to stay focused and push them to an unoccupied corner of my brain. "Get rest over break. Enjoy yourself," is what is said. "Here's the list of supplies and books to buy. You should read...before you return...you will be expected to know....and be ready to discuss during the first weeks of didactic..." is what the emails say - some from professors, others from upperclassmen who are trying to give us the heads up. I just laughed at a two page memo that came from the professor of one class. I started looking up the prices of the tools we're required to buy before school starts (suturing needles, forceps for holding the needles, etc) and had to stop. I wonder if you can use regular needles (ie: sewing needles) to practice suturing on chickens and foam? Why spend so much money on these supplies that are only temporary? (I don't think I'll be taking these supplies to work with me...the hospitals provide these things...so making an investment - like a homebirth midwife would have to do- seems silly and wasteful?) Maybe my real break will be the 5 days that my mama is visitin...especially since she insists that we do not go anywhere that jeans are not "allowed." And the rest I will just accept as a "test free period."



All of my conversation centers around this experience. I must be so boring to talk to right now.

My Mind

I have been out and about reading blogs on break. I am here to let the anger at not being able to write what I want and say what I want regularly out onto the page so I can move on. My mind isn't even my own anymore. Someone else tells me what to say. What to think. How to think, and then how to say what I think. As I sit here in a basement library, I memorize diagnoses and treatments irrelevant of whomever's history. I am supposed to construct these "plans of care" in isolation of the whole person...or rather, keeping the whole person in mind in theory but in reality fitting ABC and XYZ in a 10 minute appointment. I was thinking that midwifery was a way to melt the medical/biological information with the woman who is actually standing in front of you. A way to give the power back to women. But really, it's so much like medicine when you're here. Yes it has its pot lucks, and sisterhoods, and warm and fuzzy feelings...but the meat of it is the same. The physiology, the details, the stress. I am tired of memorizing. That's all. And I am tired of fighting the oppressiveness of this learning style. I know it's easier to give in to it. I've done it before, successfully. But success is relative. My grades were fine but my mental health was crumbling. I have been told that you just do what you have to do to get through it, and then you take your life back. I hear it. And I understand the wisdom of it coming from someone who knows it to be the only way she survived it. But I'm not sure if it's right for me. I keep trying to stop reading the stuff I'm not supposed to be reading...books and blogs about everything BUT what the hell I'm studying. But my mind is fighting with itself about what is important. I keep telling myself that this is only the stepping stone. This, too, shall pass. But in reality...this might be it. After this, there is more of the same. More school. More people telling me what is right and wrong with what I am saying/writing. More feelings of personal betrayal for not having the time...real time...full time...to write about what's in my head...for always responding and never really initiating. I have something to say and it's being stiffled by my education. And my time constraints. And my mental fight with anonymity. I have something to say and its choked up behind my tongue and I'm only realizing the full weight of the censorship right now as tears are being held hostage by eyelids. Only as I type this post am I realizing the real cost of this education. My time. My thoughts. My mind. My mutherfuggin mind. I signed up for this. I agreed to turn my mind over for the next three years. And I think it was an experiment. What happens when we apply this kind of education, in this kind of place, taught by these kinds of people...to this kind of girl... Why shouldn't it have been an experiment to them? It was certainly an experiment to me. Can I do this? Can people like me do this? Here? With what I came with? With who I came with? My hypothesis was that, YES, I can do this, even with all the constraints. But right now, in the analysis of my experiment I notice some variables that I had not planned for: mental exhaustion and guilt. Guilt at not doing this my way. Wait, this is my way...but it's the comprimised version. The version that took all the facts into consideration...the liability, the truth about which populations use which kinds of midwives, the resources available to those who choose to go the path of least resistance and of safety. The uncomprimised version allowed me to explore more. At my own pace. With other women of various educational levels. With respect for those who came before me in unknown towns with cotton lined dirt roads. I would not feel disconnected because I would BE connected. I would not have to wonder what it would be like to sit in a room full of women who look like me at a blessing of the hands ceremony. Wondering if I will be welcomed at in this community that actually does exist, and what my role could be. But mostly I am frustrated with my inability to really make all of this work. How come I can't learn what I'm supposed to...and what I WANT to? How come my fighting the assimilation that seems so inevitable is so hard? I mean really? I've been doing this all my life...it should be easier.

Drowning...Thinking...Remembering

It's not that I'm not coping well. I am. But I'm drowning all the same. It's a perpetual state of drowning, that is now making me very, very tired. I'm trying to study for finals without a dead week/reading week/study week. I don't know if they mean to kill us...or only make us think that we will die. How to give presentations and learn new material and go to clinical while also trying to synthesize what you've learned so that you can be tested...by a test that is worth almost half your grade...and comprehensive...seems a little...psycho?

I had to carry three bags to the library today. Three. A bookbag. My canvas midwifery bag (gift from faculty). Laptop bag. My back. OMG, my back. But all the books I needed for TWO classes would not fit in one bag. I started at noonish...it's 5:30. I took some mini breaks, but not too long. I'll be here until they turn out the lights...2:45 am.

I am so glad that I have this blog. To vent, to whine, to share, and move along.

Last night I had the pleasure of braiding my friend's hair and it immediately took me back to a good place. To a place where I am loved and supported. A place where I belong...even if it's only in the comparitive sense...meaning I belong there more/better than I do anywhere else. Hair can be so cathartic for me. It's girlfriend talk. It's remembering that I am good at something. That I belong somewhere...a place where hair gets "did" in kitchen sinks and at kitchen stovetops. Grease and picks and combs - the unbreakable afro kind and the perm kind with the pointed tip for parting. The smell of coconut grease. Oil sheen. Dookey gel. JAM! The twisting and winding of cornrows. The drinking, the smoking, the shit talking. The venting about these men, these kids, and these crazy azz white people. The love.

Ooooh. I remember.

Yes I do.

One day. One day soon.

We will go back there, and it won't just be for "break."

And maybe someone will lovingly pick the lint from my dreads...

My Community

Mixing and Mingling With My Peers

Moving on.

My patience is wearing thin lately. I notice it with the man, with my classmates, and with myself. A few posts ago, I said "maybe I'll come out and play, and maybe I won't." I think I'm done playing for a while. I agreed to do a group activity that's happening next week...how perfect would it be to just lay low from now until then? A kind of self-imposed hibernation for all things unmandatory.

There's this pesky blessing of the hands taking place this week. I had to send out an email about my disagreeing with it being so "religious." It went from a simple ceremony where we read a passage while pouring water over their hands (which are suspended over a bowl we each made/bought for our big sib that has a tea light candle in it) to an all out religious/spiritual (not saying those are the same - they aren't...only putting in writing the fact that people keep confusing religion with spirituality in this group!) affair, complete with a "shaman," blessing of the space that is to be kept "sacred," and the presenting of Tibetan scarves. Um. NO. I had to send an email. Firstly, because our group of big sibs expressly stated that they didn't want this kind of ceremony when they asked that we not do the whole "chanting" thing...they expressly asked for a PAR-TAY including immeasurable amounts of booze and dancing...and the very simple blessing of the hands that is tradition at our school - namely the reading of the passage, the fire (candle), and the water. I thought we all understood this. But apparently not. Second, having a shaman preside over the ceremony is inappropriate. Later this woman who was named as shaman refused, saying that she never agreed to this. I'm glad she spoke up, cause I don't think this is anything to be messed with. I am not trying to knowingly be in any room that has been blessed by someone/for something that I don't even understand, nor am I trying to be blessed with anything like holy water, sage brush, or anything else that, again, I don't understand (not saying these practices are done by shamans, saying that this is the feeling that was evoked). AND, I'm not trying to give worship to somebody's god for whom I have no understanding of, and if you participate in such rituals, aren't doing just that? Third, where the hell did Tibetan scarves from. I said, "please tell me *somebody* is Tibetan" in our group and that's why we're doing this...otherwise, especially as you've explained the significance of the scarves, I don't see how our cutting up some cloth is appropriate, not to mention the complete co-opt of someone else's culture to be used as we see fit. Um, NO. In my mind, this is Disrespectful with a capitol D. Lastly, how do we maintain a "sacred space" where talking and everything else is supposed to be discouraged...but then turn around and pass the booze in same said place? I understand that in some religions this is acceptable...but is it appropriate for Tibetans? Shamans? I don't know, and neither do they, and that's my point.

I bought an IKEA bowl for my big sib, and covered it with rub-on quotes of encouragement, perseverance, and words like miracle, cherish birth, beginnings, etc. Then I wrote our names in silver and red paint. It's beautiful and creative, yet simple. I also purchased a leather bound measuring tape as a gift to her. I liked my big sib, she was very supportive during my first year, and went above and beyond the call of duty. It will be my honor to participate in the blessing of her hands. And to pass the bourbon, Bacardi, or beer as long as she can take it because that's what she wants, and it is, after all, their ceremony.

And while I'm ranting...a while back labor payne said this in her comment to a post by Sage Femme:

"There is an unrelenting psychic weight to being surrounded by members of other classes and cultures who may assume that you don't measure up, aren't as smart, aren't even as attractive, aren't there on the same merit as them"

I want to add this: "And you feel that weight in a million different ways, even when you least expect it...like when you go to the potluck and everything is so. friggin. weird. (to you) that you're paralyzed by it." Sometimes I just stand there for a minute and look, trying to figure out what the hell I do want. Sometimes, rarely, I'm in that, "great! let's try new stuff" mood...other times I'm wishing that there's more than just salad that I recognize. Thinking how different it would be if the tables were always filled with food I eat on a regular basis? What if it were collard greens, fried okra, catfish, yams, hell....STEAK! Instead of tofu, hummus, edmame, and brie? Don't be confused, not all black people eat these foods, and the foods that fill the tables at our potlucks are not the domain of solely white folk. But, I'm saying, as for me and my house...ya know? I'm saying there's some stuff going on for me there, when I'm supposed to be relaxing, like you. I'm saying there's something wrong with the fact that because vegetarians "can't" eat meat, but meat eaters "can" eat foods that are vegetarian, everything on the table (except what I brought :o) is meatless. All of this to say, I am bringing a real dish (instead of an appetizer) to the ceremony. This dish will have meat. Lot's of it. And it will be RED meat. And PORK. Uh oh, double whammy! For once, I will make a heaping plate, and go back for seconds, like everyone else. And I will be full like every one else.

And my liqueur will be soaked up, like everyone else.

Blogsided...

by email.

by the dean.


*sigh*

4 GYN Cases

For a basic description of what happens during the annual exam, see this post. Below I am going to add things that are slightly different than normal.

Case A: 18yr old, in for an annual exam - her first. BMI 31. Family history of hypertension, diabetes, and hypercholesterol. Having casual sex for one year, using condoms "always." Wants to add oral contraceptives.

I always ask a general "how is everything?" and then a specific "how is school? how is home? how are things with your friends?" She's here for an annual exam, so that was first: because it was her first exam, I talk about the parts of the exam (external inspection, insert speculum, pap and STD exam, bimanual exam, etc) I show her the speculum. If she looks really nervous, I remind her that she does not have to have a physical exam to get birth control, and ask if she's still ready to have the exam. Then I tell her we can stop at any time. I ask all first timers if they want to see their cervix when I find it, and if they seem unsure I err on the side of them wanting to see it. She asked a few questions, and we proceeded.

I spent more time on nutrition and exercise counseling because of her BMI. I pointed out where her BMI falls on the chart, and what the number represents. I pointed out my BMI on the chart, and told her how I felt about my category, and then asked her how she felt about her BMI. She said she thought it was "too high," and so I made some recomendations. 1. Because she was only doing cardio twice a week, upper body toning once a week, and lower body toning once a week, I suggested that she up her cardio to every time she goes to the gym, which is about 4 times a week. 2. lay off the soda 3. switch her amounts of refined carbs with her amounts of vegetables (ie: less white bread, more green beans). I then talked to her about getting her cholesterol and glucose checked because of her BMI and family history. She agreed. Then we got to contraceptive counseling and safer sex conversations. I ask her again about her condom use. Turns out it's NOT everytime. Ok, so, now I suggest a full STD and HIV screening. I ask her to give me a scenario where she didn't manage to use any protection. ("Didn't have it with me, and we really wanted to") Then we role played what she could say and do next time. The main question...Do I want to bad enough to risk HIV? (or any other infection) But of course no one is thinking of HIV (or anything else) when they're trying to get to it, so the next question she can ask herself is can I wait 15 minutes? (hopefully that's long enought to find something) and if all else fails, "don't be rough (trying to avoid abrasions), make sure you're eroused (ie: 'wet') again with the abrasions, and withdraw." Last note: "Please be safe. We're here on Thursdays, if you want to talk." She left with a prescription for birth control pills.



Case B: 17yr old in for first annual exam, and full STD screening. Complains of vaginal itch and discharge. I notice on the chart that she came in last week for urine gonorrhea and chylamydia testing.

The exam was pretty much the same as the above, but without extensive counseling on diet and exercise or lipid/glucose testing. We talk to every woman about eating healthy and exercising in general though. Here's what was different for this woman:

I asked she was coming in only a week later for repeat STD testing? "I don't know I just feel like I should get checked."

"OK. Let's talk about it. Are you currently in a relationship, having casual sex...or how would you define your current activities surrounding sexuality?"

"I'm in a monogamous relationship."

"OK. It's excellent that you're trying to stay on top of your health by getting checked for STDs...are you using protection every time?"

"Yes."

"OK, well we do not normally recommend STD testing so frequently if your having sex, protected, with the same partner long term. But sometimes people, understandably so, don't completely trust the person they're with and would like testing more often and we can certainly test you...You were here last week...has anything changed since last week?"

"Yeah I have a different partner." ding ding ding. This makes me look at the chart where people list their sexual "numbers"...how many partners in the last year? Lifetime? Age when first had sex. I usually don't look at these numbers because I don't really agree with them being on the form in the first place...it seems like a way to be judgemental...and if the provider feels that it's important, they can always ask...this is another post...so anyway, I looked and she wrote that she had just become sexually active this year, but had already had 17 partners. Something else that stuck out in my mind was rape. Why? She was just here last week...a week later she thinks she might be infected...even though she was fine last week...she's being vague about the situation...she's drinking quite a bit on weekends (4-5 drinks in one sitting, 2-3 times over the weekend)...which puts her at risk simply becaus of the college campus environment and her behaviors. So I ask the hard question: "I'm going to ask you a question that I ask a lot of women I see...Have you been sexually assaulted?"

"No."

"Ok, do you feel safe with the people you party with?"

"Yes."

"OK. Well, I want you to know that if you ever want to talk about anything, I'm here. And when I'm not, the other midwives are here. And when we're not, there's free services at the mental health clinic next door - and people go there even when they just want to talk." And then the exam commenced. Her itch? Was really on the outer upper labia and mons pubis...from shaving. Her discharge? Normal. I looked at her mucus under the microscope to make sure there was no yeast (or not a lot of yeast) before I told her it was normal.


(BTW, This was new to me...that midwives looked under microscopes to diagnose STDs and other changes in vaginal flora...I had no idea before I came to school that we would be doing this!)

That's all I'm going to say for now for that day of patients, but I did want to say something quick about another patient I had on a different day:

This woman did not have anything out of the ordinary for her going on. She was a little stressed with school and work, but was doing ok. We talked a lot about her career goals because she is a junior in college, and considering graduate school. So we talked about that, and she asked me about the GREs and about what it's like to be in graduate school. It was such an unexpected conversation. But it made me remember that it's about so much more than pap smears, STDs, and pregnant bellies. Even though I say it on this blog all the time, I forget...sometimes you just want to see someone who looks like who's doing any smidgen of something you want to do....someone who says "YES! I took the GREs, let me tell you about it..." or "NO! you don't have to have had been on the dean's list the whole time to considered a good applicant...and YES! You can do this!" The reality is that this woman might not have known anyone who was trying to do what she's doing before coming to the clinic. It was good to be there.

I'm stopping now because something else has started to occupy my mind...

Gynecology Clinical Week 11

God was good to me today.

4 patients.

All young black women.

All shocked that I was going to be their provider.

All excited. Happy. Grateful.

All reminding me of why I went into midwifery.

All taking so long to talk...to get out everything that they hadn't been saying to their health care providers (I asked). Testing me...waiting to see if I lived up to who they thought I'd be based on that initial recognition. I am who I am, so I lived up to their expectations just fine. Really, it's easy - you only have to listen, know what they're talking about, tell the truth, and help them make a decision based on whatever options are available between the two of you.

I can do that.

Over and over again, all day, I can do that.

In keeping with the purpose of this blog, I wanted to say this: If you think it matters, you're right. If you're doing it because you think it will make a difference for those in your community - however you define that - you're right. The BS of playing the grad school game, the invisibility, the isolation of being one of a few in the profession at this level...it's all worth it for this moment.

Tomorrow I'll talk about the patients as "cases" because I think they're good examples for learning. But know that I don't think of these women as cases; they are my purpose for midwifing.

Coming Out From Under

I've been laying around, but reading other blogs in the mean time. Thanks everyone for checking in on me! I've been healing just fine physically from the dental surgery (stiches have been removed) but the rest of it...the emotional and mental, and the financial burden is taking a little longer. $618 could have been two plane tickets out of here...that would have been nice, but I'm also looking forward to a childfree family Christmas here at home with just the two of us. We'll have to do something grown and sexy.

Me and the man have been dissecting that day and it's tedious. The comments folks left on that post was a great jump off point for the conversations that had to be had. But because yesterday I had yet another "I've been reading your blog!" interaction, I have a bit of writer's block, and am still trying to find a way to not censor myself...yes, I realize the irony...the only way to do it is to keep writing. I had to go back and read my own anonymity post like 5 times. I guess part of the fun of reading blogs is trying to figure out who/where the person is. Apparently, once you figure out the school I attend (which is easy to do if you actually go here because I listed my course schedule not so long ago (doh!), figuring out which black student I am is not so hard....in fact it's easy enough to allow folks to walk up to you and confidently say that they read your blog. My friend pointed out that, duh, the rest of them aren't married. How simple was that. It's stressing me out, but what can I do? Keep it movin.

Anyway. I took a brutal Patho exam yesterday. Finished fast, but it was all a blur. The GYN exam over that massive number of units went well enough, and now I'm in the middle of preparing for 2 presentations. I'm ready for the semester to be over, but not ready for next semester to start so I guess I'll just take this moment for exactly what it is.

Thanksgiving was great. Made the 6ish hour trek to the inlaws. Ate good food. Spent an obnoxious number of hours braiding my MIL's hair. Went to see This Christmas. Did some day after Thanksgiving browsing, and didn't buy a thing. Didn't study one ounce of Patho, and didn't regret it. (Screw tests that happen the day folks come back from break!) Now I'm trying to catch up, but that's fine by me.

A Day in the Life of Humans

Went to bed Monday night with tooth pain. Took some tylenol and thought it'd be gone by the AM. Um, no. Woke up at 2 am in agony. Took some vicodin, little relief. Woke up three hours later, in serious pain. Tried to wait for that last hour to pass before I could take more vicodin. Lasted 15 minutes and caved. No relief, couldn't go back to sleep, so it's time to find an ER dentist. Realized I had a meeting that couldn't be rescheduled and had to go to school. Called around to find a dentist, found one who said walk in this afternoon after 1. Perfect, my meeting is at noon, office is near the school. I go to the meeting and by this time I'm swaying with pain. I'm nauseous from pain. Very close to passing out from pain. Didn't mention that by noon I had already taken another 1500 mg of Tylenol and then 2 Excedrine migraine because of course at this point the pain is no longer confined to my mouth, but to my whole face and head. Then it started to swell. Meeting went quick enough, she asked if I was ok, said I looked "faint." I said "yep" and promptly went to call a cab to take me to the dentist's office.

3 hours, 1 minor surgery to remove two impacted, infected teeth (1 of which was a wisdom tooth) with stitches and everything, and $618 later, the whole right side of my face was numb and I was told to make it to Walgreen's for my prescription and home safely. But of course I had to go to work right then, so I took some vicodin because I didn't have time to get my prescription filled. Left prescription for the man. Went to work, drooling, but numb and therefore pain free. I took the vicodin at 6 pm, I had to work until 10, so I figured the pain pills would wear off right when I was getting off work and that I'd still be numb anyway. No problem because the man would be there to pick me up and I could take my real pain pills and go to bed. But what I hadn't accounted for was the numbness wearing completely off right as the medicine was wearing off...oh. my. goodness. Tears.

But it's ok because I get off in like 15 minutes, no problem.

Except 15 minutes...25 minutes...35 minutes...45 minutes later I am STILL at work...waiting on the man to pick me up. I could've gone home 30 minutes ago, except I don't have any keys (which he knew when he dropped me off) so I'm waiting because if I go home, I still can't get in and it's COLD outside...and when the cold hits the side of my face...oh my. I'm thinking he's out gathering the items I need from the store (soft stuff...which I don't each much of, so it means sorbet, basically, some kind of heat source and my pain meds) cause that's where he was going when he dropped me off, and he'll be here any minute. I kept hoping. All the while, no more numbness, no more pain pills. Tears. Finally I get on a bus home. I figure I will sit at my neighbor's place until he comes home. OH! And he did not ONCE answer his cell phone. I called a million times, and then I thought...Oh! It's probably dead because I knew he hadn't charged it the night before. So I get off the bus...and there is our car sitting in the parking lot.

Tears dry up, FUMES commence.

I ring the doorbell a million times. He comes to the door. Groggy. I don't speak, I just walk to the kitchen looking for bags and pills. There are none. Looked in the oven because I asked him to bake me some sweet potatoes when he got home so I could also have something HOT and soft to eat. Oven ice cold. Still no words. Then, I look in the refrigerator, hoping to find something...anything. Something is gone...my leftover Chinese food from yesterday. Now, it's 10pm, and I haven't one morsel of food since 7pm the day before. Tears, tears, tears.

Then quiet RAGE:

"Am I to understand that you have not only not baked me a potato or picked up anything else soft for me to eat after I have come from having my gums sliced open, teeth removed and then sewed back up...but that you have actually eaten what was left of the food I did have knowing I haven't eaten since yesterday? And that not only did you forget to pick me up, but that you also have not even attempted to pick up my percocet? I just want to be clear."

"I fell asleep."

"Oh but not before you ate my shit though." I laugh, and that's the end of the conversation because I am too angry. too hungry. in too much pain to keep yelling.

I say "Ok" and exit to Walgreen's.

Today I dropped him off at work and he didn't get out. The cold has hit my swollen face to bring him there, and now I'm in pain again and I'm pissed.

"What?"

"Are you picking me up today?"

"Yep."

He gets out the car.

And I will be there because I wouldn't give him the satisfaction of not showing up on a day when he's expecting it and therefore prepared with a back up ride. The vindictive me says wait until a month from now, when all is forgotten.

When it's 20 degrees outside, and he has no bus money.

Madness

Why is my Gynecology, Exam 2, over 10 units?

• HIV
• Gynecological Physiology
• Vaginitis (yeasts, BV, etc) and STDs
• Paps and Gynecological Cancers
• Urinary Conditions (UTI, Kidney infection, etc)
• Menstrual Disorders (PCOS, DUB, fibroids)
• Breast Mass/Diseases (cancers, mastitis, etc)
• Climacteric (Menopause)
• Unplanned Pregnancy (including abortion lecture)

Unreasonable. Every time I step out of the fire, they throw me back in.

What can I be thankful for?

• Some of the stuff on the exam will be stuff I've seen in clinical...that helps
• It's the only exam I have next week (Monday).
• Next week is Thanksgiving. (but for some reason teachers love to have exams the Monday following the holiday...tis year it's Patho. There should be a rule...)
• I'm getting closer to the end of the semester...and I'm passing...although Stats exam was questionable this morning...

Another week in the life of a nursing student.

And I Quote:

"I think democracy is the most revolutionary thing in the world, far more revolutionary than socialist ideas, or anybody else's idea because if you have power, you use it to meet the needs of your community. And this idea of choice, which capitol talks about all the time, "you gotta have a choice." Choice depends on the freedom to choose, and if you're shackled with debt, you don't have freedom to choose."

MM: "But it benefits the system if the average working person is shackled with debt..."

"Yeah, because people in debt become hopeless, and hopeless people don't vote. See they will say that everyone should vote, but I think if the poor in Britain or the United States turned out and voted for people that represented their interests it would be a real democratic revolution. So they don't want it to happen, so keep people hopeless and pessimistic. I think there are two ways in which people are controlled; first of all, frighten people, and secondly, demoralize them. An educated, healthy, confident nation is harder to govern, and I think there's an element in the thinking of some people - we don't want people to be educated and healthy and confident, they would get out of control (laugh). The top 1% of the world's population owns 80% of the worlds wealth. It's incredible that people put up with it, but they're poor, they're demoralized, they're frightened and therefore they think perhaps the safest thing to do is take orders and hope for the best."

~An English man, former member of the parliament (?)

Yes sir. I've heard it all before, but still, thank you for saying it yeat again.

I only got halfway through Sicko, before I had to turn it off. It's not new, what's being said, but it's painful. It's everything you already know, but have tuned out so that you can be numb. It requires people to admit that they just don't give a damn, or that they're lazy. One of the conversations we had at happy hour last week was about this idea (brought up in a discussion about this book) that most people don't really know about poor people in this country...that people are just completely ignorant to the fact that so many children in this country are living at 200% below poverty, or what poverty in the U.S. looks like ( I think the figure is about 40%). But I (along with others) argue that this is simply not the case. People know. They do. Maybe not all, but most of them definitely know. I said, "I don’t think that folks are just that ignorant. I think we want to, have to, believe that they’re ignorant because otherwise we have to deal with the pain of knowing that they know and just don’t give a damn." That's something that came up again as I was watching this film. Our own government conspiring against us (us, conspiring against ourselves) on purpose, watching folks die, killing them by refusing to provide care...it's...it's...nauseating? There are no words.

A Wednesday Off

Yesterday was my day off from everything and anything I didn't want to do. Here's some stuff I did do:

:: Watched this beautiful engagement video. You can visit the photographer's site (and watch the video) here. I have a lot to say about materialism (my own included), extravagant engagements/weddings that immediately turn into failing marriages, but I tried not to take it there when watching this video (don't forget to turn on speakers). I just let myself watch this couple and their family, a full (10?) minutes of black love on screen. (Is anybody else starved to see more images of us like this?) I won't let myself comment about anything other than the moment (hours long) they were in and how wonderful it made me feel. I especially love the moments when their loved ones are holding hands around them and praying...10 different times...10 different rooms...10 times the prayer. The time and thought it took to coordinate. The hope everyone has for them and their future. It's beautiful.

:: Watched a lot of TV, mostly stuff I had saved on TiVo. I've been watching Gotti's Way which is about hip hop head Irv Gotti's life and family. I was all set to hate it, but I actually like it. Him and his wife are separated but he still spends a considerable amount of time at the house (he has a spot of his own as well). 2 episodes ago, they were arguing about how to raise their children. He said that the main responsibility of raising the boys should fall to him because he knows what it is to grow up male in this country, and she has no idea. He wants them to be ready, and strong...often telling them to "man up." She "hates" when he tells them that and wants them to have the space to cry and talk about their feelings, which he of course is not feelin.' She says the boys are afraid of him, and she told the boys that "daddy cries, too, and it doesn't make him any less of a man." He says that he does not step in and make comments when his wife is talkin to their daughter, "tellin her that women shyt" and he wants her to back off and give him the same room to raise "his" boys. Me and the man talk about this a lot, so it's interesting to be allowed into someone else's kitchen as they work through it. I also watch the Salt-N-Peppa show, which is less and less interesting to me as it goes one because I find Salt so processed (in that Pleasantville sort of way) that it grates my nerves. I caught up on a lot of TV yesterday.

:: I also watched some movies. Chuck and Larry Get Married, which was only ok, until the ending court scene which made me think of life and friendship in a good way...about what it is to be a partner to someone without the being in a sexual relationship...about how much you can know a person, love a person, be a pillar in a person's life, and not be their actual partner/spouse/lover. Diary of a Mad Black Woman, which I've seen a million times because I really love Kimberly Elise in anything she plays, and I'm also a Tyler Perry fan. Also, Reign Over Me (which was my second dose of Adam Sandler that day, and ALL I could take) which also stars Don Cheadle. That one was good. There were some snags...Sandler's character's inflammatory remarks, and the flatness of Jada Pinkett's character come to mind, but overall, good film about grief, and PTSD, our tendency to want people to grieve the way we want them to, and in the time frames that we set. About what we think it is to live a "normal" life and what's acceptable behavior for adults.

:: I went to happy hour with two women from my midwifery class to celebrate the end of physical assessment and the survival of a really tough couple of weeks. We also went out last week, but this time was a little different because last week we pretty much stuck to clinical topics (what we're learning/not learning, etc) And this week we waded into more controversial territory...our own lives, beliefs, and current events local to us. That's where it got a little sticky because we're all strong minded, opinionated black women. I welcome dialog because I feel starved right now, but I must say, I was still starved when I left, and not the least bit exhausted, which is how I usually feel after 3 hours of conversation with black women who are talking about their lives and how the hell to move through them. In short, I was a little disappointed. Happy for the time we shared, which was needed, but disappointed at our inability to really take it there. I ascribe this to not really knowing these women yet, to only having just met them, really. At least that's what I'd like to credit it to...because to say that it's probably more like, once again, meeting over drinks with black women who aren't willing to go the distance of getting into the kinds of conversations I want to get into is a little crushing. People almost always get that "oh no, here she goes again with that black talk/that race talk/that woman talk/that poor people talk" look on their face. Like I'm supposed to look at my life through a different lens...put down my brown shades. Step over the elephant in the room. Ignore the sighs from privileged black people who are tired of hearing about "other" black people who complain too much about what the hell is going on. Avoid these conversations, mute my thoughts, because they just wanna get along. Maybe it's the exhaustion. We're all so tired. Who has time to think about anything other than cells, germs, symptoms, treatments, and patients. Maybe that's how they feel, they just can't take one more thing to think about, it's much easier to agree to disagree, or say "that's just how people are," without doing the work of understanding why people...why WE...are the way we are. I think one of the women would talk about it, but takes a while to warm up, plus she's so...polite...it's like...it's ok, you can get heated, my feelings won't be hurt, or maybe they will be, but so what, that's what happens when impassioned women speak...do you think what I'm saying is BS? Tell me. I think you're smart, and witty, and have some experiences that I don't, and I want to hear what you have to say! Or, in the case of the other, she's just tired of the conversation. But what can I say? I am who I am and she is who she is. Do you think what I'm saying is BS? I wish you'd just say that because I think some of what you're saying is safe, and over conciliatory . And I think sometimes defensiveness is a protective mechanism elicited to keep from having to feel all that stuff that you have only just been confronted with in this, your (first?) attempt at friendship with someone who shares the same skin as you but not the same upper-middle class/beautiful text-book diversity of color west coast neighborhood/very little KKK-esque racism upbringing...and does not feel the need to ignore that to make you feel better. I hope you continue to talk about what it is you liked and didn't like about the life you've lived. I also hope our conversations become messier, less safe, less defensive...more real...as time goes on. But even if it doesn't, there is love, because even without naked, vulnerable conversations, we are here, black women, learning midwifery together and the journey is definitely smoother than it was for all of those women before us who had to do it as the only one in the program. I asked them about what they wanted to do after school...what kind of midwife? practicing where? with whom? why? These are the things that go through my mind all day long, and I'm longing to talk to some other folks who are thinking about it (I think I need to visit my neighbor, N, it's been a while and she definitely talks about these things...I miss you!) I feel like I have to be conscious right now of what I'm learning, how I'm learning it, and WHY I'm learning it because if you aren't careful, you come into these kinds of programs believing in empowering women (and yourself) to trust birth, but walk out believing in something that only resembles empowerment...But some people aren't worried about it all. They'll deal with it when it gets here. That blows my mind...I tried that...it's not for me. I have found that my goals need to be written to be realized...otherwise I end up any-ol-where with any-ol-body doing any-ol-thing feeling like I'm wasting precious time.

I also know this about myself: I can very easily crawl into a hole of self-reflection, solitude, and (as one of my best friends calls it) arrogant aloofness (she, I, we haven't decided is this is good or bad), that serves me perfectly well. But I'm trying to be a person who dialogs more often, who makes herself more available for conversation...more social, less introverted...I am a 15-year only child, trying to learn to play with others, despite the fact that I like to play by myself. But I'm starting to think that the street lights have come on, and therefore it is time to go home and read a book.

Maybe I'll come out and play tomorrow...maybe I won't.

Um...it is MY BODY...isn't it?

I passed my Patho exam over genetics. There was one major concept that just confused me more and more as I continually looked at. I decided that I might miss every one of those questions (almost 25% of the exam), but I will not miss any others. My exam grade reflects that, exactly. A pass is good enough for me in this course. Every time I see the dean she asks me about Patho because I really, really struggled with Biomed (its precursor) and a LOT of students get their "you're a failure, drop out of school immediately" letters for this course. Last time she saw me she said "well it must be going ok, I don't have any letters with your name on them!" I laughed and said "so far, so good." Glad test two is over.

Yesterday I took a Primary Care for Midwives exam over headache, HEENT, respiratory, endocrine, and asthma. That one can go either way, but I'm close enough, I think.


This morning I took a physical assessment lecture exam over integument, peripheral vascular, lymphatic system, and musculoskeletal systems. A pass is expected. A couple hours later I did my final exam/comprehensive checkoff for physical assessment. A head to toe physical exam in 30 minutes, with explanation. That wasn't very good. The teacher kept stopping me in the middle of the exam, asking me questions about where things were...and then she said "inferior" means "above" and of course I corrected her, which was frustrating because here we are having this conversation in the middle of my check off when she was NOT supposed to speak or ASK any questions unless at the end I had more time left and she wanted clarification. I would have much rather lost the one point, than to take 3 minutes explaining it/answering her questions. And it happened more than once, so I ran out of time. And I said to her "I didn't think you were supposed to ask questions while I was doing the exam. There isn't enough time even without the Q&A" And she replied "well, I didn't always know what you were doing, so i had to ask to be able to give you the point." I let it go at that because I knew that some of the things that she was asking about might have been easier for her to see if my partner and I had taken off all of our clothes. So, long story short, I passed it, but that's it. Which is good enough, because I know I would have gotten an honors, had I not run out of time...which I wouldn't have done without her interruptions. All I can say is, I. am. so. glad. this. class. is. over.

I'm glad that knowing what I was capable of, and what I would have earned, is actually good enough for me, despite the grade. Some folks don't have the same peace of mind when they encounter the same injustice. (wink ;o) at my lab partner) But I wish her peace of mind, too, even it's only from having conquered the check offs, never to have to do them again.

I am trying to separate who I am, and know myself to be, from who they think I am and want me to be. It isn't easy. This whole semester I have fought to keep my clothes on in this class. As a future midwife, I'd like to think that I am adamant about women being able to advocate for their rights, and backing them up if they are new to such practice or otherwise find it difficult. So I found it very ironic that I was finding it so uncomfortable to fight for my own right to keep my clothes on each and every week while being "inspected, auscultated, percussed, and palpated." This is absolutely my right, so why all the internal conflict? The unfairness of taking points from my partner for my refusal to remove my clothing made it difficult. (luckily, this turned out ok for both us) but it has me thinking...if they had not conceded, and we did not continually have the same "your body is yours" midwife checking us off, would I have held my ground? When my partner's grade was on the line...would I have held my ground? If they said, you do this or you don't pass the class...if you don't pass the class, you must leave the program...would I have held my ground? Probably not. I probably would have taken off my clothes obediently (probably would have sued their ass soon after, but still) and that does not sit well with me. To think that I am telling/showing/ensuring women that they absolutely own the rights to their own bodies and I don't feel that I have the same rights...or, more clearly, I recognize the right-and believe in it fully, but would not have had the courage to demand it, makes me ill. Am I really so stuck on this institution that I would really do something I feel so physically, mentally uncomfortable with just to stay? What else am I willing to trade my basic right to my body for? Today, enrollment at ivy1...tomorrow my entire soul. Slippery slope.

But for now, I'm done. So I am going to breathe today, party tomorrow (cuz I just finished a CLASS, HELLO!), and get back to work on Thursday.

But for now...I have a class from 3:30-5:30 today, then...

Cry

Pray

Nap

Eat

Drink

Drink

Drink

Drink

You get the point...

LP

The Bridge Poem (Me Winding Down)

I took my Patho exam as scheduled yesterday, and my advanced physical assessment lab exam (where you do a physical exam of a random system on your partner) today. I pulled "neuromuscular" so that's the 30 minute exam I had to do on my partner. It included things like testing all of the cranial nerves, sensory function tests, motor function tests, etc. I'm glad the exams for this week are over and done. I owe myself one day (or at least a few hours) of winding down...of taking back possession of my thoughts. Do I still have thoughts of my own? Nursing/Midwifery/Graduate school in general will really make you question whether you know anything at all. Some days I'm not even sure I know the color of my own shirt...even when looking right at it! It's like if "they" come tell me that it's not grey...even though I know it is...I might actually question whether I'm wrong. Now, it's not really a big deal when it's the color of your shirt, but when it's, say, your identity, your sense of self, it gets a little scarier....another post for another time...



For now, let's see if I can still write a decent sentence (or two) about something other than how Prader Willi syndrome is due to a deletion of the father's portion of chromosome 15 (aka: how come they never ask you the shit you do know on the exam?) Anyway.

A couple days ago I said "The Bridge Poem" was one of my favorite poems. Dark Daughta asked why. I haven't ever really thought about "why," other than to recognize that the first time I read it (it was handed to me, I think, at a time when I was in a mentor's office venting about something) I instantly loved it. After that I had to read it out loud, over and over again, and eventually I read it at a poetry reading during a Malcolm X Festival.


When I read it, I see myself. What is it that makes me feel responsible for translating for people? How often have people asked me to translate vs. my volunteering myself for the task based on my assumption that I can and should? I don't know, it might be about equal. People are not afraid to ask (or they overcome their fear, similar to when Sage Femme asked me if it was rude to ask someone (me) to teach her about racism, which is in itself a request of me to be a bridge between the uncomfortableness of addressing racism head-on, viscerally, and the safety of her self-acknowledged privilege) I didn't mind offering a starting point. Why? Because I was thinking, this is a huge topic...where does one start? You could say, "at the beginning," but it has been my personal experience that starting "at the beginning" (ie: at the point where two groups of people first met and started making judgements based on "race") doesn't work...I always, narcissistic or not, have to start with myself, something that fundamentally matters to me...so I thought, pick a book that might allow her to relate through another avenue (Killing the Black Body - for its reproductive rights focus) which also clearly begins a discussion about racism. Her asking the question and my agreeing to be a bridge benefits our profession because the dialogue is running, and her next brown patient will be greeted by a provider with a slightly better understanding of some of the nuances of her life. But was it my responsibility? No, it was not. I could have said, girl please! As if! But I felt personally responsible, and that's something that always comes up when I read the poem.

What I relate to in the poem is the sense of frustration with being the bridge...or, in my case, with my own acceptance of/acquiescing to being the bridge. I feel the exhaustion of playing the role of negotiator, and my irritation is only heightened by the fact that I am not even sure if my negotiations are for the right cause or are being used in the way I intend them to be. As I am explaining myself and my people to classmates, are they hearing it/using it to provide better care? That's one of the reasons I'm offering the information. Or are they using it (ignorantly or purposefully) to the detriment of those seeking care? An example is those "cultural competence" sections of health care textbooks...you read these excerpts about different cultures, and it's supposed to help you give better care to patients that come from these different backgrounds...but the problem is that it's hard to write such excerpts without succumbing to lists of stereotypes...and then we take those stereotypes to the population and if they're offended, and their care is then compromised. Someone was trying to be the bridge, provide the bridge, but at what cost?

What is the cost to me? Exhaustion? Frustration? Time? There are days when I decide that it is not worth it to explain one side to the other...when I am tired of being the only brown person in the room trying to stand up for myself and the other brown people who are not able to be in the room (or in the case of my school, not even within the gates surrounding the institution). There are times when in a split second I decide that I am not speaking that day. I will not raise my hand to say what other people know is true but are unwilling to say for fear of being that person. Those are the days when I think (lines 41-48):

I am sick
Of having to remind you
To breathe
Before you suffocate
Your own fool self

Forget it
Stretch or drown
Evolve or die

(except, often in my mind I say "Fuck it" instead of "Forget it" :o)

I'm always thinking, this is going to be the end of us. (I'll leave you to decide who "us" is...I'm not sure myself...ethnic people? Women? Americans? Global people/All people?) But the "this" is our unwillingness to call a spade a spade/to acknowledge our humanity and our hatred /to see more than one side of things/to tell the truth. Our refusal to do these things with real effort is going to undo us because as we complacently go about our lives, some folks' defenses fall, while other folks' frustration rises...the balance (for lack of a better word) that keeps us going along as we are is disrupted and, eventually, the oppressed "rise," or shall we say "get fed up enough," and life as we know it will be over. I'd like to believe that what will happen is revolution, but I have the sinking feeling that instead of revolution, what we will have is chaos...so I'm thinking, go ahead and "suffocate your own fool self" because I'm tired. And the more I tell you to breathe, the less time I have for myself before this end of times that you're/we're bringing on.

Moving along from that tangent, dark daughta mentioned people's tendency to "confuse building political coalition, with forcing many of us to be bridges where we are not supposed to centralize our own experiences, but instead are forced to centralize and tip toe around the beliefs, values and experiences of others who may be obscuring their own realities so as to better accrue privilege that we ourselves cannot." (from the comments section of this post) I'll let her unpack it her way (either here or at your place) but this is what I instantly thought about when I read it (which I'm sure is different than what she was thinking...which makes this great! anyway...)

I've been thinking about/journaling about hip hop/my life/my husband/black men and the connection among them for quite some time now. Her quote made me think more about this...I often say, "I love hip hop, the good, the bad, and the ugly." But right now I'm thinking, yep, that's me, I confuse political coalition with being the bridge between hip hop/my husband and the rest of the world. I accept hip hop for exactly what, or personified in my husband (usually, in this blog, and hereafter termed "the man") who, it is because I believe that without doing so I cannot maintain political coalition with it/him which I find to be vital to my existence. That is, the me I'm trying to be/trying to hold on to in this new world I'm moving through, is fractionally dependent on maintaining our coalition. But our coalition is not to be confused with/mistaken for any political coalition between hip hop/the man and the rest of the world, because they do not have a political coalition...that's the problem, by the way, with hip hop right now, I think...(another post for another time)... Instead, I, and people like me, are the bridges that are holding/centralizing the beliefs/values/experiences of both parties. How? I'm living/loving/learning on both sides (one side is hip hop/the man and the other is a lot of stuff, but I'll call it academia) and I'm taking on the responsibility of defending both sides because of a (false?) sense of (needed?) political coalition between the two. Maybe it's selfish bridge-building on my part...maybe I'm building this bridge in the hopes of forming a coalition so that my life (exemplified in this post) will be a little easier - so that the tugging will not be so violent. Whatever the case, does my United Nations-esque translating really do any good if neither side is telling the truth? The academic side (which represents privileged people, in this post) is not going to tell the whole truth because they're interested in maintaining their privilege. But, I argue that hip hop/the man is not telling the whole truth of their lives either, and as a result they, too, are continuing to accrue/use privileges that I cannot because at this point I have somehow become "too educated" to hang. These privileges that I speak of are probably not privileges to the average reader of this blog, but some of you will understand what I'm talking about...it was not until recently (last year) that I lost the privilege of walking around in the middle of my community as an insider. I lost the privilege to ride the city bus and be welcomed, rather than looked at questioningly as to why I'm on the bus. I lost the privilege of speaking black english (aka: African American Vernacular English) without someone looking at me like I "know better." What a difference a year makes. From last year to this year I was supposed to become a completely different person...walk different, talk different, get to the mall different! And I'm supposed to tip toe around it. Why? Because I'm building bridges, not burning them. And if I stop centralizing/reconciling our beliefs, the political coalition that I thought might have already existed, will never exist...and I think I need it to, less my own damn identity never come full circle.

That felt good. Back to studying for hell week.

Thursday's Clinical Patients

I saw 5 patients and they were mostly annual physicals and birth control renewals, although one does not have to have a physical exam to receive birth control. This is what the typical exams look like:

1. Introduce yourself to the woman, ask her how things are going. If she doesn't talk much, you specifically ask about school (I'm at a university health center doing women's clinic), work, stress, eating and physical activity. The you ask if she has concerns. Most of the time they say "no" until you're in the middle of the physical exam.

2. Tell her what you plan to do (physical, etc) and ask if that's ok.

3. You leave the room, she changes, you come back and do the following:

• palpate (feel/touch) the thyroid


• listen to her heart (I do three points)


• listen to her lungs (I listen in four quadrants, plus right middle lobe)


• clinical breast exam - at which time you ask about self breast exams (does she do them? does she know how? how often does she do it? etc)


• then you do the pap smear (for cervical cells) and gen probe (for gonorrhea & chlamydia - yes we do it on everyone, unless she says "no" when you tell her what you're going to do today)


• last, do the bimanual exam
  

While doing the exam I ask about her vaginal hygiene (ie: do not douche, try to avoid perfumey products, etc), whether sex is painful (a LOT of women say "yes" which makes me go into another list of questions to ascertain whether it's positional or other), and whether they have anything out of the ordinary for them going on.

Then I leave, they get dressed, I come back and we sit down again and talk about safe sex (you wouldn't believe how many women are not using protection) and safety in general (domestic violence, drinking, and drugs), and about the free mental health services available for free next door (also on campus) if they should ever need anything. We talk about anxiety and stress management right now because it's midterm time, and we talk about smoking cessation if they smoke. If they are renewing their birth control subscription, we go over the risks, use, and benefits of the method they're using just like it's the first time they're ever hearing it, and write the prescription or sell them the discounted methods we have in the office.

We set up the next appointment, and they're off and back in the world!

Outside of this, last week I had a woman who was 32 and had been on Depo Provera for more than 10 years. The protocol in our clinic is to take women off Depo after 10 years because of the black box warning for risk of decreased bone density and osteoporosis. This was also the protocol of her primary physician, but she refuses to go off the Depo. So, she gets bone-density scans every year or two, does increased weight bearing exercise, and takes calcium and vitamin D supplements. I got a taste of "charting for litigation" when i had to chart my conversation with her advising her to go off Depo, and her subsequent refusal. I had to chart the other methods I suggested, and her response to them (a very simple "no") and then wrote the prescription for Depo because it was her choice.

Now, back to studying patho. I'll be glad when this exam is over tomorrow.