Breathe Easy, You've Found Me ((HUGS))
To that person especially, WELCOME.
Monday, December 31, 2007
Sunday, December 30, 2007
Tying Up Loose Ends
[::] 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%.
Friday, December 28, 2007
Brain Spasm
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
Wednesday, December 26, 2007
Sunday, December 23, 2007
Homesick
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.
Saturday, December 22, 2007
I Realize
"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
Friday, December 21, 2007
New from the ACNM
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
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.
Thursday, December 20, 2007
End of the Semester
"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.
Wednesday, December 19, 2007
GYN Final Exam
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.
Tuesday, December 18, 2007
1/2 Way...
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*
Saturday, December 15, 2007
It's That Time Again
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.
Tuesday, December 11, 2007
My Commercial
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.
Monday, December 10, 2007
Random Bloggin on a Study Break
All of my conversation centers around this experience. I must be so boring to talk to right now.
Sunday, December 9, 2007
My Mind
Drowning...Thinking...Remembering
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...
Wednesday, December 5, 2007
Tuesday, December 4, 2007
Mixing and Mingling With My Peers
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.
Sunday, December 2, 2007
4 GYN Cases
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...