For the joy set before.
I took my Pediatrics final exam yesterday, which naturally meant that today and tomorrow’s tomorrows were filled with the little joys of housekeeping tasks that I had housekept for later. Am I an adult if I get an endorphin rush from cleaning out old files? I found so many photos that I never got around to sharing with the people for whom I captured them. I found videos of little moments: my dad following my dog around the backyard with an umbrella so he wouldn’t get wet while going to the bathroom; a baby clapping along with a song during a Bible study, and shouting AMEN! in little silences; a karaoke party for independence day in Madagascar; Pacific waves against dirty feet. I found that every morning for a few weeks, I had taken a picture of the sunrise from the 11th floor of the hospital. I guess it had just been such a reflex for me to take pictures of sunrises that I didn’t realize I had captured day after day of almost identical muggy dawns at 6:28 AM, right before going to sign-out. Lately I feel like my life has been all night. I needed the encouragement of the sun’s promise: new beginnings, hope, healing, resurrection.
My time in Ob/Gyn did some healing of its own. I had read in a research article on perceptions of labor that each woman is battling against her own personal mythology of labor, developed over centuries of culture and a lifetime of stories, comments, jokes, references to, and media about what labor will feel like. Often when a patient arrives to be induced, I ask her how she feels. “Nervous!” was my most frequent answer. But every once in a while, I’d get, “Excited. I can’t wait!”
[sidebar] If you asked me before my Ob/Gyn rotation, I’d laugh at that answer and make some quip about how I would rather skip the delivery ordeal and get straight to the good part—delivering those babies right off to college [side-sidebar] Sorry, I’m a cynic. Dear hypothetical future children, this was written before I became the serenely maternal sage you now know and love. Also, how did you find this blog? Don’t you have better things to play with, like laser cars and hover aquariums? Run along. Nothing to see here.[/side-sidebar].[/sidebar]
I wondered about the difference between the nervous patients and the excited ones. What were the differences in their mythologies? Or how did they respond to what they saw and heard? How could medicine help or hurt by validating or invalidating our patients’ statements? And what kind of mom did I want to be? How do I go from nervousness to excitement?
I have too many little stories and not enough neurons left to connect them into any sort of storyline, so have them piecemeal.
The first patient I ever helped to deliver was on her sixth child. She was an old pro at the labor game, and her previous deliveries had been expeditious. I watched her contractions on the screen at the nurse’s station like a hawk so I wouldn’t miss her delivery. But as it turns out, this baby’s head wasn’t turned the ideal way; she was stuck at the almost-there point, fuzzy scalp visible during pushes, but just refusing to come out for what seemed like forever. Mom had never had that much trouble with labor before. She was puffing, shaking, exhausted, and really cranky. Close to the end, she began to yell with all her might while pushing. I was a little scared, there, clutching one of her legs, wondering when it’d end. After an eternity or two, her daughter slid into the world. Within seconds, she was lifted up, toweled en route, and brought to her mom’s arms, slimy hair and all. And in that moment, it seemed like the last few hours had been just a second. We went from screams and shouted encouragement to baby wails to almost silence. Mom was holding her baby to her chest, oblivious with joy. It was like they were in their own world. Besides the sweat still on her brow, there was no trace of the travail of labor. We went from war to peace. Did the war even happen?
One night around 9 PM, a midwife came in to start her overnight shift and enthusiastically greeted the bleary-eyed crew of MDs with “Good evening my beautiful people! I feel so blessed to bring forth life with all of you tonight!” She exuded light. I didn’t have enough coffee in my body to respond in kind.
The second stage of labor is called the descent phase. It’s like the term in aeronautics. The airstrip is ready, the landing gear is deployed. The ground crew is flashing their signals. It’s time to push. I had helped one nurse push with her patients a few nights in a row. She was a real cheerleader, holding a leg and shouting, “Push-push-push-PUSH HARDER! You’re almost there! Keep going! You’re doing so well! Perfect! PUSH!” The first night helping, I just held the leg and timidly added my own demands to the chorus. The next few nights, I got a bit stronger, a bit louder. By the end of the week, I didn’t care if I looked crazy or aggressive, I was shouting with the nurse too.
There was one couple in the labor and delivery room who had a whole country music playlist prepared for their induction. By the time I had come into the room, the baby had been stuck, half-descended, for three hours. Mom and Dad looked exhausted. Most parents I’ve met at this point were spent, non-verbal, just faces grim, saving energy for the pushes. But in between contractions, with Chris Stapleton crooning in the background, they talked to their baby boy, urging him to come out and meet them. They talked about the fun times they’d have going to the beach, seeing the leaves change color, playing sports, riding bikes. Eventually a less-than-reassuring fetal heart tracing brought them to do a C-section. It was past my shift, so I didn’t see it happen. But I’m sure that meeting of baby and parents was full of joy, even if it were under different circumstances than they had planned.
Part of my own mythology about children, I realized, was about fathers. Not my dad—he’s incredible. Or my heavenly Father, obviously. But hasn’t everybody watched movies of guys who viewed babies as shackles? Or the distraught teenage dads, pressured into loveless marriages for society’s sake, or the brow-beaten gaffers who have to cater to unreasonable pregnancy cravings and pregnancy mood swings and post-partum depressed wives and shrieking miserable home fronts who dream of the good ol’ days when their wives resembled hourglasses more than fruits. Basically the media caricature of guys who feared an end to their own childhood and women with baby fever and ticking biological clocks. I didn’t want to be any of those characters. I think this myth healed a bit on my Ob-Gyn rotation, too.
I shadowed ultrasound techs for about a week, and there was one couple who came in for their regular weekly ultrasound (it was a high-risk pregnancy). We pulled up all the normal views of their baby girl, starting with the high-domed head and the tiny fluttering heartbeat. Then the laundry list of wiggling parts: kidneys, bladder, genitalia, hands, feet, etc. Mom just nodded along as we scanned through. It probably hadn’t changed much from the last week. But dad was absolutely enchanted. When his daughter’s head bobbed, he chuckled to himself. He gasped when he saw the two feet next two each other, like footprints. Throughout the exam, he kept making little sounds of wonder. I struggled to keep from grinning. I was lucky the room was dark. After we left the exam room, I remarked to the ultrasound tech, “That dad is so cute! Was he seeing his baby for the first time?” And the tech said, “Nah, he’s here every week. But yes, he’s really in love with that girl, and it shows.”
Another dad, this time on my Pediatrics rotation. I was seeing a patient in the pediatric ICU, where the sickest kids go, the ones who need constant monitoring, or machines to help them breathe. But as I was asking my patient’s parents questions, I heard in the adjacent bed (just separated by a curtain) a man’s voice singing softly and tunelessly, “Baby, get well. Baby, come home. Mommy misses you. Lydia misses you. Be strong, get well. Come home soon.” It was hard not to lose my train of thought while talking to my patient’s family while straining to hear what this man was singing. As I left, I caught a glimpse of his back. He was large, burly, quarterback-sized, bouncing a sleeping baby in his arms despite a thicket of wires and tubes trailing off to one side. I must have been in that room for 20 minutes, but through it all, the gentle wheeze of the ventilator and his song never stopped.
A third dad. My patient was 15, slightly belligerent, and scared out of her mind in the labor and delivery ward. Her boyfriend was bleach-blonde, had a smile for everyone, and never let go of her hand. Sometimes from the pain, she cursed him out, or cried with him. He only had eyes for her. He was always asking her if she needed anything. Her labor was particularly long. I saw her on my first shift, and 24 hours later, I saw her on my next shift. Somehow, miraculously, her boyfriend was still bright-eyed and bushy-tailed. By that time, though, gossip had gotten around the ward, and it was cold-pressed juice. That girl had cheated on the boyfriend with another guy, the father of that baby, and the baby daddy’s current girlfriend had threatened to come to the patient’s delivery and steal her kid. Total E! material. And the current boyfriend knew it all, and stayed with the patient anyway. That night, I heard nurses talking about it. The stories just got wilder. Details were added about the patient’s parents. The residents even got into it. And attendings. But eventually daylight broke, and my patient’s boyfriend wheeled his girlfriend out, triumphant, to the postpartum floor, and gave effusive thanks to the whole L&D team for the birth of his son. I couldn’t help but match his beaming smile. Who cares what a bunch of strangers think about your life, and your relationships, and your choices? Who cares whether they think you’re a dad or not? That boy acted every bit the father and partner that he was.
A sister, after reading what I shared in my previous post about childbirth, shared with me her own experience with her five children. She hung onto one verse through each labor:
Hebrews 12:2. “Looking away unto Jesus, the Author and Perfecter of our faith, who for the joy set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God.”
When Jesus went to the cross, He wasn’t looking at the cross, but at the joy set before Him: the redemption of man, the birth of the new creation, His wife prepared.
For this sister, she had decided in her being that she would also go through childbirth for the joy set before her: her children yet to be, the life they would share. That joy set before her made any price worthwhile, thousands of times over. And it was that joy that colored her memories of labor, that collapsed like an accordion the hours of toil and stretched out into little infinities the moment of meeting, face to face, skin to skin.
I had dinner at another sister’s house a couple months ago. She had recently gotten married, and to get married she left behind a full life in Korea to come to Nowheresville, New York. But when we sat down to dinner, she said, “A—, when are you getting married?” She told me that marriage was such joy. Before she was married, she didn’t really understand what that meant, or why everyone was so pushy and inquisitive about such a personal matter. Then when she got married, she understood. There’s a different plane of joy, she said, to being paired. It’s like being complete.
She had a beautiful baby girl last month, and I went over her house today to learn how to babysit her. And today, she asked me, “A—, when do you want to have kids?” I could only laugh. She said, “My friend told this to me, and I think it’s true too. When you get married, you think, wow, there’s no way I can experience any joy like this. This is really a different world. Then you have a baby, and you realize, marriage was nothing in comparison to this.”
I used to brush off these kinds of questions about marriage and children with typical second-wave feminist aplomb. “Hahaha, don’t hold your breath, I learned in medical school that if you do that, you will die.” Or, “I’m struggling just to feed myself, let’s not bring any other humans into the picture!” Or, “I’m more of a traditional doctor. It’s med school, residency, fellowship, and 20-year-old trophy husband when I’m 40.” But with this sister (and, belatedly, probably many other people), I realized she had just found unspeakable joy. And she wanted me to have that, too.
