A Midwife's Lessons from Her Patients
August 03, 2011
Patricia Harman, Certified Nurse Midwife, is the author of Arms Wide Open and The Blue Cotton Gown. Harman has published in the Journal of Midwifery and Women's Health and the Journal of Nursing Scholarship, as well as in alternative publications.
The exam room is like a confessional; I’ve thought this before, so intimate, patients tell me their secrets.
“So, how you doing?” I ask Verona Jenkins, a 50-year-old high school teacher. Her straight brown gray hair is cut in a bob and she sits on the end of the rose vinyl exam table in her blue cotton gown with two strings in the back, swinging her legs like a girl. She has a few small red varicose veins on her calf, but her ankles are tan and slim.
“Ok, I guess. Better.” This interests me. I have her lie down to check her breasts and her abdomen.
“What’s your stress level lately between 1 and 10?” I smile. “Ten means you are about to check into the psych hospital.”
“It was eleven last year, but I’d say only a seven now,” the patient gives me a short laugh, indicating this is a joke, but not much. That’s when our real conversation begins.
The exam room is also like a classroom, a place where I learn countless lessons, and these women, my teachers.
I study Vernona’s face as I palpate her lower pelvis, “Any pain?” She shakes her head no. Occasionally I find a tender ovary or sore uterus that needs further attention, but more often in these encounters I find pain in the heart.
This time Verona looks right at me. “Remember my exam last year? It was the first time I’d seen you.” I finish her internal, take off my exam gloves and settle myself on the rolling stool. The patient sits up and primly straightens her blue cotton gown. “I was a real mess. My seventeen-year-old daughter was out of control. She’d dropped out of school and moved in with her boyfriend. I was so scared; this was my baby, now out of my reach, running hell-bent toward disaster. She was using drugs, marijuana and ecstasy. She told me right to my face…no birth control. She wanted to get pregnant.”
Verona stops and tucks a strand of her hair behind her ear. “I was so frightened for her. We were fighting all the time, and my husband was no help. He just withdrew into his work, even told me once, if I mellowed out and got off her case, things would be better.”
Verona smiles, lets out her air and wipes the few tears with the back of her hand. I reach over and offer her a tissue. “Better. The boyfriend didn’t last long and she came home. She was treated for an STD at the health department, but never got pregnant, thank God.”
“So, is she back in school and everything alright?” I am waiting for a happy ending.
“No.” Verona tips her head to the side with a little regret. “She doesn’t do much of anything. Sleeps late, watches TV, reads a little; sometimes she cooks.”
I squint. This would be difficult.
“So isn’t that hard for you?”
“At first, it was, but I was just so glad to have her home and safe, I decided to give up on the lectures and just accept her for who she is.” The voice in my head goes quiet. “Just accept her for who she is.”
“And guess what?” the patient goes on. “The other day, the three of us went out to dinner and Kayla said to us, ‘You know Mom and Dad. You are my favorite people. You accept me unconditionally.’ Twelve months ago we were wolverines at each other’s throats.
“Just the way she said it, unconditionally. I knew she had been reading or maybe only watching Oprah, but she was going to be ok.”
Now I have tears in my eyes. Just accept them for who they are. I’ve read of the miracles it brings when you just love someone unconditionally. I do that with my patients, but with my own boys, Zen, Mica and Orion, I must constantly be shepherding, trying, with my wooden crook, to steer them away from cliffs, lead them down into the green valleys. And does it work? No. I just meet resistance.
I write Verona a script for her hormone replacement and give her a hug. The woman can’t know the gift she has given me. Outside the exam room, I place my hand on the cherry wood door, palm open, fingers spread. I look down the carpeted, hall, and seeing no one, bow from the waist.