j a n e s i l v e r

* T * S * A *

2010-11-24T05:21:00.000-08:00

Happy holidays!

Note: If you want to see a truly happy holidaymessage see this. As this note is not really very happy atall.

Now if you are like most families the holidays meana trip to your local airport for a jaunt across the lands to visit places,people, and because the holidays are not without commercialism.. things! Wellthis holiday, I want you to do something very important. I want you to"Opt Out" of the backscatter x-ray imaging machine at airportsecurity. If you think you might need a bit more convincing than that, thenread onward.

1) Don't get voluntarily x-rayed. It's bad for yourhealth. Cells get warped and become more prone to cancer. X-rays arecarcinogenic. The more you get the merrier those cancer causing cellsproliferate. Think that a little old x-ray won't be as harmful as dental facex-rays or flying in a plane in general or other exposures? Well, just think ofit as living in moderation. Decide what cancer causing beams of radiation areworth it and which are not. If you have had cancer or have it now or just don'tlike the idea or the word cancer, then don't get x-rayed at the airport! Thetruth is folks, we don't know what levels are cancer-causing, we are alldifferent. The posted toxicity thresholds per TSA are not based on the elderly,children, pregnant women or anyone with any kind of medical condition. We justdon't know. It is not worth it.

b) Also, it's a nude shot. If this bothers you(transgenedered, woman of Islam who cannot be viewed by a man other than herhusband, child, modest anybody) then great! Don't get x-rayed for thosereasons, whatever your reason, don't get x-rayed. OPT OUT.

$$) Health or Nudity aside the reason we all of asudden have these intense homeland security devices is because MichaelChertoff, who used to be the Secretary of Homeland Security under Bush, iscurrently a paid lobbyist for the manufacture and installation of the"backscatter body scan machines". That, my friends, is corruption,fear-mongering, abuse of power for direct financial gain, and pure absurdity atit's finest.

2) Ok, so this means you are signing up for thegrope. Please refrain from using the euphemism "enhanced pat down"because it is a grope. Please announce, "I opt out of the x-ray, can Iplease be felt up instead?" or "Nope, no radiation for me, pleaseshow me your best moves!"

d) Fine, maybe that doesn't sound good either. Thenthere are two options:

!) Don't fly. Staycation it up! This is easy forsome to say, I bought tickets to Mexico for the holidays, before TSA bought theright to get in my underpants, and I want to go to Mexico damnit.

A) Write to your senators, and congressionallegislators. I have already taken liberties to provide email addresses, phonenumbers and canned letters. Feel free to edit them as you see fit. I became alittle emotion-heavy at the end of mine. Do with it as you will.

Phone statement for Maria Cantwell'svoicemail (202) 224-3441: "I think that the TSA has gonetoo far. Body scanning and inappropriate groping are unconstitutional andwrong. If you want my vote, change the policy."

Write to Senator Patty Murray: http://murray.senate.gov/public/index.cfm?p=ContactMe

Write to Senator Maria Cantwell: http://cantwell.senate.gov/contact/

Write to U.S. Congresswoman Cathy McMorris Rodgersof Washington's 5th Dist.: http://mcmorris.house.gov/index.cfm?sectionid=82&sectiontree=4,82

This is what I wrote each of them:

Dear Cathy McMorris Rodgers/Senator PattyMurray/Senator Maria Cantwell,

I am writing to you to urgently request yourimmediate support and action to become a co-sponsor of the crucial legislationthat is H.R. 6416: The American Traveler Dignity Act in Congress.

Dispersed ionized radiation in backscatter scansare clinically harmful to soft tissue. The threshold is listed in mediapublications as requiring 1,000 scans in one year. This exposure iscarcinogenic and the threshold is not based on children, the elderly, pregnantwomen or individuals with medical complications or conditions. It is absolutelydetrimental to our health.

"Enhanced pat downs" are a despicable,unwarranted invasion and sexual assault on our children, pregnant wives,elderly mothers, mentally disabled adults and everyone in between.

I have rights. I have the right to not be subjectedto harmful x-rays that take and save photographs of my naked body. I have theright to not be sexually abused by a stranger.

Women of religious sects that forbid the oppositegender's viewing of their bodies is violated.

Children, your innocent kids or grandchildren, aredefenseless against this horrendous invasion and molestation of their privatebodies.

Survivors of rape and incest are irreparablytraumatized by airport security.

This is disgusting. I want to fly my pregnantsister, her husband, and their 4 year old daughter out to see me and my familyfor Christmas, and I refuse to have them radiated or sexually abused becausethey might have toothpaste in their luggage.

This has got to stop. I am sick with hatred forwhat our country has become. Not because of terrorists but because of fear andpower.

Stop. Stop allowing TSA personnel access to mylittle niece's privates! Is that too graphic? Better x-ray through her princessjammies and save an image of her nudity in some database instead then.

Dear Senator/Cathy/Patty/Maria, please help usput an end to this crime.

Sincerely,

Jane

Enraged citizen.

Incidentally here is alist of possible options to recite during your friendly safety grope:

· Oh, you've just got toteach my husband that technique!

· Here's some handsanitizer, you'll want this afterward.

· [commence "When HarryMet Sally" bogus orgasm sequence]

· Since I paid for firstclass, I get a happy ending with this right?

· I havebed-bugs/lice/crabs/scabies.

· Reveal your naked-selfunderneath your trench-coat and shout "I got naked for national security!

· Well, that was humiliatingfor the both of us.

· That was wonderful, wherecan I leave a tip?

· [initiate crying sequence]

· Turn your head to the sideand cough.

· Look the agent directly inthe eye and simply state "thank you for groping me."

And if this post has leftyou feeling distraught, here are your actual rights: You do not have aconstitutional right to buy an airline ticket (air travel is a privilege not aright, it is voluntary), therefore it cannot technically violate the 4thamendment--which this otherwise totally violates! You have the right to opt outof the x-ray scan, which means you are subjected to a "grope." Ifundergoing a grope, you have the right to a same-sex groper, you have the rightto be groped in private instead of public, and you have the right to have asupport person present for your groping. Don't forget to say something awkwardto your TSA Groper so they feel uncomfortable, but not threatened, you don't wantthings to escalate and end up on a No-Fly list or worse.

One more thing, manystories I have read about personal experiences, relate that the larger thegroup of people opting out the more likely the TSA crew is to just pass youthrough the original wand scanners out of annoyance for slowing down the line.So get there early. Talk to people in line around you. Encourage others to optout for their safety. Take the time, and make the airlines and TSA personnelcomplain that the expensive x-ray machines aren't worth it. And write to yourpoliticians, this is the only way to stop this ridiculous power-trip.

Thank you for you time readers,may you travel this holiday in peace and solidarity, without fear, radiationand molestation!

No, You Can't Call Me Doctor

2010-10-06T11:46:00.000-07:00

I have begun the last leg of this academic tour in life, I am in my second quarter of a three year doctorate program in nurse-midwifery. And no mom, I will not be doctor-nurse Jane, but I do appreciate the humor.

To everyone who is confused by this title, I will help you out. But just so you know, I was confused too until after I had been accepted into the program, and finally decided I better learn what all this alphabet soup really means for fear of an extended family member asking and me not having any idea of how to respond.

Currently I have a degree in nursing, a bachelors degree, and a nursing license to practice: alphabet soup = BSN, RN. This translates to "a Bachelors of Science degree in Nursing and licensed by the state of Washington as a Registered Nurse."

Now I am pursuing a higher ed degree in nursing, specializing in midwifery. The degree is a DNP, or Doctorate of Nursing Practice, and the license is CNM, or Certified Nurse-Midwife. It is a doctorate of practice not a doctorate of philosophy (PhD). The DNP is replacing the masters in nursing, MN. It is simply a new level of education for all those familiar ARNPs or Nurse-Practitioners out there who we know we all see for our primary care because family physicians are becoming fewer and farther between.

It'll be a journey, but it's surreal to be studying birth, officially, finally, gloriously. Bottom line, I will be a midwife.

Seven

2010-07-03T07:54:00.000-07:00

Been pretty busy lately... we bought a home. That's 'Diva with our "Sold" sign from the street. When she went for first sniffs I said to her, "G, you will be here forever, because I will bury you here, this is your sacred ground." She seemed cool with it. She has since made official her fav spots, including a ceremonious scratching of the surface in an exquisitely climate controlled dirt patch.

Our first night home: Joe declined to be misled by my optimism that we would get the keys any earlier than June 17th, but we did, so late on the 16th we brought over sleeping bags, some art, some guitars, the dog and a bottle of champagne. We probably should have slept on a floor with radiant heating, but our new living room will never seem as spacious and unbelievably ours as it did that first night with nothing in the house but us.

Yesterday, weeding the veggie starts before work I heard something in the hill above the rock wall. I ran upstairs so that Joe could simply look out the bedroom window and see a beautiful deer with her polka-dotted fawn twins walk past.

This is my happiest place on earth.

Other news keeping me very busy: I just started graduate school.

Mother of Many

2010-05-06T18:41:00.000-07:00

Winner of the UK's BAFTA Award for animated shorts, I was able to purchase a copy and have it mailed to me.

Yesterday was Midwives Day, and it's Nurses Week, and my good friend Marian gave birth today!

Happy birthing, happy mother's, happy families; in honor of upcoming Mother's Day.

xoxo

Art Show: Portraiture of the Birth of a Mother

2010-04-14T18:23:00.000-07:00

Artist statement: Jane began painting bellies in 2005 when her sister was placed on bedrest. wishing to assist and spend quality time with her , jane painted her belly as she focused on growing her daughter. Nearly 30 paintings later, an alphabet book was born for baby Alayla. belly painting then reached other doula clients and now jane paints for anyone with a full womb! Bellies make a beautiful canvas; mothers are a work of art. It’s a wonderful & fun way to honor your pregnancy. Come to sante restaurant & charcuterie to honor mamas for mothers day and any other day in may!

Jane the Pain

2010-03-30T06:13:00.000-07:00

My sister taunted a little ditty that started like that when we were small & frivolous...

Let's discuss P A I N, is it a four-letter "p-word"? It's starting to become one due to my current working environment.

Emergency nursing/healthcare is about knowing a little bit of everything (and not a lot about anything?). Every ailment walks through those doors, not just anything, but everything. So where does a provider start? That's where my role begins, I prioritize patients, triage, pinpoint chief complaints, perform focused assessments, vitalize, anticipate procedural and pharmacological needs, order them, discuss these with the Emergency physician in my zone, prepare piggybacked machine pumped triple intravenous lines, after I've placed an IV line and collected blood specimens and sent them to the lab. Oh and I dole out our prized creature comfort; the toasted blanket.

Pain is a large part of why folks arrive in my unit, why any one goes to the ER. I work with adults, so we use the numerical pain scale; "Zero being 'No Pain' and ten being the 'Worst Pain of Your Life', where exactly would you place yourself at this moment?" kind of an assessment. Pain is considered a sixth vital statistic regarding your medical presentation and subsequent care, along with blood pressure, pulse, respirations, temperature and oxygen saturation. Pain is important and while we cannot detect a standardized measurement of a person's pain, we can ask and we can believe and trust and respect that individual's pain experience.

Here is where it gets tricky, two things can happen; 1) someone becomes a victim of a fear-mongering society full of shows and stories of friends of friends co-workers who are addicted to pain medications. So, your patient doesn't want to take pain meds, or won't admit to the severity of their pain to avoid requiring pain meds. 2) people are in fact addicted to pain meds, and will do almost anything to receive them.

Jane's adapted response to assessing PAIN:

To confront patient #1 who is presenting with right sided flank pain (read: kidney stones) and says she prefers not to take narcotics, she needs to hear some patient teaching regarding pain receptors and cost-benefit analyses. First of all pain is your body indicating to your brain that something is intrinsically wrong. Pain is a helpful signal to let us know we need to do something about what is wrong. Kidney stones, to choose a random, common, and excruciating example (see also; appendicitis, migraine, symptoms of a myocardial infarction, fractured limb) is not good. All of these things are not good for you, therefore when they present, they trigger pain receptors. When your body is lighting up its pain receptor circuit board, it is waiting impatiently for that special someone, an opiate-derivative narcotic pharmacopeia that will switch it off thereby releasing the tension build up that pain creates, release and relax the contracting muscles and organs and allow normal body functioning to return to baseline.

Note the number one thing people say to me when I inject a milligram of dilaudid into their vein is "how can people be addicted to that stuff? that feels awful!"

Now, for patient #2, I tend to see a presentation along these lines; woman walks to room chasing three little kids around the hallway, reaching, running, bending, carrying and then tells me she fell and her wrist, back, neck, ankle and foot are a 10/10 pain.... and "could I just get an IV and 2 mg Dilaudid to start and some Phenergen as well,... thanks." This is when I don't have to start an IV and I can give her an oral tablet of a single Percocet and try to convince her that it is not okay to take medical equipment from the supplies locker in her patient room. OR, how about the woman who tells me she is having 32 out of 10 for pain. So I given the prescribed 2 mg Dilaudid. Well, she tells me she is "a little bit better, maybe a 9/10 now" So another 2 mg dose slides into her vein, she relays that she is definitely an 8 now, but still having a really hard time, so this time I give 1 mg of Dilaudid to her. At which point, she has become completely snowed, and is barely rousable, to the point that I have to poke and yell and slap on the blood pressure cuff and oxygen tubing, cranking it up from the wall source and try to perk her up. So, as she's stabilizing I, just curious, ask her what she would rate her pain now? "I'm... uh-......" and I poke and prod and stimulate her awake again, what number, I ask? "-uh, 7." she manages to say, and falls asleep again. OR the middle aged man who comes in with his wife, he's here for abdominal pain and has been nauseated and vomiting all day and night. Currently he is writhing on the gurney. I am trying to get an IV in so we can replenish fluids, bring his blood pressure back up, and have access so as to draw blood for samples and provide alleviating medications, so I prep my lidocaine numbing medicine to give a tiny--skinny shorty--needle injection to the site where I want to place the bigger, longer, more painful IV needle. I break the skin and my patient yelps and cries out, I pause looking up blankly and ask flatly "was that excruciating?" and he snaps "yes!" Well, this makes me think he has a very little pain tolerance, and therefore is being awfully dramatic about the whole abdominal pain and violent writhing acrobatics. In a phrase; loss of credibility.

Two take home messages:

One, working in situations like those mentioned above where patients are clearly, and sadly addicted, dependent or otherwise exceptionally tolerant of pain medication is slowly but surely already turning me into a nurse who maintains judgment, cynicism, a lack of respect and ultimately annoyance and embarrassment for the patients I work with. I am completely devastated when I am lied to about a person's pain. Tactics that are used to obtain unnecessary pain meds, all back-fire, I can turn my mr. nice nurse off completely if I am being taken advantage of, manipulated and treated rudely, and bottom line is I don't like the way it makes me act and feel toward patients. I can see how positive spirits are broken down in this line of work.

Two, pain is a bad sign unless you are in labor and going to give birth (did you think I wasn't going to bring up birthing?) then pain means Purposeful Anticipated Intermittent Normal experiences your body undergoes to prepare you for the transition Earthside your baby makes with you. Birth pain does not harm you or your baby, there is a system of hormones in place to guide your body through it (provided you aren't taking drugs in labor to speed up labor or stop the pain, that messes with your hormones and thus the whole process).

So cheers to real pain, good or bad.

Violet Fever!

2010-02-28T01:43:00.000-08:00

This clip is courtesy of Selina Shehan, vendor guest/local artist who attended the Spokane Shrinking Violet Society Event we put on yesterday. A fantastic and overwhelmingly successful vendor fair, art exhibit, full entertainment line-up, champagne & cupcake toast, keynote speaker, first annual Violet celebration!

Violet love,
J

Sex Ed with Red Wigglers

2010-02-22T00:30:00.000-08:00

No, I'm dead serious.

Someday when I have kiddos in school I want to "moonlight" as a school nurse. I dream of offering a healthy and productive (pun.. intended?) atmosphere for the education of sex for our society's youth.

I currently volunteer at APPLE, the elementary school program that I attended, as a "parent" reader for five first and second graders. Recently one of my readers chose a favorite dessert book (as opposed to a vegetable/challenging book) called Diary of a Worm by Doreen Cronin. Amelia loved this book, and therefore, hence, ergo she exhibited a surprising fascination with worms.

Coincidentally, I recently attended the increasingly popular Worm Bin workshop presented by avid worm goddess (she literally generates entire communities and worlds of worms out of your garbage heap) the lovely Miss Mariah McKay. During this presentation on composting Inlanders and coffee grounds in your apartment, I had an epiphany. As petite and stylish twenty-something Mariah reaches into her bin and produces a handful of rotting fruit (in a productive anti-green house gas way) and dead leaves (totally alive with beneficial microbes) she exclaims "oh these two red wigglers are having sex!" Then, to test the audiences professed commitment to spreading the worm-bin love, she dumps her handful into my bare hands and we all take turns feigning comfort as we examine the twisty-tie couplet of wormies.

Jane's Epiphany: Kids (who like bugs and stuff and learning) + Worms (who like to reproduce and don't look particularly risque when doing so: they don't have penises or vulvas or faces for that matter*) = perfect opportunity to bring up where babies come from (a topic near and dear to my heart for political/health/community/feminism/humanity/and other important reasons).

I believe if a young school-aged child (I'm suggesting as fresh as a four-year-old here folks**) was taught where babies came from by holding in their hands two wormies who were knotted together, sharing their bodies, organs and hormones to create another wormie, we could eradicate the playground taboo of gross and mysterious sex, and the mis-education thereof, be rid of parental and teacher squeamishness and instruction ineptitude, say ciao to uninformed curiosities leading to adolescent sexual experimentation resulting in negative outcomes (Spokane's teen preggo rate remains slightly higher than average) and boom, we've got a therapeutic introduction to comprehensive sex-ed (not to mention composting and gardening)!

* Except for the whole hermaphrodite component of worm fornication, which might require a collective viewing of "Hedwig and the Angry Inch" as a pre-requisite***

** Statistically boys experiment with masturbation at the tender age of 8: a full two years before standard human growth and development and sexual education begins in primary school. Teach 'em! Don't make 'em guess and feel isolated!

*** Ok, maybe I took it one step too far, no "Hedwig.." I take it back.

Happy VD!

2010-02-11T19:21:00.000-08:00

Violet Love Notes! For my girlfriends at the lunch this weekend. Every second Saturday Spokane's Shrinking Violet Society meets at One World Cafe (local! organic! vega/vege-friendly! pay what you can!) Here, this saucy social co-op, convenes to network, empower, and depart full and inspired. This was how I was welcomed into the Spokane scene immediately upon arrival, and now I consider myself a violet. Recently while recruiting performers for our upcoming Violet Fair at the end of February, one of the lady DJs replied that she'd be honored to play for the "screaming violets." I love this misnomer, sometimes we could definitely rock a more hard-core name than shrinking but the name has meaning and was originally likened to the Ladies Sewing Circle and Terrorist Society.

So this Love Nest Day, the lasses are exchanging Valentines. I couldn't swing the card making party so I've taken over the kitchen and have been generating fun cards all week in preparation. It feels like solid therapy to make something out of the dregs of your art supply bin with your hands and still-gooey glue.

PSA from Nurse Jane: Happy Cardiac Day to my readers! Remember dark chocolate + red wine + oxytocin (the love hormone) is good for your old ticker.

xoxo

Curious about life in Emergency?

2010-01-06T18:03:00.000-08:00

Note to self: Take glucose breaks so my blood sugar isn't lower than the patient's while I'm giving an amp of D50 [intravenous dextrous]!

Today I went in to do discharge paperwork for another RN, and the patient was a teacher I recognized from high school. I think we both feigned ignorance. I also met someone who knew my grandmother in her younger, political years.

"[Quietly with a sheepish voice] I hate needles... [louder and in a creepy voice] but 'Jay' loooves needles, pain keeps 'Jay' going"

-says my patient who walked at least one mile barefoot in snow, being treated for frost bite.

"Last time I had this done it was a new nurse and it hurt and she obviously didn't know what she was doing... you did great though, I didn't even feel it, how long have you been a nurse?"

-hahahah! I told her "oh, a few months" but technically I've only been working for one month. That was an awesome ego-boost [for iv starts]!

A severely inebriated man comes in on my first day in triage and has difficulty describing his knee pain, the intake nurse is also having trouble understanding him. "R------ did you keep it wrapped and take the medications we gave you yesterday?" I said recognizing him from his previous three visits this week.

A 30-year experienced Emergency RN pulls me aside one day; "the world outside isn't really like this, you can forget that sometimes working in here, but remember the rest of the world is happy, safe and normal...

most the time."

My days in the ED tend to come with "themes"
like a broken bone day,
or everybody's bleeding!-day,
there are general themes like
our community is just not well today
or the general public is not taking care of themselves today...
there was also the post Christmas weekend theme:
everybody ate and drank and sat around too much
and now abdomens, dormant illnesses, cardiac muscles
and stress-inducing conditions are all a'flare.
I'm always curious what the next "episode" will be about.

[word-compiling year-end reflection application cop-out]

2010-01-03T12:30:00.000-08:00

Ruthless Beta Blockers v. Scandalous Ace Inhibitors

2009-12-17T00:51:00.000-08:00

Nope, not an in-depth analysis of the actions and contraindications of cardiac pharmacotherapeutics... but an intense evening of girl-on-girl ROLLER DERBY!

A benefit to: Smash Tarts for Open Hearts, as the Sacred Heart Medical Center Surgical Team gears up to head to Rwanda to preform much needed open heart surgery.

And a fantastic and inspirational quality athletic event, to be sure.
Note: I have a new dream to encourage my rambunctious 4-year-old niece to join the ranks. I can see her now, trading in those new Barbie roller skates for a more hardcore pair.

"Bouts" occur at the old Pattison's Rink where I recall awkward sweaty Junior High hand-holding. Spokane's Lilac City Rollergirls created the Beta-Blockers and Ace-Inhibitors for the Benefit's benefit, but you can catch these official competitors at their regularly scheduled and promoted girl fights: The Toothless Annies, The Pretty Deadly's, and The She-Wolves.

Pure Ridiculousness

2009-12-04T00:25:00.000-08:00

* happy holidays *

Try JibJab Sendables® eCards today!

FRUiTS

2009-11-25T23:35:00.000-08:00

FRUiTS is a fun favorite. A free gawk at freestyle fashion.

And now you can check out some Spovegas (Spokyo?) street fashion of our own. The artist collective RiVerSpeAK, requested photographers to submit snapped representations of local identity. Two are mine. My descriptions for the submissions are as follows:

Twenty-something, aqua pashmina from Calcutta, mom's old sweater, floral long underwear, fallen leaves. Spotted: Spokane November 8, Regal & 77th.

Three-year-old, tutu, tights, pink cowgirl boots, apple, toy stroller. Spotted: Spokane November 6, Jackson & Washington.

This one is for you Stine, including the alliteration.

Dress to express? x

Sayonara nose piercing!

2009-11-12T10:54:00.000-08:00

Hola awesome job!
   I just received the call, I am a brand new nurse in the Emergency Department at Sacred Heart. Thank you, thank you... now, no one better visit me at work! Dad... Christine's kids... etc.
   Late in the evening yesterday I received a call from the Emergency Department Director asking if I could come in for that second interview she'd mentioned (and in my head I had convinced myself I had hallucinated about..). But bright and early this very morning I met with two Assistant Nurse Managers and fielded questions about my experiences: Harborview's Level I Emergency unit, and Psychiatric ED and Trauma ICU, Thailand, my research in Indonesia and my experience with the Nursing Action Forum committee at Virginia Mason.
   Joey and I made bets on what day I would get the call, we both lost. Not two hours later good ol' Bob at HR, who I've met now several times, called to offer me the position (so long prospects on the step-down trauma unit and the pediatrics department)! I am the first new grad RN to be hired into the ED at Sacred Heart. A level II trauma center, serving the Inland Northwest, in the hospital where I was born.
   I start on Monday the 23rd (so yes, I'm coming to Seattle next week for a visit)!

Join me in my red tent...

2009-11-08T20:55:00.001-08:00

Since moving to the Inland Northwest, I have joined up with some pretty rad ladies. The Shrinking Violet Society. We are young, we are free... wait no, we are entrepreneurial, motivated, active, and energized in general to connect to our community and make it work for us, as we work for, it.

Right off the bat, I got excited about the upcoming November Book Group read, Anita Diamant's The Red Tent. Then all of a sudden, as I do, I was raising my hand, marking my planner and declaring myself capable of leading the discussion. So here it is a week away, and I am accumulating talking points.

I first read this book on my way to Calcutta in 2006. My mom says, respectful of my journey into poverty, "That's a downer." I had read the first few pages already, as I do when I pick up an unfamiliar book, and replied "It can't be, it's all about birth and midwifery!"

I want to share some talking points with this forum (whoever you are.. Mom, Chanel, Chelle, Elizabeth, Johanna...)

We don't have red tents anymore, we don't honor and celebrate womanhood in our society, we shun it and perpetuate the mystery and fear, we successfully maintain the taboo and thus the misunderstanding, the unknown, the false. This goes for coming of age, rites of passage, menarche or first menses or as a young girlfriend said to me one day in the fifth grade: Have you come to the end of your sentence yet? THE PERIOD. Awesome example in my opinion. This also goes for SEX, conception, pregnancy, BIRTH, breastfeeding, childrearing, loss of pregnancy, termination of pregnancy, and in the end (as it always is) DEATH. Big, heavy, important stuff.

All I want, if you are inclined, is for you to think about your experiences. Here's a lead; Reminisce fondly and fearfully with a splash of mortification, about your first menstruation. What went well (hahah!), and what did not? How could that experience have been better, more supported? If you could bestow a different experience on a daughter/niece/friend's kid/student/other, what might that look like?

There are zillions of ways to empower women, this is one that is WAY up there on the list of Best Ways to Ensure Empowerment/Disempowerment in our female youth.

Men, you are not excluded. I was a part of a curriculum committee for a new course in the Women Studies department for this academic year, a Masculinities course. Men are also (perhaps not equally, but nonetheless) disempowered in our society. Women and men must support all of our youth. This is how new generations can change the world.

If you want to share stories, gosh, I'd sure LOVE to hear 'em! .

Jane's delicious reads

Alaylagirl

2009-10-23T12:55:00.000-07:00

Here are seven seconds full of so many emotions I just couldn't contain myself.

Heehheeeehe! She's so funny when she's on Ativan.

Little miss Alayla is doing much much better. Her burn injuries are healing, her care has been consolidated and perfected, her meds have been figured out, she has actually been seen by her doctor (the burn and plastics specialist), she's eating and starting physical therapy and at this rate she will likely go home in the next couple of days.

Also, in case anyone didn't already know this, my sister (Alayla's mommy) is the most amazing, stoic, infinitely patient, wonderful mommy in the world. I love you Stine!

And "Sanks guys!" to everyone who has sent well-wishes, thoughts, reiki, prayers, toys, cards, emails, treats and lots and lots of love and support.

Bubble in people, bubble in!

2009-10-19T15:41:00.000-07:00

Ballots are out in Washington State. These are some very important initiatives, please do your part to make a difference.

______________________________________________

This is our story in Washington too.

That's my hospital and my neighborhood featured in those last two short films.

Brush Your Eyes

2009-10-15T18:29:00.000-07:00

Or A Story of Poot. Or An Ode to Alayla & Jules. Or Crazy Things Kiddos Say That Just Make Everything In The World Okay.

By Jane & Her Small Friends

___________________________________

There once were two little girls who were learning new words all the time and learning how to say these new words in a string like making a sandwich. Sometimes folks around them, the big ones, didn't get the message, and frustration ensued. Other times, everyone just laughed and laughed and we all just had such a wonderful time.

One little girl is Alayla, and she calls me Jimmy. Today I went to visit her and she was sleeping. I sat there for a long time, staring, 'cause she's cute and you can look at her for really long periods of time like that. She rolled over during her sleep and her eyes fluttered open, and a husky groggy old-manish voice came out, "heeey Jimmmmieeeee" she said unenthusiastically and went back to sleep.

I became Jimmee when she said "Hi Aunt Jim!" one day, years ago now. And my mom spent the entire next day saying "Jaaaayy-nnnnuh" to which she dutifully rehearsed "Jiiimmmmm-eeeeeee". I love being Auntie Jimi. Secretly, I did try to get her to call me uncle Jane early on. But Uncle Jim, sounded a bit much.

Anyway, here are other stories of Alaylaisms that need to go down in the books, so that we never forget:

I believe one of her first words (noises?) was a definite growl. We have since accomplished a fine monkey, dog, sealion and chicken. We're still working on the dolphin.

I want bites = I'm hungry

Dats bunny! = That's funny just as "Coot bowers" = "Cute Flowers" and Bish = Fish

Kids will pick up anything you say around the house, so when she dropped her cereal all over the kitchen floor one day we were not surprised she let out a huge gasp and said "Oh! Hunny!"

Poot = Poop. As in "Bye-bye poot" as she waves it down the toity.

My all time favorite potty story is when Alayla was staying over at Nanalee's house in Seattle and walked by the bathroom, opening the door, she clasps her hands on her knees, bending forward just a little and beams like the proud little granddaughter she is and says "Good boy Nana!"

Ok, one more poot story: A first poot in the potty with the little tike involved her peeking into the bowl upon completion and exclaiming "Ohmygosh ish hooge!"

Joey and I were driving her back to Spokane from a Nanalee visit once and she said, when we were home, "Poskane!"

Nowadays this kid reads stories from her books to anyone who will listen, chuckles from the audience just egg her on and the story instantly becomes even wilder and pulled out of the ever-reaching imagination. It's a real treat.

The past few days have been a true testament to her incredible strength, vivacity, power and of course her language and humor. In a horrible freak home crock-pot cooking accident she was rushed to the Pediatric Emergency of SHMC. Once drugged on morphine and bandaged up she told her long distance grandma, "Hi Nan'ee, I got owwies". Then she turns to her grandpa and says "Yook* Elmo**, it's Gomitch***" Which is explained as follows: *Yook = Look **Elmo is who you think he is and ***Gomitch is my dad, who acquired his grandpa name when Alayla used to tell her folks "I gomitch's house" at the door with a bag full of blankie and rocks and stuff.

A pediatrician came in today and Alayla promptly thrust out her hand stuck with an IV line and bandaged up. "Can you take dis awf?" No, I can't, I'm sorry. Are you in any pain? [Alayla nods] Can you tell me where you hurt? [Alayla obligingly thrusts her IV hand in the doc's face--again.]

A nurse walks into her room and says "What are you watching?" Alayla looks at the nurse, and turns right back to the TV (also known as a strong toddler sedative) "This."

Lastly, and the selected title of this piece, is one from a lovely lady called Jules. She lives in Seattle with her folks, who are dear dear friends of mine. This past year I was able to help out in the nanny role and Jules and I became fast friends. While she didn't call me Jimee, she did say Jane before everything...

Jane, Jane, [s]Choolbus. Or Jane, we go see 'Diva? Or Jane, Jane today is dansclass. Or [someone sneezes...] I bless you! Or Jane, wanna play Legos? Or Jane, we go How-Are-You-Park-Swing?

You all know that one right? The park with the swing that is next to the place where Gymboree class is, where they sing the song that goes "How are you..."? Of course you do.

And because day after day I would show up at her home, and at some point while hanging out with Jules, take a moment to apply my mascara (I have to wear the stuff, blond eyelashes need shade protection from unforgiving albeit brief sunlight!) Anyway, Jules always followed me in and propped herself up to quietly observe the ritual until one day, before I had the opportunity yet, she says, "Jane, you brush your eyes?"

Pink Bellies On Parade

2009-09-24T16:02:00.000-07:00

"Bellies" Printed photographed painted pregnant bellies piece by J. Silver, 2005-2009

This is just a little note announcing that my piece of photographed painted bellies was selected by a juried art exhibit organization. It will be on display in a fantastic local art show, in Spokane, on October 2nd. If you can, come and see, it will be a fabulous free fun event showcasing local young artists. I'm super proud of Spokane for hosting such an event, and incredibly honored to be able to be part of it.

So, huge thank you to my belly models you do make the best canvas (some very recent and others from years ago now!) And thanks especially to my unseen stars, couldn't have done it without you:

Alayla Ellison

Emelia Audra

Kahin Abdirahman

Brian Lee

Eibhleann Ray

Sofia Christine

Oliver Frederick

Lyra Soliel

Louise Marie

Adeline Louise

Julia Pearl

Carina Lourdes

Aspen Elisabeth

Another featured artist... my sister!

"The Moment" Ceramic piece by Christine Anderson, 2008

Love Love Love

2009-09-09T10:33:00.000-07:00

Baby updates!

Here is a photo I just recieved in an email update from a proud papa from a birth I attended in Bali over a year ago. This is his "epitome of cuteness" daughter, Gek:

See previous post for a newbie shot.

A Mass

2009-09-01T15:53:00.000-07:00

I managed to rise early enough Sunday morning to get myself ready to attend my first ever Catholic Mass. I wore the Balinese sarong I had brought in lieu of a towel, as a long skirt. Donned some extra jewlery and felt ready for such an occasion until I actually arrived at the iglesia. Now I felt all kinds of awkward. Instantly my nose itched and I was certain I wasn't supposed to scratch it (itch it?) My skirt felt too tight to sit on the narrow pew comfortably. In fact I didn´t fit on the pew quite right at all. Music filled the congregation, a little peppy festive hispanic diddy with guitarra y marimba accompaniment. Padre Gregorio (who is actually Father Greg from Minnesota despite his foreign sounding title) made his way down the procession following the altar kiddos. He kissed the heads of the little tikes and shook hands with everyone else.

What proceeded was more awkwardness for me; when to stand? when to bow your head? when to sit? when to kneel? when to sing? (or pretent to...) when to just get on the floor full on?--well maybe nobody really did that one.. Then it was: quick scramble to find your friend who was sitting next to you recently in the crammed pew but who got up to sit somewhere else with her head between her legs due to the intensity of the incense permeating almost all of your orifices, and ask her to slip you some coins to place in the basket that is floating around because of course, you'd forgotten all about this minor detail when going to church.

It has been so long since I've been to any kind of service, but all of a sudden the memory of the collection basket came flooding back. I remember my baby sister and I quietly but effectively fighting over who got to place the larger of the two sums of money mom had handed over, into the basket.

The experience here was enchanting. At one point the Padre instructed us to Greet Thy Neighbor, and the whole lot of us became uber chummy and we all enjoyed round after round of exuberant hand shaking. I loved hearing the sermon in Spanish, it was beautiful and oozing with power and solidarity. I wouldn't be too surprised if I started looking for ways to attend more mass down the road, especially in another language. In a small way, I began to feel a little connection to the community, we were at this moment sharing (on different levels of course) something unique compared to my inter-cultural experiences to date. It was humbling.

Incidentally, for those who were expecting a medical mass and not a religious one... We did conduct a prenatal visit for a woman who seemed to have a couple of heads in there. Both midwives crammed into the tiny room and crouched around her so each could tap out the heart rate they were listening to via both the fetoscope and pinard. If they were not exactly a match, then sure enough we could say there were two heads in there (and likely also two full bodies..) But alas, only one heart rate, which led us to ponder some sort of uterine fibroid or other finding that would require someone with one of those x-ray vision machines (an ultrasound).

That was Sunday, and tomorrow is Wednesday, the 2nd. It is finally my day to be on-call for births at the clinic. Will there be a midnight baby girl tonight between the 1st and the 2nd? Twenty-seven years and another continent later? I am just praying to the birth goddess that it all works out, and if it's meant to be, then I will tell all about it I'm sure.

xoxox

Estoy Embarazado

2009-08-27T16:39:00.000-07:00

Heheheheheh...

This is one of my favorite puns in Spanish-English mistranslation.

Anyway, today while orchestrating one of our now famous whirlwind prenatal clinics in a tiny village around town we had a local comadrona come asking for us to attend a birth at one of the homes down the road. Catherine, the professor and midwife, told us to choose a number between one and ten... Meant to be...

I followed her and the comadrona into a bedroom where a woman lay flat and with contractions her mother-in-law pushed on her fundus. She looked exhausted and strained. We auscultated fetal tones, palpated, sat with her through a few contractions, encouraged fluid and movement. Had her mother-in-law help us to remove the extra belt she was wearing around her abdomen (perhaps to also "help" push on the fundus, but really these seem to just block complete movement of the baby--we've seen lots of transverse and oblique presentations in the clinics). The comadrona asked Catherine to check her cervix. Only 4 or 5 centimeters. Definitely not time to be pushing, sheesh.

We left, Catherine saying, in all her years she has never been asked to a home birth in Guatemala. While it could have been considered an honor, it felt more like the family wanted all these foreign medic people to offer them some other standard of care than they assumed they were already receiving. They asked for an IV, and more gloves, and for us to stay.

We gave them reassurance, a bundle of onesies and receiving blankets and moved on to the next village for our scheduled prenatal clinic set-up. Our cultural broker, the local Health Promoter, told us that although the family may have wanted us to stay, the comadrona would not be paid for the birth if so, and these women put in their time and expertise working with each woman and family, we think she was being polite in front of us and the family. The woman has already had many babies, and she was going to do fine.

Sure enough, we got word by the end of the prenatal clinic at the next village, she gave birth at 4pm (2 hours ago) and everyone is great.

Birth is most exciting and wonderful, when least eventful and interrupted eh?

Dia de los diabeticos!

2009-08-22T09:48:00.000-07:00

Not Dia de los muertos..

This morning was our first clinic day, unless I can count our last night´s late call to the hotel where we stay asking if we were "the nurses" and could we come help another foreign volunteer with her suspicious and menacing mozzie bites. I brought my first aid goods, including not the norm stuff like a vial of chloroprep and of course my arnica and calendula homeopathics. This poor girls' wounds made me want to become a fan of DEET. They were boiling, exploading, oozing and inflamming a decent surface area.

Anyway, this morning at 6am we were up and whoever wanted--all of us--trekked to the clinica where Jesus-Antonio consults with the local Type 2's. We did many a manual blood pressure check and when the physician came out to tell the remainder handful of folks that he couldn't see anymore of them because they had just run out of test strips, I interrupted and supplied my own. There were maybe 5 or 6 people left, and they had been waiting for hours. I can't sustain another diabetic clinic with my own supply, but I was glad that I had a match with so many different kinds of machines and strips out there.

¡Me encanta hablando Español! It was so fun to speak to everyone today, I got real friendly and chatty. It feels great to be back in a Spanish speaking country, my limited Spanish goes incredibly further than my Thai, Indonesian, or Kiswahili!! Now however, I'm going to try to pick up some Kaqchikel, the local Maya dialect.

San Lucas Toliman on the Lake of Atitlan in southern Guatemala is one of the most beauitful lakeside mountain villages I have seen. Food served by the old Father from Minnesota who has lived here for 45 years is not so good. I'm going to sneak some rice and beans and tortillas instead.

"Our Culture is Our Resistance"

2009-08-18T11:47:00.000-07:00

I LOVE having a bag full of the following items in my living room:

* receiving blankets, onesies, hats, teeny socks, and sleepers (x 40)

* stethoscope, sphygmomanometer, fetoscope, penlight and non-sterile gloves

* bottles and bottles of ibuprofen, prenatal vitamins, ferrous gluconate and syringes

* scrubs, self-filtering water bottles, arnica, expensive camera, sketchbook and journal (the real paper kind, not a computer)

* Call the Midwife, A Midwife's Tale, Where There Are No Doctors, a Spanish dictionary and The Glass Castle

* poncho from a friend who went last year for the afternoons when it drenches and pours

* an expectation that I will somehow get to experience a sweat lodge with one of the traditional Mayan midwives, comadronas, and learn more Spanish.

* passport

Wish me luck on yet another guaranteed-to-change-your-life-once-in-a-lifetime-experience-cultural-immersion-adventure.

PS. if you ever find yourself capable of acquiring any of the following items, I decided that I could probably use a regular income of these for future endeavors: onesies, receiving blankets, non-sterile gloves (smalls), prenatal vitamins, iron, ibuprofen, arnica (homeopathic), amoxicillin, metformin, glucophage, one touch test strips, or urine dip sticks. Save 'em for me, I promise to spread them around the world.

Cheers!

Photographs from the amazing and beautiful book Our Culture is Our Resistance: repression, refuge, and healing in Guatemala by Jonathan Moller.

Bear and the Dove Studio

2009-07-31T13:14:00.000-07:00

I took a yoga class today. I was excited about continuing my practice after my intensive summer course through UW [see previous post: 'Oga]. I found that I was a far better yogi than I had ever been previously. I have taken beginning yoga and pacing myself for a steady 10 years, but I finally see advancement in my personal practice now. It feels effective, productive, therapeutic and great!

But… this new yoga practitioner was like none other! His name is Bear. He is dreadlocked, white, metaphysical, singsong yet monotonous, and I’d like to share a glimpse into his class. First of all he spoke the entire (poorly advertised) 2 hour class. I could never possibly repeat here everything he said, but certain words or phrases really stuck out, so I am jotting them down here to share this almost hilarious yoga experience with you all. The following are snippets that were spoken with a poetic and bizarre cadence that I have attempted to capture here with generic English punctuation.

“blissicipline, and discipline react. Within. The body…

…find your. Self. In a state of relaxment…

…In frog pose, bring your index and middle fingers up, curling your remaining digits inward into your palm and… peace out…

…Find your breath in this pose as you breathe further into it. It is made in Japan, in China, in Asia and you are made. In here. Find this now...

…Perfect. Wow. This pose is speaking of truth. Summer. Barbecues, suntanning—both sides, swimming. Enjoy…

…forty—, thou—, sand… nerve endings in the soles of your feet. 72,000 in your navel—WOW—and only 72 are vital, with 10 the vitalist of them all…

…Your body is made up of at least 70% of water, your mind 80%. Water is truth. Find your truth. Water never lies. Now do you believe that water holds the vibration? Water—wawa wagedesha ohm. Now you know when a child says "wawa," they are speaking of the elements, the vibrations that come easiest to them…

…186,000. Miles per second. Is. Thespeedoflight. Atwhichourbodyand mind. Travel away from your place in this pose and bring yourself into vinyasana even faster than this speed.”

I wish I could recall more. Joey thinks I should bring in a recorder next time…

Namaste.

Spoaquin

2009-07-29T10:18:00.000-07:00

I moved.

My first day in my new town I went to an event on Main St. to celebrate Washington's most honored LEED certified green building, platinum style, at the Saranac. I hung out with the Mayor of the city, Mary Verner... well, I stood next to her at least after her speech about further "greening" the city and the parks project and working toward an even more bike friendly atmosphere in light of a seven million dollar budget cut for 2010.

I was chatted up and openly sized up by a local lady looking for the best spot for me in her political agenda for optimizing her beloved city. She is the amazing, young and beautiful Mariah who has already recruited me to join her circle of feminist activists/do-gooders/rad bunch of lasses in general, the Shrinking Violets.

Dinner overlooking the falls was beautiful at sunset in the old Flour Mill building.

The next day I went to the post office and the library to get myself updated. Both the postal clerk and the librarian looked me up and smiled at me saying "Welcome home."

My childhood best friend moved as well, and on her birthday started a new job as the head pastry chef at Sante's. A gorgeous local foods French restaurant that invites studiers to hang. Other favs are: Cafe Marron, Zola's, and the Elk (where you can substitute Small Planet Tofu for any meat on the menu).

I've been going for groceries at Huckelberry's but can't wait for the Main Market Co-op to open grandly in the fall, I prematurely became a member back in May. Also there are Farmer's Market days Wednesdays and Saturdays.

On the schedule for the week is to scope out the nursing opportunities at one of the two hospitals in town; one I admire for its non-profit platform, and the other where I was born. I'm also hoping to start up a volunteer doula program in the labor & delivery unit at either hospital, can't wait to get involved in the doula community here!

Also, we'll stop in to see a film at the new and improved Magic Lantern Theatre, the city's historic film house where I once snuck in to see the Rocky Horror Picture Show as a pre-teen.

I live in a neighborhood called Peaceful Valley, come visit anytime!

Flashback: Africa 2004

2009-07-21T21:00:00.000-07:00

Writings from Africa...

I dozed off and on during the 8 hour bus ride from Nairobi to Moshi, the scenery seemed to change drastically every time I opened my eyes. It wasn't long before I saw my first wild game--a zebra... smashed, complete with splattered guts all over the road.

We were first shown the maternity ward and met the head nurse, Sister Beatrice. There was a woman on a cot in the back who had given birth to her third son the afternoon before. The nurse showed the four of us volunteers this tiny new person, with the smallest pink fingers I've ever seen. His mama looked pleased and exhausted. That was it for midwifery lessons, on to the clinic next door where we met Sister Mbawa, who is diabetic. She and I had a good chat.

Women and children were lined up outside the small vaccination room, waiting. Most of the kiddos were crying. One woman pointed to me and told her toddler "mzungu!" I was meant to either distract or entertain her fearful child. I owned up to the name [white foreignor] very well, I am rather white--I have been living in England for the past year.

We took off into the rain forest paradise of Kilimanjaro. An 8 km trek to the first hut, through Seattlesque mossy wilderness that transformed into Dr. Suessian skinny looming feathery trees as we climbed elevation.

So tired, so many babies! On the way home from clinic we stopped in to visit the Honey Badger Ranch. Home to the blue scrotum monkeys. A lovely periwinkle shade.

Woke up with a burning sensation in my bum. Climbed off the bunk and slipped into the loo where I spent some quality time with my exploading arse. Popped some Immodium AD and set off for work. Instead of Majengo Clinic, we went to Mweni Primary School to help with the choir competition. "Jeni! Jeni!" a few girls hollered to me from there seats.

After a meal we had feedback hour, then history and politics with Zik followed by Kiswahili lessons [Marieta tells me I am a very good student. She gave me an envelope after class today with a photo of her children inside, and invited me to visit her home, anytime. The letter was marked "Jenny"]. During feedback I was moved to tears by Mary's account of the Upendo orphanage and Karen's account of the OCAT classroom [One Child At a Time]. At the school the kids sit quietly in their classroom in their blue and white uniforms until noon when they go home. There is no teacher.

Dara and I went in search of the perfect fabric at the market. We made it back just in time to make our Swahili lesson. Number day. When Marieta got to '10' she went wide eyed and clasped her hand over her mouth. We made her explain. She whispered to us that she accidentally said kuma instead of kumi. Kuma, incidentally means vagina, not the number 10. After a ton of pleading, she also taught us mmboo. Man can that woman giggle.

Sister Beatrice grabbed me and placed my hands on an 8 month pregnant belly in the prenatal clinic. I palpated for the baby's head like she had shown me. This babe was looking for light and a tunnel. I listened to the speedy heart tones with the fetoscope contraption. Another woman was across the room in a cot, she was dilated to 3 cm, her baby would arrive later that night.

Elaine: What if I get acclimated on the Kili hike?

Sarah: That'd be a good thing!

We picked up Karen at the school, she told us they played charades today. One team of kids acted out smacking each other and the other team of kids emphatically guessed correctly "teacher!"

Elaine: What happens if you break down in the Serengeti? You can't just call AA.

Sarah: Not unless you immediately find you have a drinking problem, no.

We had finally arrived at our destination inside the Ngorongoro National Park. While we decide where to pitch the tents Lesley says she wants to "room" with me. She sprayed our tent with perfume, put up photos and her cell phone even rang once. The she passed around orange juice and vodka. Camping with Lesley is fun!

Lesley woke me with a start saying she thought she heard a shot. We waited and heard it again so we popped our heads out of the tent only to see a massive adult male elephant standing maybe 30 feet away from our tent under the big acacia tree. He was lurching back on his hind legs, suspending his entire upper body to grab a very large branch off the tree with his trunk which then comes crashing down to the ground, hence the thundering noise. Then he munches. "Holy sh*t" we begin to hear from the other tents nearby. The elephant turns and faces our tent directly, his ears flared out. That's when we heard the cocking of a firearm. The armed guard was directly behind us. We were in the line of fire. He was steady, and aimed. For about a minute everyone just waited in silence to see who would make the first move. My first thought was, dude are you going to try to freaking shoot this huge thing?? Then I thought, wait, is this freaking huge thing going to trample me?? All of a sudden, the elephant simply turned around and starting munching again, a small while later he eventually meandered away. After I realized that I was in fact surviving this moment, I recalled the incredible full moon that brilliantly lit the event and framed the elephant perfectly, and the vast African night sky chock full of stars, complete with one shooting across the landscape of others. Wow.

Someone counted 65 hippopotami for me. And it smelled like it too. Hippopoo. There were kissing hippos, mating hippos, baby hippos [that's usually how that happens I guess], pooping hippos, farting and general oozing hippos, grunting hippos, hiding hippos, running hippos, swimming hippos... so many hippos!

I went to Upendo instead of Majengo today, so glad I did. I wish I could be here longer. I wrote down everyone's name. We played hard. Some peed. Some cried. Some ate some dirt, and some held on to you so tight and wouldn't let go. Two kiddos could fit on one swing, they piled onto everything they could. I played with Brightness and Lucy. We quickly became live jungle gyms for these toddlers.

Lunch time today was noticeably different. No screaming kids, no throwing food, no tears, no talking even. It was ominous. Then it hit me. My nose stung and my eyes swelled up. I jumped up to see the tiny kittens outside to get my mind off the tiny children inside. The van arrived early today. I walked to it almost without looking back, almost. I saw the kids and nurses waving slowly, I waved back. They ran to the van, singing and smiling to us. We sang and smiled back, and we cried.

In Arusha, we met Peter O'Neil, an exiled American Black Panther. He has been here in exile for 34 years and has started the United African Alliance Community Center. He told us when he left he brought 19 year old Charlotte with him. The US papers stated that he was likely somewhere around the Mexican or Canadian border. He read this in Sweden. He moved on to Algeria and stayed for two years. Later Charlotte gave birth to their first son, Malcolm in a Chinese Maoist Hospital where she was told to only say one thing during labor I give you this soldier! Pete wanted to build a raft and get to the states and hide out in the Rockies until the Revolution came. Charlotte convinced him to try Tanzania first, and they've been here ever since.

...and said my goodbyes, and cried a bit more. One last time I heard the neighbor boy say hellogoodbye in one breath and in a perfect American accent. I watched the scenery change from dirt to pavement, from slow rural labor to bustling town business. I bought a book about India at a stop.

See you there.

'Oga

2009-07-15T22:51:00.000-07:00

"Let's do 'oga!" Says this little lady, who then proceeds to climb all over you as you select body positions that will best allow for this new weight lifting form of yoga, er, 'Oga.

I had to take an interesting class this summer, a graduation requirement for my other degree, so every morning I take a yoga class at the university, for credit. This means I had to write a paper. Here is that piece.

Yogic practice includes ethical codes that serve to better one's life. I am to generate my own codes, and they are also 5 yamas (what we should not do) and 5 niyamas (what we should do). The original code of ethics has beautiful Sanskrit names, mine are neither beautiful nor Sanskrit, but I felt like naming them.

Yamas [Watch out and...]

1. Whadacrac Don't be ridiculous. Really, if we consider what being ridiculous often entails we are either being pessimistic which is never healthy or acting outside of generally accepted social norms (this can range from public displays of bodily functions to brining physical injury--or worse--to another human being). It is important to essentially keep your inner-crazy in check.

2. Urwhaueet Don't drink the water. This speaks to "my body is a temple", be careful what you put in there, it has to be digested and absorbed into your amazing but ultimately sensitive liver and alimentary tract. Toxins come in all shapes and sizes and flavors; like expensive antifreeze laced street drugs, or giardia infested unsanitary water or just a second slice of 'death by chocolate' that you know you don't need.

3. Noawphensmahn Don't be surprised if no one likes you. Love thyself, and let others follow. If you are in a place where you are having trouble with daily functioning, let alone making productive contributions to society as a model citizen, than life is going to get tough. Find support resources or coping mechanisms that are effective.

4. Vajaneuh Don't be messy. Yes, clean your home/room/desk. But also clean the entire space you occupy in this world. Pack it in, pack it out. Litter and it will hurt (this slogan was always a stretch for me...) Try not to ignore global climate change. All those toxins mentioned above, and loads more, can pollute our bodies to the point of disease, so don't mess up your body either.

5. Lalalula Please remember to wipe your feet. This means that we should all be tuned into the relationships we inevitably have with those around us. Our cosmic energies, chi's and general life forces relate and interact with everyone we encounter. We should always try to remember that we can cause effect and receive it as well. Tune in when you are feeling out of sorts, only you can direct your own reactions. Be in control, or know when you can be out of it.

Niyamas [Instead we should...]

1. Kairaemacorlynju Always surround yourself with loved ones. As with above, we have the choice to let others influence how we respond to situations and feelings. If you are at least able to conjure up the thought or a memory of a dear loved one in a pinch, then you will find that things become smoother in life. Love is a many splendid thing.

2. Ouagadougou Always leave footprints. Ok, this one means get yourself some much needed time off, and a plane ticket and go see the world! Or a new park. Move and shake. Become connected to the global community by learning and sharing and growing. Open eyes, boundaries and passports. There is nothing more rewarding in this life than to leave the comforts of your own space and the routine to go get lost. When we are lost we find something new.

3. Blahdiblah Always think global and act local. Go global, yes. BUT, consider what this can mean sometimes. Levi's and Nike are made in sweatshops with no labor standards in low-resourced nation-states. Just consider what precious resources it requires to ship produce from the tropics to our huge grocery shops during the winter months. Don't but apples from New Zealand if you live in Washington. Sheesh.

4. Govindajaiajaia Always love and appreciate life and death. These are two very important experiences. They are clearly taboo in our culture, and this needs to be divested. Everyone is born. Everyone dies. Birth and death can be beautiful and meaningful and shared and honored. No one has a grasp on what it all means, see the absolute beauty in this.

5. Mariskahargitay Please remember to sleep and gorge in moderation. Seriously. We sleep too little, and we are really good at gorging ourselves. Reverse it! Indulge in sleep, and restrict obscene intake. Sleep is for healing and rejuvenating, and if you do it right you get to dream. Eating is for fuel and function and if you do it right you get to enjoy it.

Oh, and do 'Oga with a three-year-old. It's fun.

... because she believes in me.

2009-07-06T13:51:00.000-07:00

Today I saw three Seattle Metro buses sporting the above advertisement.

I stopped and stared and began to smile.

For the past three years I have been teaching a course at UW on the culture of birth in this country. The following have been my course titles:

Birth 101: Everything You Ever Wanted To Know About Birth (2009)

Birth; Delivered (2008)

Inquiry Into Childbirth Culture in Contemporary American Society (2007-Inaugural Course)

This was the absolutely brilliant idea of my former doula business partner, Jane Harris. Together we propositioned the CHID department, no not Child, CHID stands for Comparative History of Ideas, in which Jane H. has a degree. This department has a course, CHID 496 that enables students to teach whatever they want, an incredible opportunity that has solidly become one of the highlights on my year.

I am struck today by this in-your-face advert because I have begun my class each year by saying something along these lines:

This class is biased, I will happily be up front about this, you should all know that I support out of hospital birth for healthy term pregnant women, and I support local midwives--providers best suited for the majority of pregnant women out there, healthy, normal and at term (as defined by weeks gestation: 37-42). Ninety-eight percent of babies are born in the hospital in the United States and still you see billboards and sides of buses with advertisements oozing with the cuteness of perfect mini humans all smiles, with phrases like: My Baby Was Born at Ballard, Born at Swedish, and my favorite pretentious claim, Smart Babies Ask to be Born at the UWMC. See, hospitals capitalize on birth, thereby squaring away lifelong loyalty by coaxing patients even before they're born. Question that statement? Who do young women go to for their first exam in the pelvic floor department (I'm talking about "smearing your pap" ladies)? The gynecologist of course, the OBGYN--Obstetrician/Gynecologist in fact. Which means what? Well, that when a lady finds herself preggers, she automatically turns to her Gyno who she's been "seeing" for years. Boom, scheduled sectional surgery later* and there you have another loyal lifelong patient already in place.

*Important note necessary here: This is of course not always the case, depends on a few things, also as much as a I knock surgical birth, please note that what I am actually opposed to is unnecessary medical intervention in an otherwise more-than-perfectly-normal bodily experience, birthing a baby. It is absurd to think that it is normal for our nation to have evolved just so that in that last two and half decades females can no longer accomplish what has been occurring for centuries--thousands of them in fact. What is also worthy of particular mention here is that we have amazing medical interventions today that literally save mother's and baby's lives. The cesarean was born so-to-speak for just that purpose, saving both mother and baby, an option previously unavailable. When cesareans are the only way out for a new member of society, they are one of the most impressive acts of the human hand to witness. It is still very much the birth of a baby.

Anyway, I am very tangential when you get me started talking about birth--did ya ever notice that?

The point is, today there were bus adverts for midwives! My class is based on the underlying philosophy that we live in an economically-based society with the expectation that we have consumer options in life, about everything. And we do, we have the option to birth however we want. Not very many of us even know exactly what midwives do. Incidentally they catch babies, they are trained, experienced, and professional baby catchers who are fully equipped and prepared for any twist and turn in labor. This goes for the scary ones too, at which point midwives make a note of the pink flag, not waiting for it to turn into a red flag and get thee to a medical facility that can implement the tools necessary to keep birth safe. It is extremely rare for an out of hospital birth to transfer in a state of true emergency. So, with consumer options comes public education and commodity marketing. Market away midwives of Seattle! Hurray for choice in this part of the world, exercise your right to education and make the right choice for you. Learn and believe that birth is one of life's most normal events. That, and dying... but I'll save this topic for another moment of sharing down the line. Know that death is also something I am rather passionate about, and like birth it is often medicalized, painful, scary, and in the hospital, alone with providers who don't trust it and therefore tend to contribute to the emotional instability of it, when it could otherwise be supported and protected, peaceful and beautiful.

Speaking of matters of life and death (because this is what keeps you ticking), even though I'm pretty bad at this, I've decided to do the crossword everyday this week... any suggestions?

Shoe part that touches the floor [7 letters] / Wedding rental [4 letters]

Climax

2009-06-17T22:13:00.000-07:00

Waring: This post is pretty self-congratulatory.

Graduation was far more climactic than I had anticipated. Especially since I merely walked, I won't technically receive my degrees until August. A minor detail the director of the nursing program assured me, since there aren't any nursing positions right now anyway, and more time to study (read: more time to procrastinate studying?) for the NCLEX board exam for licensure. As close as I am to achieving my second degree, I would be academically bummed if I didn't go for the BA in Women Studies.

It's true, I miss the Women Studies atmosphere. Good old fashioned liberal academia, full of freedoms, individualism, empowerment, anger, human rights, attitude and political activism. I remember when I used to think that this was what nursing school would be about. Well now I know a bit more about that. I do feel that while nursing school has been a proverbial hoop, discipline, struggle, frustration, blood and sweat certainly do have their place in this world. I also realize that while a BA in Women Studies gives me an invaluable grounded position in this society, it doesn't--as readily--give me a job.

Enough negativity. Here is some positivity.

I graduated! Did I mention that? My first bachelor's degree(s). I started down this road 8 years ago. First I dabbled in mathematics, primarily because I had a crush on my high school calculus teacher. Turns out I'm not great at math. So I switched to nursing, practical reasons; I could do well to take better care of myself, what classes would encourage that? Wait, do those classes offer a degree? A job!? Wooooow, I love nursing. Too bad nursing is really hard to get into these days. So I dinked around a bit, studied in the UK, became a doula, volunteered internationally etc. etc. Started a new degree in the meantime, and finally I was in [passed the perseverance test I'm thinking.] Two more-or-less amnesiac years later, poof! I can put some letters behind my name, never thought I'd see the day, nor did my folks.

There was even a grand culminating moment to all of this, my four and half minutes of small-scale fame. I was nominated by my peers and a faculty committee to give the student's commencement remarks. The only free-style speech at the ceremony. A responsibility traditionally offered to a graduate student in fact. So on behalf of 245 graduating BSNers, Masters, DNPers and PhDers I spoke the following words at my graduation last Friday:

_________________

What a privilege it is to speak on behalf of the various degrees of nurses having accomplished a major feat of academic pursuit and who are ready to re-join our greater community as a new and improved member of society. This is a ceremony of transition. Many of us are transitioning for the first time into the field of nursing; many others are transitioning from long standing nursing careers and are now here reborn as a nurse of a different color.

We are all functioning, contributing members of our healthcare system—no matter the political or financial condition. We are now officially a community of nurses who sometimes shared pain and suffering but who today share a sense of empowerment and great accomplishment. We transition through this stage in our lives together and with each other’s support so that we will be more capable of empowering others, namely, the patient populations we will soon disperse widely amongst us all, and contribute to a healthier society as a whole.

After all, nurses are patient-people.

It is also a great privilege to share this moment with an audience like you. Full of unconditional supporters: faculty, family, and friends. It is likely that without your encouragement, motivational, perhaps financial and certainly emotional support, that a few of us might not have made it. Nurses are strong, but we often require stronger support from those we love. Thank you all, for this.

I want to cheers to Nurse Flo, our founding foremother, in all her revolutionary glory, may we follow in her path and think of the little things that ease the discomfort of our patients as well think of the bigger things, and make room for more revolutions in healthcare. Say for example, advocating for a single payer healthcare system. And we again honor Miss Nightingale, and always wash our hands.

Today’s nursing graduations no longer involve the starched white cap ceremonies, but we know that we are part of an important tradition of care and expertise in our field. We do not need to denote our status in the field with this symbol of otherness; we are a community of healthcare professionals who meet our patients where they are in their process of health and healing.

Reflecting on what it means to be a part of this tradition of nursing, I often come back to 3 questions that frequently lurk when I am in a stressful nursing situation:

When is the best time?

Who is most important? and

What is the right thing to do?

Today I have the answers, they are universal, timeless, relevant to everyone and to me they represent what it means to be a nurse. They are from a children’s story adapted from a piece by Leo Tolstoy called The Three Questions:

“Remember that there is only one important time,

and that time is now.

The most important one

is always the one you are with.

And the most important thing

is to do good for the one who is by your side.

For these are the answers to what is most important in this world.

This is why we are here.”

oo la la ladies n gents

2009-06-14T00:38:00.000-07:00

j o e y & j a n e

c a t a r i n a w i n e b a r , s p o k a n e

I like to tell people we met at the gym... when we were 12 and seated alphabetically in phys. ed.

But sometimes I tell people that we met online... because we reconnected, after growing up, via a mutual friend on facebook.

Joe Sheehan is my long lost crush, and I have new appreciation for Spokane. That 4 1/2 hour drive stinks. But we share it.

Fun, fun.

Memoirs of a Nursing Student in a Lock-Down Psychiatric Emergency Department

2009-04-14T10:18:00.000-07:00

[place holder post to remind me to fill in soon!]

***

Wow, so apparently this was a ridiculously busy quarter. It's now June 5th. I finished all my hundreds of practicum hours just yesterday. So naturally, now I have some time to update.

"Psychiatric Emergency, this is Jane,"

This is how I answer the phone down in the psych ED at Harborview Medical Center. It feels like we're in a basement with no windows (for safety), and it's kinda dreary with nothing on the walls; no eclectic hospital art or any color at all really (for safety in reference to the lack of art, but color?) But I love it. I love psychiatric patients. I love the team of providers and staff. It has been, by far, my most rewarding clinical experience in nursing school. I had chosen "Psych" for my senior practicum placement because I studied psych nursing in Thailand, and wanted to see what the American system was like. Now I have an idea. It's horrendous. Psychiatric illness and care carries an intense stigma in our culture, and it is one of the least resourced sectors of our healthcare system. In fact, the majority of our population suffering from psychiatric illness is homeless and the biggest provider of psychiatric "care" is our prison system.

This may very well be one of the main reasons why I feel so drawn to this patient population, it is one of the most vulnerable and disadvantaged communities in our country. For me, as a pseudo-provider, this means that often a small gesture can go a long way for an individual in crisis. I can do small gestures, I can make very small differences, and this helps because there is an infinite amount that I cannot do for this population...

Enough political advocacy for now, here are some of my favorite stories from the past 10 weeks.

A patient watches me give medications to another patient in the hallway. He comes up to afterward and says, "Hey, I take Topomax, and I haven't had it yet today..." and I replied, "Oh, I'm sorry, but you're here because you overdosed on Topomax." The patient starts laughing, "oh yeah, I forgot. I'm probably good for a few days."

My preceptor says to staffing on the phone: "We're great, we have three nurses" and I say, well maybe 2.5. He says again, "Oh no Jane, When we get a float nurse from the main ED, then we have 2.5. We count you as a whole nurse here."

Wow, a whole nurse!

Once we did get a float nurse from the main ED (see previous post: A Montage regarding the Harborview Emergency Department from August 2008-a serious ED that has amazing nurses, but they are not psych nurses..) She asks the group of us, or maybe no one in particular, "So what are you guys doing these days for folks with mental problems.. er, uh, mental issues or whatever it is you call it now?"

The Emergency overhead pager goes off: A voice crackles over our heads "51 year old male whose been involved in a scuffle with a gun-" is immediately interrupted by another, more snarky voice chiming in with "Ok Lexi, as soon as there's a gun involved, it's no longer a 'scuffle', new criteria have been met"

One new admit on the psych emergency unit demands "How can you detain Jesus?" RN answers: "Immaculate detention?" Later, same patient profoundly inquires "How can you inject Jesus?" RN suggests "Omnipotent injection?" Patient states matter-of-factly during an initial assessment on the unit, "Yes, I am Jesus... but I can't walk on water." Religious preoccupation was one of my favorite manifestations of an illness presentation.

And on a heavier note:

I became inducted into the team officially as a psychosis doula. I went to the admission room to collect a new patient. He was sitting at the processing desk with a ball point pen aimed at his jugular. The receptionist says "What are you doing with that pen, can I have it back?" I ask him to give me the pen, and I will take him back. He responds and mentions "I am supposed to do it, today is the day.." We enter the lock-down unit and he pauses in the doorway, "I don't know if I can go in here, they say it's not a good idea," We settle into his room and begin to talk. I leave to retrieve some water and a urine specimen cup for him to pee in. When I return to his room he is crouched on the floor lifting the head of the gurney and looking underneath. He turns to me when I distract him and says "I am supposed to lift this, and put my head here, and then pull it down, hard." We talk more. We discuss safety, and self-control. He asks to be placed in restraints, he doesn't feel that he can be in control. After doing so, he reacts to the physical restraint by yelling, and jerking his body on the gurney, which is now chained to the wall in this tiny fear-inducing room. I sit with him, with my hand on his shoulder, and all of a sudden doula voice sets in. It's ok, you are safe now. This is a safe place. When you feel anxious about not being able to move freely, take a deep breath--like this, with me--and tell yourself you are safe, you are safe. The patient breathes with me, deeply, like we have been transported to a beautiful sunny yuppie yoga studio. He repeats "I'm safe, I'm safe, it's ok, I'm safe" over and over until he actually falls asleep.

My preceptor walked by and observed this for a moment. She pulled me aside and said "I'd heard you were a doula... well done."

This is when I fell in love with schizophrenia, for anyone remotely interested please read this incredible story: The Day The Voices Stopped by Ken Steele.

After many more experiences on this unit I became twitter-pated with Autism, Asberger's, Borderline Personality Disorder, Delirium Tremens, methamphetamine-induced psychosis, hallucinations in general, mania, malingering and more. My love for them relates to a strong desire to learn everything about these conditions and how they effect a person, and how society in turn treats them. There is a lot to learn.

Self-induced premature quarter life crisis...

2009-03-25T20:09:00.000-07:00

...which I fully realize means that I am apparently intending to live to be 104.

For me, so far, the quarter life crisis has been fantastic (it was mentioned to me that it cannot technically be a crisis then..) but I moved into my own place, I pop about 12 vitamins, minerals and supplements a day, including nutrient-rich alfalfa infused drinks--the chlorophyll I brought back from Bali. I exercise and dance to my heart's content and, oh yeah, had my nostril studded with a rhinestone. Not too bad really.

Then, for the clincher; this year I went to Miami for Spring Break, South Beach baby! I went to visit a girlfriend of mine, one I've known since we were 6 and 7 years old. She is a pastry chef at an uber swank hotel in Miami Beach. Miami has got to be one of the most fascinating cities in this world. It is so colorful, everything is pastel or flourescent, all is bright, which is perky and great, but then there are the Miamese..

People are amazing. I honestly felt like a naive farm girl. Miami is only-one-article-of-clothing-necessary if not clothing-optional entirely; your choice article can be namely a longish top, OR bottoms. Simply the bikini or speedo will do just fine as well. And anything that offers full view and leaves nothing to the imagination as far as shape, size, color or otherwise of any normally covered part of the body, is perfectly acceptable. I've witnessed many lifestyles, and I can appreciate the naked human form like no other, but I was caught gawking! I'm convinced that no where else are the '80's so alive and vibrantly celebrated as South Beach Miami during the Spring Break season. For full effect, Pflueg's husby Craig repeatedly sang me "Joey" by Concrete Blonde--a classic '80's jingle that was music to my ears this week in all this pastel and cheesy class (oh yes, cheesy class, apparently is not an oxymoron). Sadly, my fanny pack didn't actually fit the bill, where is that old black and hot pink nylon number anyway??

My first encounter with Miami folk was walking down the street with coffees and chocolates from Pflueg's pastry shop where an older babushka woman linked arms with a young woman wearing trendy scrubs, she swerves her body in front of us and says in a thick Slavic accent: Hyou dvinking Vodka??!! Ah the beauty and sadness of dementia, I'm sure she's not allowed, but would absolutely feel divine after a swig!

In light of the "crisis" I had been seriously considering a tattoo, which I figured Lynette would fully support as she has made a beautiful canvas of her own rad self. But, Lynette, being the all practical one, told me to try a pseudo tat first that would last one month. I wanted it on the back of my neck, but couldn't decide what to get. After contemplating getting just any old thing put there just to see what having something there was really like, I freaked out. Ohmysoul, thank goodness, but no thank you.

I haven't dolled up with another girly for a night out in a while, last time Nette and I did, I believe we were 18 and in Bali.

Ms. Lynette Louise and I had a proper catching up not to mention I finally met her husband of nearly two years! A charmer to be sure. I'm hoping they move closer someday, but not before I can pop back over for another guilty pleasure* visit to the wonder that is Miami...

*Next time I'm schlepping my white trousers and any and all pastels and flourescents I may possibly own! When in Miami wear blue eyeshadow and pink lipstick, huge earrings and your bikini for a bra with the best of 'em!

Wish I could pull off orange shades, hot pink bikini and blue eyeshadow in Seattle... Thanks for the make-over babe!

Undercover Doula

2009-03-08T18:42:00.000-07:00

Disclaimer: I am a HIPAA-Happy provider, don't fret, details have been changed to protect privacy, or permission has been granted.

I am totally freaked out by L&D [labor and delivery] nursing.

I just finished my last clinical during this quarters' OB rotation. When the quarter started, the first thing I did was make an announcement on the doula community boards to warn them that there would be purple scrubbed nursing students roaming the halls of three major obstetrical units in the Seattle area, and to tell their clients to request that there be no students present for their births. To our credit, the nursing students were told it was an observational clinical only, and the most we could do was offer support, like be a doula!!

So the weeks ensued, and I attended a few births at the baby factory that is Swedish First Hill Hospital, where upwards of 800 births occur each month--holy crap--you know that means they put mama's on a ticking clock to make room for the next labor, at absolutely all costs. But I made the most of it, and resorted to my tried-and-true doula alter ego. I successfully avoided doing the charting and administration of procedures and injections and ordering of interventions. Phew. Ethically, I cannot phathom the role of the labor and delivery nurse [incidentally, pizzas are delivered and babies are born]. You leave a labor when your shift is up, not when the baby is born, and you meet the family in the throws of labor, not prentally where you have time to develop a trusting relationship and bond. So I'm just not on board with the whole concept.

A recent repeat doula client's newest babe--also photographed above holding dad's finger.

So on my last clinical day I attended a high risk birth, and morphed again into their doula and not the nursing student. I, alone, coached her through three hours of second stage pushing, with an epidrual, which requires a little coaching as you can't freakin' tell when you're contracting! And the nurse preceptor later tells me, "thanks for doing the pushing--I hate that part" Yikes. And ahem, I did no such thing, that mama pushed her baby out! The baby was called Joseph Michael, tribute is due here to a certain unaware namesake :)

I was later taken into a small hallway room where they keep "memory box" supplies and there was a nurse carrying what looked like just a baby blanket as if she were carrying a baby; nestled into the crux of her arm. She placed the blanket down and unwrapped it on the counter. A teeny less than 1 pound, 21 weeker baby girl was unveiled. She had just been born, after inducing her death because of spina bifida, a spinal cord deformity that is sometimes incapatible with life, as they say. Her tiny finger pads and toes looked like little tadpole digits. Her skin was sticky and transparent so that you could see the intense red of her vascular system barely beneath it. She had perfect ears and nose and eyebrows and even fingernails. She looked like a little tiny alien creature, and she was beautiful in her miniscule human way. The two nurses in the room with me were chatting amongst themselves about their various judgements they had toward the family. I listened, perturbed to the core at their very nerve, and softly touched this little being and sent her soul some reiki. I couldn't help it. Back out on the unit, I thanked my nurse for showing me the "fetal demise" and she said, "oh no problem, we get a lot of those here"...

I was then reading up on incoming patient's charts in the nurses' station, when I saw out of the corner of my eye a familiar face. A doula! I went out into the patient waiting room and chatted with long time doula, Jennifer Mendleson, we attended a birth together, ages ago now, my first home birth actually, the sixth time mom who labored for an hour and with a single push caught her own son and brought him straight out of her home jacuzzi onto her breast. It was so fun to see Jennifer there. She was waiting for her client to come out of surgery for an abdominal birth (sectioned as the L&D nurses affectionately call the cesarean). She asked me if I felt like I was undercover. I laughed. I absolutely do. I love it.

I love birth, and was happy to be a part of the one's I was assigned to, during this rotation, but now I know with conviction that I could never be a labor and delivery nurse, and that I will be a midwife. I think I could make a good birth nurse if I had to, a doula-esque nurse, but it would be ethically challenging for me to do so.

This is one of my doula babies, an awesome birth from 2007. I nanny for her twice a week now. We play, and she teaches me Mandarin. The other day she was playing on the fake phone and apparently having a conference call between my mom, President Obama, and her baby girlfiend. "Hi C. Lee, hi c lee hi clee Obama, Zoe, Obama, Maumi, (Mandarin for Kitty), Zoe, hi c lee, Obama" I love her to pieces!

Next quarter is my last in the nursing program, and my senior practicum placement is the Harborview Psych Emergency Department. Get ready to be spit on, pinned and swung at... says a few knowing colleagues. I'm totally stoked.

Flashback: India 2006

2009-02-25T22:29:00.000-08:00

In India: Part I

I am here, well, and in love with India. It has already been one week and I have done so much, with so much left to do still. I am working in the mornings at an orphanage for children with disabilities which is rather cheery and very fun, so far there are too many to pick one favorite! In the afternoons I spend my time at Kalighat, Mother Teresa's home for the dying destitute. This has been very hard work and a beautiful experience, something new every time. Wonderful. I also gave a lecture to the OB nurses at the local private hospital--with special permission from the head of nursing staff. The nurses were so darling, I love them, and they were very interested in what I did. I donated my birthing balls and other tools that I had lugged all the way here. It felt great to pass them on and to share a little doula spirit with them.

Pashminas, mirrored Indian woolen blankets, beaded slippers, bangles, scarves, saris... these are the things I've been eyeing, everything is so enticing and beautiful. The sheer contrasts of this city are mesmerizing. The smells around every corner consist of all of the following all at once: incense, garbage, fruit, petrol, lotus blossoms, sewage, sweat and curry. It's exquisitely intense.

Other than all of this, I have been drowning in my own sweat. It feels like I've been on a long hot run, and then put on my nice clothes and headed in for work without a shower. It's great. I am staying in a hostel with several other girls, quite a worldly room, for about $1 a night, fully equipped with a luxurious cold "shower" faucet. A necessity in this heat. Showers are equally necessary and futile, I love it. Not so much in the way of Monsoon season actually, a few days of rain--torrential and flooding--at first, then simply sweltering heat. I am eating more and more each day, I started out with just one lassi, I think I'm too hot and awe-struck to be hungry. But my energy is depleting. After this email I am going for a real dinner, and I'm really excited, daal, naan, curry, chai, sweet lime juice, even the fresh roadside peeled cucumber is amazing! (Thank you Sakina)

Tomorrow after the workday is finished I am heading to Darjeeling for a quiet misty mountain respite. Very much looking forward to this. I have, in my head, grand plans to visit Nepal and Bhutan while I'm up there. We shall see if it all actually works.

You must see this country to believe it. I wish you all that opportunity.

All my love,
namaste

J

In India: Part II

Happy Indian Independence Day today (the 15th), or Gandhi Day!

I am finally back in Calcutta, although it is again stiflingly hot, it feels good to be somewhere familiar, and in the company of other people!

I managed to make my escape to the hills but not without undergoing many adventures. So I last left you all with the prospect of my first real meal in India. It was grand, loads of food, spicy and filling and loads of it really! Well, that has still been my only real meal thus far. Immediately afterward I spiraled down the sickly slopes into Indian-illness delirium. The entire next day I writhed and wallowed. I was in a very sad state when one my dorm mates finally returned in the afternoon and got me situated. She gave me a handful of pills and made sure I took them, one of them was ciprofloxacin and I don't know the rest! Hahah. I remember having all my own, happier, natural medications laid out in front of me, but I couldn’t leave to get water without vomiting all over the courtyard of the hostel. She got me water and tucked me into bed and had me listen to her soothing music. When she left, thunder struck, literally. The rains and thunder were therapeutic and I remember coming slowly back to consciousness and testing blood sugar constantly praying that I wouldn't go low because I couldn't fathom ingesting anything. I actually dreamed that I had to give myself that emergency glucagon shot. I recovered enough to somehow checkout, get a taxi and get on my train going north that evening. I was in a sleeper class compartment which was packed with stinky sweaty bodies; I could see only men for about three whole cars. I believe it’s convenient to be vomiting constantly when you are maybe concerned for your things and safety. No one paid me any attention!

After my nearly 12 hour trip I went straight for the border town of Kakarvitta, Nepal. It was an amazing transformation from the bustle of India. Not a tourist in sight. A very quiet, slow, lush town. The children found me wandering the street and we soon had a huge parade. A real pied piper. They were all so lovely. Even the adults were thrilled with my unannounced arrival. I wanted to scoop them all up and take them home. One girl was called Jinita; everyone else’s name was nearly 5 syllables so I have no idea! I loved my small taste of Nepal.

The next day I went to Darjeeling, which involved a gorgeous mountain drive through green tea fields and lush forests, but I spent my energy not throwing up, which was a good thing. The mountains were stunning, but I unfortunately found only a sad dingy hotel that had vacancies. It was a horrible place to spend any amount of time. Especially alone. I was hit very hard with the reality of loneliness. I did some fun things; learned about teas, had a cooking lesson in Tibetan dumplings and shopped for beautiful jeweler. But the only people who talked to me were the sleezeballs who followed me around. I was very fed up. The cool temperatures were wonderful but after only two days I had to head back down the mountains and see what else I could see.

Back in the junction town of Siliguri, I shut myself up in a hotel room for almost a whole day. Overcome with being alone and frustrated and still ill I tried to recuperate a little more. Unfortunately there were three knocks on my door in the first 15 minutes (once for the bellboy to simply hand me the card of the hotel and actually recite the entire telephone number to me! I was too bewildered to interrupt him) then my phone rang off the hook. I hung up on it a few times, but the receptionist would just call back. I explained to her that I was sick and didn't want to be bothered. When she called again she said, "I'm sorry ma'am, but I have never met a foreigner, I want to ask you questions..." Oh dear, so charmingly sweet and innocent. Later I humored her and spoke with her in the lobby. The entire staff gathered around. It was great. "I wouldn't let my daughter do what you are doing even if she were twice your age!" sad one man. They sure thought I was interesting.

The next day I hopped on a four hour bus ride to the border of India and Bhutan. It costs tourists a $200/day foreigners tax, (plus a $50 visa obtained ahead of time only) to get across the border. But my guide book said that this border town allowed visitors for free until 10 o'clock. Then I heard that they aren't even doing that anymore. So I thought I would go anyway and see for myself. Sure enough a few months ago they stopped letting day visitors in for free, and it would be impossible for me to enter. Well, that sounded like a challenge. So I put on my best "just rode a four hour bus after coming all the way here from Calcutta where I am a volunteer, ALONE, just to visit the beautiful city of Phentsholing, and I had no idea!" face. Well lo and behold, not only did I get across the border, in the city and officially become a visitor in the lovely and tranquil mountains of Bhutan, but I had a personal government guide as well! Hahahha. That was good fun.

Rather pleased I headed back to catch my late train heading back to Kolkata. In an A/C compartment this time which was wonderful. Now I am here again, ready to return to my volunteering and do some more sightseeing around this city. I head back to the US on Sunday morning early. I am following the news a bit too, so hopefully shouldn't have any trouble at the airport.

And, I am eating. Light teas, broths, rice and energy bars. I can't wait to go out for Indian cuisine when I return!! This illness has broken my heart because I can't eat my beloved foods here. I am working up to it maybe. We'll see.

So, a very distinct change in experiences since my last email, but it's all part of India, and therefore I love it. I laugh now at all the mishaps and all the things that made my stomach churn. But I can't complain. India is everything that I had dreamed, and nothing that I could have ever prepared for. How wonderful and fun is that!?

Thank you for listening,

All my love
namaste,
Jane

In India: Part III

The final installment:

Hope all is well with everyone, thank you so much for all your emails, they have brightened everyday for me. You are all wonderful people.

I had a great last few days in Kolkata. After my last email I came down with a vicious head cold, probably the transition from a cold to hot climate. My first day back I went to work anyway, feeling crummy, and then a friend of mine who is actually a UW Law student (yay Julie!) asked me to go with him to a project he was working on with the children of the prostitutes in Calcutta's red light district. It was very Born into Brothels. I played with all the little kids while my friend worked with the older kids on a project of theirs. I had so much fun. But I had such a mixture of feelings for these kids. In one way they are so normal with the same opportunities and prospects as any other child, but the reality is harsh. It's so incredibly painful and sad to think of what might actually happen to their lives. The likelihood of these young girls following their mothers is too real to bear. It tears me apart. It was wonderful and surreal to meet them.

I laid low the next morning recuperating some more with some discovered honey lemon ginger tea. It seems I am always in recuperation mode. In the afternoon I met up with a fellow traveler I met coming back from the north and we visited the Kali Temple near to where I work. This is a temple of worship for the goddess of destruction, Kali. It is a gruesome figure with a huge round black face and three orange eyes. There are burning incense sticks and red flowers everywhere in the temple, but all you see is a blur of red and smoke, making the scene very eerie. We missed the goat sacrifice from earlier in the day-phew! I love the spirit and the intensity of these people. Afterward I took my friend to visit my work at the dying home, he is a doctor of internal medicine in Switzerland and turned out to be a great help to the sister's and to a handful of the patients. It was great of him to jump right in and do some assessments and look over some charts and answer the sister's questions. Apparently they see one volunteer doctor a week for a short time one afternoon only. And of all the nuns, only one sister is actually a nurse, although many of the volunteers are nurses.

The following day was a day off for all the volunteers so I spent it doing some shopping and sightseeing. The shopping has been fantastic, fabric and jewelry galore. Everything is colorful and shiny. It's amazing to look down a busy street and see lots of dreary colors from the dust and dirt, but to be able to focus on one woman's vibrant and crisp sari: bright orange or yellow or pink or turquoise. It shows the rich culture and beauty amidst some of the world's poorest places. This is India. I ended up sitting in a sari shop with dozens of other women, wealthy Indian couples, as the wives sifted through piles of fabrics. I was shown a stunning piece right off the bat, and then after seeing countless others I decided upon that very first penetrating fuschia silk with silver embroidery. It was 6 meters of incredible material, and soon it was my very own. I was so excited. I went straight to the tailor's down the street from where I was staying and was measured for the blouse; the remaining 5 1/2 meters are to be draped to perfection for traditional Indian fashion. That evening I had arranged to see a show put on by the children I'd visited earlier in the red light district, the children of the "untouchables" as the director of the program sadly told me. It was a delightful performance. All kinds of classic mishaps when you get a bunch of children together and put them on stage. But it was a big audience and the kids had so much fun. It was beautiful to witness. I wanted to burst into tears I was so moved by their happiness.

I worked very hard on my last couple of days, it felt great. I was feeling my absolute best since my arrival almost three weeks ago. Rather sad that I had been ill pretty much the whole time, I was relieved that I could at least feel strong for my final days. I managed to eat three meals on my last day, which was quite a feat. The best being the street food called the Kati Roll. It was prepared like the New York City Hot Dog stand I thought. You order the ingredients and they pack it all into greasy, recently fried bread, squirt some hot hot sauce inside and roll it up. It was cheap, fast, spicy, and fantastic. I loved it. I also ate cool peeled cucumbers and fresh soothing coconut milk right out of the coconut. It was really good to be able to eat a little, I felt like I could stay another three weeks now.

I made the most of this adventure I think. I had some lofty goals that I didn't manage, but I kept myself very busy at the dying home and the orphanage and supporting the children of the red light district at the end. And I can't forget all my efforts early on to talk with the OB nurses at the hospital and make my doula donation. I didn't see one birth or one death, but I learned a lot about both. I see plenty of both at home, and that's where I am needed now. My experience in India has been very powerful and wonderful, and someday I will go back, and do more. This was just a taste, but I did it; by myself and I feel very accomplished. I will never forget my India and what it has done for me. For that I am beyond grateful.

Now I am home, I will recover fully and be healthy again, and get back into my busy life here. I am happy to be back, but look forward to the next time I can escape and pretend to be a part of someone else's culture; it's good for my soul.

Thank you again for listening and sharing this with me, it's been a pleasure to share it with you and think of all the wonderful people I am lucky enough to have in my life.

Love to you all,
see you soon!!
J

You too can go to India with your insulin pump.

2009-01-24T14:46:00.000-08:00

The title for this post is a working book title from a dear Divabetic friend of mine who traveled to India and decided she wanted to compile a book of diabetic anecdotes, stories, and general hilariousness surrounding experiences with this often crappy, lifelong battle with disease.

Here are some of my stories:

"Hi!" my glucose meter says cheerfully to me, like we haven't seen each other in weeks and have been having a sensational substituted relationship with each other's voicemail boxes. Ok, my meter doesn't actually speak, but the technology cannot be that far off. And, sadly when my meter does say HI, it spells it wrong (high) and it means I have not been taking care of myself.

The above picture is me and my pod. My pod prefers it's formal name though: Insulet Corporation Omnipod, a new wireless insulin pump system that allows you to be catheter-tube-free and receive all the benefits of 24-hour access to your life-sustaining medications, and it's waterproof, swim and shower away my dears!

I like the nickname "pod" this comes in handy when you are wearing it on your abdomen and in Thailand receiving a $4 massage and the practitioner exclaims "what this!? Is ok?" and I reply "Oh that, it's my ipod, you know for music." There is really no where else to go with this conversation so the massage continues, discretely avoiding a generous perimeter around the pod, and quiet questioning exchanges from my masseuse to my friend's masseuse next to me. Meanwhile my friend is laughing and likely missing out on her own abdominal massage.

Two things: truly the ipod markets can't be that far off from invasively inserting the hordes with internal music devices that send wave signals though your interstitial fluid straight to your inner cochlea and with a simple twitch or click of the tongue you can fully adjust your playlist or volume! [By the way I now officially have a medical alert ipod shuffle that was inscribed by Forest: Jane Silver / Type 1 Diabetic, which was ridiculously sweet of him, and now as a healthcare professional I will always look to an unconscious person's ipod for medical information!] Second thing, the diabetic devices department of any pharmaceutical research company is ever on the lookout for the next absolute coolest way to manage every aspect of your diabetes. So much so, in fact, that is widely known that diabetes medicine and supplies tops the charts for pharmaceutical funding in the United States, which means one very flooring, very serious, very sad reality: there is no monetary incentive to work for the cure for diabetes when all this money can be made simply palliating the struggle.

I'd rather have a brand spanking new insulin producing system installed in my pancreas please! I love my pancreas, I do, goddess bless it for all that it does do, and for not petering out until I was 17, I still remember birthday cakes and halloween candy! I also take on the philosophy that diabetes can be truly fantastic for you if you let it. Counting calories is so 90's anyway, let's all count carbs together! And fiber and simple sugars and protein. Diabetes re-directs you every time to a healthier diet and lifestyle. I have recently taken on a triathlon-a-day exercise program for myself: hahah, well this means I run with my dog in the mornings, commute to class and clinical on my bike and swim laps at the university gym in the evenings. But hey, that is sooo good for me, and I love it. Endorphins are a gorgeous bonus too.

That's the word on me, my pod and the diabetes we share.

ps. and, yes, I am bringing back the fanny pack.

I caught my first baby today!

2009-01-17T00:37:00.000-08:00

Ok, now that the title has no doubt grabbed you--be forewarned that this post may indeed come across as a smidge gratuitous...

First things first, yes today I did catch a baby, my very first. Today my clinical nursing group had a lab for our OB studies. One station was "the birth" where a simulation mannequin births a sim-baby. Each patient has real pulses and can make real sounds, pretty cool nursy-techy stuff really. And, well among the group of us, someone had to be the baby-catcher. So there I was, and it was a little scary and very very exciting, even if everything was rubbery and bolted together.

Now, onto more thought-provoking matters of the vagina...

This glorious quote comes to mind: My Vagina Is Under-utilized.

A great friend said this to me one evening in Thailand, and later I experienced first hand what that might entail. In Bangkok there is an infamous event that is referred to as a Ping-Pong Show. Those who are proper, avid Tom Robbins' readers may be familiar--this was my source of course (Villa Incognito). But, as suspected this was certainly something to be seen to be believed. So I will leave out many a detail so that those interested may get the full experience for themselves one day. Though, as another dear friend said: Jane, I wouldn't go see a ping-pong show much like a wouldn't support zoos. Word.

What I do want to share with you all here is the amazingness that is the vagina. Apparently women (possibly only a select few) can extract a collection of razors, or open a glass Coke bottle, or indeed shoot ping-pong balls into a target (or sometimes the audience..) all with their vaginas! But I noticed something else, something very interesting among these women. The first couple of talented ladies had obvious Caesarean birth scars on their lower abdomens. I thought, oh no, I hope these ping-pong artists are not choosing a surgical birth for the sake of their demanding professions! The theory that your vagina never returns to normal after a vaginal birth is about to be further debunked with this rather unique example: as lo and behold the remainder of the vagicians had no surgical birth scars in combination with unequivocal evidence of a birth (stretchmarks and the post-delivery belly). I was so excited... that these women were using their vaginas to the utmost potential, taking on a great challenge and making a living off of their fantatic tissue integrity. It was a very rewarding ethnographical study to be sure.

There are no pictures to accompany this posting. Now that would be inappropriate.

Hmm, I think vagicians™ might be my new favorite word... I hereby coin it. Can I do that?

Yum!

2009-01-03T01:47:00.001-08:00

...ah the myriad culinary delights of the greater southeast asian circuit.

Collage

2009-01-03T00:37:00.001-08:00

starting out in bangkok

balinese bartender santa (hahah, these are way out of order)

brunei jetty to the jungle

indian santa in kuala lumpur. he told me santa was outsourcing.

butterfly garden in singapore

mobile phone ad in papua new guinea

this smiley man is holding a tiny baby wild boar (ready for eatin' ma is being handled by the guy with the arms)

guadalcanal in the solomons is doused in oil

a blond boy in honiara, solomon islands

aboriginal art in the making in darwin, outback

east timor chap selling cheap and delicious bananas

folks oozing out of a minibus in dili, east timor

proudly flying the gold star communist flag into hualong bay, vietnam

and a cheeky puppet face in the burma market

Lasting Impressions

2008-12-29T12:14:00.000-08:00

***check back in a week, photos to be posted***

This is my final day in Southeast Asia, after a full five months. I feel like I've truly done so much, that all I have on my agenda for today is to eat some street vendor pad thai and get a massage. Bangkok has grown on me to the point of becoming one of my favorite cities, first impressions do only terrible things for this city's reputation, but there's more beneath the touts, pollution, tuk-tuk traffic and all.

Wrapping up the excursion of a lifetime with pops I will recap our final week: From Hanoi, Vietnam we went to Yangon, Myanmar. Having visited the country under very different circumstances, namely for research into the plight of the persecuted refugee seekers, it was interesting to venture into the capital city. Guilt about spending any money in this dictator-administration made us pay close attention to the family run small guesthouses and Thai-based airlines. We have been told, and hold firm to this, that a little international exposure of what life outside this oppressive government can be like is good for the citizens of Myanmar/Burma/Bagan*.

*Myanmar is the name given by the corrupt genocidal government. Burma was the name of the country under British imperialism, locals have never referred to their country as Burma. So perhaps we should call it Bagan, the only original claim to unadulterated identity.

A small word on corruption: If you were to change money from USD to Myanmar Kyat at an official government run money changer the exchange rate would be 6:$1, however if you were to change on the illegal black market in the alleys of downtown you're looking at 1,150 Kyat to one US dollar. That is beyond ridiculous. And of course pity the fool who attempts to be official in this land and changes money "officially" they'll be spending nearly $200 for a cup a joe, that might cost 2500 Kyat. One dude who approached us with an itinerary for the day to all the sites and asked questions like, "what do you do for a living? What do you study in school? Are you staying in a big hotel or a guesthouse?" He told us he was the administrator official of something, and we quickly left him. Otherwise people were immensely friendly, invitations to homes flew at us, we were of course some of the only foreigners, and certainly two of the few actual tourists around.

Christmas Eve was spent in Kuala Lumpur, Malyasia. It was a riotous time of every Western holiday jumbled into one night (Santas everywhere, aerosol sprays to look like snow, red heart shaped confetti, roast turkey dinners at every restaurant, people in costumes: minnie mouses, reindeer, rabbits, crazy wigs, streamers and noise makers and partiers in the streets... truly a little of everything, pretty impressive for an Islamic Nation. The next morning we just missed our flight to Bali because I didn't realize it was an hour later time zone. Our only hiccup, and we were put on the next flight. Penalty: spending Christmas day in an airport.

We did make it back to Bali, beautiful beach weather, luscious gardens, ohmysoul fantastic food! And I got a moment to pop back to the clinic and give big hugs and kisses to my favorite midwives, Ibu Kadek and Ibu Agung Mas! It was a wonderful surprise reunion. Bali was good to us, as always. I can't wait to be back.

Lastly in Bangkok, and here I wrap up all. I will be back Monday night late. Looong flight awaits, and then snow and friends and family and classes and Godiva and American grocery stores and skiing and my own pillow (if Forest will send it back!) and so much more!

I can't speak Vietnamese

2008-12-24T23:43:00.000-08:00

I love Hanoi. I will absolutely venture back to this country. I had the absolute hardest time with the language, which has only further justified my need to return... someday. I have been very proud of myself for picking up a surprising handful of words and phrases, everywhere we go. But no matter how hard I tried, I could not convince anyone in Vietnam that I was attempting to speak in fact, their language.

Some of favorite moments were:

Dad approached by a classic shoe shine boy who leans in close and says "Very cheap, I shine your shoes, only one million dollars."

Marvelous pho, though vegetarian is rather unheard of, so I'm still very much looking forward to that cozy spot on the Ave back home, as well as of course the Taramind Tree on Jackson (the Little Saigon of Seattle.)

And my best vegetarian moment thus far in all my travels...
(Dad and I are planning a trip to Hu Long Bay which includes a meal.)

I say: I'm vegetarian.

Our booker says: OK, no problem, if you don't like the seafood you can have beef.

Me: Oh, but I'm vegetarian, I don't eat meat.

He: Oh, absolutely, no problem. If you don't like beef, we have chicken.

Me: I'm sorry, but I don't eat chicken, only vegetables.

He: Absolutely, we have everything, if you don't like chicken we have BEEF! (my emphasis)

There are many other reasons why I loved Vietnam, but for now here is my little snippet. Still without photographs*, but too bad!

Well, Happy Merry Christmas Eve to those out there practicing, and Happy Whatever-else to All, where ever you are. I cannot wait for snow in Seattle, despite what everyone says.

*These were added at a later date. Photographs of old propaganda posters, still ubiquitous.

The Rundown

2008-12-20T08:49:00.000-08:00

Brunei, not to be confused with Bahrain or Burundi (which is what dad's emailed itinerary said for a long time, and I thought, "wow we start out in sub-Saharan Africa eh?"), happens to be a tiny Islamic Nation on the island of Borneo, shared with Indonesian and Malaysian Borneo. On our flight there we were blessed by a reading over the PA system of the "Muslim Travel Prayer" which was translated into English on the screens. Oh Allah that he may deliver us in this vessel to other lands in his Great name, Praise Allah. Something like this, all in glorious Arabic monotone syllables trailing deeply at the end of each stanza. It is Federally prohibited by law to tamper with the smoke detector in the lavatories... or to eat pork. Once settled into the capital (which takes up a good portion of the country) Badar Seri Begawan, We promptly ventured into the jungles of Borneo. It was beautiful, a rain forest complete with steamy canopy of treetops. I've never seeped so much from my sebaceous glands in my life!

Our next stop required that we transit through Singapore (busy bustling city that we very nearly saw only through the metro system until we decided to visit the zoo where we saw beautiful enormous trees like I've never seen before and lush gardens, not to mention a stroll with the Dik-Diks and Zaboomafoo Lemurs) and on to Cairns, Australia for a slightly longer layover. Cairns, turns out, is prime Great Barrier Reef going, so we did. Yes indeed, I snorkeled yet again, and who wouldn't chuck their ictheaophobia to the surf at the old GBR? Dad did an introductory dive that in the end I wish I had done as well, but the experience was still amazing. Cerulean waters that can otherwise only be conjured with pallet-able acrylics. The fish were pretty freaky, but far enough away that I was not entirely threatened. One of our boat crew tried to point out a turtle and "inadvertently" chucked me overboard! He proceeded to entice me to swim around while he threw leftovers to the massive horrifying big ones with incisors, well, I did no such thing. Bizarre phobias like mine elicit everyone to attempt fish antics.

Port Moresby is notoriously one of the most dangerous cities around these days--so says guidebooks and everyone we met. Where do we sign? After a fitful rest full of terrifying nightmares shortly after we arrived, of people entering the hotel room and brandishing machetes and blowing up barricades, we ended up having loads of fun in Papua New Guinea. Fantastic folks, we never saw any machetes or rape or throat slitting that the area is known for. We were by far the only tourists, a few foreigners (Japanese and Australian) on business with oil, but no tourists. We met a coffee farmer, called Joe, who loves his half of the island (not caring so much for the Indonesian half) and showed us a great time.

From PNG we realized we were that close to the Solomon Islands, so why not? We paid a visit to Honiara, where again only NGOs and missionaries tend to tread. This was the spot where JFK washed up shore after his ship was torpedoed in WWII. Some of the Solomoners have amazingly contrasted dark skin with bright blond hair! Goes to show me (I can only speak for myself I suppose) how little of this world I can really know tucked away in our ethnocentric U.S. of A.

We had to return to Oz-tralia to the outback capital of Darwin, which despite my predisposed ideas, was nothing like cowboyland Montana. From there we took off to Dili, East Timor. Everyone kept asking if we were on the UN flight? Oh no, we said, we're on the earlier one, we'll make sure it's OK for them though. Dili was awesome. It was fun to try to speak a blend of Indonesian and Portuguese. We met several of the UN presence that were around every corner, and learned that they don't associate much with the locals, they (the UNers) seemed suspicious and pretentious. But I would definitely make my way back to Timor Leste someday. I'm also happy to have made it through the densest part of the disease-carrying mosquito territory for the trip (resistant malaria, hemorrhagic dengue, yellow fever, Japanese encephalitis, blah blah blah).

Back through Singapore and onto Bangkok we have recharged for the remainder of the ride. With two shiny new visas in hand and after having finally found the movie theater where you sit in luxurious lazy boys and are treated to massage chairs and complimentary drinks all for $15, we are ready to keep going.

It's been a whirlwind to say the least and once-in-a-lifetime to say the most!

Must Use Words

2008-12-15T19:59:00.000-08:00

I cannot yet post photos. I will at some point. But it makes me realize how much I rely on photography to capture moments and insights. Does a picture really tell a 1000 words, I feel like at least more words than I feel I can write (even I don't read really long blog postings.)

I think back on so many things I've seen that I did not capture (hahah, despite what many may think, I didn't spend the past 5 months behind a lens) Some of my favorite savored memories are the following (ones I wish I had a photo of, but will have to etch it into my memory instead): a gaggle of novice monks in Burma wearing vibrant orange all trying on faux gold Rolex watches, jostling each other, enjoying a taste of materialism. A well balanced toddler, maybe 3 or 4 riding a bicycle that was built for an adult, straddling the lowest bar, tippie-toe on the pedals and barely reaching the bottom of the handle bars to steer.

Ok, now let's see if I can describe the past two weeks and the six countries I have visited while whirlwind traveling with my dad...

***shoot! Ran out of time, hahahah, will post again soon!***

Heaviness

2008-11-30T08:25:00.000-08:00

Dear all,

The above photo gallery goes like this: Village Spirit Man and grandson, Dorothy's ruby slippers in the hills of Northern Thailand, 85 year old traditional Lahu midwife, Three photographs of watercolor paintings from a book I bought depicting the illegal refuge seeking journey of the Karen people escaping Burma, A small girl crossing the road in a "floating village" in Cambodia, Myself with some new friends (one 5 months pregnant with the first of probably 7 children she said), and a somber face of Angkor Wot.

Since last posting I have been in a bit of a whirlwind of tragedy.

It all began very sweetly with a farewell to Forest, and then the entire group ventured off on our "educational trek." To the surrounding hills of Chiang Mai to spend some time with the hill tribe communities in northern Thailand. We were received with incredible hospitality in the home of the spirit man from the Lahu tribe. You can see him photographed wearing his toddler grandson on his back. We had a beautiful time even though I couldn't stop thinking about the difference between Thailand's Native communitites and North America's as far as brutality, oppression, and genocide. This kind of cultural observation tourism rightfully would never happen in the States--leaving me rather uncomfortable in this setting. Then, I returned Chiang Mai to devastating news from home.

With so little time to comprehend it all, I had to leave almost immediately for our site visit to the border town of Mae Sot. Kimberlee and I were conducting our research into the healthcare system disparities facing displaced persons escaping political turmoil and persecution in Burma. The currupt military Junta has been striving for massive ethnic cleansing and genocide since the 60s.

We visited a grass roots healthcare clinic that was started by a physician from Burma who escaped in order to help others in their plight for refuge. We also were invited to visit the medical director of the nearby refugee camp. Although we had previously attempted to gain official government documentation in order to enter the camp and were in constant contact with the Ministry of Interior, time was not on our side. We thought it was a lost cause. When we met with a French NGO working with the camp (AMI) we were told that it would be possible--if we were willing to follow specific instructions. Up for the challenge we were told to hop on a pick up truck heading to the next town (7 hours from Mae Sot), and to tell anyone who asks, that's where we were heading. We were to pass a police check point, followed by an army check point (if we passed another army check point we missed it). We would start to see a fence, sometimes bamboo, sometimes barbed wire. Wait to get off the truck until you see the end of the 4 km fenced off camp. Walk around until you see a hole or bent part of the fence and just walk through. Yikes!

Well we did so, but not before witnessing two women and their small toddlers get plucked off the truck at the army point because they didn't have identification. We were told that sometimes these patrollings result in imprisonment, and sometimes people are made to clean the army barracks and then are allowed to continue on. This was difficult for us to observe, women attempting to bring bags of rice and fresh vegetables to the camp for their families and roughly ordered off the vehicle by the same officers who smiled at the two of us, like this was a perfectly normal thing a tourist like us would see.

Inside the camp we wandered through slippery muddy narrow walk ways on precarious hills in the two feet alotted between some homes. Homes were bamboo thatch, but poorly-made, cramped and populated. We started asking for "hospital?" and a Karen woman called Rebecca left her cooking to walk us there. We met the medical director of the camp's main hospital and interviewed him for our project and received a tour of the stark concrete and tent structure, housing patients with Tb, cholera, psychosis, and run-of-the-mill myriad other illnesses including an entire unit dedicated to diarrhea. Apparently there was also an avian influenzae outbreak at the next camp north. We were incredibly moved by the dedication, determination and optimism of this man and the plight of his community; displaced, illegal, without access to sustainable resources and living in despair, many for nearly 20 years now. When we asked him what were his un-met needs, he told us they could really use stretchers to collect the patients.

I could go on forever about this single experience; one of the most profound moments of my life.

Back in Chiang Mai I presented another project on schizophrenia and then turned right around again to head to Cambodia for the extended Thanksgiving holiday. It wasn't until we'd arrived by train to Bangkok that we learned there had been a bomb at the airport. The anti-government protestors, who have been working hard at gaining some justice in their corrupt society for over 6 months, staged what was to be a very difficult and terrifying finale to the politic unrest here in Thailand. [I could go on and on, but let me get back to Cambodia.]

We travelled by land across the border into the far more corrupt, Communist government of Cambodia. We made it to Siem Reap, home of the ancient Buddhist ruins of Angkor Wat. We spent our few days surrounded by the beauty of the temples and the incredible humor and laughter of the Cambodians (all of whom are our dear friends now) while at the same time we took in all we could about the horrifying recent history of Pol Pot and the tortuous, insane massacres of nearly a 1/3 of the population by the Khmer Rouge.

Somehow we made it back to Chiang Mai (actually via a 15-hour freezing open air train, I'm just trying to block that out of my memory) in time to give our final culminating project on the story of the Burmese Refugees. Other group projects included child sex traffiking, methamphetamine abuse, and HIV/AIDS. Happy World AIDS day December 1st.

Now it is all over, even annoyed travellers can get to their beach getaway again. These are my final hours in my sweet Chiang Mai, tomorrow I make my way to find Dad. He has somehow also made it to Thailand afterall and together we take off to greater Southeast Asia until sometime around the holidays.

I'm sure I will let you know all about it.

Ps: At least I've plowed through some "uplifting" reading material lately: A Thousand Splendid Suns (rape, war and oppression in Afghanistan), A Child Called It (one of the worst ever recorded cases of child abuse), First, They Killed My Father (Genocide in the Khmer Rouge) and next up: A Long Way Gone (Child soldiers in war-stricken Africa), oh and Sophie's Choice.

***

My heart goes out to Nick Belles and his family & friends

To the people of Thailand right now as they hope/fight for justice, unity and peace

To the situation in Burma, and may refugees rights be formally recognized in Thailand

To the survivors of the Cambodian Khmer Rouge, may you continue smiling and living fully

***

In memory of Leslie Green

Suay Siam Part Deuce

2008-11-10T21:25:00.000-08:00

A rare experience both enchanting and excrutiating, here in Thailand. My mixed emotions were curtailed by the beauty of these magnificent cats.

Suay Siam

2008-11-10T17:29:00.000-08:00

Beautiful Thailand...

The festival of lights is this week in Chiang Mai. The fire latern evening was probably the most beautiful thing I've ever seen.

Yes We Can

2008-11-04T21:35:00.000-08:00

For the first time in my small life, I am proud to be an American.

I am patriotic. I do love my country. I love my President elect.

I will never forget where I was when my country made history... in a tiny computer study room full of fellow American students, at the moment displaced, but bonding like we never knew we could. Tears, and sweat in the heat of the day in Northern Thailand, as the American people and our Obama, made me proud.

Ohmysoul! VOTE!

2008-11-04T01:36:00.002-08:00

There is such a thing as nursing student syndrome, a form of hypochondria.

Today in class we studied anxiety disorders and panic attacks.

So now I believe I am currently having a panic attack....

VOTE for you country! VOTE for your future! VOTE for your rights! VOTE for Obama!

Otherwise I may experience quite a serious nervous breakdown here in Thailand. This PTSD stems from the 2004 elections where I vehemently threatened to disown my American citizenship if Bush were re-elected, and then shamefully went back on my word when I researched and discovered that Canadian nurses didn't enjoy as many of the great privileges American nursing education offered. So here I am having flashbacks, please help me out and VOTE!

Poppies & Globalization

2008-10-31T03:55:00.000-07:00

I like my cuppa tea now and then, but whoa...

So when the Dutch Empire began exporting goods from Asia, namely "exotic" teas from Darjeeling, India (where it had been used therapeutically for while already) back to Queen Victoria of England, there began an amazing story of poppies and globalization. Vicky's desires for tea quickly became trend and soon all of England was tea crazed. Tea was determined to be best consumed in porcelain, so thus began the rise in porcelain production--a minor note, but interesting. Of course, tea was significantly improved with a bit of sugar to enhance it's bitter flavor. Thus began the need to also create and export sugar. Thus began the slave trade to sugar plantations in the Americas (here's one more reason for me to boycott sugar... as if being diabetic wasn't enough) Tea was also implicated in the American Revolution, due to it's culpricity in the Boston Tea Party.

Ok, so fascinating chain of events, but stay with me here...

Meanwhile in, for the most part, unexploited lands of native communities in Asia, such as the Golden Triangle (where Burma, Lao and Thailand meet in the north), Turkey and Afghanistan, poppy fields were being harvested as usual for therapeutic and medicinal purposes (easing pain mostly.)

The East Indian Trading Company began to sell opium in order to pay it's tea expenses. Conflict quickly arose between commercially powerful Britain and opium controlling China. Thus began the opium wars. These wars ended when Britain forced unequal treaties upon China which left China with incredibly restricted export regulations and they had to fork over Hong Kong with a cherry on top for the subsequent 155 years to British occupation. China, depleted not only by Britain, but also by opium--economically and physically as so many of the population were addicted and severely ill (1 in 30.) China had a revolution, which lead to the modern Chinese power. China desperately wanted to stop opium traffiking because of the extensive damage.

The opium trading restrictions simply lead to a rise in sales and use/abuse in Siam (now Thailand) and its imports to the west. Thais were imposed by an unlimiting importation of opium. Later the American CIA covertly endorsed opium production in Thailand (specifically the area of the "Golden Triangle") the intention was to compete with and defeat opium efforts in Communist China, the American enemy. CIA endorsement of opium production was underway in Afghanistan as well, to fund and supply weapons to the Afghan people as allies to the American enemy, Communist Russia. In Afghanistan these efforts lead to its neighboring consumers, Pakistan, currently becoming one of the highest density populations of Heroin addiction in the world.

Incidentally, opium is made for consumption by boiling the raw material from poppies to eliminate impurities, it is then reduced to a thick and beautiful molasses-esque batter. So intense in fact that critter-passers-by keel over dead simply due to the toxic fumes. Not just weak tiny bug respiratory systems, but big critters.. die. Anyway, the development of the more common powdered heroin substance came to be because of the ease of transport, particularly to America, where it was purchased from various mafia cohorts and sold with additives for bulking (powdered sugar or various other, often rather dangerous, substances.) This powder is typically snorted, boiled with water and injected, or boiled all the way to its original form and smoked.

Now, back to the impacts of mass, unregulated production of opium; in Thailand opium was so widely available that the degrees of addiction warranted grand intervention by the present royal family. The beloved King of Thailand made great strides in the illegalization and banishment of recreational opium, but because addiction is, well, addictive, a new drug simply took the lead. Methamphetamine, in Thai: Ya Ba (meaning insane medicine) became the drug of choice, particularly for Thai youth. Now public health measures are making a big difference in its rates of abuse and rehabilitation... and now alcoholism is on the rise.

Unfortunately, I'm sure, this will not be The End of the amazing story of poppies and globalization.

This has been a public service announcement from your friendly global nursing student. Thank you for listening!

Vast flood of information credited to the Hall of Opium in the "Golden Triangle" Chiang Rai province of Northern Thailand. Photo courtesy of google images.

Muay Thai Boxing is like Tap Dancing Recitals

2008-10-27T10:20:00.000-07:00

It's an art. It's practiced, by generations, and entire families, in anticipation of a big performance. And yes, sometimes people get hurt. Ok, maybe not like the tap dance recitals that moi particiapted in per se.

Kai, in Thai, means "Chicken"

2008-10-27T10:12:00.000-07:00

So it was rather appropriate, when we were leaving the cooking farm, to have Kai say "that's my face" as we passed a chicken farm on the side of the little dirt road in random outskirts Chiang Mai.

Peace Love & Mango Sticky Rice

2008-10-27T09:43:00.000-07:00

Internal happiness is like dirty laundry, advises our organic farm Thai cooking instructor--already I feel like I'm going to be able to relate to this... "if you have a dirty shirt, you can't get it clean by adding clean shirts to it, it will just get everything else dirty. You must wash your shirt, wash, by hand, all the dirt off, and beneath will be what was there all along, your clean shirt!"

Roughly, but rather poetically, this means that happiness cannot be purchased with material things and wants and desires. Happiness is in there, and if it's not readily available to you, work on that a little, and soon enough, you'll find it.

Hmm, this reminds me of a joke:

What did the Dalai Lama say to the hot dog vendor?

"Make me one with everything!"

What did the hot dog vendor say to the Dalai Lama?

"That'll be two bucks."

The Dalai Lama hands the man a five, and waits.

...and waits, and says to the vendor "where's my change?"

And the man says to the Dalai Lama: "Change comes from within."

ps. Thank you to mom for so many rad opportunities together in Thailand on your visit, we did so much, and had a beautiful time--all three generations. I feel very lucky and truly happy--no need to wash any dirt off this happiness.

pps. Happy 57th wedding anniversary G & P and happy 75th birthday grammy!

Yum, I Love Pai.

2008-10-20T11:08:00.001-07:00

Sawatdii Krap, followed by a flirty whistle is how we are greeted in Pai by the pretty talking bird at the gate of our beautiful bungalow. Pai is charming, it's a quiet and quaint mountain town four hours north of Chiang Mai [not an easy few hours mind you, thank goodness for ginger supplements, but it was well worth the wooziness!]

We cruised around the hills on a little motorbike for a few days, taking it all in... natural hot springs parks, a bare-back elephant jaunt, organic riverside restaurants and lounges, traditional Thai massage and medicinal herb saunas... it was soo delicious. We had a beautiful time.

Now, I am back to classes, and Forest has taken off again to meet Mike and head into Laos.

Obama and Palin and Penis Envy

2008-10-12T10:29:00.000-07:00

I can now count to 999,999 in Thai*. I should ask someone how to say a million, then get someone to challenge me, like kindergarteners... but alas, I am doing more important things with my time, such as discovering the best way to simultaneously spend one hour of my life plus six dollars. My body type was made for Thai massage; fairly bendable, happy to be popped and cracked and layered just enough so the pain is good pain, for example, when your masseuse curls into a ball and rolls onto her back while holding your arms over her head and walking her knees into your back as your bum lifts off the ground. Très acrobatic.

This weekend I jaunted off to see mom and grammy in Krabi, on the southern peninsula of Thailand, west coast, Andaman Sea. It was über fun. Mom and I even took Gram out for a 3 person kayak trip (she was our queen in the middle, sans oars.) Turns out my camera isn't of the underwater variety--thankfully my pictures were salvaged and people seem to be hopeful that it can be nursed back to life; "it happens everyday" the locals kindly reassure.

For clinical this past week we visited the local Planned Parenthood for our community health course. Again massage and acupuncture are widely used modalities, just like at prison, the drug addiction treatment center and the child development hospital too. We were at one point shared the information that STI prevention and education is being done in outreach settings in rural Thailand. Apparently it's tricky because the condoms don't fit. We were told they are too small for Thai people and too big for the Hill Tribe communities. To which I promptly asked if that was an actual valid statement based on a documented report of clinical testing, or if it was a massive general assumption possibly based on institutionalized racism? This was very much lost in translation. I reserve my suspicions. Later we were shown the condoms, as our curiosity was not lost on our presenter. What was most unique about these was the expiration date, 2555! Wow, that's some serious preservative (melamine?) This is when we learned a great new fact about Thai culture; the calendar is, of course, based on Buddhism. Buddha was born 543 years before J.C., so there you go: normal preservative (I suppose it could still be melamine), presently it is the year 2551 in all Buddhist countries and the size-discrepancy is still to be investigated.... but I probably just won't have the time. However, my offense at the likely affront on the phallusism of it all shall remain.

Unrelated, though it makes for a good title, I now segue into politics--a previously indirectly mentioned topic in this space. Namely, I am having a heck of a time being so removed from much of the goings on, but I am equally relishing in the stark absence of those awful televised party bashings that many of you back home are no doubt inescapably being inundated. I am by no means out of touch completely. The class has convened at one of the professor's apartments for every debate thus far, even if it meant shifting her own theory class for it. I also have the internet. So I have replayed many times the glorious Palin interviews. And just a word here, if I may, "because she's so pretty." is not an answer to: "Why do you support Sarah Palin as a VP hopeful?" Source: BBC.

A lot of things are pretty; Miss America is probably really pretty, I think male peacocks are pretty, and stained glass windows. But I don't think these would make very good options for president (McCain is a septegenerarian, and probably a really stressed out one too.) Now, I'm not saying pretty equates with stupid or inept, not at all. Case in point: my model friend Kaiulani, if you're lucky enough to know her. I'm only saying that Americans (you know the "hockey moms" and I believe Palin also used the phrase "Joe Beer Belly,") cannot use "pretty" or even drop-dead gorgeous for that matter, as a criterion for choosing to sway McPalin. Or maybe I should just say what I really feel here... I heart Barack! He would beat Palin in a poltical beauty contest any day of the week, Obama, you're beautiful.

*Incidentally 999,999 goes like this: Gǎao s33n gǎao muun gǎao pan gǎao rćcy gǎao sìb gǎao!

Chiang Mai Living

2008-10-04T02:50:00.000-07:00

Sawatdii Ká!

Kun chūū arai ká?

Mai chūū? Mai bpen rai ká!

We have been learning Thai, it's fabulous. Last week we were given Thai names. Most Thai folks have long multi-syllabic elaborate names, and most tend to go by nicknames such as; "cup", "the verb to grind a large mortar and pestle", or funny sounds, or even, "pig". So we had a lot of fun acquiring Thai nicknames in class. Incidentally I am Jǔm, which is a fun sound.

In other courses: our first psych clinical is Monday, we will be visiting the Chiang Mai Child Development and Drug Addiction Treatment center. I’m looking forward to learning how mental health is viewed by the Thai community, if there is more or less stigma/acceptance/understanding than I imagine there is at home, or from my only previous mental health experience working in England as an auxiliary nurse in a mother-baby mental health hospital. We are also taking community health nursing courses, and our first clinical was to explore a given neighborhood and perform a community health assessment from our observations. My group and I chose the area around the Women’s Correctional Prison. It was fascinating, perhaps we can arrange a visit inside the prison at a later date, but we did receive massages from former inmates who are taught massage in prison so that they may have access to a sustainable occupation when they are released. Eighty five percent of the incarcerated women were there for methamphetamine use. My masseuse volunteered that she used to sell cocaine... sort of, here is how that came about:

My friend Kimberlee said: "How was your experience in prison?"

Massage practitioner: "What do you mean?"

Kimberlee: "What did you do... [trailing off "there in prison?"]

Masseuse: "[Interrupting her] Ah, cocaine."

Kimberlee: "Oh, cooking?"

Masseuse: "I sell."

Kimberlee: "sewing?"

Jane: "She just told us she was imprisoned for selling cocaine."

***

We're staying in the faculty nursing dorms on campus at CMU and my end of the hall is full of international masters and PhD students in the nursing department; from China, Lao, and Vietnam. It's very fun, especially cooking together in the kitchen. I have been recruited for English grammar assistance on a regular basis, just the other night I edited a 20 page excerpt from a PhD students thesis on job satisfaction in nursing. It was a huge editing project. I am certainly going to be busy with homework while studying in Thailand... just not my own!

We had our first field trip as a group this weekend as well. We have been seeing lots of great nooks and crannies of this amazing northern town. The photos above are from the trip to Doi Suthep, a marvelous temple with 306 steep steps, already high up in the mountains—it was beautifully misty, as well as the elephant reserve, where we cuddled sweet elephants and fed them sugar cane and bananas.

Life here is wonderful, and my mom and grandmother just arrived in Bangkok! Welcome to Thailand!

***

Jane Silver

Faculty Nursing Dormitory 3

Chiang Mai University

110 Inthawaroros Road

Sriphum District Muang

Chiang Mai, Thailand 50200

Mobile #:

[from the US] 011 66 853 404 155

[from within Thailand] 0853 404 155

Crazy Royal Thainess

2008-09-27T09:45:00.001-07:00

This is crazy-beautiful Thailand. Bangkok is glorious and ridiculous. I had a great time! But I am happy to be settling into slower and routinized life in the north, in Chaing Mai.

In the 'Kok we toured many o' wat, pictured above are shots from Wat Pho; the hugely impressive reclining Buddha, as well as the Grand Palace; home of the exquisite solid jade Buddha. Wats [temples] are decked out with gold colored glass and foil that cover absolutely as much as possible, and then everything else is rendered in colored glass pieces. It's all very shiny and pretty. Tre different from the ubiquitous offerings in Bali. Though hand woven grass offering boxes and fresh flowers and whatever goods were available were very beautiful (my favorite offering was the Mars bar and frangipani!) I came to find them a reminder of the oppression of women. Everyday women sit and make these beautiful offerings, and everyday the old ones are tossed to the gutter and new ones are laid. Perpetual, tedious work, that only women can do. Truly, I also only ever saw women steadily stacking cinder blocks on their heads for roadside construction--while men were "tinkering" with motorbike repairs.

***

The last picture up there is a few fellow nursing students and I practicing first aid safety for a venomous snake bite at the snake farm in Bangkok. Thailand has loads of these guys. The videos reminded us of Patty and Susanna's pathophys class from last year--ah... the coagulation cascade. We also observed a venom extraction up close and personal. They get these poisonous dudes to bite a rubber capped jar to elicit and collect their venom and this is then injected into a horse at the nearby Red Cross Snake Farm/Horse Ranch. Horses metabolize the small amount of venom and make antibodies to it, they then "donate" their blood for the purposes of sequestering the antibody-rich plasma. It's prepared so that it can be administered as an anti-venom serum as the antidote to scary neurotoxins that slowly and miserably kill you when you get bit by one of these cuddly creatures. Pretty rad.

Also up there in those pics, is Kai! Kaiulani, my darling, thank you for your fabulous Thai hospitality, for living in Bangkok while I'm here, and for working it like you do.

Feeling very lucky for all there is to be enjoyed here at the moment.

Back from the Beach

2008-09-22T16:03:00.000-07:00

After a little respite on the beaches of a few islands off of Southern Thailand, Forest, Mike and I are back in Bangkok.

Photos here are of 1) a shelf of ciggies. FINALLY appropriately labeled! Can you see the cover art? 2) Mike Dow and a puppy. The Thai dogs are by far lovelier and friendlier and way more chill then the Bali dogs--though not less dirty. And 3) our bungalow in quiet Koh Pangnang in the north of the island, pretty much the whole place to ourselves... and I went snorkeling-yikes! It was pretty cool.

Now we are moments away from meeting up with Kaiulani in bustling Bangkok, and tomorrow I start school. Sure beats the day before a new year of classes starts in Seattle. Though I do miss the fall.

love, peace & curry

At Peace

2008-09-14T23:20:00.000-07:00

The above glorious photo of a pregnant angel is from a temple in Brasilia, Brazil. My good friend Elizabeth just sent this to me. She has been living and working there all summer.

Me, I am leaving Bali in a few days and will move on to Thailand for the rest of the year, then Elizabeth will find herself in Costa Rica, also for nursing. It amazes me the things we are doing, all around the world.

I have met amazing people here, who do so much, it all touches me greatly. It's an honor to be here, to have met each and every one.

I do love Bali, and I will be back.

...Forest arrives in 2 days!!!

ciao

Politicized Birth... and yes, the Ocean.

2008-09-08T05:20:00.001-07:00

So I've traded the lulling sounds of the ocean waves, breezes and the chiming of wooden carvings for the barking dogs of "home" at the birth center again. I spent some time in Lovina and swam in the hot spings, then to Amed where I went a smidge crispy on the beach and finally to Tirta Gangga a hillside village on Mount Agung with misty rice paddies out my front door and nighttime fireflies! I had a gorgeous time, but was looking forward to coming back.

***

Birthing in Bali is just as political as anywhere else in the world I suppose.

Medical care is not available or subsidized by the government, it's all out of pocket. To the point where cars speed up and pass someone on the street who has just been hit and is now in a bad motorbike accident. People won't stop and help, no one comes to take the injured to the hospital because then they would be expected to pay for the hospital bill!

For births, there are many small clinics around the island that offer "low-cost" maternity care, which is an option for those who cannot afford the hospital. In hospital, a cesarean birth may cost 5 million rupiah, or roughly $500. This is a ridiculously high price for the majority of the Balinese. Here's the catch: If you cannot pay your medical bill after birthing in hospital, you do not get to bring your baby home until you do settle that debt.

The birth center here is free, and safe and good. But you know, after a few days away, I've been really thinking about the births here. And they are not so gentle sometimes. Maybe they are still better than a hospital where they can keep your baby for ransom, but there are so many things that could be made gentler here. There are a lot of postpartum bleeds--near hemorrhage--and part of it may be the aggressiveness in which the bidans anticipate and worry about the potential for a bleed and therefore are overzealous with the oxytocin injections, cord tugging, and manual extractions. I've seen things here that I have never seen at home. My first bleeds, my first atonic babies, my first fainting in labor, my first neonatal resuscitation. I don't see this in the hospital, at homebirths or at birth centers back home. It makes it really hard and scary to think about families telling the midwives to do anything they can to keep them here at the clinic when things are going badly, because they would rather bring a baby kept alive only by epinephrine to the hospital where it will be allowed to die rather than cope with the debt that befalls the whole village if they transferred for a cesar. This of course is not the case for everyone, not even close, but apparently it does happen. The family who had the one cesarean we've had here in the past 5 weeks told me that their neighbor, an ex-pat from New Zealand, paid their hospital charges.

Maybe this post should be titled: How being a doula in Bali cannot change the political atmosphere of birthing and health care administration, or even ease the fear-based practices of the midwives who work under pressure of policy and protocol.

Little lady born September 2

2008-09-02T06:26:00.000-07:00

...and in the middle of the night (but not quite at midnight.)

It was a quick second time mom though, and so I didn't get called to the birth.

That babe is not pictured here, this is a lassie whose parents and I bonded. Birth brings people together (at least in places where support is--well... supported), sharing this is a beautiful treasure and honor.

***

I'm just posting a little note here to say that I am actually heading to the coast to see the ocean today. I'm really looking forward to it, and was worried that I wasn't ever going to sneak away from this place if I didn't just do it.

So I Have Shingles

2008-08-27T22:04:00.000-07:00

Yep, I have developed shingles. Apparently it's rather uncommon for an otherwise healthy young adult to acquire this post-chicken-pox disease that normally occurs in late adulthood. Hopeully this means I will continue to have a mild case. It can crop up from stress, of course. So here's what happened; I was at my acupunture visit and I was telling Bobbi that I had had a rough day two days before when a couple had to transfer to the hospital and ended up with a "Caesar" as they call them here. This is my first transfer experience as a doula. The following day I was part of four births, three of which were pretty dramatic. Later on in our visit I mentioned that I noticed a few "spider bites" on my abdomen about two days before. She pauses and says "really? Two days ago?"

So the ensuing week turned my spider bites into full fledged shingles along the dermatome (nerve root) in the middle of my abdomen from midline to spine on my right side. Only last night did I wince and swear with every tiny movement. It's incredible shooting, sharp and numbing nerve pain. The natural course of it is 2-3 weeks, so I'm about halfway. I will hit an infectious stage here soon, but it's short lived and only causes chicken pox in someone who has never had it, even then it's direct contact contraction. Also there are no symptoms of malaise or fever, so really it's only this bizarre nerve pain. It can turn into chronic neuralgia in a few cases, but it's not likely, and once you get it it's very rare to get shingles even one more time. So I feel like my research of it has given me an assuredly positive prognosis actually.

The clinic is pretty quiet this week too, another holiday is in the making, so we'll see about next week. I plan to still sequester myself during my active phase of the shingles. Maybe another photography excursion to the rice paddies, or maybe to a quiet beach town. Seems to me like a great way to be going through something like this I suppose.

The Midwoof

2008-08-23T00:45:00.000-07:00

There are angry mangy dogs everywhere in Bali, and organizations called “I *heart* Bali Dogs” try and save them from their potential miserable lives. But I’ve decided I don’t love the dogs, or the monkeys who try to steel everything from you; cameras, food, sunglasses, I’ve heard about them picking up burning cigarette butts and put the wrong end in their mouths. But they chase, and bite and hiss, they are nasty. They live in the Monkey Forest Sanctuary which I walk through if I need to get to town from the village I’m staying in: Nyuh Kuning village which means “yellow coconut."

There is one dog who has decided for some reason that he needs to walk me from the clinic to the ashram if it’s during the night after a birth. I just learned that his name is Highway, and he’s considered the “midwoof” of Bumi Sehat. Ah, I love it.

***

This week there was a grand ceremony holiday called Galungan, and it's been described as the Hindu Christmas, meaning it's probably the biggest holiday of the year. It's mainly for the children and each family compound spends days building and creating a beautiful and uniquely decorated HUGE branch from the forest and sticks it upright in the ground with dyed palm strands and lanterns and flags and amazing floral and fruit arrangements hanging all over it. You can see in the photo of the street (from in front of the clinic) that it's lined with these overarching "Christmas trees." The kids eat a ton of sweets, traditional Balinese meals are made, and family's spend money they don't have to put it all on. I've been told that bellies, cupboards, and health tend to go without for a few days before and after in order to make it work financially.

What was very striking to me was that the clinic was very busy the day before the holiday, chock full of primips (first-timers) in very early labor and multips (not first-timers) who were drinking lots of young coconut water in an attempt to get labors going. There were 8 babies born the day before the big day. Then... nothing. Then a flood of births came on the day following the holiday! I think that's hilarious. It's been amazing, but exhausting. The number of volunteers has also dwindled, so my own workload has picked up. I'm doing a lot more clinical tasks than on top of the labor support, which is very good for keeping up my nursing skills, it's been great. And, I consider this kind of thing a bonus or perk to this job, I saw a baby born in the caul for the first time. This happens when the membrane of amniotic fluid never rupture during labor, and labor progresses fine without the need to have it ruptured which is soooo common to have done. So the baby is actually birthed still in the sac--face all smooshed up. It's imperative to break the sac at that point but it is considered very spiritually lucky, in many cultures. It was exciting for me.

***

Also posted is a photo of Robin Lim and her daughter Déjà. We were privleged to see the very first unofficial "premier" of Déjà's new documentary Guerilla Midwife. The film is about Robin and her incredible life's work to bring peace on earth with every gentle birth. She and her organization did a lot for the Tsunami victims in Aceh on Sumatra, the stories in the film told by survivors are horrendous and beautiful. I can't wait till the film is available for everyone, it's a "must-see."

You Can Only Get Hit By the Truck That You Don’t See Coming

2008-08-17T10:56:00.000-07:00

I love attending births on other people's birthdays... it feels like I'm honoring that person. So here's to Sara Sage!

This morning I got called into the clinic to assist a labor for a woman already at 7 centimeters dilation. After three hours of back-labor progressing into a resistant second stage there was another full moon baby at Bumi Sehat. My predictions of raining babies this weekend definitely came true after a relatively quiet week. Afternoon rolled along and I was actually going to make the appointment I'd made the evening before to get my first massage here. It was a new place highly recommended by the staff at the clinic, and this month there is a grand opening 50% discount. So I went for some therapeutic pampering. And it was. I received an hour and forty-five minute massage and body scrub of rice, ginger, peanuts, oil and potato and then finishing with a bath in the first warm water I've felt (I shower under a hose of icy cold water at the ashram!) not to mention the bath was dense with frangipani buds and ginger bark. The whole experience was incredible, and it cost $7. I stopped in at the clinic on my way back and we have two primips (first-time moms) here both at 1 centimeter, and they are sisters-in-law! It's going to be a long night--good thing I feel completely mushed yet rejuvenated.

Take care of yourself, pay attention to the signs your body gives you and really listen and then don’t forget to respond. Namely; slow down and you might live a longer life--literally (hence the title of this entry.) This is reiterated to me by Dr. Bobbi, the acupuncturist at the clinic. I am going to be getting my first treatment by her this week. I have always recommended acupuncture for folks for a lot of ailments—but I have never had it! When I was freshly diagnosed with diabetes, almost nine years ago now, I was told that there was an acupuncturist who was curing newly diagnosed diabetics. I remember that my mom actually spoke with this person, and he wanted me to immediately stop taking any insulin therapy, and that I should come and stay wherever he was practicing for a proper healing, unfortunately that would mean leaving in the middle of my junior year of high school. It was not practical. So here I am years--and loads of insulin--later, finally about to receive my first treatment. I’m hoping for some boost in the circulation department, possibly a recharge of my energy overall, and any kind of kick in the pants on the old pancreas that I can get!

Speaking of health and diabetes: I have noticed a few wonderful perks to this already pretty fantastic experience. I walk everywhere like the poorer Balinese (i.e. no Motorbike) and I eat like the ex-pats (trendy macrobiotic health cafés) and so far I have been enjoying a steady stream of blood glucose levels right around 130. I’m very pleased with this. And, though unrelated, I’m also very happy to notice that my usually miserable cuticles are very healthy looking, which is helping me to grow fingernails (which for me and my nasty nail biting habit is a really big deal!)

So, my body and my soul are very happy here.

Meet some families

2008-08-17T09:12:00.000-07:00

A few photos of some beloved families from the clinic.

I've been working mostly with families coming in from the "fields" as they say here, with very very little, still almost everyone has a mobile phone. To announce a few generalizations here: almost every woman has experienced a pretty decent tear, the theory here is that folks are very malnourished because of an increase in white rice production thus decreasing tissue integrity. Also there are occasionally sad faces with a family having just birthed another daughter. But there are wonderful things too: dads are very involved in labor; cooing, massaging, and perpetually smiling. Also I never know what any of the babies' names are before they leave here because there is typically a three-day naming ceremony, which sounds very fun--so I have to wait for a postnatal visit to learn all these newest little folks' names.

Contact Information and the Dirty Duck Diner

2008-08-11T20:04:00.000-07:00

I eat gado gado everyday. My first dish was at the local Dirty Duck Diner a favorite restaurant from when I was here last with the girls in 2001. Apparently it was named for its first guests; before it was completed, a flock of ducks ran through the restaurant to the rice paddies out back and left their muddy tracks! Gado gado is a dish of sprouted grains, kale, bok choy, carrots, green beans, tofu, colorful chilis and a liberal amount of peanut sauce. It’s even better than it sounds! This meal was accompanied by a blended fresh watermelon, ginger and mint leaf drink [Raederle, Kaiulani, Corinne & Lynette, it was even better than I remembered; you have no idea how much I wish you were all here again with me!]

At the center, if not at a birth, I have been assisting in the clinic. There are prenatal visits, acupuncture, moxabustion, cupping, massage and reiki [Grammy I am doing lots of wonderful and energy rich reiki here, thank you!] and they do a pediatric clinic on Mondays. Kids with cerebral palsy can get routine acupuncture and there have been numerous improvements on body movement and stabilization of nerves apparently.

***

I can be reached by mail via the clinic at:

JANE SILVER

c/o Yayasan Bumi Sehat

Nyuh Kuning Village PO Box 116

Ubud, Bali 80571 Indonesia

and I now have a phone from the clinic to be on-call, it's free to receive calls, so if you're inclined... Forest...

0 62* 81 353 01 2276

*please note the change!

Nafas... santai... bagus.

2008-08-10T06:21:00.000-07:00

Breathe... relax.... good.

Bali is exquisite.

I arrived late afternoon on Friday 8/8/8 after 24 hours of traveling. Robin Lim met me at the clinic gate with kisses. This is her baby (well, one of many I suppose), but her Yayasan Bumi Sehat clinic means Healthy Mother Earth. At the clinic there are 8 local Indonesian midwives, or bidans, and several volunteer midwives who come from all over to bring their expertise and learn the Balinese way of birth, or maybe Robin’s way of birth—which is worth learning. When I arrived I met two nurse-midwives, one from Australia, one from Italy, as well as a Canadian studying midwifery in New Zealand. There was also another doula/nurse from San Francisco; today was her first day as well.

Robin tells me immediately that there are two women in labor right now... taking the hint, I unpacked my things in the volunteer ashram across the street, and headed back. Apparently there hasn’t been much going on all week, so of course tonight was the night there were four babies born and thunderstorms struck outside. Hmm, now that I think about it, I started menstruating as well, and last month I started on the night of the double birth mentioned in a previous posting...

So many beautiful things happen here when someone is born. Robin does two very striking things in preparation for a birth. She asks someone to bring pusba or flowers. That night she asked her granddaughter Zhouie to go across the street to shake the tree in front of the ashram and she brought back beautiful plumeria blossoms. With these Robin drizzles them into the warm bath water where a woman is laboring, and I am crouched and bent over with my arm in the bath so that she can have the counter-pressure she needs on her lower back as her baby descends. Robin then asks all her moms what religion they practice or place their faith, and she proceeds to chant or recite a beautiful prayer with each contraction until the baby is born. This night she sang the Balinese Hindu prayer song, recited the Catholic prayer to Our Heavenly Father and sang Ave Maria, and then by morning she was saying Allah to the Muslim couple in anticipation of the father reading the full prayer to this new baby as the first words she hears. Someone asks later and she tells us that her own religion is primarily based on women and babies and "gentle births bringing peace on earth"—sounds like a good religion to me. Lastly, though Robin does a gazillion things, something very sweet she does is to scoop the plumeria blossoms and strew them around the placenta in a bowl. I think it’s a gorgeous tribute to one, if not the most amazing organs in the human body. You need one, you make one, you need another one, and you make another one! When you’re done with one it nourishes whatever it goes to; the earth if planted or the body if ingested, anyplace that is except a biohazardous waste bag in a landfill somewhere.

Of the six births during my first 24 hours I saw the above stunning posterior water birth (baby with his face up to the sky and eyes opening under water as he was born), and I walked into a room where a man kept poking his head out, his wife was laboring beautifully but he seemed so nervous. I stepped back out to get the midwife and went right back in to her room. She lifted her skirt and there was a baby’s head all the way out! The midwife came in behind me and with no time for gloves, eased out the rest of this little lady. It was a beautiful and busy number of hours. We did, unfortunately, have to send one baby to the hospital for suspected respiratory complications, a perfect birth but she just couldn’t cry that fluid out of her lungs.

This birth center and clinic is amazing how it creates so much with so little. I think my favorite so far is instead of medical supply KY lubricant for the Doppler ultrasound machine for listening to fetal heart tones, we use cheap and lovely smelling aloe vera gel!

Robin has many theories on why this world works in the ways that it does, and sometimes that involves saying things like, “I’ve never had a good feeling about this bed, tomorrow we’re getting rid of it,” after the baby who was transferred to the hospital was born in it. Getting rid of beds aside, they are definitely at capacity here, there are several beds to a room already, and so Robin is hoping to expand the clinic to accommodate the community—this is part of the One Million Mothers campaign.

And so it goes, this is birthing in Bali.

Harborview Moments: A montage..

2008-08-06T21:10:00.000-07:00

Harborview Medical Center is the WAMI region Level 1 Trauma center, meaning Washington, Alaska, Montana and Idaho all send their critically ill and injured to HMC in downtown Seattle. This is where I have been for all of my clinical rotations as a nursing student, except for my peds rotation at Children's Regional Medical Hospital where I battled with toddlers to listen to their tummies and give them goopy sickeningly sweet smelling medications. One of my highlights at Children's was the "patient teaching" I did for my eight year old with an infected broken bone, I taught him how to play Battleship, we played for hours, it was awesome.

Anyway, Harborview is an incredible place. Let me give you a little run down of the past 9 months...

Key Words: ED = Emergency Department, TICU = Trauma Intensive Care Unit, BICU = Burn ICU, sedated = medication induced depressed central nervous system state in which a person is asleep and possibly without memory of experience, intubated = tube down a patient's throat to provide on airway, ventilator = machine that is hooked up to intubation device to manually or mechanically breathe for someone who is otherwise unable to breathe on their own e.g. a sedated individual, KCJ = King County Jail, CT = computed tomography, referred to sometimes as a CAT scan, FEMA = Federal Emergency Management Agency, divert = not enough beds or staff at the hospital to take any more non-critical patients--must be dispatched to other hospitals, IV = intravenous, BP = blood pressure, stridor = abnormal high-pitched breathing sound usually caused by throat blockage. Please let me know if I missed any!

One of my first weeks on the medical unit I had a patient who had a septic abdominal and pelvic infection and he needed a femur traction to stabilize the leg bone in place of the acetabulum in his pelvis. A surgical resident arrived bedside to perform the procedure, and asked if I'd be willing to help. As I'm donning sterile gloves, my first time practicing sterile field technique, he warns me that he recently had an army medic assist him in the ED and the guy passed out from the blood. The surgeon tells me it's a pretty barbaric procedure, "Ortho always is," he says. So far I think I'll be fine. I position myself to hold my patient's thigh with one hand and his knee with the other, to stabilize the femur. Andrew (as the surgeon had introduced himself) was giving lidocaine injections to the pin sites, the spots where the traction pin was to be inserted and then exit the leg on the other side. He begins to hand drill directly into the first lidocaine mark on the inside of the leg. My patient is psyching himself out to be royally in pain, I tell him to hold onto my elbow, and he grips it for dear life. Moments later, Andrew says, "Did you feel that? That vibration means we're in the bone now." After more manual drilling of this rather serious looking hardware the pin begins pushing its way out the other side. Andrew says, "Hmm, I think I missed the lidocaine wheel, but we're almost done here." As the pin emerges the skin around the site has become twisted with the manual turning, and Andrew very simply takes a scalpel and quickly slices from the pin outward about a centimeter to "unscrew" the tighly coiled skin. Now he attaches the device that will connect to the end of the bed and the rope that will be connected to each pin on the traction piece and the 15 lbs of weight that is hanging from this rope and dangling off the side of the bed, ya know to stabilize the leg.

Fast forward a few months (to just a few weeks ago) in the TICU where my nurse tells me to go watch a "Halo" placement on a newly admitted patient with a spine injury from a high speed motor vehicle collision. I stand in the back as a Neuro surgeon proceeds to inject lidocaine wheels into several key targets on this man's head. Then the halo contraption is placed and the pins are being screwed in. There were two of them working on either side with another surgeon holding his head, the patient here was sedated and ventilated. Once the whole procedure was finished the main surgeon turns to me and says, "Well, what did you think of that?" and I said, "Not as barbaric as a femur traction..." and he replies, "Ortho always is more barbaric..."

The day that I first shadowed in the ED was a day that folks in the community were not taking care of themselves as a general rule. I was immediately ushered into a curtained section where a man was sitting perfectly calmly as people buzzed all around him. His left hand was wrapped in gauze. He had been working in a steel cutting factory and had sliced off his fingers. The digits were in the cooler next to him. This became the main focus. The cooler was opened, the ice was dug through, a plastic biohazard bag was found and opened, rollls and rolls of gauze were unraveled and four separate dirty, but very cleanly severed fingers were revealed. You could see a creamy white round disc at the base of each finger, and when the hand was simultaneously unraveled from the gauze it also had four matching white discs of bone where his fingers had recently been. The patient was peering over the side of the bed and sneaking peaks at his own flesh. The doc said he's do his best, and that he was about to be wheeled in for a day of fine tuned surgery. The patient, very calmly, says "I just need one, just save at least one..."

The first bed in the ED is typically saved for a big trauma. So that's who showed up next. A KCJ man of 25 had jumped, he was later affectionately called the "jumper," from a two-story building and landed on his head... and never lost consciousness. He was immediately stapled and whisked into CT to scan for skull fractures and anything else. I peaked in on an x-ray and saw a couple of teeth in his stomach on the image they were collecting. When he was back out on the floor he needed to have his staples removed and proper sutchuring done to keep the swelling in check. I had been blotting his dry and cracked lips with a wet paper towel because he desparately wanted something to drink and wasn't able. As the doc was sutchuring two observing amry medics gathered and offered to help, he was obliging. First he asked for saline. The first medic grabbed a vial and handed it to the doc, and as the doc said, "that's lidocaine" I handed the assistant medic the saline flush. After a moment of trying his hardest to push the plunger on the syringe I reached over and unscrewed the cap for him. With the patients eyes covered he asked which one of these guys was helping him out with the wet paper towel... I did it one more time and then moved on to something else.

A classmate of mine also spent a day in the ED, and during report at the end of the day she says, "Jane, I thought of you down there today... we had a woman come in with contractions after dosing up with heroin that morning. This was her 8th baby and there wasn't time to take her to the UWMC where they have a Labor & Delivery unit, so we called in an on-call OBGYN doc and took her a semi-private room in the holding zone where she started pushing." This classmate says she's terrified of birth, and did not want to be there, but tried to at least slip into the background when her precepting nurse said they needed her help. She ended up holding a leg and saw very first hand her first birth. Unfortunately the baby (one of probably very few born at HMC) was born addicted to heroin.

I also had the amazing opportunity of riding with the paramedics on the Medic One rig for a day. I rode in the back of the ambulance while two paramedics were in the front (there were no medic students that day, just me). These two had impressive resumes that came up throughout the day; Carl had been with the fire department for over 30 years, and here at Harborview for 27, previously he had worked with FEMA as well--he said he quit after Katrina. Patty had also been doing this for decades and had previously worked as the medic for the swat team, she told me a story about her friend shooting a perfect shot, and that she could still save the guy.

Our first call was to 3rd avenue where a guy was having chest pain. After we assessed we called the EMTs to take him to Providence as Harborview was on divert. Next call took us across the street to the shelter where a woman was having shortness of breath, same deal happened to her. After we joked about hanging out on this block all day we got a call to hop on the freeway and out to a guy who seized and then fell and had a head injury or fell then seized, etc. CPR was on-going at the scene. When we arrived the fire department had revived him, but his blood pressure was dropping. In the back of the rig I watched as IV lines were started as the rig swerved through the streets and the equipement barely stayed put. One of the fire men came with us and helped manually bag the patient after the paramedic intubated him. The fireman was fumbling with the attachments and seemed to always have the wrong one ready. Back at Harborview the patient was taken away and the paramedics split up to do paperwork and re-stock the rig. I was given a pager and told to run to the rig if it went off. Rather soon after that, the pager went off and I found my way back to "my crew," I jumped in the back and we sped off to an address near to where I lived. The medic called back to me, "It's an assualt, we're being called along with the police." All I could think was, should I have a bullet proof vest on for this? At a local Vietnamese restaurant there was a man down on the ground, mumbling, but otherwise conscious. The medics waved the police away, if he had been assaulted, there was no one else there now. We put him in the truck, and the medic asks if I want to put in the IV, absolutely! I tried (we had just had our IV lab the week before) but I swear that 16 gauge needle was bigger than this guys' veins. The medic got it in no problem, and the patient was quicly sedated, intubated and ventilated. This time there was no extra person in the back, so I took on the role of manual ventialtor, and because I had just seen this done, I was much better at it than the fireman. Back at the ED I ran into my classmate who was down there that day, he'd been on the rigs the day before and nothing had really happened that day, he said he stuck around till about 10 pm when he finally went home. Again my two paramedics dispersed and I stayed there with the patient as he began his assessment by the ED Docs. People were shouting out questions, so I thought I would shout out answers; What was his glucose at scene? 138! What was his last BP? Systolic: 130s! What's his name? Last name: L...! Does he have a trauma number? 8....! That was fun. Next page was for a 3 year old boy/allergic reaction. We rushed down to a bus stop nearby. After barely touching a pistachio to his lips this little guy started having trouble breathing. The firemen set him down on the back of the firetruck and tried to tell him how brave he was, one of the medics brought out a teddybear from our rig which this kiddo clung to. He was showing signs of stridor, so we put him in our truck and headed off to Children's Emergency. Here was my big moment... everyone was vying for a distraction, trying to place and IV, give him a shot of epinephrine and benadryl, keep him calm, and all along he's been non-verbal, not making eye-contact and absolutely pertrified, and he looks up at me and mouths, "Wha-what's your name?"

After dropping this little guy off, the medics tell me it's time for lunch. They drive up to Capitol Hill and we all pop out to our respective meals. As I'm waiting for the guy to finish toasting my bagel the pager goes off. I tell the guy I'm actually going to need that bagel now, and I run out the door. I'm about two blocks away from the truck and hear the sirens. They bust down the road and swing into on-coming traffic blocking the street and slam on the brakes. I run around the rig and jump in the back doors. Off we go, and Patty shouts, "Did you get your bagel Jane?"

***

I've had countless experiences like this during my shifts at Harborview, an incredible place to learn, I love it. To my knowledge every one of the above stories proceeded well, with various degrees of recovery and health and survival. I may play a very small role right now, but it seems to be important nonetheless.

Welcome lots of new babies!

2008-07-14T18:12:00.000-07:00

All along my three July clients have been neck and neck, maybe I should have seen it coming.

All serendipitous matches to begin with, I felt such a strong pull to work with each of these familiesl. So of course I thought it would all work out and didn't really feel that pull to square away solid back-up!

Each told me at one point they thought they would have Fourth of July babies... none did, but I ended up attending another mama's birth on the 4th as I was back-up doula for the holiday weekend. Each of mine were checked out at 1-2 cm that week, and then each remained unchanged, still 1-2 the next week.

Then Friday, my first due date mama swigged back a little caster oil to get a labor going after nearly 24 hours of ruptured membranes and no contractions. While I was on the way to meet her at the hospital as contractions had definitely begun minutes after the caster oil... I got a call from due date number 2, I thought she was confirming a prenatal visit we had set up for Saturday morning. Nope, contractions were coming and going. But she was certain it was still early. Once due date 1 was admitted and checked (almost 4cm) I got a call from due date 2, they had just gone to their hospital (of course, clear across town) to get checked out, and they too were admitted at 4cm!!

**here is the moment where I had a mini doula panic attack**

Second couple said they didn't want an interim doula, me or no one.

I called nearly all the doulas I had in my phone, one answered, and was in fact willing, wonderful and ready to come to my rescue to hospital number 1 (I know I was already there, but they were coping beautifully, and I felt that I needed to be at hospital number 2) she could be there in 40 minutes. I went to present the idea of a swap with first family laboring in the jacuzzi... nope, me or nobody at this point they said.

Called to cancel emergency doula rescue, and prayed to the doula goddess, and before I could finish my plea--in shuffled a huffing due date 1 to the labor room from the jacuzzi room, and 10 minutes later she had pushed out her baby! Unbelievable. They thanked me profusely for staying, and I thanked them profusely for having the fastest labor ever! I left them semi-settled, but exquisitely happy (in that familiar incredible state; oblivious to everything but their shiny new hot slippery baby...) and went on to the next one. I listened to all the messages left by everyone I called. It was cozy warm doula vibes all around. Called second dad on my way, and he says (music to my ears) "you have plenty of time."

Second labor took a different route than the first, but both were amazing, glorious, un-medicated (ok, a little for labor number 2...) and ended with both mama's dream: I want this baby (second baby for both) in my arms immediately!! Needless to say, this was not the scenario for both first labors and it certainly was the case for both seconds. Hurray!

And a big thank you to due date 3 for not calling Friday night, I'm ready now though.

So this was a first for me, and it worked somehow. I've still never used back-up... Knock on something wooden!

What an amazing thing it is to be a doula?