Tears

December is harder than I thought it would be. Looking at the comments on Tash's post, the names, the love. Remembering. And so many names.

They just keep falling.

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I'm supposed to be writing about Foucault in relation to the impact of loss on women in academia. Discourse analysis is not happening. I was going to write something about a plan for a project, using Foucault's ideas, but that's not happening either.

The loss is not just about my babies dying. It's a lot of it. some writers have talked about the conflict women in academia face when they consider starting a family during their doctoral process or their search for/beginning tenure-track jobs. There's a mind-body conflict: the biological clock versus the tenure clock.

In a project I did last February, I talked about the possibility exploring the potential change in world view for women like me, in academia and with late pregnancy loss. Several women I've talked to have expressed differing ways of integrating their losses into their lives and careers.

I wonder if it's more about determining how much of one's (my) identity is tied in with motherhood/potential motherhood/loss and what changes (or doesn't) over time. How I once saw myself as a mother -- in the future or in the past versus how I see myself as an academic, a professional.

Who am I?

How do I understand who I am now?

Foucault talks about normal versus abnormal; the power of authorities over the mind and/or the body. How do I understand who I am now?

He talks about how societies, authorities, doctors determine what is right, what is normal. Doctors are one of the ultimate holders of medical knowledge: we are taught that by looking at you by a variety of means, casting their "gaze" upon the patient, they can determine what is wrong with you. And what needs to be done to fix you. Your own contributions as a patient are less important.

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During my pregnancy, it was determined I was high risk. Advanced maternal age. Clotting disorder. My OB had to work with other doctors. He didn't like it. He was passive in treating me. If I wanted care for a problem, I had to ask for it. Beg for it. Demand it. Despite need, some doctors thought I was merely being emotional. Despite need, my insurance carrier denied coverage that would enhance my well-being. I sucked it up.

When my water broke, the nurse at the hospital made me wait to see a doctor ("She thinks her water broke.") for at least 15 minutes. The radiologist was unavailable. I would have to settle for second best, an educated guess from the doctor on call (annoyed his holiday was interrupted) until the next morning.

Days of strangers examining me in the most personal way. (I think I lost count at nine.) Asking the same questions. All except the neo-natologist resident, who showed up (looking exhausted -- it's been a bad few days, she said) after two days of requests to talk with her about the possibilities. My family and I asked questions, and she did answer them, gravely. New words, new conditions to be explained.

After a week, when we determined that all hope was lost and that I would deliver my twins at the local hospital, we geared ourselves up and went. My OB had said he would set everything up. Already in my hospital gown, IV in my arm, and Ativan in my veins, the nurse came with apologies. The lawmakers determined that the hospital couldn't help me that day. The next hospital I went to needed me to sign a form that said I had considered my options for at least 24 hours.

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The room I was put in was small. Not enough room for my husband and family and doctor. All around me heartbeat monitors echoed with the healthy rhythm of other people's babies. Normal pregnant women about to give birth to normal healthy babies. All around me. The nurse kindly turned down volumes after I asked.

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The pharmacy delayed getting my labor-inducing drugs for 6 hours because they doubted the doctor's orders. The epidural was in after the fourth try. But it didn't wholly take. Instead, they gave me drugs that would distract me. That would mostly knock me out.

I started the day with one doctor, ended it with another to whom I don't recall being introduced.

I have little memory of the delivery: it's like a very bad dream, complete with a spotlight piercing darkness. Horrid images. Lots of blood. Strangers invading my body. More, and more deeply.

A transfusion, said the doctor. You'll need two units of blood.

****

I called the OB with a fever one week after delivery. The fever went away with a Tylenol, but left an infection that required surgery.

Six weeks or so post-partum, I received he pathology report for the placentas of my dead babies. I had had an appointment with my OB, but forgot to bring the report. I told him that I read through it, and thought I understood some of it, but obviously, I wanted to discuss it with him, hear his thoughts.

He said, "Well, yes, of course...lots of big words in that. And I did go to medical school..."

Two and a half years later I have not gone back to him.

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Almost three years past these events, and I think I begin to understand the experience in a different way.

We tried for two years to have a child. We almost did. It was what I wanted more than almost anything. But what about my studies, my potential career? How do I think of the world, of my identity as a person, as a woman without this? Or, as a woman who basically failed at having a living baby. Could I succeed at it eventually? Could I succeed at anything?

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A year and a half of sadness, guilt, no answers. Still, there are virtually no answers.

And being treated like...well, a body. To be dealt with. To be fixed. Some folks were kind. It seems though, when I tried to get answers, for the most part, it took pushing. Or it took physical and visual examination of my body. And responses like, "if only we had a crystal ball."

The doctors who were supposed to be helping me to finally have my twins could barely help me in losing them. Could barely help me in trying to understand.

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This is something which makes no sense. That is what the grief counselor said. What many folks have said, trying to help.

It just pisses me off. I want answers. Even though I know that knowledge doesn't exist.

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What about the way that I was treated? I had to push and push to get test results. To get them explained to me. To get someone to commit to some answers. Risks.

I only found out after the fact that one of my doctors considered me to be at "dramatically high risk" for pre-term labor, as noted on one of my appointment reports.

For most of the ten days between my water breaking and the delivery of my dead or dying sons, I learned more about the practice of medicine than I ever wanted to learn.

Despite their high status (as Foucault describes them in The Birth of the Clinic), medical doctors apparently seem to have very little definite knowledge. Everything "depends." In my five years of trying to have a child, only one of the many doctors I met with admitted that medicine is as much or more art than science. There are few definite answers. Medicine, it seems, is postmodern.

Doctors are human. They have egos and insecurities. They seem to assume patients would not understand, or would not be interested in knowing, the details. Why did I have to push so hard to get information that I had a right to know, that may have affected my choices.

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I was medicated out of my own ability to advocate for myself. I was acted upon. After the delivery, a nurse gave me a sponge bath before taking me back to my room. She changed the linens, rolling me this way and that. I vaguely remember it. Mostly I remember being without will. I let her do what she needed to do.

I gave in. My body was no longer my own.

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In addition to the loss of my sons, I lost my faith in any so-called authority. When my mother became ill six years earlier, I learned the importance of advocating for yourself and getting information as possible. It wasn't easy.

Being a grown woman, with a variety of life experiences -- achievements and losses -- I had already learned that there are few things one can depend upon. Somehow, I still believed in medicine.

I still go to doctors, though I try to see them for what they are: human beings with fallibility and not nearly as much knowledge as our society would like to believe.

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In developing my comps exam responses, I found confirmation in the literature that there was an enormous surge in the importance of pregnancy and motherhood in the media: TV shows, news shows, movies, commercials. They all implied to one degree or another that a woman was not complete without a child.

In the academy, commitment to one's work may be questioned if there is suggestion that motherhood may interfere somewhat with one's pursuit of degree or tenure.

The literature suggested that there was an implicit (and sometimes explicit) demand that a woman choose between family and academic career. Certainly in considering that only 27% of full, tenured professors in four-year colleges are women (with children or not), professional gender equity is still not present. What does it mean to be committed to one's career? To be committed to one's family?

The myth of the superwoman who can do it all seems to live on. And at the same time, there is strife between those who choose to stay home and those who choose to work. Or who need to do one or the other. To be a woman and/or a mother and/or a professional seems to be a lose/lose/lose situation.

You can't please all of the people all of the time, but, apparently according to the culture, you should try.

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I tried to perform a discourse analysis on several posts another blog, but don't feel confident in the practice.

My situation, my loss, is abnormal. Only about 1% of pregnancies end without a live birth. And yet, my story, the interaction with my doctor(s), my worries about my own responsibility in the loss, my interaction with the doctor about my body (not my self), seem if not universal, then common. At least where I live. The information shared with me, about my body -- or need to ask for it, seemed to separate the two (body and self). The social workers and counselors were kind, generally. The doctors were generally kind, but somewhat withholding of information. They were in charge, sort of. The kindness rather seemed like an afterthought. Discomfort with the situation made them quiet.

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I'm still learning the central concepts Foucault put forward, but I am sensing it all over my own story. And, to some extent, it changes the way I talk and think about it.

Power. Knowledge. Power-Knowledge relationships. Power over the mind. Power over the body. Discourses of the body, of what it can and can't do. Discourses. Authority. Normal/Abnormal.

I'm still working it out.