jumping right in

I unpacked all my things, and claimed the same bed I had last year. There is an intern here who has a car, and she graciously offered to take me to Sun Harvest, the local health food store. I got all stocked up on yummy, healthy food. I've been eating my greens (chard and broccoli) nearly every day, and there were some really good cherries to be had as well.

Pretty quickly after I was settled in, there was someone in the clinic in labor. All right! This is what I came for. Though I wasn't scheduled to work the first night I arrived, I helped one of the newer interns do the "2nd on" job--the assistant at the birth. It may seem like a bummer to observe, but really it's not. You always learn something at a birth, and there's always something interesting happening. If nothing else, you can practice in your head what you will do when you get to be the "hands-on" girl.

Wednesday was a busy day, full of citas and birth. The "1st on" in the daytime is very new to midwifery, and the "2nd on" as well. I was "3rd on." After the citas began, we had someone come in laboring. The 1st on is responsible for monitoring the laboring woman, and continuing to help out with the prenatal and postpartum appointments. Then another woman came in in labor. This would also be the job of the 1st on if she were experienced, but the staff midwife decided to give the 2nd on this person to be her primary. That left me doing citas, which was pretty fine with me. I did most of the appointments that day, and began working on cleaning up the clinic.

Late in the afternoon, a third woman entered the clinic in labor. So, I was assigned her care. Since she was in early labor, I guessed that I probably wouldn't be primary at her birth. The rule is that if the birth is imminent at the end of your shift, you stay in the primary 1st on role, and complete 2 hours of vitals, and do her laundry as well. Honestly, it's kind of nice to be able to be off after a 12 hour shift, so I'm glad that I got to hand her over to the shift that came on at 6pm.

The incoming shift included an intern who's been here nearly a month and didn't have that many births. That was a bummer for her, so I was glad that she got to be first on when these ladies finally birthed. My time will come.

I observed the first birth that happened in the evening, but decided to go to bed before the second birth. Since I was pretty tired, and had only been asleep perhaps 30 minutes when the code was called (the students get paged when a birth is imminent so that they can choose to observe), I decided instead to sleep. My time will come, for sure!

Thursday is only a half day of appointments, and then the clinic gets thoroughly cleaned and restocked by the interns. We were very busy cleaning, sterilizing instruments, making gauze packs for sterilization. It was hot and sweaty work, but also satisfying to tidy everything up, make sure there is enough paper towels, tissues, and ky stocked in all the rooms.

Back to the intern house after the shift for some dinner and bonding with the girls. I think it's important to bond with the other interns, because sometimes this work is hard, and we have to be a team. We have to work together, regardless of how tired, stressed, overwhelmed, or cranky we are. Having a little fun together is priceless team building.

leaving and arriving

This trip to Casa is different in a lot of ways than the trip last summer. I feel like I'm a completely different person. I have a lot more midwifery education and experience under my belt; I have some pretty specific goals for learning this time around. When I remember that I really only knew how to take a blood pressure and not much else, it's no wonder that the experience was overwhelming at times. I'm looking forward to this stay primarily because I'm feeling more confident with my skills.

But the last couple of days before leaving are feeling sad to me. I'll be gone 5 weeks this time. It's a long time. Short in the big scheme of things, but a long time to be away from my regular life. I'll be missing some births back home while I'm gone, and since they are clients I've come to know, that feels sad as well. My partnership with Andi in Appleton Community Midwives feels like it's taking on some inspired momentum, and now I won't be contributing much to that effort while I'm gone. I'm definitely measuring the trade-offs this year. The benefits of this experience are still out-weighing the drawbacks, but there is sadness there nonetheless.

So, 5/6 of the Farins drove to Milwaukee on Monday night. There we visited with cousins, and I stayed overnight because my flight left at 6 the next morning. Auntie Juj pointed out that my one, gigantic suitcase may not make the weight limit. We got out the bathroom scale and proceeded to shift my possessions around a bit while several people commented on the contents of my bags. I was trying to avoid having to ship a box this year, but it did make for some heavy bags.

My brother-in-law gave me an early morning ride to the airport through a bit of a mist. Awfully nice of him to wake up at 4:30 am to get me to the airport. Thanks, Steve! I like these early morning flights--they're cheaper, they're rarely delayed, and no one talks to you. It's my kind of flight. I had checked in via internet the night before, and it really made my experience at the ticketing counter a breeze. I was the only person in the web check-in line, so I literally cut in front of probably 30 people standing in line, handed them my bag, showed my ID and was on to security. Since there was a problem with their computers, it took everyone else another 45 minutes to check in.

The flight was uneventful; probably half of the travelers were sleeping. It was nice to fly over the clouds that have been so pervasive the last week or so at home, and to see the blue sky and sun out my window. As we descended into Denver, the plane slipped through a silky fog and we were once again under the blanket of grey clouds.



I had about an hour and 45 minutes to spend in the Denver airport. Food seemed important. Lunch at 9:30 in the morning is weird until you remember that you've been up for 5 hours already. And I decided that I wanted some reading material. I had planned on knitting during the flights, but in the great shuffle of my bags the previous night, not all of my things were in one place. Lunch first, then I set out to browse the tiny selection of books in the airport newsstand.

A bit of fiction was on my mind, something that didn't have anything to do with birthing babies. And it can't make my bags exceed the weight limit. Or be scary or violent. I feel like my heart has been cracked open wide by being a mom, and in my middle age has become a big mushy puddle. This situation is compounded by my chosen profession. I've met some seasoned midwives who seem like the kind who will hitch up their dog team and mush out to your birth in 20 degrees below zero, and perhaps kill something for dinner on the way there. Not me and my mush puddle of a heart, with tears brimming embarrasingly close to the surface at all times. I was pretty devastated by The Kite Runner and then The Life of Pi, read in quick succession some years ago, and I'm not sure I'm quite over it yet. I need my fiction to be gentle with me. A lightweight paperback of only 288 pages, The Guernsey Literary and Potato Peel Pie Society seemed to fit the bill perfectly.
My belly full, and my book tucked under my arm, I was soon boarding a small plane for the remaining leg of the journey to El Paso. I know many people don't like these smaller planes, but I think it's pretty cool to be able to see the land as I'm flying over it. A regular patchwork of rectangular farm fields and roads on the high plateau of Colorado gave way to the earth all crumpled up on itself and winding roads through the mountains. Greens turned greener as we passed over the mountains, and there were even some white capped peaks; eventually the colors became the unmistakable browns of the desert. Our arrival in El Paso was greeted by overcast skies and the the Bienvenudo a El Paso sign on the airport roof.

An eager cab driver grabbed my bags before I was totally aware that he wasn't intending to steal them, and we headed to Casa. It was lunch time when I arrived, so people weren't all crazy with citas. I met my fellow interns, only three others are here right now. One is getting ready to leave soon, and the other two have been here a week. No one is quite as green as I was last year. I understand that there are 30 births on the books for this month, and only one had happened before I arrived. I hope that all the 29 others and some from July will come while I'm here.

getting ready

The last six weeks or so of the school year are quite the whirlwind. There are numerous activites-- awards nights, concerts, fieldtrips. With four kids, the schedule is mind-boggling. I've been thinking about getting ready for my second trip to Casa, but not making terribly much progress towards that.

Additionally, there was the garden. I had great success with winter sowing this year, and had lots of seedlings to plant. Plus, we expanded our vegetable garden space nearly double from last year, so there was plenty of yard work to do.

Graduations and their ensuing parties are populating our calendar currently. Lots to celebrate for friends and family!

Jasper was invited to sing in a local production of "Carmen." In between soccer practices, we were running him to choir rehearsals. The show was great; it was a great opportunity for him.

There seem to be a lot of special projects at school during the last month of school as well. Food needed to be brought in at specific times, and prepared in specific ways. Liam's kindergarten teacher sent home a request for a picture of him at each age he's been so far. Is she serious? Does she think I don't have anything else to do? I'm not entirely sure I even have a picture of him at every age. As a fourth child (who is, of course, loved no less than his older sibs), there is a relative dearth of photographic documentation of his life. The morning I was to send this assignment in to school with him, I spent an hour and a half digging through photos. I was missing two years. Two whole years? Surely I'd taken some pictures for those two years. Where were they? I filled in with a photo from the fridge, and Elena did an excellent drawing of one that is framed. Oh, did I mention that the pictures were going to be destroyed in the making of the project? That little wrinkle made me a little less willing to part with the pictures.

Kids activities that I have no control over aside, then there were the things that I did have control over. Like starting some sewing projects. A summer top and skirt for El, some baby dresses for friends with new babies. I really didn't need to start another project, but somehow I talked myself into it. I do like the meditative quality of ironing and sewing, so I did get some good thinking done. I located the missing two years of pictures when I went on a failed hunt for my button collection. And one day, I even listened to some Spanish tapes.

Oh, yes, the Spanish. My goal was to be pretty fluent when I came back to Casa. I bought an internet program, and some birth Spanish tapes. I spent relatively little time with either of these tools, and found myself trying to "cram" the language during the last several weeks before I left. How silly! I feel pretty disappointed with that, but I think it will come a little easier this time. They say that you have to use a language, or you'll lose it. I believe that to a point. I have found some French vocabulary come out of my mouth when the Spanish just wouldn't come to me, and I knew I needed a foreign word. I haven't used that French since college. It's in there somewhere; just a little rusty.

Once again this year, I feel the support of my family and friends as I take this on. It's great to know that there are people who will bake belly cakes for me, loan me suitcases, and offer prayers and good wishes. It's especially nice to have a husband who is supportive and ready to be super dad again. Hopefully, it's a productive month!

it's raining babies here in the desert

We went through a little bit of a dry spell after the three baby day from last week's post, but the last two days have more than made up for the dry spell. One of the interns who is leaving today, Kelly, lucked out because she got two babies on her last shift. The fantasy that we all have of someone arriving on the front steps, cervix at 10 centimeters dilated, and ready to push became Kelly's dream come true today. It was pretty awesome, and a lovely birth.
Shannon and Kelly with the ubiquitous can of cola.


Shannon, Kelly, and Judy in our "spot" in the office where we've asked questions, gotten into lots of conversations about birth and life, had our convictions challenged, and watched many a movie on long nights when there weren't any babies being born here.
Shannon, Kelly, me and Consuelo in that intern couch mentioned above. Consuelo is a visiting midwife who has also been a patient and respectful teacher.
Kelly mopping up after one of her two births today.
Well, the story goes like this. We all remember Charlie's Angels (some of us are so young that we only remember the movie), so we had to pose like the Angels sin pistolas, con specula. It doesn't seem to matter how old you are, when you mix fatigue, chocolate, and cola you come up with some pretty goofy behaviours.
Shannon and Judy. Judy's taken to parenting Shannon. She's the youngest one here, and Judy is the mother of us all, but especially Shannon.
I'm not sure I really want to explain this picture. I'm not sure that I even can.
So, the goodbyes have begun. I said goodbye to A'Maya last week, because she left for vacation and won't be back until after I leave. She's been a good and patient teacher, and a whole lot of fun and support. When I come back next summer, I'll be sure to watch the Kill Bill II movie with her.

Today, we all said goodbye to Kelly. She's kept us all laughing, especially when we're all dead tired. She's going to be an awesome hardworking midwife in California, and we all wish her well.

Tomorrow I'll work my second to last shift. I said goodbye to Gina and Cynthia today, the secretaries who do so much to keep this place running. They not only manage all the administrative tasks, but also pitch in and do citas when they have a new batch of interns or we've had a birth and are overwhelmed with duties. Luz does secretarial work, citas and teaches childbirth classes as well, and I hope to say goodbye to her on Sunday. They all have to put up with new batches of interns all the time, teaching everyone the ropes every other week. It's crazy, and must make for a stressful workplace.

Even with all the hard work, and the fatigue, and the challenging situations I've faced while I've been here, I am really looking forward to back next summer to work for another month on my internship. I'm also really looking forward to going home and sleeping in my own bed, and seeing all my family and friends again.

a three baby day

I got roused out of bed this morning at 3:00. I had told one of the other intens that I would take a shift change baby if she got one so that she could sleep, since she was working on 48 hours with hardly any z's. It turned out that no one was really having a baby, so I went back to bed until 5:50 a.m. when I started my crazy first on shift.

Thursdays aren't supposed to be crazy days. The clinic is only open for citas in the morning, and then we get to deep clean in the afternoon--wipe everything down, sterilize tools, make birth kits, etc. Today was very different from that. It became clear pretty quickly after the start of my shift that two women were in big time labor. Since I'm first on, I'm in charge of getting their vitals, checking heart tones, labor coaching, and checking in with the staff midwife about their progress. One labor is a big enough job, but two is another story altogether. That kept me hopping for a couple of hours until it was obvious that these two were going to have their babies pretty close together. Because of the relative inexperience of both me and the second on intern, we each took one birth as first on.

After the excitement of the births, there's the two hours of vitals, the discharge of the client, and then there is the clean up. Laundry is totally crazy after a birth, perhaps I've mentioned it before. Of course, the laundry from both of these births was really soiled. I had just enough time to scrub and soak and get a load in the washer before another client came in in labor.

A birth that happens 20 minutes before the end of your 12 hour shift is yours until the first two hours of vitals are done. By the time I'd finished those two hours and all the paperwork, I was finally sitting down for dinner at about 9:00 p.m.

I'm grateful for all the lessons learned today. It's rapid fire repetition when you deal with three births in a day, because there's always something to learn from each birth, and there's always something to remember from your last experience, even if it was just 2 hours ago. I'm totally grateful for the great bunch of interns I'm with right now--most of them were rousted out of bed to pitch in for a while today, and everyone helps with the laundry and the clean-up. I like the "we all pitch" in attitude. I hope that they feel that I pitch in for them when they need it.

Anyway, I'm second on now from 6 p.m until 6 a.m., then I'm off for 12 hours. I can honestly say that I'm hoping that no one is born tonight at Casa.

Buenas Noches!

an English cita?

I had a client yesterday who spoke fluent English. It was fun, and a good confidence builder, because I actually understood her questions, and actually had a few answers. But, ironically, I found the Spanish for the cita coming to my brain before the English. I chuckled with the client about my inability to do a prenatal check-up in anything other than broken Spanish. As someone who has spent some time thinking about education, this is an interesting phenomenon to me. I learned all these new skills along with some rudimentary Spanish at the same time. The language and the skills became linked in my brain to where now I have to re-think how I communicate in English during an appointment.

I've always been interested in other languages, but mostly have just played around with words. Everyone who has become fluent in a language other than their first has told me that you have to be immersed. I think that's true, since after only 2 1/2 weeks I have a rather functional grasp of the language. I probably speak like a two year old, though--with no articles, wrong conjugations of verbs, and a sprinkling of English thrown in. The motivation to continue to learn, though, is high when you are required to communicate. So, I've started moving beyond the statements in my handy-dandy Spanish handbook for Casa, and asking the secretaries if they can help me to understand some other things. And it's feeling more like a fun challenge, rather than something stressful. I think I'll definitely spend a lot more time studying Spanish before I come back here next summer, though, so I'll sound less like a toddler.

hellos and goodbyes

At Casa, maybe more than other places I've been, the cycle of hellos and goodbyes is at the forefront of everything. We are always welcoming people, and then saying goodbye. Welcoming babies, and then sending them off with their parents to become a family. Welcoming new interns and sending them off to continue their learning elsewhere. It must be hard on the staff here to have so many hellos and goodbyes. Yesterday two new interns arrived. Sometimes (all right, a lot of the time) the hellos here consist of a genuine welcome followed very quickly by a request to don scrubs and jump right in. We all have to make the most of our short time here, so we don't linger too long on the hellos.

Today we said goodbye to Marcie. Marcie had a car, and was very sweet to take us all grocery shopping, and running other little errands as well. She is very generous, and didn't want money for gas or anything. She has a good way with laboring moms, and she and I have lots of things in common--we both have more kids than most people think we should have, and we both homeschooled. She will be missed.

When you spend so much time living and working with people, you get to know them pretty well. And when you spend so much time working as hard as we all do, the time moves pretty quickly. The interns almost all have families at home, so there is the additional need to connect with each other. So, already, I'm feeling a little twinge of sadness because I'm suddenly finding myself half way through my stay here, and I know that the goodbyes are coming.

Here are some good things that I can take stock in: my skills really are improving; my Spanish is still a comical mix of sign language and English words with "a" or "o" clumsily tacked on to the end, but it seems to mostly work; I've made some good friends; and I've learned that there's lots that I still need to learn. This is all good.

The current crop of interns is pretty fun, as well. We all were rolling on the floor laughing about our Spanish the other night. When you find yourself trying to talk to a mom about her pechos (breasts) because you think that she asked you about the red parts on them, only to discover that she was trying to ask you about her baby's diaper rash, the best strategy is really to just giggle about it with friends. Sometimes the addition of the "a" or "o" onto an English word really doesn't work, either, as one intern discovered. She told some bewildered parents that they didn't really need to wash their baby with sopa, a word that she thought meant soap, but really means soup. And we all very much enjoy the Spanish word for your bottom, pompis. The Spanish grammer isn't coming together as quickly as individual words, and we are often so tired sometimes it's hard to come up with words in any language. Our current Spanglish joke is "lift up your pompis, please," as one intern requested of someone needing a change of chux pads. It's probably funnier in person.

So, we're all working hard, learning lots, and thankfully we're getting a chances to laugh with each other. And even though I'm really looking forward to going home and not wearing scrubs anymore, I'm not looking forward to all the goodbyes.