Lessening the trauma of loss

An anonymous commenter left this link, awhile back now, about a group of mothers in England -- from an Internet forum, no less!! -- calling for the establishment of a new code of practice to help lessen the trauma of miscarriage. Go have a read; it's a great article.

As the article says, you would think that, with at least one in four pregnancies ending in miscarriage, our healthcare system(s) would know how to properly care for women in these situations. But as far too many of us know from personal experience (whether we live in England, Canada, the United States, Australia or elsewhere), this is too often sadly not the case.

As a volunteer facilitator for a pregnancy loss support group for more than 10 years, I heard many sad stories of how an already-awful situation was made even worse by the actions & attitudes (ranging from indifferent to brusque) of medical staff. Those who had experienced multiple losses often compared the way they were treated from one loss to the next, sometimes at different facilities but sometimes at the very same hospital.

(This is not, of course, to say that all parents have bad experiences. I've also heard many, many stories of incredible kindness & compassion shown by caring doctors and nurses.)

Beyond any attitudinal adjustments needed, there is no clear, single protocol that's followed when a baby is miscarried or stillborn. Practices and procedures differ not only from hospital to hospital, even within the same city, but sometimes from shift to shift, depending on who's working that night. In some hospitals, women are delivering stillborn babies next door to women celebrating the birth of live, healthy, wailing infants with their jubilant families. In some hospitals, autopsies are performed as a matter of routine; in others, they're not.

The vast majority of parents, of course, have no idea whether there are alternatives to the way they are being treated. They're in a situation where neither they nor their families have many precedents to fall back on, that their prenatal classes didn't prepare them for. This is where established protocols & gentle guidance and suggestions from well-trained staff are so important.

What did you think of the article?

The beauty and burden of choice

An article in Friday morning's Globe & Mail caught my eye. Titled "The beauty -- and the burden -- of having choices," it focuses on the work of Sheena Iyengar. a professor at Columbia Business School who also teaches psychology. She's recently written a book called "The Art of Choosing."

I haven't read the book yet, but I'll be looking for it. Iyengar's theory is that having more choices isn't necessarily a good thing. In fact, it can lead to "consumer paralysis. More was less."

While I am generally pro-choice, in all aspects of that term, I understand where she's coming from. How often have I grabbed a box from the grocery store or drugstore aisle, only to find out when I got home that I grabbed the wrong one? (Instead of Tide Ultra Free HE, I grabbed plain ol' Tide Ultra Free, not formulated for my new high-efficiency front load washing machine.) Will that be bar soap or liquid? Creamy or clear? One of 10 different scents or unscented? (If you can even find unscented.) Decisions, decisions....

I was reminded of a previous post I wrote, which touched on a TV show I had been watching about happiness:

"Then they moved on to talk about happiness & choices, including an experiment in which students were shown works of art. Students in one group were told they could pick any poster they wanted, but they couldn't change their mind later. Students in another group were told they could each choose a poster too, but they were allowed to exchange their posters at any time during the session. The people who were told they couldn't exchange their posters were more satisfied with their choices than those who had more options. The conclusion was that people will find ways to like/make the best of things when they know they're stuck with them. We adapt. We learn how to make lemonade when life hands us lemons."

Although I found the entire Iyengar story fascinating (and I'd encourage you to read it -- it should be available on the site for about a week), there was one paragraph that particularly grabbed my attention:

"Her work touches on all aspects of our lives, from birth to death. Indeed, she writes about one study that compared American and French parents of gravely ill infants who had to be removed from life support. While the American parents had the final say on when the plug was pulled, the French parents were forced to defer to the doctors. And yet, months later, the French parents had evidently coped better with their losses than the Americans, who seemed psychologically stuck at the awful moment of their decision."

As you can imagine, this hit home. In situations like this, in all situations where grief and loss are involved, I think all of us make the best choices we can with the information we have at the time. And despite the conclusions of this study, I'm not sure many of us would want to go back to the days when the medical staff whisked stillborn infants out of sight the moment they were delivered, buried in anonyous, mass graves & told parents simply to forget about it and have another baby.

But it's hard not to second-guess ourselves and wonder whether our choices were the right ones. When you're dealing with stillbirth, or premature birth or a critically ill baby, you're in uncharted territory. There is no manual telling you what to do, what's "normal," what's "permitted." It's hard to make choices when you don't even know what the choices really are in the first place.

Choice was also one of the more frustrating things about infertility treatment for me. How not just to choose, but to make the RIGHT choices, how to decide when to try something else, especially when the stakes were so damned high. It seemed like there was always a new choice, a new carrot, that the doctors could dangle in front of us to keep our hopes alive. Good ol' fashioned sex didn't work? Let's try charting, a la TCOYF. How about some OPKs? Maybe a saliva microscope? How about some Clomid? No? Let's try some injectable drugs. That ones's not working for you? Let's try this one. And next time, we can increase the dosage. How do you feel about IVF? Your eggs getting old -- how about finding a donor? Have you ever thought of adoption? And so on & so on & so on.

In discussing how to resolve infertility, the book "Sweet Grapes" irked me in its insistence that all you had to do was to "choose" to be childFREE, & all would be well. "Some choice," I remember snorting. I still feel that way. (Melissa said pretty much the same thing in her book, "Navigating the Land of If," but I didn't find her presentation of the concept quite so annoying, lol.)

What do you think?

Definitely the wrong house

This was hanging from our front doorknob when we arrived home tonight. (A strip of Pampers coupons.)

I guess I could have saved this for Show & Tell tomorrow, but I haven't posted in over a week, so what the heck. ; )

I've been swamped with work lately (especially with my boss & a coworker on vacation) and my Google Reader total is back up over 1,000 unread posts again. :(

Spring break/odds & ends

It's spring break hereabouts. You would think that, as a non-parent, spring break would not affect me.  

You would be wrong. 

On a positive note, the commuter train tomorrow morning is almost guaranteed to be much less crowded (& much more quiet!) than usual. It will be easier to find a parking spot. It won't be as crowded at the coffee shops in the concourse below my office tower in the morning. 

However. 

It will be next to impossible to get hold of certain people at the office next week -- who are off with their kids to Florida, or Mexico, or Cuba or the DR, or skiing in Collingwood or Mont Tremblant or Whistler, or just hanging around the city, checking out the King Tut exhibit at the art gallery or the dinosaurs at the local museum. 

There will be more than the usual number of children wandering through the underground PATH that links the office towers of downtown Toronto. 

Restaurants are likely to be very busy. Dh & I decided to go to Jack Astors for dinner on Saturday night. (The Jack Astor's in question is located in a big-box complex that includes a multiplex movie theatre and a Chuck E. Cheese.) I said to dh, "It's going to be either totally dead or insanely busy" (because of spring break), & even though it wasn't even 5 p.m. yet (!), we still had to wait for a table. 

The afternoon rush-hour train home is likely to be just as packed as usual, if not more so -- with an added contingent of parents & kids heading home from an excursion into the city. Many of them don't normally ride the trains, & aren't aware of the "norms" of polite train behaviour that the rest of us have come to know over the years. Things like, if you're going to stand & stare at the board that announces what trains are leaving from what track, try not to do it smack dab in the middle of the path, thus blocking the way for those of us who already know (from years & years of taking the same train from the same track). Things like, if you're going to sit on the steps that lead to the upper level, you should try to get up & clear the path well before the train starts pulling into the next station to allow other travellers an easy exit. Things like trying to keep the conversation to a reasonable decibel level. 

I remember vividly one trip home during spring break a few years ago, when two moms & half a dozen kids piled onto the train dh & I normally ride. They were practically bouncing off the walls with excitement from their outing -- in sharp contrast to those of us who had put in another long day at the office & wanted nothing more than to nap or read our newspapers in peace. ; ) The train was already 3/4 full and there was no way they were going to find six seats together. So a few of them sat in seats relatively close to each other. Two of the kids sat on the steps heading to the upper level, & one sat on his mother's lap (although it became apparent he wasn't going to stay there long). 

And then they proceeded to shout at each other across the length of the car for the 25-minute duration of the trip. One of the moms let the kids take her cellphone to play with, & then proceeded to shout at them about what to text message to their father. The kids would then shout back what dad had text messaged back, & she would shout back what to text message him in reply. 

Needless to say, dh & I were very glad to exit the train that day. 

*** *** *** 

Speaking of the office, a new person has moved into the cubicle kitty-corner from mine, which has mostly been occupied by part-time students recently. She's with us on "secondment" for the next several months and, since her arrival, the noise level has increased substantially -- lots of calls (both on the office phone & personal cellphone), lots of personal calls to & from her child's nanny, & lots of chit-chat with one of the moms nearby, whose baby is about the same age, comparing mommy notes. 

As I think I've written before, I've been lucky: the majority of my immediate co-workers over the past 20 years or so have either been young singles or newlyweds, or older women who were either childless or had older children. So I'm not used to all the mommy chatter. There are getting to be more & more parents of babies & young children around the office, though (& likely to be more in the near future), so I guess I'd better (try to) get used to it. Or get a good pair of earplugs. ; ) 

*** *** ***

Little Girl Next Door, who will turn 11 shortly -- my yardstick for all things that Katie might have been wearing, doing etc. -- is outside right now with her friends today, zooming around on her rollerblades. 

Last week, I arrived home from work (by myself -- dh was working late) & she was outside with a friend. "Guess what, Lori?" she said to me. "My mom got tickets for Disney on Ice this Sunday! We're going with my aunt & my cousin." "That's great," I said, thinking of my own childhood (& grownup, lol) ice show excursions -- & how much I would have loved to share my love of figure skating with Katie. "You're going to have a great time!" 

A few weeks earlier, when dh & I arrived home from work, she was outside -- waiting for us, no doubt -- & eager to show off her new "toy" -- a cellphone. I've since seen her standing outside, talking on it. And felt very old. Ten-year-old girls with cellphones?? Katie with a cellphone? I guess it could have happened. It's a very different world than the one I grew up in, that's for sure.

"All of us know -- or will know -- grief"

This story is a little old, coming out of the Olympics, but I love it. Her keen observations remind me once again why Judith Timson is one of my favourite columnists. (And why I shouldn't read the comments on online news articles...!)

I've added in a few links.

*** *** ***

Judith Timson on loss

We all grieve with Joannie Rochette

We all know – or will know – grief, so when our poised and poignant figure-skating star lost her mother, we all got a lump in our throats

Judith Timson
Published on Thursday, Feb. 25, 2010 4:30PM EST

Last updated on Friday, Feb. 26, 2010 5:08AM EST

There’s an obvious reason why so many people have been wrapped up in the Joannie Rochette story. Most of us will never know what it is like to do anything athletic as brilliantly as Ms. Rochette skates. But all of us know – or will know – what grief is.

Human beings are hardwired for bereavement – it’s the cost of our emotional sentience. And what could be sadder than a daughter unexpectedly losing her mother at one of the pinnacle moments of her life? And so we have all become lump-in-the-throat cheerleaders for our poised and poignant figure-skating star.

We want her to skate brilliantly partly because we know what’s coming next for her: the hard-slogging work of grief.

Grief has lately found its way into the news in unexpected ways. There was British designer Alexander McQueen, who hanged himself, reportedly distraught over his mother’s death. There was the shocking death of Georgian luger Nodar Kumaritashvili at the start of the Games. And there was the study this week that confirmed our longevity has increased. Nothing sad about that, but it changes the future of grieving.

As more of us live longer, one of the stranger effects will be a raft of newly created “orphans” in their 70s, as their parents don't die until 99. At a recent gathering, we all laughed darkly when someone quoted a friend saying, “My mother dying practically ruined my 70s!”

The interest in grief as a passage, an art, and an inevitability, has of course intensified as the boomers see off not only their parents, but also their contemporaries.

Grief in the 21st century may have some distinctly modern elements – memorial services with shamelessly cool production values; e-mailed condolences; death announcements by Twitter – but what everyone discovers is that grieving takes up an inordinate amount of personal time, no matter how fast-paced a society we've become.

It’s also far messier than psychiatrist Elisabeth Kübler-Ross led us to believe with her famous five stages of death and dying – “denial, anger, bargaining, depression, and acceptance” – which became the paradigm for grieving.

In a recent essay in the New Yorker on finding a better way to grieve, writer Meghan O”Rourke argues that this staging “turns out largely to be a fiction” and that “grief and mourning don’t follow a checklist; they’re complicated and untidy processes, less like a progression of stages and more like an ongoing process – sometimes one that never fully ends.”

Ms. O’Rourke doesn’t think our modern society does a bang-up job of acknowledging grief. We may bring in grief counsellors by the truckload, but we’ve adopted “a sort of ‘ask, don’t tell’ policy,” she writes. “The question ‘How are you?’ is an expression of concern, but mourners quickly figure out that it shouldn’t be mistaken for an actual inquiry.”

And yet grief is so infinitely interesting. It's practically the last way to be sad in our society that isn't instantly pathologized.

The new, paperback edition of The Mourner’s Dance, Katherine Ashenburg’s beautifully written account of how we grieve, includes a moving afterword about the author’s own parents dying. One of the discoveries Ms. Ashenburg made when she originally researched her book was that grievers uniformly report that spending time with the body of their loved one is hugely important. So when her father died, Ms. Ashenburg made her way to New York, and there he was, in a hospital bed, wearing “an old favourite, a V-necked brown cashmere sweater” and “except for his pallor, he looked cozy.”

She writes: “People talk about their hearts breaking, but I felt, instead, that my head was bursting … with one phrase, as if the words, in different fonts and sizes … were swelling my head beyond bearing. The words that came from my throbbing brain, but not my lips, over and over, were ‘Thank you. Thank you. Thank you’ … for a parent who had shaped my life with his constant encouragement and admiration.”

In the recent anthology The Heart Does Break, various Canadian writers tell the story of their own grief, from writer Marni Jackson’s funny and moving account of her father’s cremation, to Jill Frayne, daughter of the late activist June Callwood, who writes that “the state of emergency that came with her death has passed, and I have a sense of her again, not in the world, of course, but in myself, in memory and in dreams, but strongest in my body, in breath and bone, as if by physical feat I have incorporated her.”

This past January, I felt the familiar stone in my chest as I approached the third anniversary of my mother’s death. It was like living the moment over and over again. But this year, I surprised myself by sitting down and writing my mother a letter, catching her up on all that has happened since she left us, most of which would absolutely delight her: an upcoming family wedding, graduations and quite possibly the news that I am finally having that root canal.

I felt a little foolish, but the more I wrote the lighter my heart became, until the stone disappeared and my day seemed full of possibility again.

Grief changes us, deepens us, surprises us. Joannie Rochette has made all of us who grieve ache a little more profoundly on her behalf. She has a whole country of people mourning her loss – not to mention their own.

Parents, the childless/free & friendship

As you can probably tell from the number of times I highlight her posts here (lol), Lisa Belkin's Motherlode parenting blog on the New York Times website is often, well, a motherlode of interesting thoughts & conversation on parenting & family issues, which sometimes cross over the border into the Land of IF.

Two recent posts, on monitoring your child's friendships, and how friendships change after having a baby (which was more about how difficult it is to make friends after having kids), were followed by a third this week -- actually two guest posts in one -- one complaining about the post-baby gap between herself and a vehemently childless-by-choice friend, and another by a mom who longs for friendship that extends beyond baby babble.

The first post is the one that seems to be getting the most comments. It's heartening that (so far, anyway…!), the tone of the conversation has been relatively civil -- and also to see how many commenter (both moms & childless/free people) point out that not all people living without children are child haters. A few people have even mentioned infertility-related childlessness or being "childless not by choice" (although I wish there were more from that point of view).

Comment #12 by Starflower was probably the one that resonated most with me (& to date, it's been the comment most recommended by readers -- including me!). In part, it reads:

No one has to become a mother to truly feel love or to feel like a "real" woman, Sasha. My husband, friends and family already make me feel that way. And frankly, I've heard about all I'd care to on the gigantic gap that separates you from me. I get it. You’ve made a choice that radically changed your life, and what you're doing is very hard. But don't you dare lump me in with all the humorless child-haters that you believe are lurking around every corner. As the years go by and my friends' beautiful children grow and change, I hope to be able to play a unique role in their lives: the friend, who by very reason of her childlessness, has the time and energy to offer help, comfort, and support should they need it.

And please don't forget that we childless women also quietly attend your showers, tenderly cradle your newborns (if we're allowed to), and melt over pictures of your precious little ones, all without ever experiencing an ounce of the same approval and congratulations that are heaped upon women who've chosen to be mothers.

Amen.

Loriology

Rules: YOU! Yes, you, reading this. You’re tagged. Now that you know more about me than you ever wanted to know, play the game, it’s fun! Let others know a little more about yourself, repost this as your name followedy by “ology.”

FOODOLOGY:
What is your salad dressing of choice? ranch
What is your favorite sit-down restuarant? Mmm... probably Montana's at the moment.
What is your favorite fast food restaurant? McD's (for the fries!)
What food could you eat every day for two weeks and not get sick of? Pasta
What are your pizza toppings of choice? Sadly, I can't eat pizza anymore, because of my issues with tomatos. :( When I could, I liked just plain ol' pepperoni with extra cheese.
How many televisions are in your house? Three (for two people!)
What color cell phone do you have? Silver

BIOLOGY:
Are you right-handed or left-handed? Right
Have you ever had anything removed from your body? My wisdom teeth, but I think that's about it.
What is the last heavy item you lifted? My briefcase??! lol
Have you ever been knocked unconscious? No
Have you ever fainted? No

BULLCRAPOLOGY:
If it were possible, would you want to know the day you were going to die? No.
If you could change your name, what would you change it to? When I was a kid, I wished, wished, wished my mother had named me Laura instead of Lori. These days, I don't mind it so much. It's me!
How many pairs of flip flops do you own? I don't think I own any sandals that could be classified as true flipflops, but I have plenty of sandals, & three pairs of "athletic" sandals (Rockports). They are incredibly comfortable.
Last person you talked to? Besides dh? I had an hour-long phone conversation last night with a former coworker (now retired).

FAVORITOLOGY:
Season? Anything but winter, lol.
Holiday? Christmas.
Day of the week? Friday
Month? Not sure. Probably May or June. Not too hot yet, but nice enough.
Colour? It's always been blue, but I like others these days too.
Drink? Coke, tea.
Alcoholic? Not a big drinker, but I will usually order a nice glass of Chardonnay. Baileys also goes over well with me, lol.

CURRENTOLOGY:
Missing someone? You bet.
What are you listening to? Dh downstairs, strumming on his guitar.
What are you watching? Nothing right now, but I'll be heading down shortly to watch the Oscars. : )
Worrying about? Work. :(
What’s the last movie you saw? In the theatre? Crazy Heart with Jeff Bridges. On DVD? We very seldom watch movies on DVD. I honestly can't remember!
Do you smile often? Not as often as I'd like to.
If you could change your eye color what would it be? I like my eye colour well enough. Maybe I'd make them a little more blue?
What’s on your wish list for your birthday? A sunspot vacation & a birthstone ring. (Hey, it will be my 50th! -- I think I can splurge!)
Can you do a chin-up? VERY doubtful.
Does the future make you more nervous or excited? Nervous.
Have you been in a car wreck? Yes
Have you caused a car wreck? No
Do you have an accent? My American cousins say I do, but I think they're the ones with the accents. : ) (And I do NOT say "aboot!")
Last time you cried? Thursday night
Plans tonight? Watch the Oscars, with a big bowl of popcorn.
Have you ever felt like you hit rock bottom? No, but I've had some low points.
Name three things you bought yesterday? Dinner, a book for dh with my Chapters rewards card, & coffees for us at Starbucks.
Have you met someone who changed your life? Yeah -- dh! lol
For the better or worse? Better. : )
How did you bring in the New Year? At home with dh.
Would you go back in time if you were given the chance? To revisit certain people & places, yes. To redo things, probably not.
What songs do you sing in the shower? Golden oldies -- girl group stuff from the 60s, lol.
Have you held hands with someone today? Yes, dh.
Who was the last person you took a picture of? FIL (on his 81st birthday) with stepMIL & her grandson.
Are most of the friends in your life new or old? Mostly old, or older.
Do you like pulpy orange juice? I love orange juice, but pulp-free is better.
Last time you ate peanut butter and jelly? It was so long ago, I don't remember.
What were you doing at 12 a.m. last night? Sleeping.
What was the first thing you thought of when you woke up? "Ahhhh, it's sooooo nice to sleep in!!"

At the cemetery

Today was a gorgeous, sunny, springlike day (10C/50F), and so, when we made our usual weekly visit to the cemetery, we decided to take a walk around the property. On our way back to Katie's niche, we decided to make a stop at the nearby Garden of Angels, which is the part of the cemetery designated for infant burials. Making arrangements after Katie's stillbirth, we were shown a spot there that could have been hers, but declined: it just seemed too, too sad, & the thought of interring her ashes in a niche seemed somewhat more bearable than lowering them into the cold, unforgiving ground.

Over the 11+ years since then, however, through our support group, we've met many parents -- probably almost a dozen that I can think of -- whose babies were buried there (as well as a few others whose babies were buried in the same cemetery but, like Katie, just not in the Garden of Angels). And we go over there to visit, every now & then, and sadly note the number of new mounds of earth & temporary markers that have appeared since our last visit.

We hadn't been there in awhile, & oh my. :( So many fresh, new, tiny graves. Three from January; two in the past week alone. Dh sadly noted that, from the first time we visited there in 1998, at least three new rows have been added to the Garden, stretching back further & further from the road.

Some of the graves have flowers & notes, stuffed animals & small toys sitting on top. Some are empty, every time we visit. Eventually, the temporary markers get removed; some have never been replaced with permanent ones. I wonder whether it's a matter of cost, whether it's a matter that's just too painful for the parents to face, or whether the absence of a marker indicates that they are trying to forget that the pregnancy ever happened.

While I know that not everyone visits the cemetery weekly, as dh & I do, it makes me sad to think that some of these babies' final resting places go unmarked & unvisited.

Those of you who have buried babies: how often do you visit the cemetery (if ever)?

Resurfacing : )

My last post, well over a week ago, was titled "Is there life beyond the Olympics?" -- and, as one wisecracking commenter posted, "Judging from the lack of updates, the answer is no." Touche, lol.

There IS life -- but just not online lately, it seems. The Olympics, busy season at work, computer AND Internet/phone company issues at home, and just life generally seem to have conspired to keep me offline for most of these past two weeks. My Google Reader totals have soared back above 1,000 posts again (although I did manage to wrestle them back down around 850). So my apologies for not being more up to date on others' posts, & my lack of commenting.

I've found a few interesting articles that I hope to share with you shortly.