Good Bread

One of my absolute favorite things in life is excellent bread.  I have a particular affinity for the chewy, crusty, open-structured artisan loaves that have proliferated in recent years – to the point where they’re easily available in most grocery stores.  Over the last few years, I often asked Arthur to grab one on his lunch to bring home for dinner that night.

Obviously, the pandemic changed that.

I’ve been baking since I was small, but artisan loaves have always eluded me.  Commercial bakeries have steam-injected ovens that help immensely with the crust texture and while I’ve tried most of the suggestions for home bakers (ice cubes to the bottom of the oven, small pan of water, throwing water onto a hot baking sheet underneath the bread), I’ve never gotten the combination of chewy/crunchy that comes so easily from the grocery store.

Since dropping by the grocery store isn’t the usual quick stop now and when I’ve tried to order artisan loaves the store hasn’t had any, I decided to tackle the project.  Armed with baker’s tools amassed over nearly fifteen years of adult life and cooking and fortifying myself with some of the bread episodes from The Great British Baking Show, I pulled out the flour, yeast, salt, and water that was supposed to turn into excellence.

I started with French baguettes following this recipe.  While my rise times were slightly longer than the recipe indicated, a cast-iron skillet preheated in the oven with boiling water poured over to create the steam was a revelation.  I don’t know how, exactly, it’s different than the other methods of making steam, but it worked better than anything I’ve tried before.  I suspect it has something to do with the way the skillet holds and diffuses the heat in the oven.  Leaving the baguettes in the cooling oven with the door cracked a couple of inches also helped the crust texture – much better than putting them on a rack on the counter.  I cut the number of loaves to two (I like a slightly thicker loaf) and while it’s not quite commercial bakery perfection, it’s also pretty darned good.

Ciabatta for sandwiches came yesterday (recipe here).  With my trusty stand mixer to knead the incredibly wet dough and a baking stone, I was amazed at how easy this particular bread turned out.  It also was every bit as good as anything I buy in the store, making me wonder why I’ve been paying $2.50 – $3.50 a loaf for years.  The crust was perfect, the open texture fully present.

The irony, of course, is now I have no dinner parties to plan, no people to host, and no small groups for places like church to throw open the doors.  Bread feels like it should be baked for people.

There’s a lot of clashing think-pieces generated by the pandemic and quarantine: chance to learn a new skill!  Collective trauma!  Optimize your life!  It’s okay to not be productive!  We can figure this out!  We’re all sitting in the corner with no attention span!  Learning to bake these loaves seems to fall under all of the above for me.  It feels like the kind of thing that I could post to social media as proof that I am doing great under quarantine, but that belies the quiet desperation and anxiety that’s somewhat soothed by shaping dough, the crash that comes after the picture of the pretty loaves: what’s next?

I don’t know.  Nobody knows.

It reminds me a bit of when I was pregnant with the pregnancy that turned out to be ectopic, that rollercoaster of hope dashing into unpleasant realities.  Desperately clinging to any good sign, cognizant of the many bad ones, hoping for the best, all with an underlying suspicion that this is not going to turn out well.  One of the qualities of trauma that the TV shows tend to elide is the long stretches of waiting and boredom and worry.  The bad news is preceded by hours, days, weeks of build-up.  It’s sitting with a book in my hands, unable to focus more than a few minutes, counting the time before the next lab result, the next ultrasound, when the doctor arrives, the phone call (then) or the next news report, the next zoom gathering, the next phone call (now).  Trying to find ways to fill the time.  It could be better.  It could be worse.

I miss people.  It’s a weird thing for an introvert to admit.  I miss running into acquaintances at the zoo or the grocery and chatting, small talk that I usually feel awkward making and used to dread a bit but now feels like a lifeline.  I miss my parents visiting, miss hosting two of my SILs for dinner periodically, miss visiting with BIL/SIL and niece and nephew, having my MIL and FIL come over.  I miss choir and church and the collective responses: Peace be with you!  And also with you.  And also with you.  And also with you.  The absolution, the communion, and then the other communion of doughnuts and institutional coffee and talk.

Perfecting recipes feels like faith.  Faith that someday there will be dinner parties and small groups and people to bake for again.

At least there’s good bread to eat while I wait.

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The ciabatta loaves.

Step, Step

We take everything one day at a time these days.  I’ve heard that as advice a lot over the years (and mostly ignored it), but now it’s all but impossible to do anything else.  It’s strange to see our normally bustling calendar stripped bare of notations, just the date in each square. We’ve been listening to the Frozen 2 soundtrack in our house and one of the songs, titled “The Next Right Thing” has a resonance it’s impossible to miss right now:

Take a step, step again

It is all that I can do

The next right thing.

In a moment I’ve been dreading since the news broke about the Life Care home in Seattle back in February and I more fully began to understand what we were dealing with, my grandfather passed away last week, Covid-19 the most likely cause of death.  The staff at his nursing home took great care of him and for him and I am grateful for them and their good work.  We grieve our private loss, but I know we are also grieving in a community that extends from Italy to Spain to China, across the United States, around the entire world as the virus grimly marches forward.  Friends have lost family members or had relatives seriously ill.  Others are laid off or furloughed and worried.  Still others are parted from living loved ones that they desperately miss.  So many unique losses for so many people, so much collective sadness.  I haven’t decorated the plain wreath I hung on our door at the start of Lent or put up flowers to replace the bare branches in my vases.  No matter what the church calendar may say, the light has not burst forth yet in this season.

And with the dawn, what comes then?

When it’s clear that everything will never be the same again…

Yesterday morning, when Arthur got ready to leave for work, the car refused to start.  This was not a total surprise as we knew the battery’s getting old and we’re trying not to do too much with it since we know we’re going to most likely be buying a new vehicle in the fall.  With no time to try to jump it right then, we hustled everyone into the other car and I drove Arthur to work.

It was the most novel, lovely thing, just going out and driving an essential 30-minute round-trip.

The route to Arthur’s work is fairly scenic, which helps.  There was a heron wading in the marsh and the sun shining across the waters.  After weeks of not leaving the house for days at a time other than work and picking up groceries every once in a while, though, it was such a strange, pleasant feeling to drive further than my extremely short commute.

It’s funny how these little events that I barely would have noticed in The Time Before are taking on such significance now.  Sitting on the porch swing as the weather gets nicer has become a welcome break from indoors.  Having a conversation with a neighbor across the yard and safely socially-distant is wonderful.  We watch the birds at our feeders, mostly goldfinches now.  There are also some events that never would have happened in The Time Before: we got to watch our local Air Force wing take the fighter planes for a flyover to salute the hospitals and all the healthcare workers.

We are – like so many others – okay and also not okay.

We stay home.  Go to essential jobs.  So far, all healthy.  Wait.

But break it down to this next breath

This next step

This next choice is one that I can make…

The next right thing.

 

A Slow Burn

One of my more visceral memories from childhood comes from when I had chickenpox.  Age-wise, I’m among the oldest Millenials and I got it before the vaccine was widely given.  Mostly, what I remember is the incredible itching.  I had gotten a full-blown case, spots everywhere with fever, but no major complications.  “Don’t scratch,” my dad told me.

“But it ITCHES!” I wailed.

“You don’t want to get infections and scars, especially on your face.”

“I DON’T CARE IF I GET SCARS!”

“You will when you’re 16.”

As I grew up, though, I read more about diseases like polio (author Peg Kehret’s Small Steps: The Year I Got Polio is a well-written, YA-level account) and mumps and measles.  I shivered at the horrific accounts of the Spanish Flu and did high school reports on the Black Plague.  I was glad that I never had to experience them, and even as my belief that medical science could conquer almost anything faded quickly, I felt fairly secure.  I rejoiced when the girls got their chickenpox vaccines, that they wouldn’t have to know even a week’s itchy misery, let alone the more serious complications.

~*~

After E got home from the NICU, we were under quarantine for a year.  I was allowed to take her to medical appointments and occasional shopping expeditions (where I kept her covered in her car seat and sanitized virtually everything we touched).  Arthur went to work and did everything he could to stay away from illness, as did I.  I had an elaborate routine post-shift of changing at work, washing any exposed skin from my shift, my scrubs sealed in bags and washed separately with the washer bleached afterwards.  E and I didn’t go to church, and after his second job ended in the early fall (before cold/flu season), Arthur didn’t either.  We didn’t go to gatherings (with the exception of my brother’s memorial service, where the worry E would catch something added to the general awfulness of the situation).  I used to take E for walks in the fresh air when it was nice, social-distancing ourselves by at least 3 feet from other people before the term entered the lexicon.  We had hand sanitizer stationed all around the house and my hands were often dry and cracked from washing.

All this to say, these precautions aren’t totally new to me.  The fear isn’t new.  The isolation isn’t new.

It’s a deep breath and the slow burn of anxiety as we wait in ways I never thought we’d have to do again.

~*~

In my house, we are all low-risk as possible for the serious complications and doing everything we can to be responsible citizens to prevent the virus spreading/complying with social distancing.  I know the virus can be severe in younger people as well and we are not by any means taking that potential lightly.  Strangely, I’m less anxious about working in health care than I would have thought – but, then, I’ve known since long before going to nursing school that communicable diseases were a risk I had to assume if I chose this field.  Obviously will be following all guidance closely and extremely careful complying with all personal protective equipment/isolation requirements (as always).

I am definitely worried about my parents, friends, my last surviving grandparent, all the elderly/immunocompromised and what happens next.  Reading about Italy’s current situation is almost overwhelming in its awfulness and the decisions that I suspect we will shortly face in many other places.

I know that experts have long modeled and predicted pandemic scenarios, but in day-to-day life, it’s felt easy to rest secure.  There are so many things to worry about just in a normal course of existence.  This one really didn’t make the cut in my head.

Yet here we are.  I gave blood on Monday – one tangible thing I could do as someone who’s eligible, currently healthy, and has a blood type in high demand.  Now we take the precautions recommended by the experts, comply with public health recommendations, check in with people by internet/phone, and wait.

Waiting, as I think we all have experienced in various ways, is far tougher than most people give it credit.

Here We Are

Seven years.

Seven medicated cycles.

One attempt at a medicated cycle, stopped on day one due to cyst.

Two fresh rounds of IVF.

Two FETs.

Six total embryos transferred between 2013-2019.

One natural pregnancy.

Two daughters born.

One big unknown.

It seems a bit fitting that in the same month I got the PCOS diagnosis back in 2012, we are wrapping up the last loose ends in 2019.  Same sunshine, same crisp air, same bright trees and dusty corn fields.  I wore space rocket socks both to commemorate the first all-female space walk and also because we are lifting off to journey to new places.

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Fertility treatments ended with my fourth and final transfer today.  It’s a weird feeling.  It’s like if my brain is a desk that’s usually stacked high with all manner of paperwork and other items, I just reached out, swiped everything off, and the whole thing is open and blank (there’s a huge mess on the floor, but the sorting is for another day).

I’m not going to pretend I’m not anxious – anxiety is kind of what I do.  I’ve been anxious that something would delay the start of the cycle, then anxious that something would happen to force me to restart the cycle next month, then anxious that the embryo wouldn’t thaw correctly, now anxious about a negative pregnancy test. But here we are, and no anxiety can take away from the fact that #6 (a euploid “fair” graded day 6 embryo that gives us around a 40% chance of live birth) is successfully transferred and we no longer have anything left in storage.  This is it.

Yesterday, after my brain spiraled into dark places, I put an old Fredrick Buechner quote on my letterboard:

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That’s my goal.  Whatever happens next, be not afraid.

Ready, Set…

Last week, I called the RE’s office about a few assorted matters since the FET visits and meds should start fairly shortly (within the next week or so).  First up was my flu shot.  Due to my job, it’s not so much a question of if I’ll get exposed to influenza, it’s a matter of when.  As I’d read over the medication instructions again, it occurred to me that the steroids – designed to weaken the immune system to provide a better chance at implantation for the embryo – might cause my body not to form much of an immune response to the vaccination.

Based on my period-tracking app (which is fairly accurate for me), my cycle is set to commence this weekend, which also concerned me.  Weekends are the worst time to have to start things or call medical offices in general, not to mention I work on the weekends.  I wanted to make sure everything was squared away and I knew who to call and what to expect.

Turned out to be a good thing I checked in.  Dr. E confirmed that the flu shot did need to be obtained before I started the steroids and hopefully in enough time to give my immune system the time to build the antibodies.  That meant the day before leaving on a major trip I was calling pharmacies to see where I could get one.  The one that had vaccine was the one not in my insurance network, so I paid about $41 for something I usually get for free.  Add it onto my running infertility tab, I guess.  Better than getting sick later – if this cycle works, I’m on the steroids until I’m 8 weeks along, which puts me into December, aka flu season, based on the best information I have (the dark part of my mind is grumbling that this is ridiculously optimistic, why would I think this cycle is going to work at all?).

It also transpired that the local office isn’t staffed with a nurse on the weekends currently, just a lab tech and ultrasound tech, so start cycle visits have to go to the main office (around 2 hours away) on Saturday/Sunday.  “I can’t do that,” I said.  The nurse – who knows me well and was at the office through 2013-2014 when I was doing the majority of my cycles and IVF – said that since I know the protocol, can do my injections, and understand when to call if something gets strange, she could do my start cycle visit the week before my period is projected to start and then she’d leave word with the office that I could be seen locally for the ultrasound + blood work.

I’m not sure if I’m comforted by the fact that I knew to call in and check the finer details (because there’s always something) or a little unnerved that I’ve spent this much time doing ART.

Anyway, I had my start cycle visit Tuesday.  That went well, I nailed down the details of exactly which office to call at any point in the weekend if my period starts, and we mapped out as much of the cycle as possible based on my app.  At this point, it’s just a waiting game.

Clear

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I went for my saline infusion sonogram (SIS) today.  Walking into the building, I could feel my anxiety almost immediately ratchet up.  I mean, I think my RE’s great, the staff at the office has always been fantastic, but it’s the site of more than a few Really Bad Days so my body/mind seems to have a fairly automatic response to walking through the doors.

I checked in, waited, and was ushered through to the ultrasound room.  Changed.  Dr. E came in and, seeing my reader, asked what I was reading.  “Dr. Deirdre Cooper Owen’s book Medical Bondage, about James Marion Sims, the origins of American gynecology, and the way the use of Black enslaved women and Irish immigrant women as test subjects has influenced pervasive myths about pain tolerance and such that are still coming up today,” I responded*.

Never let it be said that I am not honest (and exceptionally bad at making small talk).

Dr. E thankfully engaged the topic and so that’s a good bit of what we talked about while I had my SIS.

As far as results, things look fine.  My ovaries are mildly polycystic (the usual) and my uterus is clear.  Now I get to wait for September.

*It’s an excellent book so far – if a hard read – that absolutely deserves a serious discussion of its own.  I read about it on NPR’s Code Switch Book Club and picked it up because anything that talks about medical biases regarding race and sex, especially ones that effect perception of pain and treatment, is an extremely relevant read professionally and personally.  

This post is a part of Microblog Mondays – if you want to read more, head on over to Stirrup Queens.  Thanks to Mel for originating and hosting.

“And”

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Content note: pregnancy, children, loss – none recent

This weekend, we tore up some of the scrotty grass that’s never grown well next to our patio in the back and put in hostas.  I pulled out the dead hydrangeas from the back bed and planted shade loving coral bells.  We went to visit college friends and as we sat, I had one of those moments that might be called transcendent or even holy, where for just a second, everything was right with the world and good.

The new life, both literal and figurative, was all around us.

I came home, checked my calendar, and realized that it’s not all that much longer until my saline infusion sonogram for this final transfer.  And before I knew it, this morning I was ugly crying, the one that isn’t a couple of crystal tears decorously sliding down the cheeks, but the red-faced, sobbing, snotty Kleenex filled kind.

That’s life, though, isn’t it?  At least after a certain point?  Where the most extraordinary exists among the prosaic of every day and the deepest, darkest muck that can be dragged up?

I am so incredibly, amazingly thankful for my girls.  And I am so terribly sad that I never got to meet the three that died and were miscarried early, long before they truly lived.

I honor the truly ordinary, uneventful pregnancy I got the immense privilege of experiencing.  And I grieve the long weeks of waiting, of fertility treatments and IVF, of hope mingled with sadness, of ultimately having three others over far too early.

I get the loveliness of watching my older daughter survive and now thrive.  And I mourn that she lost the last weeks in pregnancy that she should have had, that she went through so many painful procedures, that we were separated by plexiglass walls and nights apart at the beginning of her life.

I can’t even express how much gratitude I have to see the girls treasuring each other and also fighting – as siblings do.  And I can feel my heart breaking again and again and again that my sibling is gone, that a person I held as he came into the world left it long before me in such a terrible, senseless way.

I hold my dear ones close, their precious selves tangible and messy and wonderful and alive.  And I cry remembering the unnatural coldness of my brother’s still face, the benediction of viewing him in death, the slight smear of blood that transferred to my hand when I put it on his cheek.

I am fiercely glad for my marriage and the love my husband and I get to share every day.  And I mourn the things we have both broken over the years, some of which are still being repaired.

I am grateful for the chance to complete this final cycle, to close out this particular road, to know that no matter the outcome, I am truly fortunate and ready to live this good life I have.  And I am anxious, struggling with the months of waiting in the lead-up, dreading some painful procedures, and worried about the potential for more hurt.

For the last several months, I’ve been veering back and forth between the extremes, saying how I’m fine (true) and FINE – F*cked Up, Insecure, Neurotic, and Egotistical * – (also true).   It doesn’t sum up neatly, the pros and cons on the paper don’t cancel each other out.  They’re all true, all a part of what poet Mary Oliver termed “your one wild and precious life”.

I am, without a doubt, in today’s parlance, a hot mess these days.

And…it’s an absolutely beautiful mess as well.

*credit to Louise Penny

This post is a part of Microblog Monday.  If you want to read more or add your own, please head over to Stirrup Queens’ blog.  Thanks to Mel for originating and hosting.  

Ticket In Hand

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We had our RE consult today and it did not take me long to realize that in the fast-moving world of reproductive endocrinology, I’m definitely a blast from the past.

When I did my first FET cycle in early 2014, I used Lup.ron, oral estrogen, PIO, baby aspirin, a short burst of Medrol, and valium for the transfer.  Today, the FET we’ll undertake in September/October will involve injected estrogen every four days, PIO twice a day (!), dexamethasone, baby aspirin, medrol, and predisone.

My response: “I JUST got feeling back in all the areas of my butt and now PIO is TWICE A DAY?!”

Apparently, this protocol results in much higher implantation rates.  Dr. E explained that there’s too much variability with oral estrogen to be comfortable – apparently some women really struggle to get levels high enough even with high doses – but with the injections, it’s been much more consistent.  The steroids lower the immune system a bit to allow the embryo to implant and the different types plus longer dose periods than before seem to really help this process more effectively.  No more valium for transfer either.  Two days of taking it easy, like before.

I asked how likely the blastocyst we have in storage was to thaw properly and Dr. E told us since it’s frozen with the newer cryopreservation methods, it’s around 98% certain that we’ll have a transfer.

I am…a little overwhelmed, to be honest.  Not so much by the protocol itself (though it certainly is different than any other fertility protocol I’ve undertaken) but simply by the fact that this is it.  As weird and f—ed up as this sounds, the RE’s office and fertility treatments and reproduction (or lack thereof) have been this huge part of my life for about seven years.  Whether or not this FET or anything else results in a pregnancy, my reproductive years are coming to a close.

I won’t miss the worry, the miscarriages, the fertility treatments, the incredible sadness of failed cycles, the two-week wait, or any of that stuff.  Infertility, high-risk pregnancy, loss, and NICU inflicted real wounds that are still healing and scars that still ache at times.

But there were silver linings that I couldn’t appreciate in the trenches.  Dealing with infertility and the associated complications also moved me from being someone who looked over her shoulder for another person when someone asked for an adult to someone who says “here, me, I’m an adult”.  I can battle with a ferocity I didn’t know was possible and also know when it’s time to walk away from a fight.  I know how to talk to an insurance company, how to marshal my resources, and who to call.

It’s more that I’m letting go of something that consumed vast amounts of time, resources, emotions, and despite the fact that this is, inherently, not a bad thing, it’s a change and a door closing.  It’s moving into an entirely different landscape – where I won’t chart my cycle, pee on OPKs, alternately (depending on where I am in an attempt to get pregnant) hope for or dread my period, or take pregnancy tests.  I’ll get rid of the maternity clothes and the baby stuff.  Labor and Delivery will go back to being a department with no more significance to me than Endoscopy or Medical-Surgical.  I’ll change into whatever lies ahead and deal with it, hopefully gracefully.

It’s strange, though, being here.  It’s like waiting in an airport, ticket in hand, and not knowing exactly where I’m going next or how many transfers or bits of lost luggage, but knowing that my flight will depart soon for somewhere.

This post has been a part of Microblog Mondays.  If you want more, please visit Stirrup Queens‘ blog.  Thanks to Mel for originating and hosting.

Luck

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Ever since I called my RE’s office to set up the series of appointments to lead up to the final transfer, it’s been on my mind a lot.

Like, a lot.  As in a truly ridiculous amount.

I think a big part of it is the unknown aspect to the thing.  I’m truly privileged in the infertility world with my kids and can be happy whatever way life takes me, but the not-knowing part bothers me.  The other part that tends to get under my skin is that – other than showing up and taking medications as ordered – I have no real control over the outcome.

On the spectrum between the laid-back people and the iron-fisted control people, I am definitely a control freak.  Some of this stems from anxiety (as in the diagnosed type).  My brain has a not-so-marvelous tendency towards getting stuck and panic attacks.  I like predictability, stability, and known quantities – and privilege has allowed me some insulation from the unpredictability of life in other areas.  This, I suspect, is why infertility in general has messed with my sense of self so much.

Earlier this week, I ran across an article about socioeconomic privilege entitled The Radical Moral Implications of Luck in Human Life: Acknowledging the role of luck is the secular equivalent of a religious awakening.  Author David Roberts states: “It’s not difficult to see why many people take offense when reminded of their luck, especially those who have received the most. Allowing for luck can dent our self-conception. It can diminish our sense of control. It opens up all kinds of uncomfortable questions about obligations to other, less fortunate people.”

Infertility is nothing if not one giant game of luck.  Diagnoses, lack of diagnoses, economic status to pursue treatment or adoption, one partner or both, what doctors/labs one has access to, the quality/growth of embryos, whether or not those embryos implant, miscarriages, emotional resources – none of these are really factors individuals have control over.  Heck, when pursuing treatment, I know I don’t even have control over when I have to be at the clinic during cycles.

Acknowledging how little control I really have over my life circumstances – and how much good luck has played a role – is a bit unnerving.  Roberts points out in his article that “I get why people bridle at this point. They want credit for their achievements and for their better qualities. As Varney said, it can be insulting to be told that one’s success is in large part a lucky roll of the dice.”

It feels like – given the sums of money, emotion, and time that are in play during treatment – the outcome should be more predictable.  That anyone who rolls the dice (or wants to roll the dice) at anything related to infertility should be rewarded commensurately.

This post is a part of Microblog Mondays.  If you want to read more, head on over to Stirrup Queens.  Thanks to Mel for originating and hosting.  

Coffee-Mug Philosophy

In my offline life, I’m in the process of some new stuff at my job that changes my workflow and sort of upends my established routines there.  It’s fine, positive even, and it’s something expected/planned but it’s amazing how much energy goes into change and re-configuring my habits.

The other day, these words fell out of my mouth: “It will be fine!  All this upheaval and hard stuff is going to make us stronger, right?”

Ironic, because I really hate that particular cliché.

~*~

I heard it quite a bit throughout the infertility journey: what doesn’t kill you makes you stronger.  I heard it when Arthur went through job losses.  I heard it in NICU.  I’m grateful no one said it too me after my brother died because suicide pretty much flies in the face of that kind of gritty positivity.  But that statement has hovered in the background of most of the big, tough moments of my life.

I think – as with most “sound bite” or “meme-ready” sorts of statements – the reality is much more complex.  I also think sometimes it’s employed as a quick conversation ender or a way to escape big feelings.

There are hard experiences that I feel have made me stronger, mostly those that are designed to break down before building up.  Nursing school sucked.  It was terribly long hours often (getting up at 4:15 am to drive two hours to a clinical site, being there for 8-10 hours, then going home), the studying was a full-time job, and I have never forgotten my first semester lab where everyone cried at least once except for the two students who had been in the military.  It was also truly worth it and the toughness was incredibly important when I got into real world and took my first assignment on a general medical-surgical/telemetry floor.

Some of the job losses for Arthur fall into this category as well.  It was sort of a surprise to me that after Arthur’s first job loss, the sky didn’t fall and we figured things out.  We were really privileged in many ways, but the experience helped me better hone savings plans and recognize that while it was 100% not optimal, it was survivable.

But as far as some of the infertility experiences go?  Being told there was no heartbeat?  Sitting in a hospital bed being told that I was ruptured and going to lose our very wanted baby?  Waiting in NICU for test results to come back to see if E had NEC?  Losing my brother?  No.

That sh*t broke me to the very core.

I mean, there’s a way in which all these experiences have given me a lot of perspective.  Going through all that reminds me on the days where all the little ridiculous stuff is piling up and it’s frustrating that I’ve survived so much worse.  That I will make it through that day.  I’m much better now at differentiating my small life stuff from what constitutes my bigger life stuff and reacting accordingly.  It’s also made me more able to take some forms of tension or frustration in stride, because, well, I can manage.  In that sense, the adage is correct.  Perspective is valuable in life, absolutely.

What the saying doesn’t reflect, however, is that there are some really ugly broken, jagged edges that are still in the process of being smoothed.  It doesn’t reflect the big ways in which these events changed the course, not always for the better.

I started out in elder care as a nursing assistant when I was 19 years old.  I loved it.  I always envisioned myself as a hospice nurse eventually.  I did some clinical time with hospice and felt confirmed in that calling.  Even when I started in the “real world”, I took assignments that would give me experience.

Then infertility hit and I was just so sad.  Conflicted.  Too many emotions running rampant to step back and be in a high-emotion field like hospice.  I put the dream on hold, mentally, and moved forward with a different path hoping to eventually move back that direction.  Then all the losses happened, NICU happened, and my brother died.

Now, I work in an area where I come in contact with the “hard stuff”, but in far more limited doses than a field like hospice.  It’s a good balance, I’m good at it, and I’m happy.

But I still mourn, a bit, that I had to admit that infertility, miscarriage, prematurity, and suicide loss limited me.  Maybe someday, but it will be years and a lot of therapy if hospice is ever back in my path.  I won’t do it unless I know my stuff is fully handled and integrated.

Empathy is another sort of mixed bag in life after everything.  On the one hand, I know these experiences have made me more empathetic in many ways.  I definitely can identify with people’s struggles and have a better ability to be present in those moments.

But it’s also made it far easier – especially when I’m tired, stressed, overwhelmed, or overstimulated – to fall into a pain Olympics sort of mentality or get really jealous.  I don’t think this is true for everyone by any means, but it’s definitely an issue for me.  I’m ashamed to admit that even while I was very happy for my BIL and SIL when they got pregnant, I was positively green with envy that they had gotten pregnant with twins on their first fertility treatment.  It threw me back mentally into every f*cking failed cycle and miscarrying twins on that first hopeful IVF.  I was happy for them but absolutely overwhelmed also at how sad and angry I was for my own losses.  This resolved with time and things are fine in that set of relationships at this point, but it’s not a great quality and one I’m on close guard against.

All the grief has also exposed the fault lines in some relationships and the Awful Things People Say.  After my brother died, it’s been a revelation how much stigma suicide really carries and also how uncomfortable some people are with grief and strong emotions.  Those secondary losses were really unexpected and the reshuffling of boundaries has been painful.

The fall-out also shows up with everything related to pregnancy or conception.  I’m afraid to embrace the idea of this final embryo transfer – even when I know, no matter how things fall out, I will be okay – because the whole thing activates all the panic responses and pushes me back to thinking on all the other memories.  When I was pregnant with M, my OB wound up allowing me to have appointments weekly through the first trimester, until both the risk of pregnancy loss had gone down and I could pick up the heartbeat on my home fetal doppler.  I was having panic attacks I couldn’t get under control, despite knowing I would manage no matter what the outcome.  It was awful and I’m really grateful that my OB was so kind.

And perhaps that’s one other little silver lining to the tough stuff: I’ve had the opportunity to see people step up to the plate as well.  People who have gone above and beyond and helped so much.  It gives me faith in humanity, in the idea that there is goodness out there.  It helps me better identify where I can be that goodness for others.

All this to say: it’s a mixed bag.  What doesn’t kill me has made me stronger and weaker…and panic attacks…and exposed my limitations along with my less than awesome qualities…and brought out some of my good ones.  But I guess that doesn’t fit as nicely on a coffee mug.