Life's Transitions

My parents, who are excellent planners, have been (thoughtfully) thoughtful and practical about their later years. They are in excellent health, still eating well, exercising, and world-traveling. However, as we all know, time doesn't stop and, into their seventies, they know their remaining good years are limited (I have also been having many tough end-of-life conversations with my aging and elderly patients, which is eye-opening for all of us).  They have bought an apartment, and decided recently to make the move out of their townhome on Hallcrest (the only real US "home" I knew as a child and young adult and which they purchased before we returned to McLean for my high school years in the nineties), as soon as the end of next month. 

Although I have never been very attached to a "place," having moved around almost every 3-4 years in my lifetime (until I moved to Humboldt!), there are a lot of memories (and things!) wrapped up in that house (albeit more for my parents).  The only time during the past thirty years that they haven't been in that house (which was a home base for Vanessa and me through our different educational journeys and holidays home) was one gap during their one post in Copenhagen, Denmark during my med school years. 

While my parents have never struck me as particularly sentimental people, in the de-cluttering process, they have worked hard to off-load many things that have had homes there for the better part of thirty years, including decorations that once belonged to my grandmother Georgine and mementos like beautiful vases, art, and textiles that they saved from their many years abroad (I blew through The Gentle Art of Swedish Death Cleaning by Margareta Magnusson, which practically and sweetly explains what they're doing, in order to save us kids from having to do it).  My mom has been sending me snippets and photos from items from the childhoods of my sister and me (including journals, photos, scrapbooks, and more) which has been quite nostalgic, despite us being in much different places and stages in our own adult lives, and also very far away from McLean (in distance and in years).

I have also been very motivated and proactive about de-cluttering our own home here in California.  As someone who prefers "less" (clutter, junk, etc.), purging or donating kids' clothes, toys, or items (picture frames, obsolete CD disks, outdoor gear etc.) that have been boxed up and collecting dust in our garage or closets for years hasn't felt uncomfortable in the slightest for me and has been very therapeutic in my newfound free time.

However, I have found myself resisting or putting off "going through" many of the more sentimental items in our possession, including certificates, projects, photos, letters, and more that date from my childhood and twenties, before I met Kelvin. I have some, but not that many, things from my own kids' early years (probably less than my mother saved for me even with all of the moving around that we did!).  With so much more being digital these days, I don't have that many printed photos of my kiddos but I do have blogs that I periodically print in book form and have saved some key cards and school mementoes, pretty well organized by year in their school keepsake books. 

I was a big scrapbook-maker and album- keeper, as well as journal-writer as a child and young adult; however, if albums or notebooks just sit in boxes (even if I've now carefully labeled/catalogued them all!), are they worth saving/keeping?  Is there enduring worth in these things, even if not handled frequently or actively "sparking joy"?  At this point, we are not "out of space," planning to move, or on our last days (probably-- as we never know, right!?), which can sometimes (when the fill the space you have) be a driver of off-loading things.  I am trying to figure and sort out "why" I feel so conflicted about releasing some of these mementos, but I know I'm not alone-- there is a reason that Marie Kondo and her KonMari method recommends saving the decluttering of such "sentimental items" for last (however, she writes to try to help us, "Mementos are not memories. We can still honor our past while letting go of excess."). 

I am thinking about my parents frequently as they make this big life transition. I won't get to "say goodbye" in person to our Hallcrest home, but I will, as Marie Kondo writes, "thank it for its service" and move forward to a new chapter.  Thankfully, a house is just a place and things are just things.  I am thankful to still have my parents around and good health for, with hope, many more years!

#LadiesOfNPS say good-bye

 “How lucky am I to have something that makes saying goodbye so hard.”

        -AA Milne, The Complete Tales of Winnie-the-Pooh

If you received/read our family's Christmas letter, you know that 2024 was a rough year!  We pivoted on vacation spots due to the middle east conflict, fled a devastating wildfire on vacation in Canada, lost our beloved 14-year-old pup, Pepper, to heart failure, faced the closure of our local birth center in October, and then endured more terrible election results where he-who-shall-not-be-named prevailed against the better-qualified candidate and superior human being.  The grief and change has been almost too much to process and bear, although we just continue to put one foot in front of the other, and continue to work through it all...

Today, I worked my last day (morning) and saw my very last patient ever at NPS, the delightful and homey prenatal clinic at which, alongside the most amazing team of staff one could imagine, I've served patients and families for over thirteen years (and at which I had my own prenatal visits). After the Mad River Birth center closed, we weren't sure what the future held for our prenatal site. Due to resources, space, and other organizational reasons, Open Door decided that it made the most sense to consolidate prenatal programs under one roof in Eureka. Unfortunately, we were given about one month's notice to swallow the news (although we negotiated for two, having a hard time coming to terms with the abrupt changes and knowing our patients would struggle additionally with little time to adjust to more whiplash).  The prenatal sites are both closed tomorrow (MOVE DAY), so that beds, equipment, supplies, papers, and more can be transferred from town to town to the other prenatal building, RCHC.  

(Now closed for more than lunch)

I was extremely sad when we learned about this (latest) change, grieving another huge community loss. NPS has had a small group prenatal practice with high continuity and satisfaction for patients, families, staff, and providers alike. The COVID pandemic challenged us all (and led to quite a bit of burnout), and, while several incredible prenatal nurses that are dear friends have moved away to other local positions, and providers have also left (or retired from birth work) over the years, we still maintained an extremely high quality of patient care, something uniquely special and unlike anything I have experienced anywhere or any other time in my career. I've delivered multiple children of multiple families, which is incredibly special to me and gets us treasured handwritten notes, cards, and baby photos!

I also have loved commuting 10 minutes to and from work and being able to drop off my kids at school and pick them up (now, likely, and sadly, a thing of the past).  And, although we will be continuing prenatal services at RPS/RCHC in Eureka and, with hope, will continue to offer high-quality and personalized care, I know there will be some kinks that need to be worked out and a tough adjustment period for staff and patients alike.  It's so hard when things that have been working so well for so long come to an end (for reasons out of one's control), and change. is. so. hard (especially for "dinosaurs" like me).

Christmas party photobooth photos from years past...

From a White Elephant Christmas Party- IYKYK

(#LadiesOfNPS, including Aileen, Molly, Dani, and Kayla)

One of the very last sessions at this workstation, my second home

I'm genuinely trying to find the silver linings in the clinic merge (additional exceptional colleagues and less care fragmentation are a plus!), despite the upheaval of everything we've been through in recent months. I've accepted the changes (even logging of EPIC today and walking off campus without tears), am looking ahead to effecting positive change at my "new" job location. Nevertheless, today, I reflect and hold space for grief and feelings, grateful for the wonderful years and laughs I've had and all the friends and memories I will keep despite this conclusion. It's been a huge blessing and privilege to work with the best humans and at the best prenatal clinic around... 

 

Bye Bye, Birth Center

We found out in August that the Mad River Birth Center was, after more than fifty years, no longer going to be offering maternity care/birth services after October (the hospital plans to stay open otherwise).  While shocking (and the timeline was way too abrupt), it was also not surprising, given the hospital's nursing staffing struggles in recent years as well as trends in maternity care in this country.  There are many expanding "maternity care deserts" in the U.S. due to rural community hospitals deciding to cut obstetrics programs, as high-quality maternity care is not a money-maker (in large part due to horrifically low insurance reimbursements for women's care and birth).

Over the last couple of months, I've read a million e-mails and attended "transition" meetings about a shift in birth in the county-- with all hospital births in the county now heading to Providence St. Joseph's Hospital in Eureka, which has also made national news due to a lawsuit involving other less-than-optimal treatment of a local woman with a impending loss of a much-desired but high risk pregnancy due to ethical/religious directives. Redwood Memorial Hospital in Fortuna closed down in 2021.

I just completed my last call shift and attended some of the very last births (one vaginal, one scheduled cesarean birth in my final hours!) at the hospital where I've worked for thirteen years alongside many incredible nurses and birthworkers. I've been a part of some truly miraculous and joyful experiences of so many families, and also sobbed in the hallway with some tough births and traumas (especially during the COVID pandemic). I chose to have my two children there. I went from a brand-new attending to a (mostly unflappable) veteran, crafting my birth style in a way that I'm proud of-- aiming to support patients for empowered, physiologic birth whenever possible (and ruffling some administrative feathers from time to time when fighting for patient bodily autonomy).  I had one last partial night of sleep in the tiny (and cold) call room where I've spent many a night (most weeks, in fact) over more than a decade. It's hard to to believe we're actually done.  I wish lots of luck to the ER docs and nurses for the unplanned/out of hospital births/transfers and other pregnancy bleeders, which will inevitably hit the hospital doors (and, most of all, I pray for the women and babies, who will bear the burden of the risk and outcomes with the hospital's decision).

I didn't actually leave the unit with tears today, but feel somewhat numb, and am trying to stay neutral (cautiously optimistic?) about what the change will bring to me personally.  I will start providing obstetrical care and attending births with an expanded group of Open Door providers in Eureka starting in November. The hospital is about twice as far from my house and we are shifting to more of a organizational laborist model. For now, I'm looking forward to not to have to multitask constantly, juggling both outpatient and inpatient patient care including labors as well as and nurse calls from clinic and the hospital at the same time. I'm excited to not be "the call person" the ER calls periodically, because my former hospital didn't staff or pay OBGYNs for providing consult care. I'm so happy to not to have to be on for ninety six straight hours of OB call (?ever again) and to have fewer call shifts per month (while possibly being busier when working).  I'm looking forward to working at a hospital which seems to have a better and safer staffing model-- for nurses, for surgical crew, for anesthesiologists, for doctors, and for patients, even though there will be some growing pains with the added birth volume.

However, it's  hard to teach me (an old dog) new tricks-- I'm intimidated by the new hospital's medical records system, and have to had to jump through a ton of hoops with log-in training, EMR training, and in-person "orientation" to come soon.  I have some degree of anticipatory anxiety about being a "newbie" in a different system, with different nursing staff and work-flows, as well as supervising residents, rather than working as an individual on my own. However, I know it will get easier with time.

I'm hoping that the state of California and Partnership Medi-Cal can work to encourage better support of local women's birthing options (Moonstone Midwives birth center is another local player, offering low-risk women out-of-hospital births. However, as we know, sometimes birth turns not-low-risk rather quickly and many women prefer to deliver in a familiar homey hospital, which we've now lost for our community).  I truly feel that supporting women and families is my calling and professional passion so, for now, I plan to keep my "foot in the door" of local birth work-- until it becomes personally or professionally overwhelming or unsustainable while still juggling a family practice panel. 

We also have an important election coming up in seven short days, where women's rights are atop the ballot with repercussions that will be far-reaching if the preferred candidate does not win. While I am fairly pessimistic about the outcome, due to the number of (often clueless about women's health and autonomy) men who still run most systems in this country and who vote in appalling patterns (as well as some serious past election trauma, ahem, 2016), I sincerely pray that we could have a different future-- where all women in this country are granted the rights, choices, and health care we all deserve!

Update: some photos from the "Good-bye Goddess Gala" on Friday night

Some wonderful nurses (Tracy, Michelle, Dorothy, Lori, Christie, Kristen) I've worked with over the years.

Lori, Patricia

Group pic (a few generations of birthworkers)

Keep the joy of the moment

I definitely suffer from worrying about the future before it even happens. Many others can probably relate! These wise words were shared by a physician mom (Sarah Rose Wheatley Hartnett) on FB and I thought they was too lovely to not share.  

"I gave my first grader his new light up dinosaur shoes for the first day of school this morning. They are legitimately the best shoes ever, and little dude was over the moon in love with them. Then out of nowhere he started sobbing like his heart had broken. I asked what was wrong, and he said, "My birthday is next year, and I will grow, and on my birthday the shoes will be too small and I won't be able to wear them!"

So we sat and talked, and after he had calmed down I was able to help him understand that if we let ourselves be unhappy about things in the future that haven't even happened yet, we don't get to be happy about what we have right now. And then we are sad twice instead of just once.

And then I sat with myself for a bit, and I thought about how often my enjoyment of the moment is overshadowed by the inevitability of loss, fear of change, the bitterness of free floating guilt, or some other barrier my brain has manufactured to steal my joy.

So as the school year starts, I am going to think about those awesome dinosaur sneakers whenever I hold myself back from diving fully into the things that light me up.

The price of love is pain and loss, and that price can be very high. But we don't need to pay it up front, and we certainly don't need to pay it twice."

May we all do better at enjoying our current joy-filled moments and avoid catastrophizing about future events and potential losses. May we teach our dear children to do the same. 

Koalified 4-ever!

I have to say that I'm not a super sentimental parent about the newborn and little-kid stages of my kids. I adore that they're getting older and have real interests, personalities, and we can connect better as humans (not just as parent/children).  I am a super anti-baby-stuff hoarder and have relished in getting rid of (rehoming, mostly) all of their well-loved infant and toddler clothes and gear as soon as our youngest, Niall, outgrows things. 

Nevertheless, I couldn't bring myself to part with this toddler shirt (Trust me, I'm Koalified) that both kids wore frequently. I think it was given to us/them by their aunt Katherine, although I admit I am not 100% sure. 

 (Iver, left, in ~2017 and Niall, R in 2021)

 I found an Etsy seller (Angela) to turn it into a Keepsake bear, and it arrived this week. 

I love the product so much that I am considering enlisting Angela to re-purpose another item of favorite kids' clothing, like the bear hoodie that Niall wore for about two straight pandemic years!

OreGONE (Part 3): Nostalgia & Throwbacks

I can't recall exactly how long ago it was, but I reconnected with my old middle school (seventh grade) language arts & social studies teacher, Lee, on Facebook sometime in the last year. My mom, who knew him and his wife Lynn well from our days in Kathmandu, Nepal (where I lived for three years in the nineties from grades 6-8), told me that they lived in Bend, Oregon, which is where we happened to decide to go on our little getaway this weekend. 

(My mom also sent me this photo of me and some other Lincolnites from 1994)

We had planned to stay in an AirBnB rental but I reached out to tell him we'd be in town and that we (vaccinated) would love to meet up and catch up if it worked. Well, not only was he (vaccinated also) was willing to meet us, he offered to let us stay in his guest cottage ("casita") on his property for our trip!

We've been out and about during the day, but how incredible it has been to reconnect with Lee and Lynn after about twenty-six years (we left Nepal in 1995 while they stayed several more years).  Lincoln School in Kathmandu is a tiny K-12 international school.  I remember those years so well and so fondly, and still remember so many of the people that were there when I was and that my family knew (through work at the State Department and socially), although our paths have diverged.  The international community has shaped such a big part of who I am and I remember my time in Nepal as being some of the happiest years of my whole life. You also never forget great teachers in your past (even though I find it hard to believe they remember their students!). Lee and Lynn's path took them to Zimbabwe and Argentina, Bend at first being somewhere to spend a few weeks per year on breaks until they fully retired here a few years ago. We have been in Humboldt County almost ten years and have been to Bend a couple of times, but both instances were before they resided here permanently (and long before we knew they were in town). 

We loved hearing about their (now-adult) kids, their paths (and they ours-- they were also very interested in learning Kelvin's story!), as we enjoyed chats as well as a lovely Italian dinner on their back deck.  There is something truly comforting about reconnecting with people you knew in a *former* life, and the time was incredibly special to me. After knowing each other on another continent across the world more than a half-lifetime ago (for me), we have landed seven hours' drive away (what a small world, indeed!) and were able to connect (thanks to vaccines) in person despite the biggest global pandemic in a century. We enjoyed truly the most beautiful of guest rooms in a house directly overlooking the picturesque Deschutes River, with a kitchen and lots of cool amenities (induction stove, pellet stove for heat, solar tubes for light, and heated-seat deluxe bidet. They even had a hot tub on their deck!).

Speaking of throwbacks, Kelvin spotted this Blockbuster in Bend on our way out of town to go on a hike.  Kelvin thought that he had read that there was also one open in Alaska, but brief internet research has confirmed that this is indeed the very last Blockbuster store on the planet (Alaska's store closed in 2018 and Australia's followed in 2019, and apparently there's a Netflix documentary about this very store and story that I’ll have to watch sometime). Any of you who grew up in the eighties and nineties are surely familiar with this relic of American life... seeing this sign made us nostalgic, for sure!  Who would have thought... BEND, Oregon?!  

(and to think we almost just zoomed by instead of stopping for a photo since we were on our way to start a long hiking day, but Kelvin insisted!)

While in Bend, we enjoyed some of our first meals out in a restaurant in fourteen months-- due to the pandemic, it's been over a year of eating my home-cooked food (or getting take-from from two reliable places in Arcata).  Here are some photos celebrating a return to an activity of a former era-- eating at restaurants (which we won't enjoy nor feel comfortable doing with our unvaccinated, might-lick-everything and squirmy, questionably-mannered kids for a long time).

Outdoor dining at Spork

(I couldn't decide if the food tasted so good because of the novelty of the restaurant experience after such a long time or just because I've also gotten tired of my own mediocre cooking!)

We also had delicious northern Thai food at Wild Rose for another meal.

The future (especially a post-pandemic one) is alluring. But remembering those special things-- and people-- from our past is so good for the heart and soul!