'Buddhish':
The Unfeeling Doctor's Freefall into
Buddhism, Grief and Grace
By Melissa Yuan-Innes, M.D.
Copyright Melissa Yuan-Innes 2011
Published by Olo Books
Smashwords Edition
In association with Windtree Press
For Isadora
and
for those who have loved and lost
"I don't call myself a Buddhist," I recently told my husband, Matt. I hadn't formally studied Buddhism. I didn't meditate enough. "I'm Buddhist-ish." I imitated my half-Jewish friend who said he was "Jew. Ish," with a little hand waggle on the "ish," indicating so-so.
Matt laughed. "Buddhish."
Right. Buddhish.
So this book is not the definitive guide to Buddhism.
I did, however, take a messed-up ride down to H-E-double hockey sticks. This is the story of how Buddhism was one of my crutches on the way out.
Which is strange, because I was never terribly interested in religion.
My parents were both raised by super-Christians, which meant they raised us as nothing in particular. "If you want to, do it yourself" was their M.O., so when I was in grade three, I asked to tag along with my friends to church. I got to be the old lady in the Christmas play (yeehaw) and I sang in the choir, but Sunday school was pretty boring, so I dropped out.
One of my grade seven vocabulary words was "agnostic," which suited me perfectly. I didn't know if God existed and didn't think you could prove it either way. "Fence-sitter," said one of my friends, and I agreed.
Then, years later, my life shattered.
I had finally started practicing medicine as a full-fledged emergency doctor. I was 12 weeks pregnant and I couldn't feel the baby moving. So naturally, I ordered blood tests on myself and whipped out the fetal Doppler on my own stomach. I couldn't hear any fetal heartbeat and my B-HCG test seemed low normal. (This was before bedside ultrasounds were commonplace in the emerg, especially in the under-funded Quebec medical system.)
I freaked. I was sure I'd had a missed miscarriage, which means that the baby has died without any outward signs like bleeding. My hospital's radiology department squeezed me in for a proper ultrasound the next day. Before the ultrasound tech could say a word, the baby wiggled its arms and legs at me.
I burst into tears. The tech chided me because she couldn't get proper images with me weeping, but I loved this baby already and now I could finally relax.
But at 20 weeks, I delivered a stillborn baby girl.
We named her Isadora Jane. We buried her ashes. And I tried not to lose my mind.
Since Quebec is probably Canada's most socialist province, its physicians' association offers eight to twelve weeks maternity leave to all mothers of stillborn children (20 weeks to term). I could have refused it and gone back to work, but I knew I needed some semblance of sanity first. Winston Churchill said, “If you are going through hell, keep going.”
I was in hell. I kept going. But I needed guidance.
I felt like a mother, but not a mother. I was a doctor, but not a doctor who was practicing. I was agnostic, so I couldn't even pretend my baby was in heaven.
I was just messed up.
I went to see the local priest. This is not as weird as it sounds for an agnostic. We'd moved to the country and there was a church at the end of our road. Father Dan was cool. He went jogging, often accompanied by a local dog, and a few weeks before, he'd knocked on our door to say hi.
He listened to my story and said, "You need to forgive yourself, and I can't help you with that." He paused and added, "I knew a man who accidentally ran over his three-year-old daughter. He had to forgive himself. But he was the one who had to do it."
This helped enormously. Now I had a goal. Forgiveness. But how should I achieve it? I knew it wasn't like getting an A on a test, which was much easier for me.
I rummaged through the grief and self-help shelves at the Cornwall library and came up with Sylvia Boorstein's It's Easier Than You Think. She wrote about a 40-year-old woman dying of cancer who said, "I'm a better and wiser person because of this cancer. But I'd rather not have cancer."
Bingo. I loved the honesty of it. Yes, Isadora's death could make me a better person. But I'd rather have my baby.
I picked up the book and stumbled into Buddhism.
Life contains suffering.
Perfect. No sugar-coating. You're alive? Not everything will turn out the way you want.
Isadora died.
I was suffering.
I turned the page.
The Second Noble Truth:
Craving causes suffering.
I understood the concept.
I craved my child.
I longed for her. I clung to her. I wept for her.
And yep, I was still suffering.
I turned the page.
The Third Noble Truth:
Stop craving and you can stop suffering.
I knew that if I could let Isadora go and forgive myself, I wouldn't suffer as much.
But how could I do that? How could I say, "Hey, no problem, my daughter's dead?"
I turned the page.
Also known as the Fourth Noble Truth.
Eight things you should try to do simultaneously. No pressure.
Right Understanding
Right Aspiration
Right Concentration
Right Action
Right Speech
Right Livelihood
Right Effort
Right Mindfulness
I tried to wrap my head around the eightfold path by translating these puppies into my own idiosyncratic, "Buddhism for doughheads" version that follows. Mostly, it was easier if I didn't think about Isadora, but about the rest of my life.
Right Understanding
Everything changes. Good and bad. That's what you're supposed to understand.
Or as the great TV show Six Feet Under put it, "Everything. Everyone. Everywhere. Ends."
That made sense.
My family moved to Frankfurt, Germany, for two years. When I returned to my former school for grade eight, the boys called me "bag lady" and threw spitballs at me while the girls gossiped and drew cartoons about me.
The most vicious attacker, "Zelda," had been one of my best friends before I moved.
I just bided my time for the one remaining year until high school, when I would move on to a more evolved pool of humanity. The end was in sight. Ironically, just after our grade eight graduation, Zelda's father was transferred to London, England, so it was her turn to be the new girl. Much later, as in a few years ago, she tried to friend me on Facebook. Eventually, I did friend her back, but by then, her invitation had expired.
Everything changes.
Once upon a time, a great king asked for a ring that would make him happy when he was sad and sad when he was happy. The sages made him a ring that said, "This too shall pass."
***
This too shall pass.
Well, my daughter already passed, to use one of the euphemisms for dying that I'd never particularly liked.
I knew that one day, my heart would no longer be smashed, but I was scared about that, too.
More than anything else, I worried about Isadora. Where was she, now that she was gone? Was she in another realm? Was she just...dust to dust? Was she here, now, crying, "Mommy, don't let me go"?
Right aspiration
Life is transience. Got it. My daughter had already transitioned.
Question: What were you supposed to do about that?
Answer: Aspire to be okay with transience.
Sylvia Boorstein said that since the world was always changing, you should try to be like a surfer riding the waves.
Things might be awful or awesome, but you just ride it out, either way.
Huh. I always wanted to control the waves, or at least control my reaction to them. I would train extra hard! I would study the weather forecast! I would rent the best surfboard!
In real life, I've surfed a few times in Hawaii, but I'm a weak swimmer. In Waikiki once, just after a storm, the waves were strong, which meant they were easy to "catch" and push you along, but you had to be able to swim out to them, against the tide. Repeatedly.
After our first ride, while I battled my way back to the rest of the group, whom I could hardly see without my glasses, our instructor shook his head and said to my husband, "I think your wife has had it."
The Australian guy in our group swam over to ask me, "Are you okay?"
"Yup," I gasped, and paddled slowly after him.
I was exhausted. But I knew where I wanted to go and what I wanted to do. I'm not strong, but I'm fairly flexible and have good balance from yoga training. Plus I'm super stubborn.
I rode the waves several more times.
Sylvia Boorstein told two important stories about Right Aspiration. One was about a grandmother who stayed angry at her daughter right up until the day she died. She no longer remembered why she was so furious, "but I remember that I am angry."
When I was 17, my grandmother looked at me and said, "You look so much like your mother. Just looking at you, I am angry."
This didn't bother me, since any simpleton could tell she and my mother were always sparring. My grandmother and I had never been close. But it meant that I had been marinated in anger from an early age.
Sylvia's other story was that she was planting onions with a friend. They anticipated a bumper crop. The friend suggested they give them to the food bank. Sylvia thought, No, I'll buy you a truckload of onions for the food bank, but these are my onions. Then she took a deep breath and said, "Good idea."
They hadn't even harvested a single onion yet, but Sylvia already wanted to hold on to every single one of them. This story made me smile because it was exactly like me and my family. My family loves stuff. Stuff on sale, stuff that's "cute," stuff that's handmade, stuff that's spewed out by a factory overseas. Anything and everything.
Anger. Grudge-holding. Hoarding things.
If these were Olympic events, my family could easily sweep the gold in all three categories.
Gandhi said, famously, "You must be the change you want to see in the world."
***
So what did I aspire to?
I wanted to honour Isadora.
I wanted her to be safe. I couldn't convince myself she was in heaven, but I wanted her to be safe.
I wanted to forgive myself.
"For what?" my husband, Matt, asked.
"I am the mother. I am the doctor. I should have protected her," I said.
He didn't understand, but I did.
Right Concentration
Captain Cheri Maples, a police officer who has studied Buddhism with the renown spiritual leader Thich Nhat Hanh, said that her first Zen activity was baseball because it absorbed her concentration. (http://being.publicradio.org/programs/thichnhathanh/transcript.shtml)
What does that have to do with religion or philosophy? Not much, on the surface. But I think concentration means you stick with something instead of running from thing to thing.
I had a friend who was always on his way to this fantastic party or texting that amazing friend. Even when he was in front of you, you got the feeling that he wasn't there.
I told him once, "Why are you calling me if you have so much other stuff to do? Just don't call."
He was taken aback, but I wasn't angry, simply matter-of-fact. "I don't care if you call me for one minute. But when you do, I want you to talk to me for that minute."
Of course, I said that when I wasn't lodged in the black hole of grief. Right now, I wanted anyone and everyone to call. But in general, I could see how concentration helped.
The most beautiful description of concentration I ever heard was by the French philosopher, Simone Weil: "Absolutely unmixed attention is prayer."
Stephen Mitchell, a translator interviewed on the public radio show Speaking of Faith (now called On Being), explained, "In that sense, prayer has nothing spiritual or religious about it. A mathematician working at a problem or a little kid trying to pick out scales on the piano is a person at prayer...whether it's inside a church or inside a toy box, [the attention itself is] the quality that is the sacred one." http://being.publicradio.org/programs/approachingprayer/kristasjournal.shtml
I could concentrate. Once I sat in my dorm room and said, "I'm not leaving here until I've mastered this section of organic chemistry." I studied for over eight hours in a row, until the sunlight faded, armed with only a glass of water. When I emerged, my apartment mate, Leah, gave me a strange look and said, "I didn't even know if you were in there or not."
Now, though, I multi-task all the time. It's an occupational hazard. But it's not until I pause in the emergency room for a second that I remember stuff like, "Oops. What happened to the 'rule out gallstones' woman? Did she get her ultrasound yet?" Sure, the nurse will advocate for the patient (thank heavens), but if I could pay attention to one thing at a time, yet still have an overall meta-awareness of the emergency room, I would feel less scattered.
***
I did not want to concentrate on my grief, but I knew that I had to, or it would just bite me in the ass.
Right Action
Sylvia wrote, "Act carefully. Everything matters."
When I saw a female patient with abdominal pain, I often did a pelvic exam and took swabs for chlamydia and gonorrhea.
A lot of emergency doctors did not. They would say, oh, well, the pain is epigastric (around the stomach), even when the patient was pointing directly at her vagina. They would order a urine dip, blood tests and an ultrasound and send the patient away.
I didn't get paid extra to get the patient in a gown, wait for our one gyne room, coach her in the stirrups, grab the Muco gel, and try not to hurt her with the speculum because she was already in pain.
It would be easier and faster to skip the pelvic exam and pretend sexually transmitted infections didn't exist, or to treat on spec (give antibiotics) without the exam. But if I could prevent one case of chronic pain or infertility, I was doing it.
I'm not saying I was a hero, but this was right to me.
***
The problem right now was, though, I didn't have any clear action to take and nothing felt "right."
What should I do?
What could I do?
Probably nothing.
That felt the worst of all.
Right Speech
I'm pretty good at biting my tongue.
Of course I'm not wise all the time, but for example, I try to avoid bad-mouthing other doctors. Everyone's always trash-talking other doctors in the ER, whether it's this specialist who didn't answer a page or that colleague who screwed the pooch on a diagnosis.
If a patient tells me about a bad experience with a doctor, I listen a little before I tell them, "I can't comment on another doctor's care." I have to say, though, two separate people told me that the same physician fell asleep while taking a patient history. I can't think of how you could give good medical care while asleep.
Even so, in Buddhism, you should wait for someone to ask three times before you give advice, to make sure they're really ready for the answer.
In the emergency room, you have about three seconds to give advice.
Hm.
Also, in my personal life, I have a tendency to bite my tongue, brood, try to talk to the person in a calm way while s/he continues to wrong me, bite my tongue, try to talk again while still calm, and then just go postal on them.
I have lost a lot of friends this way.
Hmmm.
***
Two days after I delivered Isadora, I thought I would be okay. I started writing again. I didn't go to sleep clutching the blanket my father had embroidered with her name. I left my handkerchief by the computer. I was going to be all right.
I woke up sobbing.
I tried not to disturb Matt. I'd been waking Matt up every night.
In fact, I'd made up a new rule: only wake him up if you really start bawling.
I began bawling.
He slept on.
I snuggled closer to him.
He woke up and held me.
I described the dream/nightmare I'd just had. He hugged me. He consoled me. Then he started to fall asleep while I was still talking.
I had a lot of speech. It might not be the right speech, though.
Right Livelihood
This means, First, do no harm, i.e., choose a job that does not harm.
That's the first part of the Hippocratic Oath. You would think medicine would be a slam dunk in this respect. We Help People. And yet...
My community hospital is in debt. Beds are closed, or perpetually filled by people waiting for nursing home beds. So that means people are stuck in the emergency room, waiting for a bed upstairs. That means we have no space to see or treat the new people coming hourly (minute-dly?) to the ER. That means we see people in chairs and/or in the hallway. That means we're perpetually running. If you work in the system, you know the drill.
As a female doctor, patients would often ask me for a blanket or help to the bathroom. That wasn't what I was there for. I had a stack of new patients to see and old patients to review. And I kind of didn't know where anything was. (This is usually a guy's tactic. Be ignorant and someone else will take over.)
"It's easier for me to just get the blanket," said my now-doctor friend, Leah. But she did palliative care. She took the time with a few patients instead of managing the masses.
***
"Help. I need help here. Help. I need to get to the toilet. Help," a patient called, loud and clear.
I tensed. I was writing my orders at the nursing station before I started on the next.
The one nurse between patients was also trying to do a blood requisition.
"Help. I—oh. It's too late."
"Oh, well," said the nurse.
I kept on working too.
Later, I felt terrible.
***
Right now, I had no livelihood.
I was afraid.
The Quebec medical association was supposed to pay me maternity leave, since Isadora had been over 20 weeks old, but any Quebec administration is capricious in the extreme.
I was worried about the money, but I was more worried that if they turned me down, it meant I wasn't a real mother.
People had also encouraged me to apply for a disability payment, since I carried disability insurance. So now I was one of "those people," asking a doctor to sign a disability form for me.
One of my doctor friends was in mourning and went right back to the emergency room. Later, he confessed, "There were times when people were talking to me and I had no idea what they were saying. There were times that the nurse took me by the arm and said, 'Dr. Bellomo. This is a prescription. Sign here.'"
I could have gone back to work, but I knew I might very well kill someone. I stayed off.
One week, after walking our dog, I opened the mailbox and found a letter granting me maternity leave, $730 a week for eight weeks.
I burst into tears. Nearly six thousand dollars. Because Isadora was dead.
Right Effort
I was jealous of every pregnant woman I saw. They were living, breathing embodiments of what I wanted and what I couldn't have. I tried to explain it to a friend like, "It's like you're starving and everywhere you turn, you see a sign for a buffet, but you can't go in."
Eight weeks after Isadora's death, I returned to work. Naturally, I tended to pregnant women, listened to their babies' heartbeats, and watched them snap at their other children. "Don't touch that, Dakota. I said, don't touch it!"
When I told other grieving women online, they were like, "It's normal. Me too. Don't worry about it."
But I did worry about it. I didn't like the anger and the jealousy corroding my veins. Telling myself I was normal didn't help. Telling myself to think kindly thought towards them didn't help.
Matt said, "It's not a zero-sum game. Their pregnancy has nothing to do with your pregnancy."
Didn't help.
I knew I was doing one thing right. If I smiled and pretended nothing was wrong, that I looooved working with pregnant women, that I should switch to obstetrics because I adored it so, I would end up very, very angry.
I just did my job and left the exam room as soon as possible. But I couldn't detach from other women's pregnancy.
Fortunately, Buddhism didn't judge me.
Right effort just means moving toward wholesomeness. You know what it's like to be kind, generous and thoughtful. Aim for that. And if you fail, that's okay. No judgment, no cat o' nine tails. Just keep moving overall in the right direction.
It's kind of like moving toward a healthy diet. You know you should eat more spinach and butternut squash. When you do, you feel good about it. But if you end up eating deep-fried Kool Aid one day, well, all right. Just aim for better next time.
I remembered a famous Native American story where a grandfather said, "I have two wolves battling inside me. One wolf is full of anger, fear, and greed. The other is full love, joy and kindness. The same wolves fight inside your heart, too."
The grandson said, "But Grandfather, which one will win?"
The grandfather smiled. "The one you feed."
***
I should add that Buddhism is not into labels. Instead of the "good" wolf or the "bad" wolf, we're all just wolves, trying to do our best. But I knew what kind of wolf I wanted to be: the wolf that didn't feel threatened by another wolf's pregnancy.
Right Mindfulness
Years before, at a novel workshop, the writer Dean Wesley Smith castigated all of us for not including concrete sensory details and description of what things looked, smelled, sounded, tasted, or felt like. It made me realize that I'd concentrated on plot and character, but left out this sensory description because I lived in my head all the time.
Instead of right mindfulness, I was into braininess. Medicine is all about memorizing and applying facts and, once you start moving up in the ranks, your ability to perform procedures and make decisions. But no one cares if you notice how a rose smells.
So that weekend, I made a conscious decision to start paying attention to my surroundings.
I re-examined at my writing. I'd always included smells. For whatever reason, smells do register on my radar, good and bad. But the other senses, mmph.
My cousin gave me a meditation book that suggested I pay attention to taking a piece of clothing out of my closet, feeling the fabric against my skin and hearing the hangers ring together.
How many times in my life had I yanked on a blouse and run out the door, barely noticing if I had my collar the right way out? (Hint: once one of my classmates straightened the collar of my white coat and said, "You're never too busy to fix your collar.")
In The Miracle of Mindfulness, Thich Nhat Hanh said if you paid this kind of intense attention to your own life, it made you wake up and focus, much as if you were driving a car or walking on stilts. Every moment counted.
***
I realized that after Isadora died, it would have been easier for me to turn to sugar, alcohol, or workaholism than to pay attention to, say, the fact that my milk had come in and I had no baby to feed.
But I was slowly starting to see the judgement and condemnation in my own thoughts. Yes, my baby was dead. Yes, my milk had come in. But Buddhism told me, Just stay with the fact that your milk is here. That's what's happening right now.
I'm not big on labels, but I did think Buddhism was extra-hard to classify. I'd always heard it was a religion. "It's not a religion," said some sources. "It's a philosophy." "No, it's a science!" exclaimed another.
The Dalai Lama said his religion was kindness. I didn't get that, either. Aren't you a Buddhist, dude (if you can call His Holiness a dude)? Why don't you just say that?
After doing some more reading, I figured out that it's not a religion like the other major players because it doesn't do the whole "My way or the highway to Hell" thing that so turns me off every other form.
In fact, Buddha actively encouraged people to test his theories out for themselves. "As the wise test gold by burning, cutting and rubbing it, so are you to accept my words after examining them and not merely out of regard for me."
He also explained it like this: "No blind faith is necessary to understand these four Noble Truths."
He didn't say, Drink my Kool Aid, suckas. He said, Try it out for yourselves and make up your own minds.
I liked that. I could see how that was a more scientific approach, especially after I read The Joy of Living : Unlocking the Secret and Science of Happiness, by Rinpoche Yongey Mingyur.
Also, since proselytizing gives me the heebie jeebies (I don't even like preaching about smoking cessation or promoting my writing, although I do both), I was pleased that the Buddha said, "Do not trouble yourself as to whether all or some have realized it [the Truth] or not."
Awesome. I could hardly manage to keep my own head screwed on, let alone try and sway others into the fold. Buddha himself gave me the green light to just concentrate on myself. In fact, that seemed to be the first step.
Buddha didn't ask you to believe in one god or a certain Parthenon of gods. In fact, Buddhism didn't seem to believe in God at all. In Things Fall Apart, Pema Chodrön called it non-theism. She basically compared theism (believing in a god) to believing in a cosmic babysitter who's always going to hold your hand, whereas in Buddhism, you figure WYSIWYG (what you see is what you get), so you might as well make peace with death and taxes, 'cause they ain't going anywhere.
But, like everything else, Buddhism seemed very mellow on the whole theism thing. You could believe in a god and be a good Buddhist, too. In fact, the Dalai Lama encouraged Westerners to maintain their own religious traditions instead of converting to Buddhism. "All major religions carry the same messages. Messages of love, compassion, forgiveness, tolerance, contentment and self-discipline. I have Muslim friends, Christian friends. All have these same values."
I liked the inherent acceptance, that you could be Buddhist and anything else. It was so common to be Jewish and Buddhist that they had their own nicknames (Ju-Bus or Bu-Jus). It was like having dual citizenship. So I could certainly be Buddhist (Buddhish) and agnostic. Ag-Bu?
Buddha.net summed up "the Buddhist path" as following:
1. to lead an ethical life,
2. to think and act mindfullys
3. to develop wisdom.
This made perfect sense to me.
However, this also brought me to one thing Buddhism was famous for.
The M word.
Meditation.
Could I really sit down and do nothing?
Could I make myself sit down in a comfortable chair for fifteen minutes?
Okay, ten?
Five?
One?
I wasn't a big meditator. I kind of skipped those parts of the books, just like I clicked past the breathing bits on my live-streaming yoga videos.
I kept reading.
Fortunately, I didn't have to meditate in order to recognize the five hindrances, or mental states that led you away from enlightenment. Sylvia Boorstein called them "difficult mind states."
Pop Quiz Time
Click on your answer and find your favourite hindrance! It's like a Cosmo quiz, only it's all spritual, yo.
Let's say you're a nurse who's been up all night, tending to the sick and saving lives. When you go to the parking lot for a well-deserved rest because you've got another night shift in 12 hours, someone has stolen your truck. You
a) swear profusely, call the police, swear some more, and then start yelling at the security guards;
e) go to sleep as soon as you've filed the police report. It's all too friggin' much.
There was once an emergency doctor who liked to yell a lot.
Dr. Loud was short, skinny, and always shouting. If I answered a question wrong, she wouldn't just say so, she would bellow, "BULL*#^@."
So then I'd try again.
"BULL&$#%."
I'd try not to get rattled, take a deep breath, and try a third time.
"BULL!&$#$."
Once a patient threatened a nurse. Dr. Loud got in on the action and swung some punches herself. She sustained two broken ribs, but I imagine she earned some respect too.
When I was in first year residency (translation: still pretty green), Dr. Loud had a pregnant patient with a vaginal bleed. Dr. Loud paged the OB on call several times, but he was doing a C-section, so she turned on me. "Your job is to go up to OB and stand by the obstetrician. Do not leave his side until he comes down here."
I found the OB writing his operative note. When I explained what service I was on, he frowned at me. "I'll be there as soon as I can. Can she not handle it for a few more minutes?" I wasn't sure what to reply.
When I was on ICU call in second year, Dr. Loud started paging me repeatedly. "I can't get a hold of the cardiologist. Look at this electrocardiogram."
I looked. I saw diffuse ST elevation that might make you think of pericarditis (inflammation around the heart), but it didn't quite fit the criteria, and the patient was having worrisome pain.
"Your job," said Dr. Loud, "is to keep paging the cardiologist until he answers."
This sounded familiar, but I didn't see how my 3 a.m. pages were so different from her 3 a.m. pages. Fortunately, on my second try, the cardiologist picked up and said, "Why are you calling my children's telephone line? I never answer this one."
I explained and faxed him the EKG.
Afterward, Dr. Loud showed me the latest cardiogram. The ST changes had settled down.
"So it is cardiac," I told Dr. Loud. She nodded.
But by them I realized something quite clearly: she was scared.
All that noise, all that bluster, even the broken ribs, and she really was frightened when the pregnant patient might bleed out or the man in resus might have a massive heart attack without warning.
Anger, or aversion, is really about fear.
***
I never considered suing the obstetrician about Isadora, but I turned the anger on myself. I didn't want to look in the mirror. I'd hated gaining weight and developing a little belly—but now I hated losing the belly and fitting back in my old clothes.
I already mentioned the other-pregnant-women thing.
I even asked my husband, "Why couldn't our dog have died instead?" I loved our dog, but I loved our baby more.
Yep. I knew aversion.
I called my friend Isabel and listed my many infractions: when my husband and I went to Costa Rica, I didn't realize I was pregnant, so I didn't bring folic acid (and was too cheap to buy more), I took a dip in the hot and cold therapeutic pools; I'd given myself the flu shot when I was unwittingly six weeks along; I got my cavities done at eleven weeks.
"Melissa," she said, "some women are on cocaine when they're pregnant, and you're worried about going to the dentist?"
I paused. "It was the carelessness of it. I wasn't worried about her when I did it."
"Okay," she said.
But she did make me think. In one of my favourite children's books, A Summer to Die, a man says to the narrator, "Sometimes it's nice to have someone to blame, even if it's only yourself."
But once I stopped blaming and hating myself, Isadora would be just one step closer to gone.
Do I want stuff?
OMG.
I looooove stuff.
But I was raised by cheap Chinese immigrants, so my craving takes the form of obsession for tiny, peculiar things, like a $10 robot watch I must buy on eBay NOW. I also love to eat.
This is all a great distraction, usually. But when Isadora's ashes were buried in our backyard, it stopped working so well. It started seeming cheap and unimportant.
Sylvia Boorstein made the point that desire is normal for everyone, even ultra-nuns, but if you get stuck craving the one thing you cannot have, that's creating suffering.
Matt kept busy. He built her a little box out of purpleheart wood. He tried to dig her grave, even though the ground was frozen. It kept him busy.
I didn't want anything—except another baby.
That, I wanted really badly.
That, I could not stop thinking about.
I borrowed Taking Charge of Your Fertility from the library. I went on the message boards. I initiated sex and really did try to stand on my head afterward, or at least shoulderstand.
It distracted me more than a little.
But I was still in mourning.
"When I can't sleep," said my grandmother, "I look at my pictures and I feel better." She pointed at a photo of the sweaters she'd knit.
I nodded. Even before emergency room shifts screwed up my sleep, I was a crummy sleeper. If anything was the slightest bit wrong in my life, I'd wake up at 3 a.m., mulling it over and over again. My mother wakes up at 3 or 4 a.m. regularly in order to cook or generally "get things done" before she crashes at 7 a.m.
Sylvia Boorstein calls this fretting. And she points out that you feel like you're doing something, because you devote so much energy to this, even if it's just wringing your hands.
I could major in worry any day of the week. I can create sound and fury on a dime.
Occasionally, it helps. I can brainstorm like nobody's business and come up with very creative solutions.
But no amount of worrying was going to bring Isadora back. And in fact, everyone kept telling me that worrying could interfere with conceiving another baby, so in effect, I should worry about worrying.
So what else was I supposed to do? Just sit here, helpless, with my torment?
Really?
I called up my friends, rotating through them so as not to exhaust them with my angst.
They knew doubt, too. A friend's uncle had died on a trip overseas and he felt guilty about that.
"How could you have helped him?" I asked.
"I was thinking of going with him. He could have told me earlier if he'd had chest pain. And I could have resuscitated him on the plane."
I think that when you're a doctor and your job is to save lives, you get to the point that any death, any illness, feels like something you could have prevented. Did your mother develop diabetes? Well, gosh darn it, you should have dragged her on a walk every day and lectured her not to put jam on her toast. You know the data on preventative medicine. So why didn't you do it?
Having some power and some control makes you think that you should be able to control everything. And that everything that goes wrong is your fault.
My husband is an engineer and an atheist. He believes in facts, not doubt. And, probably on a related note, he is an excellent sleeper.
"Do you think about Isadora?" I asked him.
"Sometimes. When I'm driving."
"Do you worry about her?"
"No." He touched my hair. "She's not hurting anymore."
But how could we be sure? What if our baby went to hell? What if she was reincarnated as an ant that got squished? My doubt not only covered this life, but the next. (I asked my Hindu friend, who assured me that Isadora was not a bug, "because she didn't do anything wrong." Another friend, who was a Christian, told me, "I think she has her own soul." My atheist friend Leah said, "I don't think you would see her again, but you could encounter her molecules again. That bit of carbon, or that piece of oxygen..." This didn't help.)
I drew a little comfort from grilling religious and non-religious people about their views of the afterlife.
I read one line in a book, Let go and let God. I'd probably heard it before and not thought too much about it, but something inside me released when I read this. I realized that if I could abdicate responsibility, if I could just say and believe, I did not have control over this and I'm not responsible, some higher power's got to take the hit on this one, I would feel better.
George W. Bush always struck me as an extremely happy guy. He did whatever he felt like. Make up evidence about weapons of mass destruction? Sure. Spy on your own people? Why not? Keep a baseball score card of all the "enemies" you killed? Right on! Everything was hunky-dory because Jesus had chosen him to lead "the free world."
He never had doubt.
Now, that was why Kurt Vonnegut labeled him a psychopath, so I couldn't go there.
But in general, setting aside my doubt and trusting in a higher power? That would really help me relax.
I just couldn't do it.
When I was a kid, my mother used to yank the blanket off of me every day of summer vacation and yell, "What are you going to do today?"
I'd growl, "I want to sleep."
She would goggle at me and say, "I've been up since 3 a.m.!"
"So?" I'd grumble, but of course, she'd already woken me up, so I'd get dressed and start accomplishing things, as she intended. They kept me in summer school, camp, organ lessons, swim class, and gymnastics lessons, so it wasn't like I had a whole lot of days to sleep in anyway.
I remember calling a friend in high school at 10 a.m. and her mother saying, "I'm sorry, she's sleeping. May I take a message?"
I was highly impressed. My mother would have been salivating at the opportunity to bang on my door and wake me up. You have to get up! Your friend is calling!
So when our family moved to Germany for over two years, I loathed traveling. Not only was I an annoying 10-year-old who just wanted to stay at home and, at absolute maximum, go to McDonald's, but my family's brand of travel was to pick a country, drive for days, sleep in the car, and buy things, filling up the trunk and all the leg space. We'd brush our teeth in restaurant bathrooms and rent a hotel every week or so for a shower. When it was time to sleep, my parents would recline their seats while my brother and I tried to sleep in the backseat, leaning on our respective windows or on the headrest between us.
Needless to say, I don't "get" sloth or torpor.
I see it all the time, though. Patients are always asking me for work notes. I'm like, Why? And they're like, My nose is dripping.
I stare at them with the same kind of incomprehension as my mother, who boycotted summer vacations.
However, my husband is very good at sloth. He figures things will work out. I took the first enjoyable vacation of my life with him, when we drove to the Maritimes and just hung out. Yes, I had a guide book and I booked where we'd sleep and (more importantly) chose where we'd eat. But we didn't have to study up on the history. We didn't have to tear from one "must see" sight to the next.
One of my neighbours suggested we go on vacation after Isadora died.
I thought about it. There was a conference in New Orleans, during its famous jazz festival. But it felt like we were celebrating Isadora's death. I couldn't do it.
On the other hand, we'd already booked a trip to Hawaii in autumn with our air miles, before I got pregnant. I didn't cancel it.
My neighbour put me in touch with a minister whom I'll call Eleanor. She asked me, "Are you being gentle with yourself?"