Harman - The blue cotton gown: a midwifes memoir

To midwife: To be with women, at childbirth and for life.

The Blue Cotton Gown is based on my experiences and stories told to me by my patients. All names, identifiable characteristics, details of time, and names of places have been changed for the sake of preserving confidentiality. Several patients, professionals, and staff are composites. The events and conversations described are how I remember them.

Heartfelt thanks to every precious woman who has shared her story with me in her thin blue cotton exam gown, and to every health-care provider who has persisted in his or her calling despite personal and professional obstacles. We each have our own story. This is mine.

Patricia Harman, CNM

Confessional

I have insomnia and I drink a little. I might as well tell you. In the middle of the night, I drink scotch when I cant sleep. Actually, I cant sleep most nights; actually, every night. Even before I stopped delivering babies, I wanted to write about the women. Now I have time.

Its 2:00 a.m., and I pull my white terry bathrobe closer, thinking about the patients whose stories I hear. Theres something about the exam room thats like a confessional. Its not dim and secret the way I imagine a confessional is in a Catholic church, the way Ive seen them in movies. I peer at the clock. Its now 2:06.

The exam room where these stories are shared is brightly illuminated with recessed lighting. The walls are painted off-white and have a wallpaper border of soft leaves and berries. There are framed photographs of babies and flowers and trees, pictures I took myself and hung to make the space seem less clinical, and a bulletin board with handouts on stress reduction, wellness, and calcium.

The room is not big. Its the usual size. If I had to guess, Id say eight feet by ten feet. The countertop under the tall white cupboard is hunter green, and theres a small stainless-steel sink in the corner. Other than a guest chair, my rolling stool, and a small trash can with a lid, theres just the exam table, angled away from the wall, with a flowered pillow and rose vinyl upholstery. On it lies a folded white sheet and a blue cotton gown with two strings for a tie. The exam table dominates everything.

I dont drink for fun. I dont even like scotch. Its for the sleep. I cant work if I cant sleep. The scotch is my sleep medicine and I want it to taste like medicine. The little jam jar with the black line at three ounces sits in the bathroom cupboard. My husband fills it for me, then locks the bottle in the closet. I ask him to do that. When you have as many alcoholics in your family as I do, you dont take chances. On nights when Im restless, I drink it down sip by sip, making a bad face after each swallow. Then in an hour, I go back to bed.

I stand now at the window listening to the song of the spring frogs and thinking of the stories the women tell me, and then, in the stillest part of the deep night, I sit down to write. I need to sleep but I need to tell the stories. The stories need to be told because they are from the hearts of women; the tender, angry hearts; the broken, beautiful hearts of women.

HEATHER

Its Monday morning and Im late again. Waving to the receptionists, I rush through the waiting room. They turn to greet me in their aqua checked scrubs but keep on with their work. I know they keep track of how often Im tardy.

Hi, Donna, I say as I pull open the heavy cherry door to the clinical area. Donna, at the checkout desk, looks over her sleek horn-rim glasses and gives me a smile. The phone is tucked under her ear and shes clacking away at her computer.

Around the corner and down the hall is my office. Its small, just enough room for a desk, a file cabinet, two bookcases, and a guest chair. The cream walls are lined with my photographs: the highland forest in full autumn color, a pregnant woman stepping out of the shower, and our barn with the red roof next to our cottage in Canada. On the window ledge are purple African violets rooted in a green pot that Tom threw on the wheel in his studio and a framed photo of the five of us last Christmas. I toss my briefcase into the corner.

In the picture, three mostly grown boys, Mica, Orion, and Zen, clown in front of the slightly crooked spruce tree. Thats me in the back, with round pink cheeks, short straight brown hair streaked with gray, and wide blue eyes; a tall, girlish, middle-aged woman. Tom, stocky, slightly balding, with wire-rim glasses and short gray hair, stands with his arms around me. Hes laughing too. It would take a miracle drug to get us all looking normal in front of a camera.

The Womens Health Clinic is located in Torrington, home of Torrington State University, on the fifth floor of the Family Health Center. Our private practice is composed of Tom Harman, ob-gyn; our two nurse-practitioners; and a staff of seven nurses and secretaries, all women. The suite, which we designed ourselves, is arranged in a rectangle with nine exam rooms, five offices, a lab, and a conference room. Theres also a small kitchen, the waiting room, and the large secretaries area up front. On two sides, windows run the length of the office. I wanted the staff and the patients to be able to look out at the sky.

Five minutes after I arrive, Im standing in the exam room holding out my hand to a skinny young woman who stares at it as if shes just been offered something shed rather not touch, a dead fish or rotten banana. She has short curly red hair, a beautiful girl, but she holds her head down like she doesnt know it. An eyebrow ring mars her perfect face. I pull my hand back and try again. Im Patsy Harman, nurse-midwife, you must be glancing at the new chartHeather Moffett.

Heather doesnt say hello or anything else. Theres also an older woman and a young man in the room, so I start talking to them, turning first to the older lady whos sitting in the guest chair, clutching her large white pocketbook. And you are family? The grim-faced, gray-haired woman nods once. She inspects me through her glasses, clear plastic frames with rhinestones at the corners.

I was hoping she would introduce herself. Heathers mother or aunt ? I prompt. Its always better to flatter than insult, though the woman appears to be in her seventies.

Im her grandma.

This is not a cordial group, and Im wondering what kind of conversation they were having before I came in. The air feels like cement just beginning to harden. And you? I turn to the young man.

T.J., he responds sullenly. Thats all he says.

Heather is sitting hunched over on the small built-in bench in the dressing corner of the exam room, her arms tucked into her blue exam gown. T.J. swivels back and forth on my stool. The grandmother is perched on the one gray guest chair, so theres nowhere left for me to sit except the exam table, and that isnt going to happen.

Before we get started, lets rearrange things, I say energetically. Heather, you sit up here on the exam table. T.J., you sit where she was, and Ill take the stool. We all trade places and when the young man stands I realize hes over six feet tall. His hair reaches past his shoulders and hes good-looking, like a heavy-metal star in the eighties, thin and sensuous with flat gray-blue eyes. No one says anything. They just move to where I point.