Unplanned

Pregnancy is one of those strange medical mysteries where any symptom can just as easily be normal, as it can be concerning. 

Cramps? Could be your expanding uterus, but also might not be. 

Spotting? Many women experience it and nothing happens; many women experience it and something does happen. 

You can google just about anything and hear both sides to every possible symptom.

This was the first pregnancy where I have ever had any spotting and it started shortly after I found out I was pregnant.  The doctor said not to worry, so I tried my best.  I know very well that what is meant to happen, will happen, and that worrying doesn’t help anyone in the moment.  I know this and I generally live by this.  But for those of us who have lost children in pregnancy, not worrying is not an option.  In fact, you worry more than you normally worry about anything.  You just sometimes pretend like you’re not worried, so that those around you don’t catch on and start to worry enough that you now have to worry about them too.  Being a mama bear is hard work and balancing your fears with everyone else’s fears becomes a full time job in pregnancy. 

I was worried. 

Every minute of every day. 

I was worried.

If you know, you know, and none of this has to be explained. 

The morning ritual of preparing yourself mentally as you wake up to see if there is any blood in your bed. 

The fear of having to urinate because you know you will have to wipe yourself and of what you may find on that tissue or in the toilet bowl. 

Wanting to be excited about every passing day because it gets you closer to that 3-month mark, a moment of temporary relief, while being too afraid to feel excited about anything.

Wondering how connected you should allow yourself to feel to this growing baby, while preparing yourself to mourn yet another loss.

Navigating the feeling of all the excitement around you, while inside, you’re terrified of letting everyone down.   

This was my 7^th pregnancy. 

I am blessed with 3 beautiful boys.

One pregnancy ended with an abortion; one of the most difficult decisions I’ve ever had to make. 

The other 2 pregnancies, now 3, have ended in miscarriage. 

This pain is not one that is foreign to me but nothing could have prepared me for what was to come.    

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If you are familiar with me and my writing, you know that I do not sugar coat life.  For this, I am adding an additional “trigger warning” because what happens next is raw and real and painful as fuck.  If you choose not to continue reading, this will be a good time to shut it down.  I won’t be offended. 

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Up until this point of my pregnancy, any spotting had been related to sexual intercourse.  Yes, I worried, but THAT really is normal.  Anything that causes an irritation to your cervix during pregnancy can lead to spotting; all of it was fairly light and easily explained.  At 8 weeks, I got to see my baby on an ultrasound and hear its perfectly perfect heartbeat.  Everything was progressing as it should, despite the fears and despite the spotting.  The risk of miscarriage goes down significantly when you see a viable pregnancy with a heartbeat in an ultrasound at 8 weeks and because of this, I allowed myself extra moments of excitement, in between the fear. 

It was really real now.

I hadn’t planned on getting pregnant.  In fact, I was doing just about everything to make sure it never happened again.  4 days before my scheduled tubal ligation, the surgery was cancelled due to COVID-19.  By the time that 8 week ultrasound rolled around, I finally admitted to myself just how much I really wanted this baby. 

Every day was crossed off my mental calendar as we inched closer and closer to the 12 week “safety” mark.  My clothes no longer fit, and I embraced the purchase of some maternity clothes to get me through the next few months.  I took pictures of my growing belly.  I told my children that we would be welcoming another child into the home.  As everyone celebrated their excitement, even I allowed myself to join in at times. 

Cautiously. 

I found myself saying “if everything goes well” less and saying “when the baby is here” more.  Things were changing, a little every day.

Then, it happened. 

I woke up one morning with blood on the bed.  Not a lot of blood, but an unprovoked spotting.  I had waited 12 weeks for this moment and I began whatever mental preparation I knew I needed in order to process what I expected to follow.  But, like every other time, the blood just stopped. No one seemed to be worried, but I knew something was wrong. 

There was a bigger scare after that, but I’ll spare everyone the details of that one.  What I will say, is that my boyfriend’s face showed a terror that I had never seen in him.  I knew in that moment that the fear was shared, and I immediately switched to wanting to protect him from all I already felt.  He is one of the strongest and most optimistic people I have ever met.  When we both processed what had happened and went into separate washrooms to get ready, I was absolutely certain that he was in the shower, praying harder than he had ever prayed.    

I messaged the doctor to let her know what was happening and she called me the next day.  Again, no one was worried, but I knew something was wrong.  She booked me in for a PAP the next morning.  That morning, I woke up with cramps.  Mild cramps that could just as easily been caused by my expanding uterus as it could be caused by something worse.  Everything is normal or not, nothing in between.  During my PAP, the doctor said there was a little spotting but it wasn’t anything out of the ordinary.  She wasn’t wrong, but I know my body.  I asked for an ultrasound and she gave me the requisition.  I was able to go home in between and I drove to my boyfriend’s house to pick him up.  On the way there, I cried whatever tears I had in me, so that I would be ok when I saw him.  We came home and waited until it was time to go.  As we were heading out the door for the appointment, I kissed him and told him for the first time that I wasn’t going into the appointment for good news.  Forever the optimist, he smiled and repeated for the millionth time that “we will be fine”.  I know he meant that he and I would be fine no matter what happened, but I also know that he really thought the “we” would be the 3 of us.  It was in that moment, as we walked out the door, that I knew his heart was about to break and that there was nothing I could do about it. 

You try to smile through it but there is a heaviness that comes from that feeling; one that none of my words could ever do justice.  I won’t bother trying to explain it; if you know, you know.      

We laughed and joked all the way to the appointment and while we waited in the clinic to be called in.  I’ve had many ultrasounds in my life, and when the technician doesn’t allow you to see the screen at all, it’s not a good sign.  At this point, I was having full on contractions.  3 months in and I felt like I was in labour.  There was no good news at the end of this. 

My boyfriend was scheduled to work a 15 hour shift that night and I offered to drive him in.  I knew from previous miscarriages, what the next stages may look like and I equal parts wanted to be alone and wanted him to be distracted by work so that he didn’t have to experience it.  The pain was getting bad so I took whatever breaths I had to take in order to mask it.  I told him I might go to the hospital later, if it continued to get worse, but I dropped him off and told him I was going home to monitor and see what happens.  He left with the direction to call him immediately if I was going to go to the hospital.  I didn’t want him to leave but I didn’t want him to stay; I didn’t know what I wanted.  The second he walked out of that car, I broke down.  Months of tears finally being released because I knew now that this baby wasn’t going to make it. 

I drove home and curled up in a ball on my couch.  The contractions were getting stronger and more frequent and it was getting harder and harder to breathe through them.  My head started to hurt, I was dizzy from not eating or drinking and nauseous from trying to.  There was no more blood and I knew something was very wrong.  I called an Uber and went to the nearest emergency room. At triage, they asked me why I was there and I said “I’m having a miscarriage”.  I listed off my symptoms and they gave me the usual “could be something, could be nothing” speech.  Eventually, I was registered and sat in the packed waiting room waiting to be called in.  Less than 10 minutes after I sat down, I felt a tiny pop in my body.  At first, nothing.  I tried to get up to go to the washroom and within seconds, I had a massive hemorrhage. I didn’t initially know what was coming out of me, it was both solid and liquid.  I looked at the woman in front of me and saw the horror in her face before I finally looked down.  There was blood everywhere.   

Everywhere.

I looked around the room and saw everyone looking over with the same look of horror as the woman, and I immediately broke into tears.  All I kept thinking was that I had just passed the baby and that I was sitting on it and I couldn’t move.  The woman ran to the nurses station to get help and I could hear them asking her what was wrong with me.  She was telling them that she didn’t know me but that I needed help.  Another women heard all their casual questions and she ran over and told them to help me NOW.  That’s when they saw the blood and rushed over.  They helped me walk to a room down the hall and the blood just kept oozing out of me with every step.  My entire trail was marked with my blood and I just kept thinking about the faces in that waiting room. 

In seconds, I had lost a huge amount of blood and it became a life threatening emergency.  They had to undress me in front of the wide open doors; anyone who walked by got to witness what most typically only see on television.  When they pulled my pants off, everything fell to the floor and exploded.  I couldn’t help but look, the blood was all over the room now.  There was no baby in all of that, I had a massive hemorrhage with equally massive blood clots.  By now, I was in serious pain but they needed to take some blood and urine before administering the morphine.  I lay there while they violently dug into my arm in search of barely there, severely dehydrated veins.  They asked me to walk to the washroom to get some urine and I told them I didn’t want to go alone so the nurse brought a wheelchair and helped me into it.  I knew something bad was going to happen but I didn’t even have enough energy to speak.  She wheeled me into the hallway and walked away for a second to grab something.  I don’t remember what happened after that but I had collapsed.  As I started to come to, I realized I was on the floor and I could hear voices around me talking about how I just had a seizure. 

I knew I had fainted. 

I knew this because when I faint, it always looks like a seizure.  My body convulses, my eyes roll to the back of my head and I sometimes foam at the mouth.  There is no one in my life that has witnessed it that can talk about it without getting emotional.  To see it, is extremely traumatizing – or so I am told.  The doctor and 4 nurses were around me and I looked down the hall and saw the same woman who watched me hemorrhage standing there in equal horror.  I wanted to apologize to her but she was too far away.  The doctor said he didn’t think I had a seizure but the nurses were convinced.  I tried to speak and they met me on the ground, “it wasn’t a seizure, it always looks like that when I faint”.  The nurses were scared, and suddenly, I knew I was completely alone, without any rock. 

COVID-19 comes with strict restrictions.  This means you can’t have anyone with you at the hospital.  I was on my own, in pools of blood, in a room covered in blood splatter for almost 24 hours. 

By the time they got me up and back in bed, they decided to wait on the urine sample and give me morphine.  It didn’t do much for the pain, but it took enough of the edge off for me to be able to give slightly sugar coated updates to those that knew what was happening.  My boyfriend was sitting in the ER entrance when all of that happened; it was as close as they would let him get to me.  They told him “we are taking the best care of your wife” and asked that he “wait patiently until you are called upon.”  This was heartbreaking to hear as I could only imagine how hard it was for him to be so close and yet, so far.  Still, there was a relief for me in that he didn’t have to see any of this.  He eventually went home to wait there instead, at least home has Netflix. 

They prepared for a possible blood transfusion as the blood wasn’t stopping and hooked me up to an IV drip.  Liquid and solids continued to flow out of me; blood everywhere.  Because they needed to monitor me often, they removed the privacy screen from my room and everyone who walked by could see me. 

(Thank you COVID masks and long hair for providing a little more privacy than I would have had in pre-COVID times.)

They were determined to get that urine sample from me but didn’t want a repeat of what happened last time so they brought me a commode.  I still knew I wasn’t ok but at least now I was staying in my room.  This time, I was equally worried about what kind of tissue would fall out of my underwear as it would be caught in the bedpan where I could see it.  Again, it fell to the ground and splattered everywhere.  No fetal tissue, thank God!  I sat on the toilet with blood clots pouring out of me.  I don’t remember what happened after that but I had collapsed.  As I started to come to, I could hear the nurse screaming for help and I could feel her holding me up.  As my eyes opened, she told me I did it again.  This time, I could feel that I had bitten my tongue; it was swollen and I could taste blood.  I knew now that I wasn’t going home anytime soon.    

I was very nauseous and not able to hold down any water.  The IV was helping with the dehydration, but I hadn’t eaten since my boyfriend forced me to eat a piece of peanut butter toast in the morning.  My body was weak, my blood pressure continued to drop, the blood wasn’t stopping and I was so exhausted from everything.  I found myself staring at the ceiling because it was the only place that I could look and not see blood.  I sent text messages and more sugar coated updates and cried in between.  I went from feeling nothing to everything and back and forth, sometimes by the minute.  I thought about reading a book but I didn’t want anything to be associated with this memory, so I opted for doing nothing instead.  By the time they gave me gravol, I could feel it burning through my veins.  I could feel everything and nothing.  They also started me on medication to stop the bleeding.  The medication cocktail was enough to help me sleep, and I was in and out of consciousness for the next few hours. 

Somewhere around 4:30 in the morning, they wheeled me into the ultrasound department.  They gave me an hour to lay there and drink a massive cup of water.  It hurt to sit up but there was no one there to help me so I rolled over just enough to get the straw into my mouth.  I was nauseous with every sip and the quiet, empty room, was proving not to be good for my mind.  I instead used the time to try to perfectly calculate how much water I would need to drink every 5 minutes so that I would be finished in exactly an hour.  The calculations made for a good enough distraction but about 30 mins in, I knew I would vomit if I had even one more sip of water.  It was about that time that I felt a very large clot pass and I decided that would be a good time to go numb for a bit.  I don’t remember what happened between that and when they wheeled me into the ultrasound room.  During the ultrasound, she asked me if I had a previous ultrasound and I said yes.  She asked me if there was a baby and I said yes.  This time, there was no baby.  She said I had to go to the washroom and empty my bladder so that they could do the vaginal ultrasound.  I immediately thought about the mass I had passed about 30 mins prior and realized what it was.  I started crying and telling her that I didn’t want to go to the washroom but she said I had to.  I didn’t have any nurses here and I knew that I had no choice.  She offered me a bed pan but I couldn’t do it.  I didn’t want to see it like that.  I begged her not to let me go alone but she had a job to do and it had to be done.  She took me as far as the door but when it closed, it was just me and the toilet.  I leaned back as far over the toilet as I could and prayed that this time, nothing fell on the floor.  The baby fell into the water and I told myself not to look but I looked.  There was so much blood and I was suddenly grateful for the blur it created.  I sat there and cried as I emptied my bladder and as I stood up to say goodbye, the automatic flush washed away everything that was left. 

I didn’t speak to the ultrasound technician again after that, I couldn’t.  I was numb. 

I remember going through the motions of the vaginal ultrasound and no longer giving a fuck about anything.  I didn’t take anything she offered to clean myself with because it didn’t even matter now.  I put on a new pad and lay down and waited until the porter came to take me back.  How long that process took, I have no idea.  I just remember being mad at the stupid painted sky and clouds in the room, as if that was supposed to bring anyone any kind of joy. 

I had no more tears.

The bleeding wasn’t stopping so they gave me more medication and more pain killers.  I was numb to the pain now but it put me back to sleep. 

When I woke up, they told me that I hadn’t passed the placenta and they were worried.  They decided to prepare me for surgery.  The bleeding wasn’t stopping despite the medication and now I was additionally concerned about the possibility of having to remove my reproductive organs.   It’s one thing to lose a baby, it’s a whole other to lose the choice of ever having one again. 

The tears came back, hard. 

After a few hours, the specialist came to see me.  The medication had slowed down the bleeding enough to save me from surgery and I had passed the bulk of what remained inside me but my levels weren’t stabilized enough for me to leave. 

What I would have given to not be alone during all of it. 

The thing about silence is that it is both a blessing and a curse.  Sometimes, I search for it.  Sometimes, I need it.  This was not a good time for silence.  After all that time trying not to have anything to associate with that pain, I am left with silence.  When the lights go off and everything goes quiet, I am alone again.  Even if I’m not. 

When everything finally stabilized and I was told that I could go home, I messaged my boyfriend to bring me my dark blue Michigan sweat suit. He got to the emergency entrance and the nurse went to pick up the bag of my clothes from him.  He messaged me to tell me that the nurse had my clothes and he asked that I put on his “Champion” hoodie that he packed for me because “I was his champion.”

I wanted to tell him that I didn’t feel like a champion.  Far from one.

But, I knew what it meant to him and that he needed it. 

As alone as I was, he was equally alone.

He was just as much my champion; even though he didn’t know it.

I put on the sweatshirt and walked out of the hospital and into his arms.   

This was my 7^th pregnancy. 

Unplanned.

I didn’t know how much I wanted this baby, until it was gone.

In those moments of quiet, when I find myself alone again, I will forever remind myself that I got the privilege of holding this baby every single day of its life.  It chose me, even if only for a moment and that, I’m eternally grateful for.

72 Hours

Days are long here in Bangladesh; hot, emotionally heavy and physically exhausting. All of this is compounded with a mysterious illness that has been taking out the team, one by one; sometimes two by two. During the first rotation, only 3 delegates were able to escape isolation; the second rotation seems to be following along nicely.

I’m determined to not get sick.

Isolation means a couple nights in a hotel, never further than a couple steps from the toilet. It’s not the sickness I fear though, it’s the quiet. Two days in a hotel room could sound like a dream in this exhaustion, but the quiet scares me because of the truth it often speaks.

In order to survive, truth is not an option.

Not now anyway.

___________________________

I’m a psychosocial support delegate working in the field hospital and in the refugee camps that currently house over 625,000 people.

625,000 people.

It’s one of the largest humanitarian crises’ in the world right now and there are few words to describe it. The sounds. The smells. The sights. The silence. The screams. Babies. Children. Youth. Women. Men. All things in between.

625,000 people.

Having fled a recent eruption of violence in their home country of Myanmar, many walked for days to cross into neighbouring Bangladesh. Carrying only what they could on their person, everything they once owned now left behind. Homes were burned to ash. Women and young girls gang raped. Men forced to watch. Shot. Killed. Babies thrown alive into raging fires, leaving nothing but the painful screams of the mothers whose arms they had been ripped from. Those who could walk, walked. Those who could be carried, were carried. Hours. Days. Weeks. Eventually, the relief of the border for those who survived to cross it.

With little to no food and illness spreading between groups, many were sent directly to the field hospital for treatment. Others were able to move from the Transit camp, where they could rest and get their basic needs met for a few days before moving into the larger camps.

625,000 people.

___________________________

It’s already been a long day. If the constant work doesn’t tire you, the hot sun over an open field will! Our fridge is full of water; nothing but water. Someone here is always around to remind you to stay hydrated, “did you drink water?” is almost like the new “hello, how are you?” The answer is always “yes, but probably not enough!” You drink every chance you get here, there is little relief from the heat and the humidity.

The hospital is a 24 hour operation and we’ve been operating mostly with ex-pats as we try to secure local staffing support. We are all tired, but we are one solid team.

I’m closing up the psychosocial tent for the evening when I get called into the outpatient department. I can already hear the screams as I get closer to the tent. I turn the corner to enter and stare into the eyes of a terrified mother. From the mother, I follow the screams coming from her 6-year-old daughter; whose leg and foot are covered in blood. After all the walking and surviving the border crossing, S was run over on the road by a passing tuk-tuk. The language barrier is always difficult, but many times in this deployment I have been grateful for it. “We are going to have to amputate, let’s get her to the Operating Theatre”, the mother knows nothing and this gives me a better opportunity to explain it to her in a much more sensitive way.

By the time dinner rolls around, I’m not hungry; but I have to eat. Being a vegan in the field isn’t ideal but I’ve found a couple options in the boxes of rations. Tonight, it’s tomato and pasta sauce with a soy ground “beef” – not horribly disgusting and it ends up being my favourite by the time my mission is complete.

I sit alone in an attempt to process the last few hours of my day, but solitude is rare here. I’m joined by a few other colleagues and I take a moment to appreciate the ability to laugh.

“Did you drink water?”

“Yes, but probably not enough!”

I drink some more, take my antimalarial and fill up my water bottle for the night. As hot as the sun can be in the field, it’s even hotter in the tents.

By 9pm, the wifi signal begins to strengthen and I’m able to connect with my loved ones at home. Unfortunately, the time difference doesn’t allow for much of that as the kids are in school when I’m going to bed. Some meaningless, and painfully slow, internet browsing works just as well to pass the time. My roommates are both still in surgery and I have the tent to myself for some much needed alone time, with music.

It’s a good half hour before my roommate returns and I can tell by her face that there is something wrong. She has just returned from a couple days in isolation, after only about a week in the field and I ask “Did you drink water?” She immediately begins to cry and I brace myself for what’s to come.

“How did the surgery go? Everything ok?”

“No, the baby died.”

We have yet to have one survive.

“Did the mother make it?”

“Yes, it’ll be a long night for her, but she survived.”

We spend the next couple hours talking about her experiences here; it’s her first mission. She tells me that her daughter lost a baby late in pregnancy the year before and that she is pregnant again; due to give birth in a couple weeks. There is nowhere else she would rather be, even though she knows she is needed here. I can almost feel the weight of her pain and I know, without her saying, that she won’t survive here another week.

I need to sleep.

The call to prayer begins at 4am and angrily wakes up the sleep deprived team daily. Most of the delegates sleep with earplugs to try to drown the sound but I find it helps me get back to sleep when I am having trouble. It’s now after 1am and I say goodnight to my roommate.

___________________________

An hour later, I hear my name being called. At first, it fits into the dream I’m having but I wake up anyway and realize that it’s not. As my eyes struggle to open towards the bright headlight shining on me, I start to make out the shape of our 6’7″ team leader over my cot. She is trying not to startle me and apologizes for having to come in to my tent. We have an emergency in the Operating Theatre. I look around the tent and see that my roommates have already gone to prepare. I get up and get dressed and head to the Operating room.

I pick up the on-call interpreter on the way and get briefed while walking. A man in his 20’s has been rushed to the hospital for emergency surgery, no one is expecting him to survive. He is local engineer who, while working on a build, fell onto a bamboo pole; puncturing his trachea and lung. The team worked REALLY HARD and managed to repair most of the damage but there is still a leak in his airway. He’s on a ventilator when I get there and will need to be transferred to a hospital 50kms away for more specialized surgery, if he survives the night.

I’m called for his wife, who has accompanied him to the hospital and did not handle the news well. She’s been crying for hours, alone. They came here together for his work from another city in Bangladesh and have no family and friends in the area, just each other. She tells me that she has never left his side and that she doesn’t know what life is without him.

She asks if she could see him.

The doctors have told her that she cannot, but I am not satisfied with that. I go into the Operating Theatre to speak with them and explain that she needs to see him in order to be able to get some rest. They are concerned with how she may react when she sees him connected to all the machines, I ask that they let that be my problem if it gets to it. They agree and we cover him as much as we can, leaving only his head and one arm exposed.

I go back and prepare her for what she is about to see. I explain what the machines are for and tell her the importance of being quiet while we are inside there. She takes my hand and allows me to lead the way. When we get inside, I can feel her hand tighten, and I remind her that he needs to sleep. She remains quiet and walks with me to him. She releases my hand and puts it on her husband’s exposed arm. Tears start to form and I tell her he’s just sleeping. She moves her hand to his head and starts to stroke his hair, telling him that she’s here and that she loves him. I know exactly what is coming next and I tell her we have to go. She looks at me and as she turns around to leave, releases the loudest, most painful scream.

Love.

A powerful emotion.

I take her outside and set up a bed for her in a tent nearby. She has to rest, they both do.

___________________________

Before I know it, it’s the morning call to prayer – signalling that I have another 2 hours to fit in a power nap before my next work day. I manage to fall asleep and wake up to my morning alarm for breakfast.

I’m such a mess right now.

___________________________

Breakfast is crackers, peanut butter and a Larabar from home – with coffee, of course.

Every experienced humanitarian aid worker has 1 (or a few) items that they wouldn’t dream of deploying without. For me, one of those is a couple boxes of Starbucks single serve instant coffee. We search for home in the strangest ways sometimes.

Our morning meeting begins, and we have good news and bad news. The good news is the man survived the night and they transported him and his wife this morning. The bad news, the mother who lost the baby yesterday, has also died.

Every day starts and ends with death here but I’m choosing to hold on to the good news today; our medical team is amazing.

Gratitude.

___________________________

Whatever fumes I have left in my tank will have to keep me running for the rest of the day. My partner and I open the psychosocial tent and meet with our team of volunteers.

The team is made up of 8; 4 men and 4 women. They range in age, but it’s almost impossible to get real ages here and I’ve never been very good at guessing. All 8 have made the journey to Bangladesh themselves, the most recent arriving just a couple months earlier. They are the true heroes of any mission, and this one is no different. Despite what they have been through, and their own living conditions and challenges, they choose to give back every single day (or 6 days a week because we force them to at least take a day off to rest). After our morning check in to make sure they are doing well, we break the teams up and send them off for their daily activities inside and outside the hospital.

Dedication.

___________________________

It’s 10am now and I’m called to the maternity tent. An 18-year-old girl, who doesn’t look older than 14, arrived to the camp alone; no family, no friends, no support. On her second night, she was assaulted by a group of men. She was brought to the hospital overnight, assessed and treated. The physical wounds were easily visible but it’s not until the morning that the invisible wounds really start to appear.

After being cleared medically, she refuses to leave the hospital. With nowhere to go, the terror in her eyes speaks louder than her silence. I meet with her to discuss some possible next steps, as staying in the hospital is not possible. I refer her another NGO’s medical clinic nearby, where she can stay to access some psychological support. The relationship between our sites has been a strong one. We have services they cannot offer, they have services we cannot offer – partnerships are the only way to survive in these environments. But even with strong partnerships, we watch individuals walk out of our hospital and hope they make it to the next location safely.

Barefoot and in pain, she makes her way out to door and I watch her walk away.

Hopelessness

___________________________

I return to the psychosocial tent, where there is a 13 year old boy whose younger sister is admitted to the hospital. He and his 4 other younger siblings have been playing in the children’s safe area for the last two days.

He’s bored of having to take care of them and I could use a distraction.

11 games of Snakes and Ladders later, I’m tired again and need a break from everyone.

Here, sometimes the only solitude you can find is while using the washroom and even then, there is no guarantee. I make my way to the porta potty and hang out for a couple minutes. It’s way too hot in there but I’m not ready to go back yet. I decide to sit in the kitchen area for a couple more minutes and I see about 50 bananas in our ration area. In this moment, there is no happiness like a fresh banana.

It’s delicious.

I drink some water and a few minutes later, its back to the tent.

Rejuvenation.

___________________________

I’m called into the pediatric ward where a 5-year-old girl is dying. Her father carried her several miles to the hospital, by foot. Her mother stayed in the camp with their 3 other children. He is frantic for support but cannot bring himself to tell his wife that he will be returning home alone. He is pacing back and forth, and I can hear the faint wheezing of her breaths, uncertain of how much time she has left. Everyone in the ward is watching and the other mothers are starting to angrily yell at the father to call his wife. I ask him if he wants to go into the psychosocial tent, where he can be with his daughter alone, and he says yes. He doesn’t want to touch her, too afraid that he will breakdown. I carry her nearly lifeless body across the field hospital and lay her on a cot in the tent. I wrap her up in a blanket and hold her hand as she takes her last breath because no child should have to die thinking they are alone.

He gathers the strength to call his wife and I hear her screams through the phone. They are both screaming now, and it takes every ounce of strength I have left in me not to scream too.

The smallest coffins, are the heaviest.

Strength.

___________________________

After the wife’s brother comes to take the father and his daughter’s body home for burial, I run as fast as I can back to my sleeping tent.

I must have watched the video my kids sent me that morning a hundred times. What I wouldn’t give to hold them right now.

Longing.

___________________________

My roommate comes in and begins to pack her belongings. I ask her if she’s ok and she says she is not feeling well again. She is going back to the hotel for isolation.

I say goodbye and thank her for all the amazing work she has done.

I know this will be the last time I see her here.

___________________________

The psychosocial tent has reopened after the death and I can hear the sweet sounds of children playing as I walk towards it. I go inside and see the beautiful smile on S’s face as she looks up at me. It’s the first time I’ve seen her since the amputation and she is the most perfect gift at this moment.

Her painful screams now replaced with the best giggles I’ve ever heard (after my own children, of course).

___________________________

It’s time for S to eat and I carry her back to her mother in the pediatric ward. While there, I check in with my favourite little 9-year-old boy.

Two weeks earlier, a group of wild elephants attacked one of the camps; killing 4 and injuring another 4. This little man had both his legs broken in the attack; he’s been bedridden with us ever since. His older brother never leaves his side, and up until yesterday, he believed he would be here forever. I’m glad to have helped clear that up for him and his spirits have definitely lifted since. I try to get him to do his upper body exercises using a creative contraption that one of our technicians put together for him, but he laughs, and I know that he’s not interested right now. I leave some toys with him and tell him I’ll come visit later as a call comes in asking me to go to the maternity ward.

___________________________

A young woman lays in silence on the bed. After being violently gang raped while pregnant before crossing the border, she has now suffered a miscarriage. She’s alive, on the outside. I can’t tell you how much more of her survived that.

___________________________

My partner and I are shutting down the tent for the day and getting ready for our daily debrief. It’s her first deployment, and it’s not an easy one! While our personalities are very different, they are also quite complimentary. No one else has a very strong understanding of the work we do and just how difficult it can be to provide support to EVERYONE, so I’m incredibly grateful to have her on this journey with me.

We’ve created a bit of an evening debriefing ritual, where we talk about the day (and life, in general) while playing background music and doing our stretches/yoga. It’s something I look forward to, and today is no different.

I’m not hungry again but I force myself to eat.

And drink water.

___________________________

I go to bed and start to cry.

Crying, for me, is a very good thing. A release. A cleansing of sort.

It’s the lack of feeling that scares me, and these tears remind me that I am still alive and well.

I don’t know when or how it happens but at some point, I fall into a deep sleep. For the first time since I arrived, I don’t need the call to prayer to lull me back to sleep. In fact, tonight, I sleep through it completely.

Exhaustion.

___________________________

A new delegate arrived the night before, one I’ve worked with in the past.

I am genuinely happy to see him; he looks well rested and excited to face the day. We eat breakfast together and do a quick life catch up before I start. Since he doesn’t have much on his schedule for today, he tells me he will connect with me later for a psychosocial operation overview.

I wish him luck and tell him to drink lots of water.

___________________________

It’s not long after breakfast that I’m called to the outpatient department to speak to a male patient. The gender dynamics here are interesting. It’s a predominately Muslim country, and normally, men and women are kept separate from one another. We’ve redesigned the hospital to respect the culture and religious practices, and everything we do is done in consultation with the affected population and community leaders. While men wouldn’t normally access support from women, at the hospital we have found that when it comes to psychological concerns, they are more likely to open up to a female. Still, I respect an individual’s right to choose and so, I pick a male translator to accompany me to the ward. The man doesn’t speak; not because he can’t but because he hasn’t in weeks. He is sitting cross-legged on the bed and I can see his genitals – he’s completely unaware of this as he stares blankly at the wall beside me. I ask my translator to discreetly adjust that for him, and he does. The man doesn’t move. He was brought to the hospital by a friend, who was growing increasingly concerned about this behaviour. Through the translator, I ask his friend when this started, and he begins to tell me in his language.

When his village was attacked, they captured his wife and children. After killing his sons, they forced him to watch the rape of his wife and daughter; before killing them too. He fled alone; crossing the border with nothing else to live for.

I look at him, two shiny streams of tears now running down both sides of his face.

The first signs of life his friend has seen in weeks.

___________________________

After an hour with him, I desperately need to hear S’s laugh again. Her and her younger brother are starting to spend more time in the child safe tent and even the doctor’s stop in regularly to see her smile.

The psychosocial tent has become a bit of an escape for those needing a short time-out from reality. It’s the only place where you can hear constant laughter, and we make sure we always have cold drinking water on hand.

Today, we are visited by one of the technicians.

Regardless of everything that is going on, he goes out of his way to smile. A genuine soul, he quickly became one of my favourite people to work with.

But something is different today.

He asks if he can come hang out with us for a bit, and both my partner and I ask him if he is ok at the same time. He sits down and immediately starts to cry. My partner gets up and gets him a glass of water.

“What happened?”

He got news from home that his uncle died. Far away and feeling helpless, he says he can’t think of a better place to go. He tries to apologize but we don’t accept apologies for feelings. He laughs and says, “that’s why I came here.”

We let him cry for as long as he needs. We speak when we need to. We watch children play. We drink water. We listen to laughter. We just are.

And then our radios go off and we spring back into action.

___________________________

Another emergency C-Section.

Another baby dead.

___________________________

Our isolation tent is now filled with children with measles. The crowded refugee camps are the perfect breeding ground for all things communicable and we are in desperate need of a vaccination campaign.

Watching any child die is awful, but there is something about measles that looks especially violent.

Another child dead.

___________________________

S is learning to walk with her crutches. They were able to save enough of her foot in surgery so that she will be able to put her weight on it.

That smile.

Hers and her mothers, as she takes her first steps.

___________________________

The new delegate returns after providing support for the child who died earlier. I can see that he is upset by it.

Of course, he is.

Although I’m just starting to process the events of my own day, I know he needs me to be there for him.

Present.

He sits down and looks me in the eye, fighting tears, his voice shaking. I can almost feel his heart breaking as he asks me, “Was that the first death?”

I take a breath, get up and pour him some water.

“Here, you’re going to need a drink.”

*names have been changed to protect the confidentiality of individuals.

Haunted

 

“Do you have any sleeping pills?”

It had been weeks since I had heard from him.

“How many do you want?”

It pained him to need anything from anyone, but especially me.  To ask me now, like this,   I could almost feel the desperation in the writing on my screen. I read the words again,

“Do you have any sleeping pills?”

Some of us are haunted.  Our thoughts.  Darkness.  He and I are cut from the same cloth.

“3, if you can spare them.”

I don’t hesitate.  I know what it is to need that relief.  To find a few hours of peace, after days, weeks, months, years.  I know what it is to be haunted.

“Sure, come by.”

Today, the sleeping pills will be his peace.  My peace will be in his presence.

Some of us can only ever be understood by the rest of us.

Luckily, you’ll never have to understand.

 

 

September 22nd

Some days are rough.

Days like today.

Today was rough.

It was late when I finally closed my eyes last night. I already knew what kind of day I would be waking up to. Still, I went to sleep with a smile on my face.

September 22nd.

Today was my father’s birthday. We celebrated 66 years of his life this evening, as we do every year. My father is happiest when he’s surrounded by his grandchildren, this is obvious to anyone who knows him. Today, I watched him blow out his candles with the help of my sons. They love him as much as he loves them. This is equally obvious.

September 22nd is bittersweet.

My parents moved to Canada in their late 20s. My father is one of 8 children, my mother is the youngest of 9. By the time they moved here, both of them were already used to living away from their families. My sister was born a few years later; 14 months after that, I came along. They had created their own family in Canada; a family they hand picked for all of us. While there was a shortage of blood relations, there was never a shortage of love.

Within that family, was the most special woman of all. I call her my grandmother because she was the closest thing I had to one. Truth is, she often felt like the closest thing I had to a mother too. She raised my sister and I from the time we were only weeks old, until our early teens. She raised us like her own. She was my grandmother, I was her granddaughter. Her family was mine and my family was hers. Naturally, she was married to the man I call my grandfather. He worked all day but we would all wait for him to come home when school was finished. His routine was simple; he always sat down and had a beer. We would give him his space but we would hang around him until he was ready to chase us around the house. He would pretend to take our noses by pinching them between his index and middle fingers. And we’d run because it actually hurt. But we would laugh anyway. We loved his attention. We loved him.

September 22nd was also the day we celebrated his birthday.

But he is no longer here.

He lost his battle to cancer on October 12, 1998. I was 17 years old. We stood next to his bed and he tried to speak to us. He tried but he was too weak. I imagine he probably wanted to tell us that he got our nose one last time. He died later that evening.

While my children celebrate September 22nd with their grandfather, I wake up remembering how much I miss mine.

In 3 weeks, I will visit his grave, as I do every year. This year marks 17 years since his death. He’s been gone for as long as I had the chance to know him. Some people you never forget.

September 22nd.

Goodnight.

Choose Your Own Adventure

I remember when I was a child, I’m not sure how old anymore. It must have been somewhere between grades 2 and 6, between 8 and 11 years of age. I used to love reading those “choose your own adventure” novels.

Remember those?

You would start reading the novel just like any other book; at the beginning. You would read it until a certain point and then you’d have to choose the next step. You were given two or three options, usually, and each option changed the direction of the book completely. In a sense, you were writing that book as you went along. You were the author of that story.

Life is like that too; just a series of quick pauses and a few options.

I wish someone had explained that to us as kids. To me. How truly symbolic a “Choose your own Adventure” novel is of a human life. A personal journey. Now THAT would have been a lesson to learn all those years ago.

Perhaps if we had been taught that growing up, we would find ourselves less attached to outcomes and more open to possibilities.

Every novel would start at the beginning, the way everything starts. You couldn’t choose when, where, who, etc, you just had to make choices based on what you were given. The same way we don’t get to choose when we are born, where we live, who our parents are and what we are given, or not given.

You would rush to your first set of options. You knew in advance that you would be given some, but there was no way of knowing what they would be.

Would they lead to travel in faraway lands? Would they help you find love? Friendships? Hidden treasure? Success? You were unsure, but the story was full of possibilities.

Your first set of options were always so exciting.

Some seemed terrifying. Almost too adventurous for your first real choice. You had to test the waters. Get your feet wet before you committed to something so unfamiliar. Some seemed to lead to a sadness that was equally terrifying. Some were happy. Some were strange. It didn’t matter what you chose though, you knew that it was just the first of many.

By the time your next set of options came, you were far more committed to the journey. You started to figure out who the main character was. Maybe you even started to enjoy where that journey was taking you.

The next options took you closer to the end. You knew you had less time for the outcome that you wanted and you started to think more strategically about the choices you were making.

At this point, you may have learned that the most terrifying things led to the most wonderful treasures. Or that what seemed like the happiest paths led to a loss you weren’t prepared for. Sometimes treasures were lost as quickly as they were found.

The only certainty you had was that you had to continue making choices to get to the end. It was the only way. You had started a journey and you had to see it through.

What I learned from reading those “Choose your own adventure” novels is that you didn’t have to like the ending. That it was just a story. A journey. If you didn’t like the ending you chose, you could go back to the turning point and choose again. You could go back as many turning points as you needed to and try a new path.

Sometimes in life, we get so stuck on an ending we don’t like, we forget that we are the authors of this story. That at any moment, we can try again. Pick another path. Rewrite the ending.

The difference between life and a novel is that life only gives you one true ending; death. In the meantime, you get to “choose your own adventure.” The same way you did as a child, so many years ago.

Death

Less than 5 months ago, I sat in a graveyard surrounded by freshly dug graves. In those graves were the bodies of hundreds of Ebola victims. In those bodies, lived beautiful souls.

Death is so final.

Not including war and HIV/AIDS, I’ve now worked disasters that led to the total death of over 20, 000 people. That is only my international experience. An experience I don’t often discuss. How can you even begin to describe what that feels like? How can you even want to explain what that looks like?

Death ends a life and destroys so many others.

It’s an interesting thing for me though, death. Being faced with so much of it, I’ve spent a lot of time processing what it means to die. And what it means to watch someone die. And what it means to be the one that gets to live.

I’ve seen some of the most violent deaths you can imagine. In my field, death is rarely peaceful. I’ve heard countless stories of the same. I’ve seen the scars; physical, mental and emotional. I’ve wiped the tears. I’ve held children that were now left completely alone in this world. Sometimes I wonder how I can be so numb to it all.

But I am numb.

You go through periods where you question how you can do what you do. How you can watch everyone around you fall apart completely, and you don’t even shed a tear. That’s often spoken of as a strength, but the truth is, it scares the hell out of me sometimes. In the moment and shortly afterwards.

But I am only numb because I have to be.

There is no weakness in feeling. There is no shame in crying. But I have to play a role that involves allowing everyone else to do that, without turning to that myself. In the moment, I have to be numb to keep moving. To keep working. To keep my focus.

It scares me but I understand it.

You don’t bounce back from this work. You don’t heal. You don’t forget. But you get to survive. Sometimes, even that can feel like you drew the short straw. But I am grateful. Always.

You go numb and you do whatever you have to do to feel again. My self care routine is strong. So strong, that sometimes it looks selfish to those who don’t understand. I don’t fault them for their feelings, but I don’t care either. I take my time to myself. I work out. I travel alone. I speak about it when I need to. I write. I do what I have to do to process my feelings. To feel again. To remember that my numbness isn’t as permanent as the death that causes it.

5 months ago, I returned from Sierra Leone, after working at the Ebola Treatment Centre. I left death and arrived home, to the news of another death. A more personal one. I thought I was ready for the funeral. I was still numb.

Standing in that graveyard, the whole world was spinning around me. I was surrounded by people who were feeling something. So much of something. So much of everything. People that I loved.

I stood there and all I could see was death. I couldn’t hear anything. I couldn’t breathe. In a graveyard, so close to home. I saw names. I saw graves. I saw Sierra Leone. Africa. The Ebola Treatment Centre. Death. I could feel the vomit coming. I couldn’t stop the tears. I had to leave.

It was in that moment that I came back to me.

I always do and I always will. This is the cycle I live.

Until my dying day.

What is 15 years?

15 years.
5478 days.
131,472 hours.

I miss you every day.

Sometimes, it feels like forever. Sometimes, it feels like you’re still here. So long. So short. You’re gone and you’re never coming back.

15 years without you in this world is too long to comprehend.

I still hear your voice on the other line. Laughing. I’ve replayed that last conversation thousands of times. All the things I would have said if I knew what I would be waking up to the next morning.

I want a do-over.

I want to say goodbye the way I should have said goodbye.

I want to tell you I love you and how amazing I always thought you were.

How truly blessed I felt to be in your presence.

I sat with you today, like I do every year. My voice still trembles. My tears still flow.

I left because I had to save myself.

Some things you never forgive yourself for.

15 years.
5478 days.
131,472 hours.

Rest in paradise brother.

All I had to say…

The lonliness inside my soul

the emptiness in my heart

slowly losing more of myself

every minute we’re apart

I wish I would have told you

all I had to say

just can’t help but wonder now

if it would have made you stay

these four walls are closing in

it’s hard for me to breathe

choking on the words I said

the ones that made you leave

I wish I would have told you

All I had to say

just can’t help but wonder now

if it would have made you stay

the day you got your wings

it was me who learned to fly

you taught me how to live

the day you died.

My to-do list.

Here I am. 

It’s the eve of my long awaited 17. 

17 years on borrowed time. 

I made it!

There were days when I wasn’t sure I would. 

But here I am. 

Closing one chapter tonight, starting a new one tomorrow. A chapter full of wonderful adventures. Creative expression.  Personal freedom.  Love. Life. And so much laughter.

A chapter full of whatever it is that my little heart desires.  

I’m so excited, I can’t even express it with words.  There is no smile big enough, no jump high enough, no screech loud enough to express this kind of excitement.  This feeling.  This moment is mine.  Only mine. 

I’ve done so much with my time here. I’ve lived. I’ve lost. I’ve moved. And moved. And moved.  I’ve travelled. I’ve loved. I’ve cried. I’ve laughed. I’ve given life.  I’ve raised children. I’ve married. I’ve owned property. I’ve learned. And learned. And learned. I’ve worked. I’ve failed. I’ve succeeded. I’ve jumped. I’ve landed.  I’ve created. I’ve written. I’ve danced. I’ve played. And played. And played. 

Oh, how I have truly lived my 34 years.

And still, I have a long list of things to do. Things to see. Things to feel. Experience. Witness.  Hear. Touch. Smell.  So many things to look forward to. 

The most important lesson I’ve learned is that the only guarantee you get in life, is death.  No date. No time. Sometimes no warning whatsoever. Just an end and the knowledge that it will come.  

I’ve been fortunate to have already been given 17 years of borrowed time.  I’m proud of what I’ve done with it.  But I’m far from done. 

My to-do list is long.  But I have no idea how much time I will have left.  So, I’m making a promise to myself. A promise to keep crossing those items off my list. To put more energy into the things I want to accomplish and less focus on the things I cannot control.

As I was reading over my list, I started to reflect on the people that have been in my life.  I thought about friendships, relationships, co-workers, family. People who have a to-do list of their own. People who have added me to their lists. People I’ve added to mine.  I thought about how many people in my life never truly cross off their items.  How so many people allow life to get in the way of them living.  I thought about how many things I’ve missed out on because I waited for them to be ready.  For timing to be right. For everyone involved to be in a good financial position.  I’ve waited on others because at some point, I told them I would.  Because my word meant something. 

Not anymore!!!

No more promises to others.  From now on, my to-do list is mine alone.  It will only involve those who are ready and able to do it when I’m ready and able to do it.  If I want to travel, I will travel with whoever is ready to go. If I want to jump out of a plane, I will jump with whoever is willing. If I want to learn another language, I will do so with someone who wants to follow the same process. Sports. Movies. Activities. School. I will do whatever I want. Whenever I’m ready. Whenever I’m able. And alone if I must.  Happily.  

Clean slate. 

My life is mine to live. 

MY experience. These are MY memories. MY laughter. MY tears.  MY gift.  

This is MY to-do list.

And I’m doing it. 

History Repeats Itself

I’ve been looking forward to April 12, 2015 for half my life. 

17 years. 

Since April 12, 1998. 

The day I almost died. 

Since that moment, I’ve waited to celebrate this one.  

17 years on borrowed time. 

I’ve doubled my life. 

I am grateful. 

I’ve celebrated the anniversary every year since.  Counting down to this exact moment.  This day. 

On April 12, 1998, I attempted suicide.  That was the best failure of my life. 

I had never fought so hard to survive as I did then.  And I survived.  I knew that my life had to be about something more. Something bigger than what it was.  Something better than how it felt.  Something. 

The days that followed were all about setting goals for myself.  Preparing for that something.  Whatever that something was. 

I thought about where my life had been. Where my life was now. Where my life was headed.  I thought about the things I had wanted. The things I had sacrificed. The things I was doing, not doing and wanting to do.  I thought. Every single day.  

I made a list.  

I wasn’t interested in a life without spontenaiety, so my list didn’t include a plan. Just goals.  How I would reach those, that remained a mystery even to me. I just knew that I would.  

I made a list of all the things I would do in the next 17 years.  Everything I would have accomplished by April 12, 2015. 

A few months ago, I reviewed that list.  I went back to see where I was, to ensure that I would have it completed in time.  I had.  I had done every single thing I said I would do.  I was doing everything I wanted to do.  Every single thing. 

It was amazing. 

A feeling of absolute completion. Accomplishment. Satisfaction.  Pride.  

And then it hit me like a ton of fucking bricks.  I had planned the rest of my life as if it were going to end on April 12, 2015.  I hadn’t considered what my goals would be like after that.  As far as I was concerned, I was done. 

At 34, I had done everything I set out to do.

And then things got weird.  I found myself mourning the end of this stage and completely unsure about what the next 17 years would bring.  

I thought about where my life had been. Where my life was now. Where my life was headed.  I thought about the things I had wanted. The things I had sacrificed. The things I was doing, not doing and wanting to do.  I thought. Every single day.  

I’ve always had to feel like I was in control of myself. Of my life. Of my choices. Sure, I understood that absolute control was impossible, but if I could control something, I would. And I did. 

The day I found myself crumbled on the ground was the day I realized I was not in control.  I had somehow, without even realizing it, recreated the end of my first 17.  I designed the last 17 years as if they were my end. My last ones. Then I mourned it. Believed it. And I set the scene.  Right down to the emotions. 

At no point was I actually suicidal but I didn’t care if I lived or died. Looking back, I guess I never have. 

People ask me every day why I’m not scared to do the work I do.  The answer is simple, I’ve never feared death. 

I am not afraid to die. 

It sounds strange but there it is.  I enjoy walking on the edge of the cliff knowing that I’m strong enough to not jump.  I crave that feeling.  Not wanting to die but not caring if I live. 

And so, the universe gave me the lesson I needed. The real lesson about life and death. 

I returned home from my mission to painful news of another death. This one hit home. So close to my heart. It hurt.  

Here I was, mourning my own end. Fearless.  Not caring.  And what I had to see that day, was shattering. 

17 years ago, seeing my sister’s face when she found me.  I saw in her, what it would look like if I was gone. 

17 years later, walking towards her lifeless body, I saw what life looked like for my friend, now that her mother was gone.  

History repeated itself. 

I repeated history. 

This is the end of 17. 

April 12, 2015 is a few days away. 

I am so proud of where I’ve come from. I am amazed at where I’ve been. I’ve lived more in my 34 years than many do in 80. 

But I have a newfound excitement for whatever remains of my life.  A thirst for it.  A hunger.  There will be no more 17 for me after I celebrate this milestone.  

Just days. Every day. Weeks. Months. Years. Living. Truly living. Doing. Being. 

Creating. 

That’s the only goal I’m setting for myself.  I will create.  That’s it.  

Watch me.