Monday, July 27, 2009

Kira arrives!

Monday July 27, 2009 9:57pm

It’s quieter tonight. After the heavy rains, it got noisier at night –some kind of frog came out of hibernation, or went into heat, or god knows what, decided to thank the froggy gods for so much rain I guess. For whatever reason, every night for a few nights, after the heaviest of the rains, the choking sound of their croaks was layered over the top of the already considerable Balinese wildlife caucophony and it was harder to sleep. It hasn’t really rained in a few days now, and tonight we’re back to the locusts and the regular frogs and the crickets and the geckos and whatever else.

My comforter has disappeared. Which is ironic, because I’ve always thought the thick comforter on my bed was kind of odd given how humid it is here. I’d often wrestled with it in the night, trying to find the balance between the comfort of it’s weight (hence “comforter”) over me, and kicking enough leg or arm out of it’s cover to make it cool enough to sleep. But now that it is gone, I miss it. The day after Austin left, the housekeeper changed my sheets. I was sort of sad about that because I lost his smell on the pillows, and grateful for it as well. I took it as a sign of compassion from the housekeeper, like she understood the psychic implications of sleeping alone in a bed you had shared with someone you love but who is gone. It seemed better that she changed the sheets after he went home, so I could reclaim my bed for myself, not sleep every night in the ghost of his presence. I realize this is probably NOT why she chose to change the sheets when she did, but was grateful for it anyway. But she took my comforter to wash it as well. It needed a good wash, because it had spots of blood all over it from my leg wound. But it hasn’t returned. I asked about it yesterday and they told me that it has been too rainy, so nothing will dry in the humidity. While I understand that, really there isn’t another comforter I can use? Anywhere?

So tonight, we will improvise. We! Kira is here! I picked her up from the airport today and have spent the afternoon with her showing her around Ubud, catching up, talking about best friend stuff. She’s currently showering and getting ready for bed, which makes another reason why its great that the sheets were changed, because who wants to sleep in the bedding of a couple? But doubly inconvenient that the comforter has absconded, because who wants to sleep on a bed with no covers, especially on your first night in a strange place with strange sounds, sharing a bed with someone who is not your husband?

Tomorrow is the cremation ceremony everyone has been preparing for all month. One of the villagers died recently, and so they have a big cremation ceremony to burn an effigy of the body (they bury the real body nowadays). We will attend, in ceremonial dress, which I am excited about. This is a very big deal, everyone will be there, and it’s a pretty neat opportunity to witness real Balinese culture in action. Beyond that, the day is unplanned. Kira is feeling like a trip to the spa would be nice and what kind of a friend would I be if I didn’t oblige her? My guest is ready for bed. More soon.

Saturday, July 25, 2009

Tea For The Tillerman

Friday July 24, 2009 11:37pm

I spent a long day at the clinic today attending the birth of a first time mom with a very asynclitic baby –a child neither committed to being transverse OR straight posterior, but in a funny place in between. The mother was complete at 11:30 this morning, and began to push and continued to push until she finally had her baby, with 13 people in the room, most of them midwives, at 5:15 this evening. That is a loooong time to push out a baby, even for a first timer, and not something midwives normally do at home. Kate, who was primary for this birth, caught the stubborn stinker and managed through either luck or skill, to help keep a very tight perineum intact. Well done, Kate. All through the first hour or so of pushing, my spidey sense was tingling. There was something not right about this second stage and while my heart continued to chime in that the baby would come, I was uncomfortable with it. In the end, the baby did come. And I was also right that there was something unusual about what I was seeing. But I definitely had moments, like the 2 hours of visible head, the hour of crowning, when I thought maybe the baby wouldn’t come on its own. Today was a good lesson in patience and a reminder to trust this process. That even after 6 hours of pushing and seemingly impossible positions and fits, babies do tend to come.

This baby came, I need to acknowledge, after Sue arrived. A reminder of my revolving door of characters: Sue is a homebirth midwife from Austrailia, has been for 30 years, was traine by an old timey doc who still did homebirths and who was eventually stripped of his medical license for training homebirth midwives. She knows great luminaries of midwifery and woman centered care like Ina May Gaskin and Sarah Buckley. She’s amazing and I’ve been learning a lot from her since being here. She’s also the mother of Tessa, the Australian doctor that I’ve become friends with here as well. They are a great team to have here. Sue’s energy was fresh when she walked into the birthroom about 30 minutes before the baby came. Everyone was tired, but the energy picked up as soon as she arrived. I cannot overstate the help and importance of having someone fresh to revive flagging energies at a long hard birth. Whenever I observe a particularly difficult birth, it is easy to sort of deflect it like, well, this won’t ever happen to me. But that’s not true. I have to pay attention ESPECIALLY at the hard long ones because, like it or not, there will be hard births where I will be exhausted and out of ideas and feeling like maybe the baby won’t ever come. And it is at that point that I will need help, a second pair of hands, a fresh set of eyes, some new perspective. This is why I love the idea of working in partnership instead of alone, of having a community that is supportive of you, so you have other midwives you can call on when its been 24 hours and you haven’t eaten or slept and you can smell yourself and you’re starting to hate the family you’re working with, and thinking about just walking out of the house and out of your job. Because there will be days when I will need to be able to say “Oh my god! This is taking forever!” and someone I trust to say to me, “Yeah, and? The baby is coming.” At any rate, the baby came. Probably would have come even without Sue’s energy, but I probably wouldn’t have wanted to stay for the end.

I was thinking about this a few hours after the birth when Sue called me over to “meet” her husband on Skype’s video chat. Her husband and I exchanged pleasantries and he asked if I was a “budding midwife” and Sue piped up, “She’s a midwife already. She’s getting ready to sit her final exams. She’s very skilled and a straight shooter and has a wicked sense of humor and I’m trying to convince her to move near us to set up a group homebirth practice with me.” As I burned with pride and embarrassment at such glowing remarks from someone I respected so well, her husband informed me that it was quite a compliment coming from her. I totally got that.

It is true that Sue has mentioned a few times recently, in a breezy mostly-teasing sort of way, that I should move to Australia and come to births with her. Of course it has my interest piqued. I don’t know what the next step in my life is. I feel like I’m ordering the rest of my life over the phone from a menu written only in a language I don’t speak, pressing buttons and hoping whatever is delivered is something I’ll like. I am feeling anxious about getting to a place in my skills where I feel more confident, worrying that I won’t have the kind of support I feel like I’ll need to practice where I live now. Would it be so outlandish to move across the globe to work with someone I respect immensely, who has more than my lifetime’s worth of experience, and not be her apprentice, but actually work with her?

I was exhausted when I got home from the clinic tonight, but my brain was still busy so I decided I would walk into town and get some quiet time alone. I happily used the headlamp that Austin brought for me on the dark walk through the Monkey Forest, finally not afraid of cobras in the shadows, or falling into unseen holes. The rain finally stopped this morning and everything is soggy and the humidity was intense today. In town, I stopped at one of the bootlegged DVD stores and got 2 movies for $1.50 each. Then I went to my favorite restaurant here and had yummy chicken soup and iced tea. I geeked out on some early Cat Stevens while I ate, and I missed Austin. Walking home, it was especially late and the Balinese aren’t used to white women walking alone in the dark at night. I was probably stopped 10 times by guys on motorbikes wanting to know if I needed a ride to my hotel (“Free?” one of them offered as I waved him off). Since Austin and therefore the scooter has gone and I’m back to walking everywhere, I noticed that I’m developing quite a phobia of the sidewalks in Ubud because of my fall. I am seeing every foot of walkway ahead of me as having the potential to crumble beneath my feet and send me back into the grimy, watery depths of the Bainese gutter. So I’ve been walking on the curb, or even in the street. I’m less afraid of being hit by a car or a motorbike than I am of falling through the sidewalk or not seeing a hole where the sidewalk used to be. Every time I feel one of the walk tiles shift under my feet, my heart jumps up into my throat and my pulse quickens. It is making walking around here unpleasant.

As I alternated between gingerly stepping on the wobbly sidewalk and playing chicken with the oncoming traffic in the street, I wondered if taking one of these “helpful” gentlemen up on their offer of a ride wouldn’t be the worst idea in the world. Which, of course, got me thinking about men in general and sort of fondly acknowledging that guys the world over are basically the same. Most of the guys pulling over to offer me a ride were hoping to get paid to ride me down the hill a few blocks, but I think there was also a secondary motivation of a young woman walking alone at night and the potential that I might “like” them. That’s basically how guys work, right? While Austin was here, we came to the decision to stop denying that we are in a relationship. Both of us were wanting to take it “slow,” to test the waters for a while, not pressure ourselves with a label, to give me some time to heal from my previous relationship (that only ended two months ago!). But we both had to admit that we were not really taking it slow, that we’d spent all our time together since we met up until I left, and then he flew halfway around the world and at great expense to surprise me here. Did either one of us want to see other people still? No. We were falling in love. It was time to just call a spade a spade. I can’t predict what is on the road ahead for us, but I adore him. He showed up so completely while he was here, participating in the clinic, making real connections with my friends here, adopting this temporary home of mine as his too. It was exactly what I would have wanted. Its so early still and I know the love drugs are running strong in our systems right now, but I’m really happy.

With all the happiness comes some insecurity, because I DON’T know what comes next. It echoes the thread that is running through my life at the moment. What am I doing? Where am I going? What do I want? EVERYTHING feels young and tender right now. There isn’t anything that feels established or old news. It’s a strange time in my life, to be sure. Embarking on what feels like a totally new chapter in my life, everything still in its cellophane to be unwrapped, explored, hoping it won’t get spoiled, and knowing it is the nature of things to change. I keep thinking of Cat Stevens songs (yes, I’m obsessing on him a little bit right now), “Miles from nowhere/ guess I’ll take my/ time to reach there.” and “You’re still young/ that’s your fault/ there’s so much you have to go through.” I am so acutely aware of my age right now, feeling SO young and immature, recognizing that most of what I’m going through will only go away with more time and experience. I feel like I’m re-living that awkward geeky stage of ages 14 and 15, when I was all lumpy and too big for myself and my teeth didn’t fit in my mouth well and my boobs made me uncomfortable. I am feeling that way spiritually right now. Just uncomfortable in my skin, self-aware enough to mostly laugh about it, and generally just looking forward to it being over, not feeling like the ugly duckling anymore. I’m ready to be the swan.

Thursday, July 23, 2009

Departures

Thursday July 23, 2009 9:09pm

Austin left this morning, back to foggy San Francisco. I'm sad. We spent our last couple days together having a great time. I convinced him to volunteer with me at the acupuncture clinic on Monday night as "moxa boy" --the guy taking blood pressures and changing rounds of moxa on acupuncture patients. He was nervous and shy to jump into the fray (acupuncture clinic is CRAZY busy and the acupuncturist, Dr. B, is intense) but I stayed with him through for the first few patients and everyone else stepped in to help him and in no time, he was doing great. He was AMAZING, actually, and rocked clinic, remembering instructions and details about the patients' treatment that I couldn't have done. He also now does a hilarious Dr. B impression that gets us all rolling in our seats. After clinic, he has his first acupuncture treatment, which was not nearly painful enough to warrant revenge for his delight in my pain the previous week. I also had another acupuncture treatment on my sore leg (another round of "Ring The Dragon" which means they circle the whole wound with acupuncture needles OUCH, and they also "bled my liver" again which means they pricked my big toe with a lancet and made me bleed. Double ouch. I'm a whiner.) but I'm excited to say that it FINALLY looks and feels SOOOOO much better. It has started itching like crazy, which everyone is glad about, but I'm not sure its much better than the pain because its making me a little nuts.

We made a new friend with another Californian acupuncture student, Tyler, who was here visiting Danielle, and we hung pretty hard with him Sunday, Monday, and Tuesday when he left. Its amazing how quickly you can build friendships when you're out of your element and far from home. We spent Monday morning going through the big market and getting dubious "good prices" on various things for Austin to take home for friends and family. I have discovered that I am a GREAT haggler, and have been employing my skill to my own advantage on taxis, a new bag and THREE dresses (all for under $75 total). On Tuesday night, Danielle, Austin and I went to Mosaic, which is considered the French Laundry of Bali. I panicked when informed the dress code stated no flip flops and I didn't have anything else, but was able to borrow a pair of Danielle's shoes. We arrived, went through a metal detector, were shown into a lovely lounge, and then had a really tasty 6 course French meal for $55 each, which is VERY expensive by Balinese standards, but bargain basement for food and service of this quality compared to home. It was a lovely evening, and I think deserves a reprise with Kira when she arrives next week. Last night, to commemorate his last day, Austin wanted to go back to Sari Organic, the magical organic restaurant out in the rice paddies, with Tessa, Sue, and Danielle. We decided to ride scooters, with three of us on Austin's scooter and two on Danielle's. We got through the Monkey Forest, giggling mightily over the sight of three adults on a scooter, and then saw we had caused a flat tire. Oops. So we had to hire a taxi to take us the rest of the way. The taxi dropped us at the end of the driveway that marked the beginning of the mile long walk in the dark out to the restaurant. As we began our walk, it began to drizzle. Then rain. Then POUR. We were screaming, laughing and RUNNING along the narrow path between paddies, barely able to see through the rain and the darkness with our meager little phone flashlights. It was hysterical and we took many pictures to prove the ridiculousness of it. We got to the restaurant and, due to the inclement weather, they had closed early. However, in true Balinese fashion, re-opened and served us a wonderful dinner as rain pounded on the thatched roof over us and they wrapped us in table cloths to keep us warm in our soaked clothes. Of course, we had to go back out into the rain when we finished, which was less fun, but it worked out okay in the end.

Really though, does it get any more magical? Its not just anywhere that you can run through the rain in the dark to get to a lovely organic restaurant in the middle of miles of rice paddies, to be served dinner privately with some of your favorite people, wrapped all up in table cloths.

I said a tearful goodbye to Austin this morning and then, to quell my welling homesickness and Austsickness and because the clinic was closed today, a group of us went out to lunch and then to a lovely spa where I had a manicure and a pedicure ($10!!). Its been raining on and off since last night's deluge. Not just raining, but RAINING. The kind of rain that makes you understand how people can see the weather as an indicator of the moods of the Gods. I woke up at one point in the night last night and sleepily wondered if the house could collapse under the power of the rain. Its been RAINING. It began raining again during my pedicure, on a chaise lounge in an open air room, with some of my friends sitting close by and we discussed midwifery, the births we've seen here, and it poured all around us in the good natured warm Bali rain kind of way that it does, and we sipped warm ginger tea and I understood how people could never leave here. So long as their boyfriends are here too. As for me, I'm going home when this trip is over. But maybe I'll be back. Too much magic here to just let it sit here all unabsorbed.

p.s. I've gotten a couple emails expressing concern and wonder that I may have gotten back together with my ex-boyfriend Austin. I would like to clarify that this is NOT the same Austin, just someone with the same name. Thanks for all the concern though, peeps!

Wednesday, July 22, 2009

Half way through

Wednesday July 22, 2009 11:39am

I haven’t been to a birth in a week. This is mostly okay with me, but I’m starting to stress about it a little bit. It is not about the “numbers” (the number of births I need to attend as a primary midwife before I qualify to sit for licensure) because, technically, I have all my numbers. But I don’t feel “good” about all those numbers, so I’ve been sort of replacing some births that I counted as primary at home in the States with births I’m doing as primary here because I feel like I was more autonomous at the birth and would prefer to count it toward my license instead. This probably makes very little sense, and is probably very unnecessary, but I’m noticing that it has felt important to me to do. So, if there are only 3 births from home that I feel good about counting, added to the births from Senegal that I want to count, added to the births that I’ve done here so far, I’d like to do 4 more births here before I go. Which is totally doable. Before coming to Bali, I expected to attend on the order of 20 to 30 births as primary while I was here. So far, in three weeks, I’ve attended 8. That doesn’t mean that I won’t get to 20 or 30 births, but it doesn’t look great. This is at least partly, if not entirely, my own doing. If I wanted to spend every night at the clinic, I’d have done a lot more. I don’t live next to the clinic so its not easy for me to get to a birth if its happening quickly, and I’m not as “in” with the Indonesian midwives as other volunteers so I don’t always get called. And Bali is distracting. In Senegal, we were in such a remote place, that there was actually NOTHING to do but lurk at a clinic, read, or sleep, and the midwives called us on one of our two phones and we all collectively decided who would go. Things work differently here. And there’s so much more to do. Cafes, bookstores, monkey forests, boyfriends all luring me away from my intended purpose here. So, starting tomorrow, I’m back to hanging around the clinic like a bad smell.

I’m trying to decipher what it is that I want to come away from this trip with. What is my educational goal? The numbers are not the motivating factor. If anything, it’s the remaining sense of greenness I am seeking to scrub away, the wondering when and how I’m going to feel Ready if being nearly qualified to sit for my license hasn’t produced that sense of confidence. I feel more like a midwife now than I did when I left for Senegal, more like one even since I returned only 7 months ago, but I still don’t feel qualified to be solely responsible as a primary caregiver. I’ve mostly made my peace with the fact that, once licensed, I probably *still* won’t feel fully qualified and have resolved to spend my first few years working only in team with other midwives whose experience and qualification I trust, because two heads are better than one and because I am not going to be the foolhardy youngster charging full speed ahead straight out of the gate. That’s not my style.

The importance that I gain that confidence feels so urgent because it’s not just me I’m concerned about. Of course, my ego worries that I could be shamed publicly, could lose the respect of the midwifery community (if I can gain it in the first place), or lose the respect of my friends and family if I ended up in a situation that I couldn’t handle and had bad outcomes. But what about those outcomes? They translate to people. And the ego pales in comparison to the weight of my conscience if I had something tragic happen on my watch that could have been prevented if only I had been better prepared. The entire time I’ve been working toward this license I’ve been wondering how I can know what I don’t know, if I don’t know I don’t know it. I cannot afford, spiritually or emotionally, to be caught with my pants down. Further, midwives are a hunted species. If something happens due to ignorance or irresponsibility that reflects on ALL midwives EVERYWHERE. That’s not true for doctors, for firefighters and paramedics, or even police officers. Sure, sometimes individuals are singled out, questioned for negligence or poor training or abuse, but that’s the exception rather than the rule. They have communities who protect them, who advocate for them, who support them. That is not as true for midwives. We stand, for now anyway, more or less alone.

Anyway, I have practical skills I need practice with, like suturing. And they use a lot of herbs here, which is something I have next to no knowledge of. So I stand to gain some skill in those departments over the next few weeks, if I can make nuisance enough of myself to be included. I am, however, still chewing on the question of what I’m really doing here. Honestly, if it weren’t for those last 4 catches, and Kira coming next week, I’d probably just head home. This is not what I was hoping for, and of course it so rarely is. But its so far from what I felt like I was needing. Even writing that, I’m aware of the naivete of the statement. There is what I feel like I need, and then there is what I actually need. And while there are a lot of moments in my life I can point to and say I didn’t get what I WANTED, I don’t know that there is any time I can point to and say I didn’t get what I ultimately needed. So I guess my counsel to myself is that I need to have faith. I need to believe that, while this trip so far has been disappointing on many levels, it has been surprising and wonderful in many other unexpected ways. And even though I may come away with some lingering sense of disappointment overall, as long as I make myself available to it, I’ll get what I need. Even if it’s just 4 more catches.

Friday, July 17, 2009

Home again home again

2:36pm Saturday July 18th, 2009

In the car heading home to Ubud. We had a mellow and uneventful remainder of our stay in Amed. We spent most of the afternoon sunbathing and then reading/napping in the shade and took the motorbike a few miles down the road for a forgettable dinner at a cute restaurant on the water. We had to get gas for the scooter and were sent across the street by the hotel receptionist to a little roadside store. For 60 cents US, we bought a liter of gas from a little girl who poured it into our tank from an Absolut Citron bottle and a funnel. On the way to dinner, we marveled at the beauty of the coastline, especially as the sun was setting, and I had to admit I was beginning to understand why people came to vacation in this region. The ride to dinner was only marred by the number of bugs we got beaned in the face with on the scooter, and passing two villagers carrying a huge pig tied to a long bamboo branch carried between them, squealing for its life. Almost enough to make me a vegetarian. We had the morning to ourselves before our driver came to collect us and spent a good portion of it by the pool and tangled in each other’s legs reading in the chaise lounge on the porch of our little bungalow. I’ve been picking up and putting down The People’s Act of Love by James Meek for the better part of the last year and I finally hit my stride with it while in Amed and then couldn’t put it down. I had read maybe a quarter of it over the last year and then read the remaining three quarters over the last 24 hours. A VERY good book. One of the best I’ve read in a while and it was a total sneak attack –I love when books surprise you and turn into more than you could have anticipated from them. Anyway, I’m sad its over, as I’ve now run out of fiction to read. Luckily, there are English book shops in Ubud. Once again, stark contrast to Senegal, where I was reduced to re-reading Eat Pray Love (and hating it less the second time around).

Our driver told us about a bombing at the Ritz in Jakarta yesterday which, I think, underscores some of the issues at play in 3rd world countries such as Indonesia’s and the influx of Western influence and wealth. Anyway, its very sad to hear so many people died, and for what?

We asked our driver about whether the hotels like the ones in Amed are good for the village or not. He said he thought they were good. They bring jobs, they bring people to buy the things they sell. Balinese, he said, don’t differentiate between white skin and brown skin –if you’re a westerner and you come and are respectful of the Balinese, you become family. So maybe my haughty dismissal of Amed’s false paradise as a bourgeois parasite on a poor fishing village was hasty. Maybe I’m just being pretentious assuming I know what the Balinese need better than they do, maybe they welcome the rich westerners. What do I know, really?

We stopped by the big Water Palace on the way home, a sprawling 500 year old temple made primarily of ponds and pools. CRAZY beautiful (also home to the wettest, grossest toilets ever known to man). You can pay 6,000 Rpa (about 60 cents) and swim in the large pools, which are black with algae and full of fish. If we weren’t so eager to get home and my leg were a little better, I’d have gone for it. Austin and I agreed it would be a perfect place to spend a day sunbathing and swimming surrounded by total beauty.

Looking forward to getting back to our sleepy village, familiar faces, better food, and some birthin’.

Thursday, July 16, 2009

Live From Amed

1:31pm Friday July 17th, 2009

Okay. Here we have to get into uncomfortable territory, where I talk about the elephant that enters the room whenever someone like me (middle-class, educated, white, American) travels to a third world country. I am not well-equipped to discuss this topic eloquently, and am bound to say ignorant things or trip over topics I don’t fully comprehend, or stuff both my feet in my mouth by the time I’m done, but here goes. So we are in Amed. It is a remote area of Eastern Bali, about 45 minutes beyond Candidasa (where were planning to stay originally based on some friends’ recent travels and enjoyment). Amed, according to my guide book, is actually only one village out of the several villages along the coastline here but savvy hoteliers have lumped them all together to lure tourists to “the Amed region.” My landlord Made insisted this was the place to come, said it is “paradise” and told us it is a relatively undeveloped, quiet coastal village, that it would be easy to find someplace small right on the beach to stay for about $40 US a night, including breakfast. We were told to expect to have the place to ourselves.

Instead, we spent 2 and a half hours trying to find a hotel that had rooms available, with nothing cheaper available than $65 a night –and that was at a private villa with a strange punch drunk European couple whose dog barked at us mercilessly and bit our driver so we opted not to stay. We chose the cutest and second-cheapest place we saw, a hotel with a series of little detached houses leading down to the beach. Ours has a queen bed downstairs and a loft upstairs with two twin beds, a nice bathroom and an outdoor shower. Its clean, nicely landscaped and has a pool and beach access, though there isn’t much beach to speak of, as most of it is taken up by the fishing boats that the rest of the village use to make their living every day. There is no place to “go” from here –its all hotels or beach, there is a hotel cafĂ© that is overpriced and not very good, and the place itself is full of fat Australians, loud Italians, and their collective obnoxious offspring (okay, okay and two, late-twenties, pasty skinned, childless, judgmental and self righteous Americans). We had come too far to turn around and go home last night so we bought our driver dinner and stayed but both Austin and I lay awake feeling unsettled about what we had just set ourselves up for. We were expecting low key beach getaway, not this weird Club Med in Bali. We both fell asleep more out of defeat than actual exhaustion at about 9pm last night and were awakened through the night by the sounds of dogs barking and fighting, and then the bossy roosters that seem to be everywhere and have no sense of time or decency.

This morning, we ate the included breakfast, which was passable, if not inspiring, and then went to walk on the beach to stake out a place to sunbathe. We’d been on the beach maybe 3 minutes when we were approached by a Balinese guy carrying a pair of flippers. He introduced himself, asked where we are from, commented that we were in the “best” place to be seeing Bali for the first time, and offered to take us snorkeling or out in his boat to see an American warship wreck from WWII. We declined politely. He told us he lived next door to the hotel so we could come ask for him if we changed our minds. He seemed so earnest and desperate to make a sale and continued to make small talk, at one point mentioning that the hotel we are staying at is owned by an American. Austin stiffened at that –he had been particularly specific with our driver that he wanted to stay someplace Balinese owned. We assumed we were doing that and it was a bummer to learn we were not. I eventually had to suggest we keep walking before the guy with the flippers got the hint and let us continue on our way. We made it to the end of the beach and Austin was quiet next to me, I could tell feeling uncomfortable with being “American Tourists” and all its attendant implications. We made our way back the way we’d come and were greeted by a Balinese woman at the shoreline. Her shirt had holes in the shoulders and back. She introduced herself and asked if we’d like to buy a massage. Again we politely declined. She followed us back towards the hotel and she was met by a younger woman with a small child coming from the property next door to the hotel, where the man with the flippers said he lived. I looked beyond the two women and the child and saw there was a group of people on the property, working on something together. They were obviously very, very poor. The women continued to call after us as we walked to the hotel, trying to convince us to get a massage with them, but their calls stopped as we stepped onto the hotel’s pathway, and I got the sense that we were now “off limits” to them and I felt incredibly self-conscious.

Austin and I tried to sunbathe by the pool for a while, but he couldn’t sit still. He’d lie down for a minute and pick up his book, then go back to the room for a few minutes, then come back, then lie back down, then go stand at the hotel wall and look at the ocean, then come back. I finally asked what was wrong. He said he didn’t really know but he was having a hard time just being here. I agreed. We finally had to acknowledge that this sucks. We aren’t good at just laying by a pool, let alone at a really swanky hotel that we can’t afford, especially with people who have next to nothing waiting on the property line to beg to sell us something so their kids can eat. We aren’t impervious to the facts of the matter. I don’t know how to turn of my conscience for this kind of thing. This is not what we came here expecting. This is not what we thought we were signing up for.

The other tourists here seem content. They’re paying hotel staff to massage them by the pool, letting their kids splash the other guests laying out near by, not wandering off the property. Austin and I rented a motorbike for the day and cruised up the road. Everywhere that isn’t a posh hotel here is a slum. Cinderblock houses and warrungs and sundry stores. It’s a completely fabricated paradise. It is Las Vegas. Even the Balinese on the street don’t seem friendly like in the village where I live –which I am now realizing is far more affluent than I understood it to be. All along the road they scowled, instead of smiling. I would too, I suppose, if this is what had become of my home. I hate it here. So we’ve decided to go home. We’ll spend the night tonight, because it was too late to not pay for the room by the time we’d been honest with each other with how not into this we both were, and we’ll hightail it out of here first thing in the morning. What a bummer and a waste of money.

I don’t know what I’m supposed to do with this discomfort. Because it’s not like I can just go hand Rupiah to each person on the street outside this stupid hotel, or like it would make much of a difference if I did. Or like this is the only place where terrible opulence sits in counterpoint to extreme poverty. I am aware that I am contributing to the problem by staying in this place, by coming for a beach vacation sight unseen without doing my research first, but staying one less night, or having not come at all doesn’t eliminate the problem either. Maybe I’m not giving the other tourists here benefit of the doubt. Maybe they’re all as disgusted with this as I am, but had paid in advance for a week’s stay and got the time off work to take a holiday with their families and they got here and found out that this isn’t a sleepy beach town with Balinese hoteliers feeding their families by hosting Europeans and Australians and Americans. Maybe they’re stuck here and are making the most of it. But I doubt it.

I have been wondering what my landlord thinks of me that he thought *this* was what I wanted for a weekend holiday? (A “honeymoon” he called it) I guess he assumes I want what other Americans or Europeans he’s hosted have wanted or enjoyed. But this isn’t paradise. This is embarrassing and shameful and I’m disgusted that we’re here at all, that I traded time in the clinic for this. There are no Balinese staying here, so I don’t imagine this is where he brings his family to vacation at the beach.

Sigh. Rant over. It’s a challenge. In short, don’t bother going to Amed. It’ll only bring you down.

Wednesday, July 15, 2009

Stress Not

9:00am Thursday July 16, 2009
Listening to Aretha Franklin, waking up slowly this morning. I finally slept well last night after three consecutive nights of relative sleeplessness due mostly, I think, to an extra body in my bed. Austin came to Bali to surprise me on Sunday, which is pretty amazing any way you slice it (even if it does raise the temperature of the mosquito netted bed to an uncomfortable level).

For those of you who don’t know about Austin, my relationship with my previous boyfriend ended just before my birthday in May. Two weeks later, I went camping with some homies and Austin came along too. It isn’t much of an exaggeration to say that we haven’t really been apart since. So that happened. I’ve been missing Austin pretty intensely since getting here and when he got here Sunday, I’d been having a pretty miserable day. He couldn’t have picked a better time to show up and I’m really, REALLY, glad he’s here.

So what’s happened since the kittens made their bed my home, you ask? Well, the mama cat crept back in not long after I fell asleep and was shocked and amazed to find me sleeping with her babies. I tried not to scare her, but she hissed and growled and ran away anyway, and spent the next hour outside my bedroom window yoweling for her babies. I tried sitting on the floor away from the bed and encouraging her to come in. She didn’t go for it. I tried gathering my comforter around me and going to sleep on my porch, but it was uncomfortable and she didn’t go for that either. So I finally went back to bed and slept curled as far away from the kittens as I could. I woke up to her creeping out of my bed with a kitten in her mouth a few hours later. When she had safely left the room, I checked under the pillow and the kittens were gone.

I caught another baby on Sunday afternoon, a first timer who dilated quickly and pushed her baby out like a champ but tore badly and dumped some blood. I’d estimate her total blood loss at 600 ccs which is a bleed for sure, but a relatively small one. However, because she was small and thin and undernourished, it has taken a bit more of a toll on her than it would on a woman I might serve at home. I sutured the tear with the help of the Indonesian midwives, but didn’t feel good about my repair job. The Indonesian midwives eventually took over and I felt awful, wondering if I would ever get the practice and experience I need to suture competently, wondering what business I have trying to sit my license exam if I can’t confidently suture a second degree tear by myself at home. Once the mama was resting and nursing her baby and everyone left her alone, I spent the next few hours checking her vitals and monitoring her blood loss with the Australian midwife and doctor who were both supportive and reassuring to me that I hadn’t botched the birth. And she fainted while trying to use the toilet afterwards, which isn’t fun when it happens in English I can can communicate with the mother before she goes down, and with the father or other support people after she’s gone down, and can now attest that its even less fun when they do it in a language you don’t speak. Nevertheless, I was feeling low, my leg was still bothering me and I was wondering why I am here.

My phone rang with a blocked number. A familiar voice on the other end of the line, but he sounded strange. Austin made small talk with me while I cried with relief that he’d called me when he did, needing to hear a friendly voice so badly. It was the first time I’d talked on the phone to someone from home. He was asking me weird questions, like what I was doing, where I was, etc. “What’s going on? You sound weird. Are you okay?” I asked him. “Yeah, I’m fine. Just really excited to be talking to you.” He told me. Then it dawned on me. “Are you HERE?” I asked him. “No…” he began, “Well, maybe.” 20 minutes later he was at the clinic. Totally unprecedented and totally amazing.

So having Austin here has been interesting. We rented a motorbike, and he’s been riding me around Ubud on it since Monday. We got him a handphone so I can get hold of him when I need to be at the clinic. We’ve been eating A LOT. And it has been just all around pretty magical to have him here. I’ve only attended two births in the 4 days he’s been here, which is a little challenging for me since I’m here to attend births, not traipse around paradise with a handsome man on the back of his motorbike. But the two births I’ve attended have been lovely and a nice counterpoint to the confidence shaking of Sunday’s birth. The day before yesterday, I came down to the clinic to support Tessa, who was catching, and saw her do a nice waterbirth for a first timer, with a gorgeous third stage –I’ve never so clearly watched a placenta just creep down and come out unassisted—and then observed Tessa while she sutured. That night, as I was falling asleep, I had an Ah-HA! moment regarding suturing that I’d been needing, and felt much better prepared for the next tear I see. Yesterday, I was having lunch with Austin and got a text that there was a first timer at 3cm at the clinic if I wanted to come do the birth so I had Austin drop me off on the way home. Another lovely birth. She labored stoically, almost silently, and I saw no difference in her behavior or body language between 4 centimeters and 10 centimeters. Even when her water broke while she pushed, it was silent, undramatic, barely registering on anyone’s radar. I joked that she was just going to have her baby under her sarong and we wouldn’t know until it cried. As she began to bring the baby down more, I noticed that part of her labia looked odd, like raw meat and I wondered if she had some kind of STD or other infection that was causing her skin to look so…yucky. As the baby’s head began to crown, the labia parted further and I saw that it wasn’t her labia that was raw but that there was a long strip of it that was not attached to the rest of her vagina, and had a hole in it, through which I had been seeing her urethral sponge (sorry, to the squeamish amongst you). I’ve never seen anything like it before. I showed the other midwives in the room and everyone sort of shrugged their shoulders and said, lets hold it back and see what happens. So we did. Gorgeous, squalling baby was born with a nuchal hand, crossed over his chest and up near his opposite ear (little stinker), over an intact peri --no need for suturing, though the strip did detach on one side, leaving a very long skin tag that one of the Indonesian midwives cut off. I was THRILLED to have such a lovely birth with so many people in attendance, to help wipe away any negative perceptions that may have been formed after Sunday’s birth.

In other rockstar news, I may have correctly diagnosed a congenital defect in a newborn born at the clinic yesterday morning. No one knew what to make of the baby, but talking about what she was presenting with, I immediately offered up hypothyroidsim of the newborn, based on a case I saw a few years ago. The baby was transported to Denpasar to a hospital in the early afternoon and we are waiting to hear what the pediatricians think, but it was gratifying to learn that, after a bunch of research, everyone agreed my diagnosis was the best fit. Go me. Maybe.

My leg continues its slow road toward what I am hoping is healing. It was better over the weekend, and then worsened substantially Monday, Tuesday and Wednesday. On Monday afternoon, we ran into the clinic acupuncturist, Dr. B, on the street and, seeing my leg, she asked that I come down to the clinic that evening for treatment because it was looking infected. Austin and I showed up at the end of clinic and Danielle and Dr. B conferred over my leg and then took me over to the table to “ring the dragon” which involved having acupuncture needles inserted all around the perimeter of the injury. It hurt like hell. Dr. B also looked at my tongue and declared I needed my liver and my stomach bled. What now? This meant they took lancets to my big and second toes on each foot. I bled like a stuck pig and started to regret my decision to let them treat me at all. In truth, it was great fun. Everyone from the clinic was there, including the mom of the baby I had caught Sunday night, and everyone laughed while I cried out in pain, and everyone took pictures of me being miserable on the bed. It was hilarious and painful and good times. After I thought all the torture was over, I showed someone how the bruise of my leg hadn’t ever materialized around the actual injury, but had pooled in my foot, below my ankle where there was now a huge purple spot. Dr. B scolded me for not pointing this out to her before and promptly stuck six more needles in the tender part of my foot. Me and my big mouth.

I began to get worried yesterday when the swelling was getting obviously worse. Tessa and I had a laugh on Tuesday night when she was examining it and we realized how bad the edema was and were poking our fingers into my tender leg and laughing at how deep the finger imprints left on my leg were. She warned me that she doesn’t like how close to the bone the infection is and that, in Australia, the treatment if my infection got worse would be maybe 4-6 weeks of IV antibiotics. Yeah, lets not go there. So I’ve been being extra diligent with the antibiotic cream everyone swears by and trying to elevate it whenever possible but it was undeniable yesterday that my leg hurt worse and looked bad again. I finally agreed to take antibiotics, if we could find the appropriate ones for me. Danielle overheard these plans and asked if I’d taken the Chinese herbs that Dr. B had suggested I mix in with the antibiotic cream for my leg. Of course I hadn’t. I’m lazy. Take them orally, she said. Seriously. So I took two doses yesterday and, this morning, my leg is 80% better. That stuff is NO JOKE. So I’ve got 8 more doses of the herb, and I’ll continue taking it over the next day or so and if my leg isn’t substantially better, then I’ll take the antibiotics. Who knew being injured in Indonesia would prove to be such a debacle?

Other magical things that have happened:
Austin and I walked through the monkey forest at dusk the other night and followed a path that I hadn’t gone down before. It led to a staircase/bridge over a deep ravine, surrounded on all sides by tall trees with roots plunging down from their branches. We followed the bridge down and walked past an old stone reflecting pool and along the river with the night falling quickly around us and could see bats flying nearby and the monkeys overhead. It was so lovely and amazing –like something out of a movie, like someone made it all up. It is still hard to fathom that someplace as beautiful as this exists.

Dr. B is associated with a school of spiritual teaching related to zen meditation I guess. Every Wednesday, she shows a movie related to these teachings and then gives a kind of blessing she was “ordained” (my word not hers) with on a pilgrimage to India. So, after my birth yesterday, someone mentioned she was going to see the movie and I remembered what day it was and quickly asked Austin if he wanted to go get blessed by Dr. B. “Duh” he said and we hopped on the motorbike and ran off. The movie was good –it was a taped interview with a teacher of the spiritual practice Dr. B is involved with but it was closely related to the tenets of Buddhism that I have been interested in for the past year, so it spoke to me anyway. Austin was pretty into the movie too and leaned over to me at one point and said “this is so much like The Process!” which I could totally relate it. I found myself renewing my promise to continue on the spiritual journey which I’ve been actively cultivating for the past year and feeling grateful to be building a relationship with someone who has parallel experience to me (via The Process) and is interested in doing that exploration with me. After the movie, Dr. B explained how the blessing works, what it’s purpose is, and how to receive it and then they turned down the lights, turned on some om shanti music and got to business. I don’t know if the blessing worked, but I can say if feels really good to get blessed by Dr. B –like she was massaging my brain. Whatever it was, Austin and I left feeling great, had a nice meal together, and then konked out like we hadn’t slept in days.

So, its now been a few hours since I began this entry, and Austin and I have packed our bags and are headed to spend a few days at the beach. We were planning to go one place on the island, knew where we would stay and everything, but then at the last minute had our minds changed by my landlord, who called his brother, who picked us up, and now we are being whisked off to a more remote part of the island where we have been promised quiet, both black and white sand beaches, coral reefs, diving if we want it, and generally “a honeymoon.” I realize this is totally counter to my purpose here but I’ve realized a few things over the last week. First, I’m here to observe and gain extra experience. No finite number of births is going to make or break me as a midwife –if I miss 3 births because I was gone 3 days, its not actually going to make a difference. Second, what I’m observing at the clinic isn’t how I practice at home or how I’m going to practice at home. If anything, many things I’ve observed have been educational primarily in how they reinforce how I’m NOT going to do it. This isn’t to say that what happens at the clinic isn’t appropriate –I think it is, for this clinic and this culture and level of poverty, etc. It is not homebirth in northern california. Not that I came here expecting homebirth, but it’s a good reality check that you alter your practice based on many circumstances, some of them not so obvious or even clinically based. In short, this clinic is not going to dramatically alter how I practice back home. Third, the clinic is crowded right now and tensions have been running high. I can remove myself from that for a few days, recharge, and make one less body at the clinic trying to “get” a birth. Fine with me. Even better that I’m going to spend those days on the beach with my man. So I feel less anxious to be at the clinic all the time. Probably the most valuable learning I’ve gotten here so far has been just sitting and talking with the Australian homebirth midwife, learning how she practices, listening to her 30 years worth of amazing stories. I have half a mind to invite myself to Eastern Australia where she lives and pick her brain and watch her births for 6 months. Anyway, I’m on vacation on my vacation and I’m stoked about it. I don’t feel in the least bit guilty. I’ve got 4 more weeks here. I would love 5 more primary births, but I don’t even need them. I’ve decided to just enjoy the time I have here, and stress not.

That’s the key to being here happily: Stress not.