Last Will and Testament

Hear me out.

I’m not dying. I mean, not anymore than the rest of you. But for those poor souls who end up at my funeral, first of all, congratulations — you’ve outlived me, which means one of three things:

You’re a vegetarian.

I met an untimely death at the hands of Nashville drivers (most probable).

Or sushi and yoga were bad for us all along.

I only hope we did not all die in some apocalyptic everyone-at-once sort of manner. Because then you will have been robbed of the absurd irreverence that promises to be my funeral. And what a shame that would be. Please find herein my expressed wishes for festivities marking the occasion.

First and foremost, I wish to be taxidermied. Then I would like you to hire my least favorite people to carry me around the party, Weekend at Bernie’s style. There will be bonus points awarded to those who come up with the most classic scenes to act out with my stuffed corpse. Pics or it didn’t happen.

Other games to include funeral cliche Bingo. Look out for phrases like “long hard struggle,” “she’s in a better place,” and “blah blah God blah blah.” The middle square will read: “she was one badass bitch” because you don’t deserve points for something you’ll hear said that often.

Next, karaoke: dead lady’s choice, meaning songs I choose and expect to be performed in the following order:

1. Both sides now

2. Remix to ignition

3. Hallelujah

4. MmmBop

5. The Boy is Mine

6. One Request from the Audience

7. Miseducation of Lauryn Hill (entire album)

8. Sister Christian

9. Adam’s Song

10. Whatever you like

11. White America (to sum up my life)

The most important thing I want for my funeral is joy. I know I’ll reflect on these grueling grad school days with a smirk because I’ve had harder days I look back on with a grin. I’m grateful to be here and happy to be alive. If someone decides to mark the occasion when I’m not with anything other than what’s listed above, you set ’em straight, and do it with a smile.

And if you think life and death ought to be treated with more seriousness than I’ve given them here today, it’s my pleasure to agree to disagree. #likemotherlikedaughter

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Be Wrong! It’s Good For You. 

I love being proven wrong. Seriously. As a chronic self evaluator I feel strongly that having our thoughts, beliefs and assumptions challenged is one of the easiest ways to grow, if we’re open to it. And that’s a big IF. In a culture where we seek out self and thought affirming information both in news and research, I know how scary it can be to step outside the echo chamber of one’s own Facebook page. The like-minded communities we tend to foster are comforting but they carry the risk of becoming so homogenous that we cease to be challenged.

I have spent most of my life in relatively (and often overtly) liberal cities, the culture of which have been mostly in line with my own. The southern cities I’ve lived in certainly have their own individual flavors, as do the northern ones. Anyone who paints with brushes as broad as “The South” or “The North” hasn’t spent enough time in both because this is a big country and we have a LOT of different people living here. And those people each have different motivations, unique lived experiences and when election time comes everyone gets the same number of votes. They don’t have equal opportunity to cast them, but that’s not the topic of this post.

This post is about smiling when you’re proven wrong. Mazel Tov to you! What a wonderful opportunity you’ve been given to broaden your experience of humanity. I have recently found myself spending the 8-5 in a brand new place with people who have customs, perspectives and a vernacular entirely foreign to me. And I’ve only traveled an hour from the safety of my current urban center. I’ve spent 22 of my 29 years below the Mason-Dixon and ain’t never met people like this before. They lend out medical equipment knowing patients will return it, they regularly offer to drive patients to outside appointments they can’t get to and they always ask how your mama or daddy is doing. Based on how many conversations I’ve had/heard about the Bible and Trump this week, I can all but guarantee we come from very different religious and political perspectives and how great is that? Because people are more than who they vote for or pray to.

Healthcare can be a unifying point for people working in or needing it, which makes it a good meeting place for otherwise polarized individuals. Being an eternal optimist (albeit a cynical one) I still believe we have more in common than not but too often we make assumptions about what other people think and why they think it. Some people are just selfish and some people are just racist but assuming these things about entire groups does nothing to foster mutual respect, without which we will never move the conversation forward.

People are more complex than a party platform and time is more effectively and enjoyably spent learning about them and letting them learn about you. This is the only way we break stereotypes, both our own and the ones others hold of us. So add small town Tennesseans to the list of things I was wrong about. Also on this list: olives, running, Sarah Silverman, Amy Poehler, hot yoga, anchovies and marriage. These are all wonderful.*

*Marriage is still pretty dumb, but I love Jared so much it makes the list.

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Epidurals, Opioids and Nitrous. Oh My!

One of the wonderful parts about being a human family made up of unique individuals is that we are all different. We go to different jobs, we love different people, we experience a rainy day differently. How neat is that? We have a daily opportunity to embrace each other for the quirks and choices that make us each special. And when I put it that way, it seems easy to do. Where we get hung up is in thinking that someone else’s preference is better or worse than your preference. This can lead to feelings of superiority and resentment, neither of which help us celebrate each other’s differences.

This is true in day to day conversation. If I learn that you like olives (which I despise*), I don’t have to say, “Olives? YUCK.” Instead I might try, “Great! More olives for you, then!” You liking olives is not an affront to the fact that I dislike them so I shouldn’t feel compelled to express my disgust, after all this isn’t about me. And surely a two person divergence on briny foods has a relatively low impact on the way we relate in society, but it doesn’t stop there.

*seamless segue to women’s health*

Women (or those with vaginas) be they trying to prevent pregnancy, decide how to proceed in pregnancy or manage the pain of labor, have a Las Vegas-style buffet of options available to them (and I would like to keep it that way, but that’s not the subject of this post). From pills to implants to shots to little T-shaped pieces of plastic or metal, women have choices when it comes to birth control. To all of them, I say yes. You like taking pills every day? Good for you. You want to never have a period again? Also an option. I would never recommend my chosen form of birth control to anyone, because it’s ridiculous, and this isn’t about me.

I talk to pregnant women all day about how they plan to manage the pain of labor and, surprise! They all have different answers. Some plan to do hypnobirth, others hypnobabies (not the same thing), some want to try nitrous oxide, others plan epidurals and, guess what? They all have babies at the end. It’s not a contest and the prize is the same for everyone. Most importantly it doesn’t matter what I think about how a mother chooses to experience her birth because, you guessed it, still not about me.

And it’s not about you either. And neither is a woman’s decision to breastfeed or bottle feed or stay home with her children or to go back to work. Immunizations are about all of us, but more on that later. As for now here is an infographic of what I think is the best way to present information: here are your options and I will support your choices. That’s my job.

Source: The Parent College

*Olives are delicious. Anyone who says differently is 5 years old.

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Tuk Tuks and Inspiration: Better Experienced than Described.

I don’t know how to write about inspiration. It’s a feeling and those are difficult to illustrate in words. I remember a lightness that rushed over me during a tuk tuk ride in northern Thailand in November of 2012. Jared and I stayed up late into the night watching Fox News, which was comically the only available coverage of the US election. The results hadn’t fully come in when we had to leave early in the morning for an overnight hike into the jungle. The timing was such that we might not learn the results of our nation’s election until 48 hours after it occurred.

2012 felt different than 2008; it felt like the test of a heavily-scrutinized president that I very much wanted to see reelected. It wasn’t for the fear of his opponent. Especially in the context of our current political landscape, Mitt Romney seems like he probably would have done a pretty good job keeping the country safe, which for some people is enough. However, he likely would not have come out in support of marriage equality, gone to bat for women’s reproductive rights or made any honest acknowledgment of the systemic racism that permeates our law enforcement and justice system.

These are considered by some to be soft issues and inherently secondary to national security and the economy. I’ve been called immature for prioritizing them but if accessible healthcare, affordable education and equal rights under the law are idealistic and unattainable, I’m not sure what we’re spending so much trying to protect. If fear is the main theme we operate under, we build nothing. With so much anxiety, there is no room for creativity. When our energy is focused on being great, we lose the capacity for for being good.

Four years ago, I sat in a tuk tuk that rattled along a dirt road out of town and headed for the jungle. Jared turned on his phone for a brief moment to see if any text updates would come through. Right before we lost service, a message from his brother read: Obama wins in a landslide. The feeling I had that day and night was one of elated optimism. As a country, we had decided that goodness mattered and not just for 47% of us. We didn’t beat our chests and we weren’t afraid. The next four years would see the expansion of healthcare, the recognition of marriage equality, and a policy that began to prioritize climate change as a national responsibility. In these four years my partner and I found ourselves and each other; they have been personally and communally transformative; easily the best four years of my life.

Today, I do not feel hopeful or optimistic, but I will also not be discouraged. I still believe that love is stronger than fear and exposure to difference makes space for understanding. The next four years will not see the end of the progress because we are all still here. We will create art and take care of each other and stand up in support of what we believe and protest what we don’t. We will become the inspiration. We will be the good.

And here’s a photo (that’s probably offensive):

554047_10100729589094419_414982408_n.jpg

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Chicken Poop for the Soul

Hear me out…

Vanderbilt nurse-midwifery students are strongly encouraged to attend the ACNM (American College of Nurse-Midwives) Annual Meeting, which will be held in Chicago this year. Because this is optional we have to pay for it ourselves and some of the more industrious students have fundraised by selling felt vulvas, which are amazing, but far beyond the reach of my creativity. Whilst hiking with one of my colleagues, the topic of bowel movements came up. When you spend all day talking about vaginas and looking at cervixes, nothing is really off limits. We were sharing the stories our of most memorable twosies when, bam! I was hit by a stroke of genius.

What if I interviewed my friends and colleagues about their most distinguished bowel movements and then compiled them into a book of short stories? It would be perfectly sized for the back of a toilet and each entry expertly written to be enjoyed during one’s morning constitution.

Guys, it’s a book about poop to read while you’re pooping. Who wouldn’t want that?

After strongly considering dropping out of school to pursue this goldmine of a business venture, I decided I could probably do both. The working title for this project is Chicken Poop for the Soul because I received a cease and desist letter from Walt Disney when I floated the idea of Winnie the Poop by my social network.

I’m now accepting submissions so don’t miss your chance to be a part of this groundbreaking opportunity. Chicken Poop for the Soul will revolutionize your bathroom experience much like the Squatty Potty has. Your participation and/or purchase will help send a student midwife to an expensive conference she has been asked/bullied into attending.

Now as a reward, and because I’m deeply committed to dropping knowledge, among other things (see what I did there?) please enjoy this pictorial representation of the medically-recognized categories of feces. Poop on, Wayne.*

BristolStoolChart.png

*NBC has asked me to refrain from using this phrase, but I say come at me, bro.

Submissions accepted at leacraftspencer@gmail.com

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Holidays, Laughter and Foreskin: The Fundamentals

The back to school or work adjustment is always a challenge post-holidays. On the one hand, people are often invigorated with big plans for new year, which is adorable. On the other hand it’s cold and, in my case, lonely and trying to get back into a routine after time off can be a little bumpy. Everything you had delegated to future you is now present you’s problem and I always have more faith in future Lea than she really deserves. But in any event, here we are. Mostly due to excessive aforementioned faith in my future self, my past self decided that my partner and I should visit three states in the 10 days he could reasonably be expected to take off work for the holidays. Fun!

So, we did it: Texas for Christmas, Florida for Hanukkah and New York for New Years. It was as crazy as it sounds but totally necessary and worth it. We had recently seen the family we have in Arkansas and California, but the Floridians and New Yorkers had yet to see the whites of our eyes since we became a married couple. Our jaunt included planes, trains and automobiles, Texas BBQ, Florida beaches and Times Square on New Years (just kidding, only a crazy person would do that). Our hearts and stomachs were filled with love, pizza and bagels and before we knew it was back to reality, whoops there goes gravity.

School has been back for a week now and this year marks the start of my clinical rotations as a midwifery student. It reminds me a lot of my first rotation as a nursing student with all the fumbles, missteps and fear. I had the great pleasure of enjoying dinner with some of the colleagues I shared my very first nursing rotation with and the laughs we had while reminiscing reminded me of the post-rotation conferences we had when we were all still learning to listen to hearts and lungs.

I always consider the beautiful souls I went through undergrad with to be kindred spirits from whom I can never really part. The impact of nursing school has bonded me to some of these people in a similar way. The image of being surrounded by my male colleagues outside the room of a patient whom I was about to catheterize is forever burned in my memory.

“Is he circumcised?” they asked.

“I’m not sure,” I replied. My preceptor then asked if I had ever seen a foreskin, to which I quickly replied, “I really don’t see how that’s any of your business.” We were off to a great start. Ultimately the procedure was successful, but there was and is always one thing to do in nursing school before you are allowed to call it a day: reflect.

In keeping with the tradition of reflection, I shared my experience of the catheterization with my group. Specifically, I highlighted my surprise at how profoundly I was able to feel the catheter in my hand through the patient’s penis. I looked at one of my colleagues, a woman I admire more than most on this Earth and admitted, “I guess I’ve just never held a flaccid penis before.” Without missing a beat this incredible woman facetiously replied, “Well, good for you!”

It was the best day of my life.

Any day that comes anywhere close to feeling as connected as I did to those people during that rotation will be an opal in a week of dumb, stupid rocks. Here’s to hoping we all continue expanding ourselves with people we can have a really good belly laugh with; I’m convinced those are all that really matter in this world.

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Placenta. Enigma. Namaste.

The placenta is a confounding element of labor and delivery. Giving birth to a brand new entire person is largely hailed as the single most challenging and unifying event humans undertake (along with death, but more on that later). This monumental feat comes after growing this would-be human INSIDE of you, which – let’s be honest – is pretty bananas. So after 40ish weeks of gestation and who-really-knows how many hours of labor, you have a baby!

But, it’s not over yet.

Now comes what we refer to as the 3rd stage of labor, a part so important it had its own category: delivery of the placenta. This new organ is something you grew before the belly fruit began to resemble anything other than a seahorse (yes, offense). The placenta makes good use of all the extra blood you’ve been pumping around (up to 50% more in fact) as it transmits nutrients and oxygen to the fetus and acts as filter for bacteria and other unsavory characters you’d prefer your child waited until daycare to meet. Its delivery has to be carefully attended to because any retained pieces can cause serious problems for you and ain’t nobody got time for that – you’ve got a baby now! So once this blood filled, brain looking, much-bigger-than-you-thought-it-would-be thing is delivered and examined, what do you do with it?

I’m glad you asked.

The placenta is a mystifying entity that different cultures hold in various high regard. Some groups believe it has a spirit of its own and must be buried near the family house as a guide of sorts. This doesn’t seem so strange to me – it has to be gestated and born along with the baby, and without it, baby would have never made it this far. Other cultures use it more practically as fertilizer – all hail the pragmatist. Companies have been built around their ability to encapsulate it so that you can eat it; preesh you, capitalism. And, of course my favorite, carrying it around with the baby until the umbilical cord (along with the placenta) dries up and detaches on its own: the lotus birth. A majority of westerners do nothing with it and it is incinerated (BOR-ING).

As with most things in birth, to all of these options I say yes. Women need to support other women as we navigate the veritable cornucopia of options available to us.

And now, a picture. Because in 2017, infographics and nihilism will be the only truth.

Source: National Institute of Health

 

Lotus birth, even though we both know you already Googled it.

Source: MJY 

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Midwifery FAQ

1. What the hell does 6cm look like?

Sure, I could pull out a tape measure and treat you like an adult, but instead please direct your attention to this gross chart so I can fulfill a childhood dream of mine by comparing your cervix to a bagel (which, by the way, vary in size greatly).

Source: Sweet Leigh Mama

2. Why is the midwife always squeezing my tummy? And who is this Leopold?

Christian Gerhard Leopold (24 February 1846 – 12 September 1911) was a German gynecologist who developed these four maneuvers for determining the position of the fetus in the uterus. They are used by midwives to assess for a breech presentation (feet or butt first) and to estimate the size of the growing fetus.

Source: Wikipedia

3. Oh, you’re going to be a midwife? Is that better than a doula?

Well, that’s like asking if a pilot is better than a flight attendant. It’s not wrong, it just means our profession needs a better PR department.

But yes, I’m also a doula — many of us are.

Source: Ancestral Wellness Temple

4. Why is my baby covered in cheese? No, I don’t want to touch it. You touch it!

Vernix is an expected finding on a newborn and its benefits (along with thermoregulation) are part of the reason the WHO recommends that baby’s first bath be delayed at least 6 hours (and ideally 24h).

Sidebar: Has anyone checked out The Alternative Mom, from whom I stole this photo via the Pinterest? She sounds feisty.

Source: The Alternative Mom

5. What exactly is the difference between a vagina, a cervix and a uterus?

More than you’d think! If a female person is standing up, the vagina is closest to the ground and is accessible through the middle of the three openings that persons with two X chromosomes typically have.

The cervix is the (normally closed) canal that leads to the uterus and becomes thinner and more open during labor. Ask to take a look the next time you have a pelvic exam or check back here soon for a series I’m working on called Guess Whose Cervix?*

For more info on the cervix, check out this great post on Across The Speculum.

The uterus is the uppermost cavity where tissue builds up every month to either support a fertilized egg, be shed during a woman’s period or be safely reabsorbed if she is on progesterone-only contraception (more on that later).

For now, this:

Source (and on sale now): Blue Barn House Store

*currently accepting photos for this series at leacraftspencer@gmail.com

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Long Distance Relationships

Sometimes they work. Especially when you’re both busy taking busy to the next level. It has now been 18 months since my person and I lived in the same state and we have 12 more to go. We’re super codependent at night so sleeping apart is just the worst. Seriously, I hate it. But during the day we’re obnoxiously independent, as evidenced by our shared refusal to compromise our goals. We’re not jerks; we each happened to be given opportunities we couldn’t turn down at the exact same time. One of us could have set their goals aside for the good of the relationship, but instead we decided to have it all.

Best decision ever.

This accelerated nursing curriculum is intense, and the only thing I can imagine being harder than doing it alone might be doing with a partner’s needs to consider. Jared works for Amazon; I’m sure you’ve heard of them, they sell books online. And praise be to whatever-deity-you-choose that he is the type of person who hears 16-hour days and thinks bring it on. Don’t get me wrong; being apart is tough for all obvious reasons: hugs make everything better, traveling is stressful, texts don’t convey tone, watching NFL together on FaceTime is hard because his feed is always ahead of mine because everything gets to The South later. You know, basic relationship stuff.

But it’s easier for a whole bunch of other reasons: When one of us has to spend all day in class or working and then come home and continue working, there’s no one to disappoint. Our reliance on verbal communication has sharpened a set of skills I think are crucial to sustaining relationship happiness. We have found joy in new activities that the other isn’t at all interested in; for him it’s learning how to box, for me it’s watching network TV in bed while eating a cheese plate.

Point is, we’ve both got goals. And we’re in this together.

We liken our current arrangement to two members of the same tribe having embarked on separate expeditions to learn skills and gather resources so we can bring them back to the village and build a stronger hut. We’ve been together since we were tiny baby 19-year-olds. This is probably the only time we’ll ever live apart so we’re embracing it as a short part of the long journey we’re on together. We have become better apart and that will make us better together.

As for right now, I know it’s easier for me to be supportive of him working all night from afar and he doesn’t have a panic attack every time I eat in bed.

It’s a win-win.

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Certified Nurse Midwife: Huh?

I wait tables in Nashville from time to time and am often caught explaining to people what I really do. Servers love this question because it manages to be invasive and critical at the same time. On one such occasion I was explaining to the stranger who had inquired that, in addition to supporting myself by waiting on people like her, I was a nurse and studying to be a midwife. She became very excited and said, “Oh, wow! My niece is doing the same thing. Oh, no… wait.. No, I’m sorry, my niece is going to be a nanny.” Now, I’ve answered an impressive range of questions about what a midwife is, how it is similar to a doctor and how it differs from a witch. But this genuine mistaking of a midwife for a nanny has been by far the most amusing.

Nursing school is a bubble land and it can be very difficult to remember how little the public really knows about advanced practice nursing. This is partly because the profession is evolving and has been for the past several decades, but it’s also because the general public doesn’t really care where their healthcare comes from — which is fine. It’s my job to know how to be a midwife, but it’s also important to offer digest-able knowledge to people when they want it (if only for the survival of our trade). To that end, I went digging for some straightforward definitions of what a midwife is and came across this infographic from 2010.* Some of the information might be a little dated, but I think it breaks it down pretty well. What do you think?

 

Infographics: making complicated concepts simple enough for you, me and everyone we know.

(Source: Scrubs Magazine)

*That’s a lie — I was looking for giggle-worthy memes and found this by accident. Whew, felt good to get that off my chest.

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