I am eating the last of the leftover lettuce.
Radish metaphors for our adventures, so seldom anymore.
Doubt creeps into my mind, every time.
Every time you drive off into the sunset, I say goodbye for the last time.
I steel myself a little for the possibility that this is the inevitable.
I have carried this suspicion for so long, it's silly.
I suspect I won't have any warning. Maybe it's more of a hope...
For years, I have held my breath a little every time I pick up your call, every "Open" click.
I wonder where I learned that little fear, maybe a long time ago? Something I never left behind?
Hope, then.
A little hope that you won't go the way of the Dodo, drooling and grinning at your own sad, punchlineless joke.
I don't want you to slow down. I don't want you to lie down to sleep and I see it a little, here and there.
I see your grand conflagration gradually extinquishing itself. Like a forest fire that finally runs out of fuel.
Part of me wishes it were true, that I could preserve you in my memory now, rather than waiting a lifetime for your dreams to slowly disappear.
That would be the greatest tragedy for you, to disappear.

But, you have many more stories to tell, I think. Many more bright suns in your eyes.
You have to finish your own tale, anyway. As much as I fuss and quietly fret, and I know the ending, yes, but I don't know how we get there. Many chapters are still to be written.
Yes, many stories still to be told.

Digging in.

Reset.

Starting over again, yet again.

I am surrounded by love and laughter, I am the richest in that which is truly most important in life.

I am still learning, though, always a new lesson.

Today's: there's always more.

More to be done, more to be cleaned, 

Will I ever be clean?  Washed of my sins, cleansed of the clouds in my eyes, the cobwebs in my soul?

There's always more to be said, more to be fought, more to be built and torn away.

It's a process, a long, long process and I am still fighting through.

Another February begins.  

Another long winter takes stock of my sandbagged post.

I've dug in, it's a fine line between enough and too deep.

The February of my discontent, you called it, pretty accurate.

I will pull myself up, hop back in the saddle, and continue the slog through the muck.

It's nice to have the sun shine on my face, but sometimes I am still cold.  The wind still stings.

List.

Nodding daisies, I know how you feel.  

Had one on my toe, but it stalked off, too - jumped in some other vase, I'm sure. 

Traitorous Aster. 

Sleepy, bowing stems too thin to hold their caricature heads up. Fountain streams, bowtails that fall out of line, over the edge of the cup, 

I wonder if it's my fault.  

I kill plants alot. I've learned not to buy them, no matter how cute, because they end up frail, withered brown things on my tabletop. Howard saves them sometimes, sometimes not. Our Savior of Vegetation. 

I leave them there for weeks, sometimes, watering them and fussing that they might be resurrected. 

On the third day, Christ rose from the dead.  

In the third week, my plants land in the trash. No miracles for them. 

There's a forgotten tumbleweed in a corner of my yard. Tumbleweeds are different, they grow to die. Only in death, splintered off from their life-giving earth, they fulfill their true purpose; shaking out their seeds as they tumble and stumble across the ground. I wonder if they're lonely, tumbleweeds. If they hold back, never truly connecting with other plants. If they don't make any real friends because their fate hangs low before their eyes. The other species whisper about the aloof tumbleweed, wondering "what's his problem?". But the green shoots don't realize in their shortsightedness, like teenagers in their invincibility they just don't see the truth and the tragedy of it all. The wise and weathered tumbleweed knows what's coming in the autumn...  

Christmas Eve, stolen long ago from an ancient tradition of birth and rebirth. I miss my own ancient traditions of snickerdoodles and fudge.  

Of the dog chewing through the crumpled wrapping paper, of stockings hung by the chimney with care.  

I miss the silly advent calendar with the mice on it.  

"Murder-your-own" Christmas tree outings. 

I'm working through Christmas, this year. I figured it's better to let the people with kids stay home. I sort of wish I could just skip the whole thing.  

But I bought a tree of my very own for the first time, yesterday. It's about 8 inches tall, rooted in a copper-colored pot, Its branches reach out, offering a tiny snowflake symbol of peace. I thought long and hard about the consequences for the poor little thing - becoming *my* plant isn't something I'd wish on my worst enemy. But I bought it anyway, I need something that says "It's Christmas" around the house. It shivers and sparkles on the table by the front door. I put two presents on the floor next to it, satisfied with my lame attempt at a tradition.

My daisies bow deeper: out of exaggerated respect or exhaustion, I'm not quite sure. 

I want a dog. A puppy for Christmas.  

Shorter, redder hair, too.  

And a red convertible to match.  You could just set your reindeer to work on my Volkswagen...

I want world peace, an end to hunger and violence. I want my cousin to be ok.  

Please, Santa, now that I have a Christmas tree, would you put my family under it tomorrow morning?  

Or, maybe just some new slippers, a book or two, and something that resembles a heater for my car.  

If it's not too much, I'd like homes for all the lost children in the world.  

A green thumb.  

Cooking ability.

I've been very good this year; kind to my friends and strangers. I didn't lie, cheat, or steal.

Can I have longer legs? Warmer weather? New eyeliner?

I would just love a basket full of patience. Sanity. Wisdom. Extra time.

I want a new laptop for Christmas. Or, a bigger garage. Either one would be great.

Or, if you can't do any of these things, give me another year of blessings like this one: filled with the love of my family and friends, success in my artistic endeavors, challenges that teach me how to be a better human being, enough money to get by comfortably, a good job that keeps me interested, and a warm home with a wonderful husband in it. If you could just make next year as good as this one was, that would be more than enough.

Thanks Santa. I'll owe you big time.

-Me

CouldaShouldaWoulda

More, could have done more.

Still more, intubate. 

Compressions, rhythm, shock, epi, rhythm.

No rhythm, no air.

Bagged more, compressed faster, why didn't they start a line?

Why no drugs?

You just called it, and I was stunned.  I wanted to do more

My rational mind has set there was nothing to be done, nothing more to do

Futility most raw, most burning

Gone so long, success would have meant quantity instead of quality

Instead.  Of Quality.

But did I do it right?  I don't remember who was bagging, 

Why didn't you take over for me, tell me what I was doing?

I only remember one face, and that awful silence.

"Let's call it."  Words that still sting, here months later.  

Compressions, breathe, rhythm, harmony, trigger, feeling, shock, grief, shame.

Shame on you.  Is there something wrong with me?  Something wrong with us women, we are so supportive to these women in crisis, what about my crisis?  

I can't be the only one.  The only one who wonders...

What if?  

Could have, should have, rhythm, fluid, volume, cardiac, heartache, headache, ischemia.

Isolation.

Maybe I'm just not cut out for this.  

Or, maybe I'm tired or hungry and have hair-trigger tears these days.

Trauma, Tamponade, Tension Pneumo, Toxins, Terror, Treatment, Torrent, Terrible.

Hypovolemia, Hypoxia, Help, Hypoglycemia, Horror, Hidden, Hydrogen Ion, Hydrogen Bomb.

Help.

Help.

The T's and H's can't explain it all away.  Can't save you even though I tried.

There's always a reason, bleeding always stops, not your turn.

Not your turn.

Help.

1 in 275

Traitor.

Traitorous awful wench.

I'm afraid of you, of your power, of your thousand million ways to change.

Changes that spell a disaster for me.

You know, you've made me money.  I am something famous because of you.

We should be working together, you and I,

For the benefit of many.

They all appreciate you, call you perfect, sing your praises.

And here you are.

Knocking at my door, singing your own deadly song.

Low-risk, awareness, modified, sparing, aspiration.

The meaning in those words that you can evoke weighs heavy on my mind today.

I have aspirations, you know.  Plans for you.

It seems you might take us down a different path.

I'm sure it will be fine, I tell myself, try not to feel betrayed.

1 in 275 is pretty slim odds, right?

No air.

"Code Blue, Post Partum, 3rd floor" the page repeated overhead.
We all looked at eachother, disbelieving. We were used to the pages for the code team to the ICU, CCU, Tele floor... But our own?
Should we go? Help out? Postpartum nurses aren't much for adrenaline rushes, our patients have specific reasons for coding and the team doesn't want to touch a pregnant lady or someone who has been recently pregnant with anything less than a 10-foot pole.
Alright, we go.
I wish I hadn't.
We took the elevator, expecting the best.
Should have taken the stairs.
We bolted down the dark hall, turned the corner and found the worst, the very worst.
Wish I had expected it.
We came upon a nurse fluttering around a crib with an oxygen mask. My ears roared. I ran through a checklist in my head.
Fumbled with a stethoscope. Wish she'd stop bagging so I could listen, I can't hear a heartbeat with her bagging.
I can't hear a heartbeat.
Babies frequently need a kickstart. They need a little oxygen, a little pressure to start the gradient shift that will mark the transition out of their previously watery existence.
They finally gasp, turn pink and cry a bit and we walk away.
They all finally gasp, eventually.
All of them.
Where's that heartbeat? I pause compressions, shifting my hands. Am I doing this right? Compress to 1/3 the diameter of the chest. 90 per minute or 120? Bagging too fast. Something about counting, but I can't remember, so I keep counting. I lose it at 100 and start again.
The NICU team arrives. Good someone else to do compressions.
Someone else want to do this? Because so far I'm failing.
Fumble with a stethoscope again. There's a cartoon that I remind myself of but I can't remember which one.
Can't think, keep compressing.
"Do you want to call this?"
What?
Call it?
You've only done two doses of epi. It's only been like 5 minutes.
12 minutes? It's been 12? I've been compressing the whole time. Bagging, compressing, keeping going...
He was a little cold, I guess.
Livido, already, mottled when I got there.
No heartbeat for at least 12 minutes.
"3:56am."
Gone. Long, long gone.
Isn't there more we can do? Other drugs? I took ACLS, can we give lidocaine? Atropine? ECG? I blinked and stopped. They extubated.
I blinked and thought of his parents. Who would tell them?
Who would say "I'm sorry, there was nothing we could do."?
He was dead when I got there. Tiny soul only 28 hours old, already gone. Long gone.
I'm sure they thought they were home free. Having negotiated the treacherous pregnancy and birth process, they were relieved and waiting to go home. Waiting to take their new son home to meet his brothers and sisters, his aunts and grandparents.
But now, they'd just have an empty crib. Empty booties, shirts carefully folded away.

"Do you want to call it?"
There is nothing in the world more tragic.
But sometimes, babies die.

I wandered slowly back downstairs. Thanked the ICU nurses for coming and sat, deer-in-the-headlights. I looked up the NRP guidelines, I'd done it right, it just didn't work.
I heard the story later that the baby had been tucked in the fluffy sheets with his dad. So proud, so happy to have his new son. Fell asleep with the new babe next to him and awoke to find no breaths, no heartbeat. We educate families on bed safety - no babies in the bed because they can get wrapped up in the soft sheets. Sleeping parents have rolled onto their children, unknowing. We educate for precisely this reason. I cannot imagine that father's horror.
The autopsy showed he'd died of suffocation.

Something?

I still see them, here and there. Perfect tiny dolls with heads that were too big and hearts that were too big but voices too small.
One tried to tell me his name. Tried to tell me his story but was interrupted by his destiny.
I wish I knew what his small purpose was. Maybe I'd sleep a little easier.
I watched a birth too soon into a world that just wasn't ready for it yet.
And, to add insult to injury, 15 minutes passed and his brother came toddling behind.
I can imagine that's how it would have been - one always following the other into adventure and trouble. Dirty knees and dripping noses, they might have fought and cried together.
Loved together. Always joined in that secret knowledge that only twins have.

She, in shock, couldn't bear to face the fact. Couldn't bear to look into their little faces so soon so I took them away.
Couldn't take them to the demise room, there would be time for that later. Couldn't leave them alone but I couldn't be far away so I took them to 218 and held them close. The strong one gasped every now and then, surprising me. His chest didn't move but with each heartbeat.
For lack of anything else to do but wait, I sang them lullabies. I sang them to sleep, to death, to heaven or limbo. I sang quietly and tried to keep the notes from catching in my throat.
"Hush, little baby, don't say a word..."
I sang and waited. Checked the clock and their tiny chests over and over again. Kept them warm and tried not to move too much.
Replayed that first moment in my mind, seeing that pink translucent skin and heaving ribs, hearing that first gasping breath, too short.
All too short.
I wondered, "isn't there something we can do?"
Anything? We have to do something, what if? What if this is the one-in-a-million? I'm a gambling person, can't we intubate? Umbi-lines? Do we really have to just let go?
Misplaced hope tumbled over me like so many hard, cold rocks. I know the truth, I've seen the consequences of 'doing something'. The pokes and stabs and exams and X-rays. The infections and head bleeds and pain and pain and more pain that their little lives would hold. That their chances for living a quality life approached their chances of becoming President. Close, but not quite.
23-week twin boys just don't make it. I know this.
So I shift my hope to something new. I hope that they were comforted by my songs. That they heard their father's wracking sobs and felt some sadness and some understanding. I hope that they were relieved to be out from the squeezing pressure and stress of their shared apartment. I hope we were able to make a horrible and tragic day the best it could be for a woman losing her dreams, her heart, for the 6th time.

I hope that those little souls hang around for a while and maybe make it through her body again, this time to sing their own songs to their own children someday.