A Love Letter to the NHS....

Dear NHS,

I love you.

The adoration that I have for you is complex and not easily put into words but much like a lover on their deathbed I feel that I must so that you can hear it and know you are loved.

I can see that you are struggling and that there are people who are trying to bring you down. You trusted them as friends but now you realise that they have been undermining you at every turn and have left you demoralised and insecure.

I need you to know that I still see you for everything that you are and everything you are capable of being. My love for you remains steadfast.

You see, I know you of old.

I was a junior doctor once. I craved those five letters from my early teens, MBChB, refusing to let anything get in my way. Despite my desperation to get to the front line and start helping people, I found myself convinced that I was woefully inadequate; consumed with the fear of hurting anyone. This daily terror forced me to, reluctantly and sorrowfully, desert the profession. I now realise that the vast majority of your junior doctors also battle with this terror every day and yet continue to turn up; continue to devote themselves to the service of others. The risks they undertake and the vast responsibility that is prematurely thrust upon them is crushing; yet their labours go largely unrecognised and poorly rewarded.

And they are not alone.

NHS, I know that in your heart you are kind. You long to meet the needs and surpass the expectations of everyone of your charges and yet you are thwarted at every turn by bureaucracy and meagre funding. Your caring nature is dispersed through every last one your nursing and midwifery staff who tirelessly tend to the masses whilst making each one feel like they were the first.

I have been the patient, more often than I would like. I take advantage of your benevolence on a weekly basis from the multitude of health professionals who wage war on my failed pancreas and my body's inability to house my unborn children without peril to those who mend my the resultant anatomical consequences borne by my child.

For that I thank you. I shall be eternally grateful.

Don't let them get you down.

You are so much to so many people and we love you.

The Pregnancy: The Reprieve

The next seven days are stagnant and misery filled. Surreally, life goes on as before; morning comes, breakfast is eaten (albeit not tasted), work is attended, co-workers’ jokes are laughed at and deadlines are met. All the while I try to ignore the searing pain in my throat, biting back the deluge of tears that threaten to flow.

When we do finally return home at the end of each day it is to an almost palpable sadness. The grief hangs in the air between us and any comforting word or gesture unleashes a further torrent of tears. So we say little. Privately, I alternate between desperate pleas to an unfathomable deity and utter resignation to our wretched fate.

The day arrives for our repeat scan. I am utterly despondent and yet, intensely aware that I no longer feel pregnant. The nausea that had plagued my first twelve weeks seems to have dissipated and my chest is no longer excruciatingly tender. Instead, I feel almost back to my pre- pregnant self but, with no sign of an imminent natural miscarriage, I am consumed with fear of the process that the hospital are undoubtedly going to recommend to put an end to our brief parental journey.

We make our way to the waiting room where prospective parents bubble with nervous excitement at seeing their unborn child on screen for the first time. They eagerly beam at us in a conspiratorial manner as we navigate our way through the labyrinth of legs, acknowledging their welcome with lacklustre smiles. The happy news of Prince George’s birth adorns the front pages which are held aloft in the waiting room; giving the strangers common ground on which to engage their neighbours in jovial conversation.

I close my eyes and pray. I pray for help but also to stop my thoughts and halt my tears. In the space of a week my prayers have evolved from various petitions for a miraculous intervention to a cyclical plead; merely for the strength to cope with what is inevitably to follow.

My name. I stand up. I enter the room. The bench awaits. Paper towel tucked in. Cold jelly. We turn away from the monitor. Silent tears roll. My body shakes uncontrollably. I know I am making her job harder. "Nearly done. OK so this is what is happening. "

The kind lady doctor who broke our hearts one week ago is smiling. It's not a beaming smile but one of fragile optimism. She tells us the fluid level has increased. The baby is moving. The heartbeat appears strong and currently there appears to be no evidence that the pregnancy is imminently about to abort. She'll allow us to go and return in three weeks for another scan but advises us to have our first trimester screening done. This may actually result in an infant.

Edinburgh's Modern Art Gallery: Everything Will Be Alright

The Birth Part: Take One

So, there I am with my Gestational Diabetes, my blood that won’t clot, two weeks until D-day, one week into maternity leave, three days into our new house (fools) and I am sitting up in bed drinking my (decaf) coffee when I spring a leak. Husband is sitting next to me but I don’t mention it straight away. Initially I have to work out exactly what the source was before I own up to it. Whilst there is no great air of mystery in our marriage, I feel that if a little wee had escaped I should probably keep that one to myself. So I gingerly sidle out of the bed and, with my best nonchalant face, stand up and release an almighty deluge. The air may no longer be mysterious but the floor is decidedly wet.

It is worth noting at this point that my previous years of medical experience had always contradicted the classic American sitcom conspiracy that the rupture of membranes is the first sign of labour and would undoubtedly be followed by the immediate onset of contractions. I knew what not to expect but improbably my contractions commenced directly. With my, now, rather high risk gravidity we phone the maternity triage directly and are advised to attend as soon as we “please” (genuinely). Rightly or wrongly, following an assessment, we are sent back to the ranch to wait things out. Phil and Holly are there (not literally in the room but through the medium of the TV) and we must last a solid 40mins before we are back in the car on the way to triage. Contractions are thick, fast and agonising, conversation is lacking and resentment is building. Husband decides to “distract” me from the excruciating “discomfort” by taking the scenic route to the hospital. This teaches me a few things:

1.  Cobbles are not the labouring woman’s ally

2. Husbands can be cruel task masters and an intense loathing for one’s spouse during labour is an entirely acceptable emotion

3. A pretty vista does not divert anyone’s attention from the impending cannonball thrust through the vagina situation happening elsewhere

Finally we make the car park and forty minutes later we have navigated the 200yards to the triage desk where I throw myself upon their mercy, begging for help. Obviously, I don’t actually do this as I seem to have become some sort of mute and can now only communicate through grunts, wild gesticulations and shakes of the head. We are put on the monitor and the ever understaffed NHS (do not get me started) employees run around, each trying to do the work of ten (highly trained) others. So it is perhaps unsurprising that the decelerations which are slow to recover are missed and presumed to be a loss of contact. Perhaps, they will forgive the husband for getting rather testy with them when he felt that our baby was in danger and not getting the attention that it required. I will admit that no Tiger Mum erupted at this time, it was all I could do to breathe and I do not mean deep, centred, hypnobirthing breaths but mere drawing of air into the most superficial of lung tissue. He had this, he would see this baby right.

Sure enough, the decelerations are confirmed and we are moved upstairs to labour ward. The midwife vacates the room for a mere ten minutes, abandoning a terrified looking student, before a prolonged deceleration is audible and the cannonball is threatening to burst its way out my nether regions. The ashen faced student springs into action and hauls in the first passer-by who happens to be a Consultant. Huzzah! Happy Day, I hear you cry! No. The truth is, if you want a baby delivered normally then you want a midwife. Doctors are thoroughly trained to deal with an infant who is struggling to traverse the birth canal; they will guide them towards the light (sunroof or otherwise) and reassemble you afterwards. No problem. However, ask them to deliver a child the way nature intended and you will see utter terror flash across their face. They aren’t used to it, they haven’t been trained for it and they are just not comfortable doing it. There is too much inactivity, too much reliance on nature and too few instruments required.

Thankfully, my cannonball needed very little assistance and following a brief period of my pelvis threatening to shatter into fragments; she was here.

Upon reflection, it was actually a rather speedy process in comparison to other birth stories that I have heard and despite the ever growing pile of manure that had accumulated during my pregnancy very little of it truly hit the fan at the climactic moment. The inability to have an epidural (due to dearth of the required platelets and therefore the increased risk of bleeding) and the fear that a caesarean section under general anaesthetic was my only alternative should I be unable to birth my baby under my own steam added an extra terror to the birthing process and I swore that should I ever have to repeat I would sign myself up for an elective section. Whether I did or not, is another story…

The Working Mother... Is It Working?

When I was on maternity leave with my daughter, I lasted seven months before I had to go back to work. I told myself that this was because I had a qualification that needed completed in a timely manner and that I owed it to my daughter to be a strong role model by being a mother with a fulfilling career. To be honest, I had found maternity leave hard and lonely. I couldn’t wait to get back to the adult world where coffee is drunk while it is hot, toileting is an independent activity, conversations are rooted in gossip rather than babble and Makaton signage (thank you Mr Tumble) and lunch is consumed without being at the risk of informal highlights. In my ignorant baby free days I had imagined maternity leave to be a montage of long lunches, cooing, box sets and cake but in reality it turned out to be cheese toasties, screaming, snippets of CBeebies (did we ever meet Topsy and Tim’s younger subling?) and soggy rusks. I will admit that I am not particularly outgoing and really struggled to make any new mummy friends, despite sporting a prize winning smile to all potential chums at the weigh in sessions. So all in all it was quite an isolating time and as devoted as I was to my cherub, her conversational skills were somewhat lacking. At this point work seemed an attractive alternative so an agreement was made and the husband stepped his work down while I returned full time. In for a penny, in for a pound.  

As I got myself showered, dressed (huzzah!) and made my way to the door for the return to adult life I could feel my cape billowing behind me. I adjusted my mask, placed my hands on my hips and stared into the distance. I had this. Charlotte, my darling, it is true, you can have it all.

It didn’t take long to realise that I was miserable. I felt like I was missing everything and as hard as it had been at times during maternity leave, the fear of missing out (as the young ones will tell you) is crippling. With Charlotte having her childcare split between my husband, my mother and a local nursery she started seeking others reassurance in times of trouble and had started interacting with those around her so much more than when I had been at the helm. I believe this is due to developmental stages and not my questionable parenting.

We formed a new plan. The husband would step his work back up and I would take over his childcare duties. My employer allowed me to step down to three days a week (the part-time Holy Grail) and we were off, sailing off into the new normal.

What I hadn’t been prepared for was the guilt. The guilt of forsaking my daughter for the workplace was not a new sensation and I struggle to believe that there is a single working mother out there who has not felt it at some point in time. No, the guilt that I wasn’t prepared for was the one I felt towards my employer. I went from an employee who could be relied upon to pick up the slack, work late into the night and come into the office at weekends, to a part time, nine to fiver who would intermittently call in sick; not because I was unwell but because my child was lurgy filled and banished from nursery (anyone who argues that this is a ‘work from home’ situation has clearly never had a sick child.) They had employed one very capable, focussed person and had them supplanted with a part-timer whose heart was no longer in it.

It wasn’t a new realisation to me that my current job was rather dull and far from my ideal occupation but the original plan had been to use it as a stepping stone into, what would undoubtedly be, a glittering career (based around what, no one was quite sure.) Now I find myself a mother, working part time for an understanding employer albeit in a cripplingly tedious industry. I am no longer an attractive prospect in the job market and yet am not ready to step up to full time working and miss out on my children’s pre-school years. Does this mean that I must accept my fate for the next four years, bide my time and just plod on? For this, I have no answer… yet.  

The Pregnancy: When Bad Things Happen To Good Embryos

So we are pregnant and just about used to the idea. There is a little nausea, there is a lot of bloating. I feel thick, not fat just thick around the middle. It is a permanent state of PMS. Just delightful. Around the corner we have our 12 week scan and I am excited. The booking appointment was very formulaic; a list of dull questions (name, DOB, address, etc.), some slightly more interesting ones (last period, family medical history, etc.), a bit of wee, a few vials of blood and a ‘close your eyes and hum loudly to yourself’ date with the weighing scales then the receipt of a lovely green ‘low risk’ stamp. Huzzah. Straight to the midwifery led birthing unit, do not pass go. But the scan, that was going to be exciting, it would all feel so real after that and we can start sharing our happy news.

I wasn’t a fool though, as an innately pessimistic human I had all my anxious thoughts neatly collated in preparation for my scan. I have a weird belief that if I have considered the worst possibility and verbalised that to all in sundry then it is less likely to happen. I have no experience on which to base this belief other than the fact that I have done this routinely and led a largely charmed life up to this point. (Husband is almost the complete opposite and lives by the ‘worry is like a rocking chair; gives you something to do but gets you nowhere’ school of thinking. I drive him insane but he humours me.) So there I am, prepared, or so I thought. They call my name. Deep breath and in we go.

“Just some cold jelly”. I see a head. As a side point, how can babies be quite so beautiful when their heads are twice the size of the rest of their bodies? A head is good, I know nothing about the measurements so just cross my fingers and toes (literally) while the nice sonographer concentrates on the job in hand. This isn’t too bad. There is clearly a heartbeat, which we have all enjoyed listening to and there is a bit of wriggling going on. That is a positive sign. Then it comes.

“I am just going to step out for a moment.”

I look at my husband, he is trying to be reassuring but I have seen the flash of panic in his eyes.

Then she comes back in, except this time she has brought someone who doesn’t wear a uniform. This is not good. Uniforms are reassuring; they have a clear job, they do the grafting. They are very talented but have a remit. Go out with their remit and the big guns are called in. Big guns don’t wear uniforms. Big guns are also rarely required in good news scenarios.

The lady with the kind face introduces herself (there was a doctor in there somewhere) and tells me that she is “just going to take a look”, which she does and then she asks the sonographer to see if the room is free. I know that room. I have seen people go into that room composed and coming out broken and bereft. In my head I am saying “no, just tell me now” but I have no words, I can barely stand never mind speak. It’s like I am underwater and screaming for help but no one can hear me. I am locked in with my panicked thoughts and I need someone to pull me out.

She comes in and explains very clearly what they have found and what it means.

“There is no fluid around the baby.”

“This is normally associated with non-viable pregnancies largely due to chromosomal abnormalities.”

“The baby’s heart is beating but a miscarriage is almost inevitable. It is a waiting game.”

“If nothing happens in the interim, we need you to return in a week for another scan and then we will make a plan.”

“I am sorry.”

So we leave. Broken and bereft. I have failed you before you have even taken a breath. I am evicting you when I should be the one who keeps you safe from harm.

There is nothing I can do but cry. So I cry. All I do is cry.

My husband suggests we go for a walk. In hind sight, this was a terrible idea. We say some things, none of which I can remember but I imagine along the lines of “this isn’t fair”, “was it [insert ridiculous self-blaming activity here] that caused this? ” and then we stumble across a nursery school out for their walk, holding hands, wearing their high-viz jackets and looking more adorable than any living creature should be permitted to look. My heart hurts more than I ever thought possible.

So I cry some more.

The Start

Do you ever think back to your pre-child family aspirations? I was having 3 children (two boys and a girl – no other combinations acceptable) and these children would be born within 18months of each other, you know, so they could be friends. There was no consideration towards the energy, nurturing and expense of each individual child nor the fact that it might just not happen like that.

So I got married.

He’s nice, you would like him. I won’t bore you with the numerous ways in which he is nice and why I decided to let him sire my children (good word, right? I think ‘sire’ should be used more in modern day vocabulary, anyhow, I digress) as I am sure that once you get to know me a bit better it will become obvious that he must have some saintly qualities to have stuck around and sycophantic musings on other halves always brings a little vomit to my mouth. Seriously, if I hear one more person write into to Steve Wright on a Sunday and describe someone as their ‘rock’ I may just tie that someone round their neck and throw them into a lagoon. See how the "rock" analogy works out for them then! Anyway,  I got married, we did that for a bit while I tried one career after another, trying to find one that would fit and then the pang from my fallopian tubes hit.

My ovaries were twisting; crying out to have one of their monthly offerings put to good use. In hind sight they probably just wanted some time off the monthly grind, maternity leave if you will but without the dependent to worry about (can you even imagine?) All of a sudden there was no assuaging my need to procreate, it was an insatiable thirst that would only be quenched by bringing an infant into my life and the greater world. I was ready. We were in our late 20s and had been together for seven years. We had done the drunken nights out, the pub lunches with friends that go on late into the evening and the two day hangovers that would undoubtedly lead to the Monday blues. We knew that we could do whatever we wanted with our time but we were over that freedom and wanted a new challenge. (We have since decided that we may have had a brief period of insanity and perhaps should have considered checking into the local asylum rather than procreating.) However, I was in the middle of quite an intensive professional exam schedule and getting pregnant, whilst not terminal would have been ill advised.

So we got pregnant.

After years of desperately trying not to get pregnant I was convinced that we would be the unlucky ones who would require intervention. My periods were intermittent at best and my pessimistic outlook in life had convinced me that we should start trying so that we could get a few months under our belt before presenting to the GP for help whilst we were still in the NHS accepted child bearing years.

It happened first time.

My evil husband (not really Love) made me run a rather gruelling 10k on the morning of my father’s 60^th birthday celebration. I was aware of a mild cramping pain in my pelvis as I plodded around the ridiculously hilly course but I thought I was just ‘coming on’ and tried to push the discomfort to the back of my head (next to the mounting dislike for my husband.) At one point, there was a supporter on the side line shouting encouragement to everyone who passed, until she saw my face (which was apparently drained of all colour) and literally said “Oh my God!”, not in a good way and definitely not encouraging. Anyway, I am stubborn and we finished the run in his intended sub 55minute time (bastard) and proceeded to the 60^th celebrations where we drank copious amounts of champagne, wine and gin, in no particular order. I awoke the next morning waiting for the ominous tom-tom drum to start thumping between my temples but instead the pain settled a little further south; somewhere in my nipples. They were in agony. As in, the sheet was torturing me by wielding its vice like grip on my delicate protuberances. Still, the penny did not drop. My husband set off for a day’s cycling and it was only as I was left to the quiet of the house that I thought “might just do a test, you know, so I can enjoy a hair of the dog later”. 

It was positive. 

It was positive and I was on my own. 

Do guys get annoyed at missing out on these magical urine focussed events? Should I lie? Could I lie? The answer to this is always no. My face is terrible at it and he knows straight away. Great for him, terrible for me. Wait, what? Never mind him, I am pregnant. Impregnated. With child. Bun in the oven. Up the duff (lovely expression by the way, such positive connotations). I needed a drink. Why is it that the one time you really need a drink is the one time you really shouldn’t drink and to be honest, I had probably had more than my fair share the night before. Thus, the mother’s guilt begins.

What have I done?