You're Still not Here

Although Rolling Stone only ranks Green Day's American Idiot as number 225 on their list of The 500 Greatest Albums of All Time, I rate it as one of the best ever. I offer a few compelling arguments. This album matured the band from the grunge punk era, where their songs discussed the inertia of their generation, to a group that was demanding to be taken seriously. Politically, it was so brazen. Just a year earlier, the Dixie Chicks were boycotted for their mere mention of embarrassment to be from the same state as George W Bush. Green Day delivered a no-holds-barred stinging criticism with their lyrics "Seig Heil to President gasman/Bombs away is your punishment/Pulverise your Eiffel Towers/Who criticise your government" and they were embraced with the 2005 Grammy Award for Best Rock Album. It seemed to represent the first time since 9/11 that the citizens of the United States could look at their country with a critical eye. Musically, it was loud and featured "balls-out" boldness (Billy Joe Armstrong's words) which also makes the album a great running track. Artistically, it re-introduced the rock opera and the composition lead to the production of a broadway play and upcoming film. Interestingly, the behind the music backstory reports that the main tracks from their current project were stolen from their studio. Thanks to the thieves in Oakland, the band decided to produce something new that promised to be better than their prior work. A great reminder that a setback is merely an opportunity to become more creative and innovative. Practically; it's the only CD I have in my car and I know every word of every line in every song.

Recently I've been drawn to the third verse in the musical suite Homecoming:

I feel asleep while watching Spike TV
After ten cups of coffee (months of cycles)
And you're still not here,
Dreaming of a song, where something went wrong
And I can't tell anyone
Cause no one's here...

You're still not here.

I've often prepared my patients who have miscarried that the marking of the would have been due date may be difficult, because I merely projected that it could be.  Now I know personally that it is. I also now know that it could feel easier if I were pregnant at this time. At the time of my miscarriage I felt encouraged, if not bolstered by the prospect that I could actually get pregnant. We had been trying for just under a year and technically only had seven valid attempts. Heck, maybe we weren't even that infertile! It feels like the verdict has been rendered -oh, yes, you are. 

Last November, one of our previous front desk receptionists presented for a new OB appointment. She left about a year ago to work in the main administrative office. It was her sixth pregnancy. She had five kids, four of them were delivered by C/section. Her last two deliveries were fairly complicated and her doctor encouraged her to have a tubal ligation. As a devout Catholic, she refused. The doctor even wrote a letter to her priest, explaining that her life could be in danger if she were to go through another pregnancy, but he maintained that she could only use natural family planning methods. She seemed a little indifferent about the pregnancy and confided to our office manage that she had finally adjusted to having five kids. Co-worker and I just looked at each other and acknowledged with our eyes that we weren't at all surprised that the most fertile of Myrtles was pregnant before either of us.

Her ultrasound revealed an embryo measuring just over 6 weeks without any cardiac activity. By dates, she should have been closer to eight weeks. I've had a few patients with unplanned pregnancies that were not viable and they actually expressed a slight feeling of relief. This was not one of those cases. She burst into tears and cried hysterically. I spent quite a bit of time counseling her and I gave her my personal contact information. Interestingly, I was late leaving the office that night and we needed to catch a later showing of Skyfall. I had a positive ovulation predictor on my Clearblue monitor that morning. We returned home too late to have coitus that night and settled for a Hail Mary bang the next night, which led to our brief conception.

She wanted to return for weekly ultrasounds to see if any cardiac activity would emerge. My colleague did her scans, but about four weeks after her initial visit, she sent me an email asking to arrange for a D+C. She requested to have a copy of all of her records to give to her priest (which I thought was a little creepy) and she also asked to have her products. "I know it won't look like anything, but we would like to have a proper burial". I didn't think her second request was odd, as I had buried my own products a week earlier.

I learned from some of her Facebook friends that they held a memorial service and had a burial complete with a small headstone reading 'Angel'. It struck me that both an atheist and devout Catholic went through nearly the same process to heal from a miscarriage. A few months ago I sent her an email to request a change to my schedule. At the end of my message, I added a note 'how are you doing?' She replied, "I am okay. Still taking it one day at a time. Thanks for asking."

It resonated to me that a miscarriage can be extremely difficult for anyone to process, regardless of your faith (or lack there of) or whether it was an unplanned sixth pregnancy or a conception finally achieved after infertility. We all share the same pain. I needed to visit this spot today and soak in the beauty of the view of the bay.

My heart is beating from me

I am standing all alone

Please call me only if you are coming home

Waste another year flies by

Waste a night or two

You taught me how to live