HW #50 - First Third of Jessica Mitford's "The American Way of Death: Revisited"

Précis:

      
My exploration of the funeral industry has hugely contributed to its figurative professional menopause, which in turn brought about an industry-wide hatred of me and book’s revealing of the horrors within it. Unfortunately, the majority of funeral services remain full of manipulative marketing antics, if not more so.  Their antics include gaging the cost of their products based on their speculations of family’s ability to pay, hiding as many facts as possible from their clients, taking advantage of the survivors’ ignorance, grief and need and desire to make significant financial decisions on the spot. They fabricate laws to guarantee expensive practices and products such as embalming, caskets and vaults. They justify their high prices by pretending that the prices includes the services of newspaper organizations, grave-diggers, and churches, and by exaggerating the number of hours they spend on a given funeral.  Their reasoning for their various ridiculous practices is that they are part of a sacred “American Tradition”, that the casket must match the appearance of the body which must match the body’s dress which must match the vault (all of which must be impeccable for the sake of respecting the dead body and preventing emotional and mental scarring of the surviving loved ones), that the money spent on a dead body reflects the amount of love and respect the survivors have for the deceased, that avoidance of such practices is illegal and hazardous to public health, and that emotional catharsis is provided through correct ceremony. The general absence of informational texts on the subject of funeral services allows and encourages the industry to strive for its common goal: extract as much profit as possible from funeral-seekers.

Quotes I Enjoyed:

• "It will be noted that the prices all end in the number seven, 'Purposely styled to allow you to quote as 'sixty dollars additional' or 'save a hundred dollars' ' " (page 24).
• "...Cremation of an un-coffined body is prohibited under California Law. This was said in all three cases with such a ring of conviction that I began to doubt the evidence before my eyes in the state code" (page 27).
• " 'I sell vaults. I listened to Mrs. Mitford's speech and seh never said that when Jesus Christ our Lord was crucified, a rich man gave him his vault'...to my pleasure, not a soul stirred. They were all keen to discuss their mother's funeral" (page 37).
• "In an era when huge television audiences watch surgical operations in the comfort of their living rooms, when, thanks to the animated cartoon, the geography of the digestive system has become familiar territory even to the nursery-school set, in a land where the satisfaction of curiousity about almost all matters is a national past-time, surely the secretness of embalming cannot be attributed to the inherent gruesomeness of the subject" (page 44).
• "How true; once the blood is removed, chances of live burial are indeed remote" (page 46).  

Analytical Paragraph:
      
I am continually befuddled by the twisted logic of funeral directors. Either they lack a collective consciounce that would keep them from their continually deceptive ways, or Mitford was right when she said that the industry had "hypnotized" itself into believing its propaganda. For example, a supporter of the funeral industry promoted the practice of embalming because the lessened the number of deaths in the US can be attributed to embalming by 50%. Not only is this probably lacking in evidence (where did he get that statistic? Is that even quantifiable?), but by his logic embalming is ultimately hurting the business because the funeral industry's profit is very dependent on the numberof deaths in the US (the only country that embalms). This kind of reasoning continually arises in industry, according to the book. Society's profound ignorance of this business fuels this logic I think, because a few simple questions can reveal the reasoning of funeral directors to be anything but legitimate.   

HW #48 - Family Perspectives On The Care of The Dead

I interviewed my mom about her views surrounding death and after-death. Of my mother's experiences with death, my grandma's death and her grandmother's death stick out to her the most. She never discussed death when she was young, so she infers that whatever she learned about death was probably from the media. She did not express strong feelings or have ideas about what influenced her current views on death. When she thinks of funerals, she remembers sadness. When the casket opens the deceased look horrible and "I don't want to remember them that way....I know there is an embalming practice and people at the funeral home try to make the deceased look as natural as possible. The person in the casket usually doesn't look anything like what you remember."

My mom would like to be cremated. "The thought of being buried and decomposing slowly I find kind of creepy. Whoever survives me can do what they want with my ashes. It doesn't matter what they do because I feel like it wouldn't be me anymore. I would like people to remember good things and not be sad but that's unrealistic I guess." One big problem with funerals, to my mom, is that people spend way too much money. "Thousands and thousands of dollars on embalming and caskets just to be put in the ground. You'd be much better off putting the money towards those who are alive." Another problem involves cremation. My mom thinks that to be cremated a body must be embalmed and put in a casket, according to law. She finds this to be incredibly stupid. To my mom, when someone is elderly and they have lived for a long time the funeral can be joyful because it marks the end of a life well lived, but when someone dies young it's simply sad. Additionally, "there is a huge difference in mood when someone is a Christian; it is more joyous. If they are unsaved or young, it is tragic and makes for a difficult funeral."

My dad's first reaction to the concept of death was a sense of wrongness. Although many think of it as a natural part of life, it seems to him like part of a "broken world, somehow or another." He has experienced the unexpected death of many close friends, most of whom were young and/or healthy when they died. He was the last close person to speak to his grandfather before he died. He had a heart attack and my father called and ambulance and waited with his grandfather. As they heard the sirens approaching, his grandfather said "I reckon that would be them here directly." These were the last words my dad heard him utter. This death and several shocking deaths of younger, more physically optimal friends have left my father with the impression that everyone has a part of their mind that goes into a mode of denail or numbness. "You are going through the motions of life without really letting the emotions of loss hit you fully. There is something about you that does carry through that, but it seems like you shouldn't be able to. You see someone carry through and smile at the funeral for their wife and you kind of wonder 'How could you?'"

My dad knows that after death bodies undergo embalming in funeral homes. This process entails "draining the blood in the body and pumping this other stuff in." After his death, my dad would like "just whatever the standard morticians do in terms of embalming, putting me in a box, and burying me." He would rather not be cremated because there is a notion of "becoming part of the universe" that often accompanies it, and that he doesn't believe in. My dad noticed that at funerals, people muse over the morbitidy of the fact that there is a dead body on display and that they are visiting over it. They seem to think that the situation would be far more "tidy" if the body just disappeared. My dad thinks this is perhaps a problematic view because that practice "is a way of honoring that person and facing thier death. I think it's a healthy thing as part fo the mourning practice to do what we do."

In the face of death, my family values respect of the dead as well as the family of the dead. When my father wonders at the behavior of someone related to the deceased, he internalizes it and draws inferences about coping mechanisms. He did not critisize my grandfather for laughing and smiling during my grandma's funeral, even when my father wondered "how could you?" My parents do not encourage repressing grief or maintaining a wooden-faced appearance for the general public. I have found that some of my peers see grief as a weakness. I once had a close friend who advised me to avoid my sadness at a tragic period in my life and make myself think of happier things, because once the damage is done, so to speak, there is nothing I can do about it. My family sees grief as a means of respecting and remembering that which has been lost, and denying the emotions as a defense mechanism. It remains unclear whether that defense mechanism is harmful or useful or necessary, but it certainly is popular.

The interviews with my peers were far less centered around emotions. They thought of blackness, void, funeral, heaven, hell, burial and cremation. I suspect that the fundamental ideas were predominant in the peers' interviews because they had much fewer first-hand experiences with death than my parents had. The repetition of loss left the predominant memory of emotion in my parents' minds.

HW #47 - Peer Perspectives On Care of The Dead

          I interviewed three of my peers: A 17 year old male (J), a 16 year old male (B), and a 16 year old female (A). My results revealed various things about how people who share my age and city see death. My first interview was with B. He admitted to attending two funerals and knowing a close friend who died. His religious upbringing has influenced how he sees death and care of the dead, he believes. Thus, if he had a choice of what happens to him after his death, he would choose “something like the way heaven is commonly depicted. The most important thing to me that I really want though is to be able to hold on to my memories and who I am even after I had passed.” Additionally, his first reactions to the words “death” and “after death” were “Heaven, Hell, funeral, cremate, bury.” In terms of what happens to his body after death, he would like to be cremated. “If I were a body, I think I would rather be ‘cleansed’ in a way by fire (which is sometimes thought of as clean) then left to rot underground forever…I also feel like it is interesting to think that the soul is freed and rises up to the heavens with smoke from the burning body. I don’t necessarily think it is true, but it is kind of a nice thought.” He knows that most dead bodies are bathed and dressed in nice clothing, and their eyes are closed before burial or cremation.

            My interview with J went somewhat differently. His first reactions to the terms “death” or “after death” were not religious in the least: “Darkness, absence, a great void.” Coincidentally, his family is atheist and he does not believe in any kind of afterlife. When his family marks the death of someone, the procedure is “little more than a memorial service held.” He does not want anything to happen to his “soul” after he dies, because “you are no longer conscious, you are nothing.” He knows that bodies are usually cremated or buried, but he would like his body to be donated to science like his father’s was, as it “serves no use for me once my brain and heart aren’t working.”

            My third interviewee, A thought only of the color black when she heard the terms “death” and “after death.” She admitted to not having to “deal with a sudden or surprising death” because she has only experienced the loss of two family members who she did not know very well and who were very old and sick. Unlike the other two interviewees, she expressed that death is “tragic” because it “comes regardless of age or how ‘ready’ a person is, and unfortunately has robbed society of many beautiful people.” She was raised in a Catholic family and raised to believe that God exists, but she does not believe in God or an afterlife. “As much as it would be lovely to believe in some kind of afterlife, heaven or reincarnation, I just don’t…I think some people are able to believe in God and some people just can’t or don’t.” She has shied away from the indoctrinations of her parents and elders to form her own opinions, but she still does not like to think about what will happen after her death or what her carcass will undergo.

                The collective reactionary thoughts to the words “death” or “after death” were of darkness, absence, void, heaven, hell, funeral, cremation, burial, and black.  The people I interviewed shied away from directly stating emotions, but they mentioned very unpleasant concepts. Darkness often symbolizes emptiness, which is something every interviewee alluded to. Either they felt that death left a hole where the deceased person used to live, or they feel emotionally empty and numb when they think of death. Perhaps they have just been taught by the media and the people they now to see death as a negative thing rather than a natural part of life, and to associate it with darkness.

                All of my interviewees had experienced the loss of an acquaintance or family member to death, but none of them expressed closeness to those who had died and only one of them admitted to having been close to any of the deceased. I think that many teenagers in this society have not yet experienced their most painful moments in life, because they have not experienced many deaths of close friends and family. I wonder if there is something that youth can do to prepare for such an experience. I think that perhaps some people prepare for their own deaths and for pain via avoidance, interviewee A said: “I don’t know (what should happen to me after death) and I prefer not to think about it.” Perhaps she prepared for her death by avoiding thinking of it as a defense mechanism, because she admitted to greatly fearing death in the past and sometimes still doing so.

            I found it interesting that one’s beliefs about an afterlife or in religion connect directly to how their body to be treated after they die. A did not believe in an afterlife, and does not like to think about what people will do to her soul-less body. J expressed that you are no longer conscious after death, but the procedures his father’s body underwent inspired him to make use of what was left of him. B, who at least likes the idea of Heaven or an afterlife, has idealistic plans for cremating his body so his soul can rise up with the smoke. It seems that views surrounding religion or God are directly tied to how a carcass should be treated, (I think) because said views include ideas of the relationship between soul and body. Perhaps that is another reason why death and treatment of the dead is rather taboo in our society; there are so many different, sensitive, deeply engrained opinions and unpleasant emotions associated with it.

HW #46 - Initial Thoughts On Care of The Dead

On the spectrum of emotions, I think that death is associated with the extreme of anger and sadness. I've rarely seen anyone talk about death light-heartedly, and when they did they were shushed or stigmatized. Most people don't enjoy dwelling on the concept of dying, and when they do they are often considered mentally distrought, suicidal or insane. Once my friend A was sad because her grandmother died. She told me and some friends around her that she had to go to the funeral soon. Amidst the condolences, my other friend B said "have fun at the funeral!" A was rather offended, and later on that day another who was part of the conversation asked Friend B to apologize. B Never did. I think this experience is an example of how we are taught by society to view death because although B meant well,  he was not "right" in associating death with fun. Friend B thought that a funeral was a place to celebrate someone's life rather than to mourn its ending, but maybe this is a less dominant perspective.

The first funeral I remember being involved in is that of a family friend's. I declined the offer to attend because I thought it would be sad for me. My family did not have a problem with me not going, but in hindsight I wonder if it was cowardly of me to shy away from sadness. The next funeral I went to was for my tortoise, Abraham. He died unexpectedly and we put his body in a little cardboard box. We waited until it was dark enough not to be bothered by security or passersby and my dad dug a little hole in the dirt, next to the courtyard entrance to my building. Sometimes when I walk in my building through that entrance I think of Abraham buried there and of the pleasant time I had with him. This sounds morbid, but I never found it particularly strange. When in class we were asked how often we walk by a grave or memorial, most people said not very often. I realized that I do this daily, but this had never occured to me before. Maybe it never occured to me because I, like the rest of society, don't like to think about death. Or perhaps this is because the dead being is just a tortoise, and not a human with whom I had a deep relationship.

The common practices surrounding care of the dead include burials, wakes, cremation, flowers, condolences and funerals. Bodies are disposed of via placement in a casket, which then is buried forever, or burning. Before cremation or burial, usually the diseased's friends and family can observe the body at a funeral home. This is called a wake. To make the body look less creepy or corpse-like, care-takers apply make-up and sew the lips together so that gravity doesn't pull the lips apart in a snarl. This indicates that people are unwilling to accept the tole nature takes on bodies. In an effort to deny death, people minimize its effects.

HW #45 - Respond To Other Peoples' Comments

To Daniel,
Thank you! I too was surprised by the leeway the doctor gave me, but I felt more honored than astounded. I did not really have time to dwell upon my surprise while there, which just left me with a sort of adrenaline.  I'm not sure if the criticisms of birth that "The Business of Being Born" explicitly or implicitly made were accurate or not. I do think that women are often abused in hospitals, but I did not witness this abuse (thankfully). Seeing birth as a medical procedure is somewhat accurate, because sometimes medical intervention is necessary. "The Business of Being Born", "Baby Catcher" and "Pushed" all referred to C-sections as a rather ugly, cruel event. Sure it is bloody and not always part of the mother's ideal plan, but I think that a happy mother during a C-section is not always a result her ignorance. Sometimes C-sections are done by knowledgeable doctors who prioritize the mother and the baby. Dr. Moritz is an example of that kidn of doctor, and he is certainly exceptional.

To Eloise,
Thank you! I thought the experience was beautiful as well. I'm not sure that all women need to aquire skills that are necessary in c-sections are births, but it is certainly joyful and educational to exercise such skills.

To Sarah,
Thank you! I know it seems like a lot to handle such "extreme" situations, but I think that a lot of people would be surprised by how much they can handle seeing and dealing with. Many people could probably rise to the occasion if they witnessed something crazy like a body coming out of another, and they had to act upon it. I'm glad you caught that birth is a normal process, because it is. It is not a problem or sickness that needs curing.

To Naima,
Thank you! I agree that we should all appreciate birth. If you were a doula, I'd hire you.

To Braxton,
Thank you!

To Jasper,
Thanks BUDDYYYYYY

To Luz,
Thank you, I wish you could have that experience too! I think it's possible, but perhaps difficult.

To Beatrice,
Thanks!

HW #44 - Comments On Other Peoples' Blogs

Sarah L,
You did a lovely job of summarizing the processes around childbirth over the past 100 years. You paused to analyze the practices in light of physiological inclings of women external effects of society on women.
I particularly valued your story of the woman who experienced birth in both Africa and the US, because it was a very relevant example of how the US treats birth like other countries don't: a medical procedure.
Your project matters to me because it provides a an explanation of the relationship between birth and society over the past century in a way that I have not yet seen. I can use your project as a frame of reference when writing about or analyzing birth over time.

Natalie,
Great job of describing the various ways that women are abused via judicial systems and doctors, and why it is considered abuse. I felt your passion oozing out of the computer screen. It was engaging and educational.
I particularly valued your insight that soon-to-be-mothers are the only people in society who are forced to undergo invasive surgery and even abuse for the sake of another life, and an un-born, dependent one at that. This had never occured to me, and I think it is particularly persuasive.
This project matters to me because I have empathy for all the women who have to fight for their ideal births, and for my future, potentially pregnant self. I sincerely recommend that you do send this blog post to an editorial-writing contest or another means of getting it published. I think this is worth reading, for many.

Naima,
You go girl! Your motivation to be involved in your stepmom's pregancy and the overall experience of birth is commendable, and the fact that your formed a strategy to do so looks effective. I think your experiences in doula training will provide life-long skills. After having seen several births, a doula in action, and what it takes to support birthing/pregnant women, I think that you have the potential to be a great doula!
Your project is important to me because I might like to take that class as well. I'm so excited for you to learn more about this process and eventually be a part of a birth.
I found it especially interesting that your aunt sings to the baby and familiarizes herself with him/her by touching the stomach...I wonder how she learned to do this.
Interesting work!

HW #42 - Pregnancy and Birth Culminating Project

            At 10:00 am this morning I arrived at St. Luke's-Roosevelt Hospital to follow Dr. Moritz for the day. I walked into the 12th floor Labor and Delivery ward, and the first thing I noticed was a huge screen on wall opposite the resident doctors' and secretary's desks. One the screen was a color-coded chart listing the names of patients, the patient's doctor, the last time they'd been checked or visited, their laboring progress, their blood type, what sexually transmitted diseases they might have, and their room number. This screen enabled all the doctors and nurses on the floor to keep track of the patients and have a common ground for communication with each-other. When Dr. Moritz found me, he gave me a side hug and said "Come with me!"

                The following 20 minutes entailed a difficult search for scrubs, greeting anyone and everyone Dr. Moritz passed in the hallway, and visiting patients. There were no size small scrubs left in the scrub vending machine, so we trekked to the basement, where stores of supplies are. Moritz joked that he had to "go all the way down to the basement where the riff-raff are" and light-heartedly cursed the lack of scrubs on the 12th floor. He said to his buddy, "Sup, Man. We got no small scrubs in labor and delivery, what's up with that? Hey hook a sister up with a some scrubs man!" His buddy responded with "And WHAT a SISTER!" "Yeahh we got a hottie on our hands; let's find some smalls for her." After obtaining them, Dr. Moritz visited a few of his patients, either pregnant or in some form of labor. He never stopped joking and making people laugh; he seemed to have an inside joke with every nurse and every mother-to-be. I noticed that in every conversation, he looked people in the eye. Throughout the day, he maintained a calm demeanor despite the many duties he had. His swift gate and quick movements revealed his hurry, and yet he hugged and kissed and conversed with those he encountered (especially his patients). I got the sense that he treated every individual like someone who had something to offer and who was valuable to the world around him. When introducing me to laboring women, he said "She's gonna deliver your baby today!" or "After seeing you in action she's never going to have sex again!" After deciding to break one woman's water, his hand gently disappeared inside her and her face crumpled as she moaned through the pain the water-breaking tool caused. He apologized for the pain involved in what he had to do, and then visited his patients in the waiting room. One of them tried to get him to accept tiny bottles of liquor, because "no one smokes cigars anymore." He kindly made fun of her, but I don't think he ever accepted the bottles.

                Dr. Moritz spoke French to many of his patients, even when they showed that they were capable of English communication. I interpreted that he did this so that he wanted his patients to know that he would try to do things on their own terms whenever possible. He did his best to communicate in their original languages, and sometimes he ignored the protocol so he could preserve the convenience of his patients. For example, he gave a sonogram to a woman whose baby was constantly moving, and that was thus often in a breech position. Although a nurse in the room criticized his unorthodox protocol, he did the sonogram while the mother stood up so that she did not have to undress or waste time moving the sonogram machine and lying down. I had trouble identifying anything in the sonogram because it was extremely fuzzy and not still (perhaps because she was standing up). They spoke in French for most of the time, and the only part of it that I understood was when she asked if she should lie down, and he said that it would be unnecessary. She commented in English that she could constantly feel the baby moving around. Moritz diagnosed an acupuncturist that would help to switch the position of the baby.

                We also visited a room full of prematurely born babies. Some weighed only two pounds. I noticed that most of them were dark-skinned and had Hispanic names, and wondered if there was a correlation between certain ethnicities and premature births.

                After making his morning rounds, he "gave" me to his midwife, Sandy, and disappeared into the operating room for a few hours. Sandy, who helps take care of his patients on Tuesdays, visited a few patients with me in tow. She broke one patient's water, and remarked that "today is the day of membranes that do not want to break" because both she and Moritz were having difficulty with it that day. She advised the patient to switch from her laying on her left side to her right side, and to sleep instead of watching television. As we walked out of the room, she muttered, "I have a real problem with visitors that need to be entertained. She needs to get rest while she can, and she can't because the people in her room want to watch television."

                Sandy, a feisty, albeit gentle woman, told me about her life story while we had some down time. She told me of her daughter, who is "smart as a whip and figured out everything on her own." She told me of her education, which included nursing school and then serving the army to help pay for it. She went to an army base in Massachusetts and spent a year in Vietnam. She took care of army wives, but informed me that she only "managed the births. I prided myself on telling the doctor when to be there to catch the baby. He would stay in his chair and say 'two more contractions' then we'd be ready to go." She went to Columbia University for the midwifery program. (She'd decided to stick with that profession because a friend told her she had something to offer in that area.) Now she has been a midwife for 35 years, and is considered one of best in the country. Dr. Moritz sang her praises while we were in the elevator, saying "Sandy is one of the best midwives in the country. She is THE BEST. Sometimes I just sit back and watch her deliver the baby; she is so patient. Her patients want me when they learn that I won't be there, but after Sandy does the birth with them they come to me and rant about her wonderful she was." I found myself making excuses for Sandy to a patient or two ("She's had a long morning", "Oh, another patient had that problem"), because several times in a five-minute check-in she asked "how many centimeters are you dilated?" or "Do you need an epidural?" I felt that Sandy deserved optimal patience and respect from her patients, because she bestowed it so freely throughout the day. Her favorite thing about being a midwife is empowering women to do what they can do with their bodies, and helping them to get in that spot where they believe that they can do anything.

                In the first birth I visited, I initially planned to stand to the side as Sandy and the nurse did their thing. The laboring patient had her husband with her, so I figured he could offer emotional support. Sandy took me to the side and explained that this woman, who had been in labor for a long time, would need a cheer-leading squad in there to make her believe that she COULD do it. I understood what she meant; the overall vibe in the room was one of exhaustion and even boredom. I stood at the end of the bed and faced the mother. With each push, the baby's head came out a little bit more, and then seemed to slide back in. I told her that every push resulted in more progress, and Sandy got a mirror and brought it to the foot of the bed so that the patient could see what her body was doing from the spectacular angle I was in. Her husband stood awkwardly to the side as he looked at her pain as though touching her would burn his hand off or hinder her progress. I moved to her side and supported her neck and head as she leaned forward in a crunch position and pushed through each contraction. Her wet hair stuck to her face, the damp cloth on her forehead went from cool to hot in a minute, she grinded her teeth, her face turned pinkish-purple, and sweat beaded in unexpected places like her chin and ears. I continually wet her forehead with a cool cloth, smoothed her hair, told her how wonderfully she was doing, helped to pull her knees up and to the sides, and brought her ice. Ice is generally the only thing a woman can consume in labor - no water or food. Once the baby was born, it did not cry for a long time; this concerned the parents. Sandy showed no concern throughout the day, but she told the nurse to call the pediatrician. The pediatrician flicked the bottom of the baby's feet and rubbed her whole body to stimulate cries and breathing. As she did so, the little babe looked up at me with squinting, dark eyes. I wondered if I was the first person she looked at with those little eyes that would go on to see so much. She used a little straw that functions as a vacuum to suck the fluid out of the baby's throat, mouth, and nostrils. The newborn never cried loudly, but the worry ended when they were able to nurse her. The new mother had a first-degree vaginal tear, which Sandy repaired with two stitches.

                The second birth I attended was a C-section. It was scheduled because the mother's previous birth had resulted in a miscarriage or still birth (I cannot remember which), and because she was carrying twins. I walked into the operating room wearing a blue hair-net-like sort of hat and a mask for my mouth and nose. Dr. Moritz adjusted my mask and told me that if I felt sick I should leave the room. I watched as the nurses bustled around me to arrange operating tools on a table near a bed, and bring extra bottled sanitized water. Their efficient movements reminded me of my sisters and I when we were little and we had to set the table before dinner time when we were extra hungry and in a hurry to eat. I knew I would not faint or be squeamish, but I realized that even if I unexpectedly did Dr. Moritz would be understanding and even concerned for my well-being rather than cruelly mocking or patronizing. Pediatricians set up two high cribs with warming overhead lights and tools to tackle any hindrance that the babies might encounter after birth. The patient's belly was a huge dome of skin and stretch marks. As I looked upon its size in awe, I saw it ripple from some force under the surface. I imagined a foot or little baby bottom pushing against the walls of the uterus. A doctor began spreading a frothy brown liquid over her stomach, upper legs, and visible crotch. I learned later that it served the purpose of protecting the mother from electrocution when the surgeons operated with electric tools. They cut through many layers of skin, membrane, nerve endings, and spongy tissue to get to the babies. They pulled the babies out one by one. Moritz insisted that the baby be held up over the curtain separating the mother from the surgery so that she could see her newborns, and then the babies were taken to their little cribs. I observed as the nurses suctioned the vast amounts of blood and as the pediatricians took babies' footprints, weighed them (5 lbs. and 5 lbs., 12 ounces), gave them shots of Vitamin K, rubbed antibiotic ointment over their closed eyes, and cleaned out their nostrils and mouths with the little vacuum-like straws. Both babies were boys. I looked at "Baby A" and mused that he would go on to hug and laugh and hold and be held. Although this cries were irritating to some, they reminded me that he had the power to use his voice in the future. I hope he uses it well. Dr. Moritz joked that Baby B had a bigger penis than Baby A and led me out of the room in his brisk manner.

                A nurse gave him an especially hard time for allowing the patient's mother to go in the room without "sterile attire" and she complained to him about her offensive comments to the surgeons. Moritz's attempts to calm her down and explanations that the patient's previous pregnancy had failed only heightened the tension in the room and the muscles of the angry nurse's mouth and forehead. I had some more down-time, this time with Dr. Moritz. He confided his frustration in the strict protocol that has to be followed, and in the focus on doctors' convenience rather than on patients. I suggested that he find a balance and adhere to a few more protocols, such as wearing safe attire in the operating room. He responded with "but I wrote the protocols, and they're good ones. But I follow the protocols I need to follow." That shut me up. Then he offered me chocolate.

                The third birth I attended was vaginal. Again I walked into the room with incorrect expectations. I knew that this patient had a doula with her, so there would probably be no lack for emotional support. When the patient was given an epidural a few hours prior, I asked the doula a few questions. She sweetly explained to me that she couldn't have a conversation just then because if the patient heard her talking to me, she would feel like the doula was not focused on her and not "with" her emotionally. I had high expectations for the doula's ability to take care of the mother to be. However, when contractions came frequently and she started pushing, Dr. Moritz said as he bent over the bed and looked between her legs, "Casey, go in the drawer and get size 6.5 gloves. Put them on." I did not ask why and put them on as fast as I could. He motioned to me to come next to him with one hand as the other hand was cupped around the protruding head. He placed my hands on the baby's fuzzy, dark head. We both pulled the head out. "Wait and see which was the face falls, and then pull the shoulders out accordingly." We eased the tiny shoulders through the astonishing chasm that is between a woman's legs. I was surprised by the color of the head, which was purple in contrast to his nearly white body. We had no trouble getting this baby to cry. After holding it to the mother's chest, Sandy allowed the father to help cut the umbilical chord and the nurse took the newborn boy to his little crib. The new mother commented on how easy this birth 4-hour birth was compared to the last one, which took three days. The patient had a 2nd degree vaginal laceration, which means that some tissue and a little bit of muscle tore in the vagina. I helped Sandy stitch the tear up, and she showed me which parts to avoid sewing so that the mother won't have painful intercourse later. After simply helping to pull that baby out, I felt an attachment to him. I cannot imagine how attached his mother must have been, and how heartbreaking it must be to be separated from him after having carried him around for 9 months and then getting to hold him for the first time. When the mother said "he has such a sweet cry", tears came to my eyes.  The doula told me afterwards, “That’s the first time I saw a 16 year old deliver a baby; it brought tears to my eyes!” When Sandy accidentally dropped a box of scissors with a bang, I could not help but think "that is the first loud noise he has ever heard, and I got to be there for it." The parents insisted on taking a picture with me and everyone else who had been in the room during the delivery. Dr. Moritz disappeared, by the rest of us smiled for the camera as the baby sucked at its mother's nipple. I promised not to put the photo on the internet, so I cannot post it on the blog.

                The fourth birth I attended was also a C-section. It was not scheduled, but Moritz decided upon it because the baby's heartbeat was becoming erratic and labor had stalled for a very long time. He told me to put my hand on the stomach and feel how the baby's head had "set" in the pelvis. In this C-section, I had to scrub my arms with soap and water, and don a mask, hat, lab coat, and gloves. I was told to stand at the operating table and not to "move a muscle". The nurse across from me explained that that meant I wasn't to touch my face or anything else because that would not be sterile. She was clearly not very happy that I was there; I was just a high school student with not surgical or birthing experience to date. I stood next to Dr. Moritz and across from the nurse. Another new doctor stood across from Moritz. He moved slowly because this was one of his first C-sections, and Moritz paused his scolding during the procedure long enough to tell me, "you're lucky that you're not one of my students", to which his student across the table emphatically nodded. At one point during their struggles to open layer after layer of tissue, I was asked to help hold the bottom flap open while they worked on the next. Later on, I was so focused on the uterus and the many layers above it that Moritz worriedly asked me if I was okay. I said "Yeah!" a little too excitedly, and he and the other doctor had to stop their work for a moment to laugh at my response. The nurse across from me basically served as the clean-up crew, suctioning the blood up and passing them scalpels and clamps. After pulling the baby half way out of the section, Moritz let the head and neck flop onto my hands. The nurse across from me scolded, saying "Nononono, you're here to observe, not participate." I found this odd, considering that simply observing in this case would mean letting the baby's head and neck flop about unsupported. While sewing the section up, Dr. Moritz looked at me and said, "Do you know how to sew?" I said "Yes, but not bodies!" He looked back at his work with stooped shoulders and I wondered if a different response from me would have resulted in a needle in my hand and a section to sew up. In hindsight, I'm glad I was never asked to do that.

                After leaving the operating room, Dr. Moritz and I visited a patient who had had a miscarriage in her ninth week of pregnancy. She did not seem very sad about it, though. She said she would try again, and laughed at all of Moritz's jokes. The procedure for a miscarriage is basically the same as the procedure for an abortion; a thin tube is passed up the cervix and hooked up to a machine which sucks the placenta through the tube. The most saddening part of the day was watching pieces of placenta float out of a woman's body, through a tube, and into some machine.

                Next, I visited the birthing center on the floor below the labor and delivery ward. The rooms were much more comfortable and homey rather than cold and white. They had little bath tubs, big exercise balls, and colorful, original art on the walls. When I asked why anyone would rather be born in the hospital, the midwives present simply laughed as if they had been wondering the same thing for years.

                I found that I was not surprised by much I saw at the hospital today, other than the odd coloring of the babies. I was very happy to have seen "The Business of Being Born" and read "Pushed" by Jennifer Block and "Baby Catcher". My extensive reading and education about birth and pregnancy enriched my firsthand experience of it, because I already knew what the doctors and nurses were discussing most of the time. They were surprised by my depth of questions and knowledge coming into Labor and Delivery, but I can attribute it only to my previous learning. I must mention that the ability to follow a doctor or midwife is totally one of a kind and I discourage others from asking Mr. Moritz for the privileges I was honored with, because he is a busy man and explicitly requested no more students. I am very thankful for the opportunity to shadow some of the best nurses, midwives, and doctors in the country. I aspire to learn Dr. Moritz's time-management skills, gregariousness, and intelligence, as well as Sandy's patience, wisdom, and "no nonsense" attitude. I stand in awe of every nurse, obstetrician, midwife, and mother because of what I witnessed today.