Our Rainbow Baby

It started on February 14, 2023 - last year. I prayed a prayer that changed my life forever. I asked to make a bigger impact on the world. The answer came instantly - "Have children and disciple them in the Lord." Well yes, I was planning on adopting... but instead, God impressed upon me that having a biological one first would allow me to learn to parent first before having to learn to also deal with the issues unique to adopted children. 

I hadn't wanted biological children. There's enough children in the world as it is, and the world is a rather horrible place to bring new children into. Also what if they made the world a worse place by making bad choices? But now I saw that in having children and discipling them in the Lord, there is also great potential to make the world a better place - children not only have the potential to be evil, but also a greater potential to be good. Ok then, I'm down. I woke up Neilson, who had always wanted at least one biological child, and told him I'm down to try having a biological child, because God said so. I pulled out my phone right then and there and made the soonest appointment to get my IUD removed. And so our adventure began. 

On July 1, I had my first positive pregnancy test. We were excited. We were afraid. We were afraid of how a baby would change our lives, prevent us from hanging out with our friends, having free time and hobbies, prevent us from sleeping. I was afraid of how this thing was going to get out - it would be physically traumatic and painful no matter how or when my uterus needed to be emptied. We were afraid of miscarriage, or that it wasn't a baby growing in there at all. 

On July 23, at about 7 weeks since my last period and just about the earliest you could definitively see a baby and get a heartbeat on ultrasound, I asked my colleague to do an ultrasound for me, and we saw for the first time, that there was indeed a baby inside. I allowed myself to get a little more excited, but realistically knew there was still a notable risk of miscarriage. 

But we made it through the first trimester, the highest risk time for miscarriage, without issue. During that time, we found out via blood test that he was a boy - of which I had been sure of since the beginning of the pregnancy, because years ago God had given me the name "Elijah" for my future child - back when I didn't want biological children. We told our friends and our parents the news and everyone was excited. I started to show and it started to feel real. And then I started to feel his movements. They got bigger. He got bigger. I got bigger. The months passed and my initial fear of delivery melted into excitement for a baby when the baby shower gifts started coming in and I started to put together the nursery. My life would certainly look different with a baby, but I was excited to hold and rub my face against my very own squirmy child. Plus I couldn't wait for the carpal tunnel syndrome to end. 

On February 4 of this year, we celebrated the upcoming arrival of Elijah with our family and friends with a large co-ed baby shower. More than anything, I wanted prayers for this baby, to support the God-sized dreams I had for him - that he would be a man after God's own heart, that like the Elijah in the Bible he would pray mighty prayers, that he would bring many into the Kingdom of God in his time. The gifts and games were nice too, but mostly I wanted the prayers. My friends prayed for safe delivery, healthy mom and healthy baby, for blessings in Elijah's life, that he would sleep well, that we would be good parents, that he would do mighty things for God's kingdom... and a plethora of other good things. From how many people celebrated with us his upcoming arrival, we knew he was already a baby well loved. 

The due date came closer, and I became term at 37 weeks. We counted down the days, knowing he could come any time, fearfully hoping he would come sooner rather than later, or maybe later rather than sooner, all the while knowing we had no real control over when he chose to show up. 

Then on February 21 at bedtime, Neilson casually asked if I had done my kick counts for the day. Well come to think of it, of the last four hours lying in bed scrolling on my phone, I don't remember feeling him move. Should we go to labor and delivery for an NST at this time in the middle of the night? If I were my own patient, I would say yes, I should go. So I called labor and delivery to let them know, but instead they wanted me to eat and drink something, and do a formal kick count for one hour and then call them back. For Neilson it was an excruciating one hour of anxiety. For me, I knew realistically that the vast majority of people who go to labor and delivery with decreased fetal movement actually end up with normal fetal testing, and nothing is wrong at all. Also I knew that God had plans for Elijah, so everything would end up fine. So we waited the full hour but I felt nothing. We packed up our stuff and early on February 22 - my birthday - headed to labor and delivery. I fully expected maybe some abnormal testing that would lead to either the decision to induce labor, or proceed directly to emergency C section, depending on the severity of fetal distress. It wasn't like him to not move at all for that long at night. Maybe more likely the C section. I might share a birthday with Elijah!

We arrived and checked in. I signed forms agreeing to treatment for both me and Elijah, in case he were to be born during this encounter at the hospital. We were placed in a triage room and I was told to undress and put on the gown. How strange to suddenly be on the other side of the medical encounter. The nurse immediately came to put me on the fetal monitor, but had some difficulty finding heart tones, so she called the doctor. Okay... in my experience, by the time the nurse fails to find heart tones and calls the doctor over, it's about a 50/50 chance whether there are even heart tones to be found - in other words, it's only about 50% chance that the baby still has a heartbeat at all. 

The doctor came quickly and looked with the ultrasound. I strained my eyes to see if I could see that flutter of the heartbeat. After a minute of looking at what in my personal opinion were suboptimal ultrasound images, she turned to us and said, "I don't see a heartbeat. I'm sorry." Well I didn't either but I would have tweaked the settings for better images and looked for a little while longer, because no fetal heartbeat is a serious diagnosis to announce. I stared at her. I didn't believe her. Did I? I looked at Neilson and looked at the doctor. Silence. "Really?" She looked so serious. Time stood still. Bad things happen to other people. Bad things do not happen to me. The vast majority of people who present to labor and delivery with decreased fetal movement have healthy babies. I am the vast majority, I always am. God has plans for Elijah. God has always ever worked in my favor. Bad things have never happened to me. 

"Do you want a second physician to confirm?" Two physicians are needed to examine a patient to confirm a diagnosis of fetal demise. In this case, she implied I was the second physician and another one who actually worked at the hospital may not be needed. ...but the suboptimal pictures... Yes, I said. Please. Turns out the second physician was in surgery and wouldn't be available for a little while, so in the meantime they gave us some space to process. As soon as they left, Neilson started pacing around the small room. Was this a dream, we wondered together? Are we going to wake up? Fear. I felt fear from Neilson. I felt nothing from myself. Disbelief. Bad things don't happen to me. God has plans for Elijah. No heartbeat? How will we tell our friends who had just been celebrating with us? How will I tell my patients, many of who had given gifts out of anticipation of Elijah's birth? I am an obstetrician. I tell people their babies have no heartbeat. No one tells me that. No one tells me that. What is this irony? Should we tell anybody now? No, I just wanted to stay in the hospital and let the hospital staff take care of us, insulated from the world outside, who was still waiting on its toes for baby Elijah to come. How will we tell our friends and family?

Finally the second physician came and showed me the heart clearly, with no blood flow within and deadly still. She convinced me. I heard Neilson trying to keep it together with deep breathing. I found I was no longer afraid of the pains of labor and delivery. Yes, we said, just induce me now. I hoped he would come on my birthday. One more thing I could share with him. 

On February 23, 2024 at 1:17 am, he came at 38 weeks exactly. He was perfect at 6 lb 6.3 oz and 19 inches. We spent a glorious day and a half with him. We touched his soft skin, kissed him, held him, spoke to him, played music for him, read to him, showed him his heartbeat earlier in the pregnancy. We cried over him and cried over him and cried over him. The sounds of grieving of parents bereaved of their children before they were born is a sound not easy to forget. Now they came from me and my husband. Saying good-bye when they took him away for the last time was not easy. And we went home. We went into the hospital expecting a baby, we came home with empty arms and hearts, brand-new carseat moved to the trunk. Our new house that we bought in anticipation of Elijah and his future siblings was now too big, too empty, and everything reminded us of the baby we couldn't bring home - the signs above the bassinet welcoming Elijah home, the rocking chair where I was supposed to nurse him, the empty picture frame that was supposed to hold monthly photos of him throughout his first year of life. And instead of the cries of a newborn baby, our house was filled with the cries of freshly bereaved parents. 

How can I explain the grief of losing a baby just before birth? The happy anticipation that slams into confusion and shock. The questions that arise - why did God not answer any of the prayers we had prayed over Elijah? Why me? Why him? What happened to him? Why would God give him to us only to allow him to be taken away? But three things I found comfort in - that I was not going through this alone, but rather with Neilson my best friend and husband. My unwavering belief that God is still God, and faithful to me. And the rainbows. 

There were rainbows in the sky on the days of each of his three baby showers (including the surprise ones thrown for me by coworkers). During the coming days, there would continue to be rainbows in the sky, rainbows that our friends and acquaintances would share with us without knowing what it meant to us. When I was in eighth grade, I had made the rainbow a sign between me and God, to remind me whenever I saw one that He is with me. When the rainbows appeared at Elijah's baby showers, I felt there was significance, but didn't understand what it was. Now I did. God had left me signs to remind me that he is still with me, even before I needed them. And then there is the concept of the "rainbow baby," which usually refers to babies born after a previous pregnancy loss. Elijah is not a rainbow baby in that sense, but in a new sense he is our rainbow baby. Elijah, mommy and daddy love and miss you so much but we hope you are having fun among the rainbows with Jesus. We will see you and hold you again soon, and we just can't wait. 

 I have a dream to adopt one day. Specifically, a sibling set. Am I crazy?? I think it’s a God dream. There are some (major) barriers but none that I don’t think my God can’t handle. I’ll leave this here as a time capsule, as the post from nearly 14 years ago now regarding finding my new “bff” has become. 

The Hilarious World of Depression

I'm reading a book called The Hilarious World of Depression, a memoir by John Moe, who is apparently chronically depressed and has interviewed many famous people who have also struggled with depression on his podcast of the same name. 

I thought I would relate to it more, but surprisingly I don't really relate to it much at all. He has the low self-esteem kind of depressed. Maybe once a very long time ago that was me too, maybe. But mostly, it's not me. Now I understand why when I told my dad I was depressed, he disbelievingly said, "But your disposition is so good!" I have great self-esteem, and a great outlook on life and the world in general. Or when I didn't, it was masquerading as religious/spiritual "maturity." (For example, when life didn't seem worth living anymore, I was "eternity/Heaven-focused." Or when guilt was my constant companion, it was because I'm not living up to the standard of what a Christian "should" be like.) Anyway I do have a great outlook on life in general, but major depression by definition comes in episodes of ... not me. 

All that to say, I think there must be different kinds of depressed and I don't have that kind of depressed. Please don't overgeneralize depressed people, thanks. (The author kind of does... reminds me of the med student/med school jokes that I didn't resonate with.) Neilson calls that kind of depressed, "the kind that benefits from CBT." Me? Too rational to benefit from CBT. I've already CBT'ed all there is to cognitize and still find myself sad, foggy, and trying to fight the obsessive-compulsive self-harm monster called "cutting" which is a sort of dissociated not-me me when I'm in an episode. I don't yet have a name for this kind of depressed, but I'd like to know more about it. Taking any book suggestions, thanks. 

That's all for today, folks. 

Commentary on abortion from a Christian OB/GYN

I figured with the recent events, I should make some commentary as some people seem to have a hard time finding a middle ground between "pro-life" and "pro-choice." I am not sure which to classify myself as, as I seem to be both.   

I am an OB/GYN who believes it is generally wrong to do/get an abortion, but that it should be legal. Now how does that figure? I want to explain. 

While morally I don't want to kill babies, and theologically, I don't know when an independent human life begins, I would rather err on the side of caution, so I choose to not perform abortions at any gestational age, nor do I foresee myself ever getting one*.

However, there is international data that suggests that whether abortion is legal or illegal doesn't seem to affect the number of women who get abortions. I repeat, making abortion illegal does not seem to decrease the number of abortions being done. In fact, in areas where abortion is illegal is where the most abortions are performed**. What it does change is the number of women who get critically ill or even die from unsafe illegal abortions. And obviously most abortions are sought because the pregnancy was unwanted. Therefore it seems logical to me that abortion should remain legal, and contraception should be widely available to best decrease the number of abortions performed, based on the evidence. 

Thus, I suppose I am both pro-life and pro-choice. 

*PS many of my absolute statements above have exceptions but for readability I have omitted the copious other commentary I have on when I think independent life begins, exceptions when I would perform an abortion, and exceptions when I would get an abortion myself. No, I do not think independent human life begins at fertilization. Yes, I have performed abortions and I will continue to. And yes, there are situations when I would get an abortion myself. The general public does not seem to understand just how gray everything really is. When you do OB/GYN like me, you start to see more nuance. Feel free to ask me about my perspective and experience on any of the above. 

**References: https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide and Obstetrics and Gynecology in Low-Resource Settings by Nawal M. Nour. 

A discovery

I discovered something key about myself, and where I've come from. Since Neilson is almost a graduated psychologist now, I thought I'd run by him my past self, to try to get some answers. Although I think I am very mentally/psychologically/emotionally healthy now, I have had difficulties in the past, which I used to think were normal difficulties of adolescence. He insists that they were not normal. Perhaps not, as I was terrified of everything psychiatry in medical school and after, because I was afraid if I even looked at the skeleton in the closet, it might come back to life to torment me again. Somehow, after my recent discoveries, it's not so scary anymore. Somehow it's deeply comforting to know now that my problems had a cause, rather than just... randomly occurring. So I am learning to admit that I've had some significant psych problems in the past, I'm trying to get used to saying that. (Although part of me wants to continue to insist that we are blowing things out of proportion, they were just normal difficulties of adolescence.) 

In brief, in high school I suffered from self-harming behaviors, mostly cutting. I remember being sad a lot, and I remember a feeling of walking around in a fog, as if I were dreaming, disconnected, for long stretches of time, weeks maybe. I remember thinking maybe I was depressed, and looking up the diagnosis for depression, but finding I didn't quite meet the criteria. I remember having intense urges to cut, constantly, for what seemed like no reason as it had little to do with my mood, but they were overpowering and consuming. I believed it was morally wrong to hurt myself, so I struggled against it, but it was constantly on my mind. And I recently found a rather alarming old blog post from back then, where I said I was having episodes of lightheadedness and such difficulty focusing that I couldn't understand any of my teachers in class, and I was "floaty" to the point of being unable to complete tasks, and I would clean forget what I was doing mid-task, to the point that my not-easily-impressed Asian parents wanted to take me to the doctor, and my dad thought it was because I was too stressed. I have absolutely no recollection about what I described in the post, but I guess that might corroborate the story. (I don't remember if they ever took me to the doctor.) Later on, in medical school, I learned about a psychiatric symptom called dissociation, which I now believe is what I was experiencing at the time. 

And I clearly remember emerging from all that my senior year of high school, spontaneously, it seemed. It was like I had new life, I was a new person, I had new eyes, and I've (mostly) had it ever since. Now and then I've had the foggy feeling come back, or periods of sadness and being unable to motivate myself to do things, and it reminds me of vaguely scary things from a shadowy time long ago, but overall I've done very well. I'm very well-adjusted and balanced now. I didn't figure out what caused my issues, but one clear blessing that came from it was that through it, I learned what God's grace is - the grace that led Jesus to enter our darkness to save those of us who are utterly helpless. 

Well I mentioned some of this to Neilson. With a strange look he asked if I had ever had anything traumatic happen to me - all these things are part of the set of symptoms that tend to follow traumas. Well, no, I don't remember anything traumatic happening to me, the only thing that wasn't perfect about my childhood was that my parents fought. He happens to do exclusively child psychology work currently, and to him, that was a red flag. No one has ever taken me that seriously before when I've said my parents fought, including myself. Don't all parents fight? Lots of my friends had their parents get divorced, and mine are somehow still married, so that means that many other families are more dysfunctional than mine, mine is only average or better than average. Well the short of the story is that now I know the degree to which my parents fought was not normal, some may even consider it domestic violence. And this, for a kid through all the years of their childhood, can be quite legitimately traumatic. Yes I used to be scared when it happened, but later on, I was able to tune it out, so I forgot how scary it used to be for me. How strange to think, this piece I always viewed as the background and not very significant, could have actually damaged me and caused my "adolescence" problems, which weren't normal adolescence issues at all. How strange that it took 30 years to figure out just how dysfunctional my family has been and how it has affected me, and in large part because my husband and my sister's husband brought fresh perspectives to the inner workings of our family - they thought arguments with raised voices between our parents counted as scary "fights," which to us was quite laughable and cute. It highlighted how distorted our view is. I always thought most older couples fought like mine. I thought it was normal. I never tried to hide it from anybody, and no one ever pointed out anything was concerning, even though there must have been red flags. All these years, I had no idea why I was so gripped with the need to hurt myself back then, and what the heck that foggy feeling was, and why I was so sad, and now I have learned that they are all common responses to trauma, which I apparently suffered for years without knowing what it was. What a relief, somehow. 

Up until last week before I discovered this, I frequently thanked God for blessing me so much. I felt that my life has essentially been perfect, I've been blessed with every blessing to set me up for the best life possible that many can only dream of - money, opportunity, a relatively intact family and parents who love me, talent, faith and salvation, no major obstacles to overcome in life. I've done so well in life because God has made life easy for me, even unfairly so. The high school days? Only a small blip on the screen that went away on its own. But this has fundamentally changed that story. Now I see that not only has God given me every blessing for a successful life, but he has given to me SO ABUNDANTLY that it has completely and SPECTACULARLY overcome what should have been a major obstacle in my life. So overwhelmingly so that I didn't even know that obstacle existed. Many of Neilson's patients have similar backgrounds, but they struggle hard, they get hospitalized psychiatrically, they try to commit suicide, they use drugs, all sorts of things, yet somehow that wasn't my story. The trauma affected me, but not nearly as much as it could or should have. And the negative effect was only temporary, and resolved "spontaneously." What a glorious testimony of God's abundant goodness in my life! What a shame that this testimony has never been told! Highest praises to my God, who has protected me and equipped me and walked with me out of troubles I didn't even understand were happening. 

And finally, a Psalm that I frequently quoted to comfort myself when I was at my darkest place, has never seemed so apt: 

1

The Lord is my shepherd, I lack nothing.
He makes me lie down in green pastures,
he leads me beside quiet waters,
he refreshes my soul.
He guides me along the right paths
for his name’s sake. 

Even though I walk
through the darkest valley,
I will fear no evil,
for you are with me;
your rod and your staff,
they comfort me.

You prepare a table before me
in the presence of my enemies.
You anoint my head with oil;
my cup overflows.
Surely your goodness and love will follow me
all the days of my life,
and I will dwell in the house of the Lord
forever.

A recent conversation I had with my husband:

Me: These medical people are so goal oriented

Him: Well that make sense, the whole path of becoming a doctor is full of one goal after another.

Me: It is?

Him: Um yeah, like first you have to get into college, then get into medical school, then pass the board exams, then match into residency, etc

Me: ...Oh I guess it is.

Him: Don't tell me that's never occurred to you before either

Me: Um no.

Him: lol you're so different, you need me to explain medical students and residents to you

Me: Well I don't set goals. If you don't set goals you won't stress about reaching them. ... Well that's not true. I've made a bucket list once before. Here's my bucket list: I want to see the purchase of sex made illegal in the US during my lifetime. I want to see North Korea freed and opened to the gospel. I want the world to be better in my wake. Those are my goals. Why in the world would you make such small goals such as to match into residency? 

But I bet the truth is most people make small goals such as to match into residency. Jesus calls us to seek his Kingdom first. That means to spend your life fighting for the things that he fought for, bringing the healing and peace and redemption that Jesus embodied into this war-torn world. That means to have big goals such as the breaking of oppressive kingdoms like North Korea and such. Can't his kingdom come whether we are accepted or not, match or not, get in or not? Sometimes being "successful" in life such as becoming a doctor is helpful to God's kingdom, but God's kingdom sure as heck can function just as well without you being that doctor. I implore everyone reading this, even if it's just my future self, to ditch the small goals and instead replace them with Kingdom-sized goals. Life is less stressful and more meaningful when your goals are dependent on the Living God, not just your measly little self, to achieve. 

I came back to this blog because I wanted to find a space to write and publish something for people to read, something I've been thinking about. In appears to have been 6 years since my last post and an awful lot has changed during this time. But I still recognize myself in my writing from back then, and I love it. Yes, I still laugh at the days to come. Some things don't change so easily.

What has changed since then? Kauffman and Breen-Church labs happened. I got married. Medical school happened. Now residency is happening. I am living my dream and even though some days it's a tough life, I love it. I love it so much. 

But one thing since starting medical school has been a common theme, and that is that I feel that I am different from others. 

It has bothered me on and off since moving to Loma Linda for med school. Most days I'm able to shrug and say, I think my way of seeing the world is the better way, you all are missing out. Some days I wish I had a duplicate of myself nearby to be my kindred-spirit-soul-mate, someone who saw the world like I do, whom I don't have to explain things to. Today, I wish to try to explain myself a little to the world.

I would like physicians and medical students to know that there is more than ONE medical school/residency experience to speak of. Many experiences are common experiences, but even common experiences are not universal. Not everyone stresses about tests and Step 1. Not everyone uses UWorld. Not everyone feels shamed when they can't answer questions the attending asks them in front of others. Not everyone gets anxiety before Step 1 and Match Day. Not every resident is burned out or stressed out. I personally do not relate to any of those experiences (except I admit I did feel stressed my first several weekend OB calls). Please do not assume that I or everyone does. Please do not stereotype and generalize. Thanks. 

I would like non-physicians to know that I do have a demanding job. I do work an average of 75-80 hours per week, which usually entails waking up at 4am to be at work at 5am, and working straight through to 7 or 8pm without any protected breaks, and hoping to have a bit of time for dinner and possibly a shower before going to bed at 9pm, for 12 days in a row before a precious two day weekend. Time to away from work is slim during the work week, so often I have to make tough choices. Some days I have to choose between eating and sleeping and showering, and I usually choose to sleep, because lack of sleep affects my functioning first. So I choose to go to bed hungry and dirty. Even now as I write this, my heart and belly are full after church and lunch, but since I worked overnight last night, I have slept less than one hour in the last 24 hours, between coming home from work and going to church. I can barely take care of myself sometimes, so maybe that explains why I have not yet tried to have kids. Maybe that explains why I have a hard time making it to weeknight activities, and rarely have time to talk on the phone, and am a little stingy about my rare weekends.  Please be understanding. Please do what you can to make spending time with me easier on me. Please do not pressure me to have children. Thanks. 

But I would like everyone to know that I do not resent this life. In fact I love it. I actually do look forward to going to work, and I do come home reminded yet again how I have the BEST job in the world, and am the MOST blessed person in the world. I do thank God from the bottom of my heart for every bathroom break I manage to squeeze in, every hot shower I can take, every meal I can eat. There's nothing like a little thirst to make you truly appreciate water. Of course I would love to have more time off. Every weekend off and 12 hour workdays sounds much more sustainable and well balanced, luxurious even. But it's ok, residency isn't forever. This life might be barely on the cusp of livable, but it is livable nonetheless. Please do not project your own opinions/feelings about my lifestyle on me. Please do not complain or feel indignant on my behalf. Thanks.

I appreciate when people inquire about what they do not know or understand about my life without assuming. I appreciate when people acknowledge it. And then I appreciate when people don't make a big deal out of it. I personally do not know any other way to see the world, so if you think I'm a little bizarre, chances are I'm probably thinking the same thing of you. But hey hey, it's cool, we can have different views on life and still be friends, eh?