Katie Taylor
Oakland, California, United States
“Are you sexually active?”
“No, but you are,” a patient, one day in early spring, responds.
Her timing is good, and the point is obvious. I am twenty weeks pregnant and showing, belly at two-thirds basketball.
When I tell an older male patient I’m pregnant, he congratulates me, tells me he wished he had met me earlier, that he had always wanted a family.
“It’s not mine, is it?” a patient asks a few days later. I tell him I haven’t seen him in over a year, so no, (and also, no). Pivoting, I say I wish I had spoken to him once for his minimally, some could say not-at-all, controlled methamphetamine-induced congestive heart failure.
Many patients take note of my pregnancy, and much is everyday pregnancy fare: I am due in August, my second child, no name yet. I appreciate the well wishes and am happy to talk about it. A few patients, mostly women, say they knew I was pregnant before I told them—from my aura, my skin, my body. Some, mostly women, guess the gender, and those that get it right inevitably and self-congratulatorily say they knew it, closely followed by proclamations about how they had known: the shape of my hips, how high I am carrying, my face.
“Girls take the beauty for themselves,” one patient explained, “but boys let you keep it.” I am having a girl.
For some, my pregnancy was a welcome digression, an easy goodness about which there could be pro-social small talk. Pregnancy questions are straightforward and polite, the script is clear and well-trodden. It is the opposite from all the lines of questioning upon which I would soon embark: questions about their drug use, their alcohol use, their mental health, their recent ER visit, ICU stay, incarceration. My growing belly is far from their methamphetamine use and how it is stressing their heart, is so deeply toxic to their myocytes, is causing water to back up in their lungs, fester in their legs, stretch out their myocardium into a floppy, useless, barely pumping sack. My due date was disconnected from their recent overnight stay in the psychiatric emergency room for agitation, for psychosis, for wandering in traffic, for suicidal ideation.
At times, talk of my pregnancy extends for longer than I would expect, for longer than I have time in this urgent care clinic for homeless patients. I sense patients holding on to the topic; it feels they are fighting the transition from my life to theirs.
For some women, my belly’s existence summons forth discussions of their pregnancies. A truth serum, my pregnant belly seems to exact stories from its owners. And within those stories, there was no symptomatology, no disclosure of use, no reports on medication adherence—they just spoke. About childhoods. Babies. Adoptions. It is a temporary portal to a place where patients actively and organically offer up consequential, unstilted details about themselves.
It was less clinician-patient, more lateral, more connected than most every other patient conversation I have. But perhaps that is what parenthood is, a metamorphosis that bonds scared soul-maker to scared soul-maker. Mycelial connection between trees—sharing information, noting each other’s distress signals, passing nutrients. We stand apart above ground, and yet are intricately, unfathomably, tied together below.
It felt good to feel in common with, to commune, with patients. I was taking care of them, and also, they were taking care of me. There was advice, Get the epidural! And also, Don’t let them stick that thing in your back, you’ll have headaches forever! Words of encouragement. Words for my partner, to not let him get off easy. “Don’t let him fuck you and leave you,” an older and long-time patient of mine said, as she headed out the door.
While telling a patient I would soon be on parental leave, he replied, “I wish I’d had a mom like you.” How difficult his childhood had been, he shared, how absent his parents. And there it was. In the face of this sublime, unifying human interrelatedness, came the stark contrasts in the outlines of our lives. With all the fellowship and humanity of reproduction, there lay the vast chasm of our differences. I had parents who cared, and happy memories. I had been allowed to fret about what to study, who to date, where to vacation. And here, this older man, living in a tent on the sidewalk in a life of unsheltered addiction and poverty. Here he was imagining himself into my family, placing himself as my son in the story of his could-have life, wishing himself born again.
He was a bright and kind spirit, and I, too, had wondered what his life could have been, had it gone a different way. Had it gone any way but this. What he would have studied, what job he would have chosen, what he could have done for himself. Instead, today, we talk about his crystal meth use.
Not infrequently, the topic of pregnancy leads to tears. Anger at Child Protective Services, anger at partners, who, I was told, fucked them and left them. There is the patient who tells me she wants to parent, but also, she is not sure her boyfriend, who is not the baby’s father, wants to parent, though she has never fully broached the subject because she feels too nervous to bring it up. He might get mad. Then her baby is born, breech, premature, and on methamphetamines, and spends weeks in the NICU without a single visitor—a baby born and cast away. Eventually the baby girl is fostered out after they never hear from the mother again.
Often, patients would not speak the saddest, worst parts. They would allude to certain pains, hint at prior lives lost. And then I would read the tragic details, which lie like landmines in dry medical language in old medical charts, which you will stumble upon when you are looking for a previously prescribed dose of an unrelated thyroid medication. And, silently, at 10pm, head in your hands, you will read what happened: a baby born jittery with methamphetamines; fetal alcohol syndrome; neonatal opioid withdrawal; an infant on the tincture of opium, tapering off narcotics from the day they were born. An infant death at six months of unknown causes, but which occurred when only the father of the baby was present, and which is currently under criminal investigation for infanticide, which sent the mother into such despair she checked herself into a psych ward soon thereafter. And then again the next month. And again, the month following. There was no one redirecting sugar to starved roots, no one sending goodness to the striving saplings in shaded stands. No beautiful underground networks, just the all-too-ordinary, silent suffering of a child.
By the end of summer, I am seven months pregnant, my belly already at full 100% basketball. A woman wanders into the clinic, unable to say why she came or what she needed, her speech disorganized and filled with delusions about demons, radio waves, and the government. She was floridly psychotic, and I was evaluating her for a psychiatric hold. Mid-explanation about what the FBI was hiding from us all, she stood up, came towards me, and laid her hands on my belly. She asked how far along I was. She told me women needed to stick together, that she had been a prostitute her whole life, and that men did not nothing but take, take, take. Then she spun around, arms aloft, and was back to radio waves that were penetrating her head, that no one was doing anything about. Returning to my belly, she cupped it again, asking if it was a boy or girl. Oh, a girl! She had been pregnant before, too, she said, but she raised none of her children. We girls must stick together. We needed to defend one another. Turning away, these demons, she told me, were telling her what to do.
In wonder of this bodily process, she was there, wanting to feel it, to connect to it. She interrupted her own delusions in order to link our pregnancies across time and space. Pregnancy rooted her synapses, kept her upright. For this, her brain would manage. For this miraculous, incredulous, impossible thing, she was completely coherent. I tried to send goodness to her too. She agreed to get into the ambulance, to go to the hospital, to figure out why she didn’t know her name.
KATHRYN ELYSE TAYLOR works as a doctor at a homeless clinic in San Francisco. When she became visibly pregnant, many patients started to speak to her about motherhood, their childhoods, and their families. The experience, she writes, “made me feel closer to patients than I ever have before. And yet, with all the fellowship and humanity of reproduction there lay the vast chasm of our differences.”
Some of her prior work can be found in the medical humanities journals In-Training, the Intima, and Hektoen International, in the San Francisco-based magazine The Bold Italic, and in the literary magazine The North American Review.
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