You'd think I'd have tons to say, right? And yet, I say nothing. I write nothing.
Let's start with Kermit Gosnell. I've followed this trial, of course. His clinic was on the same block where my girls' dad lives; picking them up or dropping them off I'd look at that dilapidated building with the crazy sign: "Women's Medical Society". I'd wonder what went on in there, if that was the euphemism I thought it was, how it could possibly be legal when PA is such a restrictive state, the place was creepy beyond belief. How can this go on? Who's watching?
I could have ended up there, in his "respectable" white-girl exam room when I was pregnant with E. I sought a second trimester abortion in the summer or 1997- I was just over the legal or ethical limit of every provider I'd been to so far. In hindsight I can see that I was only one degree away from the butcher's table. As desperate and locked in denial as I was at 17 weeks, if I'd had the ready cash for a shady abortion I might have gone for it.
I am lucky that know one I knew mentioned Gosnell or anyone like him. Some women are not that lucky. I've heard at work that over the years people have heard from patients about Gosnell's clinic. Whispers among low-income women tend to be ignored, however. Kermit Gosnell practiced with impunity for so long because no one actually gives a crap about what happens when the rabble gets pregnant, as long as it doesn't raise their taxes.
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On occasion, my job requires me to be open-minded about "options counseling". This is when I present to a pregnant patient what I like to call The Three Doors. Parenting, abortion, or adoption. The availablity of reliable pregnancy tests means we rarely see surprise pregnancies- women who come in for a test usually know what they want to do, and are just there to get the clinical documentation of pregnancy that will allow them to take them next step- either applying for medical assistance or scheduling an abortion.
I've only had a few patients who've asked me about adoption. This is what I tell them: don't contact an agency or choose a family until after the baby's born. Take the time to be a mother before being a birthmother. Choose an agency that's non-profit and secular. No independent facilitators. No faith-based agenda-pushers. This is *your* baby. After my few minutes with them are up, it's out of my hands.
As far as I can tell, no one around me that I work with has a perspective similar to mine. Until they are forced to feel otherwise, most people are content to swallow the party line on adoption- it's a win-win-win situation. The adoptive parents get a kid, the kid gets a stable home, and the birthmom gets her life back. Even in the field of reproductive health, most people don't probe any deeper than that.
In the health centers, we deal in the decison of whether or not to keep a pregnancy. Two trimesters later the decision to parent takes place. By that time whatever I've said has probably been forgotten.
I thought that the work I do in this job would soften my feelings toward adoption. In a hostile world, options are necessary. In a hostile world, painful choices must be made. Adoption is a necessary option.
I was wrong about the effect on my feelings- if I thought this would lead to healing and resolution I was mistaken. Instead of acceptance of the inevitable consequences of sex and the measures one must take for self-preservation, I am outraged. When 48% of unplanned pregnancies occur when some form of contraception is being used, I think we can put the irresponsible slutty wanton woman trope to rest. Unplanned pregnancies occur with every form of birth control. Unplanned pregnancies occur because we are human. Mistakes are made, contraception methods fail, shit happens. Technology advances, but failures always happen. Shit will keep on happening.
I am outraged because those three doors leave women no real choices. Keep your kid, and you face the reality of poverty and lost opportunities. Give up your kid, and you face the reality of being a childless mother. Abort your pregnancy and you're a moral failure. There's no right answer here. There are only degrees of loss. What are you willing to lose? What is most expendable to you? There's only one person who can make that judgement.
Fanning all this discontent is the book I'm reading: The Child Catchers, by Kathryn Joyce. She mostly talks about abuses in international adoption, but there is a section in which she tackles the domestic adoption scene, especially the big Christian agencies, like Bethany and Gladney, who use the tried-and-true redemption and rescue story for mothers and their unplanned babies. There are more religiously motivated crisis pregnancy centers than abortion providers in the United States. These centers receive federal funding while perfectly legal abortion providers do not receive any federal or state funding and are closed down for not having wide enough hallways.
I'd love to live in a world where an unplanned pregnancy is a rare event and not a crisis. Where there is easy access to contraception and sex education. Where there is infrastructure for parenthood, planned or not. Where the choice a woman makes about whether or not to become a mother is a *safe* and private one and not subjected to shifting political sands. Where every woman is entitled to and supported in raising her own children if that's what she wants to do. I'd love to live in a world where motherhood is not a punishment, where womanhood is not a biological handicap. I might as well wish for a bazillion dolllars and a no-cancer guarantee. Wishin' ain't gettin'.
It's been seven months since I started working for PP, and it's time for the annual party where the whole affiliate gets together to celebrate our accomplishments and recognize outstanding work.
I was nominated by my boss (hi Melissa!) for Rookie of the Year. (Just so we're clear, I won't win and that's okay :)) This is what she wrote about me:
"Kate ******, RHCA, Media Health Center: Starting with customer service, Kate’s contributions are outstanding: She always has a friendly smile for our clients; she is understanding and empathetic to clients in crisis; she encourages all clients to be comfortable and open about their needs; and her interactions are always clear and informative. Kate supports her teammates, both emotionally and by deed; she offers assistance without being asked, switches roles as needed and helps to orient and train new staff. She is accountable for her role in achieving the center’s daily and monthly goals; at check-in, for example, she closely monitors flow to ensure an efficient balance with the needs of walk- in clients. Kate contributes to the affiliate as a whole by staff-sharing as needed and serving as a regular floater. She stays up-to-date on women’s health issues and other “PP topics”. Our mission and values run deep for Kate, who came to PPSP with volunteer experience supporting nursing mothers."
When I started, I was green as green could be. It had been a decade since I had a Real Job, and it had been since NEVER that I had a Real Job I really cared about. And here I was, single mom of two kids, diving into a full-time job that took all of my emotional and intellectual resources to learn how to perform well.
At first it felt like I was drowning- there was so much to learn about how a clinic runs, where our funding comes from, sorting out which insurance will cover what and how much a patient is financially responsible for (more complicated than you think!).
And then there is the care of our patients: what's necessary to document and the peculiar language of medical documentation, how to draw blood and take blood pressure, how to sort through a patient's myriad of symptoms and issues and boil it down to the important bullet points, how to quickly evaluate a patient's relationship history and identify those that are at risk for intimate partner violence or birth control sabotage, how to address a patient who's been sexually assaulted without making her feel cornered.
On top of that, the guidelines are always changing: do we need a BP with every Depo shot? Does a patient in her 20's need a Pap every two years or every three? Can we give Microgestin to Select Plan patients when there's no generic in stock? And what the hell is a colposcopy anyway and at what point do you have to get one?
All that is only half the job- the other half is the administrative support, the front desk. Wrestling with the cumbersome behemoth that is NextGen, entering the correct procedures and charges, billing the right insurance, charging the right amount of money, fixing all the inevitable mistakes, and making sure everything balances at the end of the day.
I am so lucky: I work with an amazing group of people. Compassionate, respectful, knowlegeable, full of passion and experience, and not at all prone to the kind of drama that can turn a great job into an awful experience. People who I can laugh with (you can imagine how gross the jokes are, right?), people who I can ask for help, people who I can easlily read and step in to help when they're not feeling 100%.
Most valuable is the perspective I've gained: talking to patients about their finances and their sex lives all day makes me see how easy I have it. A roof over my head, kids who I adore and make me proud every day, a loving extended family that supports me and my kids in any way they can, a job I can pour my heart and soul into that fits me to a T.
I am so proud, more proud than I ever thought possible, of what I'm bringing into the world, and so humbled and grateful that I was given the opportunity to shine.
These were the bookends of my day.
This was just a normal day. Other people's crises are my new normal. My first patient was a pregnant woman who did not want to be pregnant- we went over the pros and cons of medical vs surgical abortion while she made her way steadily through the box of tissues in Counseling Room 2. Anyone who thinks this is an easy choice to make, or a comfortable corner to be backed into (because believe me, this woman didn't have much of a "choice") is flat out delusional. No one is flippant about having an abortion. Not everyone cries about it so openly, but the gravity of the act is palpable every single time*. Her visit was all over in 20 minutes, and there's nothing else for me to do, except shake it off and take the next patient.
You never know what's going to follow the open ended question: "So what brings you here today?" When you might be expecting something about itching and a discharge based on the boxes they checked on the form we gave them to fill out, you might be on the receiving end of a convoluted story about an abusive relationship, broken bones and torn skin and all, that ended with stalking and a restraining order. And then at the end of all that she might say "I have this weird pain next to my hip bone that feels like a tumor" and you know that she came in because she needed someone to talk to.
And then it's time to shake it off and take the next patient. Again.
With any luck there's a break in the drama and it's someone who needs their annual to renew their birth control for another year. Those are easy. Preventative. Responsible. You get to say, "Thanks to healthcare reform, your co-pay is waived for this visit!" and you send them on their way with a fistfull of pill packs and a baggie of condoms.
Some other things I heard today: "my girlfriend tried to tell me she got chlamydia from a toilet seat. I totally didn't believe her. But I shared a bong with my friends- could I have given it to them? Like, through my spit?" Nope, dude, chlamydia is exclusively sexually transmitted. I'm so glad you dumped the girl. Now show me your veins, so we can see where I'm gonna stick you with this needle.
Which brings me to venipuncture. It's an unexpected joy at this job- I'm now fully trained in phlebotomy and let me tell you, there are few things as satisfying as that heavy squirt of blood into a vacuutainer from a properly punctured vein. I've done countless blood draws by now and I'm still not tired of it. On Friday I worked at one of the busy downtown clinics and almost every patient needed a blood draw. I'm still new enough that it's exciting every time (how tiny are their veins? Are they soft or are they going to bounce out of my way whenever I try to stick them? WILL I HAVE TO USE THE BUTTERFLY?). I've become good enough at it that people often say "wow, I hardly felt that!". I'm good enough that I rarely miss, even when people tell me that everyone has trouble finding their veins.
It feels good to hold on to this little piece of mastery when so many people I see have unsolvable problems.
*I just want to make it clear that I don't work in a center that performs abortions. I work in family planning centers, which means we dispense birth control and do infection checks, STI screenings, and well-woman visits. I don't have any objection to assisting with abortions, but those job openings in our affiliate require someone who's bilingual.
So, I feel like I should update: I'm working in a hotbed of women's health, I've transitioned to full time employment after a decade of mommy-centric living, the amount I've learned and adapted to should warrant a post, right? You'd think. But I sit here and I can't think of a single thing to say.
I could say that the work I'm doing is satisfying and fullfilling in a way that I did not know was possible: the mission of Planned Parenthood is one that is dearly close to my heart. Birth control should be easy to get and abortions should be available when a woman deems it necessary.
But "mission-rich, money-poor" is the thing that invariably follows. In order to keep this job and fufill this mission, as I learned late one night laying sleepless in bed and crunching the numbers, means that I take home just about half of my earnings. The rest goes to childcare. And the lost time: I'm often not the person who picks my kids up in the afternoons. I'm not the person giving them their dinner, and one night a week, I'm not the person putting them to bed. Some mornings, I hand them off to be taken to school while I catch an early train to be at the clinic on time, so I miss that time too.
And then Fridays come and I'm so exhausted that I hand them off to their father at dinnertime with a kiss and a wave and no backward glances. And then I sleep and sleep and sleep.
Even on hard days, when we're short staffed and some neccesary website is down and everything is a struggle, there are the people that we see and we help. It might be the underempolyed woman figuring her life out who we can provide annuals and birth control free of charge (through a state funded program called SelectPlan), it might be the guy who's girlfriend told him to get tested and bring her the results so she knows she can trust him (a guy like tht was my first fainting after a blood draw experiece), it might be the person whose partner strayed and now has to be treated for chlamydia. For *so many* of our patients, there's no other place they can turn to.
I am really lucky- I work in a place where truth-telling and anthenticity is valued; I never have to hide who I am or where I come from or what experiece led me to this mission. I work in a place where it is considered completely reasonable to do a sage smudging on a Friday afternoon after clinic closes. A place where discreetly crying in the bathroom is considered part of the job, and not a shamefull extravagance of a histrionic personality. We see a lot of awful things; we'd be inhuman not to be affected.
And I work in a place where every day I see evidence of the *good* we do in the world. Women are *empowered* at Planned Parenthood. They have cheap and easy access to whatever kind of birth control they want, and they have a resource to turn to in case something goes awry in their nethers (affectionaly, I call those appointments Itchy and Scratchy). They have a place to go if their birth control fails (it happens, more often than people like to think. Pills are great, but they're not perfect).
I guess what I'm getting at is that things are amazing and incredibly hard at the same time. I am being stretched to my outermoust, healthiest limits on a daily basis. And because of this, I'm learning to take better care of myself than I ever have. This is all *so good*, even with all the bad parts.
There's a thing I've rarely talked about, something I've left firmly in the past. It's been brought to the fore my my girls' burgoening swimming careers and obviously, by the Olympics.
I quit swimming for good when I was 16, after nearly a decade of intense training. Toward the end, I swam thousands of yards a dayand had massages from the team trainer before and after practice to manage the chronic tension problems in my shoulders. I swam next to swimmers who qualified for nationals, for the olympics trials. I was always in lane 1, the injured lane, humiliation alley.
My mom will still remind me to this day that with dedication and effort, I could have been a world class distance swimmer. I see now, I could have. Without much effort, my best 500 time (I asked my dad, it was 5:47) was within 20-30 seconds of the qualifying time for major events. USS Junior Olympics. Olympic trials. In distance events, which were my natural home, 20 seconds was a matter of *wanting* it, *pushing* for it, committing to the training, none of which I wanted to do. I wanted to swim, but I didn't want to be *a swimmer*. It's a nuanced distinction that was too much for my 15 year old mind.
Until I was a teeenager, swimming was a neverending parade of humiliation and failure. Sprint events were the only thing available, and sprinting was not my forte. People I would dominate in long practices would kill me in a 50 or a 100 (let's not even talk about the locker room and the body image issues that going through puberty in a swimsuit would cause. That's another post). By the time the 500 and 1650 were options, I had developed a massive, immovable attitude problem. My coaches, who I loved with the adoration and loyalty of any young, talented athlete and hated to disappoint, eventually became frustrated and disengaged from me. The massages were a last-ditch effort to get me physically healthy enough to compete to my potential. After a brief freshman year season killing it in middle distance events, I quit swimming altogether when I got mononucleosis sophomore year.
That wound remained under the deepest cover until recently- I hadn't swum a full lap since the mid-90's- but suddenly I yearned for the water again. My girls have been involved in swimming for a few years now, and despite the meet related triggers and my parents' white-hot enthusiasm, I never felt any urge to re-enter the water myself.
I got into yoga in the spring and found that the breathing was unnatural in places when it should have been easy. I found that I had a deep seated, swimming-related anxiety about emptying my lungs completely- in swimming you breathe rhythmicallly but you never *ever* leave the tank empty. In yoga, this surfaced in my labored struggle to exhale completely. Yoga, done mindfully, has a way of exposing old wounds and bringing them to the forefront of your psyche. I was suddenly inundated with swimming memories, untouched and forgotten for nearly two decades.
So I re-entered the water, gently and carefully. Twenty easy laps at a time, relearning and remembering everything I ever knew of the hydrodynamics of my body. Watching for form breaks while my muscles rejoiced at being brought back to their natural home. My muscles remember- they recall the precise training in every stroke, and they also recall the tension. Withing the first 50 my trapezius muscles began their old process of locking tightly so that my shoulders hovered near my ears. Yogic breathing, slowing my stroke, consciously lengthening my neck, I began unlocking those old wounds.
Images came back with the force of crashing locomotives: the shock of cool water, the smell of chlorine and latex, mixed with baby powder in the locker room. My goggles filling up with salty tears as I swam through physical and emotional pain in pursuit of the lofty goal of not being a massive disappointment. (You know, in the pool, no one can see you cry). An REM song ran constantly in my head during practices in the trying seasons of '92 and '93: "I will try not to breathe I can hold my head still with my hands at my knees, These eyes are the eyes of the old, shivering and bold.."
What else came back? To put it simplistically, the joy. The natural feel and oneness with the water that I've enjoyed my whole life. In the struggle to regain my hard-won skills, I could feel my natural affinity bouying to the surface. I stroke, I glide, I am *whole*. I am a mermaid, built to live in water.
Suddenly my yoga practice changed: I could breathe more deeply, more steadily, with more control. A block had been released. I can breathe like a normal person again.
Today my girls competed in the yearly summer championship meet. They both swam well, but I was a wreck. They swam beautifully, joyfully, healthily. I relived every buried humiliation from when I was their age. Every undue pressure. All the things that sucked all the joy out of the thing I was so talented at: the swimming itself. I sat with the feelings and I bought some Swedish goggles- the kind of goggles with no padding that you have to assmeble yourself.
I am promising to myself: I am going to swim again. I'm going to train with no goal in mind, no pressure to perform. I'm going to set aside all the *crap* and work to my potential. My body and my soul are in enthusiastic agreement; my mind is cautiously optimistic. Now that the Big Rewards are off the table (the Nationals, the Olympics, whatever), I can strive for the personal, intimate rewards- the kind of benefits that seemed unimportant when there was a vast unwanted horizon in front of me.
I have started working for a very famous womens' health care clinic. If you know me on facebook you might know this already.
My job is to counsel the patients before they see the clinician. I find out what they need from us and how much they can pay.
It's funny how it comes in waves: one day everyone I see will want to start a new kind of birth control. The next day we'll get a bunch of people who need screenings and lab work. There was one day last week where there were more than a few surprise positive pregnancy tests; that was the day I cried on the way home and wondered if I was strong enough for this role. And there's one day a month where we do nothing but colposcopy.
I am lucky: I came into the job fairly well educated about the types of birth control available and what symptoms mean what when it comes to STIs (thanks hypochondria!). It's not so much a matter of learning new things as whittling down what I already know into concise articulations.
What I was unprepared for was the minutiae of the paperwork. The never-ending insurance chase. Keeping track of which patient has what kind of coverage so I know which lab paperwork to fill out and what vial goes with what insurance. Some days it feels like my brain is overloaded with new information to the point of shutting down.
One thing I've learned so far is that nothing is fail safe. My first week there, I saw three accidental pill pregnancies. I've seen one nuva ring pregnancy. No IUD pregnancies yet but my co-workers assure me it'll happen.
The adoption thing has come up a few times- there is literature from area angencies in every counseling room. Yesterday I found myself using a pen that came from the agency I placed through. I was pleased when it ran out of ink in my hand and I could toss it with impunity.
This is the first time in my life that i've felt like I'm truly in the right place, work-wise. I am fighting a good fight; I am of use. I have both stability and room to grow. It's good, it's really good.
What brought me back to this place was the Time Magazine cover, feeding the lactivist fervor that never quite goes away.
Once I was back, I started reading my old posts about breastfeeding and feeling the gulf between who I was and who I am. My girls are both school-age now, and nursing them is a vague (but intense) memory.
Naomi, whose weaning I obsessed over, stayed up until nearly 11 tonight finishing her last (I think) project of third grade. Miriam, who nursed perfunctorily and weaned herself at the continent age of 16 months, recently wrote a hysterical story (with pictures, of course) about an event that happened when she was a toddler (when the cat ran away). They are both so grown up, so *astounding* in their own ways.
And me, I've been unable to write, in the public way I used to. The deluge of all the social media options paralyzes me. I have a thought: do I tweet it, FB it, G+ it, forget it? What? By the time I can decide where it goes and how to get it there, it's gone. To add to that, I am ambivalent about what I want to share. Putting myself "out there" feels much scarier now.
Rereading my old posts, I've remembered the fire and passion that used to spur me to think about how and why I did whatever I did. That level of public self-examinaion has been, for better or worse, absent from my life for the last few years. I find myself suddenly in my mid-thirties, no closer to what I truly want for myself than I was at 29. Further, you could say. Dreams have died. Pragmatism has won the day.
But that's the neat thing about blogging: you can always come back, and blog like it's still 2004 with all your guts splayed out for public consumption. So I'm coming back. Hello, again :)
My grandfather died a week ago.
I was asked to give the eulogy, and of course I accepted, knowing that doing so would test the limits of my abilities. I took a deep breath and welcomed the challenge.
It was uncharacteristic of me to be so prepared, to wake up the day of his funeral with the speech finished, practiced, and parsed out on 23 index cards. There was no winging it, there was no risking failure. This is too important.
Here's what I said:
Thank you, everyone, for sharing this day with us. We're celebrating the life of a person who had a talent for bringing joy wherever he went with his sharp wit, his charming smile, and his unforgettable singing voice.
After spending any time with him, you'd know of his capacity to love. He was fortunate to fall in love twice in his lifetime- once with his wife of nearly 50 years, and after she died, with his grilfriend Agnes.
He loved his dog, Comet. And before Comet, Cosette. He loved his Diamond Club Membership at the casinos, his Irish cream (he preferred Carolann's but would drink Bailey's if that's all there was). He had a fondness for a good barbershop quartet, and MSNBC (someone should email Rachael Maddow and tell her that her most loyal fan has passed).
As I prepared for this I heard so many stories, too many to share here. There were common threads to the stories I heard: Something that came up over and over again was his generous heart. He never missed a birthday- his voice started us on every rendition of Happy Birthday we sang as a family. He made every grandchild an angel ornament for his Christmas tree, and every gift he made for our annual Polllyanna was both thoughtful and useful. He made my cousin the dancer a ballet barre one year. The year I moved into my first apartment he made me a sturdy wooden toolbox I still use today.
Another thing that came up was his intelligence: he was always turning his agile mind to one puzzle or another- whether it was figuring out how to fix a broken TV, devising a system for betting on horses, or finding a technique for growing the best, biggest tomatoes. He was always a step ahead of his time, he was one of the first people I knew to have a computer.
And then there was his sense of humor. Always quick, often biting. He had a knack for clever one-liners and nicknames with staying power: Zip, Cookie, Deedle, Whitey, Missy, Brian, and Rich the Itch are just a few.
he had a way for telling a story that gave it meaning and humor. My brother said something that rings true for me and probably for all of his children and grandchildren- all of the best family stories, the ones we tell and retell, we hear them with his voice, with his words. In this way, he'll live on inside of us forever.
Thank you, Bips. Thank you for the twinkle in your eye, the same twinkle I see in my daughters' eyes (usually when they're up to some mischief). Thank you for the example you set of toughness when facing life's adversities. Thank you for your tenderness when those close to you faced their own trials. Thank you for your irrepressible faith that the next jackpot is just around the bend, for your tenacity and hope that lasted into your final days.
Thank you for living your life and for bringing us into it. Thank you, Bips. You've cashed out a winner.
I have a family member with cancer. Being jobless and available, it makes sense that I'd be the one to provide daytime support and care.
My grandfather, the beloved patriarch of our close Irish Catholic family, has been diagnosed with a brain tumor. He had surgery last week, and came home from the hospital Monday.
I am struck with how closely it resembles infant care. He wakes up, needs to pee, needs to eat, needs to be kept up and somewhat active for some time, and then is settled back into bed, and then I do the other things that need to be done: dishes, laundry, dusting, mopping. And then he wakes up and the cycle starts again.
My days are infused with the mingling scents of Pledge and urine. My thoughts linger on mortality and meaning, on endings, beginnings, and the space between the two.
I take copious notes. I ferret through the rich family history of his house. I look away as I help him pull up his pants. I balance his dignity and his needs. I feel so grateful that I can be of service to him in such a time.
He brought us all into the world, he made my crazy-sweet-beautiful family happen. He is peaceful, sweet, compliant in my hands. I give him the tenderest care that I can: his skin is itchy and dry so I rub the lotion in. He is hungry, and I feed him. He is tired, and I settle him into bed.
It is only fitting that the way we go out of the world is the way we come into it: with our loved ones taking care of our most basic needs. I am honored and humbled to be in the position to provide this care.
This is what life is about: taking care of the people you love. That is the only meaning that makes any sense to me.
I started this blog to write about my experience of open adoption. It could still have been defined as open at the time although it had already disappointed my own expectations of what "openness" meant. And after that devastating letter six years ago, and the aftermath that followed, it would be better described as a closed adoption.
Gradually those feelings and that pain shrank into the corners of my mind. The drama of Miriam's birth, the subsequent disintegration of my marriage, and my own post-divorce rumspringa took up all of my emotional resources. And now, I hardly think of E at all. I have moved far enough away from the pain of her loss that I have to do some quick math in my head to remember how old she is (13 on Thursday). By some people's definition this would make me a success story. I have enjoyed a few years of peace. I have taken a vacation from the pain. This is the luxury a closed adoption can afford.
Events of this past year, while having absolutely nothing to do with her, have made me revisit the lessons open adoption taught me. "I am leaning toward letting the door close. I have my own mental health to think of. I don't want to be bent into shapes that fit around their insecurities, I don't want that responsibility on my shoulders anymore." Reopening that wound led to the irritation of other wounds. Her age, also, makes me wonder whether now might be a time when she needs her first mother. And for the first time in three years, I'm considering contacting her. Nothing intrusive, just a birthday card. Something to tell her, yes, I'm still here. I'm still listening. I haven't forgotten.