On our minds.

 
I hope you will go out and let stories, that is life, happen to you, and that you will work with these stories... water them with your blood and tears and your laughter till they bloom, till you yourself burst into bloom.
— Clarissa Pinkola Estés, Women Who Run with Wolves
 
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It’s 1:30 in the morning, and the Starbucks of the hospital lobby somehow ran out of hot coffee. The break room for ER staff ran out of coffee too. You have six hours left of the night shift and you won’t make it without caffeine. The only thing open is Primary Children’s cafeteria, and a remodel of that end of the hospital requires you take the long route. Which means you’ll pass the room he died in. As you read the “Newborn ICU” sign, your body remembers. There’s not a lot from that time of your life that makes your body remember. Which as it turns out, is both a relief and a burden. You pull your headphones out of your pocket, turn music on, and keep walking.

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Rewind a few months earlier, it was a Friday afternoon when I sat down at the coffee shop I had become a regular at. It was completely crowded, which was no surprise. I took a second to look around, and caught a glimpse of the quote above my table: 

“Don’t run from your monsters” it reads, “I hear they can heal you.” 

I look down at the EMT text book in front of me.

At first, it brought a lot of anxiety. Going back to the classroom three years after obtaining my bachelor’s degree. It felt weird pulling out an outdated textbook as opposed to a laptop.

I had spent my time growing a photography business and nannying on the side for two doctors that needed an extra hand. I watched them come and go at odd hours, always in scrubs and always a little tired. They worked a lot of night shifts and some holidays, but still their kids were thriving and having access to the medical community, they managed to always find the support they needed. We’d become good friends and I looked forward to the occasions we got to chat about their experiences. Nannying also allowed me take more risk creatively and every project, every collaboration that I got to participate in, it did what art does, which is help you hear yourself, notice your patterns, and you begin to see a theme emerge.

For me, there was always a deeper story brewing beneath everything I was taking part in. And it had nothing to do with career, future plans, or to do lists. It can be tempting, the capitalistic draw to revolve your days around the quickest and easiest way to make money and gain status. But the things that have a heartbeat: family and the people who become family, our DNA, our community, our health. That is where we will eventually end up, no matter if the way we get there makes sense to the outside world or not. And the reality is, while I had invested a lot of time into marketing and photography, I had some burning questions about my experience with the medical field. And while there exists an alternate reality where I therapied my way around those questions, the reality that spoke the loudest was the one where I put on scrubs and sought out the answers myself.

Go out in the woods, go out. If you don’t go out in the woods nothing will ever happen and your life will never begin.
— Clarissa Pinkola Estés
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Around the same time period, I was volunteering in the University of Utah ER. I had no responsibility other then transporting patients between departments and helping them feel comfortable. Which meant I got to observe a lot. Each shift I saw the waiting room of the ER overflow with people’s failing bodies and minds. I took note of the EMT’s through out the department, working behind the scenes to keep the flow of the ER running. I watched as they closed the curtains behind them, stepping into support the staff treating trauma and critical patients. I wanted to know what was going on behind those curtains. So when I overheard where one of the EMT’s got certified, it wasn’t too long before I found myself in the same classroom.

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Back at the coffee shop, there’s a girl sitting across the table that notices the textbook in front of me.

“Woah. Nice. When do you take your national test?” She asks. 

I look up.

“I’m almost done. Then I’ll apply to work at the U,” I say, wondering what her background is. 

“Are you going to go on to become a paramedic?” She asks. 

“Only if it helps me get a job in the hospital. I don’t want to work on an ambulance.” 

I notice her tattoo.

“Tell me about you,” I say. 

“I just finished my advanced actually. I am doing pre-reqs for medical school, so I’m in classes right now. I’m also in a band, and always on the verge of dropping everything for that.”

That pull in what felt like opposing directions was one I had become familiar with. I wondered if deciding to take medication for what appeared to be clinical depression would make me more content with life prior to this path. Maybe if things had unfolded differently for me, I would be more satisfied with light and airy things. I was beginning to see that prior to becoming an EMT, not many people around me shared my interest in trauma and it’s impact on the mind. What makes one person come out of loss more resilient than another? The question was activated when I first spent a weekend in the mountains of Sundance with other women who had lost infants. It continued as I researched more about birth trauma and continued to photograph child birth while pursuing a doula certification. It was slowly waking me up to something that although had been outside my conscious awareness, remained at the steering wheel of my life.

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The more time I spent in the ER and the more I did my own research on the mind, I started to see the holes in my own story as a patient and as the mother of one. It included an emergency C section that took under a minute, and it included an accidental three inch incision made on his back in the process, after which he was immediately life flighted to Primary Children’s where he’d sit untouched in an incubator for three days until we got there. Having never sat face to face with any of the providers who cared for him in the five days he was there, and having no connection to any staff involved in his care, coming out of that situation feeling like I had done the best I could do for him in his short time here, was a lost cause from the start. After witnessing a few distressing traumas in the ER, it became clear that practitioners aren’t only helping someone survive in the moment, they have the potential to save someone a lifetime spent drowned by unanswered questions and holes in the story. How they respond in not just stabilizing a patient, but their presence and explanation of the treatment while it’s unfolding, the resources given to patients in the long run, and the way they communicate the situation and empower patients to be involved, are all ways of helping a patient integrate and develop resiliency following a crisis.

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It was a year ago that I was asked to sit on a panel of U of U board members and other parents whose babies died in the NICU. Hearing the other’s stories and realizing the amount of unanswered questions my own experience had left me with, was overwhelming. Compared to the other couples in the room, it was clear my case had slipped under the radar at Primary Children’s. I received all information second hand through my ex, and unlike the other parents, I don’t remember any nurses or doctors names or faces. From my experience, nobody looks you in the eye when they know your kid is going to die. It was a ghost town in the NICU, and I was too drugged to even think through what I should ask for. I was never given any paperwork or a follow up call on tests that were supposed to be completed after he died. I don’t remember being told anything other then I was allowed to hold his hand through the incubator and what I could expect after they removed the wires the night he died. “I’ll take care of it” the nurse had said, after she pointed to the table we could place his body on after we pulled the plug that night.

I had no idea a year later, I’d find myself an employee at the University, which would allow me look up his record. However, when I’d see the word "alive” next to his name and birthday, i’d instantly regret it. According to the system, he never died.

Modern scientific ability has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical world have proved alarmingly unprepared for it.
— Being Mortal: Medicine and what matters in the end

I don’t think there is such thing as gaining closure around death, but I think there is are things that can be done in the crucial moments of a loss or crisis that will allow for the event to be processed with greater awareness. The truth is, being young and having only considered the life and death cycle from a religious perspective, I did what society expected of me after I left Primary Children’s that night, which was move on as quickly as possible and bury the experience along with his body. Or at least tell a comfortable, more socially accepted version of the story. One in which I didn’t call into question the way the staff approached my case. One in which I didn’t bring to light all the ways both religion and the medical system in my case, would make navigating the death in an integrated and healthy way, more difficult.

While it’s true that westernized medicine allowed my kid to live longer, it’s also true that the pill is what got me pregnant, seeing as I never had regular cycles prior. And religion is what encouraged putting life on hold to settle down at the age of 19, or risk feeling non existent as a woman in the church. I was told had my ex not brought me to the hospital right by our house where i’d have an emergency C section despite having no contractions, as opposed to making the drive to Primary Children’s where I was supposed to deliver, that we both would have died. There are days I wonder if that would have actually been better. Just because the medical model is set up to ensure a heart continues to beat, does that still mean it should? But how can we conclude the medical approach isn’t natural one, even though the system itself will at times, cause more harm than good? These are the questions that came to light, as I witnessed and heard stories of other people’s birth.

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A couple of years into my photography journey, I’d find myself photographing a birth that had been going eight hours, when the physician walked in to state that he thinks they had waited long enough. “I know you’re tired of pushing, and honestly this is frustrating for everyone involved,” he said. Her being in labor that was taking a few hours is frustrating for everyone involved? I kept my thoughts to myself. He suggested a c section and things moved quickly after that. I left the hospital with some feelings of inner turmoil, but with a lot of curiosity too.

One day he told me that he’d spent his adulthood trying to let go of his past, and he remarked how ironic it was that he had to get closer to it in order to let it go.
— Bessel A. Van Der Kolk, The Body Keeps the Score

Toward the end of the EMT course, we’d have a lecture on how to confront parents who lose infants under their own roof. And while the discussion was making me nauseous, I couldn’t get out of my head how different losing a baby in the controlled setting of the hospital would be as opposed to within the comfort of your home.

“You’ll never forget the screams.” A few of my instructors had said. I remember wondering if maybe we should be more disturbed by the silence that is promoted in medical settings. Screaming is a way to move energy up through the body when something as natural as death takes place. It is a way of giving the nervous system the chance to process the loss it’s about to endure. It’s the most important and natural response to finding that your world is about to change forever. I thought about how much I resisted coming undone during the stress of the ultrasounds that went back and forth between good and devastating news, and in the few days we sat with him in that dark room where he would open his eyes and look around the room for the first and last time. How much the eery silence of that time period still haunts me. I think about what it was like to look closely at the incision on his back when I bathed him, and to wonder why anyone was confused that he seemed to be brain dead in the first couple of days he spent alone in an incubator.

All that time, I never gave into the reaction my body was asking for. Partially from feeling drowsy from medication, and also because I was young and had no idea what to ask for or that I was allowed to ask. Growing up in the mormon church, I had become an expert at staying quiet and not asking the difficult questions. And so that night, with nobody but my ex next to me after what had felt like nothing but weeks of heavy tension between family and ourselves, I let the tears fall as silently as I could. I remained frozen and unsure, as I let the itchy wool blanket that held his body act as a barrier between us, not knowing I would regret for the rest of my life not removing it as soon as I got the chance. It turns out, the moments of silence that shouldn’t be silent, build up. And I think we often label the build up as “depression” and “anxiety”. Because maybe that means we don’t have to be accountable for the answers we don’t have or the truths we aren’t telling.

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Following his death, I gave into the idea that the next step needed to be getting his body into a coffin and into the ground as soon as possible. I had no idea i’d get divorced a year later. I had no idea i’d hear other parents experiences, and realized how much I didn’t know about my own case and have no physicians or paperwork to reference. I had no idea, i’d leave behind the religion that had been my primary coping mechanism.

All of these things were going to ask me to tap into a part of myself I hadn’t met before. And while my way out of religion led me to exploring spirituality through art, yoga and other holistic practices, it wouldn’t be enough. There was something else being asked of me too.

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A couple years ago I attended an art workshop in Yosemite, California.

It was called Yeah Field Trip, and if you were looking for the best and the brightest, the weirdos, the change makers, this was it. It was multi-media focused and all the presenters had a bunch of instagram followers or whatever.

It was a little white washed and a little less intersectional than I would have hoped an art retreat would be. But there were a few presentations that were revolutionary and expanded my mind to a way of being that I hadn’t considered. One in which career and hobbies are just ways to build on what makes you different. Which is how your life becomes the art.

A presenter that stood out was an underwater photographer who had been a nurse in the Air Force for 10 years. Hearing her story made me feel understood in a way I hadn’t felt in the creative realm. And it wasn’t just because of the moment she realized water held a spiritual space not often portrayed in photos. It was her stories as a nurse and how it eventually led her to the water and to film that stood out to me. How medicine and the survival realm was where she felt called until she began to explore the themes she had witnessed during the time she spent at people’s bedside. I didn’t have a language for what I was experiencing at that season of my life, but it would start to become clear: I was experiencing PTSD. And as long as I let fear dominate my course of action, I would remain in survival mode myself.

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I didn’t know what kind of action I should take, but I thought the first step would be to consider taking medication to treat depression. My psychiatrist was a little quirky, and based on the books that filled her shelf, she was into both new age ideas and claims backed by science. She was exactly what I needed. She explained what the medical model has now identified as being religious trauma syndrome. That it causes brain damage when you’re programmed to think within one paradigm or risk shame and isolation. That it doesn’t allow the nueropathways to develop and resilience needed to expand past that one way of thinking. So when you leave the religion as an adult, there’s a gap in how to self actualize. You don’t realize how much your sense of worth was wrapped up in approval, recognition, and being “good”. You never learned to trust yourself, and when religion was your only coping mechanism and a large part of how you navigated grief, walking away from that and the community it offered, requires that you not only start the process from scratch, but that you do it alone. I would continue to study trauma and would learn that one of the biggest indicators in a person developing resiliency following a crisis, is having access to a community that doesn’t find your experience foreign, and feeling involved and helpful in a way that is directly related to what you went through. It’s why while being in an EMT course was uncomfortable, it was also a relief too. The reality of death wasn’t something I would have to pretend didn’t exist anymore.

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In another effort to do things differently, I decided on a whim to spend Christmas in Peru. I ended up getting the chance to learn about different plants and their impact on the mind and consciousness, while running around the Amazon with an Oregon native, plant doctor, spiritual guru named Anderon. To quote him “if you let yourself exist too much in your head when you’re in the Jungle, you’ll be dead.” And I think that describes existing in the world with depression too. Spending time in the amazon taught me a lot of things I already knew but didn’t know that I knew. That our minds are a source of suffering. That they aren’t as reliable as we have believed. That reality vs what is going on in our heads can be two completely different things. That living will feel more like a privilege when we stop trying to make our existence as small and as common as possible. The endless insects and sweat and heat of the amazon reminded me that while the journey to “recreate yourself” is a popular phrase, you should be prepared to feel mostly terrified. When dysfunction is what you know, elevating from those patterns looks a lot less like a smooth float upward and more like heading straight to the ground in surrender. 

But the thing about ground level is that while it won’t make anyone envious of you, it is where the truth becomes most clear. It will show you that when things get dark, it’s not necessarily because the world is dark. It’s because you are being asked to call everything you know into question. The ground level is where you begin.

“You can’t complain about the bugs and animal sounds,” Anderon would say as we made the long muddy trek through jungle terrain, “We’re in their territory now”. And watching a six foot snake cross the trail in front of us, showed me how much the lack of physical threats in our environment has disconnected us from our survival wiring. Being surrounded by blood, shit, and tears at the U’s ER reminds me of when I first met Anderon on the flight to Lima and I told him my plan for my time in Peru. “People reject the human in themselves” he said while he talked shit on any kind of tourism I was planning on doing while I was there. “We all act like we’re hot shit. As if the earth doesn’t know. As if the earth can’t take us at any moment.” Followed by a ramble about how paying for tour guides is a huge waste of money and styrofoam and plastic are destroying the planet.

While it sounds a little extreme, Anderon’s comfort with his own mortality, and being in the survival mode of the amazon, showed me how much we have come to believe that crisis or loss are a disadvantage to the human psyche.

Because if you consider a full and worthy life to be one where you mark everything off your to do list, then they are a disadvantage. Something like coming face to face with death, wether it’s your own or someone you love, will throw your entire world into chaos and make you ask questions you never thought you would ask. Becoming a patient on the table, reliant on others to try and bring you back to what you were before, can feel like a step backwards. But it’s also a step toward the version of you that remains untouched by crisis. A step toward your own resilience, and to who we were since before you can remember. Confronting life’s impermanence will force you to live intentionally. And as you have no choice but to prioritize your health, you’ll care more about the health of the earth you’re surrounded by too. Through the process, you will see more clearly the version of you that you have yet to live out.

In that way, there is no greater advantage.

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Anderon and a couple other travelers and I spent Christmas Day in the river, about an hour into the jungle. I didn’t have any experiences in Tarapoto, Peru you couldn’t have in your own backyard if you explored enough, but that was only if that backyard didn’t include being surrounded by so much of your past.

I needed two things over the holidays: to be abroad, and to be in the part of the world that humans hadn’t destroyed yet. And as I stared into river and watched the colors take on a life of their own, I thought about what nature has to teach us about grief. I thought about how the opposite of depression isn’t happiness, it’s vitality. The will to live, so that when death knocks, you can live a better death, knowing you explored fully the questions that presented themselves in your time. In order to do that, I knew I needed to be well enough to take risk. To tell better stories than we’ve been conditioned to tell. To both take life seriously, and take none of it seriously. I used to think there was nothing beautiful or inspiring about crafting a life narrative around the experiences that caused your scars. I used to resist the times of my life when pulling back layers on what it was like to bury a baby or leave a marriage and religion and only way of life I had know, felt relevant. But I think that a life of contradiction is the one that is most true. And the questions, “Who am I outside of this?” and “Who am I because of this?” are a paradox that will stay relevant no matter what the next phase of life includes.

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We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?
— Being Mortal: Medicine and What Matters in the End

Working nightshifts in the ER allowed the reality of that grief exist somewhere other then my mind, which is something no amount of yoga, meditation or other holistic remedies would ever be able to provide. It allowed an opportunity to fill the holes of what was happening from a practitioner’s standpoint during my experience at Primary Childrens, and it helped me see that the ways our society is conditioned to handle death and loss is a reality that isolates many.

I can go into greater detail on how we can help support people who lose loved ones, but I didn’t know that what would be more productive, is to consider how we can support the medical staff who are going to be the primary face for patient’s experiences. Having worked along side the practitioners providing aide to patients, I can say that most people are doing their very best. And they are tired. I think empathy is a word often used to describe how practitioners should approach patients. But I don’t think that’s the most important word. Empathy is draining from both sides. People need to be empowered and a lot of that can come from patients knowing how to educate themselves on what to ask for and being willing to step into the role and power that comes from knowing in the end, you are always your own physician. Practitioners can try and look people in the eyes more. Hear what they aren’t saying. It’s hard.

But I couldn’t have anticipated that being around crisis and shock would end up making the abstract and softer version of life appealing again. It turns out when you have a checklist of things to perform and a lot of mindless tasks in an environment where survival is the loudest, it allows the innovative side of you to resurface. And the small joys become joys again. And while being open to those joys are what initially caused the suffering, remaining open is where you’ll find the answers to the questions that you were previously drowning in. In a way, the baby I buried is bringing a fullness to life I didn’t know before.

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I’m back at the coffee shop again, laptop open this time. It’s been nearly eight months since I’ve been working in the ER, and I’ve started feeling less afraid of stepping into the next phase.

“Don’t run from your monsters” it reads, “I hear they can heal you.”

“Don’t run from your monsters” I write in my notes,

“I hear they can free you.”

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The concept of “letting go of the past” is kind of a bullshit one. If there’s anything i’ve learned about trauma, whether it’s sharp and severe, or subtle over time, you learn to live with it not by cute quotes or stories about an after life, but by making space for it to reveal itself slowly. By making the paradoxes a vital part of the conversation. Healing and thriving isn’t some destination you reach. It comes from a lot of experimentation and in the mess, you’ll see that the alternate reality in which the tiny boy of yours lived and the whole experience didn’t rob you of some of your younger years, would have always included having a bit of a veil over your eyes. One that hides the uncomfortable truths, but it hides the most beautiful ones too. And once that veil is removed, you don’t have to hide anymore.

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And as far as that anchor that you believed was ripped out from beneath you all those years ago, you’ll soon discover was never the solid foundation you thought it was. The only anchor you’d need would be there each time you surrendered to the reality that was in front of you. Every time you told the story that was true and not the one you felt like you should. You’d find an anchor in that, and you’d find an anchor in the stories of others that were doing the same. And all those stories would show you one thing: your past might feel diverse, but your pain isn’t. There are parts of the world ready and waiting for you to stop believing you’re isolated, and to join the conversation. To bring the complexity of it with you, because you might discover it’s not that complex after all. The mind just gets a little dark sometimes. You’ve got to bring the truth out into the air and turn your face toward the sun. You’re right where you were always going to be.

 
 

Portraiture by Ashley Thalman Photography

Portrait of Jon Gabriel by Now They Lay Me Down to Sleep

Everything else, my own.