On mountains and miscarriage: a physician’s story of loss

I feel the mountain in my bones. The methodical plodding of feet over uneven terrain, a meditation, the grace of a single forward path, with no decisions, no guilt or what-ifs, no fear. Just forward movement, forward momentum. I hear Mary Oliver’s words at my core: “I don’t know exactly what a prayer is. I do know how to pay attention … how to be idle and blessed.” It’s taken me years to get to blessed. Idleness is something I’m still working on.

My third miscarriage came a week before a scheduled trip to Kauai. What had been a “last hoorah” between finishing residency and beginning my “real job” as a faculty physician in Minneapolis became an opportunity for reflection, meditation, deep grief, and healing. We’d made it to our 12-week nuchal translucency scan — a minor miracle in itself! — only to be told that this embryo, this ball of cells that was brought into and left the world in a whirlwind of love was, too, gone.

I remember the sense of dissociation, of asking my partner over and over “Is this a bad dream? Are we dreaming?” His rare and silent tears told me otherwise. I’d spent the prior year in a spiral of dark grief after losing our first two pregnancies. It was not a place I would willingly step back into. And so, I went to Kauai. And I hiked her majestic trails. I kept going. I stayed on my path, the metronome of my steps a balm for that which ached and throbbed inside my chest.

I wonder if my magnetism towards mountains stems from my Capricorn nature, the particular cocktail of stardust from which I am made. I have a mountain goat-like predilection for climbing, stumbling, and, ultimately, attempting to persevere. I love the mountain’s roughness, its glorious indifference to the waxing and waning of life. When you hike alone — and, really, isn’t that how we all think we move through life? — you dispose of ego. You must. One misstep, overconfidence, unabated eagerness, and the mountain claims you. Hiking through her harshness and beauty requires a humility and gentleness that we don’t often get to express. Like loss.

I like the physicality of the trails. The slight constriction of my lungs and the breathlessness of my ascents mirrors and somehow legitimizes the sharp inhalation, the tightness that I feel when we’re told over and over and over again “I’m sorry … there is no heartbeat.” The quiver of my powerful thighs as I descend ridges is a resounding triumph over their prior impotence, splayed open for ultrasounds, D&Cs, hysteroscopies, and whatever other procedures would come packaged for recurrent pregnancy loss.

As I pass the faces of other hikers, I wonder what their stories are. One never knows until we are brave enough to ask. It’s odd that we hold so tightly to our misery and heartache.

Weeks after we heard the heart-wrenching words, my cervix finally softened and opened. This was an objective fact I had noted in the bathroom that morning before heading north to the Kalalau trail. As a physician, I knew I wasn’t supposed to introduce foreign bodies, including fingers, into the vagina during a miscarriage, lest I increase the chance of infection. Though, like most physicians, I am a terrible patient, convinced I could correctly identify the signs of endometritis and treat myself appropriately. My macabre intrigue of my own internal process rivaled only my gross fascination with the visceral mechanics of heartbreak. Trips to the bathroom became a chance to examine the beloved detritus extruding from my womb. Doctors are strange humans indeed, attempting to differentiate early placental from fetal tissue in the midst of tragedy. How many hikers had I passed this morning who knew a sliver of what I was struggling with? How many lost tears as their bodies lost blood?

Brene Brown notes that stories are simply “data with a soul.” If that’s the case, then my story of loss is one in four women. My stories of (recurrent) loss are one in a hundred. The shared smiles of trail-goers tell me that I’m not alone. Exquisitely, I understand that we never really are.

I take a cool sip of water, wipe my brow, and hoist my water pack onto my chest, then swing it around to snuggle securely between my shoulder blades. It’s the weight of a baby. It’s the weight of my grief. I’m learning to carry it well.

Meredith Bourne is a family physician.

Image credit: Shutterstock.com

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