If You’re Having a Miscarriage, Don’t Expect Walgreen’s Pharmacy to Help You

Last week I mentioned that I am angry all the time these days.  All.  The.  Time.  Today’s outrage comes after a casual perusal of the news.  I just learned that an Arizona woman, after being told by her physician that her body was in the midst of miscarrying her fetus, was given the option of having a surgical procedure, or taking a prescription to expel the no longer developing fetus from her body.  The woman opted for the medication.  Her pharmacist refused to fill the prescription for moral and ethical reasons.

Think about that, ladies.  Since I read about it, I haven’t been able to stop thinking about it.  A woman was informed that her body was rejecting her pregnancy, that her fetus had no heartbeat and had stopped developing.  She would miscarry her pregnancy.  This was what was happening, regardless of anyone’s morals or ethics.  The fetus would never grow into a baby.  It is a brutal loss.

I have had four miscarriages.  One happened very, very early into the pregnancy, before I had even been to the doctor.  The other three were after I was in a doctor’s care, but all during the first trimester.  Those last three miscarriages were discovered during routine ultrasounds, when, just like this Arizona woman, the doctor detected no heartbeat.  I went in, happy and excited, I left wrecked.  Those experiences were devastating to me.

Two of my miscarriages required a D & C, dilation and curettage, a surgical procedure, per my physician.  The last one was allowed to pass through my body naturally.  Miscarriage is something I don’t write about often, but I am often surprised by how many women have experienced one, even when we don’t talk about it.  They are a painful and unacknowledged loss for many.

A day after learning that her pregnancy was not viable, which, by the way, is how the medical folks describe it in their notes, the Arizona woman made the decision to take the medication to enable her body to fully expel the undeveloping fetus.  She went to her local Walgreen’s to pick up her prescription, her seven year old son by her side.  The pharmacist on duty, after asking her if she was pregnant, refused to fill the prescription.  He explained that he was opposed to giving her the medication on ethical grounds.  The woman tried to explain her situation, despite it being none of his damn business, but he still refused.

What in the Handmaid’s Tale is happening here, ladies?

Under Arizona law, a pharmacist can decline to fill prescriptions for moral or ethical objections, but Walgreen’s has stated that if they do so, they are supposed to refer the prescription to another pharmacist on duty.  Walgreen’s has acknowledged that the pharmacist did not follow corporate protocol, as when the Arizona woman requested another pharmacist on duty help her, the man refused, instead saying he could phone the prescription in to another Walgreen’s.

pharmacist

BAH!  Some days I feel like I am going mad.  I hope this makes you angry.  Please tell me this makes you angry.  Ultimately, the woman got her prescription, but at a different pharmacy and on a different day.  The least of it was that she was inconvenienced.  More significant was that her grief and trauma of miscarriage worsened when a man, under legal protection, decided that a woman using a legally prescribed medication, could not miscarry her already non-viable pregnancy using pills he deemed immoral to provide.  It is madness, this America in 2018.

Where does it end?

I don’t know the answer to that question, but I sure as hell know that every day is looking more and more like an America I no longer recognize.  Last week I was griping about the fact that my insurer was bought out by CVS Pharmacy, a corporation that no longer will allow me to have my prescriptions filled at Walgreen’s, my preferred pharmacy.  If I want coverage, I now need to get that at the corporation that owns my insurer.  Today, that bothers me a little less, reading about this man who made life harder for a woman in the midst of a miscarriage, but the truth is that all of it is wrong, and, increasingly, we are just rolling with the punches.

So, yeah.  Another day, another outrage.  I’m getting pretty used to this, and that terrifies me.

__________________________

You can read more about this breaking news story HERE or watch an interview with the Arizona woman HERE.

Moss and Lichen

I stood over my daughter’s open grave and thought to myself, “It will be okay.”  The calm and peace I felt was so ill placed, but undeniable.  I remember thinking that the peace was welcome, but it was tinged with guilt, because what kind of mother experiences peace in that moment?  Sigh, always with the guilt.

Grief is hard and mysterious and layered and nuanced, knowable and unknowable all at once.  It is the ocean of my feelings about motherhood, swallowing the rivers and tributaries of love and fear and tenderness and fatigue and frustration that are commonplace for all mothers.  Grief overshadows everything, all of it, always.

In the early years after Donna died, in those first seasons of grief, I tended to my girl’s grave like I tended to my living child.  I fussed over it, nurtured it, tried to make a home for what would become my girl’s bones.  I planted bulbs, hoping beautiful things would grow from our sorrow.

Allium and hyacinth and daffodils and astilbes and iris.  There was research and nursery visits and awkward conversations with well intentioned folks in dirt covered smocks who didn’t quite know what to say when I told them I wanted to make a garden for my daughter’s grave.  Nothing worked, nothing grew.  Well, that’s not entirely true.  A few feisty allium grew, but the deer made a meal out of them.

Donna’s grave is marked with a slab of limestone that juts out from the earth and rests atop a small ridge.  It had to be rooted deep into the ground to ensure it would not move or topple.  Whatever was used to keep that stone secure did something to the soil around it.  It’s clay-like now, not like other soil or dirt you use to plant, and it doesn’t take kindly to hosting pretty spring blooms.

We chose a natural cemetery for Donna and it’s about 90 minutes from our home.  It was the only green cemetery in Illinois at the time.  I think there are a few others now.  There was no embalming and no concrete vault.  Sometimes I wonder if she is bones yet.  Donna was four when she died and bones is what she knew of death.  When you die, you become bones.  A green burial in a natural setting made sense for Donna.

After a few years, I gave up on the idea of a garden for Donna.  We bring flowers when we visit and leave pumpkins in the fall.  I choose tulips, generally, as deer like tulips.  They are delicious, apparently.  I try and remember to bring a small rake when we visit so I can clear off dead leaves and debris.

We visited on Easter, which seemed fitting, somehow.  He rises, but Donna won’t.  I was mad at myself for forgetting the rake.  I’ll need to get back soon to clear off the winter.  There were lots of dead oak leaves.  Easter Sunday was chilly this year.  It fell on April Fool’s Day.  Jokes on us, though, as there was snow and ice this morning.

Our youngest boy is four, the age Donna was when she died.  He is all about death and dying right now, his natural curiosity about it in high gear.  He was chatty during our visit, touching the limestone slab and walking around Donna’s grave.  My boys are comfortable in cemeteries, which is what happens when your older sister dies of cancer.

At one point, my sweet boy said, “The next time Donna is alive, I will teach her to practice not dying,” then he meandered away, looking at the graves of others he doesn’t know.  I keep thinking about his words, his naive, unknowing solution to something that makes his parents so very sad.  

In those early days after Donna’s death, we would walk around the woods that surrounded her grave and find rocks.  We collected enough that we were able to make a border.  The rocks are satisfying, weighty pieces of granite with smooth contours that fit in the palm of your hand, a few more are jagged limestones.

When we had work done on the front entrance of our home, I rescued two old pieces of manicured limestone that used to flank our front door.  They are cracked in half and felt like a fitting offering for Donna — bringing her a piece of home.  They now sit at the foot of Donna’s grave, one on each side.  We did with stones what we couldn’t do with plants, making a home for Donna’s bones.

The moss and lichen on Donna's gravestone, 4.1.18.
The moss and lichen on Donna’s gravestone, 4.1.18.

Moss grows on a few of those stones now and in these early days of spring, the moss is greening up.  It’s beautiful, really.  Some of the smaller stones have a lot of moss, others none at all, some just tiny little precious explosions of green no bigger than a thumb tack.  I love moss.  When you Google it, you will learn that moss is a flowerless green plant that lacks roots.  It grows in damp and shaded areas.  It is simultaneously ecologically strong and fragile.  You do nothing, and it grows.  It requires nothing from us humans to do its thing.  It just is.  It is beautiful and soft and delicate, like nature’s blanket, like Donna was.

Lichen, I’ve learned, is not a plant at all, but an organism, a living thing.  It is gray or green and crusty.  A bit like paint flakes.  Like the moss, it has made its way onto Donna’s gravestone with no effort or intention from the humans who love and remember her.  There is more there this spring than there was last fall.  The lichen is less comforting to me than the moss, but it is fascinating.

Walt Whitman wrote in Song of Myself, “The smallest sprout shows there is really no death, and if ever there was it led forward life . . .” Those are the words I think of when I see that moss and that lichen, those living things that cling to my girl’s grave.  “All goes onward and outward, nothing collapses, and to die is different from what anyone supposes, and luckier.”

Nothing is as it was before our girl was diagnosed with cancer.  We are a different family, I am a different mother, but here we are, our sorrow existing amongst the moss and the lichen, growing, present, the closest to natural we will ever be.

The Ghosts of Christmas Past

Next week is Christmas.  As the mother of two youngsters, it is supposed to be a joyous, happy time of year.  More realistically, it is supposed to be merely a busy, stressed out time of year.  But, for me, I keep thinking about the last Christmas shared with my father. Cue the tears.  

Technically speaking, I opted out of my Dad’s last Christmas.  It was too painful and I couldn’t bring myself to see him.  I didn’t think I could be there for my boys in the way they deserved if I spent time with my Dad that day.  

Ouch.  It hurts to even type those words.

We would learn a few months after the holidays that the lung cancer that just a few weeks before, he was told, had been successfully treated, well, wasn’t.  Instead his changed mental status, violent, angry outbursts, surly mood, his disheveled appearance, his bitter, angry rants at his children, his insomnia, his paranoia, and his aggressiveness with doctors and nurses were symptoms of his cancer having an epic neurological impact.

It wasn’t dementia or psychosis that we were seeing, though that is what the doctors were treating.  It was a rare side effect of his cancer known as paraneoplastic neurologic syndrome.  Long story short, because of the cancer in his lungs, my father’s immune system went into overdrive, attacking what it considered to be an invader.  It started manufacturing antibodies that leaked into his nervous system, greatly and disturbingly wrecking the last few months of my father’s life.  Sadly, none of this was understood in real time.

Yellow socks indicate a fall risk. I spent a lot of time monitoring the color and circumference of my Dad's often swollen feet and lower legs. This day was a good day.

Instead, my father was bounced between hospital floors for almost two months.  He started on a medical unit, but when he tried to choke a doctor making rounds, he was bounced to the psychiatric unit.  When that setting didn’t work out so well either, he was bounced back to a general med floor where, a CNA told me on the sly, the attending doctor tried to convince my Dad he would have more freedom and independence if he moved to a nursing home for rehab.  No one wanted to claim him.

As someone who has spent over a decade working in healthcare with older adults, I was shocked and at an utter loss.  Our medical systems, even at a place in a major urban setting with a great reputation, had no capacity to treat what ailed my Dad. And, as it turns out, I had less capacity than I thought so, too. 

Worse, save for one neurologist who cleared him for hospice, every single medical professional assigned to him at three separate hospitals had zero curiosity about what was happening with my Dad.  Responses ranged from, “Well, you know he is old.  Dementia is common at this stage of life,” to the repeated suggestion that he was suffering from alcohol abuse that he hid from his children.  My father was a teetotaler that didn’t even like his children to enjoy a glass of wine at a special dinner.  It wasn’t dementia or substance abuse or psychosis, but the docs didn’t know that because they didn’t bother to take a thorough history or connect the dots.   

In between telling me I was a rotten child who betrayed him terribly, my Dad begged and pleaded with me that last Christmas Eve to exercise my power as his health care proxy to have him discharged to family’s care so he could spend Christmas Day with us instead of with the strangers in the in-patient psychiatric unit.  

It wasn’t possible, of course.  My Dad overestimated my powers as his POA.  Sadly, he may have also overestimated my powers as his daughter, too.  The truth is, I couldn’t do it.  After a couple weeks of daily hospital visits, I established a hard line around Christmas.  I opted not to taint that day with the curses and accusations and anger and bitterness of this man I loved dearly who was suddenly and excruciatingly not himself.

The holidays can be hard in the best of times.  Holidays with aging parents can be tricky and unpredictable.  Holidays with hospitalized parents can be downright unbearable.  I think, for the rest of my days, I will be haunted by my Dad’s last Christmas.  The guilt and helplessness I felt is a burden I still carry.  The season evokes those cruel days like a flexing memory muscle.  

May this holiday season find you and the older parents you love in a place of peace and comfort.  May you not be haunted by any Christmases past, present, or future.  And, if, like myself, you are, may you find the strength to cope with your ghosts of Christmas past to enjoy the beauty and love of the day.