Next Steps 

December 2020

 Graduation is looming, years of preperation and hard work done.  Now the real work begins.  But what does that look like after you graduate from a Nurse Practitioner program?

 

 

Photographic Memories, 2019

I look at photos often. Sinking into a memory can be an emotional roulette of sorts. I see more than the single moment captured. Like a song, each photo brings with it the before and after. I cannot separate the photo from those book ends. The girl in this photo is so young. She is smiling-of course. She was taught young to not make a fuss, to smile like a good girl. Her eyes are closed, perhaps to block out a little of the embarrassment she feels at being the center of attention in a busy restaurant on Christmas Eve. It could be she is embarrassed about the fuss around her birthday or was it the attention of the classmate who happened to be sitting one table away, changed with time but familiar around the edges. High school was four years past and that was where she wanted it to stay- over. His face, watching as they sang “Happy Birthday” in front of 200 strangers made her stomach hurt but good girls smiled. Always.

I look at this girl, who in four short years had seen devastating heartbreak and violence and am filled with both sadness and a fierce pride. She is on the cusp of a new and beautiful life of healing and joy, but she didn’t know this yet. I wish I could whisper to her now, let her in on the secret that not all love hurts and not all damage is damaging forever. I wish I could tell her that I know she is alone among those who should know her the best. They will never share those secrets she keeps but that will be ok. Others will share them gracefully. I could tell her not one bit of that matters now, but I know her. I know it mattered then. Appearances mattered.

            I wish I could lean in quietly, whisper above the small pearled earing, pitch my voice just above the holiday din; and tell her that scar tissue makes a beautiful teacher.  I would tell her that her broken heart will not only heal but it will bloom and grow into a heart capable of holding space for others who are broken and hurting. She will leave this snap of time shortly, leave the mixing of perfume and candles, bourbon and steak; and step into the winter night. The air will feel cleansing, the anonymity of the street comforting. She will move through the next few months of life as she always does, doing what should be done until one night, when the dark cold takes on personality.  Everything will change the night death comes to wake her and set her on the road of life building.

I couldn’t have known that Christmas Eve that destiny has a maudlin sense of humor. Life changing moments hardly seem that at the time. I had been so sure I was broken beyond saving, that I had nothing to give anyone. I was destined to be mediocre at best. But time had more to teach. In that photo I was toeing up to the start line for the rest of my life. A little more than a month later I would find myself in another moment in time, no photo to capture the shift except the one imprinted in my brain. That night had been filled with routine with only ordinary motions and then time stopped.  When time began again everything was different in a million little and unmentionable ways. 

He had been walking home in the early February darkness. The black hoodie and jeans hid his tall, lanky body in the early northeast morning.  He was struck at 55 miles an hour, in the freezing dark.  His head hit the top of the sedan’s windshield, his face the glass and his legs the bumper. He shouldn’t have lived but he did. For better or worse, he lived through that night.  The actions taken by my EMS team that night was part of the 0.1%, a tiny slice of time when prehospital care made a life-or-death difference. This man lived because of us, because of me and my training. That night was a conjunction of time and space, when training met instinct, uncertainty of trauma met steely determination. It was the night a “nice girl” became a determined woman.

I look back to that moment. In our family we call it “Route 2.” My now husband had been senior medic on that call and witnessed the change that came over me that night.

“That was the night you were ready to move on,” he often tells me and anyone else who will listen, “You called the shots that night, stood up and took charge, you stopped being a good girl became a leader.”

Twenty-four years, four children, 23 years of marriage and a year from my FNP I look back to that photo as when my paradigm shifted irrevocably. It wasn’t an earthquake in the status quo of my thinking, more of a small and insidious crack that slowly loosened old programming.

Why does a woman being a “good girl” still have a place in our society? What does this mean for the profession of nursing and medicine? Can we be effective practitioners if we are first concerned with being liked? The girl in the photo wanted nothing more than to be referred to as good, dependable and nice. This woman is concerned with different adjectives. Compassionate has replaced nice. Competent and effective has replaced dependable. Morally sound and consistent has replaced good.

I was recently struck by a comment on social media about a female politician. “She just isn’t likeable,” said a political commentator. I was struck by this comment. We don’t hear about “likability” being an issue for men. Politicians don’t say someone is unelectable due to a lack of likeability. In healthcare, we don’t say men aren’t likable. We say they have a poor bedside manner quickly followed by “but I don’t care because he is a good provider.”  We don’t tend to label male providers difficult or opinionated when they disagree with one another. We call them strong, educated, confident. At worst a male provider may be called arrogant. Women providers are seen through a less positive lens when they exhibit the same qualities of confidence and assertive discussion. Why?  

As women, providers must work against old, long entrenched, expectations still shared by colleagues and patients. Be a lady. Smile. Don’t make a fuss. Look nice. Speak softly. We cannot serve our patients if we are constantly preoccupied with being likable. How do we function within a theatre that still expects, perhaps subconsciously, that we women providers give competent care while not rocking to boat? We can’t. We must be unafraid of who we were and proud of who we are now. I am lucky.  My training allowed me to work with providers of all genders who empowered me, mentored leadership, humility and encouraged my journey. Times are changing and I can be a part of that change for those who come next.

I can’t undo the programming for that girl in the photo. She is in the past, frozen forever at 22, smiling and stuck in so many ways I can’t change. But I am not her now. I have learned to balance assertive with respectful. I have learned to care less about likability and more about competence, effectiveness, compassion, and endurance. To make big decisions with patients about health care one needs confidence and humility of equal proportions. I can’t claim to be an authority on what it takes to be a recovered “nice girl.” I will be forever learning how to navigate roads laid by outdated paradigms of our world.  Yet I know I am eons away from that girl in the photo. I am not her and she is not me. She is the core of who I am, a germinal center locked in time. I wouldn’t be me without her.  I often wish I could let her in on the conspiracy- you don’t have to be a "good girl" to strive towards doing great things.  

 

 

Payback

By Rebecca M Holdsworth

As published in The Kid Turned Out Fine: Moms Fess Up About Cartoons, Candy, And What It Really Takes to Be a Good Parent (Paperback)
by Paula Ford-Martin (Editor)Adams Media Corporation (April 30, 2006) Language: English ISBN-10: 1593375174 ISBN-13: 978-1593375171

I have just come to a rather startling and self-effacing conclusion: I was a much better parent before I had children. Over the past five years I have traveled the twisting and turning road of parenthood and the reality of raising four young children is far different than my preconceived notions of what real parenting should be.

When I began thinking about having children I did what I imagine many potential parents do: I stopped; I took a good look around me; And I blasted every perceived slip-up of every parent I saw. Leaving my house was no longer the innocent journey it once had been. I was watching and my mental checklist was working overtime.

Restaurants and shopping malls became my hunting ground. See that mom with the screaming two-year-old in the men’s section of the department store? That will not be me. If my child ever behaves that way I will pick him up immediately and march his little screaming self to the car. All of my shopping would have to wait. I will show my child who’s the boss! Me.

Then there was that “monster” in my favorite restaurant. The one over at a table in the corner. There she was, screeching that she “wasn’t going to eat that!” Then she crawled underneath the table not to be hauled out again until the check was signed and the tip left. NO, no. My husband and I would tsk tsk, shake our heads and say, “Oh No”. Our children will eat what they are given. They will behave as proper ladies and gentlemen. They will use their utensils, speak in a properly modulated voice and always say “please” and “thank you.” Our children will behave properly.

The problem with today’s children as I saw it was a lack of manners and respect. I saw this as a direct result of the “I’m ok, you’re OK” parenting style so popular with some of my parent’s generation.

I remember it something like this:

“Oh no. Our little one is not behaving badly by hitting little Bobby. He is simply trying to express his natural athletic ability and don’t you think we should find a suitable outlet-like boxing?”

Bah! That was all a bunch of malarkey, pure lazy parenting on their part. Or so I thought. Did you ever hear the old adage about walking in another’s shoes? Or, how about the one about throwing stones in glass houses? Well honey, stand back because the stones are flying and the walls are comin’ down!

What I didn’t realize during those years of sticking my nose in the air and damming the bedraggled parenting masses was someone was listening. Someone was up there with a notebook and pencil chuckling to himself as he recorded each time I swore my child wouldn’t behave that way. And boy did I get my just due for all that pre-parenting smugness.

Do you remember that poor mother in the men’s department store stoically pushing her screaming toddler up and down the aisles of modern fashion? What I didn’t realize between the wails for candy and shushes from mom was if she came home without socks for her husband, she would have to tell him why he was missing all twelve pair of work socks and why his sock drawer still held a residual smell of diaper cream. I know this because that was me. And right after the socks mommy had to buy more diaper cream- and put it up higher this time-away from curious hands.

Remember that lovely couple with the child in the restaurant screeching about her meal? What I couldn’t possibly have known while I was calmly munching on my appetizers and sipping on a cool glass of Chardonnay was this family hadn’t been out of the house in what seemed like forever. Only their acute and unrelenting desire to eat somewhere where the meals didn’t come in a folding paper box with a prize at the bottom drove them to take such desperate measures. This was how they found themselves sitting in an elegant seafood restaurant with a little tyrant masquerading as their lovely and gracious three-year-old.

What I didn’t hear while I was enjoying light conversation about the state of the economy and our upcoming jaunt to the shore was that said three-year-old swearing she would be good if she could just have a lobster like Mommy and Daddy. Only too eager for a quiet dinner, the parents took the bait. As the waitress set the glorious steaming delicacy under her little upturned nose the precious little angel began to shriek “I’m not eating that bug!” in a voice loud enough to rattle the windows. I know this because that was me and I was the one wanting to duck under the table and come out only after the meal was over.

It was also me who, while sitting in another restaurant talking to a friend while our children ate, heard a ripple of laughter pass through the dining room. I looked around to see what joke I was missing only to see my sweet and delicate daughter sitting demurely by with two french-fries jammed up her nose. The joke was on me.

It was me who stood watching in the mall as my child threw herself onto the floor kicking and screaming after being denied another ice cream cone. It was me waiting in line at the upscale boutique while my little girl stood in the display window gaily waving and dancing for all the shoppers as they passed by. It was also me who turned to my friend and announced loudly so the cashier could hear “Will you go and get your daughter!”

I think it is much too easy for those who don’t have children to turn their noses up at those who do and add to their mental list of what kind of parent they will or will not be in the future.

As for all of those things my husband and I swore we would or would not do? We have dragged the occasional child out of a mall for bad behavior but that was usually after the major purchase had been made and all bribery with lollipops had failed. Let’s face it. How often can you find the time to even get to the store much less find an opportunity to go again? Where food is concerned, we do insist our children try everything but you do have to admit a lobster “in-the-rough” does look an awful lot like huge insect. A girlfriend of mine recently confided she is frequently seen roaming the aisles of her local grocery store trying to sing to herself loudly enough to drown out the sound of her screaming toddler.

Parenting is a challenge. It is a joy, but it is a challenge. My husband likes to repeat the adage, “The first casualty of combat is the plan.” In other words, nothing ever goes completely to plan-not even parenting. Especially not parenting. You can dream and wish and plan how you as a parent will handle your future brood but until you are there in the trenches you will never be sure. After all a family is the meshing of many different personalities in many different situations. Take two parents, one child, seven days in a week, fifty-two weeks in a year- (you can see where I am going with this)- and the possibilities are endless.

I am not saying parenting should be likened to a battle although some days it sure feels like one. It is actually the opposite. In my case, being an effective parent is more about not fighting. It is about choosing when and where and why I want to “fight” and when to retreat.

I was a much better parent before I had children. Then it was very simple. It was black and white. Yes and no. Then again, maybe it wasn’t. Maybe now that I am a parent I have changed my definitions of what a good parent is. I know now it isn’t about appearances. They are going to scream. They are going to embarrass you. They are going to stick french-fries up their nose. They are going to be…well, kids. The trick for us as adults is to remember if it isn’t fatal it isn’t, well, fatal. We need to remember to cut ourselves a break once in a while. These kinds of things are what being a child and a parent all are about. It doesn’t make us bad parents and it doesn’t mean we have failed to be the parent we thought we would be. Here the greatest tool we have in our parenting bag is a sense of humor.

As for all of you out there who are not yet convinced of the potent karmic nature of parenting I have one last note of caution. As all of you sit watching all of us floundering in the murky waters of parenthood; cut us (and your future selves) a break. Remember. When ever you feel a bout of judgment coming on as you witness some poor soul and his half-pint charges navigating through the mall or your favorite restaurant, be careful. Any judgment you make may prove to come back to you in time- threefold. Remember: Someone is listening. He is taking notes and He has a sense of humor too.

This article can be found here: https://books.google.com/books?id=Gv7sDQAAQBAJ&pg=PT43&lpg=PT43&dq=payback+paula-ford+martin&source=bl&ots=ubGXE6pXH1&sig=ACfU3U1sfDRPqt-j8nlNB0fRoFbFxGIuMA&hl=en&sa=X&ved=2ahUKEwiUppTB3e_yAhXyUjUKHbubDWsQ6AF6BAgeEAM#v=onepage&q=payback%20paula-ford%20martin&f=false

But this book : The Kid Turned Out Fine, edited by Paula Ford-Martin here: https://www.amazon.com/Kid-Turned-Out-Fine-Cartoons-ebook/dp/B005GIRNOC/ref=sr_1_2?dchild=1&keywords=the+kid+turned+out+fine&qid=1631116398&sr=8-2

 

Originally published in the Life At Home section of The Boston Globe

July 18, 2002 –modified from its original form

 

CONFESSIONS OF AN IMPERFECT MOM 

 

By, Rebecca Holdsworth

 

I have been dealt a mortal blow. I have been insulted so completely that it has shaken my entire idea of who I am and who I strive to be. What, may you ask, could be so earth shattering?  It was, in a word, perfection.

 

A friend of 10 years, one who I thought I knew so well and, more importantly, knew me, one who went through my darkest hours of college angst with me and yet our friendship still resurfaced on the other side, called me the worst name any mother can call another: perfect.

 

Perfect: an adjective. "Without defect or omission," according to Webster's. "In a condition of complete excellence."

 

As in: "You are the perfect mother. I can never hope to attain your level of perfection in the parenting of my child."

 

Pardon? Me? Are we talking about me? I let out an indignant "I am not!" and proceeded on a 20-minute tirade on just how horrible a mother I really am.

 

After hanging up with her, I called a good friend. She was a true friend, a dear friend, a realistic, down-to-earth, tell-it-like-it-is friend.  I told her my greatest insult: I was thought to be the perfect mother, cringing as the word came out of my mouth.

There was a bit of silence but that didn't worry me. It takes time for a good, true, honest friend to find a tactful way of saying, "You stink as a mom." I waited eagerly for those words.

 

"Well," she began, "you are kind of the Martha Stewart of parenting."

 

I was dumbstruck. I was aghast. I was horrified. So what if my curtains match my couch? So what if I have knickknacks artfully arranged over my kitchen cabinets? Who cares if my children's rooms are themed and there just so happen to be a few fresh herbs tucked in between the plants in my window boxes? That isn't what makes me a good parent!

 

"Hey! Don't get me wrong," she continued. "I've seen you lose your cool. I know what you look like after a full day of the Ringling Brothers and Three under Three Circus. But you seem to pull it off so effortlessly." She apologized for making me feel worse and said she had to go. "I have to wash off my kids and hose down the office wall now. Too much alone time and a little blue paint has gotten way out of control."

 

Perfect. Why does the idea of being seen as a perfect parent seem like such an abhorrent thing? Is it because the simple nature of perfection raises the bar and makes it that much harder on the next one in line? I don't want the responsibility of being a parental yardstick. I don't want to be the reason someone else feels lousy. I don't want to be different. I want to be down in the trenches with the rest of the parents, complaining about diapers and hunger strikes and potty training gone wrong. I want to be one of the gang.

 

Here is the thing: I am one of the gang. I am not perfect, a long way from it. I lose my temper and a stray four-letter word is repeated gleefully at the next family dinner. I have realized my kids have gone a week without a bath; and their brown color isn't from a lack of sunscreen at the beach yesterday. I have left a diaper on so long as to necessitate a life preserver for the wearer and a shampoo for the carpet. I'm not perfect and I don't want to be.

 

Ask any parent about perfection and you'll hear something like, "Honey, I gave that up years ago. I'll settle for convincing my kid to eat something other than corn flakes."

 

I tell people I am not saving for college but for the therapy they will surely need after 18 years with me as their perfect mom.

 

THE ESSAY

Rebecca Holdsworth writes in Shirley.

Copyright (c) 2002 Globe Newspaper Company

Record Number: 0207180034