Understanding Science Communication: Some Basics

 If you listen to scientists for long, you’ll hear them referring to “the literature” or using terms like “scientific consensus”. “Literature” and “consensus” are fairly common words, but there’s some nuance in the way that scientists use them that can be confusing if you’re not familiar with it. In this post, we’ll define those terms in a way that considers the scientist’s nuance. We’ll also talk about the different forms of scientific literature and briefly discuss the scientific process.

What is “scientific literature”?

Quite broadly (more so than most scientists would define it), scientific literature is anything written about science. However, when scientists use the term, they’re usually referring to a specific subset of scientific literature that includes review articles and original research articles (defined below). So, in order to understand the term “scientific literature” as scientists use it, we’re going to have to define the subsets of that literature. In this section, I’m borrowing heavily from a document created by my colleague, Nathan Mills, that we use to teach our students about the designations of the literature. We can loosely group scientific literature into two categories – primary literature and secondary literature.

Secondary literature

Secondary literature is usually written by a person who did not conduct the original research being communicated. It may or may not undergo the process of peer review (a process I hope to write a whole post on later, but which entails a critical reading by other scientists pre-publication. Publication is largely contingent on the approval of the peer reviewers). Some categories of secondary literature include:

Popular and technical books

These would often fall under the category that I grew up calling “living” books (a term coined, I believe, by the late British educator, Charlotte Mason). These books are engaging, often written by a single author, and capture the excitement of science. Sometimes, they tell the crazy stories of science throughout history, like The Man Who Touched His Own Heart by Rob Dunn. Others try to communicate complex ideas at an accessible level, like Your Inner Fish by Neil Shubin. Some well-known authors of popular science books include Edward O. Wilson, Rachel Carson, Stephen Hawking, Richard Feynman, and many others.

Popular books have the advantage of being really fun to read. They are a great introduction to a broad area of science or to science in general. They are often written by an expert in the field and are intended to interest, excite, and educate the general population. They do not, however, undergo the process of peer review. They are not intended to deeply contribute to the scaffolding used for experimental design, to communicate specific data, or to be used in the process of decision-making by medical personnel or by scientists. I like to read popular books when I want an engaging introduction to an area of science I’m less familiar with.

Textbooks 

Textbooks span the gamut from technical books which are not peer reviewed to edited books, in which individual chapters are peer reviewed. Textbooks are written by a small handful of experts in the field (one to ten-ish), and summarize the current state of the field. These books often contain helpful images and diagrams to communicate complex topics. The goal of textbooks is primarily to summarize our current understanding of certain areas of science and to provide a solid platform for students and those seeking to gain a technical, factual knowledge of specific areas of science.

Textbooks have the advantage of being concise summaries of the state of the field. They often provide an excellent foundational knowledge of the scientific process and of our current knowledge surrounding scientific phenomena. They may communicate and summarize some specific experimental data, but do not often communicate the entire scientific process for the generation and assessment of those data. I teach from textbooks often, and I like to use them as a quick reference to remind myself of specific well-established rules and facts.

Popular magazines

These include Scientific American, Discover, Smithsonian, etc, and their purpose is to summarize recent research that is interesting to a broad population. Articles do not undergo peer review and are often written by a scientific journalist rather than by a scientist.

I really like to read these articles to grab a quick summary of what’s currently being done in many areas of science. Very often, they’ll link to the original published study, so if I’m intrigued by the topic, it’s easy to dig deeper. However, these articles frequently overstate the findings in the articles they summarize, so it’s good to take them with a large grain of salt.

Review articles

Review articles are generally written by a very small number of invited top experts in a specific subset of science, and summarize the current data and theory in that area. Review articles undergo rigorous peer review and are published in peer reviewed journals.

Review articles are an excellent way to get a detailed “lay of the land” for a specific area of science. I just skimmed one the other day summarizing our current understanding of the contributions of calcium ions to mitochondrial function. I heavily utilize review articles when I am delving into an area of science that’s less familiar to me than my own specific area of expertise. Review articles reference a large number of original research articles and serve as a crucial launchpad as I survey the field and select key studies to read as I begin my exploration.

Primary literature

Original research articles

These articles are the “bread and butter” of scientific literature, because theoretical framework, experimental design, and results are communicated by the scientists who conducted the experiments. They are rigorously peer reviewed, and focus on the investigation of a very specific question in a specific subset of science. They typically contain an abstract which briefly summarizes the article, an introductory section which briefly summarizes the field prior to the conducting of the study and sets up the framework for the question addressed by the experiments communicated in the article, a materials and methods section which communicates the research methods used to address the question, a results section which reports the data obtained from the experiments, a discussion section in which the results are interpreted and placed into the larger framework provided in the introduction, and a literature cited section in which any referenced publication is listed with a complete citation.

Reading original research articles is the only way to really dig deeply into the rationale, experimental design, and conclusions surrounding a specific scientific question. All good scientists consult original research articles regularly during the course of their career.

The “downside” to original research articles is that they are written to a specific audience: other research scientists in the same field. To read, understand, and critically and accurately assess an original research article requires practice, dedication, focus, and training. Most lay people will not find original research articles to be accessible and will become bored, confused, and frustrated while reading them.

So, who do I trust?

Many people are currently struggling to decide who to trust when it comes to scientific and medical information. The advent of social media has resulted in ease of access to information, but has also led to information fatigue. It’s helpful if you know a scientist (like yours truly) who can quickly assess a source for you and let you know if it’s a good one or not. I assess original research articles on a one-by-one basis – do their questions make sense given the background they provide? Did they set up appropriate experiments to address their questions? Did they use the appropriate statistical analyses to assess their data? Do the data actually say what the authors say they say?

While a few will have the interest and motivation to develop their ability to read and assess original research, many don’t have time or energy to do so and need to rely on information that comes in the form of secondary scientific literature, often at the level of popular magazines, op-eds, or even blog posts. So, what then? A good rule of thumb if your goal is to make decisions based on the best information available is to follow and read sources that fall in line with current “scientific consensus,” which we’ll address next. It’s certainly ok to read things that challenge current scientific consensus, but following scientific consensus is most likely to put you in line with the best information currently available.

What is “scientific consensus”?

I read a blog post last year that, in an attempt to disparage scientists working on SARS-CoV-2, defined scientific consensus as synonymous with a “vote” or a “popularity contest”. This couldn’t be further from the truth, but it seems to be a relatively popular opinion among non-scientists.

So, if “scientific consensus” isn’t the same thing as a vote or a popularity contest, what is it? Scientific consensus is reached when multiple, independent experiments result in an accumulation of data that consistently support a common conclusion. There’s no governing body of scientists that sits down and calls a vote on whether or not we’re going to adopt a conclusion as fact. When scientists talk about scientific consensus, we mean that a large body of literature exists which supports a given conclusion. The larger the body of literature and the more rigorous the experimentation, the stronger the consensus.

Scientific consensus does not reflect the whole truth of what is happening in the physical or natural world around us. If it did, we wouldn’t need to continue conducting research because we would know everything there is to know about the world in which we live. However, those who wish to challenge scientific consensus should do so with sound experimental evidence. If the challenging hypotheses are correct, they will ultimately be supported by a plurality of well-conducted studies and scientific consensus will shift to reflect updated knowledge.

I know I hit you with a lot of information at once in this blog post. Comment below and ask questions you have about the things in this post or let me know what you’d like to hear about next.

Walking into the Storm: A Traumatic Ending to a Beautiful Life

I’ve been thinking the last few days that I need to tell the story of Jim’s death from start to finish. Mostly for me. Some for those who want to hear it but don’t want to ask.

It was Tuesday evening, July 14. My parents had been here for a long weekend and had left that morning.  We had finished dinner and were getting ready for our evening exercise. I was tired and not really feeling like getting out in the heat. “Which cup are we taking for Susan?” Jim asked.

“What do you mean – which cup?” I replied, impatiently. “There’s only one cup out.”

I apologized for being impatient as we got our children buckled into the car.

We began driving toward Harding’s campus, where we always go for our walk. He drove to the end of the street and turned right. I turned back to check and make sure the garage door was closed, as he always asked me to do. It was. I started reading to him from the gospel of Luke – we were working together reading through the New Testament. “Did you see those buildings being torn down?” he asked.

“Of course I didn’t see the buildings,” I said, exasperated. “I was reading.”

“You’ll have to notice on the way back,” he said, cheerfully. I still haven’t noticed…

When we arrived at our destination, I apologized again. “I really don’t know why I’m so irritable,” I said.

He turned to me and looked me in the eye. “Stacey, I love you. Even when you’re irritable. But, maybe some exercise outdoors will help your state of mind.”

It was our best outdoor exercise since Chris was born. We talked some – I can’t remember what about. At certain points along our walk, he would break off from the kids and me and run an extra jaunt. As we neared the end, we were both so hot and tired, but in good moods. He broke off from me one last time, as I said, “We’ve both got this!”

“We’ll see,” he said.

I finished my route before he did. I ended the workout on my Apple watch and began my cooldown walk around a small parking lot near the larger one where we parked. As I finished that loop, he came running down the sidewalk, his bright blue shirt shining in the evening sun. “Make that loop again,” he said as he crossed the crosswalk and slowed down to begin his cooldown. I did what he asked.

When I turned around to complete the last half of the loop, I saw him laying on the pavement in the bigger parking lot where we’d parked. I thought he’d gotten tired and maybe a little overheated, so I started to walk toward him. As I noticed that he really wasn’t moving, I began to jog. As I got close to him, I began calling his name. No response. I knelt on the ground beside him and shook his shoulder. It was a dead weight. I pushed him onto his back. His head flopped to the side. His jaw was slack. His eyes were open and the pupils fixed. I remembered a story he told about spooking kids in a cemetery by pretending to be dead. “You’d better not be joking with me!” I screamed, as tears flowed from my eyes and I willed my right hand to feel his neck for a pulse. I felt none.

I screamed. I shook him. I cried. A car pulled up. “Is everything ok?” a woman asked.

“I think he’s dead!” I cried.

“Do you know him?”

“He’s my husband!”

“You need to call 911!” she said as she hopped out of the car and came up to me. I fumbled with my phone, finally typing in the numbers.

I don’t remember how many people came running at various times. One man was convinced he felt a weak pulse. Another said, “He’s shaking. He must have a pulse.”

He wasn’t shaking. Not like they thought. His muscles were quivering – much like the hearts I’d seen in ventricular fibrillation during the time I spent in grad school. He really didn’t have a pulse. I knew it. The EMTs verified it when they got there. I watched them do CPR. I watched them shock his heart. I watched him void his stomach on the pavement. I saw my children being pushed by a stranger in their double stroller. I don’t know how much Susan saw.

They couldn’t find the key to our car in his pocket, so someone from the university’s Public Safety office drove me to the hospital behind the ambulance. While on the way, I called my Mom. “I think Jim just died,” I told her through my tears. She told me they’d come. When we arrived at the hospital I jumped out of the car before it stopped moving and tried to run behind his stretcher. I was restrained by a man at the door – told I had to go in through other doors to check in and complete the COVID-19 screening.

I waited in the waiting room, trembling. My friend, Trixie, left her home to come to me. I didn’t think until too late to ask her to bring the key to my house, so she drove back home, retrieved the key, and went to my house to pick up things for my children, who were being cared for by our good friends, Jon and Joyce Wrye. I sent text messages to a few friends and family, letting them know what was going on.

The president of the university came and sat with me. So did Jim’s boss. An EMT came out to tell me that they had been able to restart his heart but that he was still in critical condition. I didn’t realize how critical. I was so relieved.

When the ER doctor came to talk to me, I started to understand the seriousness of Jim’s condition. While his heart was beating on its own, he was showing no signs of brain stem activity. He was on a ventilator. It didn’t look good. She said she wanted to get him cleaned up before I saw him.

When I did see him, I could tell it wasn’t good. I sat by him for a few minutes. I think I talked to him a little. I kissed his forehead and noticed that there was still vomit in his ear. I asked the doctor to be straight with me. She told me that it didn’t look good, that I might consider letting his family know that it didn’t look good.

They were getting ready to move him to CCU, and I was so very tired. I was struggling so much because I wanted him to be ok, I wanted him back, I wanted to be with him, but I wanted desperately to get away. They asked me if I wanted to take his shoes, watch, and wedding ring. I slipped his wedding ring off of his finger and looped it on mine so that I could carry everything. When I got to the waiting room on my way out of the hospital, I slid it the rest of the way on. I still wear it every day.

The CCU nurse called me when they got him settled in. She was so sweet, and remembered him from when he was in the CCU in October following his TIA. She made sure that I knew I could call her directly any time to check in. I tried to sleep some. I checked in a couple of times. His condition was the same. My parents arrived sometime around 3:00 AM.

I was able to sleep a little after my parents arrived, but my phone rang just before 5:00 AM. It was the nurse. “James isn’t responding to medications to raise his blood pressure like we want him to,” she said. “You might want to come back.”

July 15, 2020. It was his birthday. I stood at my closet for what seemed like the longest time. What do you wear to go watch your husband die?

I entered through the ER, where they refused entrance to my mother. I felt the heaviness build as I walked toward the CCU alone. He was laying there, flat on the bed, a machine breathing for him. His blood pressures were so low, even though his heart rate was fast. I sat in a chair and leaned my head on the rail of his bed. I think I spoke to him. I can’t remember. The resident physician came in to explain his condition to me. It didn’t look good at all. In fact, he thought it was possible they’d lose him that morning. I asked him if my mother could be with me. “Of course,” he said. “I’ll tell them that she can come.”

That day was such a long, hard day. I felt so numb. When I was in the hospital with him, I felt like I should be home with my kids. When I was home with my kids, I felt like I should be in the hospital with him. I cried a lot. I sat in the corner of his hospital room for quite a while that morning. I didn’t really want to be right next to him. I felt like he was already gone. I didn’t know what I felt. I was just so lost.

At one point, I noticed that there were lots of medical personnel in the room and that the doctor hadn’t left for quite some time. I glanced at the monitor. Jim’s blood pressure was so very low. Low enough that I knew his vital organs weren’t getting enough blood to sustain life. “This could be it,” I thought, and felt like I’d been shocked awake. Eventually, his pressure rose with the medication that they were administering. They didn’t lose him right then, but something changed for me. I knew he was already gone. I knew I was going to have to make the decision no spouse should ever be asked to make. And, even though I knew all of that, I suddenly wanted to be near him – to touch him, to speak to him. That afternoon, I told my mom that I just wanted to crawl in the bed with him and lay there. The nurse couldn’t let me do that, but she brought a reclining chair for me, pushed it right up next to his bed, and lowered the rail so that I could be as close to him as possible. I lay there for most of the rest of the afternoon and evening, just holding his hand. I had to leave every few hours to go nurse my son. I told Jim I was leaving every time and then told him when I returned. I requested that they go ahead and do an EEG so that I could know whether he had any brain activity.

The next day, his sisters were both in town. We received EEG results. The news I knew we would hear – no detectable brain activity. I wept. I asked how long I had. They told me there was no time frame. The nurse and physicians we had that day and the day before were so wonderful and kind that I wanted them to be the ones to help us through the process of ending life support. We planned the rest of the day to give his sisters, niece, and myself time to say goodbye.

Right before it was time to turn off life support, I had time alone with him. I wept loudly – cries that came from the depths of my soul. I promised him that I’d raise his children well, that they’d know who he was, that I’d finish life’s race well. I told him I couldn’t wait to see him in his heavenly body. I started to sing to him. “When peace like a river attendeth my way…” As I sang the verses to the well-known hymn, I willed my voice to get stronger and stronger. I resolved that, no matter how dark the next days got, it would be well with my soul. I heard his sisters singing along with me on the other side of the curtain.

When his sisters and my mother rejoined me, we waited for the doctor to come oversee the removal of life support. While we waited, I felt an urge to pray aloud. It’s so unlike me to pray aloud spontaneously, but I did it anyway. My voice shook with emotion, but was strong and loud as I reminded God of his promise to walk with us into this storm, of his promise to raise us in the end. I called him to keep his promise. I didn’t feel disrespect. I did feel strength. I remembered the prayers recorded in the Bible – where people of God called Him to account for the promises He had made, and I followed their example. I have struggled to pray since then, but the words for that prayer came so quickly, so readily, so strongly. I’m thankful for that.

We stepped out of the room while they removed the ventilator. A nurse came over to pray with us. While she was praying, I noticed another nurse beckoning me back into his room. I slipped behind the curtain and went to his side. He looked a little more like himself without the ventilator, but he was so bloated that it was easy to see that his body had been failing over the last couple of days. The monitor in the room was off, and I found myself wondering how I would know when it was over. His sisters joined me. We cried and kissed him. Eventually, I just felt so completely empty that I sat down by his side and stared blankly while leaning against his still body. I watched the color drain from his lips. The resident came in and silently listened to his chest and checked his eyes. “Is he gone,” one of Jim’s sisters asked. He nodded.

“Time of death?” I heard myself ask.

“6:24.”

“Thank you.”

I stayed a little while with his body and then allowed my mother to walk me to the waiting room while they bathed him and changed his sheets. The nurse came to get us and I went back into the room. I touched his hand. It was cold. Oh, so cold. I shuddered. I felt like I needed to stay longer, like it was expected of me. But, I just wanted to run away. To go home to my babies. To weep alone in our bed. Finally, I cried, “Mom, I can’t stay. I can’t. I feel like I should, but I just can’t do it.”

Our wonderful nurse led me out of the hospital so that I didn’t have to talk to anyone. No judgment. No questioning. Just support.

The next days were grueling days with a full house. We planned. I selected a casket. I made arrangements. I wept when I was alone or just with my parents. It was the end, but it was only the beginning.

Today, we’re almost three weeks out from his collapse. My story is still unfolding. I don’t know what my grief journey will look like. My brain is doing weird things trying to make sense of the trauma. I’ve set up an appointment with a grief counselor. I’m trying to set up my network so that if I really sink into depression, they’ll know. I’m surrounded by family and friends. I’m overwhelmed by the kindness of strangers. And, even though I still struggle to pray real words, I keep trying. Sometimes, a few of them come. Even without them, I have been so confident that God has walked into this darkness with me.

But now thus says the Lord, he who created you, O Jacob, he who formed you, O Israel: “Fear not, for I have redeemed you; I have called you by name, you are mine. When you pass through the waters I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the Lord your God,  the Holy One of Israel, your Savior. Isaiah 43:1-3a

Our Pandemic Baby: The Birth of Christian James

My pregnancy with him was easy, mostly characterized by mental clarity and the building of good physical and organizational habits. I ate well, exercised well, organized my home well. I felt good. During my third trimester, the SARS-CoV2 virus blossomed in the USA. I began teaching online with less than a week’s notice. My fourteen month-old was home full time. My husband was home full time. We worshiped at home. We struggled, like everyone else, to find toilet paper, yeast, and normal cleaning supplies, but mostly we were not severely affected by the pandemic. I worried that Jim would not be able to be with me when I gave birth, and we briefly considered home birth but ultimately decided to continue with our plan to have our baby in the hospital where we’d had our firstborn.

He was due on Monday, May 18. Sunday evening, just before his due date, I noticed a shift in contractions away from typical Braxton Hicks contractions to more labor-like contractions. Because I had labored for 59 hours with my first, I settled in for the long haul. The contractions continued for the next several days, waking me at night, feeling perhaps a little stronger every day. By Wednesday, I was getting concerned about my mental stamina. I was weary, and what I thought was early labor had pressed into more than 60 hours. I knew we were walking into a holiday weekend, and I knew that my contractions with Susan never did become more regular, even during active labor, so I wanted some guidance about how to proceed if I hadn’t met the classic labor signs that are supposed to be the signal to head to the hospital. “If you think you’ve been laboring for that long, go on to the hospital now,” was the answer we received. We decided to wait until Thursday morning so that Jim, at least, could get a good night’s sleep.

We left home at 9:00AM on Thursday. I cried as I told Susan goodbye. I was so sad thinking that I was leaving her, to return days later and turn her little world upside down. And yet, I was 85 hours into what I would later learn was non-productive prodromal labor instead of true early labor. I was weary. I was ready to bring our new baby into the world.

The labor and delivery unit was very busy when we got there. We had our temperatures taken at the door and had masks handed to us at the L&D check-in counter. We spent no time in a waiting room, but were sent directly to triage. Our triage nurse was kind, encouraging, and calm even though she was extremely busy. I had not made any detectable progress since my OB appointment three days earlier, so she called my OB to confer about my case. They decided to monitor my contractions for an hour and then re-check. Still, no progress. Another call to the OB. Unknown to us, he was in the operating room, so we waited a long time. During that wait, my contractions became harder and started coming regularly – about every 2.5 minutes. I started dilating more quickly. When my OB called back, they decided to admit me. And then, everything slowed down. My contractions became erratic and wimpy.

Before the end of the work day, my OB visited me in my L&D room. He wasn’t on call that night, but he assured me that the on-call OB was good. “It’s up to you,” he said. “If you want us to augment your labor, Dr. Wyatt will deliver you tonight. If you want to labor slowly all night, I’ll deliver you tomorrow. I’ll tell Wyatt it’s your call.” I really love how laid back my OB is about these things. Jim and I talked through our decision. I knew from experience with Susan’s birth that I wasn’t interested in Pitocin unless I also had an epidural. Ultimately, we decided to go for Pitocin with an epidural. Everything was started by 8:20 PM. Based on my previous experience, I expected my labor to still take several hours – in fact, I thought it was quite possible that my regular OB would deliver me in the morning, even with the augmentation.

Three hours later, at 11:34 PM, I had dilated to 8 centimeters, and the nurse was telling me to let her know when I felt like pushing. My epidural was good, but not as effective as the one I had with Susan, so I was feeling some pain with my contractions. As soon as she walked out of the room, I felt the first pushing contraction. “No way,” I thought. I waited for a few minutes before telling her what I felt. Sure enough, I was completely dilated when she checked me at 11:57 PM. Dr. Wyatt was in the OR, so I breathed through contractions as best I could while my nurse got things ready. I told her I thought it might take me a while because I pushed for three hours with Susan. She told me that she was pretty sure it wouldn’t take nearly that long this time. By the time she had everything ready, Dr. Wyatt was there and I was so glad. I don’t think I could have kept from pushing much longer.

My pushing and birth this time was one of the most exhilarating things I’ve ever done. Because my epidural was not as effective as my first, I could feel a lot of what was happening. I loved that. It wasn’t comfortable, but it was so empowering to work with the sensations and to listen to my body. I knew when his head was born, his shoulders, and then there was the relieving squish as the rest of his body was born. I pushed for ten minutes - maybe. I kind of lost track of time. I loved the encouragement I received from the nurses, doctor, and my husband. It was kind of like I had my own team of cheerleaders. They were so enthusiastic, so encouraging.

I heard Jim telling me that Christian James had arrived – we didn’t know his sex until he was born. I cried. I wish I could describe the intensity of emotions in those moments just after birth. I remember the same when my first was born. I was so tired, so happy to be done with that hard work, and so very happy to meet my baby.

Chris, like Susan, was Coombs positive, which put him at high risk for jaundice. I anticipated that this time, so I worked hard on nursing him regularly in the first few hours to encourage him to have bowel movements to clear the bilirubin from his system. Even with my efforts, Chris ended up under UV lights to help his body clear the bilirubin. We stayed an extra day in the hospital. Because of pandemic protocol, no one could come to see us – including our sixteen and a half month-old daughter. We missed her so much.

We brought Chris home on Sunday, May 24. We loved reuniting with our daughter. We enjoyed six more days of my mother’s help and company. Susan had bonded with her so well, and I loved watching their relationship grow. We’re home alone as a family of four now. Jim goes back to work on campus on Monday, and I’ll go to work as the only parent at home during the day during this summer. I admit that being outnumbered by children under two years of age feels overwhelming to me, but I’m excited to see what God does in my heart and character as I learn to parent these two precious people. I’ll be praying lots for His Spirit to dwell in me and produce good fruit.

Birth is exciting. It’s a beautiful blend of beginning and end. The end of the hard work of pregnancy, the beginning of a life outside the womb. I’m thankful for the respite from growing a child in my body. I’m excited to watch Chris’ life unfold. I’m grateful for my sweet little family. May God grant us the wisdom and strength to parent these two children well.

Infants and Going to Church: Why Bother?

As everyone who follows any of my social media accounts knows, I gave birth to a daughter in January this year. I probably over-share, but there are real reasons for that. First, my family all live far away, so social media is helpful for keeping them involved in my daughter’s life. Secondly, I, like many other Millennials, value transparency. Finally, writing for an audience helps me to process life. I organize my thoughts differently when I’m writing for an audience, so private journals have never worked as well for me as a public forum. (And, don’t suggest that I “pretend” that I’m writing for a public forum when I’m journaling privately – I’ve never been good at tricking myself). This past Sunday, I posted on my Instagram and Facebook accounts that I was hoping soon to post about our Sunday routine and why I believe it is worth keeping even though it is so very difficult with a baby.

My husband and I are Christians, and it is from a Christian framework that we set our routine on Sunday. Historically, and, I believe biblically, Sunday is a special day for Christians. It is the day when Jesus defeated death. While the first Christians seemed to gather together far more often than American Christians do, it appears that the first day of the week was special to them – and it is sometimes even referred to as the Lord’s Day. And so, on this day, Christians around the world gather together in community to remember this savior and to worship him together. The times and numbers of gatherings vary from place to place and group of Christians to group of Christians, but they happen every week on Sunday and in the USA take up somewhere between one and three hours of time. Before my daughter was born, I really enjoyed Sunday. I enjoyed listening and learning. I enjoyed meditating on Jesus’ life, death, and resurrection. I enjoyed discussing doctrinal issues with other Christians. My little girl is almost four months old now, and our gathering times interfere with her sleep schedule. She is typically cranky on Sunday, complaining loudly every time the room gets quiet for prayer or meditation. I spend much of the time I used to spend in corporate worship in the nursery with her. It can be discouraging and tiring. Why keep up our Sunday routine when our daughter obviously dislikes it, when she disrupts others who are trying to worship, and when I can no longer fully participate? I admit that I now struggle with the dread of Sunday. Yet, we continue. Why?

We believe that it is right to remember God in a special way once a week.

As Christians, we believe that God has given us everything we have, sacrificing more than we will ever understand because he loves us. When you believe in a God like that, it is just plain right to give honor to him. Not only did he sacrifice for each person; he gave us the gift of community with other Christians – uniting us regardless of any physical difference. It is right for us to join together in praise of this God. Every time we meet together, every time we break the bread of Jesus’ Supper in fellowship with others, we proclaim the importance of Jesus’ life, death, and resurrection to eternal life.

We want to include our daughter in our faith.

Recently, someone asked me why we don’t just let our daughter choose for herself what she will believe. I want it to be clear that we will let her choose for herself. In fact, true Christianity demands that each person choose for him or herself. We don’t intend to force or coerce our daughter into our way of thinking. She is, however, part of our family. The Christian faith is at the core of our marriage, and is therefore at the core of our family. It is our habit to practice our faith in tangible ways which include gathering with other Christians on Sundays. It would be a sorry state of affairs for us to exclude our daughter from that which is important to us just to give ourselves the illusion that she would be a blank slate by the time she’s old enough to decide. She wouldn’t be, by the way. Children never do grow up to be blank slates. Even if we thought it was best to eliminate Christian practice from her growing up years in an effort to enhance her ability to choose, her mind and habits would still be influenced by us and our values. Even if we ceased to be Christians ourselves, we would still have parental influence over her, and our home would provide the foundation for her worldview. That’s just what it means to be part of a family. Christians have often been accused of brainwashing their children. Perhaps some do, but my experience has shown me that most Christian parents are simply doing what any other parents do – including their children in the things that are important to them.

Our daughter is a learning creature.

It’s obvious every day. She watches everything I do, and eventually mimics it. She has recently discovered her voice and is learning how to control it. She makes new sounds daily, almost hourly. She has discovered toys and how to grasp them. Every day, she gets better at it. When I sing to her, I almost wonder if she tries to sing back. Whether it feels like she’s really getting anything out of our Sunday routine or not, our daughter is learning from it. She’s too young yet to understand why we do what we do on Sunday, but she is gradually learning what we do. One day, she’ll understand what “It’s time to be quiet” means. Later, she’ll understand who Jesus is. She may not understand any of it now, but because we continue, she will learn first to be quiet and still, then to be respectful, and ultimately who God is and why we come.

Christian community is not about perfect worship decorum; it’s about community.

Sunday morning worship falls during Susan’s nap time. I try to keep her in the worship service as long as possible, but she inevitably becomes tired – and when she gets tired, she gets loud. I make the trek back up the aisle to the nursery in the back every Sunday at least once. In the nursery, I meet other mothers who are doing the same thing. Sometimes, our interaction is just knowing glances of camaraderie. Sometimes, we converse quietly. Sometimes, we sit in the dim room and nurse our babies in silence. And, we know that we’ll be there again the next week, and the next, and the next, encouraging one another to keep putting one foot in front of the other. Younger women without children often look at our full arms with longing, and being in community with them reminds us how much we yearned for these busy days. Older women whose children are long since gone from home offer their now empty arms to give our full ones a break, and being in community with them reminds us that these days will be survived.

Going “to church” every Sunday is our habit.

Habits are important in successful lives. I may not always think about why I need to brush my teeth in the morning, but I always do – because I have trained myself to do so; it is my habit. I don’t always think about all of the reasons I love my husband before he leaves for work, but I tell him that I love him every day before he walks out of the door – because I have always told him I loved him when he walks out of the door; it is my habit. It is good to know and to think about the why behind what we do, but habits are also good. Especially in times of stress and upheaval, when our minds are preoccupied and distracted, our habits keep us grounded. As Christians, we have developed habits in our relationship with God as well. And, in times of busyness, stress, and distraction, those habits help to stabilize us. Days with an infant are hard. We are constantly adjusting – there is no time for a new normal to emerge before things are changing again. I wake in the middle of the night to feed my daughter. There are never enough hours in the day. So many of my routines are just on auto-pilot because I am too busy and exhausted to think about them. My spiritual habits are important these days. Even on the Sundays when I don’t have the mental capacity to think about all of the why, I still get myself ready, I get my little girl ready, I pack the diaper bag, and we go to church as a family – because that’s what we do on Sunday. I need my habits to keep me going in these days of change and upheaval as a new parent.

We want our daughter to know what it is to be part of Christian community.

Christians aren’t perfect, but, let me tell you, this community is unlike anything I’ve experienced anywhere else. I want that for my daughter. I want her to know what it’s like to have a place to lay her head anywhere in the world because of the bond Jesus makes among his followers. I want her to know what it’s like to have friends to whom she can bare her very soul in a way that I have only known with fellow believers. I want her to see the way people handle suffering when they have the hope that Jesus brings. I want her to know what it’s like to bow her head in tearful prayer with a friend and feel the closeness that comes through praying with another person. I want her to forge friendships while serving others, because friendships formed in service are the closest friendships in the world.

Sunday worship is only one way that we live our faith, but it is an important way. Even though it disrupts her naps; even though I can’t experience it the same way I used to; even though my arms, back, and mind are weary at the end of the day – it is worth it. It brings the blessings I’ve mentioned above, and more that I know I’ve not even thought of yet.

Meeting Susan Elizabeth: A Birth Story

40 Weeks Pregnant

It’s difficult to know where to begin such a story. Do you start with the journey of trying to get pregnant? Do you start with the long wait of pregnancy? Do you start with the days of pre-labor when you’re always wondering if today is the day? Do you just give the facts? Do you share what you were thinking and feeling? The story of Susan Elizabeth begins long before she was conceived, but the story I’m telling today is the story of her birth, the story of the final working wait – the wait called Labor.

Walking the halls in Labor and Delivery

Monday, January 7, 2019 was my due date. I woke, like I had been waking for days, with anticipation but a feeling that she wasn’t coming that day. I was right. She wouldn’t come that day, but what I didn’t know is that I would begin laboring that afternoon – a labor that was to last nearly fifty-nine hours, teaching and humbling me every step of the way. That morning, I suspected that my amniotic fluid had begun to leak, but I decided to wait a little while before calling the doctor. At 2:30 in the afternoon, I woke from a nap to contractions that were different from the Braxton Hicks I had been experiencing. I didn’t realize at the time that they were labor contractions; just that they were different. I called the doctor to let him know that I suspected that my water had broken. He wanted us to go to Labor and Delivery to confirm, so we went that evening. By the time we got to L & D, I was feeling certain that my water had not broken and I was feeling so stupid. As we waited in triage, I wished we hadn’t gone. “I know I’m a first-time Mom,” I kept saying to my mother, “but I don’t want them to think I’m an idiot.” Pretty soon, a knock was followed by the entry of Emma – a cheerful, bubbly, joy of a young nurse. “I’m afraid I’m a false alarm,” I said. She laughed – a wonderful, delightful laugh. I don’t remember what she said next, but whatever it was calmed me. I was at ease with her from that point on. She didn’t think I was an idiot. We had fun guessing the sex of the baby while she hooked me up to the monitors and checked my cervix. She was getting boy vibes, she said. I was 80% effaced and dilated 2-3 centimeters. While in triage, my contractions continued. When Emma returned after determining that my amniotic fluid was not leaking, she said, “It looks like you’re in the early stages of early labor. We might see you again soon, but I’m going to send you home to labor there.” Perfect. I was completely at peace. I was wrong about my water breaking, but I was in labor.

Working through a contraction
while walking the halls

I slept relatively well Monday night, despite trips to the bathroom and contractions that continued through the night. Tuesday morning, I had an OB appointment. After checking me, the doctor asked, “Do you want to guess how far along you are?” I said, “No, I told myself that I couldn’t expect any progress.” I was 90% effaced and had dilated further to 4 cm. I was giddy. I had a feeling I would meet my baby that day. The doctor seemed to think I might meet my baby that day. I labored the rest of the day while shopping at Target, driving home, eating dinner, packing last minute hospital items. Finally, between 10 PM and 11 PM, my contractions got harder and somewhat more regular. We decided to head in to the hospital. They admitted me sometime between midnight and 1 AM on Wednesday morning, even though my contractions were somewhat erratic. It was time to focus on meeting our baby.

Working through a Pitocin-induced
contraction

Shift change at 7:00 AM brought the next nurse who was to be just the perfect person at the perfect time. Dorothy has been working in labor and delivery since 1980. When she arrived, I didn’t like her. She fussed over the state of my pillows, told me to work through contractions differently than I had been, and made me get out of bed and walk the halls. She made me her concoction of cranberry and apple juice, which was perfect and refreshing. As the day went on, I began to like her more and more. I trusted her. She was competent and straightforward, but she was always kind. By noon, I had finished effacing and my cervix had finished coming forward, but I hadn’t dilated beyond 5 centimeters. I agreed to let the doctor break my water. I’ll never forget that sensation. It felt like I was urinating but had no control. The next contraction was harder. “Good,” I thought. “This is going to work. I’m going to get to meet my baby today.”

Dorothy and me

Dorothy made me walk the halls some more after my water had been broken. I had several contractions where I had to stop and lean against my husband before continuing our circuit around Labor and Delivery. When Dorothy checked me again at 3:00 PM, I was maybe 6 centimeters. “Are you ready to really get this going with some Pitocin,” she asked, “or do you want to continue doing what you’re doing?” I was ready to get going. She turned on the Pitocin. The next three hours are a dark cloud in my head. During natural labor, I could mentally prepare myself for the peak of each contraction and surrender to the waves of pain. Not so with Pitocin-induced labor. I remember saying, “There’s no time to prepare!” as they began. I asked once during the dark cloud of contractions for Dorothy’s cranberry-apple juice and she brought it to me. The light coming in the window blinded my eyes and I asked for the shades to be drawn. Eventually, I remember saying, “I cannot do this anymore.” Over, and over, and over again, the contractions seemed to pound against my ability to keep it together. I continued to try, to breathe, to will my legs to relax with each wave, but I was weary. I had been laboring for two days. 

Getting ready to meet our baby

When Dorothy checked me at 5:30 PM, I had only progressed to 7.5 centimeters. That was the end of my control. I cried. I knew the hardest part of labor was still to come, but I couldn’t handle it. I continued to say, “I cannot do this anymore.” Finally, Dorothy said, “Ok. I need you to tell me what you mean by that. Do you want us to do something about the pain? We can do that if you really want it, but you have to be the one to make this decision.” After a few more contractions, I asked for an epidural. Dorothy told me that it would take thirty minutes before I really felt better, but it began to work immediately. Anesthesia gave me the epidural at 6:00 PM. They situated me in bed, and Dorothy asked me if I had felt the contraction I just had. I hadn’t. The fog lifted and I slept.

Pushing

Shift change at 7:00 brought Maggie to us. Dorothy introduced her and spoke well of us. She allowed us to take her picture with me before she left. Maggie was also wonderful. She was calm and reassuring. When she came to check me at 10:00 PM, she said, “You’re complete. That means I’m going to get your room ready for delivery, and we’ll work on pushing. When the baby crowns, we’ll call the doctor.”

Immediately after birth

It was time. I cried. I smiled at my husband. We were going to meet our baby. Maggie rolled me to my back and helped me to get my legs into the stirrups. My mother and I locked eyes and I giggled internally. I had been adamant that I would not be delivering my baby with my legs in stirrups, but there I was, and I didn’t care. By 10:20, Maggie began walking me through the process of pushing with an epidural. She was an excellent, patient teacher. It was a good thing, too, because I pushed for three hours. Emma, the nurse I had seen on Monday night in triage, had requested to be the second nurse for my delivery. As pushing got more difficult, Maggie, Emma, my mother, and my husband cheered me on. 

Pure bliss

Finally, Dr. Hutchinson arrived. I had never met him before, but he was great. He was calm and focused. When he thought I needed an episiotomy, he explained the reason well. I felt like I could trust him, so I consented. Following the episiotomy, I pushed twice more, and her head was born. I heard her begin to cry. I began to cry. Before I knew it, Jim was announcing that we had a baby girl by telling me that Susan Elizabeth had arrived at 1:11 AM on Thursday, January 10, 2019. She was on my chest for a moment while Jim cut the cord. We knew that she had passed meconium during pushing, so NICU nurses were waiting in the room to suction her. They worked quickly, and nine minutes after she was born, I had her with me for over an hour. I admired her hair – she had lots of it. I marveled at her strength – she could lift her head and shoulders off of my chest. I touched her and smelled her. I talked to her and showed her to my husband. We loved her. She nursed for the first time. When I was ready, Maggie took her to weigh and measure her. She weighed 7 pounds 3.5 ounces, and was 19.25 inches long.

Susan Elizabeth

Susan was born with increased risk for jaundice. All babies are at some risk, as their bodies must immediately begin to clear bilirubin, a waste product formed from red blood cell breakdown, and which the mother’s body had cleared for them while they were in utero. Susan’s blood type is A⁺ and mine is O⁺. Because of that mismatch, the lab ran a Coombs test to determine whether our blood had mixed at birth. It had, so some of the antibodies from my blood were attached to her red blood cells, enhancing red blood cell breakdown. In the hospital, her bilirubin levels were monitored closely and were always somewhat high, but not high enough for phototherapy. Bilirubin is cleared in feces, so I was encouraged to feed Susan often so that she would be able to clear as much bilirubin as possible. On Friday, we were discharged from the hospital, as long as we agreed to take her into the clinic on Saturday to have her bilirubin checked one more time. If it had not begun to level off or decrease, she would need to be readmitted to the hospital. I nursed her every two hours and prayed more often. Saturday morning, her bilirubin levels had dropped. We headed home to stay.

Daddy and Susan

Before Susan was born, I was determined to have a natural birth. No interventions. No pain meds. Beautiful, natural childbirth. Nothing about her birth was what I expected. I did not expect to labor for 59 hours. I did not expect to labor with Pitocin. I was determined not to get an epidural. I was adamant about not delivering in stirrups and about not receiving an episiotomy. I was prepared, well prepared really, to manage contractions and birth naturally. Then, as always when I’m holding stubbornly to an ideal, I was humbled. I have no regrets. None. I don’t regret any of the interventions I agreed to. I really think they were the best decisions to be made at the time. My overwhelming emotion is gratitude. Gratitude for Emma, Dorothy, and Maggie. 

Home as a family

Gratitude for God’s gentle chastisement of my pride as each of my ideals were broken down. Gratitude for medical doctors who were willing to work with my ideals but were not afraid to tell me when they thought something else was best. Gratitude for my mother and husband who were unendingly patient and kind during my long labor. Gratitude for my strong, healthy, beautiful daughter. Our story is, in my mind, a beautiful one. All stories that contain difficulty have the potential for beauty if we’ll only look for it.

To the Child I Will Never Hold

My sweet, sweet child,

You were the first. You were in my consciousness for just a few short days last year. Today is the day you were due to be born, but you left us before you even looked human. I never saw you. Your short life taught me so many lessons. When you left, you taught me about grief that comes in unpredictable waves. You taught me how to rejoice with people who had what I wanted. You taught me about the sustaining power of God. You taught me how to surrender my dearest dream and sweetest possession to the Wisdom that ordained the sun to rule the day. It was that last lesson that brought us to name you Micah – “Who is like YHWH?” You are no longer with me, but you remind me every day that I am not like YHWH. My wisdom is not supreme. Everything about you made sense to me, but YHWH knew better. Better for you. Better for my idolatrous soul. You are with the One who loves you better than I ever could.

Today, there is tension in my mind. I wanted you. I want you still. I still mourn your loss and dream of what might have been. Today, there is another baby growing inside me – your little brother or sister. I love and want this baby just as much as I loved and wanted you. I revel in its growing life and dream of what will come. You cannot both be here. Your earthly lives are mutually exclusive. And yet, you are both part of me. You are both so near to my heart. Today, I wish I were meeting you and the sorrow spills over into tears. Today, I rejoice in the growing child in my womb and the joy spills over into tears. I wonder how I can feel both emotions so strongly. How can I feel sorrow for loss and joy for gain, when it seems that one emotion should cancel out the other? I think it is love that makes these tensions possible. Love is capable of wishing you were here and of embracing the new life that is growing in the womb you left behind. You are both my children. I love you both.

I am a mother because of you, Micah. I miss you. I so looked forward to meeting you and watching you grow up. Thank you for teaching me important lessons. Someday, I hope that we’ll meet one another in heaven.

All my love,

Mother

Weeping, Rejoicing, and Generosity

Rejoice with those who rejoice, and weep with those who weep. Romans 12:15

I cut my theological teeth on this verse. Buried in the middle of many beautiful, practical, challenging instructions for how to interact with others, these words have convicted me over and over again. The idea of the last half of the verse is generally well accepted, regardless of religious affiliation. That we ought to weep with those who weep, to side with the oppressed, to reach out in solidarity with those who suffer is undoubtedly an important message that is surging through our world. I’m thankful for it. I dream, like many do, of a world in which oppression ceases, in which kindness and generosity reign, and in which the downtrodden are raised up. I have wept with those who weep; yet, that is only half of the instruction.

I have done much of my own weeping since October 19, 2017 – the day we found out that we had lost our first baby. Many have wept with me, reaching out in solidarity. Some reach out because they have felt the same pain. Others reach out though they have not, yet they weep for my pain. When you lose a baby, there are many painful things. The sight of pregnant bellies is painful. Pregnancy announcements are painful – especially when the due date is within weeks of your own. Baby shower invitations hurt. And, there’s the rub. In the midst of my weeping, others are blessed with times of rejoicing. Their announcements are not flaunting – they are simply joyful. Their changing bodies are not flaunting – they are simply the signs of blessing. Baby showers are not flaunting – they are opportunities for rejoicing.

I am struck by the lack of a qualifier in Romans 12:15. The apostle Paul does not say that we have no responsibility to weep for another in the midst of our own rejoicing. Neither does he say that we have no responsibility to rejoice with another in the midst of our own weeping. He simply tells us to rejoice and to weep with others. That, I think, is where generosity comes in. To rejoice from a place of neutral emotion costs very little. To rejoice from a place of weeping costs much. To weep from a place of neutral emotion costs very little. To weep from a place of rejoicing costs much. Strong relationships are forged in the generosity of sacrifice. When God blesses one woman with a full womb and at the same time withholds or removes that blessing from another woman, He provides an amazing opportunity for some of the strongest bonds to form between them – if they will each provide a generous sacrifice to the other. It will cost them both dearly, but the rewards will be incalculable. If the rejoicing woman will generously reach through the awkwardness she feels in the presence of weeping to comfort and to weep with her friend (and I have a few friends whose names come to mind who have done just this for me – thank you), she pours out a sacrifice of love into the relationship. If the weeping woman will generously reach through the pain she feels in the presence of rejoicing to congratulate and provide support for her friend (I hope that my friends have felt me at least attempt to do this, however imperfectly), she also pours out a sacrifice of love into the relationship. The bonds between these two women strengthen with each woman’s sacrifice, and the beauty of that friendship shines Christ’s love and redemption to the corner of the world near them.

In my life, I have had more lessons in reaching out of my rejoicing to weep with others. In the last few months, I have had opportunity to learn more fully how to reach out of my weeping to rejoice with others. It costs. It hurts. And then, it heals. If you are weeping, you will be tempted to withhold your rejoicing from another because of the pain. Let me encourage you – resist that temptation. The pain doesn’t go away, but it is made beautiful by the bonds of love. It is lessened by those who reach out to share it with you as you share in their rejoicing. Rejoice and weep generously.