She's going the distance

I feel as though I should apologize for a second post related to the overlap between sports and clinical practice, but I have decided to stand behind this second post and run with it. Badump, psh!To start a post about distance running and clinical practice, I first reference Cake's "The Distance." For those who also miss music videos of the 90s, here is a reminder of how cool we all were.(And then there's this awesome five-year old girl's cover, worth the smiles it brings you!) Digression over, back to it.Long-distance running and I truly came to know each other later in life. I tried track in high school, liked it, was average at best. I ran with my childhood best friend in a not-so-great part of our town, a mix of an attempt at a local bike path and an industrial park, both she and I alternating a ridiculously hip-heavy speed-walk with spurts of running, really just enjoying spending our time together.Last year, I developed what my mother refers to as a "wild hair," and decided to train for a half marathon. I had been out of the country, endured some really difficult medical culture shock in a maternity ward, and was not coping well with reverse culture shock upon my return to the US. Not many days after my re-entry to American culture, my closest midwife friends and I road-tripped to The Farm for the Advanced Midwifery Workshop, where I fell vertex-over-footlings for Pamela Hunt and The Farm as a whole. Another attendee of the workshop overheard my asking Pamela about running paths, the distance from The Farm entrance to the dusty paths of individual housing, and my goal to train in the mornings before our sessions. This other attendee, a midwife from Spain, mentioned how she's training also, and we should run together. Come to find out on our first run the next morning, my first run in a long time, that she had already run "a few" marathons and was adept at talking while running. I really wanted to talk with her, but also wanted to, let's say, not die. Somehow she had already learned to survive while talking and moving her legs, but I was on the brink at each turn from lack of oxygen to my lungs and increased cardiac output. Over our next few runs together she was incredibly patient with me, stopping when I needed to, encouraging me when she knew I was stopping for no good reason, and asking me how I was feeling over our group breakfasts later in the mornings. It was a wonderful way to start my training in running (and in midwifery and everything it should be - if you have not attend a workshop at The Farm... Go. Now.).Back at school, a classmate's husband who is a long-time long-distance runner, and other midwife friends who had trained for a full marathon, provided endless support and encouragement during my running ups and downs. Another midwife classmate was training for the half, and a few times we crossed paths, and she provided words of encouragement and kindness when my strength felt low. She waited in line with me at the bathroom before the marathon, started it with me, and found me at the end with a big smile and wild hair. My recent love of long-distance running began with The Farm, fellow midwives and friends near and far, and continued to grow when my same closest midwife friends and others cheered me on at multiple points during my first half marathon. It continues now with a new midwife friend and I working on running a 5k together soon.Now balancing life and work, I am learning what my friend Natalie seems to have mastered, years ago, in full-force: make the early morning workout happen, because by the evening, my energy is entirely spent and I want to spend time with my loved ones. The recent crisp fall weather in this area has allowed for some early-morning jaunts, mostly a couple of miles, which has been plenty. My endurance is not what it was, my sweat glands are confused and over-compensating (or just adequately performing), and my lungs laugh at my work and cause me to stop and cough. Each run my body proves remembrance of the last, provides worth to my early-morning wake-up, and establishes importance to the full-dresser-drawer of workout clothes that confuses my partner in its abundance. I am a runner.Mornings before clinic leave a lot of time for thinking. Running during this time allows me to focus mostly about the day to come, which succeeds at distracting me from that inner voice that says "just go ahead and stop, there's no one watching." That same inner voice can sometimes succeed at talking me out of putting on my shoes and going, convincing me of the importance of other tasks: a journal article to read before work, a blog post nagging at my brain, a friend email waiting in my inbox. But the post-run high works wonders on my system, quiets that inner voice a little each time, and on the days that I can overcome the other tasks, my worked-out self is proud and energized. I'm not going for speed, but I am going for distance, endurance, pushing myself a little more each time. Running outside can take the loneliness out of the experience: in the city, one is never alone on the streets, and people watching and running match nicely. There are days when I'm excited to have finished a little faster, to not have stopped as often, to have managed my breathing well before a hill instead of deciding that was a good place to turn around and head home. And with each run, there's an end. A realization that there will be a finish, I am the one who arrived there on my own gana, and with a deep breath the next adventure starts. It's patience yet power, time yet endurance, solitude yet community.I am finding this first year of clinical practice really a test of all of those. Each day is such a juggle of mental fortitude: how to keep each visit within a reasonable timeframe, pull random bits of information from the depths of my brain, and remember three patients back if charting is delayed due to walk-ins. There are certain "reasons for visit" on the schedule that I read, and my inner voice says, "not sure you can handle that one." It's also a lonely experience, where in this practice set-up I am the only midwife in the clinic, the only midwife on the floor, the only one who can figure it out. Yet, there are those same feelings on the runs. Patience with myself and my practice in its first year, and patience in my own blunders and re-starts. Power in my knowledge and my passion, and tapping back into that power when circumstances are difficult. Time to be managed but cherished, for the day will be endured, and each patient will forget their wait time if they feel heard and cared for during the visit. Solitude in my presence but community in our group and midwives as a profession.And what of this inner voice? Is it the same voice telling me to stop running when I feel tired that tells me that a patient's problem might be too much for me to handle? Is it that same voice that reminds me of my other obligations and talks me out of self-care? Is it the same voice that questions my abilities rather than reminds me of my strength? Our self-doubt really has a way of running the show, unless we promote our own self-confidence, especially in times of solitude. On those days when we are the only midwife in the clinic, the only runner on the road, the only woman making it happen. Give that voice a hip-check and get her out of there, because we all know that with a deep breath and a straightening of our shoulders, we got this. And by we, I mean I. But I really mean we. We got this.This journey in my first year of practice, for me like running, started with some really awesome midwives, and continues in that same fashion. We midwives have a team effort going on in our profession, despite any one partera working solely in a community, in rural America, in the global sphere. We reach out to each other over email, over text, and on the trek back home after our time spent with women, sharing in their stories, absorbing some of their difficulties with each visit. On any day, any clinic, any shift on labor and birth, each of the midwives in my graduating class and those with whom I choose to continue to surround myself would be a part of my midwifery dream team. If I really ever felt like I was alone in my work, I would be one phone call away from a voice of strength and support from a fellow midwife near or far. What an incredible feeling. And at the end of each clinic day, especially in this first year, I almost feel a resurgence of the runner's high: that I did it, alone but with a history of support and knowledge from others, and today only creates more of a path for tomorrow. Again quoting my mother, put on your "go-fasters" (shoes) and get out there.Alone, together, historically. Hey runners, hey midwives, hey women: we got this.