Jessica Bloom-Foster

To Be (Alone) or Not To Be …

I got home this morning after my third 24-hour shift this week covering labor and delivery and newborns for our family medicine service, tired from only three to four hours of sleep. I put on my face mask in the car, came through the front door, where my husband had left a thermos of coffee, ignored the whines of our puppy who wanted to greet me, and went directly to our bedroom, where I have been self-isolating at home for six days now.

I had changed out of my scrubs at the hospital, but I now threw all my clothes straight into the wash and took an immediate shower. My husband left breakfast for me by the bedroom door. We texted our check-ins about work (from me) and the kids (from him) and about how much we miss physical contact.

Kennet Square Clinic

Jessica Bloom

The young woman’s daughter
is shy and beautiful.

Her mother comes to the clinic 
with vague complaints:
headache, stomach pain,
fatigue, weakness.
A small, sturdy woman
with an anxious face,
her square jaw is just a bit
bigger on the left. I picture 
the long-healed fracture
in her jutting mandible,
sealed beneath unbroken skin
the color of wheat fields.

Her story is slow to come out.
Many of the patients here
migrate from Mexico each year
to work on the mushroom farms.
I imagine the smell of wet dirt,
the cool, shadowy barns
with stacked rows of wooden pallets,
soft, white globes emerging
out of black soil.
I do not know the nature
of their toil, but I know
the weak resistance,
the fragile release,
of pulling a mushroom
from the earth.

I understand only pieces
of her rapid Spanish, but hear
the edgy thread of despair
that unravels in her voice,
suggesting the tight fist of her will
in which she holds her self-control.

The woman admits 
to feeling depressed.
She believes her husband
drinks too much,
and has been unfaithful.
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Jessica Bloom-Foster

From the moment I walk into the room, she breaks my heart. She has just been sent to obstetrical triage from the ER, where an ultrasound has revealed a twenty-two-week pregnancy and a cervix dilated to four centimeters–halfway to delivery stage. She is moaning from her labor pains and moving restlessly on the narrow cot.

I am a second-year family medicine resident in a Midwestern hospital, and well past halfway through a busy call night. She is a thin, dusky-skinned woman, and she looks at me with wide, dark eyes full of sadness and pain. Her hair is pulled back with a nylon rag, and most of her front teeth are missing. Her face seems long and gaunt.

I take a rapid history before examining her, noting that she looks far older than her thirty-seven years. She tells me freely that she uses heroin and crack, is in a methadone program and smokes half a pack a day. She has not seen a doctor during this pregnancy. Her pains started at least twenty-four hours ago. This is her eighth child. She has only been using heroin for a few years. I ask her why she started using drugs, …

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