by Tilda Shalof
“An angry side, too.” I shudder to think how he’ll deal with the terrible twos.
I’m trying to figure out if Talia is preternaturally wise and extraordinarily compassionate – even saintly – or if she is merely naïve and incurably optimistic?
“What will happen after you discharge her from your care?”
“I will try to connect Kaitlin to adult protection services and other community agencies that assist people with special needs. I hope she goes but she may not. She’s rejected it before. There is a trustee in charge of her who gives her an allowance from her family.”
“I have a feeling you’re going to be worried about them.”
“It’s hard for her when Slade is incarcerated. He’s good at finding food for them.”
“What does he do to get food?”
“Who knows? They eat.”
Talia sees my shock at the way she nurses this client.
“It must seem that what I do is mothering or being a girlfriend. I am her nurse and she’s my client. The boundaries are definite and clear to me. And Kaitlin is an adult and is entitled to make her own decisions. I will never try to take that away from her.”
Who am I to say they can’t be suitable parents? Perhaps Talia is right. They could learn, couldn’t they? Who are we to quash their dreams? It’s not money, intelligence, or education that makes for a good parent, is it? No, but it takes more than love.
“Do you have certain goals with a client like Kaitlin?”
“My goal is to establish a good relationship with her.”
“Okay, so let’s say you have that good relationship, then what?”
“A safe delivery in a hospital, not on the street.”
“Yes, but she can walk into any hospital and be assured of safe care.”
“Yes, but she might choose not to go to a hospital and have her baby in some unsafe place. She’s felt disrespected in hospitals. Homeless people dread the hospital. They feel hostility from the staff. They feel disrespected, put down.”
This seems to be a common theme. We seem to have a bad rep.
“I know in the hospital you like things you can fix.” I nod at that. “Out here, there is no fix, only the hope that maybe, just maybe, if I take care of the mother, she will be better able to take care of her baby.” She knows I’m skeptical. “Look, I don’t know if this approach is right or wrong, good or bad, helpful or not. It’s just about taking an interest in them and their story.”
But as nurses we want to be useful, too. We’re practical people. We can’t just sit here, we have to do something. But what Talia is saying – and showing – is the opposite: It’s more like, don’t just do something, sit there. But then I consider it from another angle. What if Talia weren’t in their life? Kaitlin and Slade would have nobody, they’d be cut off from society altogether. I understand what Talia does, and appreciate its importance, when I think of its absence.
“Remember when you were first pregnant and so excited? Well, I’m the one being excited for her. When her baby was born, she looked at him with absolute love. She wants to be a good mother. She howled when they took her baby away. That sound will stay in my head. Forever.”
“How do you cope emotionally with this job?”
“Nothing stops the images, the voices, but my life is happy. I have a wonderful family. I am studying to become an art therapist.”
“Have you ever been in a situation where you felt threatened or unsafe?”
“The surroundings may be scary, but not the people.”
“What about rats? Seen any?”
“Oh, lots of rats,” Talia says with a laugh. “Bed bugs bother me more because you can carry them home. They take over your house, get into the walls. They bite, cause infections, and they are hard to get rid of.”
“What’s your measure of success?” There has to be quantifiable results or objective metrics. What about outcomes? You need these things, especially in these days of fiscal restraint and having to account for every expenditure, don’t you? It’s a stretch for me to abandon my thirty years of pragmatic, problem-solving hospital training.
Talia tells me about one evaluation method that involves examining client text messages. There is plenty of data. One month, Talia received 263 texts from one client alone – and she has twelve clients at any given time. They track the frequency and content of the texts to examine them for research purposes.
“What do they text you about?”
“Appointments, questions, chit-chat.” She scrolls down to show me a sampling from one client.
“I felt it kick.”
“I’m in pain.”
“Funky smell from my vagina.”
“Do you think they’ll take this baby away, too?”
“Sometimes they text me to disclose something like ‘I’m using.’ Or ‘I’m high.’ ”
“How do you respond to that?”
“Always the same thing. Thank you for telling me. I’m honoured by your trust.”
She shows me a back-and-forth exchange with one client:
“No epidural ”
“It’s a girl. Emily. Five pounds, two ounces.”
“Congratulations!”
“My BP is high. 24 hours and they’re kicking me out the door.”
“Where are you going?”
“Back to shelter.”
“How are you getting there?”
“Taxi.”
“What about the car seat?”
“Yup. Put in taxi. ”
“It sounds like two besties,” I say.
Talia clarifies the relationship. “We’re professional friends. Friends with boundaries.”
In this kind of nursing, the personal and the professional could become so intertwined and enmeshed, but Talia knows what she’s doing; she is clear about her boundaries and what she offers and what she doesn’t.
“Developing a relationship with the mother is the only thing I can do that will make a lasting, positive effect,” she says serenely. “Here, our successes are different. They’re difficult to measure or even describe.”
From the outside, Humewood House looks like an old-fashioned English boarding school, but not the magical Hogwarts variety, more the grim, institutional type. The inside is warm and inviting, and the women at the reception desk are expecting us. This is a group home where pregnant teens receive prenatal care, have their babies, and stay for up to six months after they give birth.
Since graduating from nursing school five years ago, Nurse Debi Wade has worked in labour and delivery and in a neonatal ICU. Recently, she started working for Toronto Public Health. “I wanted to know how they are doing after the hospital. When the mother and baby go home,” she explains.
“This teen shelter is nicer than most. One place downtown has picnic tables. It smells old and dirty and there are broken-down couches, women always slumped in them, sleeping it off.”
Many of the girls in Humewood House are in high school. That’s why it’s so quiet, the director told us. Right now, some are studying for midterm exams. We wonder what is taking Debi’s client, DeShae, such a long time to come down after we called up to let her know we’re here. We wait in the communal living area where there is nice pseudoantique furniture and upholstered, slightly frayed couches. After about ten minutes, she appears, looking drowsy and indifferent to our visit. She places a box of Ritz crackers she’d been carrying under her arm, along with a sketch drawing on a scrap of paper of little pink hearts surrounded by blue tear drops, onto the coffee table in front of us. She sits down on a faded, floral wing chair and stares blankly ahead.
“Looks like you just woke up,” Debi says, standing up to greet her.
DeShae slips off her moccasins, folds her tall self into the chair, and tucks her bare feet under her. Snuggling in deeper, she yawns broadly. Her tiny belly bulges slightly under her midriff top. She’s skinny and pretty, with even features, straightened hair with extensions falling to her shoulders in waves, and long, purpl
e fingernails. I can imagine her getting dolled up for prom night, and how much she’d probably love to be doing just that. She pulls out her phone and holds it close, resting it on her tiny baby bump.
“So, did you, DeShae?”
“Did I what?”
“Just wake up?”
“I like to be called Victoria, I mean Chloe.” She starts humming a song under her breath. I instantly recognize Rihanna’s “Diamonds.”
“So, how’s it going here at Humewood House?” Debi asks.
Chloe echoes Debi’s earlier comment: “This place is nice compared to others I’ve been in.” She rests her face in her hand, picks up her phone, and wipes the screen with the back of her forearm. She looks at it – not to make a call, but to use the screen’s reflection as a mirror so she can fix her eye makeup and pick sleep out of the corners of her eyes.
Debi gets to the point. “Do you have any questions about your pregnancy? Any questions about the baby? Let’s see … you’re at twenty-three weeks. How are you feeling?”
“Kinda good.” Chloe repositions herself, rearranges the cushions behind her back.
“Do you have any discomforts?”
“Just pressure, pain.”
“Where?” Debi asks and Chloe looks away. “In your lower back?”
“No, in my neck.” She won’t meet Debi’s eyes.
“Is she stoned?” I mouth to Debi, who shakes her head, no. To me she looks and acts that way, but Debi had told me they are very strict about their no-drug policy here, and she hasn’t heard any complaints about her so far. Debi goes through a list of symptoms like nausea, vomiting, headaches, leg pains … Chloe shakes her head no for each one.
“How did you get here to Humewood House? How did you hear about it?”
“A friend of mine told me. She got pregnant and stuff in middle school and came here.”
“Where is your family? Why are you not at home?”
“I came from a group home. I was in foster care. I’m a good kid. I didn’t get into trouble, but when I got pregnant I couldn’t stay there no more. Anyway, Imma be eighteen soon and can’t stay there no more.” She runs down the rest of her bio like a practised drill. “Seventeen years old. Came to Canada at ten. Born in Haiti – but I tell people Barbados, where Rihanna is from.” She continues. “Foster care since birth. Group home since the age of thirteen. Mother dead. Father in jail back in Haiti. Four brothers, three sisters, no contact with any of them.”
“Do you have friends from the group home?” Debi asks gently.
“No. I mean they’re nice girls and stuff, but I don’t want to bug them with my problems. Besides, they’re younger than me.” She looks down at her belly with surprise. “She’s moving.”
“Do you like that?”
“It’s annoying sometimes but at least I know she’s not dead.”
“It’s a good sign,” Debi says. “About two or three movements an hour.”
Chloe looks at her belly like it belongs on someone else’s body.
“If it’s not moving you should tell someone.”
“Why?” She stares off into space. “She’s still moving … stopped now.”
Debi takes a different tack. “So, you know it’s a girl?”
Chloe stares off into space. She looks bored. “It’s moving …” She looks excited. She looks dismayed. “Stopped now.”
“Are you comfortable staying here? Do you like it?”
“At my group home they don’t lock everything up like they do here. The rules here are too strict.”
“Yes, you do have to follow them if you want to stay.”
Chloe is quiet.
“Do you want to stay?” After a long silence, Debi asks again, “Are you planning on staying here?”
“I’ll try my best. They won’t let me back in the group home cuz I’m pregnant. Here, at least, you get an allowance and there are one-, two-, three-, or four-dollar chores. I only want the four-dollar ones. Why should I work for less than that? But those ones get snapped up fast.”
Every few minutes her mood shifts, from disinterest to defiance, from anticipation to disenchantment, from excitement to apathy; a tiny peak of interest, then it drops off.
She pokes her belly. “Best part about being here? I have my own room. I’m doing grade nine math, grade ten English. I had some rough patches at school cuz I didn’t always have a bus ticket to get there. My older sister beat me up and stuff, so I had to go into foster care, but I ran away. I rode back and forth on the subway, but then it closes at two in the morning. One night they called the police.”
“How old were you?” I ask.
“Fourteen. Foster family was okay and stuff. Better than at my mom’s.”
“What about the baby’s father?”
“He wanted me to get an abortion. So I went to a clinic. Even signed the papers, but something told me to wait. I changed my mind. It’s against my religion. ‘You don’t know what you’re getting into,’ he said. ‘The baby will cry. You won’t be able to finish school.’ He already has a kid, with another girl.” She looks at us like she knows what we must be thinking.
“We didn’t use a condom because I thought he was the one. I wanted him to be my baby’s daddy and more. I was hoping it wasn’t just a booty call with him, it was a real relationship. I thought he’d be my hubby, not just my baby’s daddy.”
“Does he know you have decided to have this baby?”
“Yes, and he promised he’d be there for me. He said, ‘If you get pregnant, I’ll support you,’ but now he says ‘sorry’ and disappeared. We argued too much. He didn’t want to spend New Year’s with me. He spent it with her. Now I want him out of the picture.” She wipes away a tear. “We haven’t spoken for a long time. Maybe three days.”
“Does he know you’re here?”
“Don’t know. I texted his mother. She said she’d be here for me, but she’s never even come to one doctor’s appointment. She has a car, so there’s no excuse. I thought I had a good relationship with her. I never disrespected her. She’s wish-wash.”
“So when you go to your appointments, does someone go with you?”
“No, I go alone. I definitely learned my lesson. I won’t get into this situation again.”
“How do you feel about going through this pregnancy?”
“Bad. I wanted a boy. It’s a girl. She hasn’t anything good to face. I have to have this baby. I don’t have a choice.”
“Sometimes, a mother decides to give her baby up for adoption.”
“That’s crossed my mind, but I don’t think I could handle it.” A tear drops down onto her lap. “I can’t imagine giving away a baby that I carried inside me.”
“We can talk more about this,” Debi says. “Chloe, do you feel depressed?”
“I never thought this is how my life would turn out. I didn’t think I’d get pregnant. I had five months of unprotected sex and didn’t get pregnant.” She sniffles and looks down, not at her belly, but the floor.
“How do you see your future? Do you plan to finish high school? If you do, it’s very possible for you to meet that goal.” Chloe doesn’t answer. She’s gone, looking out the window, very far away. “What are you thinking right now?” Debi asks gently.
“Nothing.” She returns to us. “Do you have a kid?” she asks Debi.
“No, I haven’t been able to get pregnant. We’re still trying.”
“How many pregnant women have you worked with?”
I don’t know why Chloe wants to know Debi’s credentials, but Debi’s not fazed in the least. “I’ve been a nurse for five years, but have always worked with babies and moms.”
“More than a hundred?”
“Oh yes, many more than that.”
Debi shows Chloe a picture of the developmental stages of an embryo in utero and points out one picture that is close to the stage of her fetus. Chloe studies the picture. “It looks kinda funny, with eyes on the side of the head.”
“Well, I’m he
re if you have any questions. You can call or text me anytime you like. We could go out for a walk sometime, if you’d like.”
Chloe looks down and lifts her shirt to take a look at her belly. She prods it, and jabs roughly at it in a few places. “If you poke the baby too hard, will it be born with an indent?”
Debi assures her not, if she’s gentle.
“Does it pee in there? And drink that back?” Chloe looks incredulous and disgusted.
“Yes.” Debi explains about placenta, umbilical cord. “The baby is getting its food from you. You breathe for your baby. Provide food for the baby.”
“If my last period was August 22, what was the date I would have gotten pregnant?”
Now, as we are getting up to leave, questions occur to her.
Debi checks an obstetrical app on her phone and tells Chloe her approximate due date.
“No, I mean, what was the date when we last had sex? What was the day I got pregnant?”
“Roughly two weeks after your last period … that’s if your periods were regular.”
Chloe is doing some backwards calculations in her head and counting off days on her fingers. She smiles, then sighs, happy about a memory of the day of her baby’s conception. She points to her drawings on the coffee table. “I wants to be a tattoo artist. I was an apprentice, but I didn’t have money for a licence, but the guy let me work there.”
“Do you want me to come back for another visit?” Debi asks her. “I won’t if you don’t want me to. This is voluntary.”
“Yes, please come back.” Chloe looks on the verge of tears. “I’m lonely,” she says.
But she remembers something. “Soon, I won’t be alone. I’ll have a little friend to keep me company.” She lifts her shirt and smiles down at her tummy.
MAKING AN IMPACT
“HEY, TILDA, can you work another night shift tonight? We need you.”
I worked last night and they told me the news. Richard Thornton-Sharp died. At home. Peacefully. In Jim’s arms.
Jim sent me an email, “Richard was truly the love of my life and I can appreciate the fact that I had the most wonderful thirty-three years with someone who I loved and who loved me. I am very fortunate to have had this incredible relationship. Richard was an amazing person and in my heart he is still with me as the journey continues.”
