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to push forward could keep me from eventually crumbling.

Looking back, I realize my attempts to press on were an effort to reinhabit my pre-loss life, as it were. I wanted order, predictability, and peace—the antithesis of the psychological chaos my miscarriage yielded. And in my mind, I could find it all again safely inside my office. Getting back to my patients and those meaningful sessions with them felt like exactly the balm and the rich interaction I’d been craving. I wanted to dive back in—to sit with my patients, and to foster some semblance of regularity. On some level, I probably knew that in the grander scheme, taking only a week and a few days to recover from the physical and emotional trauma of what had occurred was nowhere near enough time, but I needed to reengage—to dive back into my purpose-driven work. This is an act of self-preservation, I told myself. This is the work of rebuilding.

But when I returned to work, it became increasingly clear just how affected I was and how ineffectual my attempts at outrunning my grief had been. Before I returned to sitting in my therapy chair, it didn’t seem concerning to me that my work was inextricably linked to this type of trauma, that the kinds of exercises I had to put my mind through in my office would offer no escape from what was already echoing inside it. Only the week before, I had been able to sit and listen, as my job called for, without having any thoughts about myself. But in a race to sidestep the emotional aftermath of my pregnancy loss, I had sprinted toward a space where loss, grief, trauma, mourning, and the complex ways in which we process it all were discussed at length. I could no longer keep thoughts of my own life siloed from what my patients discussed with me. I had been exposed to the anguish and experiences of my patients’ journeys through very similar traumas. Once again, there was no going back.

• • •

I will not soon forget the first session I had upon my return to work; sitting across from Kate,* a thirtysomething patient I’d been seeing for several years. It just so happened that our meeting coincided with her first trip back to my office in months; our sessions had been on intermission, as she’d recently given birth to her third child.

We sat together in my office, aglow in the fall light, and remarked to each other how nice it was to be together again. As the session began, I felt present, measured. Sitting across from her felt familiar and warm, and I was thankful to be back in my seat and once again facilitate vulnerable moments with people brave enough to reveal buried aspects of themselves. I also welcomed the opportunity to continue concentrating on something other than my own grief. I was focused on Kate, and wholly glad to be.

“How have you been?” I asked.

“Um …” Her voice wavered as she stammered through her answer. Judging by her body language, I could tell that she was struggling. “I’ve been okay, I guess. Well, sort of.” She trailed off, then changed her answer: “Sometimes, actually … no, I haven’t. I don’t know.” Tears welled up in her eyes and started falling down her rosy cheeks. “I’m sorry …” she whispered. “I didn’t want to start crying so quickly. My hormones are all over the place, and I just don’t feel like myself these days. I feel pretty low, confused, even.”

“I’m so sorry to hear this,” I said reassuringly. “This is such a tender time. Such a big transition. Another big, life-changing transition.”

As soon as those words escaped my lips, I heard them—I mean actually heard them. They knocked the wind out of me. Or rather, I knocked the wind out of myself.

As Kate wept and spoke about those complicated feelings that can inevitably accompany the fourth trimester after a newborn enters the world, I worked to remain present and calm. Beneath the surface, though, I noticed the pace of my breath shift ever so slightly. I also noticed a warmth overtake my weary body. Not a comforting warmth though, more like a here-come-the-cold-sweats-post-body-heat-up from my postpartum hormones, but with no baby to show for them. Feelings resembling—though not quite manifesting as—an anxiety attack. Because there, across from me, sat a woman in exactly the position I’d thought I was working toward: deep in postpartum adjustments, new baby, full breasts, hair pulled up as an afterthought into a messy top knot. Her hands were full in a psychological sense, and her arms were full in a literal one. Three children.

Her. But not me.

Somehow, I made it to the end of my workday, although I couldn’t say how I managed given the complexities that surfaced in my mind, time and time again. And when I finally climbed into my car and closed the door, all I had been running from finally caught up to me. It took over my body, seared my insides, and then poured out of me with reckless abandon. I tossed my purse onto the passenger seat, slumped forward, and held my bereft face in my hands. I cried great, heaving sobs until I exhausted myself of all emotion. My tears fell from my eyes like rain. I longed to go back in time, to undo this grand loss, to return to the before-loss me. Now, there was only post-loss me to familiarize myself with, and I didn’t want to know her at all. I knew it wasn’t possible to go back and live whatever life I was headed toward, before the blood and the bathroom. But I also knew there was so much I didn’t know about what was to come, what I’d have to soldier through in the months to follow, or how this unknown would change me in ways both big and small. Loss divided time into “before” and “after,” and I felt suspended between them both.

With

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