The Unsatiated Wound
"What if I don’t get better?" Part III
In her book, The Evangelical Imagination, Karen Swallow Prior challenges the reader: “Look for the images, metaphors, and stories that fill your own imagination, your community’s social imaginary, and your own cultural experience.”1 I previously wrote The Unhealing Wound and The Unseen Wound.
There are three things that are never satisfied, yea, four things say not, It is enough: the grave; and the barren womb; the earth that is not filled with water; and the fire that saith not, It is enough. [Proverbs 30:15-16, KJV]
When I hear the news, my inner commentary has an opinion. It is usually in the words of King Solomon the Great, specifically, his collected Proverbs as translated in the King James Version. Recent events have provoked these proverbs:
‘Devise not evil against thy neighbour, seeing he dwelleth securely by thee.’ [3:29] ‘As a mad man who casteth firebrands, arrows, and death, So is the man that deceiveth his neighbour, and saith, Am not I in sport?’ [26:18-19] ‘If thou forbear to deliver them that are drawn unto death, and those that are ready to be slain; If thou sayest, Behold, we knew it not; doth not he that pondereth the heart consider it? and he that keepeth thy soul, doth not he know it? and shall not he render to every man according to his works?’ [24:11-12]
My inner monologue results from years of reading a daily chapter of Proverbs every month. The plan originated with the homeschool Program2 in which I spent adolescence. The Program Head claimed the words of the world’s wisest man would make us wise. But Solomon’s Ecclesiastes and Song of Songs did not get the same reading recommendation.
At one Program conference, I was among hundreds of young teen girls who memorized the Virtuous Woman passage in Proverbs 31 and sang it to the assembly. We never sang Miriam’s or Deborah’s or Hannah’s songs, not even Mary’s Magnificat. I wanted to marry and have children. I also wanted to be a physician, but that required outside education. The Program offered a lay midwifery program to female students. Its cost, in American dollars, was beyond the reach of my low income Canadian family.
Program seminars frequently invoked the 127th Psalm: “…Lo, children are an heritage of the Lord: and the fruit of the womb is his reward… Happy is the man that hath his quiver full of them...” Speakers suggested high reproduction in Program families as a means of societal domination. The health portions of the curriculum touted the benefits of childbearing; pontificated on the correct time of sexual intercourse during the wife’s menstrual cycle3; encouraged reversal of vasectomies and tubal ligations; and warned young women experiencing menstrual difficulties against the medical establishment, lest they get treatment damaging to their fertility.
Multiplied Pains
‘Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children’ [Genesis 3:16, KJV]
‘He said to the woman: I will intensify your labor pains; you will bear children with painful effort.’ [Ibid, CSB]
I know the Program’s health and science curriculum because I read it. Before google became a verb, my health references were a medical encyclopedia from World Book, alternative health publications my mother gathered over the years, a few basic information books, and the Program curriculum. I had questions.
The women of my mother’s working class family were quite frank about reproductive functions, often to the embarrassment of the younger generation. My mother shared all she knew about puberty with her adolescent children. But she did not expect me to begin menstruation so early. From the start, the blood and pain were dramatic – I fainted in front of a horrified sibling, whose scream, I am told, woke the entire household. By my mid-teens, I was vomiting and crying in pain mid-cycle. Emergency doctors suggested ovarian cysts and recommended ibuprofen.
When pain increased again in my mid-twenties, my family physician again suggested cysts. By this time, I was in nursing and had more information available. I wondered if I might have endometriosis, but my physician was reluctant to do extensive testing. She did refer me to a surgeon to have a large fibroadenoma of the breast removed. Thankfully, although it looked unusual on ultrasound, it was benign.
In my mid-thirties, I became anaemic from blood loss. Sudden, terrible abdominal pain would empty my bowel. Other days, both bowel and bladder function stopped. Then I started randomly vomiting. Ultrasounds, my physician said, showed nothing unusual. I glanced at the report. I had a uterine fibroid and ovarian cyst totalling over 18 cm in diameter. Large enough to interfere with digestion and elimination, I suggested. I was referred to a gynaecologist, who arranged an MRI in the middle of pandemic lockdowns.
The MRI confirmed fibroid and cyst were displacing bowel and bladder.4 It also ruled out endometriosis. While I waited for surgery, I was prescribed Lupron. The injection blocks hormone signals to either ovaries or testicles, lowering estrogen or testosterone levels. This slows or stops fibroid growth or prostate enlargement.5 I briefly entered menopause, which fully reversed when I stopped the Lupron. My wait was for a large hospital specializing in uterine-sparing fibroid removal, instead of having a hysterectomy in a local hospital.
Ovarian cysts, fibroids, and fibroadenomas are common female experiences. In normal ovulation, a follicle with an ovum swells, then bursts through the ovarian membrane. Some women, like myself, feel the pain. Most ovarian cysts are due to ovulation malfunction, and nulliparous women, since we have never had children, ovulate more. Fibroids, benign tumours of the uterus, frequently occur, but statistically are more likely in nulliparous women. Fibroadenomas, benign tumours of the breast, are common in young women. Family members’ experiences suggest the tumours usually stop growing after having children.
When I turned forty, I had a mammogram as part of the public cancer screening program. Ultrasounds had showed more fibroadenomas, but the mammogram suggested possible malignancy. Once again, thankfully, a biopsy said everything was benign. I have entered perimenopause, which brings its own risks. Being female at any life stage is fraught with physical peril. I often think the words spoken to the first Eve, “I will greatly multiply thy sorrow”, are felt by all her daughters, whether or not we ever become pregnant.
The Solitary in Families
“God setteth the solitary in families” [Psalm 68:6, KJV]
In her unfinished memoir, my great grandmother, Eva, wrote,
“I was one of a fairly large family, being the seventh child of the family. Four older sisters, and two brothers who died in infancy. After my birth there were two more boys. Our mother died at the birth of the youngest”
Oral family history says that Eva’s mother bled to death from postpartum hemorrhage. Her only medical attendant was the village apothecary.
Eva’s mother is my direct female ancestor, through Eva’s eldest daughter, Vi, my maternal grandmother. Eva had seven children, three girls and four boys – the youngest boys were twins who died in infancy. Vi had six children, three girls and three boys. My mother, Vi’s second daughter, had four children, all girls. All my maternal aunts, and female first cousins, and siblings married and became mothers themselves. My mother has fifteen grandchildren, and, to date, one great grandchild.
Surrounded by a rich family culture of motherhood, I assumed I would become a mother someday. I never married. Therefore, I never had children. I know, of course, one need not marry to become a biological mother, nor, with modern technology, even need to have relations with the opposite sex. But I have always wanted, if at all possible, my hypothetical children to grow up knowing their biological father, as I had the privilege of doing.
I often find clues to life’s questions in literature, but examples of childlessness are sparse. Lucy Maud Montgomery beautifully portrays spinster Marilla and her bachelor brother Matthew becoming adoptive parents of Anne of Green Gables. I never had the economic stability to consider adoption. Montgomery also depicts the influence a childless teacher can have in Miss Stacy. I have taught children, mostly music, but also other skills, like language and handicrafts. As Montgomery relates, there always comes a time when the teacher must say goodbye.
C. S. Lewis has a favourable depiction of a childless, married woman in The Great Divorce, but in Till We Have Faces, unmarried Orual’s surrogate motherhood nearly destroys Psyche. Orual’s narrative served as a warning not to place my need to be loved above the needs of others. I dearly love my nieces and nephews and I have spent more time with them than most aunts are able. But I never forget they are my siblings’ children, not mine; and, as time passes, they are growing into independent adults with their own lives to live.
As a young woman, I was often the subject of matchmaking speculation by my family’s elder generations. They were happy in their family life, and wanted me to be happy. But, as members of the working class, being a wife and mother was a part, not the whole of a woman’s life. Eva had been a domestic servant, Vi had worked in a WWII munitions factory, my mother had been a schoolteacher. My family wholeheartedly support my entry into nursing. As I progressed through my thirties, the good natured teasing about marriage faded. Now, the only family members who ask when I will marry and have children are my young nieces and nephews. I take their honest inquiries as evidence they think I would be a good mother.
The Children of the Barren
Sing, O barren, thou that didst not bear; break forth into singing, and cry aloud, thou that didst not travail with child: for more are the children of the desolate than the children of the married wife. [Isaiah 54:1, KJV]
When I dreamt of being a physician, I envisioned working with women in places where perinatal care was limited. I started out with a nursing diploma. In Canada, nursing education is very broad, and one of my clinical placements was in Maternity. After graduation, I took a further specialty course in Maternal-Child care. When I eventually got a nursing degree6, my final placement was on Labour and Delivery. I lost count of the number of births I helped with. I never lost that slightly tearful blending of relief, joy, and wonder over each new life.
I volunteered as a nurse for over a year in a rural community in the western part of the African continent. The polygamous culture emphasized the importance of women marrying and having children. Nearly all women were married, and most became, like my grandmothers, grand mulitparas with five or more children. But one in ten children died before the age of five. Women who were childless were given children to raise, usually by a sister.7 Such children grew up knowing the names of their real parents, but also calling their foster mother, yaay, Wolof for mother.
There were no doctors in the rural clinic, and few in the country. Locally trained midwives attended most of the births. But, after clinic hours or if my local colleagues thought I would be interested, I was sometimes called upon to help. I’ll never forget accompanying a colleague in the darkness of early morning, to find a mother lying on the back of a horse drawn cart outside the clinic, the child already born. Twice, I was the one who delivered the baby. Once, I helped stop a postpartum hemorrhage, working while our ambulance traveled the rough road to the nearest hospital. The woman survived.
The day I arrived in the community, I was given a Wolof name. My namesake was an elderly matriarch. A namesake’s family becomes your family, so I became mother, grandmother, great grandmother. My name even included the honorific title for grandparent, Maam.8 My daughter was old enough to be my grandmother, and would grin mischievously whenever she greeted me as suma yaay, my mother.
I treasure vivid memories of my visits with my family, seeing my son, the village bonesetter, threshing his rice harvest; listening to my venerable son-in-law, an elderly and highly respected man in the community, hold audience; sitting quietly with my namesake in her mud brick hut or under the mango trees. It hurt, when my health collapsed and I had to be evacuated, that I could not bid them a proper farewell. Former colleagues updated me. Son, son-in-law, and daughter, all predeceased their matriarch. During the first wave of the pandemic, my namesake became ill and passed away. I am honoured to have shared her name and family.
Karen Swallow Prior, The Evangelical Imagination: How Stories, Images & Metaphors Created a Culture in Crisis (Grand Rapids: Brazos Press, 2023), 6
As previously stated, the Program is unnamed to keep the focus on the main point, but IYKYK.
In pregnancy, the growing child dramatically displaces abdominal and pelvic organs, but hormones relax ligaments and help the mother accomodate the baby. I had no way to adjust to the cyst and fibroid.
Not an exhaustive list of approved and off-label uses of Lupron.
Midwifery is a separate degree from nursing in Canada. I applied to midwifery, but, by mere fluke, one document was delayed past the deadline and my application was denied. I applied to the nursing degree program three days after the application deadline, and was accepted. Coincidence?
The term for the sisters of one’s mother was yaay bu ndaw, little mother. Only the father’s sisters were called the equivalent of aunt.
Maam means either grandfather or grandmother, and is generally applied to venerable elders. I was in my late twenties, but, as a colleague pointed out, I might well have been a grandmother by that age.
Your suffering with fibroids and cysts sounds horrific—I recently discovered (at age 30) a large uterine fibroid myself but it’s on the outside of the uterus and not causing any symptoms. The surgery is apparently low risk so I’ll probably get it removed. But in any case the experience been very educational about this widespread condition that I wasn’t really aware of before, and now I know of at least older family in my circle who had hysterectomies on account of fibroids after they had several children. I had no idea!