Wednesday, February 25, 2009

Wednesday's Special Is...The Blue Cotton Gown!

THE BLUE COTTON GOWN by Patricia Harman

“A flower child who found her calling after coaching a friend through a home birth, nurse-midwife Harman works with her ob-gyn husband at a West Virginia clinic. In her sweetly perceptive memoir, she reveals how her exam room becomes a confessional. Coaxing women in thin blue gowns to share secrets—about abusive boyfriends, OxyContin habits, unplanned pregnancies—she reminds them that they’re not alone.” —People magazine

“Here is an intimate account of a woman, both her career as a midwife and her life as the wife of a doctor in West Virginia. Her patients’ lives are stories of hope and loss; her marriage is a story of love and faith accompanied by debt and tension. Well-written and heartfelt.” —Boston Globe

"As the mother of seven children and veteran of eight pregnancy losses, I knew when I ran my bath that I would be unable to resist Patricia Harman's memoir of midwifery. What I didn't realize was that it would cause me, a sensible person, to get into the bath with one sock still on and rise from it when the candle was gone and the water cold. Utterly true and lyrical as any novel, Harman's book should be a little classic." —Jacquelyn Mitchard, author of The Deep End of the Ocean and Cage of Stars

"A seductive read! Read it to understand the fragile thinness between the care-giver and the cared-for. Patsy Harman does not shy away from her narrative. She does not shy away from controversial topics. She grabs the reader by the literary throat." —Judy Schaefer, editor of The Poetry of Nursing

"A nurse midwife struggling to keep solvent the women's health clinic in Torrington, W.Va., that she ran with her surgeon husband shares poignant stories about her patients over the course of a year …Wearying of the financial pressures and tensions with Tom, Harman tells in this heartfelt memoir that she dreamed of leaving the practice, though a genuine love for helping women, and her great faith both in God and her spouse, sustained her." —Publisher's Weekly

Chapter 1


I have insomnia . . . and I drink a little. I might as well tell you. In the
middle of the night, I drink scotch when I can’t sleep. Actually, I
can’t sleep most nights; actually, every night. Even before I stopped
delivering babies, I wanted to write about the women. Now I have

It’s 2:00 a.m., and I pull my white terry bathrobe closer, thinking
about the patients whose stories I hear. There’s something about
the exam room that’s like a confessional. It’s not dim and secret the
way I imagine a confessional is in a Catholic church, the way I’ve
seen them in movies. I peer at the clock. It’s now 2:06.

The exam room where these stories are shared is brightly illuminated
with recessed lighting. The walls are painted off-white and
have a wallpaper border of soft leaves and berries. There are framed
photographs of babies and flowers and trees, pictures I took myself
and hung to make the space seem less clinical, and a bulletin board
with handouts on stress reduction, wellness, and calcium.

The room is not big. It’s the usual size. If I had to guess, I’d say
eight feet by ten feet. The countertop under the tall white cupboard
is hunter green, and there’s a small stainless-steel sink in the corner.
Other than a guest chair, my rolling stool, and a small trash can with
a lid, there’s just the exam table, angled away from the wall, with a
flowered pillow and rose vinyl upholstery. On it lies a folded white
sheet and a blue cotton gown with two strings for a tie. The exam
table dominates everything.

I don’t drink for fun. I don’t even like scotch. It’s for the sleep.
I can’t work if I can’t sleep. The scotch is my sleep medicine and I
want it to taste like medicine. The little jam jar with the black line
at three ounces sits in the bathroom cupboard. My husband fills it
for me, then locks the bottle in the closet. I ask him to do that.
When you have as many alcoholics in your family as I do, you don’t
take chances. On nights when I’m restless, I drink it down sip by sip,
making a bad face after each swallow. Then in an hour, I go back to

I stand now at the window listening to the song of the spring
frogs and thinking of the stories the women tell me, and then, in the
stillest part of the deep night, I sit down to write. I need to sleep
. . . but I need to tell the stories. The stories need to be told because
they are from the hearts of women; the tender, angry hearts; the
broken, beautiful hearts of women.
The Blue Cotton Gown by Patricia Harman
Copyright © 2008 by Patricia Harman
Reprinted by permission of Beacon Press, Boston
Answer the following question for a chance to win a free copy of THE BLUE COTTON GOWN. Or stop by and let's hear your confesssions...
:-) Seriously, please drop in and say hi, and feel welcome to ask questions! Patricia has a great listening ear!! Let's open the floor for discussion related to this topic.
Patricia mentions a drink as a sleep aid. What kind of drink would she recommend to writers to help them write better?


Chris Eldin said...

Good Morning everyone!!

I'm very excited about this book. It's going to be on my summer TBR list.

I'm posting early (seems I always do this), but please feel welcome to drop in as you're drinking your morning coffee!!


Julie said...

I'm with Patsy -- scotch tastes awful!When I read this book I couldn't put it down! There is a woman in the book who comes to Patricia asking for help to become a man. I'm wondering what are some of the most unusual (besides this) questions or requests she gets from patients?

Chris Eldin said...

Hi Julie,
Thanks for stopping by!
You know, about what you say, I wish I could talk to my ob/gyn like that..... With my first baby, my doctor was in med school and there was more conversation.

patricia Harman said...

Good Morning, Everyone, This is the Queen of golden speculums speaking wearing my official satin blue cotton gown for the occasion, author Patricia Harman. Since you are my special friends you can call me Patsy.

Lordy, weird question...? .What are we allowed to say here? Ok, here's the acceptable vocabulary,
Cervix...round donut thingy that opens when you have a baby
Uterus...muscle that goes from the size of a lemon when you aren't pregnant to the size of a watermelon when you are full term.
Ovaries...Organs the size of an almond that push out an ovum (egg) once a month or so.

patricia Harman said...

More on weird questions.

Yesterday, in the clinic, a woman asked at her yearly exam if she could see her cervix. That wasn't so weird, but I had to go and get a mirror and couldn't find one, because it had been so long since anyone had asked me.

Yesterday someone also asked why it hurt when she made love in certain positions. Was there something wrong with her? I said no. She was fine. Maybe he was too big. I just hope she doesn't bring him in and ask me to measure his boy part!

Julie said...

Wow! This is going to be a learning experience here on Book Roast today!I agree with Chris -- wish I could talk to my health providers the way your patients talk to you -- do accept patients from all over the country? I may have to make a road trip for my next exam!

Chris Eldin said...

LOL @ boy part! He's probably named it (Charlie or George, or maybe Irving), so you don't really have to say the word penis.

Oh, this is going to be fun!

Chris Eldin said...

I learned a lot (from the med school student) when I was pregnant. She took the time to explain so many things. I guess I realize, a decade later, how lucky I was to have had her.

patricia Harman said...

Yeah, lets hope Irving never shows up. I have actually had women with STD, bring their fellows and ask to have them tested too. I have to laugh at myself. Even though I talk to women about gyn issues and sex and such all day, I just could bring myself to do cultures on some guys penis. I had to send him to the health department.

That is so important isn't it, Chris? To have someone as a care provider who enjoys his or her work, and likes to explain things and answer questions. Our health care system is so screwed up that few physicians take the time anymore. Patsy

Chris Eldin said...

Yes, I agree Patsy!

I've had friends seek out homeopathic doctors because they weren't satisfied with their care....what's your (general) opinion? I know it's a big question that can fan out in different directions, but have you ever recommended a doctor of alternative medicine?


Susan Gregg Gilmore said...

Wow. So many body parts so early in the morning -- I think I may need some scotch -- was birthing this book anything like birthing a baby???

Charles Gramlich said...

This excerpt was very well written. This is so far outside my experience that I don't know quite how to connect to it. It's an important story that needs to be told, though.

Anonymous said...

Soooooo. Sneeking around, talking about me while I made some breakfast, huh. Can't turn my back for a moment.

Birthing the book. Was it anything like birthing a baby? Susan asks. I would say yes. Painful at the end. I wasn't the midwife...that's the editor, who cleans it up and wraps the little offspring in a nice cover. I was the woman in labor for two years. Toward the end you don't want to just want to get your job done!

Speaking of the cover. People ask, "Why is the woman lying in a field in a pink dress if the name of the book is The Blue Cotton Gown? Let me explain. The Blue Cotton Gown refers to that little garment you have to wear when you are a good girl and go to your gyn's office. You know, the one with two strings in the back and no matter your size doesn't fit and makes you feel more naked than if you were actually naked. In our clinic, I insisted they be cotton, even most though most other offices use paper now. They cost more, but the paper ones tear and give me the creeps.

Patsy Harman

patricia Harman said...

Charles, Do you have a sister, wife, mother, girl friend, woman co-worker? Then this is not our of your experience. You can listen and learn! Well, maybe you'd rather not. I have guys come into the office with their significant others and see what the women have to do. "Look fun?" I ask. They shake their heads no.

Actually, it's not so bad, if you have a gentle, respectful provider. If you don't, ladies, find one.

Back to you, Charles. I have three grown boys and a husband and I know nothing about the male equivalent of a gyn exam. I guess they aren't fun either.

Let's talk about PMS. Do you think it's real? It's a difficult question for men. If their female companion is freaking out about something that seems inconsequential, you can hardly say..."Do you have PMS, dear? Is your period due?" She'll probably hit you. That's because when you're in that hormonal zone, you are blind to it. Every mole hole is a mountain. I should know, until menopause, I was the queen of PMS. Ask my husband.

laughingwolf said...

welcome patricia... i can relate to the excerpt, many times i've been unable to sleep as well

to write better, patricia would recommend a jigger of thesaurus, two oz. dictionary, dash of creamed spell check, an oz. of elements of style, poured over crushed encyclopedia... shaken, not stirred... sipped slowly in the library, aka bathroom! ;) lol

patricia Harman said...

Back to Chris, Yes. I do refer to alternative practitioners. We don't have very many here. A few herbalists, an acupuncturist and some DOs. This is a big University Med. Center area so most of the docs are MDs. My husband, for a traditional doctor, is great, but he demands research to prove everything. I'm more intuitive. If a patient wants to try something different, so long as there is no harm, why not.

I'm also a big fan of midwifery, obviously! PH

patricia Harman said...

Laughing Wolf. You crack me up. That sounds like best drink for writing, so far. I use everything you mentioned. Especially spell check. I am the worst proof reader. Patsy

laughingwolf said...

thx patsy, thought you may ;) lol

Diesel said...

My son's birth (at a hospital, with a midwife) was like a horror show. Such a large head.... I hope he puts it to good use some day.

A drink to help one write? Well, in Greek mythology, drinking from the river Lethe made you forget. So maybe there's another river that helps you remember?

And then there's coffee, of course.

patricia Harman said...

So, here's what I'm doing while I'm waiting for you to say something funny...writing my next book. This one is a memoir of the hippie days.

Right now I'm in the chapter where I'm delivering a beech baby at home. It was only my forty third home birth and I wasn't a nurse midwife yet, or even a nurse. Scary! Should I tell you what happens? the book. Coming next year...we hope!

Diesel said...

Ok, according to Wikipedia: A few mystery religions taught the existence of another river, the Mnemosyne; those who drank from the Mnemosyne would remember everything and attain omniscience.

I'm not sure I could handle omniscience, although it would be nice to know where my socks are.

Aine said...

Hi Patsy!

Yay!! A book about midwifery. And more importantly, a book about mommy strength and human weakness. I will be buying this book today. Seriously.

Though I'm ineligible (as Jason's wife)-- my answer to the question is a Rootbeer Float! You've got to have the fizzies mixed with the sweet and a whole load of fat (no frozen yogurt allowed) when writing.

Question for Patsy: have you found many women who were truly prepared for motherhood? My observation is that we (as a society) do an injustice by romanticizing infancy. Moms also need so much more postpartum support than they get on average in America.

Oh-- and I hear you about healthcare providers who don't take time to explain things. Shhh--don't tell the insurance companies, but I used to spend an entire treatment session (I'm an OT)explaining to a patient that they had had a stroke (believe it or not, some had never been told what happened to them) and what that means, what happened in their brain.

patricia Harman said...

Hey Diesel, Nice to meet you. A river to help you remember huh? I could use that, especially when I try to remember the details of my hippie days for the new book. They blur! And really! I wasn't on drugs.

I'm sorry about your kids head. No really, I'm sorry for your baby's mom about your kids head. Yeah, no doubt, he'll be brilliant. Trust me on this, I'm a trained professional.

Why do they call you Diesel?

Sandy said...

A drink to help writers? How about Tullamore Dew? Irish whiskey to promote the gift of gab or, dare I say, blarney? Second choice: a thimble full of Slivovitz to bend the mind toward the Carpathians, and summon up the next mega-selling vampire novel.

patricia Harman said...

Ok, You begged and begged. So here it is, a sneek preview of the Breech Delivery in the forth coming book by P. Harman, Broken Halleluiah. My agent hasn't even read it.

"This is it Sue Ellen, everything’s out but the head. Push like you mean it and if you run out of air, grab some more and go down again. Push until I tell you to stop." The mother pulls back her legs once more and puts her chin on her chest. Shawn and Stacy, grim faced, lean over to give her support. The room pulses with energy. We all bear down, willing this baby be born. If we needed to, we could lift this farmhouse with our minds.
Now the infant’s body is out, drooped over my forearm and slowly, gently, the rest of the head delivers, first the nape of the neck, then the ears then the soft wet black hair. No episiotomy. No tears. I let the whole baby fall into my lap, pink and already crying.
We all cry, even Shawn, the hardened, half crazy, Vietnam vet with the Fruit of the Loom underpants now back on his head.
Bow down. Bow down. And sing the praises of the small, the weak, the miraculous. Outside the dirty bedroom window, the undersides of the maple leaves reflect the rising sun. Early in the morning, our song will rise to thee.
Patsy Harman

patricia Harman said...

Oh, Sandy. You are too sophisticated for me. You must be a real writer or a classics major. Where do you get that stuff? I do like that drink though. Patsy

laughingwolf said...

i bowed down three times to my wee ones, patsy... well said :D

patricia Harman said...

I just looked up your profile, Laughing Wolf. Do you really follow all those blogs. I always feel like I'm running and pressed for time. How do you do it? PH

Aine said...

PS-- Thank you Chris for the heads up about book roast today! This one is definitely right up my alley!


Anonymous said...

Good Day Patricia,

First, I LOVED the book!!! It was great and extremely hard to put down! Were you weary in any way in todays economy crisis to publish what seems to be a personal struggle in your Torrington W.Va. clinic?

patricia Harman said...

Hi Aine and Anonymous. Nice to meet you.
No, I wasn't too wary to publish personal stuff. Probably I should have been...I mean most people would say so, but I approach my life with honesty.

I'm glad you asked though, because it's important for people to know that I did everything I could to protect the patient's privacy. The women are so disguised, even I can hardly remember who they are and each one had a chance to read her own story. Not one said no. They felt that if there was something about their life that could help another person not feel alone they wanted it in there.

People ask how our women's health clinic is doing now. I would say much better. The book was started 4 years ago, when we first gave up Obstetrics because of the malpractice insurance crisis and we were really struggling. We aren't getting rich, but we're paying our bills. We'll see how we fare in the impending economic crisis. I imagine it will affect us as well as everyone else. PH

patricia Harman said...

Aine, No, I don't think men and women are well prepared for the experience of birth of parenting. We have so little to go on. The Baby Channel doesn't cut it. I agree that the postpartum period is critical and both parents need way more help and support. Not only are the mother's hormones going wacko, but no one gets enough sleep and if you're hating your life you can't say so. It would seem so ungrateful after you were just given this sweet little baby. If anyone is out there who had a great postpartum experience tell us about it. I don't mean the first day. That's usually great. I mean the first three months. Come one now, if you did ok, we won't hold it against you. PH

Gretchen Moran Laskas said...

Dear Patsy,

Any woman who talks open and honestly about women's health in West Virginia is likely a person dear to my heart. I look forward to reading your book, and will be sure to mention it when I am speaking about my historical novel, also about midwifery in WV.

I wish you the very best as a woman and writer!

patricia Harman said...

I've heard of your book Gretchen, A Minor's Daughter, right? We will have to talk after we've read each other's work. WV is a very poor state. We have the worst health statistics of almost any place. Highest cancer, highest heart disease, highest smoking, highest obesity, highest C/section rate, most use of prescription narcotics. Sometimes my husband Tom, the aforementioned MD, and I look at each other and wonder why we live here. I guess it's because it is a beautiful state and the people, despite everything, are wonderful. PH

Chris Eldin said...

I want to thank everyone for taking the time to talk... This is a very interesting discussion!!

Keep the comments coming in!!!

ph said...

Ok, we are being kind of serious here, so I am going to tell you a gyn joke.

A cardiac specialist died and at his funeral the coffin was placed in front of a huge mock up of a heart made up of flowers. When the pastor finished with the sermon and eulogy, and after everyone said their good-byes, the heart opened, the coffin rolled inside and the heart closed. Just then one of the mourners burst into laughter.

The guy next to him asked: "Why are you laughing?"

"I was thinking about my own funeral" the man replied.

"What's so funny about that?"

"I'm a gynecologist."

heheheheheh. Maybe you have to be in the profession to think that's funny. PH

patricia Harman said...

All quiet on the western, eastern, northern, southern front. I keep checking. Maybe we should talk more about penises and vaginias to spice things up.

Beautiful sunny day here in WV. I saw my first Robin. PH

Julie said...

OK -- I've been away for a little while and had to check much going on! I agree with you, Patsy...WV is about the most beautiful place in the country. I totally understand why you live there. Your jokes are great! Growing up I lived next door to a doctor that told the most ribald jokes and now I realize how much I've missed them. Keep 'em comin'!

pharman said...

ok, Julie. This joke is for you.

Fifteen year old, Sharon was taken to the doctor because she was putting on weight. Her mother, a somewhat overbearing woman, told the doctor all about it.

After a long monologue from her mother about how it must be her glands, the doctor examined Sharon and was able to make the diagnosis.

"Well," said the doctor, "I'm afraid that the reason why Sharon is putting on weight is that she is PREGNANT."

"Nonsense," said Sharons mother, "you're wrong, you've obviously made a mistake. Such a thing is just not possible. Sharon would never do anything like that, she doesn't know anything about such things." Turning to Sharon she boomed at her daughter, "Isn't that so?" Poor Sharon could only shake her head in abject agreement.

The doctor said nothing. He just washed his hands, walked to the window and stared intently into the evening sky.

"Well, doctor, have you nothing to say? Are you just going to stare out the window? bellowed Sharons mum.

The doctor quietly replied that he was looking for something, because the last time that this had happened a new star had arisen in the East and three wise men on camels had come looking for the fortunate mother and child.

Heh heh. PH

patricia Harman said...

ok, this is a true story. You can see why I take so tlong with my patients and why I had to write a book. I'm a story teller.

When I lived in Columbus, this was years ago, we had a young woman in the hospital who gave birth at home without a midwife or doctor and claimed she didn't even know she was pregnant.

She was tall and thin and played basketball on the University team so you think someone would have noticed or she would have felt the baby move. It was a little premature, but it made it.

She told me she had been raped, but always had irregular periods so she didn't think anything of missing one. (Very tall women sometimes don't show that much, so I can see how others missed it, but I can only figure she didn't feel movement because she didn't want to.)

When she went into labor she thought it was just flu and a very bad back ache. Her sister was with her and rubbed her back all night. In the morning, she went in to sit on the commode and had a five pound baby.

It must have been self-hypnotism. That's all I could figure. She gave the baby up for adoption and someone received a beautiful little boy.

Stranger than fiction. PH

Word said...

I feel so guilty sneaking out here and committing the ultimate sin of BAW (blogging at work) and on Ash Wednesday no less.

But I'm so glad I did.

So - of course coffee is my drink of choice for writing. Milk and cookies get me back to sleep at night. AND PMS is real. AND I can't drink my drink of choice anymore during PMS week because it really sends me over the edge. Women are such hormonal creatures arene't we?

Now that book sounds like an awesome read Patsy. I love your voice. Calming yet totally honest. I bet your patients love you.

Julie said...

Patsy -- That is a great joke! But I believe it's true -- probably many times over. I've read and heard first person accounts of girls/women not knowing they were pregnant -- just wild! Some family was really lucky to get that little guy!

Julie said...

Patsy -- That is a great joke! But I believe it's true -- probably many times over. I've read and heard first person accounts of girls/women not knowing they were pregnant -- just wild! Some family was really lucky to get that little guy!

patricia Harman said...

Hi Word. Sneaking around, hey. I'm at home today writing but the sun is coming through the windows and I'd like to take a nap. Yeah, most of my patients like me, Sometimes I'll get a teenager though. I am really honest with them and they don't always like it.

Like yesterday I told a kid to quit rolling her eyes every time her mom said something. Her mother wasn't much better. She couldn't keep her mouth shut. I could tell they were close, more like sisters than mother and daughter, but they were driving me nuts. The amazing thing is the kid did what I said. She started to do that sassy look thing and held it in. It made such a difference. You could actually listen to what she was saying like a person.
I liked her a lot better. I don't know if she'll come back to see me though...

Your drinks actually sound better than my sleep medicine. I have friends who don't get it that I really don't like booze...well a little wine is ok. They come to the house and say, how about some scotch? I go, YUCK! and give them herbal tea.



Chris Eldin said...

Hi Patsy,
You're a natural storyteller...
:-) I LOVE the cardiac joke!

Things will probably be quiet a bit now that it's dinner. Speaking of- I hope you've eaten something!

patricia Harman said...

Of course, I ate. Did you look at my picture? See those chubby cheeks?

I had a can of South Western Vege Soup by Progresso. (Highly recommended) and a half of green pepper and now I'm going to make a cup of tea.


Chris Eldin said...

Hi again,
I guess today's roast attracted the morning goers!

Thank you everyone, for stopping by and for sharing.

A very big thank to Patsy for bringing a piece of her world to us.

We'll go ahead and close the contest now, and Patsy can announce the winner (though we were so chatty, did many people answer the question?) :-)

Many, many thanks!!!!!!

Patricia Harman said...


McKoala said...

You closed?! But I only just got here! Wah! And I was all ready to spill about my two and a half day labour and then my new baby vomiting all night and the nurses who wouldn't help and the hallucinations I was having out of sheer exhaustion...

Ah, well. The book looks fantastic!

Diesel said...

Wow, look at all that happened while I was busy getting my ass kicked by this day. Glad you folks had fun.

Patricia - Sadly, there's no interesting story about my name. I think people started calling me that because I smell bad.

laughingwolf said...

patsy, i do follow them all, but not in one day ;) lol

patricia Harman said...

Ok, I loved talking to you all. I would say Laughing Wolf gets the prize for the most clever and writerly drink. If Laughing Wolf doesn't think The Blue Cotton Gown is something he'd get around to reading and doesn't have a woman he wants to give it to, then runner up is Deisel because his ass got kicked yesterday and his baby had a really big head.

Thank you all for letting me participate. It was fun! Patsy Harman

Chris Eldin said...

Thanks Patsy!! Congrats LW!!!

Diesel was just playing around for a roast master, he's ineligible for the books, no matter how big his kid's head is.

Thanks everyone for playing!!

laughingwolf said...

patsy, thank you so much :D

will send my snailmail addy as soon as i find your email addy :)

of course i'll read it!

and chris, as always, a stellar job as roast mistress :)

i have eye muscle surgery tomorrow morning, both eyes, so dunno when i'll be able to post again

hopefully by early weekend

laughingwolf said...

hi patsy, i contacted maxine :)

Carleen Brice said...

Really loved the excerpt! Will check this one out.

laughingwolf said...

hi patsy, book has arrived

thx again :)