As kids we learn about space
As adults we learn about space
As people we learn about space
As providers we learn about space
But what about the space between us?
What about space created?
What about space destroyed?
What about space held?
I consider the physical space of the health center organized externally to internally, like the planets to the sun, from parking lot, to waiting room, to exam room, to examining table, with decreasing levels of space intensifying their value.
I consider the emotional space of healthcare something that should be private, but can feel incredible public for people, as its shared in what feels like foreign, extraneous spaces created by others.
I consider the personal space of care interactions as complicating the ‘what’s yours is mine’ paradigm, since you have to share what’s yours with me, to whatever degree you are comfortable, and I mostly keep what’s mine mine, even when you ask for my personal information, but what we create between us becomes ours to share and keep sharing, if you want to.
I consider the anatomical space your own to share or not, because what I know about it is purely based on textbooks or others experiences and my historical knowledge, until I apply your own details and needs to how I care for you.
The space between us is ours to change or keep the same
I invite you closer, suggesting the chair here rather than the chair there.
I move myself to equal eye level, knowing the physical impact of height in otherwise unspoken heightened power differentials.
I offer to keep today’s visit solely verbal and based on history and symptoms, recognizing your discomfort in even discussing an exam that involves breaching physical space.
I encourage you to stop me at any point during the exam, knowing that if I do not say it you may not know that it is an option.
I ask if I can touch you prior to any physical exam, acknowledging that your personal space is not mine to access without consent.
I recognize if your body does something that changes the space but that your words have not yet caught up with, and name it to allow the opportunity for you to explain, request a change, or ask to keep going.
You, I, we can create space, seemingly breaking the laws of physics with breath and words and empathy
Silence can be broken like glass, with breath or laughter or emotion shattering its existence
Need can be respected and expanded, visualized and allowed, permitted and encouraged
Fear can be named and brought to the forefront, addressed and dismissed, or recognized and negated
Love in all its forms can, and should, and will be welcomed and broadened and expanded
Space can be destroyed, though in its wake space created
When he comes with you to your prenatal visits and silences your voice, but one day you boldly admit to me, in front of him, that you are scared at home
When I cannot find your long-desired, very much wanted baby’s heartbeat, and you leave hurriedly to the ED, and a month later come back and admit that I am both the last person you want to see and the only person you can talk to
When you expected me to call with great results but instead they were devastating to you, but the next day in clinic we start out the visit with a hug and statement that from today is a path forward
And, importantly, space can be held
I held space for you, as I witnessed your terse lips upon hearing your teenage daughter’s excitement with her own baby’s first heart tones filling the room
I held space for you, when I took the time to (lovingly, patiently, and normally) describe why some with unplanned pregnancies choose a plan other than continuation, when you curiously asked if other people really did “that”?
I held space for you, when I said that I would know you were ready for the exam when I saw your knees relaxed out to the side, and I would not rush you.
I held space for you, when I recognized that I do not know everything about your struggle, when I reminded you that you know your body better than I do, when I encouraged you to make your own decisions for your body and life because we all only do this once, when I asked questions openly rather than assuming that “you’re fine, right?”, when I start the visit by asking what is on your mind today rather than jumping into my own agenda, when I ask if you have any questions at the end of the visit, and when I tell you that you can always call me if you need me.
What does it mean to hold space?
Hold space for yourself.
Hold space for those you are honored to serve.
Hold space for the moments that otherwise flicker past us like the sparks of roman candles, bright in darkness but moving faster than it takes to blink.
Hold space for the people, the humans, the life before you.
Hold space, hold yourself, hold others, hold onto all of it with everything you have.