Dear Friends:
    I read with sadness about Holly's list of difficult clients. Each one a
tragedy; each one draining of energy from caretakers, destroying of
children's lives, and crushing hope. What a temptation it must be to think
that we can do something positive by taking control and giving Depo at
hospital discharge. It seems easy to be judgemental about cases like these
where clearly something needs to be done.           My concern is that
someone could very well look at me, and make judgements about me and my life.
Look at the great divide in the USA now, which makes the future look dim in
terms of things that I deeply care about. It may very well be in a woman's
best interests to start Depo before hospital discharge, but she has to
determine that. I am also concerned that this is a quick and easy action;
where is the support for women to learn more about themselves and mature? How
is it that there are so many women and children and families at risk in our
supposedly developed country?
    Where is the support for the caregivers that work with women in dire
straits. It is exhausting, and often infuriating work. I used to work in big
inner-city hospitals, taking care of alcoholics and drug addicts as they
bounced in and out of intensive care until they finally died. I have been in
Holly's shoes. I have heard jokes from caregivers about such patients. I
heard acronyms like SHPOSE, which stood for "sub-human piece of s**t" used to
refer to such patients. Caregivers get empty,and angry with their
helplessness. They are human also.
    This is an incredible dilemma, even for us breastfeeding professionals
who often encounter similar situations. I just don't feel the answer is
something that borders on eugenics. That scares me. We have to find ways to
keep our compassion alive, because when we act on a reactive basis, rather
than a proactive one, I don't see that we are so very different to the people
we are caring for.
    What is a solution? How about a revolution of sorts, to make the health
care system truly a caring one, with plenty of staff to nurture each other?
Why should a CEO of a health maintenance organization make 12 million dollars
a year in salary?
Now that is where the problem is!
    Warmly,
    Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI

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