The Blue Cotton Gown

Book excerpt: Heather is pale and thin, seventeen and pregnant with twins when Patricia Harman begins to care for her. Over the course of the next five seasons Patsy will see Heather through the loss of both babies and their father. She will also care for her longtime patient Nila, pregnant for the eighth time and trying to make a new life without her abusive husband. And Patsy will try to find some comfort to offer Holly, whose teenage daughter struggles with bulimia. She will help Rebba learn to find pleasure in her body and help Kaz transition into a new body. She will do noisy battle with the IRS in the very few moments she has to spare, and wage her own private battle with uterine cancer. Patricia Harman, a nurse-midwife, manages a women's health clinic with her husband, Tom, an ob-gyn, in West Virginia-a practice where patients open their hearts, where they find care and sometimes refuge. Patsy's memoir juxtaposes the tales of these women with her own story of keeping a small medical practice solvent and coping with personal challenges. Her patients range from Appalachian mothers who haven't had the opportunity to attend secondary school to Ph.D.'s on cell phones. They come to Patsy's small, windowless exam room and sit covered only by blue cotton gowns, and their infinitely varied stories are in equal parts heartbreaking and uplifting. The nurse-midwife tells of their lives over the course of a year and a quarter, a time when her outwardly successful practice is in deep financial trouble, when she is coping with malpractice threats, confronting her own serious medical problems, and fearing that her thirty-year marriage may be on the verge of collapse. In the words of Jacqueline Mitchard, this memoir, "utterly true and lyrical as any novel . . . should be a little classic." "The many moving stories of the women that Patricia Harman cares for as a nurse-midwife add up to a remarkable account of a life spent listening, helping, and taking care. Inviting us into her clinic in rural West Virginia, she shows us the joys and sorrows of listening to women's stories and attending to their bodies, and she leads us through the complicated life of a healer who is profoundly shaped by her patients and their journeys." -Perri Klass, author of The Mercy Rule and Treatment Kind and Fair "Nobody writes with more candor and compassion about women's woes and women's triumphs than nurse-midwife Patricia Harman. Her behind-the-exam-room-door memoir is a bittersweet valentine to every woman-young and old-who has ever donned that thin blue cotton gown, to every dedicated healthcare provider, and to every husband-wife medical team. I couldn't put The Blue Cotton Gown down." -Sara Pritchard, author of Crackpots and Lately "This luminescent, ruthlessly authentic, humane, and brilliantly written account of a midwife in rough-hewn Appalachia-a passionate healer plying her art and struggling to live a life of spirit-stands as a model for all of us, doctors and patients alike, of how to offer good care." -Samuel Shem, M.D., author of The House of God, Mount Misery, and The Spirit of the Place "Patricia Harman has opened for us a window, a glimpse into her life as a midwife and the lives of those women who have entered her exam room. And as the touch of her careful and caring hands learned the story of their bodies, into her heart they poured their life stories-stories of joy, of sorrow, those bright with promise, those dimmed with grief and pain." -Sheila Kay Adams, author of My Old True Love "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