Miscarried Life


I was standing at the elevator in the building where the Western Mass Recovery Learning Community’s Holyoke Center is located on February 11th, 2010 having a casual chat with a young woman who was interning for us when I felt the blood rush that signaled the start of my first miscarriage.

I was in Best Buy on July 1st, 2010 buying my seven-year-old son a video game for his half birthday (yes, I said ‘half birthday’) when I felt that familiar feeling for a second time.

On January 24th, 2011 I tested positive for my third pregnancy in about a year’s time.  I was happy.  And I was completely and utterly terrified.

Even though I’d had surgery to remove a uterine septum following my two miscarriages, I could not trust that my baby was okay.  My body was not ‘safe.’  It had killed my babies.  During the day, I couldn’t stop focusing on every little twitch and twinge, obsessing over what it meant.  When I slept, I had nightmares.  When I accidentally caught something on television that referred to babies or children hurt or dying, I would burst into tears.  I kept clinging to the idea that if I could just get through the first 12 weeks – when risk of miscarriage is at its highest – I would be okay.  Everything would be okay.

As the pregnancy progressed, the first 12 weeks passed and the baby started to kick, I’d love to say that things got easier; that the baby’s movements were reassurance that all was well.  However, it only seemed to get worse.  I rented a heart monitor and would sometimes feel compelled to race home and check for the baby’s heartbeat.  The urge would come out of nowhere and nothing would silence it until I could get the monitor in my hands, and hear my little girl’s heartbeat.  I wouldn’t event stop to say hello to my family on my way upstairs.  At other times, I would happily recognize the baby’s kicks and then only moments later feel completely unsure that I’d really felt them and become convinced that the baby was gone.  I was scaring my husband.

Although I managed to keep working and getting a reasonable amount done, this was my experience day after day after day for the bulk of 2011.  It was exhausting.

I’d like to say that the medical profession helped reassure me.  I’d like to say that they validated some of my experience as normal.  They did not.

As I sat sobbing on the edge of the examination table on the day they confirmed my second miscarriage, I remember the doctor staring perplexedly at me as if she couldn’t understand what it was exactly that I was so upset over.  When she recommended that I go sit in the waiting room among all the other patients – many of them pregnant mothers – I had to actually request (between sobs) that I be allowed to wait in a private room for the scheduler to come in and make my appointment for the D&C procedure.  She seemed to think it was an unusual request.

After several days of being haunted by repetitive words (“There’s a dead baby in your stomach!”  “Dead baby!” “DEAD BABY!”) rolling in waves through my head, I went in for my second D&C only to have to fight with the hospital staff to get them to allow my husband – the only one I trusted – to be able to stay with me during the initial preparation for the surgery.

When I went in for my post-D&C follow up visit with the gynecologist, apparently they didn’t bother to look at my chart because they expressed that they thought I was there for a postnatal (post childbirth) visit.

When I found myself pregnant a third time, I fled from the existing practice that had treated me so coldly and signed up with a new one.  However, when panic about my current pregnancy set in and I started calling and begging for them to see me sooner and explaining how badly I needed reassurance that the baby was still there, they discharged me for complaining and being difficult.  (Oh, and also because I refused to fill out the requisite paperwork disclosing my psychiatric background.)

When I finally found a new practice that was able to see me soon AND willing to do an early ultrasound to reassure me of the baby’s ongoing presence, I expected that the doctor who had been kind enough to take me in so quickly would surely tell me that what I was going through emotionally made sense based on what I had experienced in 2010.  She did not.  Instead, she asked me what medication I was on ‘for that.’

When some test results came back abnormal and I had to start having weekly non-stress tests, the lack of compassion and understanding from the medical field continued.  For example, sometimes they would tell me the test had failed because my baby was “Non Reactive.”  To me, that sounded an awful lot like it could mean, “dead.”  The actual translation?  My baby was probably asleep.  Only thing is they never offered the translation.

I grew to hate them all.  It stopped mattering if some of them were nice to me.  I hated the sight of the hospital.  My mood immediately sunk every time I entered a medical building, and I was angry and unpleasant toward everyone who crossed my path there.  I saw them all as complicit in my pain.  The only thing that kept me going was that I knew there was an end in sight; it would all be better when my baby was finally born and I could hold her in my arms and see her and feel her and know she was okay.

My baby was born at 6:29 AM on Tuesday, October 11th, 2011.  But it wasn’t automatically all better.  And here’s what I’ve never told anyone before.  Not my friends.  Not my husband.  And certainly not any professionals.  No one.

For the first year of my baby’s life, as much as I love her, I had frequent intrusive images of me hurting her.  When I was near stairways, balconies or other high up places, the images seemed to be telling me that I should drop her over them.  That’s what the images ‘wanted.’  I could feel it.  I was terrified and felt dizzy and overwhelmed whenever they would come.  I had nightmares and very much awake moments of terror when I thought about the cruise we were planning to go on shortly after she turned one because of all the high up balconies I’d have to be near.

It would have been nice to talk to someone about it.  And it would have been terribly, terribly dangerous.  Would they have asked, “Do you think you’re actually going to hurt your baby?”  (No.  I love her very much.)  Would they have asked, “Do you feel you have to act on what these images seem to be telling you to do?”  (No.  Even though they scare me and I can’t make them stop, they just make me cling to her all the more tightly.)   Would they have asked, “Why do you think they are happening?”  (Because I went through a year of deep emotional pain and loss and am absolutely terrified of losing my baby still.)

So, why am I telling you now?  Well, first of all, the images seem to have dissipated. Anyone who has their finger on the panic button after reading this can relax.  All mandated reporters can stand down.  I haven’t experienced these images in several months.  I’ve also stopped panicking that my daughter has ceased breathing in the middle of the night or been in a car accident whenever she’s out of the house without me.  My head is much quieter all around, these days.  At least where my baby is concerned.

What lingers for me still, though, is why I had to suffer in such silence?  The fear I had of telling anyone about my experiences was not just ‘paranoia.’  It was re-enforced by every interaction I’d had with medical professionals, by everything I see in the media, and by the human rights violations I hear about every day in the name of ‘safety’ and ‘risk assessment.’

Although there’s much more complexity to be found in my earlier experiences of distress and intersections with the mental health system, this particular set of experiences seems very straight forward to me.  I did not have ‘Postpartum Depression,’ or, even better, ‘Postpartum Psychosis.’  I had no need for a shiny new diagnosis.  What I ‘had’ was a really traumatic year.  I lost two babies.  It had a profound impact on me.  That impact continued to play out over much of the last two years – during my pregnancy, child birth and my daughter’s infancy.  No one seemed interested in trying to understand that from a human place.  Perhaps I could have found some support and solace at one of our local ‘Hearing Voices’ groups. My experiences might have been listenable for people there, and the whole point of that approach is to create non-judgmental space to talk about what is taboo or commonly pathologized. But I couldn’t quite bring myself to give it a try. In the end, talking out loud about me as a mother having thoughts about hurting my baby just felt too risky.  The consequence of that fear and the overall lack of empathy and interest I’d experienced drove me into isolation with my pain, and that is something we as a culture need to think about.

This is not just about pregnancy loss and motherhood.  This is reflective of how we treat many people who have experienced pain and are expressing it in ways not immediately relatable to those around them.  It is about how we as a society may contribute to some of the truly awful things that happen not by failing to properly screen and assess, but by quite successfully fostering fear and alienation.  If I had ever acted on anything I was experiencing in those moments, it no doubt would have fed all the ‘How can we catch and diagnose and intervene’ better and faster conversations.  But would it truly have been about professionals not finding out so they could stop me from continuing down some inevitable crash course? Or would it have had more to do with me getting so desperate and lost in the dark because I had no one to whom I felt I could safely turn and who could be ‘in it’ with me?  (Please note:  I never once came close to acting on any of this.  Not once.  Hands OFF the panic buttons!)

Yesterday, I was sitting in day one of a two-day training that asked me to “Get in touch with a time in my life when I made new meaning out of crisis.”  It inspired me to write about these experiences and the sense I have made out of them.  Today, as I was driving away from day two of the same training and contemplating whether or not I actually wanted to take the risk of sending this post out to the world, I heard someone on a radio program say, “Don’t let that bipolar woman drive with your child in the car near a lake!”  Now, ‘bipolar’ isn’t a label I can claim to have been given.  (They didn’t catch me in the right moment admitting to the right checklist of symptoms!)  But it sealed my decision to send this out.

I am not a danger to my children.  I am a good mother; probably better than many who can’t admit these sorts of truths and struggles.  I was not ‘sick’ or ‘mentally ill.’  My experiences – however frightening and difficult for some to understand – made sense.  I don’t need anyone else to confirm that for me anymore.  Life, our world, and sometimes, our own bodies, can be beyond our control and that is scary.  But the only way beyond that is to go through it.  Hopefully, not alone.




Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


  1. Sarah, you always amaze me with the power of your writing, but you have really outdone yourself with the brilliantly written piece that confronts the lack of human understanding in the entire medical profession – not just psychiatry – and be being willing to reveal such a profound personal experience that could easily have gotten you psychiatrized. You demonstrated so vividly why so many of us keep quiet about the things that terrify us!

    • I agree completely with Darby. Added to the medical profession you can count in the Police (if they think that you have an emotional problem, the first question will be whether you’re on medications: that of course leads into difficulty if you would tell them the scientific truth about medications). And then you have the rest of society’s good citizens like Teachers, Religious Leaders, Politicians other Leaders and the like, who so often will ask the same intrusive question. And the lack of logic is staggering.
      It’s clear what kind of an unreal world such lack of faith in the human condition elicits. Don’t feel like you’re missing out would they treat you any differently, Be glad you demure….

  2. Sera – I am so sorry you were treated this way by your health care providers. I remember being sick, in pain, terrified, and ignored throughout my own pregnancy. My daughter was treated in a similar manner when her father died, by her doctors and her school. Perhaps someday institutions will grow up and provide simple emotional support to the human beings that they are supposed to care for.

  3. The fear of doing damage to others, knowing you are not a danger really and these thoughts are a way of dealing with trauma, knowing talking to others might help, knowing a lot of people might not be able to help and knowing the state (in terms of Dr’s and others) might panic and make things worse.

    I think this might be more common than many people realise.

    I lost a job due to some therapists taking my worrying thoughts more seroiusly than they deserved. That left me traumatised for several years. I had to fight to get my medical records changed.

    What you describe, the worries about damaging your child, could be called Obsessive Thoughts, and if you like the language of Disorder, could be thought of Obsessive Compulsive Disorder. I’m not keen on that kind of language but knowing it is not that an unusual way of thinking might help. It is easy to assess how dangerous someone is, you ask about their past history and you ask them what they think of people who actually do such acts as opposed to just thinking about them and you ask how they feel about these thoughts. Practitioners seem to loose this ability as soon as it comes to dealing with behavious they have been told to look out for. That’s what happened in my case and I’m still somewhat angry.

    Glad the baby is doing well though and that you are too.

  4. Despite going to childbirth classes I still had a violent birth experience with my first baby. The details are commonplace for most women who go to industrial birth institutions (hospitals) so I won’t recount my experience here. I’m grateful that I had enough of a touchy-feely hippie background to be able to acknowledge my urge to stuff my baby down the laundry chute. At the time I explained it to myself as the overwhelming feeling of being completely responsible for the life of a helpless human being. This post makes it clear that it was also the medical system that contributed to my stress. I had a “birth buddy”, a friend who was pregnant at the same time as me who I could reveal these taboo feelings to. We were able to laugh about it and that helped so much.

    Our culture is broken. Culture begins with mothers and babies and we are screwing it up majorly. My heart goes out to you for the fear and isolation you suffered and for your courage in shining a light on this terrible oppression that has infiltrated the healing professions.

  5. Thank you Sera. For speaking out and daring to tell your story, sharing your feelings as a new mother and your pain of pregnancy loss. Well done on being difficult by complaining. That’s the way to do it!

    I was one of those who got the label of puerperal (postpartum) psychosis back in 1978 and 1984 but managed to get over the traumatic psychiatric treatment, grabbing and jagging, and off the psych drugs. Did the same again after a menopausal psychosis at age 50 in 2002, but more difficult because of the psych drug cocktails and plethora of psych labels, such as schizoaffective disorder which they pinned on me, like pinning the tail on a donkey game, blindfolded. But I never believed any of it and recovered.

    The perinatal psychiatry developments are very concerning and need to be resisted, in my opinion. Having a baby for a woman is a life changing event, especially if things don’t ‘go to plan’. Why is psychiatry always trying to control women? As in patriarchal and treating all patients like women. Dominating, forcing and making decisions on our behalf, it’s very irritating. Here’s to resisting and speaking out!

  6. Respect and thanks to you Sera for having the courage to write about such painful experiences so beautifully and candidly. I am so glad that you and your daughter are in a safe enough place now that you felt able to write this. It is a real gift to other women who have endured similar losses.

    It is awful that you had to endure this on your own because you feared others reactions; only when we have the bravery to speak out about such common yet still taboo experiences, can we try to create a world in which others others will not have to suffer such agonies in silence.

  7. “I am a good mother; probably better than many who can’t admit these sorts of truths and struggles.” You sure as hell are. If you ask me, what essentially makes for a NAMI mother is exactly the inability to admit (painful) truths and struggles — to oneself as well as to others.

  8. Sera,

    I am so sorry that this happened to you and I am so glad you posted.

    I was a doula (professional birth and labor coach for those unfamiliar with the term) and I had MANY moms who had very similar problems. NOBODY wants to admit this to their doctor for fear of having their baby taken away. It’s an awful little secret.

    I would be on the receiving end of phone calls in the middle of the night from parents who didn’t know if they were no kidding going to hurt their babies. One woman couldn’t walk into the kitchen because there were knives there.

    Sometimes I would drive over to their house right then to check on them, but generally they’d be fine after some human contact. Not one of them ever actually hurt their baby. One or two of them decided to go on medication or to therapy, but most of the time, a cup of coffee, a hot shower and some sympathy were what was needed. They needed to hear, “Yes, sometimes people have scary thoughts when they’re stressed.” or, “Being terrified means you understand the situation.”

    The biggest pathology in our culture is this idea that we must never have uncomfortable emotions. The worst persistent myth around children and motherhood is that we feel good about our children all the time.

    My oldest’s first year was the worst year of my life–somewhere in there my midwife told me that if we both made it to her first birthday alive, then it was a major victory, no matter what else happened. She did and I did. She turned 18 in March and is thriving, even considering how much I screwed up as a parent.

  9. Thank you for your sharing and writing.I am beginning to realize how powerful sharing stories are. Miscarriage is an invisible problem. I will never forget my own and my guilt that I still feel at times. I went into a hot water tub while I was very early in my pregnancy not knowing it could cause problems.When I was put on bed rest for a high risk pregnancy and had to call my hospice clients to tell them I had to stop working there were so many stories that had never been told about miscarriage. The effects last a life time. I am sorry the medical folks treated you so poorly. So many can’t handle emotion especially when it ‘s tied to medical problems. Hands off literally!
    I think in Japan they have a day set aside for mourning the loss of a child. We don’t have that here. Thanks again for your sharing.

  10. Thank you Sera for your brave courageous story. My wife has just given birth to our third baby 5 weeks ago. She came out early, small, feeding poorly and failing to thrive. This required a spell in hospital all worrying stuff. What made it worse is that the Nurses seemed to lack any understading of what a fragile sensitive time this was and behaved in a bullying way even seemingly blaming my wife for the problem though she had bent over backwards to try and feed the baby. This just undermined her confidence and sent ´her into a tailspin for a while in turn disturbing the important bond between baby and mother. That we are both health care professionals, well educated, responsible with two children who are flourishing didn’t enter into it. We were labelled a problem and more so because we complained. Now baby is on some kind of watch list at the health centre and we keep being told to give her more formula which we try and avoid. It’s all just short term risk management, cobvering their backs with no insight into the real situation. It made me realise that lazy doctoring is not eclusive to psychiatry. It’s everywhere. Also to say with all three of my babies I have had intrusive images mand fears of harm. With the first I found it disturbing. Now I understand it somehow and sort of welcome the thoughts and pass through them in some buddhist kind of way, knowing they are thougts and they are not me. It’s hard being a human why does modern medicine make it harder.

  11. This is off the topic but I just wanted to tell you how much you are on target with your attitudes about “peer workers.” I just got through listening to your presentation on Madness Radio and must tell you that I believe that it’s impossible to be a true “peer worker” in institutions run by the traditional system. These institutions are willing to hire a few of us so that they can claim that they’re really furthering recovery for those in their care, but the reality is that all they want are people who will spout the “take your meds” message and support the coercion that takes place against people in the units.

    I have spent two years as a peer worker in a state hospital and can tell you that they do not want me to walk with people in their realities. They want me to parrot the system’s message and keep quiet about anything that might raise issues with people in the units. I am a figurehead and will never be allowed to function as I was trained to function. They don’t really believe in recovery but will use me and the word to further their own gains and make themselves look good.

    I also am very uncomfortable with the title “peer worker” and especially with “peer specialist.” I had to name my position and finally settled on “peer guide” and even that has connatotations that I’m not really comfortable with.

    The system and many peers have turned this all into one big mess that I’m not comfortable with. I’m considering quitting the position since I don’t believe that I’ll ever be allowed to function in the capacity that I could with people. They don’t want me to speak my message that I have to share.

    Thanks for listening and letting me share this. Sorry for being off topic.

  12. Sera,

    I love all of your blog posts but, this one and Body Politics (which really inspired me to actually share my own story) really struck a cord with me. Both are so brave and vulnerable. Our stories are so, so important. Thank-you for sharing some of yours. This story is so important for so many parents out there. There are so many topics out there that no one wants to talk but, they NEED to be talked about. I imagine it was really difficult to write this and harder still to post it for so many people to read. Thank-you for opening up a very important dialogue and for letting other folk know that they are not alone. I am sorry that you had to feel alone with this for so long. You are such an inspiration to me and I am honored to work alongside you and more importantly, to be your friend. Thank-you for all of the great work that you do and for being such a beautiful human being.


  13. Sera,

    Once again, I am humbled by your fearless honesty and your ability to not only navigate your pain, but to transcend it with insight and compassion and a deep understanding of the universal nature of this pain.

    I have not met many people in my lifetime, including “sages,” who have this capacity, and it begs the question about who really is mentally healthy in this world (or perhaps, who is awake and honest).

    I want to echo many who have shared how “normal”/common these feelings are , and also acknowledge the pervasive fear and potentially disastrous consequences of admitting these fears to the wrong people and in the wrong setting. The history and origins of much psychiatric abuse, isn’t it?

    I can remember my grandmother saying to me before my daughter was born, “If you feel like locking your child in the refrigerator, that is normal. If you actually do it, that isn’t.” She was not exactly the paragon of motherhood, but that piece of advice has been more comforting than I would have guessed.

    I experienced those fleeting feelings myself. And I heard other mom’s share them in La Leche League groups. Your blog reminds me how the same things that make us unwell at any stage of life—isolation, fear, judgment—are things very present for new parents. We need to build more safe communities where we can share openly and without fear.

    Thank you for your willingness to speak truth to healing once again…

  14. Sera

    I’m a little late to your blog, but I must say I always learn something from both your intensely personal narratives as well as your commentary that continues to challenge us and clearly takes us out of our comfort zone. After all it is in the “discomfort zone” where most learning takes place.

    Having worked with people who have experienced trauma as well as with many overly stressed young mothers, there may be a relatively simple explanation for what you and others have experienced after suffering through the trauma of one or more miscarriages.

    Trauma like this obviously creates a very high fear response and many negative thought patterns related to anticipating another horrible outcome to becoming pregnant again. These negative thought patterns can sometimes become obsessive and very entrenched due to the effects of the trauma. Another one of those normal reactions to abnormal events.

    A mother can easily become convinced that the fetus will never finish the 9 months of development or that the new born baby will surely die in the first year of its life.

    Once the baby is born and it is clear that the miscarriage option did not occur and therefore it wasn’t the mother’s body that rejected the fetus, then surely it will be the actions of the mother herself that will lead to the baby’s death. Because after all 90 to 100% of the time the newborn baby will be in the physical care and presence of the mother.

    So therefore this tragic end to the life of the baby, which the mother is convinced will happen because of the traumatic effects of multiple miscarriages, can now only happen via a mistake, or deliberate action by the mother.

    Since no one can really predict when or how they are going to actually make a fatal mistake with a newborn; mistakes just happen. So therefore by shear deductive logic now the only way the inevitable death of the baby will occur (which the mother is quite convinced will happen because of her intense fear reinforcing her entrenched negative thought pattern) is by deliberate action of the mother.

    Hence the beginning of a intrusive fantasies of deliberate actions leading to the death of the baby; this can be the only logical outcome of being stuck in such a series of negative thought patterns.

    Of course the mother fights these thoughts and the last thing in the world she wants is for some harm to come to her child. And the more she fights these thoughts and attempts to suppress them out of shear terror and shame, the more intrusive they may become. Combine all this with the poor sleep pattern and the normal high stress level accompanying post partum women in today’s world and you have the makings of a potential severe emotional crisis.

    For most women this probably begins to subside over time as the mother starts to acquire a better sleep pattern and experiences the highs of positive interaction with the baby along with other family supports. And all these positives combined with the shear drudgery of parenthood may leave little time for such obsessive negative thoughts to retain a foothold in one’s thinking. And after all, as humans we are born with a cerebral cortex that allows us, over time, to figure out rational thought patterns from those that are irrational and do not serve our best interests as a functioning person in this world.

    Unfortunately these intrusive thoughts (mentioned above) are more common than people want to admit (thanks Sera for having the courage to discuss them) and like some one experiencing suicidal thoughts they need a SAFE place to discuss them. You have described in great detail the severe shortcomings of the way in which today’s mental health system deals with these issues.

    So many therapists and care givers today cannot tolerate the DISCOMFORT of dealing with trauma issues and the related negative thought patterns, including thoughts of self harm and the fear of harming others.

    How many women in your situation have been declared mentally ill, hospitalized, medicated with dangerous drugs, and had their child removed from their custody when all they needed was a sympathetic ear and a better way to understand how they might have ended up acquiring certain uncomfortable or intrusive thoughts.

    Sera, keep writing and challenging us in the “discomfort zone.”

    Comradely, Richard

  15. Thank you for writing about this. I say that every single time I see a post on any blog, or other public platform, that talks about this. It isn’t often, but regularly enough that I think this may be a much more common response to stress during the post-partum period than anyone-especially health professionals- realizes or acknowledges. I experienced similar intrusive thoughts not long after my daughter was born, and since then, during periods of high stress, I will have intrusive thoughts of some outside agent beyond my control harming her. Like you, I’ve never had any desire to hurt her, and have never acted on any such thought. If anything, I feel an increased sense of protection. I think this is one of those arenas where a deep misunderstanding of “mental health” overlaps with some pretty extreme hang ups we have around how we relate to motherhood in this culture, leaving women who experience these reactions to stress much largely unable to seek support or re-assurance. It steams me up. Thank you for adding your voice to those who are willing to speak about this.

  16. Hey Sera –

    I’m also “late” reading this, but figure we find things when we need to. The experience of reading this left me with a whole new level of respect and appreciation for you. This offers such a powerful and brave truth about loss, fear, and the brutality of uncaring systems.

    It is so sad to me that experiences like having a fleeting image of harming someone that is loved and cherished can be so deeply traumatic in and of themselves, producing all sorts of guilt and shame and fear and that people just have to sit with that by themselves. I agree that these sorts of out-of-nowhere opposite-to-who-we-are-and-what-we’d-ever-dream-of-doing thought image experiences are part of what it is to be human…we all have some fairly terrifying things that lurk around in trauma and grief and it’s frightening to me that people don’t talk about them or the effect that these thoughts/images/feelings have on moments in our days and lives. I guess it’s not so much that they don’t talk about them as that they can’t talk about them.

    This is so inspiring and brave…and might actually help me to get something written about how much I struggle with the conflict between loving my kids dearly and being very committed to “being here” and yet sometimes still feeling very graphically suicidal, with images. I don’t think I am in a “safe” enough space to give voice to that in a very public way…but, thank you for opening the door for mothers to talk about experiences that don’t jibe with our thinking about what the landscape of the internal world of mothers sometimes holds.

    I really don’t think there is any group so strangely alone in their pain as American mothers…because somehow it’s been determined that it is not appropriate for mothers to struggle.

    (Wow. I just got hugely triggered thinking about how mothers are treated, especially if they have a psychiatric history…a massive wave of anger and something that feels a lot like grief…and it feels good to know I’m not alone, and sad to know that so many mothers…for all practical purposes…are.)

    Much Appreciation and Mom Solidarity,


  17. …minor clarification:

    We are all, as humans, strangely alone in our pain…just in different ways depending on what is expected of us in relation to our roles and other determinants of “who we are” and “what is appropriate.”

    …again, thanks so much for writing this, Sera.