Since surviving near-fatal postpartum complications four years ago, I’ve been searching for a reason why. Now I believe that’s a dead end. A different mindset has been healing. Plus: My monthly mental health research column and recommended reading.
Takeways
- Purpose doesn’t have to be grand: You don’t need an extraordinary reason or cosmic justification for being alive; meaning can come from simply showing up for the moments in front of you
- Action creates purpose, not the other way around: Instead of needing a “why” before you act, the daily practice of being present and responsive can generate its own sense of meaning and direction.
- My latest work: My monthly mental health research column for bpHope covers the latest developments in bipolar disorder. July’s edition centers on how the specifics of someone’s bipolar journey — including the gut microbiome and how old you are when symptoms start — can inform personalized care.
- Recommended reading: The Neapolitan Quartet explores how the stories we tell ourselves fundamentally shape our reality, raising profound questions about whose perspective we trust and what “truth” really means.
Four years ago this week, I almost died.
The bleeding after I gave birth to my youngest child – repeatedly dismissed as “you’re just not resting enough” – had been filling a pad per hour for ten days. Then it became something much worse. I lost half my body’s blood volume. My body began to shut down.
But after an emergency hysterectomy, bags of blood products, and a week in the hospital, I came home instead.
At least most of me did. A part of me stays away, watching from the vantage of the timeline where I didn’t make it.
Especially this time of year – when we’ve finally finished eating my youngest son’s birthday cake leftovers, just like we did on “birthday zero” – the almost-ness of it all is just too real. At most other times, in many other places, I simply wouldn’t be.
Even in this time and place, I tried so many times in those ten days to get someone to listen to how badly I was bleeding and how awful I felt. And no one did until it was almost too late. Maybe they weren’t supposed to. Maybe I forced my salvation when I should have surrendered to fate. Maybe I shouldn’t be here.
My friends don’t like it when I talk this way. They tell me that it’s good I’m here. I don’t disagree, exactly, but I can’t quite believe them either. Why is it good? What am I here for? The question feels urgent and impossible, like trying to justify a miracle you never asked for.
When it goes against so much of history, so much of the present, when too many women die of postpartum complications, why am I still here?
I’ve been trying to answer this question for four years. Years of taking family photos and blinking away the vision of myself edited out, of chaperoning field trips and wondering how they would have gone without me, of comparing this reality to the one that diverged four years ago, and hoping I stack up.
Four years of asking what my purpose could be. Is it to be my kids’ mother? Is it to write a book? Is it something else I’m missing entirely?
I haven’t found an answer to satisfy my doubting mind. Someone else could care for my kids. There are plenty of books in the world. I’m just not sure I could do anything extraordinary enough to deserve a dispensation from fate.
I’m beginning to wonder if maybe I’m pursuing the wrong question.
Because whether I should be or shouldn’t be here, the fact is: I am. I fry eggs for my kids. I turn flour into cookies. I have changed the world around me in irreversible ways.
Accepting the responsibility of being alive, of occupying a place in the universe, can give meaning. It can be something as simple as beaming out patience in line at CVS.
Action can supply a kind of inductive purpose, a mirror image of Viktor Frankl’s Nietzschean insight: “Those who have a why can bear any how.” Because the reverse is also true, especially when purpose feels as slippery as a fish. Sometimes the hows – the daily acts of showing up – can be a way to why.
It’s like the process of feeling less needed by your kids as they age. You may be needed less of the time. But the times you are needed count as much as anything.
When, in the yawning dark, I rub my son’s back while he nestles in a pallet of towels on the bathroom floor after getting sick, it matters.
When another son asks me to snuggle with him to quiet his nighttime fears about a zombie arcade game, it matters.
When a third wants to do the old Abbot and Costello Who’s on First routine with me, it matters.
Yes, someone else could do these things. But the point is they aren’t.
Like Schrödinger’s cat, it could be anyone until the moment it happens. Then it’s only you.
Once it’s you, it’s your job to be there. To meet the moment. The moment tells you what to do.
A requirement to be responsive feels easier to hold onto than a grand explanation. It has a portable, honest shape. It’s ready for what’s next.
Just as I don’t need the early, all-encompassing days of infancy to be purposeful as a mother, maybe I shouldn’t seek a sweeping story of destiny to justify my being here now. The scale is all off.
Most days, real life is smaller than that. It’s picking up the pearls glistening in our ocean of experience, and threading them one at a time, stringing together meaning as we go.
My Latest Writing & Editing
In the July edition of my monthly research column for bpHope, I cover new research exploring how bipolar disorder intersections with dementia, gut microbiome, energy metabolism, smart pillboxes, and the transdiagnostic approach to mental health: Bipolar Research & Insights: Dementia, Gut Microbiome, Mitochondria, and More | July 2025.
Book Recommendations
My Brilliant Friend, by Elena Ferrante
The Story of a New Name, by Elena Ferrante
Those Who Leave and Those Who Stay, by Elena Ferrante
The Story of the Lost Child, by Elena Ferrante
The first time I ever read the Neapolitan Quartet – a four-novel series that follows the friendship (!?) of two women growing up in mid-twentieth-century Naples – stands out as one of my favorite all-time literary memories.
Like a lot of readers, I had to see what all the fuss was about after The New York Times named the first book in the series, My Brilliant Friend, the best book of the twentieth century (so far). A lightning deal for the Kindle version happened to coincide with the first of my two surgeries last fall. It was kismet.
The last page of My Brilliant Friend took my breath away. I can’t recall ever having such a physical reaction to a book before. It was some sort of reflex that had me smashing the Buy Now button for the second book, The Story of a New Name. I simply couldn’t tolerate the library waitlist.
I had to check in with my book-loving friends. Did they know about this? They needed to know about this! It turned out, many of them did, in fact, know about this.
They had known about it as the books were being released, when I was preoccupied with grad school and having babies. All the better for me, though, because I didn’t have to wait for the third or fourth book. I didn’t have to buy them, either, since my friends had copies to loan. (Now, I have copies to loan, too, since by coincidence, my mom kindly presented me with the box set as a gift for my convalescence, unaware I had already fallen for the series and was deep into the third book, Those Who Leave and Those Who Stay.)
Don’t let these paperback-romance covers fool you: The Neapolitan Quartet is pure literary brilliance. The picture it paints is immersive. You feel like you know this place, and you know these people. It’s specific and well-researched, yet timeless in the way closely observed literature always is.
So what is it about? It’s about friendship. It’s about class. It’s about family. It’s about Italy and writing. It’s a Rorschach test of a series. You see yourself and your world reflected back to you.
Six months after finishing the fourth book, The Story of the Lost Child, one theme continues to occupy my thoughts: How the stories we tell ourselves shape reality. And how differently the world looks, depending on whose stories you listen to.
Of course, these thoughts are inspired by the alchemy of the four books together (which I am trying not to spoil!), but they’re also inspired by our political moment. And curiosity about my own ancestry, who tells the stories, and what stories different people would tell.
We hear Elena’s story — some 1,693 pages of it — but we never hear from anyone else. Including Lila, the best friend who is as much or more the focus of the book. What would Lila say that Elena didn’t? How would our closest people describe our lives? Whose account is most honest? Who decides?
Maybe, for me (Rorschach alert!), that’s what the Neapolitan Quartet is ultimately about: Truth.
Amazon (Neapolitan Quartet Box Set)
Browse more books on my Bookshop | Read more reviews on my Goodreads
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