The Postpartum Well by

Antonio Igbokidi

It was the color of dawn. Chilled grass tips pranced about the morning lawn, Giggling at the rising sun.

The reverberation of our baby’s giggle Engulfed our home like a full moon.

Bloody,

Like how red vessels seep through your eyes from lack of sleep, Lack of oxygen, and lack of moments to breathe.

For a moment — I forget how much of a blessing our baby is, Because of the pain that you are in.

Pain that cannot be seen and only vaguely understood by onlookers. Cousins of confusion are squatters in our walls the nights that she squeals the best. Feeding and nourishment are times that reflect your frustration the most.

You scorn at your body for being ornamental — a dried manger, Instead of a cup overflowing.

Can’t you see that you’ve brought life into the world?

You’ve poured your blood to crowning — crowning to cord — cord to placenta Generated a galvanic world in your belly and merged her atmosphere with ours now Our lives circulate around and through her lungs. You’ve put the breath of life into our existence.

Yet to you, your stretch marks do not reflect a championing of miracles

They reflect battle scars, Your tears of not good enough—

Your cackles of self-deprecation— Your somber thoughts of no longer belonging to unconditionality.

Can’t you see that you’ve brought life into the world?

When you— alone — are all baby and I need.

Until grass tips no longer prance in the dawn, Until the waters run dry.

Let us consider involuntary commitment and the standards which physicians use if someone is defined as a threat “to themselves, others or property.”

Physicians use these criteria to basically hold someone against their will. So, if someone is defined as a threat to themselves, others, or property, they may find themselves involuntarily committed. Or perhaps if this person has a mental illness or, a suicide attempt or something where their capacity is questionable. So, there are certain standards which we use to ultimately benefit a patient but, in the process, restrict the patient’s autonomy, and restrict the patient’s freedom. Freedom is an especially poignant topic because we are not only physicians but citizens of the United States of America and the very First Amendment of the constitution pertains to freedom (and really all of the Constitution does). In other words, I’d like to further explore the concept of being involuntarily committed in America, rather than anywhere else in the world. In the US, impinging on someone’s freedoms and their rights to live is incredibly important and shouldn’t be taken lightly.

But on the other end of that, I’m from Jersey City.

If you look at some people from Jersey City, just on the spectrum of autonomy and on the spectrum of things that you can do, you can use that definition of “threat to themselves, others or property” very loosely and you can apply it to so many things.

For instance, if you look at boxing and Arturo Gatti, who was fighting out of Jersey City, this person is by virtue of his profession, stating, “I’m going to be a threat to this other person when I get into the ring and they’re going to be a threat to me. So, I’m going to put both of us in harm’s way.”(1) And obviously there’s a contract and there’s the legal aspect of it, and there’s the sport aspect of it and this person is a prize fighter, fighting for glory and pride and for titles and all these different things. But the very simple fact of the matter is if you look at Arturo Gatti’s fight against Floyd Mayweather, that fight needed to be stopped and I think everyone in attendance, for several rounds, including the referee and the ring-side physician would agree that this person is now putting themselves in harm’s way consistently, in a way that is not safe for them to continue this fight, and we need to stop the fight. Ergo, we need to take to the person’s autonomy away for their own good i.e. this person can’t fight any more, we’re not going to let him come out of the corner anymore. (2) And although the corner can throw in the towel, the referee can also make the decision, the ringside physician, in certain states, can also make that decision.

Let us then analyze Gatti vs Mayweather juxtaposed with Gatti vs Ward. How do we objectively analyze the threat “to themselves others or property,” when Arturo Gatti fought Micky Ward three times? Meaning it was so close the first time and the second time that they needed a third time to determine who was the best fighter. For that fight, both fighters essentially indicated “OK I don’t want you to stop the fight because even if I’m in it within an inch of my life, I can win if the other person is within 1/2 inch of their own life.” That’s the point of the sport, and we can debate the aspects of boxing and its merits, but whether we like it or not it, boxing exists and thousands of people box and thousands of people fight. My opinions and other people’s opinions about it won’t really make a difference because there are individuals in the world who enjoy fighting, and individuals in the world who will continue to fight and individuals in the world who will continue to referee those fights and be the ringside physician at those fights. So it’s an important conversation to have about what’s actually going on in this community of people, and how we can protect this community of people and how we can do our best to make sure that these people, their freedoms and their autonomy, is respected as not only citizens, but as patients. (Please bear in mind that if a fighter gets knocked out they almost always go to the hospital directly afterwards due to a preponderance of concern.)

I also wanted to include another Jersey City native: Brian Donnelly aka KAWS, the artist. This person got his start in art by going around billboards or advertisements and basically graffitiing and tagging it up with spray paint. So this person was, by definition, vandalizing and destroying property. These advertisers had paid for billboards which were subsequently altered by KAWS.

So when KAWS added something to the ad, we celebrated that destruction of property and we actually say it is not destruction property, it is actually creation of art. Whereas if someone is a threat to property in terms of arson we say that is not a form of art. In fact, we acknowledge that is not a creation of something good, instead we say that that’s now harm and something bad and we should involuntarily admit this patient and we should see what’s going on with this person because this is concerning behavior. So where do we draw the line of “good behavior and we should encourage this and celebrate this and we should let this person continue fighting, or at least let this person continue doing their craft, their art, or do whatever it is they want to do”, versus, OK now “this person is not doing something good, this is now something bad and we should no longer let this person continue, since this is a threat to themselves others and to property?”

So the real crux of the matter is what if you also now have a mental illness on top of it? Someone like Van Gogh, a very famous artist who also suffered from mental illness, found himself in a psychiatric facility at various points of his life voluntarily. Or perhaps involuntarily.

That’s what I mean.

There’s some things that aren’t clear cut and just understanding where that line is and what’s on either side of that line, whether this is good, whether this is bad, whether this is something that needs to be addressed, something that doesn’t need to be addressed. And whether, central to this person’s behavior, is there a mental illness or something which needs to be psychiatrically addressed which would then lean us towards an involuntary admission, voluntary admission or no admission at all.

Dedicated to Dr. Cheryl Kennedy and her lifetime of commitment and service to the citizens -and patients- of New Jersey.

References

1. 5/18/02, 11/23/02, 6/7/03, Gatti, Arturo. “Arturo Gatti.” BoxRec, 2007, https://boxrec.com/en/box-pro/3999. Accessed 4 Jan. 2023. https://www.youtube.com/watch?v=UM0bpk6pSBw

2. https://www.youtube.com/watch?v=THojnKPFpFA

Do not fall down 2 meters by Dulce

It is a strange creature, The one that proliferates below.

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