THE BLUE COTTON GOWN

Captivating memoir of the trials and tribulations of a doctor-nurse team struggling to keep a small West Virginia women’s health center afloat and their 30-year marriage intact.

Harman, a nurse-midwife, and her husband, a gynecological surgeon, stopped delivering babies when payments for medical insurance became unaffordable, but they continued to offer first-trimester care and gynecological examinations. The women who donned a blue cotton gown in Harman’s examining room received far more than a pelvic exam; she listened to their personal problems and freely dispensed friendly, often motherly advice and lots of warm hugs. Among those patients were Kasmar, a middle-aged woman intent on becoming a man; Heather, an unwed teenager pregnant with twins who died in the womb; Shiana, a college student with a used condom stuck inside her; Nilla, a mother of seven with a sexually abused four-year-old daughter; and Trish, whose daughter had a baby with her drug-addicted boyfriend and then may or may not have killed herself. In the midst of these female troubles, the author underplays her own surgery for uterine cancer. Meanwhile, back at the office, accountants mishandled the practice’s financial affairs, debts mounted and letters from lawyers threatened malpractice suits. Her reliance on a middle-of-the-night shot of scotch as a sleep aid, hardly the approved medical remedy for insomnia, indicates the level of stress endured. Although she writes of her husband with a mix of respect, admiration, exasperation and love, he remains a rather vague figure in this world of women. Brief chapters tell of their early life together as hippies in a commune and her first experience helping with a home birth, which led her to become a certified nurse-midwife, but her focus is on the problem-filled present.

Harman comes across as a genuinely caring health professional, writes engagingly of her world and gives a frank picture of the pressures and strains of a husband-wife team running a small medical practice.