COMING FEBRUARY 2025 WITH HARPERCOLLINS
An Invitation
Seventeen years ago, when I endured a string of life-threatening pregnancy losses and rare medical conditions, being a physician didn’t protect me from feeling isolated and overwhelmed. What I longed for was a community of women--or even one encouraging story--to reassure me that I wasn’t the only person finding the path to motherhood so complicated.
But talking about my struggles seemed unimaginable. Watching friends and colleagues host baby showers and celebrate their children’s milestones, I balanced precariously along the edges of their lives. I guarded my sadness like a shameful secret, terrified of being seen as a failure or, worse, being treated as an object of pity. As the months wore on, I recognized that my silence wasn’t easing the burden. Instead, it was preventing me from healing, both by hindering the forward movement that I needed to heal myself and by blocking me from serving as the attentive, compassionate doctor that I aspired to be to help others heal.
So I began to reveal my story, tentatively at first. As I did, other women eagerly offered their own stories in return: Stories about becoming a mother, about growing up as a daughter, about being part of a family. Stories that were deeply felt and self-defining, laced with wonder and anguish and persistence and grace. Stories full of moments they had never shared before, even with their closest friends. Stories about holding their lives together even as everything seemed to be falling apart.
Though few would have chosen their difficulties, every one of them believed that they wouldn’t be who they were if their lives had been simpler, and for the wisdom they’d gained they were grateful. They didn’t accept the intolerable assertion we too often foist on the grieving--that everything happens for a reason--but they were making meaning out of everything that had happened. The stories they told were uplifting and joyful, even in the face of great loss. The clear-eyed optimism they embodied, resolute and never naive, led the way down a tangle of paths that diverged from what they had expected and veered instead into what they had experienced. I was in awe of the strength and beauty of these ordinary women in extraordinary circumstances.
As I took in the stories of the women all around me, I realized that they were the community I had been longing for. These women changed how I understood my own narrative. Their eloquence reminded me of the power of words and the catharsis in feeling heard. Their trust gave me permission to reach out to others even while I was still finding my way. During a long stretch of time overshadowed by uncertainty, it was their resilience that steadied me, allowing me to imagine a more hopeful future. When I asked each of them if I might retell their stories alongside my own to support other women and families, they generously agreed.
And so Held Together invites you to walk alongside us as the details of our lives unfold: Infertility, multiples, abortion, surrogacy. Loss of pregnancies, death of a child, death of a spouse. Genetic disorders, mental illnesses, physical and emotional abuse. Poverty, legal struggles, career conflict, job loss. Coping with life-altering diseases in our children and in ourselves. Confronting turning points in national and global history. Watching scientific breakthroughs occur in real time. Finding faith and questioning it. Rejecting assumptions about womanhood while experiencing gender as more fluid than binary. Devoting long hours to delivering babies and caring for new mothers while pregnant. Motherless mothering. Adoption, international and domestic, successful and failed. Foster parenthood. Step-parenthood. Teen parenthood. Putting off parenthood for so long that it almost doesn’t happen. Ambivalence over whether to become a mother--or wanting to be a mother desperately and ultimately redefining what motherhood could come to mean.
As we embarked on this work together, I began to understand just how far collaboration might take us. What I had first seen as small moments were actually the heart of something much bigger. Where our stories intersected, they came alive. Where grief and joy converged, where oppression and courage coexisted, we were exploring uncomfortable ideas, and this comforted us deeply. Rejecting the notion that valid narratives required resolutions clearly achieved and adversity neatly conquered, we embraced doubt. We admitted that our stories were messy and complicated--and that we were a long way from knowing how they might end. We relished coherence, dissonance, redemption, and imperfection alike. We welcomed vulnerability and humility. We liberated ourselves and built connections with those around us by sharing our stories, again and again, and we heard our voices grow more self-assured and more resonant each time.
Held Together opens with my own story--because how can I ask others to bare their most intimate thoughts until I am ready to do the same?--then connects to the lives of women who have shaped me through the obstacles and triumphs that have woven our stories together. One close friend struggles to bond with her exceptionally unsoothable newborn as I mourn multiple pregnancy losses. Another recounts her experience of surviving a devastating cancer as I wait to learn my prognosis after pregnancy complications requiring chemotherapy. My patients teach me how to accept the pain and absurdity of the human condition with humor and dignity, even when our days are endlessly different from what we’d expected. My colleagues' doubts about their choices emerge as we lament the impossibility of finding true balance in motherhood and medicine.
All of the contributors in this project identify as mothers and as women. But they are also so much more. They are physicians, nurses, engineers, biologists. They are architects, artists, activists, teachers. They are homemakers, hired maids, office workers, massage therapists. They are partnered and single, widowed and divorced, gay and straight, city dwellers and homesteaders. They and their families represent a wide range of racial, cultural, religious, and socioeconomic backgrounds. Some have had limited opportunities for formal education while some hold multiple advanced degrees. They have lived all over the United States and have immigrated here from other countries. Their pregnancies took place from their mid-teens to their mid-forties, and their children range from newborns to fifty-somethings who are mothers of young adults themselves. They grew up financially secure and destitute, coddled and neglected, bold and afraid, innocent and tough. They have become, every one of them, courageous and outspoken women who are committed to using their stories to help support others.
They know--we know--that our words can create worlds. We are made of the stories we tell ourselves, the stories we tell each other, and even the stories we hold too tightly, fearing the power they contain in the waiting to be told. Loosening our grip on our most closely held stories can bring us together in a way that nothing else can. In every conversation, we have the opportunity to listen more carefully, to engage more thoughtfully, to give of ourselves more generously, and to ask questions that transform our personal relationships into dynamic and resilient communities. Above all, the wide-ranging perspectives of Held Together ask us to consider our common humanity. We are all just people, shepherding each other’s memories. We are creating life, raising children, and building families, even as we search for reassurance that we are not unique in our struggles. We are all patients and we are all healers, navigating tenuous boundaries between wellness and disease. We are realizing that burdens are sometimes gifts. We are living in the liminal spaces of these fragile, beautiful moments.
Collaborating with such an amazing group of women to write Held Together has changed how I see my role as a physician as well. In the listening, in the telling, in the bearing witness and the being witnessed, this project has become my practice of medicine. I am honored to call the women whose voices fill these pages my patients, my colleagues, and my dearest friends--some, in fact, are all three, and half of the contributors are medical professionals themselves--and we share years upon years of sustaining and intertwined relationships. I have learned more from them about compassion than from all my days in hospitals and in classrooms. From them, I have come to understand what true healing requires.
Physical recovery is not enough. The passage of time is not enough. Success in unrelated aspects of life is certainly never enough. More than one woman has told me, over hours of coffee shop conversations and lingering backroads strolls and tearful clinic revelations, that it was only in sharing the story of these pivotal moments that she has been able to move beyond them. To reimagine them in a way that replaces grief and regret with growth and purpose. To revisit her past--and herself--and come out stronger.
Held Together now welcomes you into this place of healing, into this refuge built from the stories that surround us and that will shelter each one of us if we are brave enough to seek them. We are holding each other together in love, offering the same to all who would join us. We are lifting our voices even as we feel the ground give way beneath us. The foundations may not always be strong, but we are.
We hope that you will find yourself among us and know that you are not alone.
