September: A Time to Remember. With Love.
September is a month that holds a lot of beautiful memories and images. It also holds the promise each year of visual loveliness that can bring me to tears. Of weather that feels so perfect on my skin that I wish it would last forever.
September is the month of my sister’s birthday. This is our families' first year without her. I’m not looking forward to that. We will spend it together and I know that we will laugh and cry and remember her. Still, it will be incomplete without her and I feel bereft as it nears.
September forever dimmed on the eleventh day in 2001. Our country and our communities first shocked, then saddened. September holds the memory, always, of people who gave their lives and families and communities who lost loved ones. Our hearts continue to go out to those men and women who are lost to violence and hatred. As September approaches each year, the mood sobers and becomes more reflective. We remember. With love.
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Fertility Loss and a Mom's Love
Today’s my mom’s birthday. It’s not an easy birthday this year. At least for me, not sure about for her although I will ask her later.
I’ve been grappling with emotions, actions, decisions and yes, words and terminology ever since my sister died less than two months ago. Do I still have two sisters, only one is deceased? Am I still one of three sisters? One of three daughters? Do I have to preface a comment with “younger” anymore since I no longer have an “older” sister? No answers to any of those questions yet and of course they have me wondering.
The loss of a child or a pregnancy loss demands a certain thoughtfulness around these questions because it hurts when we don’t acknowledge a life or even the beginning or possibility of a life. For those of us who have undergone fertility treatment, IVF particularly, we see embryos that are dividing and “growing”. Yet they are not children or even babies and will not be until they are born.
So why do they so often have names? And without question, these embryos carry our hopes and dreams for the children that they could become. If they just would. If they just would continue to divide and implant and thrive and continue developing to become the baby we are hoping for.
We mourn losses that may not make sense to others. We mourn menstruating each month when we are hoping that this will be the month that our journey towards parenthood will begin. We mourn our embryos not turning into our daughters and our sons. We mourn pregnancy losses, no matter how early, when they do not continue into becoming our children.
And we mourn the death of a child. Whether an infant loss or a two-year-old or a seven-year-old or a fifty-four-year-old. It is not our expectation to outlive our children. It’s not what we believe is the natural order of things.
Happy Birthday to Our Mom
It’s my mom’s birthday today and she has two living daughters who are here to celebrate it with her. My sister Shari believed in heaven and I have no doubt that she is where she wanted to be; with my father and uncle and grandparents. I have no doubt that Shari is sending my mom love and smiles and sunshine and warmth and hugs and kisses today. I have no doubt at all. I never, ever would doubt either of my sisters' ability to continue to be a loving presence, no matter what the circumstances. And I have enough faith for us all.
I have faith that my mom is wrapped up in love today, that the cool breezes and the spring sun and emerging buds are my sister Shari wrapping her up lovingly. I have faith that this is a glorious day because she was born and that there is joy today because she is still here with us.
I know this is a hard birthday without the physical presence of my sister Shari. I know that losses feel like the bottoms of our lives have dropped out.
Another thing that I know about my sister Shari is that she would want my mother to enjoy her birthday. My sister Shari was a joyful person despite pain, setbacks and difficulties. She would have wanted my mom, our mom, to feel loved today.
I’d like to think that all of us who have experienced losses have that additional resource of feeling loved by those beings not here with us on the earth. And if you don’t believe that or can’t feel it, that’s ok, I don’t want to impose my belief system on you.
I will just hold some extra space for all of us who are feeling those losses. Imagine that space as a vast reservoir of love and peace.
To my mom, today, a special birthday wish from all three of her daughters. We love you. We cherish you. We appreciate you. We’re so blessed to have you as our mother.
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This is a blog I never wanted to write. That I don’t know how to write. That I’m not even sure I should write and post on PathtoFertility. Maybe it’s not appropriate to share such personal information here.
Except if you are a regular reader that might make you laugh, because of course I share personal information here all the time. It’s really one whole, big hunk of the blog. By sharing my experiences of infertility and fertility treatment, you, my reader, see that your own reactions and responses are well within the range of normal, even expected feelings. My gift, as I see it, is that even though I have not been in treatment for a long time, I still relate to how it feels to be in fertility treatment and struggling to conceive. Part of that is my connection to patients and Fertile Yoga students. Part of that is because of your wonderful feedback here on this blog. Part of that is how I see things in the world; that I know so much of life is relatable. That how we see things, the glasses or lenses that we look through, affect who we are and how we are in the world. And I feel connected to you, my readers, so I will share.
Deep breath. And again.
On March 19, 2014, one week ago today, my older sister died.
I remember how much she wanted me to have children. How much she hoped and dreamed that I would. Because she could not.
She never talked about her longing or sadness about not having children. Certainly not in her later years. I will ask her best friends, identical twins, whether she spoke of this earlier in her life. I hope at this moment that she didn’t feel sadness about it. She was not a sad person. She was a very brightly alive person.
She loved children. Absolutely loved them. We have six cousins and she knew all of their children. She knew their birthdays and she always made sure to send cards and little gifts. I was reading one of her books last night and came across an envelope with her handwriting on it, with one of our cousin’s children’s names and birthdates, as well as anniversaries and more.
Even as she became more disabled and in more pain, she taught after school art programs to children. We found so many pictures and cards from the children that she taught. Loving cards, in carefully crayon written words, addressed to her, with comments only she would have understood. Pictures of children with smiles from ear to ear, showing off the carefully designed projects that she helped them create to feel proud of themselves. They were her children, her connection.
She always had children in her life. There are more pictures of her sitting, with her huge smile on her face, holding a baby than almost any other type of picture. Babies were always pretty calm on her lap. Shari was not a saint, but her gentle spirit and playful connection to the very young was genuine and readily apparent to the little ones. She was soothing and spoke to them in a way that they understood.
She understood bunnies and teddy bears and baby dolls. She really got that they had a life of their own. When I look, I see a stuffed animal collection. That is not what she saw. She saw her friends, her companions. And her babies. I had to reread the Velveteen Rabbit to remember. She never forgot. Her well loved companions will have a home with my younger sister and I. They will stay part of the family.
Shari was perhaps the best role model ever for taking childless, moving through childfree and coming out on the other side. She was an aunt, a cousin, a second cousin, a teacher, a motivator, and a friend. She was a sister. And she was a daughter.
She was pretty inspirational in those roles. When life circumstances prevented her from achieving a goal, she circumvented the obstacle or created a new goal. She let very little do more than slow her down and she did what she needed to, with a smile on her face. She was unstoppable.
I saw evidence of all of this in a simple expression of her art. While going through her home and starting to pack things, we found art work we had not seen before. Some of it was unfinished and looked abandoned. Starting with the tiniest of needlepoint, then larger pieces with bigger holes, then bigger canvases. She moved to plastic canvases and then painted frames. She started out with the tiny seed beads, where the holes were almost imperceptible, and then slightly larger beads with larger openings, to larger beads still, finally to wooden beads.
These weren’t abandoned pieces. This was her accepting that it was time to move on to art that she could see and work with more easily. She worked with her abilities and found the medium that would accommodate her. I don’t know if she had regrets about putting the previous work away. I do know that she moved on to what she could handle, a place where she could still express herself through her art.
Shari believes that she is with my father, uncles, grandparents and beloved animals. I believe Shari is where she needed to be next, where she could be her most capable and able. I believe that she is now, finally, pain free. I believe that she is whole and complete.
But then, she always was.
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A Pause for Remembrance
And in peace.
A reminder this morning that I received.
We are not alone in our suffering and loss. And we are not alone in our ability to heal and find comfort from our pain.
We hold our hearts in our hands and offer it to those who need it most. We give freely to those weeping. For whatever their reasons. Today, of all days, we remember that we are all human beings and offer ways of listening to one another so that we feel heard. And so that we feel comforted by being heard.
We feel our tragedies. Personal, local, national and international. We shed tears for our own losses around our fertility and we feel the pain echoing throughout the world for the loss of peace and serenity.
We feel the violence and prejudice and somehow, through our fear and self absorption, we find the courage to speak up against it. And when we do not, we dig deeper and find it within ourselves to find our voices the next time. For it seems, there will be a next time. Our voices count when it matters most; when someone is in pain or being oppressed or is resorting to violence. Our voices matter, individually and collectively.
We remember in love and in peace, those who are hurting enough to do violence and those affected most by it.
We remember in love and in peace, our own pain and we breathe and we find a way to stay present and compassionate to others.
We remember in love and in peace that all living beings have a right to live and love and be heard.
This morning, I feel our pain. And our hope. And our love. And our compassion and strength.
Today, I remember in love and in peace.
At 8:46 am, please spend a minute of quiet to remember. Lovingly and with peace in our hearts.
Lisa Rosenthal's Google+
Facing Loss and Funerals in Newtown, CT
Below is a blog that I wrote several years ago.
So much of what is in there is still so true.
And for me, as for many of you, life has unalterably changed in the last week.
You know that I live very close to Newtown, CT. You know where Newtown, CT is. You know what happened there. It is now part of our cultural understanding, in a horrific way that no one ever wanted or expected.
Six funerals for babies yesterday.
For six- and seven-year-olds. Many of the people grieving were younger siblings.
I can't wrap my brain around that.
I cannot wrap my heart around that.
We all grieve for these children and their families.
Today, I see these even younger children, missing their big sister or brother.
Holiday Season in Full Swing - Bah, humbug
The holiday season is now in full swing. Christmas songs are all over the radio, holiday lights are up. Parties have begun. Drinking, eating, celebrating, and oh yeah, shopping.
I went into four major retail stores, touted to have everything one needs for the holidays to get Chanukah candles and came away empty handed. A menorah, to be lit each night, needs forty four candles. Chanukah candles are sold in boxes of 44, usually easily found. Sometimes they are handcrafted, hand-dipped, specially decorated. I was content for the incredibly inexpensive, somewhat homely mass produced kind.
Nothing. Zero. Nada.
Even for those of us who don’t celebrate Chanukah, we know about menorahs. It’s a mainstay of Chanukah. See, even my Microsoft Word program capitalizes it if I forget! So I won’t even go into a tirade about how Christmas takes over the stores and that there are rows upon rows of green and red, as far as the eye can see in any store you walk into. I won’t go on and on that the Chanukah section is perhaps four feet wide if there is one at all. I’m used to that.
I’m not used to not being able to find Chanukah candles. In the stores that I went into, I asked for them and was shown fake candles. Yes, that’s the new thing. Fake candles that don’t light up and present a fire hazard. Ok, I guess I get it. I think, though, that I might even have been appeased to have found an electrical menorah. Nope, none.
It hit hard. I knew that my reaction was moving deeper than my inability to find forty-four ugly candles. It was being in the minority, being outside looking in; feeling the edges of the warmth of the season and not truly feeling warm or welcome.
Same exact feelings I had looking at babies and strollers and mothers. Because, of course, all the stores are about shopping. And so much of that shopping is about children. There's Santa Claus, holding court, with child after child confiding in him what their secret wish is. Standing on line, sometimes for hours, just to sit on his lap and whisper in his ear what their dearest hope is.
Don’t you wish we could go sit on his lap? Not in some icky, creepy way. I wanted to go sit on his lap for years and tell him how good I had been. How I had given up drinking coffee, liquor, eating many of the “wrong” foods. How I moderated my exercise, took my medications, gave myself shots, went for ultrasounds, and did what my doctors told me. That I had been a good girl, that I deserved my secret Santa Claus wish.
My wish for all of us is that we stop being on the outside, looking in. That we get to join the “Mommy” club. That this year, Santa grants our deepest, most heartfelt wish. After all, we don't want the whole bag of presents, do we. We just want that one, special wish granted.
I’d much rather have that for all of you than find my Chanukah candles.
Sending you love and comfort and support on this very hard holiday season.
Hurricane Sandy | Searching for Words After the Storm
I haven't been able to find the words that reflect the colossal damage that has occurred on the eastern part of the country due to Hurricane Sandy. There are plenty of pictures and most of us have seen, through them, a small idea of the horrific loss of property, homes, landscape, memories and life.
There have been several pieces of writing that I've started so that I could publish them here, on this blog. And I haven't published any of them. That is unusual for me.
This is so big that words truly fail me, in any conventional way.
What do you say when people have lost so many things that define their lives? Their homes; they are the places that they have lived, that have memories peeking out of every corner. Their connection to their past, what has come before. We see our families of a year ago, five years ago, twenty years ago in the places that they once were. We see them sitting in a chair reading or in the kitchen cooking, or laughing over a silly comment in a living room. Our homes are more than physical shells, they are our homes, where we've lived and laughed and cried and been alive. Our homes are our visual heritages, and are often our precious reminders of family who are no longer on this earth.
There is a sense in the air of gratiude, as absolute in it's presence as the earth below us. In some places right now, it's just the faintest of presence, existing in the air, like a scent floating on the wind as it moves past you. Just like the earth below us though, it shifts and moves and is unpredictable right now. I respect that for some, it's nearly impossible to even consider feeling grateful in the aftermath of loss.
A Time to Grieve, to Acknowledge Loss
And like every other season, there is a time to grieve. To acknowledge loss. To mourn for what is gone.
Rebuilding will come, restoring hope has already begun. Grieving has a right to it's time, rather than rushing past it. We mourn for what we've lost.
We mourn for those affected by this storm. We mourn for lives permanently changed or lost. We mourn for neighborhoods burned or flooded. We mourn for landscapes that no longer look and will never look the same.
And I encourage us all to send our love, our compassion, our gratitude to those suffering. We know what it's like to suffer. The details may be different, dramatically different.
Pain is pain. Grief is grief. Loss is loss.
Whether it is loss of our home, our loved one, our neighborhood, our pregnancy, our fertility.
Pain is pain.
Allow that to bring us together as living beings.
We breathe into gratitude for what we have. We breathe into hope for the future.
We grieve for what we lost.
As it should be.
An Infertilty Poem
Infertility. Yes, it's about loss. But, it's also about hope and love.
I hope that you find something helpful or comforting or loving in this poem - which is one of my favorites that I like to share.
This year, I grew a garden
I tilled the soil and pulled the weeds
I raised the beds and laid the seeds
before the ground would harden
I mixed the clay with fertile dirt
worked the ground till my bones hurt
I tended to little seeds
and out of dirt they sprouted bright
soaking in the water, nutrients and light
and I could feel my heart beat
I delighted in the miracle
that God and I could conspire
to make a garden grow
I think I became obsessed
Secretly planting through the night
a butterfly garden to the left
a water garden to the right
and I wasn’t finished yet
I planted bushes here and there
I even planted trees, banana and pear
I was a gardener this spring
basil, berries, melons, cilantro
cucumbers, corn and little tomatoes
fragrant, sweet and pretty things
for surely if my hands can do all of this
then my belly deserved nature’s kiss
As Autumn slowly takes over
The harvest moon has come and gone
my heart beat is not quite as strong
My stride’s a little slower
My tomatoes vines are turning brown
And I can’t pick my knees up off the ground
The air this morning was cold
My lush gardens have wilted away
butterflies didn’t visit them today
The pain in my stomach is getting strong
And I am losing hope in the garden inside
I don’t know where to go, whom to confide
This year I built a garden
I watched it bloom and fade
But I could not grow one in me
My seedlings could not be saved
I tried my best to build good soil
but no amount of tilling, no amount of toil
Could make my little garden grow
From the inside out
Will I grow a garden next year?
Right now, I feel such doubt
I doubt and I cry
I cover my face and hide
Though my heart is broken
I will not stop my stride
I will continue to till the soil
I will pull away the weeds
I will feed the ground with compost
And nurture every seed
I will fill my garden with water
And sun from up above
But above all things
I will give my garden love
One day a bean will sprout
And he will beam so bright
soaking in the water, nutrients and light
he will feel my heart beat
and take in all the love I give
As God and I will conspire
to make a baby live
Infertility and loss.
Where do you feel it most significantly?
For me, it popped up in unexpected places and in ways that I felt unprepared for.
When my father died, it was sudden. It was in the middle of infertility treatment, right after a miscarriage. I felt like I was carrying the weight of the world on my shoulders.
Several years later, still in treatment, still no success, another miscarriage later, I got leveled by infertility fall out again.
My mother was moving and deciding what to bring with her, what to give to each of her daughters and what to get rid of.
And there I was. Looking at china and stemware and wondering if I would ever have a child to hand down things to. A child to keep my grandmother's beloved things, that child's great grandmother.
Was this the end of my family lineage? My family's history? My family?
And it brought up my father's death again. Of course it did.
For the grandfather that my children, who did not exist, would never know. I grieved for the loss of relationship that could not exist between my father and my children that I still hoped for. I grieved again and again, for what could not be.
China, stemware, death and infertility. It all got very intertwined for me. It felt almost impossible to separate out one from the other. Crying over my father and over the beautiful glasses that my grandmother so lovingly took care of.
I was spared some of the horror stories that I heard from my friends. My mother was kind, as were my sisters. There was no conversation about who would inherit these things from us. No conversation that these beautiful heirlooms should go to someone else who could pass them down, keep them in the family.
And so I grieved new layers of the loss of my father. New layers of the loss of two pregnancies. New layers of infertility, life and death.
With each layer of grieving, there was some relief. Just the smallest of lifting of sadness.
I brought those beautiful things home. I put them where I could see them every day. As my grandmother taught me, I did not save them for special occasions, I used them often. I enjoyed them and loved them and they brought joyful memories of my grandmother.
I inherited much more than material things during that time. I inherited love, tenderness and compassion.
Infertility opened my eyes to what I had in my life, not just what I did not have in my life.
And every time I forgot, I looked at the sun streaming in and sending rainbows all over the room from my grandmother, my mother and my sisters.
We don’t want to be pregnant. We don’t want perfect eggs or perfect embryos or perfect cycles.
What we want are babies in our arms.
When miscarriages are experienced, we don’t necessarily enjoy the next pregnancy. Even after we pass the time of our previous miscarriage, we don’t go on to enjoy the pregnancy. As one of my Fertile Yoga students said this weekend, she’s just waiting for the other shoe to drop.
When we undergo fertility treatment, we know that sometimes it’s successful and sometimes it’s not. Pregnancy rates vary from infertility program to infertility program; you can check on the SART (Society for Reproductive Technology) website to see what they are for the programs in your area. And while we understand that sometimes fertility treatment doesn’t work, we don’t really understand it, especially with IVF (In vitro fertilization).
With IVF, we know that we are transferring fertilized, dividing embryos back to the uterus. Sometimes we literally see the cells dividing, under the microscope at our programs. We know that they are alive and well and functioning just as they are supposed to, to become babies and children.
So really what happens is that each IVF cycle becomes a loss. A miscarriage. While no pregnancy test has come back positive, we know that egg and sperm had met, the egg had fertilized and that there was an embryo dividing and alive.
And when that pregnancy test comes back negative, we feel a loss. That embryo is no longer alive, no longer has the potential of the baby we are dreaming of. If we’ve had positive pregnancy test results that have ended before our baby is born, believing in the positive results next time because even more challenging.
So if you’ve been struggling with infertility, been in treatment, had positive pregnancy tests and then find yourself unable to enjoy the positive test, give yourself a break. The anxiety of “will it work better this time?” can be nearly insurmountable. The inability to feel happy actually makes perfect sense. Especially to a heart that has been wounded by infertility.
So maybe the best advice that I can give you is that if you are not jumping for joy with a positive pregnancy test, especially with past losses, you are not alone. And it is ok. Perhaps at some point, you will be able to enjoy the pregnancy.
If not? Perhaps the very worst, if you do experience a healthy pregnancy that you feel anxious through? Nine months later, the pregnancy will be over and you will enjoy your baby.
And that would be a happy enough ending for most of us.
Reproductive Medicine Associates of Connecticut has two wonderful mental health professionals that work with our infertility practice. Lisa Tuttle PhD works with our patients in the Norwalk office and Jane Elisofon MSW sees patients in our Danbury office.
Jane was gracious and compassionate enough to tackle a very emotionally laden topic today. She offers her own brand of understanding and non-judgemental advice as well as letting you know that the feelings that you may be experiencing are normal. Enough from me, read what she has to say:
Perhaps you had an abortion as long ago as one or two decades prior to beginning infertility treatment. Like most women with that experience, you may feel that if you had to make that decision all over again you would do it the same way, for the same reasons. Maybe you even wanted to have that child but circumstances in your life made that an unrealistic possibility. You were brave and you moved on with your life. It may seem difficult to believe that something in your distant past could affect you now, but it can and it will. Abortion is an enormous loss in one’s life, no matter what the circumstances were. Losses need to be mourned. The mourning process encompasses experiencing a myriad of intense feelings. Sadness, guilt, disappointment, anger, decreased feelings of self worth are some of the more common feelings aroused in this painful process.
Usually our losses are ones that we share with those close to us. We are surrounded by people who know what we are going through. With women who have just had an abortion, however, this information is often not shared or shared with very few people. Therefore, there are few opportunities to mourn and sort out all the feelings that might surface. Many women have not even begun to grieve for the child given up through an abortion—even one or two decades later. Other women begin grieving but become stuck somewhere in the process, with no opportunity to feel free to talk it out.
Loss and mourning are inherent in many phases of the infertility process. Anyone going through infertility treatments knows the visceral feelings that one has when they receive a negative pregnancy test or a negative result of any kind during the process. We know that these highs of anticipation and lows of disappointment make one feel as if on an emotional ‘rollercoaster.’ The dream of having one’s own child is a longing unlike most wishes and needs in our life. Therefore when you receive negative news about an attempted conception or negative possibilities from a doctor, you feel more than disappointment. You feel “loss.” Many people can understand your feelings of loss when you have conceived and lost a pregnancy. However, it is more difficult to understand the legitimate feelings of loss when an IUI or IVF cycle is unsuccessful. After all, what has been lost? Plenty! For many women, the loss of an embryo at any stage is the loss of a child. But even if you do not consider this early embryo in this way, you have temporarily lost the dream of the cycle working and becoming pregnant with your child. At these times of grieving, you need to have support and understanding of those around you, so that you can sort out all the feelings you have in relation to these losses. Being able to mourn gives you the emotional strength to continue the infertility journey until you are successful in having your family. If you need to terminate the infertility treatments, regardless of the reason, it is important to mourn the losses left behind before embarking on other paths to having a family.
When we are faced with all the emotions we may be experiencing about a loss during the infertility process, there is an eruption of feelings from prior losses in our life. Even if those prior losses have been mourned, the intensity of that upsurge of affect can be difficult but manageable with support. However, when a woman has not had the opportunity to mourn an enormous previous loss, infertility issues and treatment can cause the suppressed feelings to return with a vengeance.
Many women feel guilty and think that maybe they are now being punished. Guilt is an emotion that is part of any normal mourning process but it becomes more intense and complicated when it is in response to having decided to terminate a pregnancy. Sometimes the guilt is related to strong religious belief and can leave one feeling that they do not deserve to have their desire or prayers for a child now to be answered. Too often women are unable to forgive themselves. I have heard many women blame themselves for waiting too long to try to conceive, even though it is clear to them and to me that the reasons they waited to start a family were mature and realistic. Some women feel guilty because they feel responsible about their husbands being on the emotional roller coaster with them.
Many women speak of the irony of having trouble conceiving when they easily conceived a child that they were not ready to have. Some women have spoken of wanting that baby but knowing that they did not have the support system necessary to raise the child. Thus the feelings of loss are endless and resurface with each new loss. One woman spoke of feeling that “someone was missing” in her family. She was pained at the idea of maybe not having a second child. A realization hit her: that she was not sure if she wanted a second child because that was her idea of a family, or whether ‘the empty place’ in her life was because of the lost child. That insight caused her to question whether a second child would fill that empty space. In her counseling sessions she mourned the lost child and discovered much about herself. In the end, she decided that she did want a second child for her family and that the ‘missing person’ was put to rest. This was quite important for this woman. Why? Because if she had not mourned the lost pregnancy, she would have found that having a second child would not have filled that ‘empty place,’ and that recognition could interfere in her relationship with this child. Now she is pregnant and thrilled. In addition, she expressed finding a peace within herself and in her relationships with others.
The traumatic experience of an abortion can surface in other ways. The medical procedures and appointments can stimulate memories of the medical experience of the abortion. Thus the infertility process takes on traumatic memories and can feel unbearable. I know a woman who is questioning continuing her treatments, even though her doctor feels positive about her prospects. Although encouraged to talk about her abortion experience, she fears being re-traumatized just in the ‘talking about it.’
If this blog article is speaking to you, you need to know that you are not alone. There are many women who share your past and present. There are many professionals: nurses, doctors, counselors, and other professionals involved in your care, who would understand and support you, without judgment. I strongly believe that when painful and difficult crises come into our lives, we need to try to take advantage of any opportunities for growth that the situation may present to us. For example, this infertility journey may strengthen your marital relationship or it may validate the strength you have as an individual. For some patients, this difficult journey, which no one would ask for, can present an opportunity to heal from a prior painful event, like an abortion.
Jane Elisofon MSW
Reproductive Medicine Associates of Connecticut