What a way to end the season on such a tear-jerking note! Between the storylines of Miss Higgins and her son, Trixie and her struggles, the Turners and little May, and the cherry on top of Sister Julienne being awarded Mother of the Year in Poplar (not to mention Reggie’s presentation about his two mothers, Ivy and Violet) … I was running short on tissue by the end of the episode.

Were you taken by surprise by the storyline of Millicent (Georgie Glen) and her son? That came from left field. I recall many births I’ve been privileged to be involved with; some of the births closest to my heart are those in which mothers made that heart-wrenching decision to place their babies for adoption. I have stood in amazement at the courage, resilience, and absolute selflessness of women who have carried a pregnancy, toiled fearlessly through labor and birth, only to lay their child into another woman’s arms. Perhaps because I cannot fathom the strength and bravery required to make such a sacrifice, those births have been amongst my most memorable. I was left without words when Millicent uttered, “I was there for his first breath and his last, how many mothers can say that?”

Bright’s Disease (a term that is no longer used), which affected Millicent’s son, is a term for acute or chronic glomerulonephritis. The part of our kidneys called the glomerulus acts as a filtering system– pulling both waste and toxins from our blood and pushing them into urine to be excreted from the body. Whether because of tissue injury or disease, for whatever reason the glomerulus can cease functioning. This causes toxins and waste products to build up in our bodies, eventually causing kidney failure. In current times. glomerulonephritis is treatable. Even a kidney transplant is currently a treatment, which is ironic in this storyline as Millicent would have been a willing and appropriate kidney donor had the option been available to give her son life a second time.

The other major storyline in this episode was Trixie (Helen George) spiraling down into old patterns of substance abuse: the use of pills to sleep and caffeine pills to help stay awake. Thankfully, heeding her brother’s advice, she agrees to head “across the pond” to reunite with Matthew (Olly Rix) to save both her marriage and her sobriety. Wouldn’t it be fun to see them next season as tourists in NYC?

As evidenced by Trixie’s lackluster reaction at the birth where she was also inadvertently showered with amniotic fluid (yes, been there and done that), Trixie appears to have reached that burnout point that haunts all caregivers. With her sobriety and marriage in peril, Trixie reached her limit for what she could put forth in service to the patients of Nonnatus House. One cannot pour from an empty cup, which seems a very basic truth, yet goes unacknowledged by so many of us who are caregivers. I have had midwife colleagues who wisely recognized having reached that point in their own careers and have stepped out of the profession, sometimes for a brief break, and sometimes permanently. I’m thankful for their bravery and ability to acknowledge the truth when it presents itself.

Until next season, friends…