Re-Read

I reread these three blog posts occasionally.... I wrote them during my OBGYN rotation in New York City during my third year of medical school. It was these three days that showed me my desire for pediatrics, the fragility of life, and a lot about being a human. I reread them to remind myself of why I do what I do...waking up in the 5am hour, spending time away from my son, my husband, my friends...crying on the inside for other people's children...that is the gift God has given me. I reread these so I don't forget. I will post them here because I think there is something in them for everyone.

Monday, August 04, 2008

Apgar 0/0....
Today was a normal day for me. Woke at 5:35am after tossing and turning till nearly one in the morning, showered, dried my hair, put on my scrubs, walked to car, picked up my friend Kyle and rode to work. Kyle and I got out of the car at 6:38am, as usual, and went into the hospital to begin doing discharge paperwork with our group, or those that show up early with us. One the two people we work with was on call last night. He told us that during the night an emergency C-section was done, and the baby was dead. Fetal Demise. Stillbirth. Apgar 0/0. Agpgar is the numeric measurement of a baby's viability (ie.... Activity, Pulse, Grimace, Appearance, and Respiration) with each area getting between 0-2 points, for a possible 10. This baby, a little girl, was 0/0. The mother, who was under general anesthesia, was unaware for almost seven hours of her daughter's short life, a life that did not even make it beyond the womb. I will go into the medical logistics of what happened. It would be too much medicine and too long and too complicated. And regardless of whose fault, residents, attending doctor, nurses, or no one at all or everyone at once, a baby girl is no long with us and the 24 year old mother is left to wonder. Even more, one of the delivering resident's is 18 weeks pregnant with her own son.

So while this was a normal day for me, while I was tossing and turning at 12:38 am, a girl around my age was losing her first child. It is just one of those things that reminds us to our lives in perspective.

Tuesday, August 05, 2008

Coming in 3's....
The hands were pale white, gradually getting pinker the further up the arm. As I watched for an hour, the lips, from the outside in, turned from a plump pink and to a ghastly gray. I lifted the lifeless curly-haired boy onto the scale. Seven pounds eleven ounces. Five days short of his original birthday. I rolled him to slide the yellow and green Winnie the Pooh snap up shirt onto his ashen body, placed a diaper over his bottom, pulled up the striped pants, and placed the too big hat on his head, I watched the nurse on his other side empty all of her tears from under her surgical mass. I rolled his feet in ink and stamped them, the usual practice I was told. Tears did not come. It was a moment when all the emotions you have should elicit tears but the ducts are dry. I was there.

She, the mom, said she had not felt the baby move in a few hours. Medical student, nurse, two residents, and one attending later the mother was told her third child, a son, was not "viable". Her baby was dead and was before she came to the hospital. Ten hours later, I was standing in the operating room waiting listening to the silence of beeping machines and laying a lifeless, beautiful boy onto a scale and carefully dressing him. They say it comes in threes. Deaths, births, life events. Well, I pray, sincerely and more than anything else for this week especially, that no other mother, no other father, family, doctor....no one has to hold a baby while staring so hard, begging the chest to rise and fall in a breath, feeling the disappointment when the small breastbone does not move and the pinkness turns blue-gray. So, please, if anything, do not let this come in 3s, at least for mothers.

And the enjoyment of my evening, dinner and watching Hopkins and Wipeout with my new friend, Paige, and JT, is overshadowed by the silent sorrow I witnessed today. How can you move on? I have done CPR on adults and had them die under my palms, but secondary, more times than not due to damage brought on by their own doing. But this perfect baby, this little guy did not have a fighting chance. So despite the fun, I think it is hard to erase what I saw, what I felt. I am sorry that the last two posts have been so sad, but at the same time, isn't this what my blog is supposed to be....my life in medical school, whether good or bad.

Wednesday, August 06, 2008 

Welcomed Cries....

Her head popped out of the tiny belly of her mom. Her nose and mouth were suctioned with awkward blue bulb I remember in our closet from childhood. Her PINK little body slid into my hands as the doctors, resident and attending, clamped her cord, I held onto her. Then, she fell into my arms, screaming and kicking her little legs, as I passed from her mother's belly to the pediatrician. And she kept crying, and kept crying and kept crying. All I could think of was the silence and beeping machines from 24 hours previously as I looked at the previous baby, dead baby, as this beautiful pink little girl screamed her way into the world at 3:52 pm today. It is the good for the bad, the pain for the joy, the love for the hate. The antithesis of life....

I won't be able to write tomorrow because Kyle and I are on call. I am going to sleep all day Friday, take the train to JT's office, and we are leaving for Vermont. We are going to stay in at a bed and breakfast in Wilmington, Vt as a short vacation for our 5th anniversary, which is this Saturday, August 9th!!!! It has been a short but long, difficult, and wonderful ride. I would not change a moment (well maybe two or three).

I hope everyone has a great weekend if I do not get chance to write for a few days.

~nat