Friday, January 22, 2010

A story

I first met MW when she presented to labor and delivery for contractions. Her cervix was not dilating but her blood pressure was elevated. She still had five weeks until her due date, set by the residents at the country hospital. Looking at her records she had not been seen by a doctor for at least two months.

Admitting her to the hospital for her elevated blood pressures, known as gestational hypertension, I tried on two occasions to get a twenty four hour urine collection to determine whether she had preeclampsia. This was the medical situation, the social situation was another story.

First she told me "my child's father is not paying me enough attention." Then I found him in bed with her on early morning rounds. Though she did not go into labor, her blood pressures became so high, her labor had to be induced. She quickly tired of labor and begged for a C-section. Despite epidural anesthesia, labor "hurts too much." She told me. I tried to explain that incisional pain after a C-section was also a problem.

After a long induction her labor did stall and she was on the operating room table when she asked me, "I get to eat after this, right." My reply of "No, not exactly..." and an explanation of the need for a clear liquid diet until her bowel function returned was met with cursing and crying. I understand frustration. My oldest was the product of a Cesarean section after 27 hours of labor, but this seemed a bit much. The entire OR staff allowed her to ventilate before bringing "the father of [her] child" to the delivery room.

I pulled screaming baby boy out of the incision in her abdomen about 15 minutes later. Being cleaned and dried, weighed and measured by the nursing staff, I exchanged several glances first with the circulating nurse and then "the father of [her] child." The baby's skin color did not match his.

Despite bracelets placed on baby, mother, and daddy in the delivery room, the next day this young woman was claiming those of us in the delivery room had some how drugged her and exchanged babies. She got no support from the boyfriend in this and finally gave it up.

On the day she left the hospital, I discharged her with an appointment in two weeks to see her clinic doctors. She complained about this but in a much more subdued way than all the issues of the past 8 days. As I removed the staples from her incision, she said, "But I want to come to the clinic and see you." When I explained to her that it didn't work that way, that she only had me for the days she was in the hospital due to the fact that I was on call, it began to dawn on her that our relationship was ending.

The reward for my eight days of patience came with the very last words she spoke as I turned to walk out the door. Sitting in the bed holding her son, she meet my eyes and quietly said, "Thank you."
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