Degrees of sadness

Yesterday an old friend from my private practice days asked, "What is the saddest thing you have seen while doing this job?"

My answer was, "A fifteen year old lying on as stretcher in the ER with a dead baby between her legs." I went on to explain what made this even worse for me was the fact the young woman was not upset. She acted as if for her this was a daily occurrence.

When I inquired who brought her to the emergency room, I was told, "An ambulance."

The girl told me she called the ambulance when her contractions became so painful she couldn't stand them any longer. This was necessary because she lived with her grandmother who was wheelchair bound and did not drive. The baby was dead when she delivered him shortly before her arrival. From looking at the baby, I suspected he died even before labor began.

I then ask if I could speak with her grandmother.

"She ain't here." Was the curt reply.

"Could I call and talk with her on the telephone?" I asked.

"Well, I guess you could, 'cept we got no phone at home." With this she opened her palm to show me the cell phone she was clutching. She had used to it to call the ambulance. In fact she seemed more worried about what her grandmother would say (or do) when she was caught with the cell phone, than she was about the fact she had just delivered and her baby was dead.

I did talk with the grandmother, the girl, and the social worker later that day. Hopefully things are better now. I don't know. I think about her every time I am on call and at times when I am not.

Sad, however, has reached a new level today.

Today my mental portrait of sad is a beautiful, 8 pound 4 ounce baby boy who came out screaming last night. He is now struggling to withdraw from the narcotics his mother has been taking throughout her pregnancy.