Day of hopelessness

I am just past my worst day yet. The crowning blow came on my way home. A call from one of the neonatologist informed me that a baby I delivered at midnight had just died. This past 24 + hours has left me with no faith in medicine, humanity or any shred of hope that God exists.

It began with a 41 year old diabetic found unresponsive and hypothermic by her 7 year old daughter. In a coma from a combination of her adrenal crisis, diabetes, and a pneumonia, she was brought to the emergency room by ambulance. We did an emergency C section for a 3 pound 11 oz baby who is doing better than her mother.

Next I had a 19 year old having her third baby. This one has gastrochesis. The bowels are outside the abdomen. The first surgery was last night after he was delivered. It will take at least one more to get the intestines back in. The mother, as I said is 19. She has a one year old and a two and a half year old at home.

The baby that died was the second child of a 34 year old who is married to a software engineer. They have a two and 1/2 year old at home. The baby weighed almost 3 pounds but has no lungs due to loss of amniotic fluid at twenty weeks of pregnancy. I would sleep but every time I close my eyes I see that baby's feet sticking out of the patient's vagina as I am making the decision to do an emergency C-section. Because the feet were in the vagina and she had a uterine fibroid, I had to make an incision in the top of her uterus. This will complicate any future pregnancies.

All this was interspersed with my usual steady stream of pregnant women with no prenatal care, several normal deliveries, and trips to the emergency room. I have one woman who is living in the hospital because she has lost her job and health insurance due to her placenta previa. Her two year old is living with her sister. I don't know what they will all do after the baby comes. There are thirty beds at Major Medical Center with can be filled with the same type of situations at any given time. The hospital gets them on emergency medicaid and gets paid. Yet, we (the country) have not solved the real problem.

The problems are so much deeper than that. These problems of family, death, sex, and using one another will not be solved by Congress in some sweeping reform bill. I wonder if we have what it takes find solutions individually and collectively. Some days I hope that we do but today has not been one of those days.