“How’s the baby?” she asked all smiles. The joy in my office was palpable- she was there with her sister, as her support person for her first OB visit. They both remembered me from her last pregnancy and clearly remembered that I had been pregnant myself not too long ago. And now they wanted to bring me in and share the joy with them. How sweet of them to ask; it actually pained me a little to give the truth. “Oh, my baby died.” Shock. Disbelief. Discomfort. “Oh no, I’m so sorry,” they say, with brows furrowed unknowing what more to do. “She was sick. We knew she was sick.” That made it better somehow. Sympathetic “oh”s followed making it easier to transition back to the visit at hand. I did not cry or break down. I was just mesmerized at how I felt that I had to make them feel better about my baby’s death. I practically said, “It’s ok that she died because she was sick.”
We were talking of her plans for labor. “I’m pretty easy going,” she said. “I don’t care if I end up with an epidural or not, a c-section or not, as long as she’s healthy. I just want a healthy baby, you know? As long a she’s healthy.”
I don’t know. I have NO idea what it’s like to simply want a health baby. It’s not all that matters. Each time she said healthy, the word stabbed me in the chest. Of course every one wants a healthy baby. But now I feel like there’s some sort of ignorance, or even greed to that wish. Like playing a scratch card- everyone wants to win $1million, but I’d be happy for $1, as long as I could take that dollar home.
I cut her off with a quick “ Yup. You’re next appointment is in one week.” And I left the room, exposing my pain with some unintelligible mumbling of certain cuss words under my breath.
I walked into the exam room and I could see the exasperation already on her face. Young and annoyed to simply be pregnant, she glared at me as if it were all my fault. I have faced this look before. Many women are uncomfortable at the end of pregnancy. They want to know when they’ll be able to sleep again, to be rid of bad heartburn, to shed their newly acquired cankles. We spend their whole pregnancy talking about one date- their due date. I explain in the first visit how it’s an estimated due date, give or take two weeks, but that lesson is long forgotten by the time that magic day rolls around. They are done; they just want to meet the darn kid already, not realizing they are about to trade one set of difficulties for another.
I used to be more sympathetic. Now as I looked at this young woman giving me a sour face and I want to shake her and scream You don’t know how good you have it! I don’t smile at her, trying to be her sympathetic ally. No coddling about understanding how tough it is to be so pregnant. Gone are the words I use to sweetly remind her how nature works and time will bring her a baby. Instead I talk robotically about the protocols for induction leaving emotion and compassion crumpled in a heap in the corner of the room.
“Man, labor hurt like H-E- double hockey sticks!” Her actual use of that phrase almost made me laugh. Her baby was a few years old, but she still remembered. “Do you have kids?”
I had a daughter.
“Oh, “ her voice dropped and her face took on an appropriate somberness. “Is that you in the sign?” I nodded. “I was reading it in the waiting room. I’m so sorry for your loss. She was beautiful.”
I smiled “She was, thank you. And thank you for reading about her.” And with just the right amount of pause I add, “ and yeah, labor did hurt like H-E-double hockey sticks.” No derailment; we are back on the path
If a patient declines genetic testing it is our practice in my group to make sure we document that they wouldn’t terminate for those reasons.
“If you knew you had a baby with Down Syndrome or Trisomy 18, would you consider terminating the pregnancy?” I hear them say no and write the words in their charts. Over and over I say these words- several times a day. How can I not think of Mabel?