To tell or not tell?

“And you! I heard you had a baby!” she said to me as I paused to look something up in her chart. I had already given her the half-hearted congratulations that I use to begin each of the New OB visits.

Heart pounded.

Face flushed.

Breath caught.

“Congratulations!”

“Thank you,” I said, softly, giving a small smile. I waited for the follow up question… Something to trigger me to say the words, “my baby died.”

But nothing followed.

I was left with so much unsaid in my head. I finished the visit somewhat distracted, waiting for some sort of question that would spill my secret, but one never surfaced. She left that visit thinking we shared something in common- a baby at home- but I must be shy or private and so didn’t welcome questions about her.

This interaction stuck in my ribs all day long, into the next even.

I should have told her.

She wasn’t a stranger- I had delivered her first baby and I would likely see her again in pregnancy. But she wasn’t close enough to know the real story. She’ll probably find out and then maybe she’ll feel bad that she said something (she shouldn’t) or think I don’t want to talk about my daughter (I do). I have so far always answered questions truthfully when asked, even when it’s awkward. But I don’t volunteer the info. It feels attention grabby or pity pulling. Especially with patients, it disrupts the visit.

What do you do? Do you ever volunteer the info? How does it go?

How’s work?

How’s work?  They all ask.  I don’t know how to answer just yet.  Work is.  It’s uncomfortable, to say the least.  I spend most of my time so far doing computer work, but I have spent time seeing a few patients and shadowing one of my docs as I get in the swing of things.

********

The sign I posted at the check in window:

“There has been a loss in the Greater New Haven OBGYN Community

One of our midwives, Meghan, gave birth to her daughter, Mabel, on February 15, 2014.  Meghan knew her daughter would be sick, but she was wanted and welcomed with love.  She enjoyed her pregnancy, despite a poor prognosis and hoped she would bring her baby home.  Sadly Mabel lived for only six precious hours.  Our sympathies are with her and she wished for us to share the news with the community here.  She enjoys talking about her daughter and welcomes questions and comments.  Thank you for your kindness and empathy during this difficult time for her. “  [insert photo of Mabel]

*****

Once her visit was over and the focus was not on her anymore, she turned to me in the hallway and said “Congratulations!”  I thanked her with a smile.  “How’s the baby?” she asked.

She had not seen the sign I had posted at the check in window.  I stopped walking and paused.  There was so much in that pause.  Such a simple question, the pause itself said it all.  I had been preparing for this question for the past four months.  It was showtime.  I was now a few steps behind her and didn’t want to have to raise my voice for my practiced answer.  I resumed walking and when I got closer I said after my long pause.

“My baby died.  But thank you so much for asking.”

I gave her a quick, awkward smile, in an attempt to make her feel more comfortable after such disconcerting news.  I don’t know if she said anything.  I didn’t even see the look on her face.   I turned around and retreated to my office.

*******

“How are you?”

When I entered the room I said I knew that she had been scheduled to see the doctor, but since I happened to be back, was it ok if I saw her, because I knew her.  She was happy to acquiesce.  She asked, “how are you?” in the casual, chit chatty kind of way.  Oh, what a hard question to answer.  By the way she asked, I knew she hadn’t seen the sign.  “Fine,” I said, as happy as possible.  Fake it till you make, my therapist had instructed me.  We continued the visit making small talk about her and the events in her life.  Thus begins the lies.  They are not lies exactly; they are just not truths.  People talk about white lies, but I would consider this a professional lie.  When a patient asks me “how are you?” as part of the introductory small talk, I can’t say- “Well, I’ve just had the worst few months of my life, living through one of life’s greatest tragedies.  And now I’m back work in a place where I’m constantly reminded of what I have lost.  So I’m feeling pretty crappy right now, but thanks for asking!”  So I will say “Fine.  Ok.  Good.” Minus the sad intonation I have used with others outside of work, to remind them that I am not fine, ok or good.  I will answer with a polite cheeriness that is not the truth.  It is not the truth, but it is the right thing to do.

*******

In the middle of the visit she turned to me and said, “Congratulations! Did you have a boy or a girl?”

“A girl. Thank you.”  I gave her a genuine smile.  I love when people ask about my baby.  I was also on edge, waiting for the next question.  But there was no next question.  She smiled and we went back to the visit.

******

As I walked her daughter out to the waiting room, she saw me and I could see that look of unease- worry about what to say, how to handle the awkwardness of acknowledging that my baby died but being sensitive at the same time.  She said “hi,” but the word was split into two syllables, “hi-i” with the second syllable dropping down in tone, like a sigh.  She had read the sign.  “So I heard what happened…”  Her eyes portrayed sincere sadness, but I was left somewhat speechless.  How do I respond to that?  My go-to “Thank you” would have been inappropriate; she didn’t offer condolences.  So I just said “Yup.” in that same two-toned voice she used earlier with me.  Awkward silence ensued and I quickly broke it, directing the conversation back to her daughter.