Tuesday, June 17, 2008

There's two parts to it.

I want to talk less about my work, my job, my patients, but it seems that is a tough order for me. I apologize.
I've been working a lot lately, but for about a week everything was going very well. Then last night one of my patients came in with complaints of contractions, which is what you expect in my field. Sadly, my patient (lets call her Maria) was only 22-weeks pregnant. When I assessed her I could see that her bag of waters was bulging into her birth canal, I couldn't see any cervix holding back the baby. The nurse and I immediately tilted her head back and point her feet up, a position called Trendelenberg, in hopes of relieving the pressure on the bag of waters. I just had so much hope that there was something to be done, but there wasn't. About an hour later she delivered a beautiful baby girl 17-1/2 weeks early. We'll call the baby Rosa. At first, Maria didn't want to see the baby because she knew Rosa would die, but I put the baby on her chest wrapped up in warm blankets. Immediately, Maria began to cry, the first emotion she'd shown the whole night. I encouraged Maria and Jose, the father, to carress their baby and tell her how much they love her. They did. Rosa fought for her life, gasped for air, moved her arms and legs. When her daddy slipped his finger into her perfect little hand, she seemed to find some peace. Rosa was very strong. I checked her heart beat every 3 or 4 minutes, after 25 minutes it had become slow and irregular in the 50's and 60's. She was cold, but occassionally still gasping. Her parents cooed to her, held her, kissed her, held each other and cried. At almost an hour, I checked Rosa's heart rate one last time, it was gone. I looked at her mother, but she seemed to already know. Dr C, one of my favorite back-ups, had come in to help me. Dr C., the nurse, and I all quietly cried with the parents. We bathed perfect little Rosa, dressed her, took her hand prints and foot prints and photographed her with Mommy and Daddy.
There are two parts to my job. In many ways, helping the babies die peacefully with their parents holding them is of greater significance than anything else I do. I suppose it's more meaningful to me, too, though I hope to never do it again. While I can't recall every birth I've done with clarity, I do remember every baby of "mine" who has died. Sometimes, the parents don't have the strength to do it, and as the provider I am the one who needs to hold the baby and be the person to love them and cherish them as they pass away. Whether I do it or the parents do it this is so, so hard. More than just the baby dies when the passing away occurs.
Maria and Jose are 19-years old. They are very poor. They can't afford a funeral. Last night the nurses called a funeral home, the funeral home has offered to handle the arrangements free of charge.

2 comments:

Display said...

These are meaningful moments to share with us. Grief and loss and the pain that accompanies them, no matter how much we want to avoid them, are a part of our lives. I like to think that feeling them as fully as I can allows me to feel joy more crisply and cleanly. I thank you for sharing this.

(and hello, too! I had no idea you had landed in California until I found your blog in my stats)

Mommela said...

Oh Kel, what a hard day at the office for you. Our hearts go out to Maria and Jose, and we're grateful that they had you there to support them as all their hopes and dreams ended with the death of their daughter. You give them a priceless gift when you nurture them and grieve with them, honoring little Rosa's short life, ensuring that she was surrounded by love for her journey.
We miss you,
Kjir