The Pondering Grapefruit
a blog of moments
She was 43, a bit old to be pregnant. Her chief complaint, according to the Triage notes, was "I think my water broke." I could tell that the PA didn't quite believe that, and I couldn't blame her. Most patients assume the worst. They have a headache and think that it's a brain tumor, or they have stomach ache and think they're going to die. We thought that this woman was just having strange vaginal discharge, and with these presumptions we entered room 24.
I think, sometimes healthcare providers become incredulous and slightly condescending of patients' accounts as a defense mechanism. Seeing so many cases every day and handling so many severe events becomes taxing on the psyche. This is precisely what the PA and I did: we made the presumption that it wasn't going to be that bad, and how wrong we were.
The woman sat on the bed, her husband on the chair beside her. The room tinged with disappointment and worry. She explained that she was 17 weeks pregnant. She was lying in bed watching TV this evening when she felt something wet between her legs. She thought that she may have urinated on herself, but after she went to the bathroom and peed, the liquid kept coming out. They called for an ambulance.
"I'm worried," said the woman. "I miscarried last time too. It was 15 weeks." She seemed to be convincing herself of hope, which was rapidly fading the longer she stayed in the hospital. I could feel her hopes disappearing into the furrows of her brow, her downcast eyes.
The PA asked what the discharge looked like. The patient explained that it was clear, like water. It was certainly not discharge. It was decided to order an ultrasound to see how the baby was doing. We pulled back the curtains, shielding the patient from anyone who might accidentally walk into her room, and left. Several other patients came in, and we saw them as we waited for the ultrasound to come back.
I hawked over my computer screen to watch for when the "X" turned green, signaling that the ultrasound had been taken and read. Roughly an hour after we saw the patient, it finally turned green. I opened it and began to read the results: a blur of long words I did not understand, but one caught my eye. Oligohydramnios, meaning not enough amniotic fluid. The fetus was drowning, only, it was more like the opposite of drowning. I imagined myself suffocating under water, and stranded fish flopping on the beach. Her sac had ruptured, and her child was slowly and innocently dying. The worst part was that it could not even scream.
I rarely see the providers I work with fazed, but this news dampened everyone in our care team. Even the attending seemed upset. I think it was because they all had children, and they understood the joy of having kids, and therefore could fathom how painful it would be to lose one. She was so close, and at age 43, this might be her last pregnancy. I felt guilty for not believing her story, especially when it ended up having such grave consequence.
When we came into the room again, the PA delivered the news. The patient did not cry. I think she was beyond the point where she could cry. The pain had gone much deeper, far behind her eyes, and into the womb. I could only imagine the thoughts running through her head as she sat strongly upright in bed, her jaw set straight, realizing that her son may never have a sibling to play with. She was as silent as the life drowning inside her.
I was the one to put in the orders for her to be sent to Labor and Delivery. I had only done this a couple times before. I wasn't sure if it was through a discharge or an admission request, but I vaguely remembered that it was through a discharge. Suddenly, my job seemed more pressing, and I began to feel the heaviness of responsibility.
I think I did it correctly, because about fifteen minutes later, I saw a nurse wheeling the patient down the hallway towards the Labor and Delivery floors. She looked like she had already drowned. We all watched her go, and we all said goodbye, goodbye to both of them.
About this Blog
I have no idea how to describe what my writing is about. I just write. I post when I can, which can be weekly or monthly depending on where the universe is taking me. As for the Grapefruit, my Vietnamese nickname, Buoi, means grapefruit.