Pregnant Doctor Delivers

Now that I’m older I have the true luxury of remembering. Those who died young didn’t know this.  As a physician I’ve been blessed to be present at so many pivotal, and one might well say ,sacred times.  I’ve heard countless stories and felt the lives of those who have come to me to share.

This morning, for no reason, these memories seem to rise up like that, I don’t even know of a trigger. Yet this one came to mind and I smiled as I so often do remembering work, the colleagues I knew and the patients who brought us together.

This occurred in a busy teaching hospital.  An obstetrics ward in the wee hours of the morning.  We were all gowned and masked.  We had these little paper booties that covered our shoes.  I remember them most.  The white walls and bloody red sheets. The laundry piling in the corner as all were needed for the work at hand. Later there’d be time but at that moment it wasn’t something we could think about.

“There must have been a power outage over the whole city 9 months ago,” the nurse joked.  

I was at the foot of the bed watching as the cervix dilated and the woman pushed. She’d been screaming for an hour before between contractions when the pain should be least. In addition the anesthetist had just given her a spinal block and begun to administer epidural analgesia.  She should be feeling less pain and be screaming less. If anything her screams had grown louder. 

 I’d asked the nurse about that, as an aside, concerned that something might be amiss.  She nodded to the door where a thoroughly terrified young man was there at the window peering in. He’d come to the little square glass then walk away with an older man comforting him.  I’d seen the older one put his arm around the younger man’s shoulder.

Then the father to be would pull back his shoulders, stand tall and return to peer in the little window.  There were tears in his eyes as he waited helplessly, overwrought I presumed with his inability to do anything but wait.   I’d been glancing out at him now and then while waiting, patiently, for the delivery to progress. 

While the anesthesist was speaking to the patient, the nurse was reviewing the continuous monitoring data strips.  In a low voice , beyond the hearing of the patient, who was either  listening to the anesthetist or screaming her lungs out, the nurse shared. 

‘That’s her husband and father,’ the nurse told me. “They’re old school Portuguese.  Our patient is okay but the more she screams the more the men will care for her and the baby after.  They’ll be helping her now for the whole of the coming year,’ she said smiling.  “It’s a good thing. It’s cultural. She’s going to be okay and she and her baby are going to get a lot of well deserved breakfasts in bed.’ She laughed.

I reflected on the aboriginal patients I’d delivered who’d been a different challenge. Their stoicism and silence had been the means to recognition in the family and  community.  As a doctor I had so much to learn about how people express themselves in sickness and in health.  I had to listen for the different cues that something which might be normal had changed to something that might be more concerning. The older nurses especially in Obstetrics were a wealth of experience and insight. Early days I felt like a hamster on a wheel forever playing catch up. 

I was brought back to the present, not by a fresh crescendo of screams but by the door bursting open and another gurney rolling in as it was pushed quickly  in place  by two sweating hurrying orderlies.   

“We’ve run out of anesthetists.” One said smiling as our anesthetist began to busy himself with the new arrival.  “All the delivery rooms are full and we’re  doubling up.”

I was suddenly very anxious. I was very new to this, only a few deliveries under my belt. My lady was almost fully dilated and here was this new lady well on her way by the rate of the her contractions.  

I think the older anesthetist could see I was concerned if not outright terrrifed.  He said, “Her doctor will be on the way. She was just delivering another lady before I came here.  If all else fails I’ll gladly help at your end.  I’ve been there many times before,” he laughed with the infectious confidence of maturity and experience.  My patient screamed. The other patient screamed.  The nurses eyes twinkled.  It was already a long night.

At that moment a very very large young female doctor burst into the delivery room and went to the side of the newest patient taking her hand, speaking kindly and calmly to her as she looked over the monitor.  

“You didn’t think I’d miss this for anything,” she quipped to her tired but smiling patient. “We’ve been planning this for 9 months.  Now we’re going to see that it was all worth it!:

The doctor was 10 months pregnant herself if she was a day.  Bigger than a house and nearly the size of a whale. She’d moved fast into the room but could hardly bend to speak to the patient.

Going to the foot of her patients bed she peered down and said to the nurse.  “Already crowning”.  To the patient, she said,   “ We’re doing very well.’ Not much longer now especially given how well your last delivery went. “

“Hi Charley’ she said to the Anesthetist. 

“Hi Annie,” he replied, in the tone of old friends.

“Good morning, Doctor, “ she acknowledged me kindly. 

Looking over my shoulder she saw that my patient was just beginning to crown too.. 

“Primip” she quearied,  smiling at my patient.

“Yes,” I replied

“This is Sarah’s second, could be a close match! ‘ she said looking at her patient and returning to where she could view her.  Turning to me she said, “I’m not going to say it’s a race but if this were Vegas they’re be laying close bets as to which child would come out first.‘ 

“Not much longer now , just a few more pushs Ladies.” She said to both.

It was clear that my patient was more relaxed now that this marvellous woman doctor had arrived, even if she was the size of a house and some at Vegas might be including her in the betting . 

The poor patient  was no longer dependent on me a young doctor obviously wet behind the ears. Her screams had changed  now to more like grunts as she pushed responding to the nurse who’d taken a position right beside her head , letting the patient  hold tight to her hand. 

“Here we go”  Dr. Annie said to her patient just as my patent  became fully dilated and the crown  began to appear.   There was no need for an episiotomy. Everything was going smoothly.  I reached forward as the baby came , cradled the  head, then the shoulders and the bum and finally the legs came too.. The nurse was there beside me taking up the baby in clean linen and, wiping off the amniotic fluid, then giving the beautiful little boy baby to the mother.  The placenta delivered. All the bits were there. The new mother was smiling beautifically, pleased with her little boy. I clamped and  cut  the umbilical cord.  

Normally the father would be invited into the room but with the two deliveries happening and the nurse being more aware than me she’d wheeled this bed out into the hall where the father and mother and family and in laws were all waiting to celebrate the new addition to their family. The nurse returned immediately to be there for the second delivery.  I stood by waiting to be of assistance, not knowing what else to do. 

Just as my lady was being wheeled out, with her baby clutched to her chest, the other baby was delivering.  I’d only glanced over to see the mountain of a pregnant woman doctor between the woman’s legs in stirrups.   She’d been leaning awkwardly forward , stretching out and over the mound in front of her  assisting the delivery.  Her arms had the vague resemblance to the Tyrannasaurus Rex but somehow she managed.   Lifting the baby into the air she exclaimed,  “It’s a girl!”  as she handed the baby to his mother.  

I was about to leave then when the lady doctor said, “I’d appreciate if you ‘d not go  just yet. “

“Sarah” , she said, “Congratulations, but if they don’t get me another bed I might have to ask  to share yours.  My waters broke in all the excitement of your delivery! “ She laughed. It was obvious thought she was  just a bit strained. 

The nurse with the strength of a Sumo wrestler and the speed of a jaguar  muscles  another bed into the room with my helping with the guidance.

 Sarah’s husband had joined her and the two were google gaga over the new baby as the two sweaty orderlies were moving the bed out of the room. I don’t even think they noticed us so caught up in love they were.

Dr. Annie was now  standing partially bent over grabbing hold of her thighs and Lamaze breathing as another contraction passed.  The anesthetist,Charley,  was right by her side. 

“I’m going to have to ask you to help me up on the bed,” she said, “ I don’t think I can stand much longer.”  Together with Charley I helped her onto the stool the nurse had brought forward.  Together we hefted her up onto the bed where she collapsed with a huge sigh.  Lying on her back she looked like an Anaconda who’d swallowed and elephant. I couldn’t believe how far along she’d been and delivered two babies that night before she was about to deliver her own. 

‘Could you tell me how far along I am?” she asked between panting.   Charley was establishing an IV.  The nurse  was spreading the jelly for the  ultrasound monitor.  The baby’s heart rate was suddenly visible and looking just  just fine on the screen.

I examined her then. She was fully dilated and just beginning to crown.    I said so.

“I thought as much, “ she said, between breaths and pants. “I called my own doctor before Sarah. If he doesn’t get here,  I’d appreciate you’d stay and assist. I’m rather occupied myself. “ She smiled and I could see Charley’s eyes twinkling as well.  I really was rather awkward and uncertain in those early years. I stayed of course. Never thought I’d do otherwise. 

“Of course,” I said. 

Her beautiful face was flushed and sweating profusely as another contraction took hold.  The nurse had given her her hand and she was squeezing tightly.

At that very moment,  another rather  tall doctor,  burst through the doors. He stopped abruptly beside the patient and said. 

 “I’m glad I’m not late, Annie. I hope you didn’t wait just for me. ” Another contraction came.

“Good to see you, Charley,” he said coming down to the end of the bed beside me. 

“All’s well?” He said, Charley, myself and the nurse nodding. 

I never was more happy to stand aside and let an older doctor take my place.

“I see a head Annie.  Shan’t be long.  Just another push or two if you don’t mind.”  Dr. Annie gave a powerful push and the baby’s face began to slowly appear, the obstetrician carefully guiding.

And sure enough, another baby girl was delivered that morning.  A lovely little girl.  Five fingers and five toes.  

Dr. Annie’s smile was as beautific as the other women’s.  Her husband came in as I began to make myself scarce.  Even as I was leaving, Dr. Annie, turned her beautiful eyes on me, and said,  “Thank you. ” Then her attention was all for her baby and her man.  I looked back over my shoulder at this wonderful family tableau knowing I had been blessed to be there this night. .  

I made my notes at the nursing stations surrounded by the doctors who’d been called in for this most productive night. 

 I will never forget that beautiful lady doctor 9 months pregnant delivering another woman’s baby before giving birth to her own.  That’s a memory I feel  blessed to have. Looking back I’m just thankful to have been there and thankful to have been of some service to all those amazing colleagues and patients and especially Dr. Annie.  Sacred times. 

Positive Memory and a Broken Mind

I have to be active to retrieve positive memories.  My mind’s broken.  Left to it’s own devices it will tend to replay past trauma, old wars, resentments, failures.  It’s not surprising because those were by their nature times of threat and times that my mind had to focus most. In danger we are most alert. After danger passes my mind will tend to be scanning for future threats and reminding me of past dangers. I’ll also sometimes play scenarios again in search of whatever I might think I did that had I done differently would have resulted in a more positive outcome.
Meanwhile most of my life has been exceedingly positive. Every day I’m alive my life is 51% positive.  Yet trauma and failure have tendencies to blast aside the good days and the good experiences.
I had a Corolla. Amazing car. It was something I so enjoyed for it’s workmanship and maneuvering.  I loved the sound system. It was the days I played Steely Dan on the radio. Barbara Fromm was on CBC. Life was good. That little car had magnificent studded snow tires and for a year it carried me in summer and winter to and from my first country general practice.  It was a sweet car.  Yet a dangerous , horrible, incompetent, psychopathic driver hit that car passing in a lane, semi truck barreling towards us, I was doing the correct speed, the other fellow was speeding. The road conditions were black ice. He lost control of his car, hit the front end of mine causing me to barrel and burrow right into the ditch. The car flipped 360 degrees landing upright then rolling sideways 360 degrees and landing upright again.  The seat strap kept me in the car but because of the height of the car, made for Asian market I presumed, it didn’t keep me in my seat but allowed me to be crushed into the ceiling with my head tilted.  I had a cervical spine injury.  I gave the case to a friend to help him, a new lawyer, and he didn’t do so well, so that in the end, a year later, weeks of lost work and a life time of chronic pain and disability, I was severely punished by a psychopath speeding incompetent driver, a friend who was young like me, a tough insurance system. I got the replacement value of the brand new car and immediately bought a Ford Mustang which I truly loved.  But my life flashed before my eyes, It was a near death experience.  I was appalled at the price of the insurance and that in the end there was only punishment in the system for the victim. It changed my outlook on life and was a root cause in my changing my career, my marriage and might well have been an early root cause of the subsequent addiction year that really changed my life further a decade later.
So I don’t think of that car with the joy I can actively seek to remember.  With a little conscious probing I can remember the joy I had driving it. It would also be decades before I bought an Asian made car again.  I’m driving a Mini now, British,but with my head touching the ceiling. It’s got that same attention to detail the Toyota Corolla had. Marvelous workmanship.  But I could well have been driving it when the animal hit the front of my car and the criminal system didn’t castrate him there and then to insure his genetic strain was removed from the genome.
Being a civilized man I actually got out of my brutalized car which the insurance company subsequently insisted was just fine, no reason to be replaced,  never to be trustworthy in my mind again, a source of terror, a centre for ptsd images of life flashing before my eyes, but no , it drove so I should take it home as if nothing happened.  Assholes.  I’d love the ‘new car’ smell of that Corolla. I’d loved the faith I’d put in it. It was my first ‘new car’ as before that I’d only had second hand beaters.  So there was this insurance company insisting all was well and me remember every day for life that as I bounced off the ceiling of the car I thought that I knew no one who had survived a 360 forward turn and then when i rolled again over the ceiling my neck straining again, I thought I’ll never be the same because I don’t know people who survive such a crash.  It was a miracle. Everything about it was a miracle. But at the time I was surrounded by faithless friends who were caught up completely in their own life stories and were annoyed a bit by my ‘drama’.  “You crashed your car, what of it.” And some friend would then talk about a minor fender bender and the conversation would steer into a lot of oohing and aching about stuff people knew about , parking lot crashes and city bumps.  But even today I see that semi and feel that head over heels of the first smash on the roof the world coming round like a roller coaster and then the side ways rolling and the excruciating crunch of my body weight bent up against the ceiling, sustaining me because the strap didn’t hold me in the seat.
The other car was some young guys and girls , party animals in a big beater of an old boat , an Oldsmobile or something indestructible and it had just plowed me into the ditch and continued flat out across the prairie snow drifts.  Both cars would be a trial for tow trucks to get out. The deep snow cushioned the impact.
But when I see crashes on tv and watch the cars rolling, I rarely see something as intense as my own. It’s why I liked the Diesel XXX movies and Fast and Furious. The stunt men really owned their keep.  But I’m not a stunt driver. I was dressed in a suit and survived because the Toyota was such a strongly built car and the seat belt held me. If I was 2 inches shorter I’d not have crunched my neck.  But I survived.  I lived .
My mind is like that.  I was married a few times.  I sometimes have whisps of memories of those glorious days of love and roses, the ultimate romances, the extraorinary, love and lust, the close talks at dusk and dawn, the hours of fun together, the years of best friend relationships, the pride of having a partner so extraordinary in so many ways, beautiful, accomplished, brilliant, confident, successful, admired, and to have them with you, to be able to trust them, to do things together and be so intimate.  Years of that connection. The separation and divorces in my cases seemed to happen over the last year. The negative outweighed the positives. We part and then the courts and the lawyers and the government and friends and counselors and society just makes it all so much uglier.  And the loss is like an explosion dropped into the memory bank. It wipes out the whole amazing love story of two people who felt no other was the ‘one’, who felt they’d found their ‘soul mate’ and lived with love and carefree for years, amazingly, only to find that the indestructible thing of perfection wasn’t up to the task.
Now passively the wounds come back.  I can see the one judge who was as disgusting pig of a man studying my ex’s exposed cleavage and black lace hooker stockings that day of the divorce when her own lawyer looked more like a whore with her buttons undone and cleavage exposed.  I remember that and how later when I talked to other lawyers they told me she would have jockeyed for just that judge because he was such a perverted pig and a real disgusting womanizer in his personal life, a mommy’s boy, with a little dick and a need to win women and a history of consecutively finding against men in all divorce and custody cases because he’s such a loser.  Backstabbing psychopath.  That little weasel jumps right into my passive memory.  Especially learning about him from the lawyers and learning that there’s still a pedophile judge missing and me thinking it’s got to be him because he was such a type, but really, was he.  Yes, he was a 13 year old boy who had a big position and abused it and feared men and treated women as whores but.....and here’s the but...I’ve been divorced three times, 23 years of marriage, two decades of loving the enemy, providing and protecting for all that time and 90% of it was really good for ‘us’ but I left.  I walked out on two while she walked out on one. But the important thing was there three judges and only one was a smegma. The other two were saints. Amazing considerate gentlemen with genius and wisdom and love and care who ended the marriages with the least fan fare. True I was never one to ask for anything except my life back so I walked out without anything essentially, dividing the assets of one house and giving another away but the key is that I don’t dwell on these ‘gentlemen’.  They didn’t look at the women like they were meat and they didn’t talk to me like I was a fool. They were mensch.  They were Skookum men.
My mind passively drifts to the ugly little piece of stinky dog tourd. There is if I am ‘active’ about my memory these two great men who made a bad situation less bad. These two great men did their tough job with kindness and care.
I used to have a resentment against my mother for a thing she did when I was a teen. It wasn’t anything really but I was pimple faced and awkward and tended to be ‘sensitive’ in adolescence. I expect I’m the only such teen of that kind. I had attitude and Mom wasn’t always ‘tolerant’ and ‘enlightened’ about how she should talk to an asshole kid. So we had words and I held this resentment against her.  My mom is a saint. I can go on and on about the accomplishments of my parents which include not killing me but my mind used to go to that argument instead of to the times she held me as a child when I came to her afraid. I remember that now. The adolescent ‘bomb’ memory concealed the feeling of her taking me in her arms and holding me when I was hurt child. I can feel that today.  It was the work of therapy and doing a 12th step that brought home the insanity of the mind and how ‘selective bias’ worked in the brain.
My mind is broken.  I can fix it by remember that it’s going to lie to me about my life and the relationships I had and the people I knew.  I’m blessed and I have to actively remember the truth about my life.  The Toyota Corolla is an awesome car.  I’ve driven more than a half century on on kinds of roads with all kinds of other drivers around, in cars, trucks and on motorcycles.  I drive a lot. I’ve driven desserts and freeways, and across tundra and off road and on road.  So 99.9% of the time the other drivers are incredible. I’ve had a few accidents but statistically I drive about 10x as much as every one I know and I’ve driven in worse conditions and in different countries with a whole lot of my own and rental equipment.  So statistically, and in reality, other drivers are by and large amazing, and the very vast majority actually do have the intelligence to have figured out how to use the ‘turn’ signal for changing lanes.
But I have a broken mind and most people would know my descriptors of the one driver in the morning commute whose causing the traffic jam that day, one driver out of thousands.
Just saying.
I have to be ‘active’ and make my memory remember ‘truly’ and avoid the ‘emotional memory’ of ‘selective bias’ that suffers from such inaccuracy and causes me to have a skewed view of reality.  My life is blessed. I’m really thankful for all the people I’ve known and all the machines I’ve driven.
Thank you.