I had just spent ten hours in a tiny nook near the nurses' station that the residents called the Mole Hole, listening to the cries of laboring women from the rooms around and learning to read the scrolling electrical reflections of their babies on the monitors overhead. Moderate variation: that's good. Decels: that's bad.
I learned the language of childbirth that day. The stations of labor, like stations of the cross. Massive multiparity. Maternal intolerance of labor. I stood at the foot of bed after bed as women labored and pushed and bled and tore apart before my eyes.
And then, that night, I felt the certainty that I would soon be one of them.
What I'd so wanted was suddenly too real, the course set in motion and as inexorable as those splitting women. All you wanted to do was hold them together, to stop the progress of the crowning head, to do something as you watched their flesh rend. The resident applied perineal pressure, but studies had been done. Most women tear, and there's not really anything you can do to stop that.
A few days later I was due to start my week of nights. It kicked off with a 24 hour shift. I arrived at 6am, stayed all day through my lectures and clinic, then stayed overnight on labor and delivery. We waited and watched, checked the mothers' progress, donned our gowns and watched them tear. Every time a baby was born I started to cry, and couldn't control my reaction. I'd suck in my breath in a gasp and find an excuse to leave the room, then head for the bathroom where the tears would pour out. I wasn't happy about the births, nor was I sad. I just felt, with an intensity that shocked me. By the time 3am rolled around I was in rough shape. The attending physician arrived in the morning and asked me innocently, "So, how's L&D? Like catching babies?"
The question was absurd to me, in my pregnant, horrified state. "I'd rather see someone die," I said honestly, unable to muster the energy to lie. I still can't believe I said that.
She looked at me in shock for a moment then laughed. "Wow, I've never heard that one before."
On the fourth night of five, I started to bleed. Not too much, but enough. No, no, no...like that, the inevitability was threatened, and I wanted it back. I grabbed the senior resident and dragged her into the tiny closet that served as status board, sign out room and med room in one.
"Are you ok?" she asked when I couldn't stop the tears. I suspect she noticed at least one of my awkward gasping exits as soon as the placenta was bagged.
"I'm pregnant," I said. "I just started bleeding."
"How pregnant?"
"Five weeks."
"And you...want to be pregnant?"
"Yes, absolutely." She ordered a blood test and sent me to lie down in their secret sleeping spot, which was, ironically, also maternity triage. In the morning I went to the lab and found that my level was high enough, that the baby was still growing. I called in sick that night.
It got easier from there, but wasn't without its rough patches. There's a tiny garden outside the psychiatric ward, planted by patients but languishing untended. I may or may not have thrown up there, like, a lot, on my next rotation. On ICU at 30 weeks pregnant I ran to a code blue and literally felt my pelvis destabilize. I walked to the next code. One day at 32 weeks I felt my belly tense intermittently while rounding on the ICU. When rounds were done - 4 hours later - I excused myself for another trip to maternity triage. Sure enough I was contracting, but two liters of normal saline staved off the premature contractions. I carried a water bottle on rounds after that.
When Betty was three weeks old we packed her up and drove from Portland to San Jose to Los Angeles to San Diego to Oakland and back to Portland for 5 residency interviews in 6 days. At each I had to find a place to pump breast milk, which wasn't always easy, but when the programs found out how old my baby was I enjoyed the looks on their faces. How did we do that?
On my cardiothoracic surgery rotation I spent countless hours behind a screen in the womens' OR locker room with my Medela Pump In Style and a surgical cap and mask still dangling from my neck. On pediatrics I shared an empty exam room with another pumping mother as we showed off the baby videos on our phones. When Betty stopped sleeping on that rotation I asked all five pediatricians I was working with for advice - and spent the lunch hour every day sleeping in the backseat of my car in the Adventist Hospital parking lot.
My first month of residency, I couldn't figure out when or where to pump and ended up with mastitis, fever and all.
This week, with Betty nearly 15 months old, wards were so busy that I didn't see her for four days, and before I realized what had happened she was weaned.
I chose this, I know. I'm doing this intentionally because I want her to know she can accomplish what she wants and find joy and meaning in many different ways of being - a mother, an artist, a writer, a doctor.
But it does have its toll.
So tonight I am grieving for the suckling baby who is growing up so fast, and for my exhausted intern self. We'll get through it, we always do. But tonight I miss my baby.
