In 24 hours I’ve witnessed life entering this world and I’ve witnessed it exit.
In one day, I delivered a baby for the first time on my own. And for the first time also, I was present as the body of a person who wasn’t sick failed on our watch, suddenly and without warning–a mother on what should’ve been the happiest day of her life.
I watched as everything changed in an instant, as dozens of blood products were pumped through her body, as a machine took over her breathing, as lines were hung from every major blood vessel, as her chest was pounded relentlessly with the will to live of every one of the 50+ people in the room who refused to give up. I watched as her abdomen was opened right there on the bed and the baby was delivered in a last ditch effort to save her life. I watched everything be done and I watched it not be enough and then a husband leave labor & delivery without the child he’d expected or the wife he’d created her with.
The immensity of this is too much for me to process. Young healthy women without risk factors in a first world country at a world class institution aren’t supposed to just die.
Many obstetricians go their entire careers without experiencing a maternal death, I’m told. I’m here as an emergency medicine resident for just three weeks and it’s happened: a devastating, unpredictable, unpreventable and exceedingly rare complication of pregnancy resulting in sudden cardiovascular collapse, coagulopathy & almost always, death.
A 1 in 50,000 chance, but it doesn’t matter because she was the one.
I have such unmeasurable respect for obstetricians. They’re the only acute care physicians, I realize now, who care for patients who aren’t sick. And not only are their patients almost uniformly healthy, these human beings have showed up in their care for what’s expected to be the most magical life-changing overwhelming experience of love in this lifetime. And usually it is, but sometimes it isn’t and when that happens the pressure obstetricians face is incomparable, I’ve learned.
We all want our patients to live full and healthy lives, but when they come to us already sick or injured and we can’t save them, there eventually comes a level of acceptance that the provider who loses a thriving, healthy patient will never grasp. The Labor and Delivery unit is supposed to be the one place on earth where life begins but never ends.
And then within hours, here I am guiding the most miraculous pure expression of life and love and potential into the world with my very own hands.
The polarity of these experiences is incomprehensible. Just yesterday a life, that isn’t now, was, and a life that is wasn’t. It’s hard to sit with but is there anything more real? Life and death and love and loss. How quickly everything can begin and how quickly it can end–this cyclic unpredictable free fall we call life. What a reminder today has been of how fleeting and bizarre and beautiful and tragic and fragile it all is. Of how much has to go right for us to breathe and think and move and experience and survive a single day.
What I know is this: this red hot beating heart that pumps beneath my ribcage through every second of every day is an absurd and precious blessing. And every day I forget that, wasting those miraculous beats on anything other than love and service and creation is the most disrespectful insult I can think of to this patient and her family and to all of those patients and families who have left the hospital without a loved one or who have never left at all. There is no time for playing the game or enduring things without soul or abiding by any rules other than those beating inside our very own chests.
This day I will carry with me, forever.