A Tale of Two Women

They were both in the ER that day, they were both 16 weeks pregnant. Beyond that, all similarity ended and these two women presented in stark contrast. Their lives and experiences so glaringly different from each other, yet one common thread that tied their stories together.

The first is sitting wide eyed in the exam room, my room. She is wearing a hospital gown, her black curly hair pulled back from her petite face, her eyes betraying the anxiety she is feeling. Her husband sits in the chair beside her bed, appearing equally uncomfortable. Waiting.

She is here because she noticed some bright red bleeding, and is concerned for her pregnancy. You see, she has Diabetes. There are always certain risks inherent to pregnancy; always the possibility that complications can arise. But for those with a health problem it seems that the risk is nearly always increased. Throughout her pregnancy she has been very careful to check her blood sugars regularly, and keep them under control with diet and insulin. In the past 3 days however she noticed that her blood sugar was running unusually high, then today she started bleeding.

The ultrasound has been done, the results show what I know she is hoping against hopes is not true. The baby and placenta have become detached from the uterus wall and are traveling down to the birth canal. The problem: it is 24 weeks early.

Test results in hand, the doctor and I enter the room, bringing with us the news that will crush these two strangers world. The fluorescent lights glare down, making the white room appear even brighter. The doctor clears his throat and begins to break the news. In the medical profession it is always a struggle to find the "right way" to break bad news to the people who walk through our doors. Perhaps that is because there is no "right way" to do it; there is no right way to tell someone that their world is crashing in around them and there is nothing we can do to stop it.

As the news we brought is delivered, tears begin to fall down her cheeks. The doctor's work is done and he exits the room, on to the next task, on to the next sick patient. I place my hand on her shoulder and simply say "I'm so sorry for your loss." There is no more I can do, nothing I can do to change the circumstances or the pain. She looks up at me, her eyes swimming in tears and asks "Why did this happen? I did everything right, I tried so hard!" I have no answer to give, and a tear silently slips down my own cheek.

The second of these two women is only three doors down the hall. Her arms and legs are strapped to the ER bed with leather restraints, she is in one of our psych rooms: high on Meth, suicidal, violent with staff, and generally angry at anyone and everyone. Her loud voice lashes out spewing cuss words at any staff member who happens to pass by or enter her room. She too is 16 weeks pregnant, she has been doing Meth throughout her entire pregnancy thus far, doing untold damage to her unborn baby.

Suddenly I hear a voice, with strained urgency, calling me back to my patient in room 9. As I enter the room I find her standing alone at the side of the bed, tears streaming down her face. There, on the floor between her legs is a pool of blood, growing larger by the second and in the midst of the blood I see the still-born baby and the birth products. She stares into the dark red pool forming, unhearing as I attempt to speak to her.

I ask an ER tech to assist her to the bathroom, and after she is gone I quickly begin to clean up the room. With gloved hands I gingerly pick up the baby, it easily fits into the palm of my hand, its hands and feet already perfectly formed, although small, complete with miniture fingers and toes. I gently clean the blood off and place it in a plastic container-the mother may want to see it later to help with the grieving process. I mop the blood off the floor, and put clean sheets on the bed, all in an attempt to remove the evidence of her pain before she returns.

A little while later, after the bleeding has stopped and the doctor has made sure that all the products of conception are passed from her uterus to prevent complications, my patient is discharged home.

What will happen to her? Will she try to have a baby again? Will she succeed? I probably will never know. But as I walk by the room of the other woman and hear the obscenities, and hear her say "why don't you just leave me alone and let me and my baby die!" anger fills my heart at the blatant unfairness of events. Why does one woman who wanted a baby lose it, despite trying her best to stay healthy so she could bring a healthy baby into the world to be loved? While this other woman, who is doing everything that will damage and stunt her baby has a normal pregnancy? How do I keep myself from wishing that the tables had been turned?

Uncertainties, uncertainties...

What is it about change that makes so many of us avoid it at all costs? We try our best to maintain a semblance of normalcy, we struggle to keep a certain level of "same-ness" in our day-to-day lives. I have decided that the reason we despise change is our fear of the unknown; our uncertainty of how we will approach the unfamiliar.

Change is in the air for me... (see previous post) ...and I find that I too am faced with many uncertainties. It struck me today just how quickly my Sept departure is approaching, and I was left pondering the many unknowns that loom on the horizon.

The fact that I am going to a far-off location is not much of a fear for me, after all, I have been out of the country several times in the past; visiting cultures vastly different than my own. This time, however, I will be without the security of friends, and people I am familiar with. Sure, there will be other Americans there, but I have never met them. This time I am going for much longer than any of my past excursions-8 long months, rather than 2-3 weeks.

The particular concern that I have been pondering is the fact that I will be teaching various health classes, the most daunting of which will be Anatomy and Physiology. To do this I will be drawing much confidence from the various experiences I have had teaching such classes in the past...none!

The questions echoing through my mind are: What if I am horrible at teaching? And how can I teach a class that I haven't taken myself for nearly 4 years? Sure, as a nurse I still know the basics of the human body...but what about cell mytosis, DNA replication, and protein synthesis? Or how about the effects of Actin, Myosin, and Ca++ on muscle movement/contraction? Then there's the relationship of water, electrolyte and acid-base balance, and I won't even begin to pretend to recall all the names of the 206 bones, or the more than 600 muscles in the human body...the list could continue indefinitely. All the different proteins, the many Latin names, mechanisms of function, hormones... I have a vague recollection of studying them at some point in my past, but the certainty that I am not in the least bit equipped or qualified to teach a class in any one of these subjects if I were asked to right now! Teaching will most definitely stretch me out of my comfort zone. So many unknowns, and I haven't even begun to discuss the cultural, language, and lifestyle differences I will encounter.

If I were to sum up my feelings at this exact moment it would probably sound something like "What on earth am I getting myself into??!" I have no doubt that I whole-heartedly want to go to Guyana. What I don't know, is what on earth to expect when I arrive. The unknown, that's what I see stretching before me. A conglomeration of new and exciting experiences, that will challenge me, stretch me, take me out of my comfort zone, teach me, and probably at times frustrate me.

But as I look ahead to my departure in the not-too-distant-future, I am filled with a peace that God is leading me. I know that He has many experiences in store for me, and many lessons to teach me.

"Do not pray for easy lives. Pray to be stronger men. Do not pray for tasks equal to your powers. Pray for powers equal to your tasks. Then the doing of your work shall be no miracle, but you shall be the miracle. "

- Phillip Brooks-