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?