Today's Births & Thoughts

It was a busy day at the clinic. We had prenatal exams all morning. Then we had two births just after lunch, 45 minutes apart. No anemic patients. No IV fluids needed. No meconium-stained amniotic fluid. No hemorrhage. Just two, refreshingly normal births. I realize how much I enjoy those when they happen. Truly a joy.

A not-so-great part of the day was examining a 16-year-old patient who came in complaining of pain in her lower abdomen. She's 32 weeks pregnant. The most common reasons for this are a UTI, normal pregnancy-related discomfort, or premature labor. I was pretty sure it was probably one of the first two possibilities as we quite often get women, especially first-time mommies, coming in thinking something is wrong when it really is just normal, practice contractions or normal, pregnancy-related aches and pains. But to be safe, I needed to rule out premature labor just to make sure. So I routinely had her get ready for a quick internal exam not thinking much of it.

I was shocked as I could immediately feel the baby's head because it was so low in the pelvis, and her cervix was at least 5 centimeters open already. I think I may have even gasped. The baby's head felt soft - not the typical well-developed, hard bones of the term fetus skull. I really wasn't expecting this and of course, neither was this teenager. Poor girl. I told her my findings as I discovered them and she looked at me and said innocently and ignorantly, "Is that bad?" I had to tell her that yes, this was bad and we have to transport her to the hospital right away. The really sad thing is that I know the baby is probably not going to make it. They don't have money for a private hospital and the public hospital does not have any incubators. We had to send her there anyway. Just terrible.

You know, I have seen and heard of some pretty tough things at the clinic over the past two years but for some reason this today made me feel more sad than usual. I'm really not sure why though. More than not knowing why this story makes me feel sad is the perplexity at why I don't always feel such sadness with the other tough things I've experienced. Like when my patient's baby died (at the same public hospital) after it's cord became pinched between her head her mom's pelvis in labor and the hospital didn't even do a C-section to save the baby. Again, this is what being poor in the Philippines means. No money + emergency medical need = no care + unnecessary death. I remember feeling numb about that experience. I wasn't there when the baby actually died although I did listen to the baby's heart beat slower and slower with each contraction. That was awful as I was so helpless to do anything about it.

Well who knows why you feel some things more than others? We are human after all. I think we just can't go through life feeling everything, otherwise we couldn't function. But the opposite end of the spectrum isn't good either - never feeling anything and disconnecting from the pain around us. So I'm thankful for the sadness I felt today. I want to strike the right balance of feeling. I want to be affected in some way by the suffering I see, and I want it to make me feel at least a little uncomfortable. That way I am more likely to act. It just feels right to have to deal with it, struggle with it, ask hard questions. Examine myself and my own calling and abilities. I may not always be able to do anything but many times I will be able to do something and will hopefully have the courage to do it. On the other hand, if I let myself shut off, I fear I'd become a hard-hearted person who loves being cushy, comfortable and complacent. Where's the adventure in that?