Warning: There are countless horrible things physicians encounter as a resident. The following is a particularly disturbing episode involving a stillbirth that you may not want to read. I have changed certain details to maintain privacy.
I had a list, once.
It was a list of things that I wanted to experience and treat as a resident when I would have backup and could ask for help. Things that I wanted to learn how to handle there rather than out in the “real world”.
One was a still birth.
So, one afternoon in my second year, sure enough, a young woman showed up at labor and delivery. Her baby had stopped moving a few days before she said and she was cramping a bit, in early labor.
There was no heartbeat on the Doppler or on the ultrasound. She had been about 27 weeks gestation we estimated.
It was awful telling this young mother that not only had she lost her first baby, but she was going to have to deliver the body. The baby’s father was out of the picture and she had no family in the area. She didn’t want me to call any friends or let anyone know. She intended to go through this by herself.
She also had not really had prenatal care and the hospital anesthesiologists had a barbaric policy at the time that only those who had prenatal care could have an epidural. No matter what. So as we started the pitocin to move her labor along, she had no pain management. Periodically I would hear her cry out in pain. We gave her Demerol, but that was never terribly helpful for anyone, really. I tried to stay with her, but really what she wanted, she said, was to just be left alone. She was grieving so I gave her privacy.
The baby was in breech presentation, so when I called the OB attending (he was not employed by the residency but was rather a private physician in the community who helped out covering OB call periodically) to notify him of the fetal demise and to ask if there was anything I needed to know, anything to expect in case there were any problems, he laughed. “Look, breech is a concern if you are delivering a live baby. Don’t worry about this.”
At some point the woman started to feel the urge to push but did not tell anyone. Instead she had gotten up to use the bathroom thinking she needed to have a BM. Suddenly I heard terrified screams and sobs from her room. Two nurses and I rushed in. Lying between her legs in the toilet was a body without a head.
That’s right. No head.
While I got her back into the bed, one of the nurses fished the body out of the commode. I did an exam and no head could be found vaginally. A bedside ultrasound confirmed it was still in the uterus along with the placenta. The baby had likely been dead longer than she or anyone had expected and the tissues were friable.
I called the attending in a panic. He started laughing. Laughing! “Girl, I need for you to give me head…” More snickering from him.
Yes. The bastard was making jokes about me performing fellatio on him because of a decapitated baby.
Still, I had to play nice because I needed for him to tell me what to do next.
I hated him. I hated myself. I hated God. I hated that hospital. I hated being a woman.