She’s a joyful, jubilant, glowing 27-year old, and she tells me that just 12 weeks ago she received the best news of her life.
“You are pregnant! You are going to be a mother!”
I wasn’t there, but I close my eyes to imagine the excitement. I imagine the physician coming back with the results of the urine pregnancy test, and I imagine her clenching her husband’s hand until its red, white, and blue, like Raynaud’s phenomenon. I imagine them as they hold their breath to listen, so that not even a whisper of air can distract from this moment. I imagine the tension, the electricity, the anticipation, the anxiety.
Just 12 weeks ago, they had plans of bringing a baby into this world.
Just 12 weeks ago, they began to think of names.
And just 2 weeks ago, she began to feel the ‘fetus’ move, and she became even more aware that a baby, complete with 23 maternal and 23 paternal chromosomes, was growing inside of her uterus. It had a heart beat. It had life. It had a name.
She visits the clinic – alone – at 18 weeks gestation for her routine prenatal checkup. She tells the doctor and me that, recently, she hasn’t been feeling the baby move as much. And even more concerning, she had an episode of bleeding two nights ago. And she’s worried.
She’s worried. And she’s alone.
The doctor tells her that she needs to check-in to the hospital to get a non-stress test done to assess for fetal reactivity. She agrees. I know she’s worried, so I tell her that I would be at the hospital in the afternoon, and that I will check on her. She’s thankful.
When I get there in the afternoon, she is just getting to the hospital. I walk in, and we chat. We talk about the snowstorm that we are supposed to be getting over the weekend. She jokes that meteorologists are always wrong, and that we probably won’t get more than an inch. We joke and laugh, as the nurse begins to set up the doppler and tocodynamometer. I decide to step out and allow her to finish setting up the non-stress test.
I walk to the nurses’ station, and, oddly, the nurse follows behind me. She tells another nurse to call the doctor in the clinic.
Something is off.
A few minutes pass, and I get up to go to the bathroom. As I exit the bathroom, I hear a shriek from the other end of the hallway, the type of shriek that’s filled with passion and pain, the type of shriek I’ve only heard once before in my life. And in that moment, I remember that’s the noise my father made at his grandmother’s funeral.
I walk into her room to see her balled up on the hospital bed, with the doctor holding her hand. And somehow, I know what has happened. I take one look at her eyes - filled with grief, pain, anguish, agony – and one solitary tear gently runs down my cheek onto her sheets.
The doctor holds her hand, and tells her that there is nothing she could’ve done to prevent this from happening. He explains what is going to happen next. He tells her that most of the time, it is due to anomalies that are incompatible with life. She asks questions, and he takes his time to leave none unanswered. She’s tearful, and asks if she can call her husband. We leave the room to give her privacy.
After a while, she is wheeled down to the OR to ‘evacuate the products of conception’ – a phrase that I utterly despise. To her, it is more than a ‘product of conception’. To her, it is more than just a ‘fetus’.
To her, it was her baby. It had a name. It had a life.
And just then, I become disgusted with some of the medical terminology we often use in our notes. We often dehumanize and assign expressions based on legalities and constitutionality, rather than emotions and humanism.
The ‘pregnancy’ is ‘viable,’ as to not imply life.
The ‘fetus’ is not yet a baby, as to avoid an emotional attachment.
We wheel her out of the OR, and her eyes speak an indescribable pain. A pain, that if she had read my post-operative note calling her baby an ‘aborted fetus’, she probably would’ve spit in my face. And I would not blame her.
I take one look at her eyes, and I can’t stomach what I just wrote in the chart. I feel dirty, unclean, dishonest, deceitful. And I want to take my post-operative note and rip it out of the chart. And I want to tell the resident and attending that I will not refer to her baby as an ‘aborted fetus’, and that I demand that we start using terms that illustrate the emotions that this woman is experiencing for her lost baby.
But I don’t.
And I don’t know why.
— Mahatma Gandhi
— Paracelsus (via medicaljourney)
Henry Melvill - Golden Lectures
(Or, in a case of mistaken identity of sorts, there are versions of the quote mistakenly attributed to the author Herman Melville: “We cannot live only for ourselves. A thousand fibers connect us with our fellow men” and “We cannot live only for ourselves. A thousand fibers connect us with our fellow men; and among those fibers, as sympathetic threads, our actions run as causes, and they come back to us as effects.”
They asked me to make a sign for the café indicating the new water station and because I’m a cheeky little lit nerd, here you go. The people who get it will love the shit out of it and it will confuse most people. Just my style.
Re-blogging this so you all can go read the David Foster Wallace piece that’s linked. Because it’s a great piece, and it relates whether you’ve studied liberal arts, medicine, or anything else.
— Oliver Sacks (via compoundfractur)
As an EMT, I don’t want other people to see what I do. To experience the things that I experience on a daily basis and be exposed to a lot of the pain and suffering in this world. A lot of people don’t need that extra burden in their lives.
But every now and then I meet a person who I wish could spend some time with me on the ambulance and see first hand the pain and suffering in the world.
- I wish they could be there when a patient who is busy having a stroke right in front of you refuses treatment and transport and you look into their terrified children’s eyes because they have no idea whats going on. Just that something is wrong with daddy. And then having to walk away because there is nothing you can do, knowing very well that those children may not be able to wake their father up in the morning.
- I wish they could be there when we get called to the scene where an honest worker got his head hacked open by muggers for a cellphone. I wish they could literally hear the pain in his wife’s voice as she sobs and the sudden realization in her eyes that she now has to support a family all by herself.
- I wish they could be there as the patient trapped in the car desperately holds onto your hand because they don’t want to be alone as they die.
- I wish they could be there to see the grief and pain in a fully grown man’s face while tears stream down his face as we try to resuscitate his little brother, but fail.
I wish they could see these things so that they can realize that the trivial things they complain about are not that bad and that if no one around you has died or been injured and that you are a fully functioning human being, that you are actually having a pretty fucking awesome day.
(Source: , via jnhwn)
— Vincent Van Gogh
Lungs ≡ Trees
Above is a resin cast of a lung. Notice its fractal nature - how it displays self similarity at smaller and smaller scales. You might also notice how this structure is quite ‘tree-like’. Why are they so similar?
Well actually, both lungs and trees want to maximise the surface area of their functional components while constrained to some maximum volume. For lungs this strict constraint is the size of the thorax, but for trees is more relaxed and is to do with the mass they can achieve through photosynthesis and mineral uptake and density of trees around them.
Interestingly, nature has solved both these mathematical problems of optimisation using the mathematical solution of fractals. This is a great example of complexity and universality. Complex structures such as trees and lungs emerge from very simple mathematical rules, laws and constraints. The result is some kind of universality to the structures that we humans see and assume to be very different, though they are fundamentally the same.
Check out this animation I made of a simple fractal construct being transformed into a ‘tree-like’ (or ‘lung-like’!) structure.
“A picture began circulating in November. It should be “The Picture of the Year,” or perhaps, “Picture of the Decade.” It won’t be. In fact, unless you obtained a copy of the U.S. paper which published it, you probably would never have seen it.
The picture is that of a 21-week-old unborn baby named Samuel Alexander Armas, who is being operated on by surgeon named Joseph Bruner. The baby was diagnosed with spina bifida and would not survive if removed from his mother’s womb. Little Samuel’s mother, Julie Armas, is an obstetrics nurse in Atlanta. She knew of Dr. Bruner’s remarkable surgical procedure. Practicing at Vanderbilt University Medical Center in Nashville, he performs these special operations while the baby is still in the womb.
During the procedure, the doctor removes the uterus via C-section and makes a small incision to operate on the baby. As Dr. Bruner completed the surgery on Samuel, the little guy reached his tiny, but fully developed hand through the incision and firmly grasped the surgeon’s finger. Dr. Bruner was reported as saying that when his finger was grasped, it was the most emotional moment of his life, and that for an instant during the procedure he was just frozen, totally immobile.
The photograph captures this amazing event with perfect clarity. The editors titled the picture, “Hand of Hope.” The text explaining the picture begins, “The tiny hand of 21-week-old fetus Samuel Alexander Armas emerges from the mother’s uterus to grasp the finger of Dr. Joseph Bruner as if thanking the doctor for the gift of life.”
Little Samuel’s mother said they “wept for days” when they saw the picture. She said, “The photo reminds us pregnancy isn’t about disability or an illness, it’s about a little person” Samuel was born in perfect health, the operation 100 percent successful. Now see the actual picture, and it is awesome…incredible….and hey, pass it on! The world needs to see this one!”
Doctor: (noun) The health career used to save the lives of people.