People say it's the last place
They want to go.
But when push comes to shove,
It's the next-to-the-last place.
Although there are some who are
Ready to move on to that last place.
Others stay as long as they can in this,
The last place they thought
They would ever want to go.
Clinging on, year after year,
Staying here to avoid
The last place.
"You need to give me the name of a different specialist," Ashley asserted.
For several years, Ashley, age twenty-nine, has been my patient at the residency practice where I work as a family doctor. Our relationship is not entirely comfortable; after visits, she frequently seems dissatisfied, yet she refuses to see anyone else.
Ashley's body is a source of distress to her, often developing various pains and discomforts that fade away without explanation. In search of relief, she asks for many tests, but often, when I recommend a treatment, she refuses it or has difficulty tolerating its effects. When we talk, she's usually very guarded about any aspects of her life besides those directly related to her symptoms.
I often feel ambivalent about ordering tests for Ashley, because all tests carry risks. Mostly, the risks are small. But one big and worrisome risk is the possibility of an incidental finding--something unusual that requires further testing and that would have posed no problem had it gone undiscovered.
It's called a missed miscarriage: You arrive, as I did, at the doctor for your first-ever pregnancy appointment, suffering from morning sickness and filled with joyful anticipation--only to learn that your body has not yet registered the death of your small embryo. Despite all of my doctor's tinkering and double-checking, the ultrasound screen showed no movement. There was just the outline of a baby in me, quiet and still.
Hoping for a natural miscarriage, I told my coworkers what had happened, but asked that we not discuss it at work.
Day after day, I went to the Denver office where I worked as a speech pathologist, carrying my baby deep inside me, like a single stitch woven within fold after fold of tissue and blood.
I was asking my body to let the baby go. My body refused. So the waiting continued.