Shattered

It was 6:30 a.m., and I was nearing the last hour of a nighttime rotation on labor and delivery. Over the previous eight hours, my team had overseen two vaginal deliveries and two c-sections, one emergent. During this procedure, as the medical student on the team, I was charged with requesting hemostatic agents, STAT, from the main OR. As I ran past the patient’s anxious husband with the hemorrhage cart, I informed him, trying desperately to hide the terror in my voice, that his new baby boy was healthy but that the doctors were still treating his wife.

Simultaneously, I was rehearsing explanations, in case I was quizzed by my attending, about the mechanisms of methergine, hemabate, and surgicel. The mental task-switching was fatiguing.

When the surgery was finished and the patient stabilized, I checked in at the nurses’ station to see what was happening on the floor. My attending said a woman had just arrived with bleeding at 16 weeks’ gestation, after having a selective reduction of twins a week before. Immediately, I began flipping through the causes of second-trimester bleeding—cervicitis, preterm labor, placental abruption, placenta previa . . .

Then a nurse called out from the room and completed my mental list: the patient was miscarrying. With little time to compose myself, I entered the room to see the nurse delivering the remaining twin and the mother with silent tears streaming down her face.

I stood there with every niche I’d occupied as a medical student shattered on the floor beneath my feet. I realized I could do nothing except be present. I quietly introduced myself to the patient and asked if I could sit with her. She gave a silent nod and began telling me about her son, now lying in a plastic container out of sight across the room.

She told me she’d been saving money for months to have these twins, then she’d lost one and now the other. She told me what she was going to name him. She said she’d already bought a car seat. She said her daughter lived in Haiti and “would have been so excited to have a brother.”

I held her hand and listened. I sat with her for almost an hour, until the shift change. I found it hard to leave. She expressed such gratitude, though I know my actions did nothing to change the brutality of what had just occurred. But the simple presence of another person mattered.

I walked out of the room and breathed a sigh of sadness and exhaustion—and relief, at having surrendered my clinical identity to humanity.

Abby Scurfield
New Haven, Connecticut