Medical Miracles

As much as some people believe that doctors are god, we are not. We are fallible like any other human. We are not all knowing, not all seeing, nor all powerful beings. We rely on our extensive knowledge base (with the ability to look up what we don't know), our physical exam findings, lab and imaging results, and how well the patient responds to different treatments. We often objectively manage patients in situations of uncertainty by covering our bases. This translates into throwing multiple medications at our patients and hoping that one of them was the right one to treat the underlying disease. It's not an ideal way to practice medicine but sometimes it's the best we can do. However, I now know what it feels like to be in the position of my patients' families having personally been faced with this difficult situation.

I will never forget the moment in class on Dec 22 when I received a message from my family that within 24 hours a family member went from being in their usual state of health to being confused to being admitted to the ICU, unresponsive and intubated. Despite extensive blood work, cultures, imaging, and even a lumbar puncture doctors STILL had no idea what was going on and a discussion about DNR (do not resuscitate) had been initiated . What could have possibly happened? How is that no one could figure out the etiology of such a severe and rapid deterioration in an otherwise healthy person? Sometimes our tests fail us. Sometimes everything comes back normal and it can be difficult to reconcile these normal test results with the seemingly dying patient in front of you.

I was shortly thereafter excused for the holidays and it is my philosophy that one must keep on living. Subsequently, I tried to disconnect for some much needed rest and family time. On Christmas Eve, as a gesture of good will, I decided to accompany the in-laws to Christmas Mass. Having grown up in a secular Jewish household, I had never been to mass and was curious. As we sat in the pews, nestled between strangers, I receive a message that my loved one was no longer intubated, but still unresponsive. Dammit, what if this is permanent. Despite being present for the service, I found myself distracted by the children fidgeting and crying nearby, and even more distracted by the thoughts in my head. "We will now take a moment of silence for prayer to heal those who are ill" said the priest. The room fell silent, the only sound the occasional creaking of pews as everyone bowed their heads in prayer. Praying was never something I did regularly but when in Rome; what did I have to lose? I closed my eyes, and like a nervous teenager about to ask someone to prom, said: "Um so I'm not sure if anyone is listening but uh well there is someone I would like you to help...obviously you know who. But...yeah, I would really appreciate it and it would mean a lot to my family. Thanks for listening." It was far from eloquent but I felt comforted nonetheless that there was a chance that I had been heard.

The rest of my evening was uneventful. I awoke Christmas morning to open presents and enjoy the festivities. After breakfast I checked my phone and I had received another message that my loved one was sitting up eating breakfast, completely back to normal. No one knows what exactly was the cause, nor what was the cure. With that comes the unsettling worry of could this happen again, but for now all is well. Whether it was due to divine intervention or stellar medical management or some combination of both, I think we have had a true Christmas miracle.

My First Delivery

"PUSH!" I hear from outside the room.

I run over to the board only to see it's my patient and she's at 10cm.

I open the door to the room to find my patient already pushing, all the tools needed meticulously splayed out on the green blanketed table.

"We have a gown for you, here. It's your turn."

I gown up quickly, put on my white sterile gloves,  and gently make my way over to the patient.

She has her feet in the stirrups, legs fallen to the side and a bright light shining on the exposed area. No baby yet.

She begins to scrunch her face and I see the numbers on the nearby monitor rising. A contraction.

"PUUUUUUUUUSHH!" Yells the nurse. We all count "1, 2, 3, 4"... all the way to ten, repeat it another two times and as the contraction eases of the patient has a chance to relax. Her husband clutches her hand excitedly as the moment of getting to meet their first child draws ever closer.

Another contraction. As she pushes again I can see some tiny tufts of hair for a brief moment and then they are gone. With every contraction that goes by, I see a little more hair and a little more of the baby's head, until finally  the head no longer disappears back into the vaginal canal and stays permanently visible in between contractions. I hold one hand against my patient to help support her delicate tissues and the fingers on the other hand along the baby's head. For every contraction, with the guidance of my staff, I applied gentle pressure to help control the speed at which the baby was coming out. With one big push the whole head is out. I quickly feel around the neck for a loop of umbilical cord. Thankfully there is none. As she pushes again the baby rotates sideways as they always do and with one final push the baby comes rushing out into my hands. With the support of my staff we ease this new baby onto my  patient who is now a first time mom.

"Congratulations! It's a girl"

She begins to cry and her husband eagerly cuts the umbilical cord after we have clamped it. The baby finally begins to cry forcefully and goes from a shade of worrisome blue to rosy pink; a new little human starting it's first day in our great big world.