There are very few days that I dislike my job.

Today was really one of them.  It wasn’t a hard day, or superbly busy, or even moderately stressful.  No one yelled at me, and I didn’t piss anyone off.  I can’t even say that I didn’t enjoy the most difficult sonohistogram that I’ve ever done.

I can’t really explain the dread feeling in my gut.  It’s hard to describe the way my heart pounds against my chest, and the way my breath catches in my lungs.  The tears prickle in my eyes, and my fingers tremble.  Because the worst part is that I can’t look this mother full in the face and tell her that her baby is fine, and that everything is ok.  It hurts me so much.

My patient came in after not feeling her baby move in almost three days.  She had been out of town, visiting relatives, and noticed all of a sudden that she hadn’t been feeling that familiar flutter that reminded her of her baby girl.  She called us immediately upon returning home, and was told to go eat a big meal, drink some juice, and call back if she didn’t feel any more movement.  She was 27 weeks pregnant, into her third trimester, and she was supposed to be beyond the fear of a miscarriage.

About an hour later, she was in the office in a room with the nurses trying to find the heartbeat with a “doppler.”  They couldn’t find one.  We keep hope, thinking maybe the baby is turned upside down, or laying with her arms and legs towards the dop-tone.  We pray that everything is ok, but we feel the dread in the back of our minds.  The nurse came out of the room, and asked me to scan her.  She said, “Please, tell me you can see a heartbeat in there.”

Immediately the fear sets in.  I know there is very little chance of this being a happy ending.  I tell the doctor that I’m taking the patient in to scan, but please don’t go anywhere in case I need you.

The moment I placed the transducer on her belly, I knew all was not well.  There were no sweet legs kicking back against me.  There were no precious arms waving.  Her little heart was still, no flicker of life in her chest.  I could feel the tears stinging my eyes.  I’m not prepared to deal with this.
    
    “Please, tell me… just tell me.  I need to know, please…”  she begs me. 
   
    “I need to take some pictures out to the doctor, ok?”  My voice is strong, and unbroken.  It lies about how I feel.  It doesn’t tell of my heart breaking inside, my mourning for her baby already gone.

I walked out the door, leaving her alone, and I couldn’t hold back my tears.  The doctor knew the moment she saw me, and cursed.  This was her second fetal demise today.

Dr. L came back in the room with me, to verify.  She can’t just go on my word, she has to see it with her own eyes.  The mother is nearly hysterical now, crying “Please don’t tell me… please don’t tell me.   Please, don’t tell me!”  The Doctor looks for nearly a full minute, before she is asked, “Please, doctor.  I have to know.  If it’s not ok, I need to know.”

“I’m sorry.  Your baby is gone.”

She cried, and cried.  She blamed herself.  She asked what she did wrong, and she cried again.  Dr. L held her while her body shook with sobs.  I held her hand as she started to catch her breath.  She said to us, “It’s ok.  I’m ok,” and we both told her, “You don’t have to be ok.” 

She said, “I just want to go home.”

She called her husband to come and pick her up.  She wanted some privacy while she was on the phone and we gave it to her.  But I swear to you, right now, that the hardest thing I went through today was trying to maintain my composure when her husband walked into the room, and burst into tears himself. 

They had lost their little girl.

Sometimes, I really don’t like my job.