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Why This Can't Be Happening
All names changed.
It is night shift, and the lights are low. The labor and delivery unit is filled with the smell of Seattle's Best brewing, and slightly suspicious garlic hummus someone found raiding the fridge earlier. It's a mercifully slow night, and it is winter in San Francisco, though who can tell? It is nearly Christmas, and the unit looks like a well-intentioned, but drunken Santa Claus has paid a visit. The girls, the nurses on the unit, are celebrating the downtime by filling the empty hallways with our gossip, laughter, and stories that just won't end. The unit is suddenly an adult playground without patients, and managers. We are playing jokes, including one involving water balloons that we must swear an oath never to speak of again...but it was more than fun.
The phone rings, and it's a triage call, asking to speak with a nurse. I recall that, yes, I am a nurse, and I take the call. It is a man whose wife has been having contractions for a couple of hours, and they are about every 5 minutes apart...should they come in? he wants to know. It's their first baby, and I'm pretty sure that it's the typical false alarm of the first timers, but I tell him to bring her in. Just to check.
"Incoming," I say to the charge nurse. She's trying the hummus, nurses really will eat anything.
"It's their first baby, though," I say and shrug. She shrugs back, she's thinking a quick exam and a goodbye chat for the couple when they come.
"Em has a Spanish-speaking mom in the nursery. I'm going to go translate for her," I say, and head towards the nursery. It isn't my turn to take the next labor patient, and I need to stay busy to stay awake.
I return from the nursery and the man from the phone call earlier, and his wife are now in a labor room with one of our nurses. I am contemplating eating the hummus--now even more suspicious, but I reason that at least I am in a hospital if it tries to kill me. Again, nurses will eat anything.
Jackie, the nurse taking care of the couple, comes out of the room, and quietly, without urgency, asks me, specifically, for help. As I head to the room, my intuition, the intuition that I never asked for, kicks in, and I know that something is more wrong than I can fix. I can feel it, and I know to be afraid.
I see the woman in bed's face, and I know her right away. I'd met her months earlier at a health food store. We'd chatted about her pregnancy, and I had asked her where she was going to have her baby. When she told me she was delivering at the the hospital that I was on contract with, and that she was in fact related to one of my co-workers there, we were both charmed by the coincidence. I'd said, 'maybe I'll see you there!"
Now here she is--in a labor room that is too quiet, on a fetal heart monitor that is not making any sound.
"Baby seems to be hiding...wanna give it a try?" Jackie says to me, without meeting my eyes. She knows, just like I know, that I will not find a heartbeat.
My blood goes cold, as I pretend there is any possibility that I am going to find this baby's heart beating. Jackie has been a nurse 5 times as long as I have, and if she wasn't able to get a fetal heartbeat on a pregnant woman at term who is not obese--then there was no chance I would either. We both know this.
But here's the thing. When you're looking into the eyes of a hopeful and worried mother, and her hopeful and worried partner, devastating truth is not on your side. There's part of you that has to deny it for a minute or two, or you, the nurse, will flee the scene. You'll want to quit nursing, quit life, quit time, quit the world. Truth that painful needs buffering. And nothing is true until it's said out loud, and into the world where you can no longer take it back.
Here's why this can't be happening--she's young, healthy, and in a stable relationship. She's sweet. She is not one of our crack whore patients, spitting out a kid, thanking us kindly for the IV access, and rolling out of the door before we can finish putting the delivery instruments away. She took vitamins. She loves God. She went to childbirth classes. It's nearly Christmas, and while that celebration does not mean anything to me--it does to her. It can't be happening because it's her first baby, and it's a boy, and he has a name, and a decorated nursery, and a huge family who can't wait for him to be their's. It can't be happening because no human being should ever have to carry a child for nearly a year only to have a couple of nurses tell her that her baby is--that her baby doesn't have a heartbeat. Nurses can't pronounce death. It can't be happening because she's related to one of our co-workers, our family, she's ours. It can't be happening because....my God, please hear me, a coffin should never be that small.
In my guarded, overly-sensitive teen years I wrote the phrase, "when a heart bleeds clear, it's called a tear." I didn't know anything. I hadn't yet heard the primal, soul-crippling wail of a mother's loss. Not until that night. Not until, there was no way to deny the loss of this child once a doctor, an hour later, pronounced the baby's death with an ultrasound confirming what we had pretended not to know.
Right before the doctor pronounced the baby, my co-worker,who was this baby's grandmother, had shown up in sequins, fresh from a Christmas party. She was asking questions, and I couldn't look at her. There's no book, no class, no anything that can possibly prepare a person, as a clinician, to face this scene. All you can do is to fight with everything the urge to run, and instead hold your ground while you fall apart inside. You say shamefully pitiful, and useless things like, "I'm so sorry."
What would you do?