Note: All times are estimates. Names have been changed for privacy.
0130 am The night is cool and dark as I walk home. I don't have my flashlight, but there is just enough light to guide my way from the hospital. As I round the last curve to my house, I pass the pasture where the cows are always grazing. There is rustling in the grasses. I wonder if it is a cow. Or a wild dog. I have scissors and an umbrella. Not much for fighting off an adversary.
I feel like I have been fighting all night.
I think about the picture in my purse.....the two dead babies....and Wilma.
The words of a hymn run through my mind, "Would you do service for Jesus your King? Would you livee daily His praise to sing?"
As I pass through the gate to my house, I think that though our human timing and actions are often imperfect, God's plan is exactly perfect. All things are happening for a reason.....as random and futile as they may seem.
Midnight: The blood bank is clean and I am glad of that. I lay on the cot, my arm out-stretched. My exhaustion weighs me down.
The tech pokes around in my arm. I am afraid to look - I am alittle worried I might pass out after missing dinner. How embarassing that would be. The blood flows out of my arm and into the bag. I begin to joke with my coworker about how in the US, I would get a cookie after giving blood.
We talk and laugh as the two units are collected. It feels strange to laugh.
1100pm: I am talking to the family of the second patient, Ali. I tell them that I am sorry about the baby.
Meanwhile, Wilma's blood pressure is continuing to drop. It is ~ 50/30. The drain has bright red fluid in it and she does not appear to be making urine. She is getting IVFs and has received one unit of blood. The second unit has finally arrived. Her condition can only be improved by more blood, but there is no more in the blood bank. At this point, I am worried that not even that will save her.
"What is her blood type?" my co worker asks.
"A-positive," replies the nurse.
"I will donate to her," my co-worker offers.
I am also A-positive.
1030pm: The second baby is out in less than one minute. The baby is taken out of the OR. Word comes back that this baby did not survive either.
Tears are hot in my eyes as I finish the operation.
1000pm: OtherDoc and I place surgicel and a drain and close the incision quickly. Wilma's BP has started to drop and I know that she needs to get out of the OR soon. She needs massive blood transfusion..and SOON.
Sweat runs down the sides of my face and the back of my neck.
Meanwhile, a call has come in: there is another patient pregnant and bleeding in Labor Ward.
0930pm: The bleeding has not stopped: it comes from the uterus, the SQ tissues, the skin.....a thin oozing welling up constantly. Wilma is in DIC. I ask the anesthesia guy to call my partner, OtherDoc.
0830 pm: Not just a previa. Previa + Abruption. The placenta - implanted over the cervix (previa), has started to rip away from the wall of the uterus (abruption), causing hemmorhage. The blood that could not escape throught the cervix has infiltrated into the walls of the uterus. Couvelaire uterus. It bleeds anywhere I try to stitch. I ask my co-worker to take a picture of the uterus with my camera.
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| Posterior view |
I quickly review her paperwork. Her name is Wilma and her hemoglobin is 8.4.
Oh that You would bless me indeed,
And enlarge my territory,
And keep me from evil,
That I may not Cause pain.
1 Chronicles 4:10
“We make a living by what we get. We make a life by what we give.” Winston Churchill. I don't know Carrie...this just reminded me of you. It's Pam from Nationwide Insurance. I follow your blog, I laugh and I cry. I am so proud of you!
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