I\u2019m in the back of an ambulance rig driving 110 miles an hour down the highway with the lights and sirens blaring. The knuckles of my right hand are crushed every four minutes as my patient has contractions. She cries only a bit. She\u2019s sixteen and her last period was nine-months ago but she hasn\u2019t seen any other physician before me. <\/p>\n\n\n\n
This last\ncontraction was an intense one\u2014my bruised hand can tell\u2014after it abates she turns\naway; my hand is still in hers and I absent-mindedly start to move it but she\nstops me with a firm squeeze. So I follow her lead and I stay in the\nsilence. I notice how each pothole\naccentuates a rattling in the back of the emergency truck and how the sirens\nsound distant. I reflect on how moments ago I checked her 8cm cervix, took her\nmedical history, and saw inside of her pregnant body with an ultrasound. <\/p>\n\n\n\n
Watching\nher in this experience has been stunning. \nShe has been stoic, almost wise. Politely\nanswering my questions between contractions. No drama. It\u2019s a strange rhythm:\nduring contractions there\u2019s intensity and I have the right affirming words, and\neven the knowledge to move forward and deliver this baby (if need be). But when\nthe contraction subsides and the baby has not come, there\u2019s awkward silence. <\/p>\n\n\n\n
I\u2019m\naccompanied by an EMT and an ex-OB nurse. The EMT has been helpful and\nefficient and is now engrossed in forms. Regular conversation with my other\ncolleague seems a out of place now. So the silence continues. After all, my, \u201cyou\u2019re going to be alright\u2026we\u2019re\nalmost to the hospital\u2026we\u2019ve got you\u2026your mom is on the way\u2026\u201d seem empty by the\nthird time. <\/p>\n\n\n\n
My hand begins\nto feel pressure once more. I turn to\nthe EMT, \u201cIf I need to deliver her, I want to pull over.\u201d He nods.<\/p>\n\n\n\n
I examine\nher again and see that she is not crowning. \n<\/p>\n\n\n\n
I have a\nchild who is pregnant with a child who has received no prenatal care. The odds are against her: the rates of maternal\nmortality in this geographic location are devastating. I still tell her that she will be all right. These are hopes but I say them as absolutes.<\/p>\n\n\n\n
I check-in, \u201cwhat are you thinking about?\u201d<\/p>\n\n\n\n
\u201cEverything.\u201d<\/p>\n\n\n\n
She says\nwith more weight than her 100lbs. And words\nfail me again.<\/p>\n\n\n\n
We make it\nto the OB floor of the hospital. The\nteam is well choreographed and she\u2019s situated and hooked up to monitors almost\nimmediately. I give report to the next\nphysician. I go to her to say goodbye and\ntake her hand in mine once more\u2014not a handshake but palm-to-palm with thumbs\ncrossed. She looks into my eyes and\nholds my gaze for longer than a moment: fear and courage mixed. I turn to leave. <\/p>\n","protected":false},"excerpt":{"rendered":"
I\u2019m in the back of an ambulance rig driving 110 miles an hour down the highway with the lights and sirens blaring. The knuckles of my right hand are crushed every four minutes as my patient has contractions. She cries…<\/p>\n","protected":false},"author":98,"featured_media":19641,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_jetpack_memberships_contains_paid_content":false,"jetpack_publicize_message":" @gaffmeg uses #NarrativeMedicine to reflect on a patient encounter in \"The Calm Between\"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[1],"tags":[93],"coauthors":[209],"jetpack_publicize_connections":[],"acf":[],"yoast_head":"\n