Thursday, September 15, 2011

Gone Baby Gone

"Don't wake up, won't wake up, can't wake up
No, don't wake me up"

By The Time (2009) by Mika feat. Imogen Heap

Do you know what's messed up?

I do, and I learned the meaning of it just last week. Dawn was cracking and I had just begun reviewing patients in the gynaecology ward when a woman emerged from the washroom with the bottom half of her standard-issue green hospital garb soaked with blood. Her horror was on her face. Mine wasn't.

That was not what's messed up. In fact, that's almost routine but it demanded my full attention so I dropped everything I was doing and attended to her immediately (or stat, as we like to say because five syllables was four too many in an emergency). So, I laid her down and jammed a disposable plastic speculum up her delicates, and what I saw through it... that's messed up.

I saw a fluid-filled, translucent sac bulging into her vagina. Within it, I saw a pallid miniature foot complete with miniature toes twitching and kicking against the glistening membrane. The sixteen-weeker mother had been dallying at the point of no return for a couple of days already and all of us were absentmindedly expecting the inevitable - but the reality of it rushed up my head like too much iced drink when it actually unfolded in crimson on my own two hands. I knew the foetus was still very much alive the whole time. I also knew that it's chance of survival outside of it's mother's body was precisely zero. I was to deliver, for all intents and purposes, a tiny living corpse.

After a couple of pushes, the sac slipped out and promptly burst in a warm flood of amniotic fluid, depositing an uncanny imp-like creature between the lady's legs. Its tiny mouth opened and closed like a goldfish's, screaming soundlessly and gasping to fill it's useless, half-formed lungs. I continued to attend to the woman while trying my hardest not to notice it as it squirmed impotently against the back of my hand. There was nothing I could do for you, little fella. Just die. While I waited for the placenta to detach from the womb, the baby slowly faded away.

No, not baby. In my documentation of the events later, I referred to it as "the product of conception". That's five syllables more than "baby", but in this case, it's okay.

I continued to chat with the mother conversationally, both of us determined to ignore the ugly fact of a freshly dead child in the room. She already knew what to expect, and was taking it far too well. When I removed the clammy, limp mannikin from the scene, I took great care to wrap it up completely out of sight with a piece of bloodied cloth. She can choose look at it when she's ready.

You know what's even more messed up? Most people believe that there is a God watching over us. If he really exists, it seems to me that that's all he does. He just stood by and watched; unblinking, unflinching, stone cold.

P.S. "God has a plan," they say. So did Hitler. We didn't like his plan very much, did we?

Messed up,
k0k s3n w4i


Ec5618 said...

Sounds like you had a good day.
You saved a life.

A. H said...

been there.many times.hated them.
If i remember correctly if the IUD occurred in the third trimester you'd have to poke the baby's heart to draw blood for some investigations. That's just f***ed up.

nis said...

@A.H i think you got your facts wrongly. the closest i guess you meant is chorionic villus sampling (but still not done in third trimester). Maybe cord blood sampling?

Anyhow, a 16 weeker is classified as non-viable. I'm currently in NICU. The youngest i have is a 21 weeker.

k0k s3n w4i said...

Ec5618: actually, it felt more like i lost a life.

A. H: i haven't had the pleasure of going pulp fiction on a stillborn yet, but i'm only halfway through my posting. still, why get it from the heart when you can access it from the cord?

nis: i think A. H meant after the stillborn is out. our nicu record is 21 weeks? if that's true, that's world record material.

nis said...

@k0k, oh IUD. I missed that. I remember our lecturer once told that they did procedure to decapitate the dead fetus in order to bring the out from the womb. Can't remember the name of the procedure. Not practiced nowadays.

21? my bad. haha.