Saturday, May 16, 2009 – Triage

To start at the beginning, click here…

Saturday, May 16th …. Continued …

I had to leave Jim a voice mail.

I’d somewhat anticipated it; after all, you can’t very well hear a ringtone over the roar of a commercial grade lawnmower.  But still.  A voicemail.

“Come to the hospital when you get this.  I’ll be in Labor & Delivery triage.”

I drove a few more miles on I-475 East, a highway I could navigate in my sleep.  Bubbles of giddy laughter rose in my chest, startling me.  What was so funny?  I was on my way to the hospital at twenty-four weeks pregnant, alone, and here I was, laughing.  It would be months before I realized the laughter, the “nerves" I was feeling was merely shock setting in.

As unnatural as it is, I felt very at home at The Toledo Hospital.  I’ve spent more than the average person’s share of time wandering the halls and camped in the waiting rooms of the massive brick structure.  So the enormity of what I was actually walking toward was lost on me as I parked the van, passed through the lobby, and rode the elevator to the familiar third floor Maternity ward.

My steps faltered for the first time that day, just shy of the nurses station.  The words I knew I needed to say stuck to my tongue and choked me.  The tears I’d not felt the urge to shed suddenly burned at the back of my eyes.  Before I was ready, the nurse looked up and said, “Can I help you?”

And even though in my heart, I knew the answer was a resounding, “No; no you can’t,” I stepped up to the counter and told her I’d been sent from Dr. so-and-so’s office after failure to find fetal heart tones on doppler.

Recognition immediately flooded her face, and I felt a momentary peace that at least this part was going to be easy, due to Joel’s advance phone call.

I was led to a curtained-off section of triage, and asked to put on a gown and provide a urine sample, which was the last simple, easy, and mindless thing I would do that day.

A nurse (who to this day I’m thankful was about to leave due to a shift change) came to my side, efficiently ran through the necessary patient history, placed the hospital bracelet on my wrist, and proceeded to usher me into a universe I never wanted to know.

She placed two monitor strips behind my back, and laid the loose material across my belly, which suddenly seemed so much smaller than it had just hours earlier.  One strip for contractions, one strip for fetal heart rate.  She placed the first monitor pad down, waited for an accurate read to appear on the computer screen, and fastened the elastic strip tight.  She placed the second pad down, and looked to the screen.  She moved the pad a few inches to the right; then the left; then lower on my belly, all the while, frowning at the monitor.

“I’m going to send in the doctor to take a look,” she said quietly, and stepped around the curtain.

I looked down at the second strip.  She hadn’t bothered to fasten it tight, and it lay wide open to either side of me, like a pair of empty arms.

And finally…

A thousand tears fell, and yet, he remained still.

The compassion of the doctor on call astounded me.  She came in, but merely sat on the edge of my gurney, holding my hand, and waiting with me until Jim arrived.  The truth of the silent monitor went unspoken between us; she knew that I was not strong enough to handle hearing the words spoken aloud until my husband was present.

As soon as Jim entered the curtained-off area, she rose, and had a new (and wonderfully sweet and gentle) nurse prep me for an abdominal ultrasound.  The screen was turned toward her, and therefore Jim, who was standing on her right, at such an angle that I could not see.  I was glad.  I don’t know that my psyche could have survived seeing the image on the screen and the look on Jim’s face.

I didn’t take my eyes of his as the doctor verified what they had all just seen.

“I’m so sorry.  There is no cardiac movement.”

The horror and pain and numbing disbelief that these words bring to a parent’s heart can’t be translated into words.  An audio clip of the gut-wrenching, primal cry that came simultaneously from Jim and me is the only thing that could even come close to conveying the sorrow that immediately engulfed the room.  It was as if all the oxygen had been sucked out through the folds of the triage curtains; my ears were ringing; I doubled over in a non-physical pain that left me blind and deaf to the goings-on around me.

The doctor and nurses excused themselves to give us some privacy, and we clung to each other as we wept.  Surprisingly, I found, grief that intense can only be sustained for so long, and soon enough, my brain automatically went into business mode: what was next, how would I deliver, could we stay in Ohio, would our insurance cover an out-of-network delivery, what would we name him, how would we tell our parents, which funeral home should we choose, did we have to bury him in Ohio or could we bring him back to Tennessee.  A million questions needed to be answered, and although in the moment, you feel like the least-equipped person on earth to answer them, the responsibility still falls to you.

The next several hours were spent trying to track down representatives from both the hospital and our insurance carrier.  The amount of bureaucratic red tape that needed to be negotiated was staggering, and the fact that it was 3:00 PM on a Saturday afternoon was working decidedly against us.  We waited; waited some more; named our baby; and then, waited even longer.

We were given the option to induce labor immediately, but I was hesitant.  The reality of what we were facing was horrific enough; the thought of being saddled with an $80,000 hospital bill because we delivered Duncan out-of-network was unbearable.  In the end, we had no answers.  There was no “next step” to take, other than to go home, and wait.

Saturday, May 16th …. To be continued …