COTW: Wrong Decisions

by Rachel

It’s been a rough couple of weeks, clinically speaking.  I have heard it said that in missionary medicine your highs are higher and your lows are lower...and I feel like that’s been the case for me recently.  In fact, some days the space between triumphs and failures are measured in seconds and minutes.  That does put me on quite a roller coaster of emotions.  There have been a number of maternal and fetal deaths lately, which weigh heavy on my heart.  In the last 3 days alone I have come face to face with the reality of gut-wrenching evil, watched a woman slip away before my confused eyes, and have to live with the knowledge that a decision I made, for right or for wrong, contributed to another woman’s death.  Days like this, the magnitude of the decisions I make as a physician loom larger than normal.  We all make decisions, all the time, about so many things.  Usually those decisions matter so little in the grand scheme of things.  But sometimes in medicine, they cost a life.

I am tempted at the end of the day to come home and wallow in my sorrow.  To grieve over all that’s wrong with the world, and to focus on the sadness.  There is so much to grieve, on both sides of the ocean right now...for friends and family in both our communities.  But I think back to the Israelites in the midst of their wanderings, and in the midst of their years of rebellion and captivity.  God gave them signs and wonders, stones and altars along the way so that when things got difficult, when it seemed like God no longer cared, they could look back and remember his faithfulness.  So tonight, that’s what choosing to do, too.  I’d like to share a story of faithfulness with you.

What started off my “rough couple of weeks” was one patient in particular.  Her name is T.  She first came to see me in April at the beginning of her 5th pregnancy. She had a history of preterm deliveries and one term fetal death before a C-section...so, no living children.  I wish this story was more exceptional but it’s a sadly common story.  We came up with a plan to try and prevent her from having another preterm delivery.  I did a few ultrasounds, she started on some medications, and we decided to admit her to the hospital at some point in the future to give injections to help the baby’s lungs mature faster in the event of a preterm delivery.  Fast forward to mid-October.  T was hospitalized on my service; her water had broken.  According to her chart, she was now just 4 weeks before her due date, and the baby’s heartbeat was strong.  We rejoiced together, and planned a C-section to deliver this baby.  In the back of my mind, I put on my mental checklist to go back to my office and check the ultrasound records to confirm her due date.  But the day was busy, as most are.  The morning passed in a whirlwind and soon I was walking into the operating room where she was already prepped and draped.  I made the skin incision, and opened up the uterus.  I slid my hand inside to cup the baby’s head...and again, in the back of my mind, thought to myself, this head seems smaller than I expected.  I delivered a crying baby girl and showed her to T, then passed her off to the nurse.

But as I sewed up the uterus, I kept turning to look at the baby girl.  She was no longer crying.  The nurse seemed solemn, and within minutes whisked the baby off to the NICU.  She came back to say that the baby was much smaller than normal for this age, just under 3 pounds.  As soon as the case was done, I hurried off to the NICU.  The NICU nurse and the students were assessing that the baby was actually 8 weeks early, not 4 weeks.  I found the time to check my ultrasound record.  They were right.  I hadn’t double checked the due date...the chart was wrong, and I had delivered the baby too early.  My moment of joy over T’s first live born baby instantly disappeared, replaced by a sinking pit of despair in my stomach.  I ran through justifications in my head (her water was broken anyway, maybe the baby has a better chance to survive now, it wasn’t ME that wrote down the wrong due date) but I still felt personally responsible.  We could have waited a few days and given those steroids to help the baby’s lungs mature, but we didn’t, or we could have tried to let her mature in the uterus for a few more weeks, but we didn’t, and now she was having difficulty breathing in the NICU.

I went home defeated.  I didn’t go back up to the hospital the next day (I only work three days each week) but I didn’t want to ask Alyssa about how the baby was doing.  I felt ashamed.  That afternoon, a friend called and as we discussed the case she reminded me that I was neglecting to leave space for God’s sovereignty.  True, our decisions can be weighty and life-changing, but ultimately, God is the one in control, not me.  The next day I returned to the hospital.  My student found me, and gave me good news that in fact T had been hospitalized several weeks earlier and had been given those important steroids.  I visited the NICU and her baby was off oxygen and breathing better.  T was recovering well from her C-section.  

As I type this, T’s baby is now 2 weeks old.  No baby of hers has ever survived this long.  She is still tiny and still vulnerable, but doing well.  From time to time, especially on my difficult days since then, I poke my head in the door of the NICU and my eyes meet T’s, as she holds her daughter.  We smile.  I wave, and then close the door.  God’s sovereignty.  His faithfulness.  It is hard not to be overwhelmed by thinking of all the babies this week that don’t have mothers, or the mothers who don’t have babies.  There are many.  But from time to time, redemption happens, and I pray that I can always bring these redemption stories to mind.