Swing Baby Swing

When I started medical school in the 80s I signed up for a trauma elective that was pivotal in my present-day ability to remain calm in the face of medical catastrophes. I have often said that I have a reputation of being non-excitable in emergency situations and tend to be overwhelmingly unruffled when circumstances call for ruffling.

I may have exaggerated a little.

After medical school I became a surgical resident. I did this for two years and again, tended to be calm and unexcitable, often to a fault and frequently leading to accusations of being nonchalant.

I switched my residency to anesthesia believing that my ability to remain calm would serve me well. And it did. Until I rotated through obstetrics.

Pregnant people make me nervous. That included my wife who thankfully, after several kids, won’t make me nervous like that again.

Epidural anesthesia was the all the rage in Brooklyn. Almost every pregnant patient got an epidural catheter. I did so many of them that I became comfortable doing them without supervision. And so it was that I was called to place an epidural on a 15-year-old morbidly obese very pregnant and very nervous African American patient. This, I learned, was her first pregnancy, and she was only 4 cm dilated.

We have hours before she delivers, my attending assured me.

I met Aeisha in the procedure room. In those days we sometimes did epidurals in the procedure room rather than in the patient’s bed. In retrospect that was kind of stupid, but - live and learn.

I helped her onto the procedure table and positioned her onto her side. And despite her obesity she had remarkably good spinal landmarks for the catheter.

She was feeling overheated and asked if I would “open the damn window before I start vomicking.” And she wasn’t the only one roasting. Those old rooms in County Hospital suffered from poor air circulation and stifling uncontrollable radiator heat.

Wiping the sweat from my brow and not wanting to deal with any “vomick” I walked to the foot of the table and opened the nearest window to allow some cool air to circulate.

Turning my attention back to the task at hand, I got her in position onto her left side with her knees together and pulled up to her chest. I began to prep her skin when she suddenly said “Doc, I gotta poop.”

“Oh,” I said. “I can get the nurse and we can get you to the…”

“I said I gotta’ poop!”

I put my hand on her shoulder and reassured her “Okay hang on, I’m gonna’ go get your nurse.”

“I GOTTA POOP NOW!” she screamed and with that, she bore down.

And despite her lying on her side with her legs squeezed tightly together, her firstborn child shot out of her like it was fired out of a potato gun, the audible “pop” noise punctuating the still-stifling air…

…stifling despite the open window, which the infant was flying towards…

…until its momentum was arrested by the only thing that saved its life.

The umbilical cord.

If not for that placental tether, the not-yet-crying infant would have flown out of the window, followed shortly by my medical career.

Instead, the baby stopped short in mid-air, bungee corded into the procedure table, and started swinging comically from its mother’s vagina, its head intermittently banging against the steel doors.

I like to think that I would be cool and collected in situations such as this. I like to think that I would have picked up the baby, clamped and cut the umbilical cord, and eased the child towards its first independent breaths.

But my high-pitched, shrill screams for help did not allow for such actions. And I continued to scream even as the first of several nurses and doctors burst into the room and shoved past me to do the job I couldn’t do.

Both mother and baby were ushered away, leaving me pale and trembling with my thoughts and embarrassment. I would later learn that both baby and mother did just fine. But at that moment I felt as if I had killed them both.

Before this incident I was supremely confident in my skills as a physician, borderline cocky, already arrogant. I was ultimately spared a terrible outcome, but only through pure luck and perhaps providence. While my self-assuredness had nothing to do with the force with which this teenager gave birth, it wasn’t lost on me that her baby’s life and my future as doctor was preserved by the lifeline of all lifelines and by the tiniest of margins. The randomness and undiscriminating nature of it all forced me towards humility.

After several long and lonely minutes, I gathered my wits and my things and began the slow ignoble slink back to the call room where I would wait for the next patient who would require my services.