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Sunday, January 25, 2009

The Letter That Needed To Be Written

Today when I awoke my mind was already in the middle of composing a letter. I lay there in the dark listening as the words weaved their way through my mind and to my fingers. I went straight to a journal and began to write in long hand, the words flowing and pouring forth onto the pages. My letter was in regards to a very personal experience, the birth of my children. I am finally sending a letter I feel could have been sent much sooner. I won't say "should have" because for whatever reason it must not have been time quite yet for me to write this letter. Perhaps this is the right time because I am feeling so much more open to messages from the greater universe and I find synchronicity glittering along this path I am traveling. I wanted to share my letter as I wrote it not just for myself but for all women. I write it for all women who have or will birth a child. Symbolically this letter can also be for anyone who births a painting, a book, a song, a dance...

I share to empower you to speak up when someone has not shown you or your birthing respect and consideration.


Dear Dr. Skipitis,

This letter has been residing in me for a long time. There was a point in time I thought of not writing one at all. Yet just this morning I awoke with the words flying through my head. I hadn’t even been thinking about this for quite a long time. Yet I suddenly felt compelled to write this letter, not just for myself, but for all women who will seek your care or will inadvertently find you are the physician on duty when they arrive to deliver their baby at Mercy Medical Center.

My intent in writing this letter is to share with you an experience I had almost three years ago. You played a role in the experience. I am hopeful that you will really hear me and give thought to the role you play and the impact you can have on the lives of the women you serve. You see I believe that doctors in your position serve in a beautiful way. You are there to help bring new life into this world. You are a witness to a human being’s arrival.

A little less than three years ago I arrived at the Mercy Medical Center with my husband to deliver, not just one baby, but two. I was expecting identical twin daughters. I was 36 weeks along when my water broke. The girls had been growing and developing beautifully according to the many ultrasounds. The estimates of their weights and sizes were right on track.

Early on in my pregnancy there had been a concern that the girls were monoamniotic. This was troubling when we read about the complications that could arise. Fortunately this was ruled out by an advanced ultrasound. We traveled to Sacramento several more times, as our doctor felt it was necessary, due to concerns about twin-to-twin transfusion. Again, fortunately we had no such problem.

Except for my own discomfort throughout the pregnancy, nausea that lasted for months and months, a persistent cough and the swelling, the girls appeared healthy and perfect in their safe first home. As we grew closer to the estimated delivery date the weekly monitoring of the girls heart rates began. I would lay uncomfortably propped up with pillows on a table, wires and monitors strapped to my belly. I couldn’t lay flat and being on my back, even though propped up, was quite uncomfortable. A few times during the monitoring I even experienced painful contractions. Yet this is what was required of me in order to ensure my daughters were healthy and thriving.

You were not my doctor so I had not shared any of this journey with you. It really is a journey. One that changes the contours and map of your body. It is also a journey that affects your mind, spirit and emotions profoundly. Your body is no longer your own. You are sharing it with another human being, in my case, two new human beings. My body was giving them life, feeding them and sustaining them.

While you were not my doctor and did not know me, you were the doctor on duty that night I arrived at the hospital. I learned later that my own doctor, Dr. Mooney, was attempting to celebrate an anniversary that same evening. He would eventually be disturbed with a phone call about me, his patient. He tried to assist from a distance the best he could that night.

When I arrived at the hospital that evening with my husband, bags in tow, I was beginning to feel the first tugs of the contractions. I had been feeling so completely calm ever since my water broke at home on the bathroom floor. I felt prepared. My bags were packed. I had drafted an email to family and friends already. All I had to do was hit send and load up the car.

The nursing staff was incredibly welcoming upon our arrival. I was quickly admitted and we were shown to our room. I changed into a hospital gown, leaving all sense of modesty at the door. The staff efficiently helped me into bed and began placing heart monitors on my belly and wheeled in a portable ultrasound machine.

The ultrasound showed that Baby A – our Maya – was head down and in position for delivery. Baby B – our Aubrey – had been head down for months, but just a few weeks back turned into a transverse position. This being a fairly recent change in positioning my doctor had not talked about what this might mean in regards to delivering.

It is about this point in the story, babies’ heart beats being monitored, me trying to find a more comfortable position, and the contractions beginning to intensify, that I received a phone call from you there in the room. You introduced yourself as the physician on duty and explained you would be delivering my children. The conversation we shared was rather brief so the next part of your message came out rather quickly. You said that you would be performing a c-section. I responded that we had wanted to deliver vaginally. You stated that a c-section was necessary. I asked why we couldn’t still consider a regular delivery. Instead of explaining or speaking to me as if I was an intelligent person you responded that this was the only way you’d deliver the babies. I said I needed to speak with my husband. You added at the end that if we didn’t agree then you’d have to have me removed from the hospital and flown by helicopter to a distant hospital.

I was holding the phone, lying in a bed in a hospital, in a hospital gown, contractions pulling at me more strongly, baby heart monitor beeping and I was calmly registering your statement that if I didn’t agree to a c-section with you that you would have me removed from the hospital.

There was some final statement from you about calling me back in a few minutes to find out our decision. The phone was hung up and I relayed your message to my husband. My husband felt a twinge of fear as he wondered if you really had the power to make such a decision. The idea of his wife being removed from the hospital while in labor with his children was rather terrifying. The staff in the room was listening and hearing what you had said too.

At that point in time the saving grace in this situation was the supportive and caring, truly caring, responses from the medical staff in my room and my husband. I could feel the women in that room circling around me protectively, offering me their strength and support. I was comforted with statements like “You aren’t going anywhere,” “This is your delivery,” and “You have choices.” Their statements were true and I knew it.

The mere idea that a doctor would threaten a patient in labor with twins that she could be removed from the hospital seemed ridiculous. It felt like a scare tactic to get me to do what you wanted, with no discussion or questioning of your opinion. It made me think of the old cliché “My way or the highway.” If I didn’t acquiesce immediately to your orders I needed to hit the road.

I am an intelligent and reasonable person. I needed you to explain to me and I needed you to converse with me. I didn’t need to be ordered around or spoken at.

In light of what you had told me the staff made phone calls to other doctors. We awaited another doctor’s call or arrival. In the meantime the babies were still being monitored and my contractions were growing more intense and painful.

When you called back I was focused on what was happening with my body and the babies so my husband took your call. You asked what we had decided. My husband responded that we were waiting to hear from another doctor. You sounded angry on the other end of the phone and asked who was this other doctor that was being called. My husband replied that he didn’t need to tell you that. You again sounded quite angry over the phone and stated that you wouldn’t be our doctor and would not be delivering our babies. My husband told you that he thought that had already been decided.

Not too long after that phone call from you Dr. Pena arrived to speak with us. He was kind, gentle and reasonable. He performed another ultrasound himself to check the babies’positions. I asked him why we couldn’t try for a regular delivery since Maya was head down. I suggested maybe Aubrey would then have room to turn around. Dr. Pena explained he had not heard of that happening in all his years of delivering. He calmly explained the risks. He said that if Maya was the smaller baby and she came out first we ran a risk of trying to deliver Aubrey breech and the vaginal opening not being big enough for her head to come through last. The danger was lack of oxygen and rushing to perform an emergency c-section to save her. He explained all this and shared that he was not comfortable with such a delivery, but there was no ultimatum or orders. He simply said he would give us time to ourselves to talk about it and make our decision.

Upon his departure we had our discussion. While I had hoped for an old fashioned delivery I knew that I had not carried these two beautiful and healthy girls all these months to risk something happening to one of them. We did not want to risk their safety and so we had a nurse let Dr. Pena know we would go forward with the c-section.

The exchange we shared with Dr. Pena is how I felt it should have been from the very beginning. Speak to me reasonably. Don’t just toss out orders. Especially when it comes to something so amazingly intense and personal as the birthing of ones’ children.

The story of course continues without you. Dr. Pena delivered our girls and they were healthy and beautiful. There was a complication with my recovery as I hemorrhaged and a code blue was called. There was a bit of excitement as the hospital staff worked on me to stop the bleeding and save my life. In the end I was okay and I began my recovery. In a few days we went home with our daughters and began the journey of being parents and caretakers.

Family and friends asked us about the delivery. Some of our contacts were with people in the local medical community. When they heard the story of what had been told to us about being removed from the hospital they asked who it was that said such a thing. We told them.

I am insightful and I am willing to consider that anyone can have a bad day or an off night. At one point I wondered if you were having a bad day. I was willing to make an excuse for your treatment of us. I was willing to consider that maybe this was very out of the ordinary for you. Yet, there were several people who heard the story and who either knew you or knew of you, and they gave a knowing smile and a nod of the head. This story did not appear to surprise them.

I trust that you are a good doctor. Perhaps you are even exceptional. I am sure that you have had patients who have liked you and found you to care for them in all the right ways. I have seen you on television in support of public television. In fact that was the first time I ever “saw” you. Seeing that made me think that you must be a thoughtful and caring man. I noticed at the local Kids Kingdom playground your name on a plaque as a donor. It made me think that you must also be a generous person who gives to the community and cares for children and families. I don’t think you are a horrible person from my one experience with you.

What I do still wonder though is how many patients have you treated and spoken to the way you did me that night. How many women have been scared by the threat of being removed from the hospital by you? Perhaps I am the only one. It seems doubtful, but maybe that is the case. Yet if that is the case, what made my particular situation the one where you would say such a thing?

I don’t expect or even want a response from you. You may choose to crumple up this letter and throw it away. Yet I write with the hope that you will stop, listen and really be able to see through a woman’s eyes what it was like to interact with you on a momentous occasion in her life, a night like no other. I write with the hope that you will never speak to another patient the way you spoke to me that night. The women you serve as a doctor deserve more respect and consideration than I was shown that night. I hope that will always be the case for the women you serve in the future.

Sincerely,
Michelle

P.S. I am sharing this letter with my previous physician Dr. Richard Mooney, my delivering physician Dr. Pena and with President/CEO Rick Barnett with Mercy Hospital. I believe it is also important for them to hear this story in hopes that they too will be reminded of the very important role you all play in caring for a patient and providing him or her with respect and understanding, in addition to the best medical care you know how to provide.

Cc: Dr. Richard Mooney
Dr. Jorge Pena
President/CEO Rick Barnett

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