At the Still Point of the Turning World
Residency is over, NOW what? (While I'm waiting for the answer, I'll get some spinning done....)

Monday, September 09, 2002


Another patient of mine arrived in labor today. The baby was in breech position, so she underwent a C-section while I was seeing patients in the clinic. I wanted to do the C-section but could not abandon my clinic. The little girl was born with meningomyelocele, a form of spina bifida, and hydrocephalus, a condition in which the cerebrospinal fluid does not circulate properly and accumulates in the fluid chambers of the brain. For this reason, the baby has an enormous head, too big to enter the pelvis, which is probably why she settled into breech position. She has been transferred to UCSF, my alma mater, for corrective surgery and shunting of the trapped fluid. She already shows signs of paralysis in both legs. Her mother is being very brave, with an excellent attitude: "We'll make it," she said assuredly, when I went to comfort her.

Everything was perfectly normal during prenatal care, I swear.

My grief reaction simmered for hours, then boiled over for half an hour this evening. I will never get to take care of that little girl now; she belongs to a phalanx of surgeons and specialists, occupational and physical therapists, and so many other good people for whom I am so grateful. I feel completely helpless. How can this happen? For 20 weeks I measured mom's tummy and listened to that heartbeat, waiting for this day....