Pyrrhic Victory

Last night I attended my last birth for a long time, unless one of my special people asks me over to attend her birth - and you know who you are my loves!

I was working in my capacity as a doula - to my utmost capacity - I calmly stood by while the staff dickered around about whether the meconium was thick or light. I kept a grin off my face when the young medical student estimated that the birthing woman, who was clearly very close to pushing, was "progressing nicely" at six centimeters, and I kept calm when five minutes later she started pushing in earnest. I kept the worried look off my face when it appeared that there might be an abruption, and I supported the nurse while she tried to do her job.

I supported the woman, I supported her husband and her mother. I kept my face devoid of grumpy callouts when staff acted unprofessionally. I pandered to the two young doctors, and praised the Big Doctor Man when my client asked me, in front of him, if he was "good". In short, I brown-nosed the way doulas learn to do in our maternity care system.

The doula's job is to support the birthing family, to bring love into the birthing room, to create a safe space.

So imagine my conundrum when the nurse asked my client if she agreed to erythromycin ointment for the baby's eyes. My client didn't know what to say, so she turned to me for support.
I had to think quickly. I could site the most recent statement by the Canadian Pediatric Society, (http://www.cps.ca/en/documents/position/ophthalmia-neonatorum), which suggests eliminating the practice of universal antibiotic prophylaxis for neonatal eye infections (most dangerously caused by gonorrhea or chlamydia), or I could avoid looking like a know-it-all and making the doctor feel like a fool, and simply use a tactic that I had seen him use a few years ago (something about his wife, can't remember the details).

What to do? Think fast! It's three am and your client wants an answer. She then asked me "Did you give it to your kids?".  An honest answer - yes, I did.

Pipes up the honourable physician, to the effect that my client shouldn't be so stupid as to agree to an intervention just because "someone" had it done to her kids, but rather should have it done because "doctors advise it". Um. We were all rendered rather voiceless. Then, again, Dr. A. pipes up: "Will you vaccinate your child?" My client answers that, yes, of course she will.

Intimation being that I wouldn't vaccinate my kids, and would advise my clients not to. So rude! So judgemental! So many unfounded assumptions! So disrespectful of the birth room!

It makes me sad that people that are supposed to be practicing good medicine, and good science, are practicing mediocre medicine, not reading the literature, and showing off their skills at making an older woman feel like shit at three in the morning. Bravo! Physician, heal thyself!

 

Witch Doctors?

I had to go to the hospital yesterday with my son for a small but annoying problem. While I was sitting waiting I thought about the hocus-pocus of medicine and about why we need ritual and ceremony during a healing experience.

We went to the Emergency Ward and my son was poked and prodded for an hour or so until the nurse said we had to go to the clinic in the next town. We drove down and, after doing some paperwork, we sat in a small, hot waiting room for three hours until we were admitted to see the doctor. The waiting room was uncomfortable, the chairs were hard, the other patients were anxious. Once we got into the room, the doctor was wearing a green outfit, and a young woman assisting him was wearing white. Strange-looking instruments were produced. When the young woman hit my son on the head with the metal basin, nobody laughed. Only when the doctor's cell phone started singing a White Stripes song from his pocket did my son finally crack. The doctor asked "Why do you laugh"?

The last time I went was for a series of tests a few months ago (all good!). That time, the mystique was much more serious. I had an ultrasound first. I went to the clinic, paid my money, and sat for a while in the obligatory waiting room. My name was called and I was led into a small cubicle where I had to remove all my clothes and put on a little paper gown. I was allowed to bring my purse into the examination room, where a technician smeared me with a cold blue substance and then pushed a magic wand onto my abdomen. This went on for about twenty minutes until she handed me a small tissue, told me I could leave, and left the room. I ineffectually wiped some of the blue gel off and then stickily tried to find my room. My bladder was bursting as I had not been allowed to pee since the morning. I found my room, my clothes, and the bathroom and left the clinic.

A week later I was in a similar room but this was a co-ed changing room in a public hospital. The gowns were cloth but didn't fit around the back. I was tilted on a hard table and a heavy object was placed over my pelvis. Everyone left the room. A few minutes later they came back in and said I could leave.

A few weeks later I went to my doctor and she said everything was okay. Yea! The blue goo, the isolation room, the magic wand, and the heavy object cured me!

Not so far from reality, really. Maybe all I needed was some ritual, some magic, someone knowing more than I about the mystery of my own body. Perhaps I just needed someone to say "Everything is fine - your body works". Maybe I needed to feel vulnerable in a paper gown so that I could fully comprehend how scared I was of something being really wrong.

We can't know in the end what heals and what doesn't - and why some cures work for some people and not for others. Or who will not be cured in the end, and who will walk away. For this reason, it is important to have an open mind, to accept the rituals, no matter how annoying they may seem. And to remember to do no harm.