Dear Surgeon:

I've been asked to give a talk to the OB surgery department of the hospital who "took care" of me during my second trimester loss, an expected part of my being on the OB Council that is working to improve the patient experience.  Since I've been doing much of my writing work on this today, I decided to share it with you.

Kindly say a prayer that the hearts of medical professionals learn to respect the loss of even the smallest of people.  Thank you.

(Fyi, this does not qualify as an upbeat post.  If you're looking more for that, see you tomorrow! ;) 

Dear Women & Infants Hospital,

On the worst day of my life, March 22, 2013, you and I were together.  I was devastated and terrified.  And you were in a rush.

Less than 24 hours before, I'd found out that my little girl no longer had a heartbeat.  My OB told me the world as I knew it had ended, and my baby needed to be removed A.S.A.P. 

Concerned for my health, my OB was in a hurry too.

As a woman who's had babies before, and one who'd never considered a D&C, I was terrified to think I was having surgery so soon.  As a mother who loved her baby, who 24 hours ago was buying more maternity clothes, I was not at all prepared for this separation.

No one at the hospital took the time to prepare me.  No one gave me time or space to say goodbye.

There's an odd blur that's takes over when you're rushing towards disaster. Turns out time flies when you're terrified too.  You know that moment when a loss mom signs papers agreeing to the procedure?  She's in shock.  I was in shock.  I would have signed over my house and my will at that awful moment too, if someone had asked.  How can anyone make any clear decision in a rushed atmosphere when all your mind is saying is, "My baby, my baby, my baby..."

I went home from the awful ultrasound in a daze.  I am so grateful I had the presence of mind to take some pictures of my pregnant belly.  I wish I had done more.  I had no idea how to prepare for this, and I did not know where to turn.

March 22 started normally. I held an empty hope it would continue that way. But then my parents came to watch my kids, and we had to go to the early morning appointment at your hospital.  

I walked into the beautiful hell that is your welcome lobby.  Newborns in car seats.  The nursing store to my left.  Admissions giving me a sticker with an "S" on it.  I didn't know what it stood for; all I could think of was "Sadness."  I puzzled vaguely over it as I walked in a daze to the elevators for floor 2 behind a family carrying pink balloons, bobbing a hopeless mockery to me, whose little girl would never get her pink balloons.

I'd just assumed, when I got to the floor, and least then I'd be "taken care of," that medical staff would hold my hand, speak to me gently, and lead me through the worst day of my life. 

But I was so very wrong.

Instead, when I first got to the floor and sat down to register, I was informed that my husband could not stay with me (!) since they had been having problems with men fainting during their wife's IV insertion.  I was told in an upbeat voice that my "S" was supposed to be for surgery, but it really meant "superwoman!"  (?)  I never felt less super.

No acknowledgement whatsoever was made of my loss during check-in or registration, the definition of adding insult to injury.  Instead, the one consolation of having my husband nearby was being taken away.  

I wanted so badly to leave.  But my baby was dead.  Where else could I go?  

Catherine J, my nurse, was the only light in this dark experience.  She got my husband into the room with me.  She rubbed my shoulder.  She got me more and more tissues.  She found an ultrasound machine and dragged it in, insisting to the hurried doctor with me that we check "just one more time, to be sure."  But no miracles had happened, and my little one was still.  

Typically I'm not a person who cries in public, at all.  Particularly in a circular office of curtains, filled with patients there for routine procedures who looked at me, puzzled.  But I don't think I stopped crying once while conscious at your hospital.  For the first time in my adult life, I couldn't stop the tears.

When the surgeon bounced in to ask, "How are we doing today?" I wondered what his problem was, really.  But I just said,"Oh, we are so sad!"  He faced the computer screen, briefly glancing over with a mildly sympathetic expression: "I understand."

To this day, I remain unconvinced.

I wanted this baby.  I loved this baby, ever since I saw two lines on a stick.  I loved her through months of awful morning sickness; and looking forward to having her to hold got me through the nausea.  I took vitamins and avoided alcohol and bean sprouts and always drank less than a half cup of coffee. She was worth it all to me.  

When a woman does that, even when her mind knows she's lost something dear, her body and spirit take a lot longer to let go. 

That's why I asked the surgeon to be gentle with my baby.  And he looked at me like I was off my rocker.  And heck, I probably was.  But his attitude wasn't kind, or necessary, or helpful. At all.

Primarily, I wanted to make darn sure that this wasn't a mistake (particularly since this missed miscarriage was symptom-free), but I also really, really wanted to see my baby just one more time.  While he grunted a consent to the last ultrasound, the surgeon exuded impatience and rush.  

My last glance at my child lasted three seconds, as I achingly peered at the tiny screen to see her perfect features once more.  Abruptly, he pulled the wand away.  I sobbed and asked for a final picture.  I was flatly told, "No.  It's not possible."  I asked if I could please see my baby afterwards.  The doctor looked repulsed at the request, repeated what he'd said before, and disappeared behind the curtain.

I could not stop crying.  

One of the worst parts of the day was being given the four pills to hold in my cheeks that would dilate my cervix.  Of the little research I was able to do on the procedure, I'd totally missed that part... I was expecting a "knock me out and get it over with" and not having to "do" anything. Let alone the very thing that would start the process of separating me and the baby I'd fought for months to keep.  

To go from not having a spot of blood to being told I needed to take something that would make me start bleeding, probably heavily... to having a nurse walk me to the bathroom and telling me, "You may see clots or... Let me know if you see... anything. I'd need to check... it."   
That felt like a line from a horror movie.

The only reason I was able to take those pills was because Catherine took time with me, rubbed my shoulder, looked me in the eye, and told me, over and over (because I needed to hear it, over and over,) that I was doing nothing to hurt my baby.  That I just needed to put her "to rest."  

That helped, a lot.

The other nurses' "chit chat" was not beneficial.  Distraction was not going to solve this problem; it felt oddly like people were ignoring the fact they were at a funeral.  I heard what their college age daughters were doing.  Talked a tiny bit of politics.  It just added to the unreality of what I was experiencing.

The chaplain was summoned.  And Nancy was great.  But somehow, in the busy, noisy atmosphere of zero privacy--on a floor where the rest of the hospital world raced raucously outside my thin curtain to get to the next coffee break--I never was able to relax or find any peace.   Even when I was given a sedative.  

I would not take my hands off my belly, so they were pried off.  The last thing I remember was a masked face appearing through my wild tears and demanding: "You have to cooperate. Deep breaths!" And my nose and mouth were cupped.

This was hardly the way I would have chosen to say goodbye.

No sooner did I sense light from under my heavy eyelids then I realized I was sobbing again. The first thing I overheard someone say, one of the female nurses, was "Oh no, here we go again..."  I remember feeling the horrible emptiness, seeing my deflated belly, and the blood stains on my hospital gown. 

My baby was gone. 

I asked if I could just hold the baby wrapped in a blanket.  Please, please, please...  

I still remember the grossed-out looked on the doctor's faces, as though I'd requested to hold a removed tumor and not my own child.  I was told it was impossible.  

I strongly feel that your hospital should have understood and sought to accommodate, better than anyone, what a grieving mother needed for her baby.

Someone handed me an empty, rolled-up blanket instead which I rocked and hugged and cuddled till chaplain Nancy returned.  At the time, I felt she was the only kind, empathetic soul in a room full of automatons.  I was given a quilted memory bag and a dish to vomit in before I left.

More than anything else in this experience, I wished my loss was acknowledged.  I was in mourning and losing my baby and Women & Infants handled the process just like a colonoscopy. (Actually, I've experienced more empathy from doctors during my colonoscopies.)  

For me, it would have helped my heart to be able to hold her.  I will grieve to my own grave that she was in the keeping of strangers for days when I was the one who loved her, when I was the one who'd carried her, when I was the one who needed--so badly--to have that moment for goodbye.

I wished I had known what choices I had for the procedure, and who to appeal to for more options.  I felt forced and rushed, overwhelmed with sorrow and confused with shock.  

Surgery-wise, you took excellent care of me.  I barely needed any pain meds at all.  But emotionally... part of me wishes I didn't have to see even the outside of this institution again. And unfortunately, I have met several other women who echo this sentiment.   

Your hospital's name implies that "Women and Infants" are your specialty.  But in my pregnancy loss experience at your hospital, the "woman" aspect was only taken care of physically, and generally the "infant" part wasn't even acknowledged as having been there at all.  

I did not feel my grief was respected.  Instead, I felt I was inconveniencing everyone with it, that there was an expectation that I "should" treat this like a biopsy.  Cuz that's how everyone around me was handling it.  

So while I do want to thank you for the many good things you do, and while I realize that doctors and nurses are some of the most overworked people on this planet: I would ask that you kindly remember the bodies you take care of also have hearts.  

Please take the few extra seconds to say "I'm sorry" with sincerity, to honor a life lost, and a life changed.  Those minuscule efforts to put yourself in a grieving mom's shoes, the extra moments to address the powerful feelings behind losing a child, can make all the difference in the world when women look back on the worst day of their lives.  

I will always remember nurse Catherine J. with great gratitude and fondness for taking time to address that I was going through a nadir of the human experience: losing a child.  She was an angel about it as was Nancy the chaplain, whereas every other doctor, nurse, and staff person I encountered that day else was busy, impatient, and/or ignoring my loss.

I've recounted this painful experience in the hopes that other moms like me will have a smoother grieving process from the start, that their miscarriage losses will be respected, and that these mothers will be given the time, education, and accommodations they need to say goodbye. 

Most sincerely,
Katie D.

"Are not two sparrows sold for a penny?  Yet not a single sparrow 

falls to the ground without your Father knowing it."  Matthew 10:29