![4. An Adverse Event](ch4.jpg)
July 11, 1956
Everything seemed fine until Maddie had been in labor for several hours. She had been given Twilight Sleep, a medication that put her into a groggy state in which she could tolerate the strong contractions of labor. It also provided amnesia for the experience, which nearly everyone agreed was a good thing. The drawback to Twilight Sleep was that the laboring woman needed very close observation, because in this groggy state, she could easily fall out of the labor bed and injure herself. She also wouldn't be alert enough to call for help.
Matthew Wheeler was in the Father's Waiting Room, as usual for the expectant father. He paced back and forth with four other fathers during a day that was actually a slow, quiet day in the labor ward. Matthew felt anything but slow and quiet -- he was ready to pull his hair out by the roots. What in the world could be taking so long? That damned doctor had better come out and give me an update soon!
When Maddie's doctor did come to the waiting room, his face was grave. "Mr. Wheeler? Would you come with me, please?" He escorted Matt not into the labor room with his wife, but into a tiny consultation room with two chairs. Matt felt his stomach begin to churn. The doctor did not act as if he was about to deliver good news.
"Mr. Wheeler, your wife has experienced a complication called abruptio placenta. That means the placenta has begun to separate from the wall of the womb. Hemorrhage occurs between the womb and the separating placenta. This is a critical situation and Mrs. Wheeler must have an emergency Caesarean section in order to save her and the baby. I can't guarantee the outcome, but it must be done immediately or they will both die."
Matt was speechless for a second. How could this happen? Everything had been going so well. Finding his voice, he cried, "Do it! Please save my wife!"
He quickly scrawled his signature on the consent form Dr. Harris held out to him.
The doctor turned and went back through the double doors into the labor hall. Matt paced again, feeling helpless, frustrated, and terrified.
After what seemed like hours, but was in reality only about thirty minutes, a nurse came to the father's waiting room and touched Matt's arm.
"Mr. Wheeler, would you like to see your daughter?" she asked.
"Oh, God, yes! What about my wife? When can I see her?"
"Your wife is still in surgery, Mr. Wheeler. The doctor will come and talk to you when he is finished. With a C-section, they get the baby out right away, but it takes a while to close the incision; then the mother is in recovery for an hour or two before she goes to a room."
Only slightly reassured, Matt followed the white-clad nurse down a hallway, through another set of double doors, until they reached the nursery window. Rows of clear bassinets on rolling metal carts filled most of the space. Matt saw the nurse who had brought him back speaking to another nurse garbed in a green scrub dress and wearing a cap and mask. The masked nurse nodded and picked up a baby in the very back row, swaddled in a pink blanket. She looked up at Matt through the window, and walked up to the window, holding the tiny infant so that he could see her face.
Matt let out his breath in a loud sigh – he hadn't even realized he was holding it. The baby had her eyes open, and even seemed to be looking at him. Although he had always thought all babies looked alike, he was surprised to find that this one looked special. Her head was round and nicely shaped, and she didn't have the wrinkly, red newborn look he had heard about. Her eyes were a slate blue right now. He wondered if they would change color later.
The white-uniformed nurse was next to him again. "Isn't she beautiful?" she asked.
"Oh, yes! Will her eyes stay that color? When will I be able to hold her?" Matt had never felt so overwhelmed.
"All babies' eyes are a bluish color when they are first born. In a few months they will probably begin to show the permanent color. As far as holding her – probably not until your wife is back in her room and awake. They will bring your daughter to her room tomorrow."
"I don't know if I can wait that long! Will they feed her in the nursery, then? My wife was planning to breastfeed, you know."
"Mr. Wheeler, your wife will be too groggy from anesthesia to breastfeed tonight. We'll supplement the baby with formula until Mrs. Wheeler can feed her. Now, I'll show you back to the fathers' waiting room. Dr. Harris will come to find you when he is finished."
Matt watched as the green-clad nurse carried his daughter over to a rocking chair and began to coax her to take water from a bottle. He stood there for several moments, before deciding he had better return to the father's waiting room in case Maddie's doctor was finished and needed to see him.
***********************
Hours passed, and Matt was beyond frantic. The doctor had not come; the staff had not updated him, and none of the labor and delivery nurses seemed to know anything about Maddie. Never had he felt so helpless. Perhaps she was dead. Perhaps they had finished the case and taken her to her room without telling him. Perhaps he was in the wrong waiting room. … Suddenly, Matt made up his mind to take some action. He strode out of the waiting room to the elevator. He would persuade the switchboard operator to page Dr. Harris. If he couldn't be reached, it was time to call in a few favors.
Standing at the elevator, Matt checked his watch. One o'clock in the morning! What time had they gotten here today … yesterday? Nine, ten o'clock in the morning? Just as he impatiently reached to press the elevator button again, the elevator doors opened and Dr. Harris stepped out. Like the nursery nurse, he was dressed in hospital-green scrubs. Unlike the nurse, his scrubs were smeared with blood.
"Mr. Wheeler, your wife is in recovery now. Come with me and I will tell you what is happening," said the doctor. Matt noticed that the distinguished obstetrician looked as tired as he himself felt. He followed Dr. Harris to a room which turned out to be the same tiny consultation room they had used earlier. The doctor motioned for him to sit, and when both men were seated, he began to speak.
"As I told you, Mrs. Wheeler was experiencing a serious complication called abruptio placenta. We took her to the operating room and delivered the baby; fortunately, the blood loss hadn't reached a critical point for the baby's health. Your daughter was a little sedated from medication your wife had received in labor, but she came around well after some stimulation and an injection to reverse the narcotic level in her bloodstream. However, Mrs. Wheeler was continuing to bleed heavily; she was bleeding into the myometrium -- the wall of the uterus or womb. The uterus couldn't contract; all of the blood vessels which supply the placenta were staying dilated because the muscle was boggy with accumulated blood. In order to save her life, I had to do a hysterectomy. Now, because Mrs. Wheeler had lost a significant amount of blood, she was going into shock. At this point, something happened which every doctor dreads. Her blood clotting mechanism began to go haywire. This is a condition known as DIC, or disseminated intravascular coagulation. Microscopic clots form, which can cut off circulation to affected areas and lead to death of tissue. At the same time, other parts of the clotting process fail, and bleeding continues. We have already given her blood, and she needs more blood to replace some of the clotting factors. I have to tell you, this disease has an extremely high death rate. We are doing everything possible to save your wife, but I cannot guarantee her survival."
Matt's head was reeling. All of the doctor's medical terms were completely foreign to him; he barely knew the words womb and placenta. But one thing was crystal-clear: Maddie was critically ill and might die.
"Doctor, when can I see my wife? I really need to see her."
"Mr. Wheeler, she is in an oxygen tent; she has a private nurse, and she is receiving blood. She is still very groggy from anesthesia and won't know you're there. But I will take you to see her for a moment, if you insist on seeing her tonight." It was plain to Matt that the doctor didn't think he should see her.
"I do." Matt's voice was firm, although he ran a hand through his hair in agitation.
"All right. We'll go to the ICU -- she will be there for at least several days even if everything goes well," warned the doctor.
Matt stood and forced his weary legs to follow Dr. Harris. They had to press a buzzer at the doors to the intensive care unit and be admitted by a nurse. The white-uniformed nurse in her starched cap looked as fresh as if it was the middle of the morning, rather than the middle of the night.
She led Matt over to a cubicle where Maddie lay in a narrow hospital bed under an oxygen tent. Her eyes were closed; her pale face looked pinched; Matt noticed several purplish bruised-looking areas on her arms and face. Periodically a greenish liquid dripped into a glass container on the floor from the tube coming out of her nose. The glass bottle suspended over her bed dripped blood through a tube into her vein. A fluorescent light strip above her bed cast a dim glow on the scene.
Matt was exhausted and he could not suppress an anguished sob as he looked upon this sight. His lovely, healthy young wife had been giggling over the baby's kicking just the night before last.
"What are those blotches? And how long will it take before you will know … before you'll know if she's going to be all right?"
"The blotches are signs of small hemorrhages under the skin. And the next 48 to 72 hours are critical. If she can make it through that time, she should recover, as long as infection doesn't set in. Mr. Wheeler, I assure you that we're doing everything we can for your wife. You can't help her now. Why don't you go home and get some rest?" Dr. Harris' voice was compassionate, and his hand on Matt's shoulder was firm. "You can't help her now, and you will need your strength later."
Hesitantly, Matt reached out to touch Maddie's hand as he silently said a prayer for her recovery. Then he turned reluctantly from her bed and allowed Dr. Harris to escort him to the main lobby.
"Doctor, how could something like this happen?" he asked. "How? Everything was going so well - that's what you told us."
"Mr. Wheeler, we can discuss this tomorrow. You are in no shape to talk about it now. Just let me say, it is one of the things in medicine which is unpredictable, and which respects neither wealth nor social class. It is why childbirth remains the great equalizer of women in the modern age. Again, I assure you that we will do everything modern medicine can do to help your wife to recover. I will be here at the hospital all night. If you wish to come back around nine o'clock in the morning, I will sit down with you and explain everything I possibly can. Now, the best way you can help your wife - and your new daughter - is to go home and get some rest."
![3. Anticipation back](back.jpg)
![5. Daddy's Girl next](next.jpg)