Tuesday 12 April 2011

Love's Labor's Lost - it could have been me

I am not a huge fan of "modern" TV drama. I am getting grumpy in my old age, and feel that all the good television has already been made. I recently subscribed to Sky, and now have a facility to record programmes, so am recording all the ER episodes right from the beginning. Yesterday I watched Love's Labors Lost, from series one.

I remember watching this originally back in the day, I must have been about 23 or so. So a long time ago. Since that time George Clooney has been in more blockbuster films than I've had hot dinners. ER has ceased to exist. Many of the actors that were household names, are now directors and stage actors.

My initial feelings about this episode back then were that it was good drama but entirely inaccuarate. Surely women don't die in childbirth in the latter half of the 20th century? Eclamptic shock sounded like something out of an ancient medical journal. Never, in a million years, did I consider for a moment, this could be me....

To give a brief synopsis, a healthy woman in her 38th week of pregnancy presents in the ER with frequent urination, and just feeling off colour. Dr Green diagnoses a urinary tract infection and sends her on her way, in the care of her husband. No other members of the team offered the differential diagnosis. The woman in question and her husband weren't educated enough to say "hey what about pre eclampsia"? She then collapses in the parking lot and is brought back in.

What happens next is a protracted and complex affair. She has a full blown eclamptic seizure, which is stopped with magnesium sulphate. She recovers from this quite quickly and is able to talk to Dr Green and her husband and some decisions are made. Dr Green measures the fundal height and determines the baby weighs about 5-6 pounds. He makes the decision to induce labour, rather than taking her to Obstetrics for a caesarean. During the section the woman has another seizure, and the baby gets stuck, a condition called shoulder dystocia. Dr Green can't get the baby out, decides to push it back, and then go to crash section.

It transpires that when Dr Green did the ultrasound, and determined that the baby was a girl, he failed to spot the fact that the placenta had abrupted. So once the baby is out (and not breathing but is resuscitated, happily) the woman starts bleeding profusely, and sadly, dies.

The picture I have selected above is Dr Green speaking to the husband, telling him what has happened to his wife, whilst he holds his baby in the NICU.

Obviously, being ER, this story is dramatic, and I think still, a little far fetched, and I truly hope ER doctors don't handle these cases willy nilly without handing them over to the proper personnel.

However, I can see how this happens. My pre eclampsia was nearly missed. When I went to the delivery suite, most of the midwives thought I was possibly neurotic, but, crucially, checked everything out in fine details, and my severe, early onset pre eclampsia was detected and treated.

But, watching this yesterday, my thought was, this could have been me, and the only reason, if we're honest, is that I had tip top medical care. I had a team of doctors and midwives who were skilled, and who utilised all their resources (there were several phone calls with experts around the country as to how best to manage my care) and both myself and my baby were safe and sound, and are here to tell the tale.

But, as dramatic, and inaccurate in places, this episode is, it serves as a reminder that without good, cohesive medical care, sometimes, childbirth can be risky. I am passionate about good antenatal care,about educating prospective parents about possible complications and about good emergency care, and this really reminded me yesterday what I am fighting for when I work as an activist.

Healthy babies, healthy mamas.

6 comments:

  1. There but for the grace of God eh? These experiences do change us and you're doing such an excellent job. Are you on telephone support? I'm not sure I could do that - I'd be crying before the parents :/xX

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  2. This comment has been removed by the author.

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  3. I would like to know why my comments were deleted, please. Essentially, I was asking why you based your factual 'thesis' on a fictional basis. I hope you'll feel less insecure about answering my questions this time round. I am not being threatening, I am raising valid points because I am interested.

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  4. I didn't feel it was achieving anything. This is a blog, not a thesis.

    It was my response to something I watched on television.

    Most peope who read this blog are not anonymous, and are people I know. I don't wish to make this blog private, but I felt very uncomfortable with your comments.

    I will keep these on the blog for 2 days then delete again as I do not feel they are constructive, but cannot contact you in any other way.

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  5. I have no intention of posting anonymously, however, I do not blog so there is not much of my personal information avaliable. I will try to contact you via Facebook, my name is Tabitha Reiser.

    If you are open enough to make such medical and scientific claims on how pre-eclampsia should be handled, maybe you should be brave enough to present these facts in a balanced manner to an audience who are experienced in dealing with these areas of healthcare, not just to a closed circle of friends, and equally be open to receive comments and questions. It’s not personal, it’s how social science develops. Understand that by blogging on scientific and medical topics and also by seeking awards you open yourself to having the presentation of your opinion critiqued. You have no right to restrict this type critique if you open yourself to it.

    I am not unfamiliar to the world of premature babies and (in my case) post-partum eclampsia, so I am not being unsympathetic, but it is uninformative to use a fictional patient’s case behind reasoning of scientific statistics and data. Fact can only be based on fact, your fury for a fictional patient’s poor treatment has no place here.

    I am not sure why you will re-delete the comments, you seem very insecure in your own writings. The presentation of the blogs are not particularly constructive. Please do not feel you need to delete my comments in order to protect your readers, I’m sure they are intelligent enough to understand my queries. If this is not the case, then I don’t understand why an individual would feel to need to delete my comments. Perhaps you could explain further.

    Looking forward to hearing from you.

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  6. Think the OP above is totally missing the point of this post. I totally identify with this storyline as I would have been the woman collapsing in the carpark had I not as you say been "educated enough to say hey what about pre-eclampsia".

    Although it's fiction, it's a frightening illustration of how things might have turned out for me too. Had I been an unassertive person, less well educated or not speaking English as a first language things would have been very different.

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