20 September 2006

Doctor Late, Baby Too

Some stories hurt and make you wonder...

"Linda" is well-loved by her family, friends and co-workers. Almost everyone who knows her knows she and her husband yearned to have children. But over the years, the expected event never mateialized.

Finally, at the age of 40, Linda became pregnant. A first-time mother at that age is obviously a special case and with gestational diabetes a factor, even more so. Her doctor owned a sonogram machine and every month, Linda and her husband would see their baby, growing, moving, breathing.

Linda cut back on work and travel, ate carefully-selected meals and prepared herself for the arrival of her long-awaited baby, thankfully full-term. On a sunny afternoon, Linda started feeling sharp pains, violent slashes through her abdomen. Alarmed, she called her husband and they went to the hospital.

Within minutes, Linda was under the care of nurses who undertook another sonogram, only to discover that the baby didn't seem to be breathing. The nurses called Linda's doctor at around 7:00 p.m. to tell him there seemed to be a problem with Linda's baby. The doctor told the nurses he would see Linda in the morning. The nurses told Linda and her husband the doctor would check on their baby the next day.

By the time the doctor arrived at 8:00 a.m. and started making his rounds, Linda's baby was dead. At 22 inches in length, it was determined that the baby was 3 weeks overdue. Three weeks, despite monthly sonograms to ascertain weight and growth. Linda was told her baby was dead during the night and waited until 3:00 p.m. for her doctor to see her.

At which point he told her that he preferred she push the baby out rather than do a Caesarian. Linda, too weak and heart-broken to make the effort of pushing a corpse, underwent a C-section that evening, her expected day of joy one of unbelievable grief.

As noted before, doctors are leaving the Island in droves and amongst the specialties most affected is obstetrics. Some OB-GYN specialists are tending to 40-50 births a week. What can be tolerable in the short-term quickly becomes deadly in the long-term.

Why didn't Linda's doctor go to her that evening, when the obvious problem was reported?

Why didn't the nurses, who loudly proclaimed "We called the doctor. We did our jobs." insist on finding another doctor to tend to an obviously-agonizing mother and child?

How did Linda's doctor miss the obvious signs of the baby's development, especially when monthly sonograms were available for close monitoring of its progress?

Are We facing an exodus of the excellent, the good and the opportunistic doctors only to be left with being treated by the remaining overwhelmed excellent doctors, the swamped good ones and the increasingly-dangerous mediocre and bad charlatans?

Questions We can--and must--ask, but no question can now bring back what has been Linda's desire of the heart for so very long. Her baby--her ill-treated baby--is gone. And nobody will be able--or be willing--to do anything useful about it.

In the words of Linda Ellerbee: And so it goes.


The Jenius Has Spoken.

6 comments:

Nelson said...

I hate hospitals here in Puerto Rico with a passion.

I remember back in 1994 (or there about) my wife was pregnant. She aborted one night and she didn't realize it, we both woke up in the morning with the bed full of blood. As this traumatic experience wasn't enough we were accused in the hallways of the hospital by the nurses of illegally aborting the fetus.

In the United States in 1997 or 1998 (I can't remember as I don't have the dates in front of me) she was pregnant again and the baby died inside her at around 3 to 4 months. Before any studies were done to find the cause we again moved to Puerto Rico. In the US no one was bad mouthing my wife. The caring and the professionalism in the states as compared to Puerto Rico is awesome. Which is why one of my biggest gripes with people here is the backstabbing and the gossip mongering that goes on, but I digress.

Now my wife is pregnant again here in Puerto Rico. We are being taken care of by a doctor in Camuy because most of the doctors we went to in Hatillo did not want to take care of her because she is high risk. How professional is that? At least now my wife's problem has been diagnosed, she has fibromas. In her breasts, too. Now, if I understand correctly, these are benign, and show up a lot more than usual when her hormones are jacked up--like when she is pregnant. But this is big enough of a problem to cause her to abort prematurely.

My biggest fear should be these problems, but I find myself dreading to have to deal with the hospital here in Arecibo. I just detest them.

Gil C. Schmidt said...

Nelson, I'm happy to hear that your wife is expecting again and I'm hoping this time will have a very happy ending. Best wishes!

Gabriel said...

Nelson go right now and make an appointment with a perinatologist. Lauren Lynch in Santurce is excellent. Really, Ob/Gyns are fine for some things but here in the island of reaggeateon its better to go with the best.
I am too enraged to post more right now but I will follow up. I don't think this woman's experience is uncommon and this is not new. The doctor culture here us f*cked up. I will relate some experiences later when I am calmer.

Anonymous said...

Why do we face problems like this everyday? Why can we trust to go to hospitals or the police without getting scared something bad is going to happen to us?

Apparently Gil, I too am wondering why.

My theoy: people here work for paychecks(That's the reason why most our professionals go to the US). Careers are about incomes and status. Puerto Rican healthcare system evolve around bitterness and incompetence. Nurses mantain an excesive workload for a lousy paycheck and so, they are bitter. Doctors try to mantain their work hours to 8-3 and everything that exceeds their comodity and even their intelectual capacity, makes them bitter.

Why should they care to make an effort for someone other than themselves when they are doing their jobs under their definitions?
Well their definitions are lousy then. " Let's blame the patient 'cause, obvioulsly, we made our job". Huh....maybe, just maybe, caring about others shouldn't be much of an effort, especially when they are trained to do it.

This is our problem, right here this is our problem PR. We don't care about others 'cause it's not our job. We don't care about others when we steal, when we cut in line...so on and so on.My GOD,why.....why we wait for others to take our problems and make them go away....God....why? Aren't we cappable enough? Apparently not.


Nelson, I'm with Gabriel, it's better to go to a perinatologist on this case.Ob/gyns are supposed to be trained in difficult cases like this or look for someone who is, but you can't take any chances with our so called "doctors".

Congratulations once again on my part. Let us pray for you to have a beautiful healthy baby and a beautiful healthy wife.

Maria

Nelson said...

I hear what you guys are saying. My economic situation doesn't permit me the ability to travel that far that often. We are being taken care of by one of the best doctors in the area. I like how he takes the time to explain things and keeps on top of the situation.

We are under the state medical insurance plan and they too have personally assigned an agent that has called up a few times to make sure we have actually been getting the care we need. Yes, I was shocked, too! What I dread more is actually having to deal with the hospital staff. I have had too many bad experiences with them already. I really want to go to the hospital and take care of my wife's pregnancy, not have to get into a screaming match with the staff when they go into "stupid mode."

Gabriel said...

I am going to insist you make the effort on getting a perinatologist appointment. Lynch's office is good about working with ppl with cashflow trouble. On one of our visits I saw a couple come out of the office crying. I assumed the worst, it turned out they had some insurance trouble and the doc instructed her secretary to not bill them. Many cases just need one or two visiti with her and deal the rest with the regular doc. She has equipment at her office that you won' t find in the finest hospitals here. I am a big fan of her you see, because she helped save my son' s life.
The story has some similarities with the one Gil related. The first few weeks of pregnancy we where overjoyed. When we found it was twins it was even better. My wife doc has a sonogram machine and we checked the kids regularly. After comparing the first few sonograms we saw that one of the babies had an abnormal amount of fluid, the other, almost none. Their levels of activity also vried greatly. Doc tried to stretch the time between visits but we insisted on the contrary. I also started researching. My prelim diangosis after lots of reading was TTTS, Twin to Twin Transfusion Syndrome. The doctor reluctantly agreed it looked like that and refered us to a doc in Centro Medico, the butcher shop. We wasted two precious weeks witht he Cnetro Medico doctor and her regular doctor. The Centro Medico guy was the first to bluntly stat, "just abort them and try again, its too much trouble". TTTS is lethal in most cases and after several other doctor visits and calls we found the usual treatment in PR is to space the visits so the mom comes in one day and her babies are dead. I am not kidding,lying or exagerating. This is what they do. I found about some pionering surgery that may help us in Florida and a simpatetic doctor prepped mywife for the trip. We also where reffered to Lynch who knew about the surgery and gave us an appointment for when we came back. The experience on thet St. Joseph's Women's Hospitalt in Tampa was great. Competent,caring staff, state of the art facilities. The techie in me noticed quickly the sonogram and other imaging machines moved ther pictures over the LAN, they didn' t use printouts. Its was great. The surgery was a success but unfortunately the stress for one of the baies had been to much and he never recovered, dying some time after. We where still in Tampa and the level of care was great. They sent a social worker and a nun to help us deal with the fact that for the rest of the pregnancy my wife would be caryying a live baby and a dead one. Sonograms were heartbreaking.
Back on the island, Dr. Lynch cried with us about the loss but redoubled the efforts to help our surviving baby. Byweekly and then weekly checkups where the norm. When almost full 7 months pregnant, my wife was hospitalized with an infection and contractions. During this time, Dr. Lynch delivered the baby when it was determined he wold have a better chance out than in. The baby spent about 5 weeks in the hospital and then came home. I have talked about the experience with several ppl and found many cases of twin pregnancies diying and parents not knowing why. It makes me ragin mad. Apparently is common for doctors to just let things resolve themselves th easiest way for them. The @sshole in Centro Medico, I visited him later and gave him a picture of my son, the one he was so willing to abort. The florida operation was covered by our insurance. Its my understanding, even reforma covers a good deal for this type of situations.
I have more doctor stories and if I ever leave the island, medical care will be a big factor. My burning hatred for most doctors is only matched by my hatred for political retards. Yeah, I hate more the imbecile voters than politicians but thats another post.