Wednesday, January 19, 2011

I'm Not Angry

When I published the recap of my day miscarrying in the emergency room, there was a surprising response from some of my readers. I'm sure everyone who read the story probably felt in some way indignant at my mistreatment and neglect by the emergency room staff that day. Even I, while writing about it, felt some of those feelings myself. Some suggested that I report it to the hospital or even seek retribution or litigation for it. Surely, I should want justice for having to endure such treatment at such a sensitive and difficult time.

I really, truly appreciate every bit of support I've received from my readers and friends regarding my miscarriage. I really needed that support, and probably still do need it. The emotional reactions we all felt to what happened were natural human reactions. Something wasn't done right, and it needs to be fixed. It's an instinctive response.

So here's the deal: nothing can fix what happened. I'm not saying that to be depressive or negative in some way. It's the simple truth. What happened, happened, and I'm actually not upset toward anyone about it. I never felt angry toward the overwhelmed emotionless doctor or the snickering nurses. I didn't feel upset that they basically ignored me while I miscarried right there in the ER bed. It's strange. I guess I should feel some of those things, but I don't.

I understood the circumstances, and I actually empathized for those people who were supposed to be entrusted with my care. I knew they were overwhelmed with a full emergency room that day, even before I was given a bed. I knew from the moment I got in there that the doctor was in the ER for the first time ever, and I didn't expect to be emotionally supported by him when he was essentially on a crash training course. I went there for an ultrasound. I never expected to fully miscarry right there, and I'm sure the hospital staff didn't expect it either.

They offered me the care they knew how to. They suggested treatments which I declined even before I was officially diagnosed, and they probably didn't know what to do with me because I really didn't want or need any medical treatment for a naturally occurring event that just so happened to take place in their territory. They certainly were not OB specialists and didn't know what an obstetrician would do under the circumstances. They referred me to my obstetrician because of this. They made assumptions of what the OB would probably do, but those assumptions were wrong. How were they to know that?

A few weeks after the fact, I spoke with a friend of mine who is a labor and delivery nurse. She told me that they don't routinely do D&C's on women who are miscarrying, and that the emergency department probably wasn't even aware of how the labor and delivery department would handle it. They were acting out of the knowledge and training they'd had, and it was in no way perfect for the situation.

Seeking financial retribution would be pointless and wouldn't fill the emotional pain of having a miscarriage. That pain would be there regardless of where or how it took place, and trying to get revenge on those who happened to be there with me at the time wouldn't serve any purpose to me. Yes, part of me would like to sit down with the group of individuals who interacted with me that day and let them know just how it felt to be in my shoes. Maybe that would help them be more sympathetic to the next woman who comes in with a similar situation.

I also realize that the hospital staff were practicing defensive medicine the entire time I was under their care.
  • I came in for an ultrasound and they inserted an IV before anything else was done. They were preparing for the worst, which would have likely been ectopic pregnancy requiring immediate surgery or a miscarriage requiring surgical intervention. All they knew was that I was pregnant and bleeding. Telling me they might need to give me fluids, in my opinion, was a load of bunk. I really don't think that's what they were preparing for. They were assuming the worst, which I suppose is their job. I saw it, I knew what was happening as it happened. I guess that's why I'm not mad. I didn't feel fooled by anything.
  • Not letting me have anything to eat or drink. This was the worst part of my treatment, in my opinion. I was bleeding and hadn't had any nourishment for hours. What I really needed was something to keep me stable and healthy, but they wouldn't give it to me because once again they were assuming the worst. What if they had to send me to the OR? What if I had to be put under general anesthesia? They couldn't run the risk of my having anything in my stomach “just in case”. I knew I didn't need any of those things, and I needed to eat. But once again, defensive medicine called the shots.
  • Refusing to take out my IV. Now this was just stupid. The same rules apply. They were sending me to my OB for follow-up care. “What if her OB decides to draw more blood or do a D&C?” I guess logically it made sense that the OB's office could just take it out for me, especially since I was only walking next door, but that didn't happen. It was easy enough to remove it myself when I had to.
I guess what my story shows is how defensive medicine can fail. Sure, if my case had been the worst-case scenario the hospital's legal behinds would have been covered by their defensive medicine. But it wasn't. It was a natural miscarriage needing no intervention, in which case the so-called “care” provided was horribly sub-par.

My story resembles so strongly the active management of the labor and birth of an otherwise healthy mother and child in the hospital. Every day expectant women are subjected to unnecessary interventions “just in case” which increase their risks and deprive them of the nurturing loving support they need and deserve. Whether it be induction, epidural, continuous fetal monitoring, restriction to bed, no food or drink, or even cesarean section: all are done routinely for the sake of defensive medicine. Now, that makes me angry!

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