Stuff I’ve seen (Part II)

17 02 2012
  1.  Let’s talk about twin names!  When I was at the ultrasound clinic last week, the tech did an ultrasound on a 15-year-old pregnant with twin girls.  To make conversation during a minute of down time (and because I have a mild obsession with names in general), I asked if she had names picked out.  She did.  Heaven and Nevaeh.  Yeah.  Another set of twin names encountered: Love and Cherish.  I’m not really sure what it is about twins that make people think they are two of the same person, but I feel for them.
  2. One of the C-Sections I was in last week was removing a baby from a woman who had carried 8 babies (one set of twins).  I say removing a baby from because after she had 3 kids with her husband, she became a surrogate, and every surrogacy (because of how one of her previous c-sections had to be done) was via c-section.  In 8 years, she had given 5 children to 4 couples desperate to have kids of their own.  I think this is a really selfless and amazing thing to do.  Yes, I know they get paid, but after knowing exactly what your body has to do to accommodate a pregnancy, the money would not be enough for me (unless perhaps it would take care of all of my med school loans).  Of course after having 5 c-sections, her belly was a mess of cement-like adhesions that made it very difficult to extract baby number 8.  She was advised not to carry any more children.
  3. One of the patients we had is a paranoid schizophrenic.  Legit.  She’d already had a child, but completely did not remember it at any point during the visit (the baby was a stillbirth).  She delivered her baby last night.  This morning, she had a psychotic break, beginning with speaking to the doctor as if he was simultaneously Jesus and the devil, and ending with a full-out fit of shouting and throwing things in the hallway of the maternity ward.  She likely won’t be able to keep her baby because of this episode combined with concerns of her family that she will not be able to adequately care for the child.
  4. There is a baby in the NICU who is 2 months old.  His mother hasn’t been to see him.  In fact, the little one has been abandoned.  He used to have a sister, too.  His mother was very into cocaine, and because of the drugs she had a placental abruption at 28 weeks (the placenta detached from the uterus, effectively cutting off the blood supply to the baby girl.  The mother had a c-section, but the girl didn’t make it.  The mother never came back for the boy.  And so he has been living in the NICU with the nurses being better parents that his mother ever could be, with a brain hemorrhage which likely caused permanent damage because of his prematurity, who will wind up in foster care.  He’ll probably be there until he ages out of the system because of the possibility of developmental delay, which is, in general, not something that attracts prospective adoptive parents.  The saddest thing of all for me?  He doesn’t have a legal name.  I’m not sure who even has that right.
  5. There was an 18-year-old G3 in the clinic the other day.  This means she had 2 kids and was pregnant with a 3rd (now a living child; she ended up having complications and needing a c-section 2 days later).  18 years old.  Medicaid won’t let any woman get her tubes tied until she is 21, which gives her time to crank out 3 or 4 more.  This might be a moral issue for many of you—and I know that it was for me when I first started, too—but now more than ever I feel like some people just shouldn’t be allowed to have kids.  There was a P12 (a woman who had 12 kids) in yesterday, and the state pays for all of them.  And she knows that, which is why she doesn’t care about birth control.  She refuses to get her tubes tied.  In rounds, the attendings were talking about how she had an ectopic pregnancy between children 9 and 10 one of her tubes had to be removed, and how they were hoping for her to have another one so that they could take out the other tube and this woman would stop having babies. Sounds terrible, maybe, but this woman is very attached to Xanax and Vicodin and has barely held onto custody of her 11 kids before the newest baby was born.  This isn’t like the Duggars, who are at least loving and can adequately care for their kids (all 19 of them) without state assistance.  Yes, birth control is great in theory, but even if a woman is on the Depo shot she has to remember to come to the office for it every 3 months (and Mirena, the next-best, most-permanent option is simply too expensive). It sucks the most for those poor kids.  It’s not their fault that their mothers are irresponsible morons that don’t give a rat’s tail how well they are cared for.  They shouldn’t have to suffer if their mothers show up at 10:00 for an 8:15 prenatal appointment (which happened today), which is why we see them anyway after a certain gestational age.  Those babies are the reason why all of these deadbeat, drug-addicted, apathetic women get the best prenatal care with the hospital footing the bill (I’d say Medicaid, but they reimburse so little that these doctors have to basically pay to take care of them).
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