Featured, Health Policy, Housestaff Wellness
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Contemplating Death with New Life

Very early in the morning on Wednesday, October 18th, 2023, I stumbled into the emergency department with my hair in a tangled mess and accidentally still wearing my house shoes. It was my older brother’s birthday, but I wouldn’t end up having time to send him a happy birthday message. It was my baby boy’s third day of life, but I wasn’t going to be able to hold him in my arms that day. Instead, in an extremely sleep-deprived state, I started the day by crying in front of the triage nurse and explaining that I was scared I was going to die from pre-eclampsia.

I told her the terrifying triad of symptoms — blood pressure reading of 164/110, extremely swollen legs and hands, and worsening nausea — and I expected her to immediately respond in agreement, confirming how obvious it was that I had pre-eclampsia. Instead, she calmly typed my reported symptoms into the note and tried to calm me down. Another nurse searched for a place to start an IV, but real estate was scarce since I had just been in the hospital for several days and had two sites where IVs had infiltrated. I have always handled IV sticks and blood draws well, but this time was different. My body and mind were utterly exhausted, and the thought of having another IV that might also go bad during the time I would be in the hospital was overwhelming. The tears began flowing even more heavily.

I did not expect at the age of 29 to be experiencing a moment where my life was flashing before my eyes. I had found out that I was pregnant during my very last week of medical school rotations. I had shared with my parents that I was going to be having a baby boy on Match Day. I had started my pediatrics residency in July, survived my final STEP exam, and shuffled around the hospital on swollen feet for several months. I had enjoyed a lovely baby shower with my family and friends and another fantastic, surprise baby shower organized by my co-interns. So many months of celebration, excitement, and hard work should not have culminated in such a miserable moment.

The incredibly kind ER nurses loaded me into a wheelchair and transported me back to the L&D unit. I had left this floor a few days earlier, filled with joy and cradling my baby, and I was now returning in a state of dread. My husband met me in the room with my baby sleeping comfortably in his car seat. I looked at my son’s sweet face and listened to his breathing and started crying once again. The realization that I was very sick with a condition that has claimed so many women’s lives was making it hard to breathe.

Once I was started on magnesium, things got a little better — I felt warmth spread through my body as the medication flowed through my veins and started working its magic. It was hard to distinguish the drowsiness secondary to the magnesium from the drowsiness of not having slept much for about 24 hours. I wanted so badly to sleep, but my husband and I were now in a bit of a conundrum. I couldn’t be left alone with my baby while on the magnesium, and my husband was not in a state where he could take care of the baby due to his own sleep deprivation.

At this point, my colleagues rallied around me in the most beautiful way. Co-residents who were on the newborn rotation took turns caring for my baby, while our chief resident guided my husband to an unused call room where he was able to sleep. I do not know what we would have done if it had not been for their support. After my husband got a good amount of sleep, he went home with my son while I continued my treatment. The magnesium ran for 24 hours, and then I was observed for an additional 24 hours. Finally, I was ready to be discharged once again.

When I left the hospital this time, I felt changed in a way that is hard to describe. I was physically weak after all that my body had endured. I was mentally exhausted after the trauma of suffering from pre-eclampsia, chorioamnionitis, and an induction that had involved immense pain. I was conflicted with the desire to return home immediately and finally be back with my husband and baby but also scared and overwhelmed at the thought of having to now try to take care of my newborn when I was in such a fragile physical state. I could not stop thinking about my planned date for returning to work, which was a couple of months down the road, and how it was obviously going to be entirely too soon. Even worse, my husband would be returning to work within just a few days. With these stressors lingering on the horizon, I am not quite sure how my blood pressure did not spike again. Even in hindsight, I am amazed that we all survived those first few months.

Now my son is three months old, and we are all doing quite well. Even so, I mourn for all the new parents in our country who have to endure similar struggles — nowhere enough paid leave, inadequate support for postpartum healing, and the need to work up until delivery. I know that these factors contributed to my health struggles and the onset of pre-eclampsia. I do not know if I will have another child in the future; I do not know if my body could endure all of the stressors of pregnancy again.

I hope that our country will one day provide the support that new parents need so that we can finally start to see a decline in our maternal and infant morbidity and mortality rates. I hope that my son and I will not suffer long-term health consequences from what we experienced in the postpartum period. I hope that new parents will not have to spend time contemplating death when they should be experiencing the joy of welcoming new life.

Maternity ward pt. 5” (CC BY-NC-ND 2.0) by roxeteer

Melissa Huddleston, MD Melissa Huddleston, MD (2 Posts)

Contributing Writer

University of Florida

Melissa went to medical school at the Texas Tech University Health Sciences Center El Paso. She is currently a PGY-1 at the University of Florida Pediatrics Residency Program. She is not quite sure where she will end up after residency but has thought a lot about pursuing fellowship training in infectious disease. In her spare time, Melissa enjoys going to local parks and farmer’s markets with her husband and baby. She also enjoys reading sci-fi, writing letters to her awesome pen pal (her 8-year-old nephew), and Facetiming friends and family.