| Diary Serial |

On Call — Chapter 12: Holding On  

This hospital doesn’t have a labor and delivery department — if she’s here, it’s an emergency


he ER is physically demanding at the best of times. At the worst of times — say in my eighth month — both feet are screaming in agony long before the end of my shift. Today, though, my feet are aching before I even start. Restricted caffeine intake (hello, strict OB-GYN who feels that two cups of coffee a day is more than enough?!) isn’t helping matters.

Pushing through a thick haze of fatigue, I head to my computer and log in to assess the caseload waiting for me. A few clicks, and I can see the online board showing which patients are in which rooms, along with a few lines of information from the triage nurse. A typical day — looks like a deep laceration is waiting for me in room 4, while a baby with persistent fever is next door.

“Hi, Jess,” I say cheerfully to the nurse in charge of room 4. She’s one of those nurses who knows how to be kind and firm at the same time, and her patients are always calmer and easier to deal with — just what I need right now.

She nods, dark curls bobbing. “Looks like a full day today, Ayala!”

“Wouldn’t want to get bored!” I remark wryly, and then waddle as quickly as I can to my first patient.

The next hour passes in a blur as I sew up a laceration from a piece of glass, send the baby with persistent fever for testing, prescribe medicine for a bad ear infection, order a CT scan for a young man with severe abdominal pain, and care for an older woman with an ugly compound fracture, the result of an unfortunate fall.

I need a moment to breathe, so I slip back to my computer and idly open the case board. My name is next to a new patient, a woman in labor. I frown and open the triage nurse’s assessment. This hospital doesn’t have a labor and delivery department — if she’s here, it’s an emergency, and something is probably wrong, or we would have transferred her.

“She’s 34 weeks… hasn’t felt fetal movement in two days… no prenatal care… in labor….” Based on the information, I worry about the health of the baby. There’s a tense ache in my shoulders as I stare at the screen. She’s 34 weeks along. I’m 34 weeks.

Alone with the computer, there’s a moment of panic. I know it’s not professional, but I can’t help it. The idea of walking my expecting self into the room where this woman is laboring with so little hope is tearing me apart. My baby is kicking hard, and hers….

I don’t want to go in there.

But this is the ER, and looking at the caseload on the board, I know that all my colleagues are busy. It’s a full day, Jess said. An understatement from the look of things. I’m going to do this because there’s no time for my own feelings and preferences. I’m a doctor. This is what I do.

Even so, the first step into her room is hard. Taking a deep breath, I put on my professional, caring ‘doctor look,’ and enter.

“I’m Dr. Rubin,” I say to the laboring woman on the bed. “I’m here to help you. Is there anything I can do?”

The woman’s black hair is tangled and sweaty, her face red and streaked with tears.

“No, is nothing,” she whispers in heavily accented English, looking so lost and forlorn that my heart shatters. I come close and reach for her hand, being careful not to disturb the IV line taped to her wrist. I know she feels no physical pain, but the look on her face makes me wish we had medication to numb emotions. I want to cry with this frightened woman, but that won’t do her any good. It’s the doctor she needs, the strong reassurance of someone in authority — so that’s what I give her.

The baby is born 20 minutes later — a tiny girl who never breathes — and we clean and wrap her in a soft blanket, while the woman pants, eyes half-closed with exhaustion.

“Can I see baby?” comes the hesitant question.

I quietly hand over the still bundle, and hot tears pool on the soft fabric of the blanket.

“It’s my fault! It’s all my fault!” Her body is shaking so hard the bed is rocking.

We learn about death in med school. We see death every day in the ER. We get used to it — we have to get used to it on some level, or we couldn’t stay sane. But no one tells you how the cries of a mother for her child can haunt you forever.

I put my arms around the frantic shoulders. She needs to calm down, or she’ll injure herself.

“It’s not your fault,” I whisper into her ear. She collapses into a huddled heap, leaning on me. “These things happen. Never think it’s because of you.” I can’t tell her about Hashem, and I don’t know if she even believes in G-d, but maybe she’s thinking it, because her breathing calms.

“She is so small. So beautiful. I wanted a girl,” she murmurs. Forty-five endless minutes later, fatigue is blessedly taking over as her eyes close. “I want to be a mother,” are the last words I hear before sleep overcomes her, blotting out the anguish.

I straighten her blankets, check her vitals, make her comfortable. And when I can leave, I head for the nearest chair and sink into it heavily. My feet protest, but now I welcome the pain. When I close my eyes, there is the small still face of the baby who never lived, the broken eyes of the mother — and my own gift, my living child, my baby who I hope to mother one day. Here in the ER, on a hard plastic chair, I am struck forcefully at how little we know. There’s so much in the world we don’t understand, so much pain, so much loss.

I see it all the time, but it doesn’t aways penetrate. A baby who never had a chance to live. A mother who never had a chance to be a mother. While I wait for my own first baby, these thoughts shake me with an earthquake of emotion.

In the harsh lights of the ER, sometimes the tragedy can seem arbitrary, but I know better.

My baby kicks hard, stirring with life, and I hold on to the sensation until my legs stop quivering and I can stand again.

I’m ready to go back now and face whatever is waiting behind all those closed doors. Sometimes it’s a rough ride, but that’s when I need to hold on tightly — and believe.


The characters in this series are composites; all the stories are true.


(Originally featured in Family First, Issue 899)

Oops! We could not locate your form.