Academic Medicine:
doi: 10.1097/ACM.0b013e31820cad61
Other Features: Teaching and Learning Moments

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Gaines, Sarah A. MD

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Dr. Gaines is assistant professor (clinical), Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island.

Having a beautiful, healthy baby is something that health professionals probably don't take for granted. We see how illness can ravage the body. We worry that our child will be the one to have leukemia or that we may not be able to have children at all. But that's because bad things happen to health care provider families, right? As a doctor, I think the bad things will happen to my family. But on my last night shift, I was witness to my biggest nightmare. The gut-wrenching, emotional pain that my patient was feeling was so intense that it felt like it was happening to me. As I raced the clock to help my patient, the memory of my daughter wrapping her tiny fingers around my pinky just hours earlier felt like a betrayal, not like the comfort it should have been.

Olivia had a history of ovarian torsion and a right oophorectomy two years ago. That night, she told me that the pain she was having was the same pain she'd had back then. She was so scared; she desperately wanted children and thought that chance was now being taken from her. As I examined her, I was fearful for her too. Medically, she was stable, but her dreams were absolutely threatened. She was crying, her mom was crying, her boyfriend was crying. They knew what was at risk. The ultrasound confirmed all of their fears. I held her hand as I told her that yes, her remaining ovary had torsed and that we needed to transfer her to the women's hospital for immediate treatment. I ached for her need that we all thought would remain unfilled. She smiled through her tears and thanked me for caring for her. She was facing a huge loss, and yet she took the time to say thank you for caring about her. When I got home that morning, I picked up my sleeping Grace, held her, and cried. I have never taken for granted what a miracle she is.

The empathy I unintentionally showed Olivia, as a new mother, helped her. Whether or not the help would also come in the form of saving her remaining ovary, I didn't know. And that killed me—I wanted so desperately for her to have children. I could feel the ache in the depths of me where my beautiful baby girl had grown for nine months. I live in a close-knit community and part of me hoped that someday I would run into Olivia, with a baby who had eyes like hers in her arms. Knowing that I would never know what happened to her and whether or not she would experience that awful morning sickness, or feel those little feet kick her ribcage, or hear her baby's first cry was awful. Thankfully, Olivia saved me from that ignorance.

A thank-you note arrived a few months later. She had been transferred in time, and her ovary was saved. She would have the chance to be a mommy. Her words of appreciation will resonate with me forever. What a feeling to know that our hospital's quick action helped not only one life that night, but potential future little lives as well. She thanked me for helping to save her ovary, but she almost thanked me more for showing her empathy. She told me that she will keep in touch, although whether or not we will ever meet again, I don't know. I hope she keeps in touch with me. I hope she sends me pictures of 10 little fingers and 10 little toes.

Sarah A. Gaines, MD

Dr. Gaines is assistant professor (clinical), Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island.

© 2011 Association of American Medical Colleges

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