Grandma is the word!

Alabaster, Jane

In the fall of 2006 I embark on a life changing professional odyssey that turns me into a different physician.

In 2000 I receive a leaflet in the mail inviting me to study acupuncture in Edmonton. I am certain I want to take this course and call immediately.

The kind secretary reassures me that I will take the course when the time is right.

Six years later I am in Edmonton engaging in the most extraordinary educational experience and am surprised to be learning a lot more than acupuncture.

My professor is a wonderful teacher, full of knowledge and compassion in equal measure, with an assiduous way of seeing and a fine sense of humour.

I am inspired to learn.

After each weekend I return to my family practice enthused and exhausted. I share my experiences eagerly with both patients and colleagues. Some are sceptical while others are infected by my excitement and volunteer to come to Edmonton as teaching cases.

During the course there are many extracurricular educational opportunities including Qi gong, lectures on philosophy and spirituality, horse acupuncture and a visit to the zoo to see Lucy and Samantha the elephants. Our professor explains how to recycle energy, and turn a negative into a positive.

Apart from my commitment to complete my certificate course in acupuncture, my personal and professional life are very busy too. I am unwilling to relinquish any commitments including a trip to England for a dear friend’s fiftieth birthday party. I visit all my oldest family members on this trip and I will be very glad that I follow my intuition faithfully.

My father Henry is eighty two and has recovered from a terrible stroke four years earlier. We spend a wonderful afternoon together but I have a sense that his end is near and that within a year he will be gone.

I also visit my dear mother in law Phyllis, who is declining.

I look into her eyes and find resignation. I’m sorry I looked. We enjoy her favourite meal of fish and chips, the last supper we shall eat together. I think she will live another six months.

I return to Canada and resume my course and all my usual professional responsibilities including a rigorous low risk obstetrical call schedule. Night work makes obstetrics exhausting but it is also so rewarding. Travelling the birthing journey is a sacred experience and privilege. Childbirth is unique and challenging and hopefully a source of pride for all mothers.

Phyllis passes away in mid-January. Death is the full stop which punctuates life and the end hurts. My acupuncture professor offers suggestions for grieving. My classmates are kind and supportive. I prepare for my father’s death using the 23rd psalm.

By the end of February my father is gone. I am barely ready for the news.

I make a whirlwind trip to England to attend the funeral and return to work and study.

March is a very bleak month .I feel empty as I search for inner resources to care for my patients. Obstetrics with the miracle of birth and life, provides solace, inspiration and hope and a renewed sense of future.

On Thursday, my night on call I see a nineteen year old having her second baby. She is full term and in spontaneous labour.

It is not a busy night, allowing me time to carefully review her chart and discover she used crack cocaine in the first trimester. I go into room 518 next to the nurse’s station, and introduce myself to Britney, her mother Donna and Grandma Brenda.

I quiz her tactfully about recent drug usage which she denies. Donna concurs.

She is 5cms dilated and coping well but demands an epidural. I dutifully inform her of the pros and cons. She humours me by listening.

The epidural is given.

The charge nurse tonight is a brusque no nonsense Brit, Sally from the North of England. This is a high risk unit with a constant bed shortage. Nothing escapes her watchful eye.

I say a quiet “Hello how are you doing tonight?”
We exchange brief pleasantries before she demands to know,
“What I am doing with 518?”

I tell her about the epidural, the large baby with the possibility of shoulder dystocia and of course the drug usage.

Sally listens and reminds me to enter the orders on the computer.
“I’ll do it now” I tell her with a smile.

I do as I have promised and then retreat into 518 hoping to keep a low profile for the rest of the night .This will be a challenge as Britney is forceful and vocal and we are next to the nurses’ station.

I prefer a calm, tranquil ambience for giving birth and am a quiet helper.

The epidural gives Britney comfort and we all chat. I have to answer the usual question.
“Where is your accent from?” We talk about England and Wales, family ties and my father’s funeral.

The night goes on. We talk about Britney’s previous birth.
Apparently the attending doctor told her “To shut up and push”.
A cauldron of inner apprehension begins to bubble.

“How am I going to get her to push?” I ask myself

Britney tells me about her toddler and her parents.
“I don’t listen to a word my Mum tells me” she says dismissively
“But I listen to Grandma”
I smile. She has revealed a significant secret.

I slip out quietly. Sally is waiting for me and pounces.

“So Dr A, when can we expect a delivery in 518?” she demands.
My heart sinks. Britney is contracting well, dilating and the head is descending. The baby is occipito posterior but she has a roomy pelvis and I am confident she can deliver normally.

Britney complains loudly about the ineffective epidural and the pain in her back. Grandma tells her to breathe and she calms down. I keep quiet.

The anaesthetist provides the top up.

Britney is almost fully dilated with no urge to push. The head is low. I wait.
Donna and Brenda tell her “You are going to have a baby soon!”
This is not what she wants to hear.

In spite of my best efforts Britney goes to war, swearing and cursing. Profanity fouls this holy night. I hope Sally isn’t listening.

Grandma tells her “That’s enough!” and she is quiet.

Finally the lip of cervix is gone!

Great! Then I remember, may be if I ask her to push she won’t cooperate.

This is the moment of truth.

I fasten my eyes on Brenda who meets my steady gaze.

“Grandma!” I exclaim.

She says “Britney push!” Britney pushes. The baby corkscrews her way out. The shoulder dystocia resolves with McRoberts and no sutures are needed.

The baby girl weighs a robust 9lbs 4ozs with a lusty cry.

They name her Amber. I hope that life will be kind to her.

They all thank me and I leave.

I have learnt a new lesson, the process of recycling in action, the magic of turning a negative into a positive and the power of uttering one small word “Grandma.”

Theme: Birth | Naissance
Theme: Death and Dying | Décès et le mourir
Theme: Family | Famille
Theme: Patients | Patients
Theme: Physicians | Médecins

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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