First and foremost... Sheri pointed out to me that it sucks horribly, but it's good for Seth and me to go through this together. It's easy to get through simchas together, but going through the hard parts of life is what cements a marriage. So sucky... yes, but also important. She's right. I know this isn't only my loss, but also Seth's. And I know it's probably more real for me than anyone, but it can't be easy for him either. Even so, he's been my constant source of strength and honesty for the better part of the 7 years and this past week has been no exception.
Second, a few of you know how hard it was for me to choose an OB for my care. I was resentful of all the doctors that were involved in getting me to that point in the first place and I was nervous about establishing a trusting rapport with yet another doctor. I wasn't sure I'd ever be happy, or if I'd always wonder what if I'd chosen a different doctor. My experience with my OB in the short time I've known him has given me more certainty than I'd ever expected to have that he is exactly the right doctor for me. Not everyone has that luxury. I know that OBs probably get a lot of thank you notes and baby pictures and fun stuff. But I doubt they receive a lot of acknowledgement for their care when things don't go right. For this reason, I drafted a letter today to send to my OB explaining to him exactly why it is that his careful management of my needs was so meaningful for me. It's on the long side and may contain a bit of TMI, so don't feel obligated to read it, but I'm recording it here for at least my own benefit, only slightly edited to remove names and such.
12 October 2006
Dr. D____ B____
Dear Dr. B;
I am writing to thank you for the exemplary care you provided me on Monday, October 9, 2006 when I had a miscarriage and subsequent D&C at Holy Cross Hospital 3 months into my pregnancy. I would like to take a few minutes to explain to you why this means so much to me.
After four years of trying to conceive, five rounds of Clomid, and four IUI (with injectible gonadatropins) attempts, I was caught by surprise to find out I was pregnant. When my doctor at Shady Hell Fertility Shmertility Center, Dr. L. T. , told me that what had originally appeared to be a miscarriage looked like a viable pregnancy, I didnt experience the same joy that I imagine most newly-pregnant women experience. Rather, I was afraid. I was afraid to leave the safety net of the fertility clinic and the rapport I had established with the doctors and staff there. I was afraid I wouldn't find an obstetrician I could trust. Most importantly, I was afraid I would miscarry before I even made it to my first pre-natal appointment. I had never given much thought to finding an obstetrician I could trust, under the assumption that it would never become relevant.
On the recommendation of Dr. T., and the recommendations of other friends, I made an appointment in your office for September 20th, 2006. I knew at my first appointment with you that I had made the right choice. You took my concerns seriously, but you were not overly anxious (your words were, "Its really hard to mess this up; women have been doing this for a long time"). I had been experiencing bleeding throughout my pregnancy, and you carefully reviewed my medical history, the records provided from Dr. T's office, and did a physical exam to ensure that there was no cause for alarm. I appreciated your calm, but thorough, nature immediately.
At my next appointment on October 4th, everything seemed fine and we heard a heartbeat and all was well. I asked if I needed to have any concern, as the bleeding Id been experiencing had increased dramatically the previous weekend. Though we had not planned to do an ultrasound at that appointment, you immediately offered to have an ultrasound done to make sure nothing was wrong, even though it was likely nothing to be concerned about. Sure enough, the baby was fine, measuring exactly the right number of weeks, with fingers, toes, and a heartbeat. You told me I had a subchorionic bleed, something I should not be concerned about, which does not cause miscarriages, and would resolve itself on its own over time. It was a relief to know that it wasnt all in my head. In retrospect, I am very grateful that the ultrasound was performed that day, because it gave me a glimpse of a healthy baby, something I never thought I would see on an ultrasound of my uterus.
Despite two promising appointments, and a total of four promising ultrasounds, on Monday, October 9th, I began to have severe contraction-like pain, with significant bleeding. I paged you, but within a few minutes of paging you, the contractions had become so frequent and severe that my husband put me in the car and drove me to Holy Cross. (Upon my return home, I discovered that you had called back a few minutes later, and followed up with another call to make sure everything was okay) An hour later, I miscarried in the emergency room and the ER physician, Dr. G, called you. I expected that I would either be told to go home or a doctor I didnt know would perform a D&C if necessary. Instead, I quickly received a phone call from you directly, something which I genuinely appreciate, though it was neither expected nor required. In our short conversation, you expressed sincere regrets and assured me that there was nothing I could have done differently to change the outcome.
You made immediate arrangements to come to the hospital and perform a D&C as I was still in tremendous pain and experiencing heavy bleeding. Your swift response was extremely comforting.
I learned later that you had spent the entire day at the hospital, and I know that my call pulled you away from your wife and your family after what must have been an exhausting day. Yes, its all part of the job, but I know that it takes a special kind of dedication to enter a profession with those kinds of demands on your time. I experienced tremendous relief when you arrived in the OR area where I was filling out forms and waiting for the D&C. You quickly reviewed the pregnancy history with my husband and me, and again expressed your sincere regrets for the loss we had experienced, and suggested some options for finding answers to the questions we have regarding why I experienced such a late miscarriage, saying that you would be as aggressive as we wanted you to be in finding out the answers. I know that a first miscarriage in a first pregnancy is not normally cause to aggressively seek such answers, but given my history of infertility, I am extremely grateful for whatever answers (if any) you are able to uncover. Once again your calm, but thorough, nature was comforting for both my husband and me.
Your gentle care, your thorough manner, and your swift response made a real difference in how I will look back on this otherwise rather unpleasant experience. I never felt anything but complete confidence in the care you were providing, or the choices we were making. And I have never been so certain that I chose exactly the right provider for my obstetrical care, no matter how short that care period turned out to be. I cannot thank you enough and I hope to someday soon enter your office with news that I am pregnant again.
Karen E. Cohen