November 23, 2009
A Day in the Life: The Humble Gift
Every time a baby is saved I am grateful to Boston University for my acceptance into medical school. Hollywood can keep its Academy Awards; my “Oscars” are healthy babies.
A few months ago, a patient in her early third trimester came for a routine prenatal visit. Her vital signs were good, the baby’s heart rate was normal and as I handed her an appointment slip, I asked whether she felt her baby move during the past two hours. She said no, she had not felt the baby move all day. Despite hearing the baby’s heartbeat, my antennas immediately went up and I referred her to the labor room to have further diagnostic tests.
A few weeks later, my assistant said, “Dr. Galloway, you’ve done it again.” I asked what was she talking about and she explained that our patient was seen in a follow-up clinic for the removal of her staples. The same day I sent her to the hospital, she had an emergency C-Section because her tests were extremely abnormal. Her baby was in trouble. When the on-call obstetrician delivered the baby, he noted an umbilical cord wrapped around its neck five times and once around its body. However, the baby did well and was eventually sent home in stable condition.
My most gratifying moment occurred when I saw the baby for the first time. “She’s my miracle, Dr. Galloway” said the patient, and of course, I agreed. “She was channeling me the night before I came to see you.” “What do you mean?” I asked. “The night before I had her, I dreamt that she had died but because you sent me to the hospital, she’s alive. She’s my miracle.” Tears swelled in my eyes as I struggled to maintain my composure. The miracle of life never ceases to amaze me.
September 2, 2009
Invoking the Miraculous: A Case for the Public Health Option
If JT had private insurance and not Florida Medicaid, her baby would probably be dead.
JT’s pregnancy was miraculous, considering she had conceived with only one fallopian tube and ovary and she had no prior children. Things went well until her 27th week when she developed vaginal spotting. She went to a local hospital and was discharged home with a clean bill of health although they never ordered an ultrasound.
Bleeding during pregnancy is not a normal phenomenon. When I saw JT three days later during a routine prenatal visit, I ordered an ultrasound although the bleeding had stopped. A few hours later, the radiologist emergently reported that the placenta completely covered the opening to her womb and the baby’s umbilical cord was wrapped tightly around its neck three times. JT had a complete placenta previa and someone at the local hospital had regretfully missed the diagnosis.
I discussed JT’s case with a high-risk obstetrician and we both agreed that she should be admitted to the specialty hospital if only for observation. Thankfully, JT had state-sponsored Medicaid insurance because a commercial insurer would have made us jump through hoops. They would have required pre-authorization, endless forms and an inappropriate premature discharge home where she would have subsequently returned to the hospital with a dead baby.
What was supposed to be a 24-hour admission turned into a sixty-four day hospital stay because JT bled on a weekly basis. The cord remained around the baby’s neck and the prognosis was guarded regarding successfully carrying the baby until it was full term.
At 35 weeks, JT had an amniocentesis to make certain that her baby’s lungs were mature. She was subsequently delivered by cesarean section with the umbilical cord STILL wrapped around her baby’s neck. Because of skill, compassion and medical expertise, both mother and baby are just fine.
Marie Curie once said, “Nothing in life is to be feared. It is only to be understood.”
Please do not let fear cloud your judgment. Support the public health option, America. We need these miracles to continue.
