Krystal Ball

I love personality quizzes. Whether it's the latest issue of Cosmo, the Meyers-Briggs odyssey or the back of a box of cereal, I'm right there with my number 2 pencil. It always amuses me to see my diagnosis. I read my horoscope for the same reason, although I only believe the good parts. Classic Leo, right?

It's truly staggering in a profoundly sarcastic sort of way of course, the deep insight that can be gained from answering questions like what color I would choose to be and analyzing the shape of my used lipstick. It's a novel way to try and make sense of choices, and sweeping generalizations are always fun.
I’d love to see the personality test that could make sense of some of the patients I see. How would you classify someone who’s water broke when they were:
a) In da club
b) In court on child abuse charges
c) Performing as an exotic dancer

You think I am making that up, don’t you? Sadly I don’t even need to. And yes, I know that the playing field isn’t level, and I know that many of these women were born into heartbreaking circumstances themselves. But it’s hard to not be judgmental when they are bringing another baby into their mess. It’s hard to not be disgusted when it’s 5 am and your forearm has just been swallowed by the Vagina that Ate Detroit. It’s hard to not get angry when you’ve been awake for thirty hours. It just seems senseless and hopeless.

Obsetrics is full of superstitions, many of which seem to be eeriely accurate. Ask any resident- we all know that a birth plan or more than four people in a delivery room guarantees a complication. I start preparing for the worst the second I catch site of “Amy and Don’s Birth Plan” double sided and laminated (“…the room will be absolutely silent. We will chant in between contractions. Amy is NOT to be exhorted to push. If Amy asks for pain medications, you will not let her have them the first two times she asks. On the third time, ask her husband’s permission to administer pain medications…”). It’s a classic set up. If you are determined to control something inherently unpredictable fate is obligated to step in and administer a smack down. It’s better to accept that we never really know what’s going to happen, but it takes inhuman discipline to let go of the illusion of control. I suck at it too, just look at my day planner.

Some of it’s patient profiling, that’s true. Woman with a husband, a boom box and Jack Johnson CD? Faculty patient. Woman with braids, earnest husband, incense and her own pillow? Nurse midwife! Woman that’s not actually pregnant but still brought half of her family in the ambulance to witness her fight/guilt trip her boyfriend? Family practice god bless them. Woman in handcuffs with four officers? Resident patient.

I’ll never forget a resident patient I delivered early in my second year. Second year is a journey into the heart of darkness without a map, and this particular patient still figures in my nightmares.

Did you know that crack cocaine induces labor? It does. She had been picked up on a parole violation and was out of her effing mind. She was snarling, screaming and kept trying to run out of the room. The length of chain that kept her affixed to the labor bed kept jerking her back and she’d howl with rage. It looked like she was in active labor, but it was hard to say for sure- she tried to bite me when I got close enough to her to examine her. The officers helpfully mentioned that she was positive for Hepatitis C and that this was her 6th or 9th pregnancy according to her last arrest records. They were in the room with one eye on the TV and the other watching us and the ensuing drama.

A group of us gowned in full space age protective latex encircled her, trying to establish some rapport. Our staff was convinced she could be reasoned with. I wasn’t. I’d seen her feral eyes; there was nothing human left. We couldn’t get close enough to place an IV or to give her pain medications. I knew her body was in control and she’d deliver the baby eventually, I just had no idea how I would get close enough to catch the baby and keep it from hitting the floor and not catch Hep C in the process myself. A few minutes later, I had my answer.

She grabbed the handrails of the bed, and I could tell from her face that she was pushing. I darted in. The baby exploded out of her perineum and I caught it. Her eyes opened as her son entered this world. I’ll never forget the mask of terror her face froze into- she had no idea what had just happened.