Today I watched a miscarriage.
I stood by, offering reassurance that protocol was being followed. Her husband held her hand and smiled at her, told her it would be okay, murmured that the blood was probably nothing and that, yes, the exam was uncomfortable, but it would all be over soon. She fussed at him and told him to stop messing with her hair but smiled back up at him around a nose that crinkled in discomfort.
Such a nice, polite couple--one whose halves by all appearances love one another. They were nothing like the girls and women I see in the ER all the time, who come in with complaints of unexplained abdominal pain and who walk away reeling, faces plastered with looks of shock, horror, and sometimes revulsion when they learn they're pregnant. No, this was a couple who wanted--and deserve--a child.
She'd been bleeding for days. Not a lot, but enough to be concerned. The PA cleared away accumulated blood to see if there was an opening in the os. She laughed when she realized that at first she had thought he'd said he was looking for an opening in her ass. She waited patiently as he soaked up the blood and completed the exam. When it was all over, the PA asked her to wait just a moment as he gathered up stained gauze so he could dispose of it properly. He told her she could dress, and as we left the room, he asked me to follow him.
"I think she's discharging some tissue too. But I need to look at it and I don't want to do it in front of her. I don't want to scare her."
We went into the back room where urinalysis samples are typically collected, and he unwrapped the soiled package with gloved hands.
"Yeah, it's a good bit of tissue," I said. Not to be graphic, but as a woman, I recognize this kind of discharge. The PA examined it more closely.
"Oh no. Is that what I think it is?" he asked. There, amidst the darker clots, was something small, luminescent, milky white. I stepped closer.
"Oh god."
A pearl of tissue, something I had never seen before in real life, but a thing I could instantly recognize. A tiny amniotic sac, no bigger than a marble, and inside, an embryo.
"She just passed her baby. Yeah, you can see it. I'll have to get official confirmation from one of the doctors, but..."
My heart stopped momentarily. My eyes started to well with tears, which I stifled in an attempt to be professional. As the PA walked around the corner, I walked the other way toward the wheelchair bay and allowed myself a few seconds to grieve for this couple, patiently waiting in the GYN room, still thinking they were going to be parents in fewer than nine months.
Don't get me wrong here. I will clarify from the outset that I am strongly pro-choice. I don't mourn that another child will not enter the world. I mourn instead that that particular child will not enter the world--a child conceived by two people who love one another and who want to give parenting an honest effort.
I don't often think about pregnancy. I don't want children. In fact, the thought of the whole process has always kind of, well, grossed me out. But today, seeing that pea-sized embryo in a medic's hand, I just got it. I understand how crazy and fascinating life's astonshingly fragile beginnings can be. I can begin to see how people can love something that really isn't anything yet and how profoundly the act of creating life can affect people. And god, I hurt for that couple. I know that right now they are at home, and that they are devastated.
The PA told them almost immediately. He said there was no question, and he didn't want to lie to them and keep them there waiting on test results that would tell them nothing we didn't already know. He thought instead that it would be better to offer them that time in the GYN room to grieve and to comfort one another. I agree. No one in Urgent Care ER would die if they didn't get a room in the next 20 minutes or so. But part of them had just died, and it seemed only right to give them some time to come to terms with that.
I never fail to be flummoxed by how life's most seemingly commonplace moments can totally floor you, how they can change everything.
