“May I?” I gesture to her abdomen, and she leans back for me to palpate. She winces when I reach the lower left quadrant, pressing a hand to her chest and swallowing hard. “Any diarrhea?” I ask.
“No. Just the upstairs issue.”
“No diet changes or recent travel?”
“Nope.” She pops the P like this adds emphasis.
“Any fever? Dizziness?”
“No.” She shrugs. “I’m as healthy as ever. Could it just be a stomach bug?”
“Possibly,” I say, taking a seat at the computer. I skim her history, noting no documentation for her premenstrual cycle. “Are you sexually active?” I ask, eyes still on my screen.
She chokes out a cough. “What? No, I mean, yeah. Kind of. It’s complicated.” Her tone goes from anxious, to defensive, to sheepish all within five seconds.
“Alright, when was your last period?”
“Idon’t know. It’s not regular. I stopped tracking years ago.” A mix of emotions moves across her face in a flurry. Confusion, maybe? Definitely dread. Maybe a tiny bit of hope. All fighting for a front-row seat before anxiety inevitably wins, settling deep in her eyes.
It’s a familiar look—one I saw in this very space a year ago. One that impacted me more than any other.
“Why don’t we just check?” I encourage.
She gets what I’m asking without having to spell it out. I hand her a blue specimen cup and point in the direction of the bathroom. Double fisting the cup, she takes the walk that many come in here to take. Whether it’s the walk of shame or walk of hope is up to the patient.
Ms. Richards returns quickly, and I dig up an HCG dipstick from the cabinet. The double line, the one that confirms pregnancy, lights up before I’ve even thrown the wrapper away.
“It’s positive, isn’t it?” she asks, and I can’t tell if she’s scared or excited.
My back is to her, so luckily, she can’t see my face. But I forgot to tell the rest of my body to play it cool. My body shoots upright, shoulders touching my ears, tension brimming at every corner. Without even speaking, I’ve already said too much.
I turn around so slowly it’s awkward. My smile is awkward. My jazz hands are awkward.
“Congratulations. You’re pregnant.”
She watches me like I’ve just murdered a puppy, but I ignore this, projecting my own joy onto the situation. Maybe not the most professional way to handle it, but I love babies, and I don’t get a lot of these moments in the ER. The last one was for myself, telling Emma we were pregnant, at ages thirty-eight and forty. She looked about the same as this patient does, horrified and nauseated, not liking my optimism much either.
Ms. Richards stares at me—er, more like through me—for a long second before I finally ask, “Is there someone I can call for you?”
She blinks, coming out of whatever premonition consumed her, and stutters, “I’m—I’m pregnant?”
“You are.”
“Are you sure?”
“We could do a blood test to confirm, but these”—I wave to the stick sitting on the counter—“are highly accurate.”
Before I have the last syllable out of my mouth, she begins to weep, gasping out erratic wet breaths that alert my senses like a greyhound. I take a seat at the foot of her bed.
“I didn’t think this would ever happen,” she whimpers into her hands. “I’m almost forty. He’s forty-five.” I nod in understanding, and she goes on, keeping her face in her hands, muffling her words. “You go so long without any chance, so you just stop thinking about it, ya know? I can’t believe this is happening.”
I rest a hand on her ankle. “There are resources. We have centers and social workers. If this isn’t what you want, we can—”
“What?” Her head snaps up, her red, watery eyes locking onto mine.
“If you don’t want this, there are resources out there to assist you and the baby,” I say.
“Oh no, I want this!” She’s beaming now, still crying, but it’s different. It’s the good kind. “I didn’t think this would ever happen for me. I was married before, and he left because we couldn’t get pregnant. And Tommy…gosh, he’s so wonderful. He was fine with just us, but I know he wants this. Oh my gosh, I can’t wait to tell him.” The tears are now dried up as she pulls out her phone, lets out a soft belch, and begins texting.
