While the nurses position Hannah and prepare for surgery, I lock on to Joss. We’re both masked. HerDon’t Be Extrascrub cap hides most of her blond hair. Even with only her eyes visible, the silent support and encouragement bolsters me.
The uncomfortable tightness beneath my ribs eases slightly.
She turns away and draws up the drugs, then prepares for intubation.
The harried OB hospitalist, Evie O’Hara, steps into the OR. “What’ve we got?”
Besides their numerous other duties, the hospitalists help the private docs with difficult C-sections. I give her a quick rundown of the current situation, and she whistles.
“Right.” She slips a ring off her index finger. “Let’s go scrub.”
Ten minutes later, I’m standing on the right side of Hannah’s OR table, a scalpel in my hand. Evie is across from me. Jocelyn’s induction of anesthesia is fast, followed by a masterful intubation.
“All right, Doctor Foley,” Joss says. “Go.”
So I do.
I perform the surgery I’ve performed hundreds of times, and it’s just as much of a nightmare as I imagined. The good thing about scar tissue: it doesn’t bleed. But there’sso muchofit. Layers and layers of distorted anatomy and missing landmarks.
Sweat gathers beneath my scrub cap, fogging my eye mask. Evie and I work as a team, snipping, bluntly dissecting.
Guessing.
And that’s when the bleeding starts.
Aberrant arteries. Oozing veins. Snipped muscle between layers of tissue that looks like—but isn’t—fascia. This woman’s body uses scar tissue like the US Army uses tanks—as offensive weaponry. By the time I reach the uterus—too many minutes later—there isn’t enough room to extract the baby.
We do our best. Tugging. Cutting. Avoiding bowel like it’s Covid.
I think there’s enough room, so I open the uterus and elevate the baby’s head.
There isnotenough room.
So now we’re in a deep, dark cave of an abdomen full of blood where nothing is visible. I’m operating by feel alone. Elbow-deep in a woman’s body.
“I need a vacuum!” I yell.
The device is thrown into my field of vision, and I shove it into the cave. Thanks to the sheer quantity of blood, the vacuum pops off four times before the suction takes.
A head of dark, bloody hair becomes visible in the hole.
And the vacuum pops off again. Each pop sprays blood across the OR. It’s on my face. Dripping down my neck. Obscuring my vision through the eye mask.
I apply it once more, and finally,finally, the head delivers, followed by a limp body.
The baby doesn’t cry. Doesn’t move.
With a clamp and a quick cut, she’s detached from her cord and handed off to the nursing staff.
And I pause.
Because Ihatethis. These conceivably avoidable situations. These OB nightmares that keep me awake wondering... what if? Is it not enough to have one life in my hands? No, I have two. I chose OB-GYN because it’s the happiest specialty.
But it can also be the saddest.
Did I fuck up? Would this have gone smoother with a different surgeon? A better surgeon? Am I a total fucking fraud?
“I need a new mask,” I say, then head back into the bloody cave.
