Salt in the wounds (phrase, informal): To make a difficult situation even worse for someone
Let’s be clear from the outset, I love the NHS: Great institution, fantastic values, good and diligent people. Lots of my family and friends work for the NHS and they really are the backbone of this country, salt of the earth. I hope my appreciation for the NHS was made abundantly clear in my earlier blog about the care that Summer and I received on the Labour Ward in March of this year.
That said, I have had a few conversations with people about how their experience with baby loss, on occasion, felt short. I have to say, I’ve felt the same. Some of the negative encounters can stick in our heads, birthing an associated upset or trauma, instead of a baby. And so I’ve decided to write this blog, largely because I believe there’s strength and forgiveness to be found in saying “me too”. I also think it of paramount importance to tell the – most overused made-up-word on this blog – bruth. In this day of social media perfection, airbrushing and photoshop, more often than not, we should be telling it like it is. Finally, who knows, maybe a medical professional will read this and either pat themselves on the back (for not being a numpty) or, perhaps be stirred to act more mindfully going forwards.
Here are some stories, the majority of which occurred in the Early Pregnancy Unit (‘EPU’): the room which no parent ever wants to be in. If you’ve had healthy pregnancies, you may never have heard of it. It’s where pregnant ladies go when stuff goes awry. So you would think that this is the place where sensitivity is heightened, the care is at its greatest, where empathy runs rife – sadly, that’s not been my experience. I have spent so much time there, I’d really like to not have to go back there, but I know it’s probably inevitable given my follow-up investigations etc that are yet to come.
On the whole, I know these are decent people, doing good things. However, I’m not sure I’ve forgiven some of these medical insensitivities yet, so perhaps getting it all out, will help with the healing.
The receptionist: There is a receptionist in the EPU that neither James nor I like. We know her by sight, we know her by name, we always prefer it when she’s not there (is this slander? maybe).
There was a young lady, by herself, in the EPU who needed to give a urine sample. Now, I know that this isn’t uncommon for pregnant ladies, but it is uncommon (by definition) if you’ve never done it before! This lady was uncertain, unsure – again not unusual traits for women in the EPU. She was handed a grey medical boat and asked to give a urine sample – she needed it explaining. When she went into the cubicle to do as she was asked, the receptionist turned to her colleague and said “can you believe that? She probably wanted me to hold the boat for her too!” and then they laughed at her. That still hurts my heart. Everyone in the waiting area heard those comments. I was horrified. As someone who genuinely avoided giving all urine samples until I was pregnant (“oops I forgot” I always white-lied to my GP!) up until age 32, that easily could have been me. A week earlier, I needed the boat explaining. Who’s ever looked at that grey thing and immediately known what it is? I tell you who: no one. That would be WEIRD. Oh how I glared at that receptionist, I still really regret not saying something. Her lack of empathy shocked me. It made me wonder what she’d be saying about the rest of us, once we were out of earshot. Being in the EPU, I had enough to worry about, without worrying about that too. We have a couple more stories about this particular receptionist, which I’ll refrain from sharing. Let’s just say, she’s never received a thank you card.
The second opinion: If you recall from my blog about BoC, we found out that he had no heartbeat at a private scan. They handled it wonderfully, delivering the news kindly, but unfortunately it meant that we’d have to go through it all again, officially via the NHS. We went into the EPU a few days later. The sonographer confirmed that she couldn’t detect a heartbeat, but she needed a second opinion, so she called in another lady. After a repeat scan, tears streaming down my face, the second lady softly said “I’m really sorry, I can’t see a heartbeat” I said “that’s ok”. She then completely forgot herself, turned to her colleague the sonographer and said “Cups! You’ve got spare cups in this room! Can I have some?” All – faked – sincerity gone in an instant. Unbelievable.
The anaesthetist: After I miscarried with My Baby at home, we went ahead with our pre-planned trip to China. I continued to bleed throughout. On our return we went for a hospital check-up and I was told I needed a surgical procedure (called an ERPC), as there was still some remaining placenta and a blood supply to it. I was really upset about having to have surgery. I am a prude (remember the urine thing!) and the thought of surgery, under anaesthesia was horrible. The lack of control. I cried when the consultant told me. I told him that I went to university with medical students and I know how often they mucked about and mocked people. He used the perfect word, he said: “I assure you, we will maintain your dignity”. If only they had.
I was wheeled in to the operating theatre the next day. The anaesthetists were very nice, both chatty, both male. They were playing music and asked me to choose a song to fall asleep to (oh right, you want me to choose a song to ruin forever? A song to forever remind me of surgery after miscarriage?) I was wearing a hospital gown and said “oh wait, I’m still wearing my underwear, should I remove it?” and the anaesthetist replied “nah don’t worry, we’ll remove your knickers when you’re unconscious”. And just like that, all dignity was gone.
The 12 week scan: Do sonographers know how momentous the 12 week scan is? Of course they do, but some may need reminding. I was so looking forward to my 12 week scan, it was third time lucky. I was finally going to get one! BoC and My Baby never made it that far, but Summer, Summer did. The sonographer was off with us from the beginning, perhaps having a bad day, perhaps just a grump in general. She was running ahead of schedule and wanted me to go ahead with the scan, without James. I told her I was 10 minutes early and that he was parking the car, but would be here in time for the appointment. She wasn’t happy, she made us wait 40 minutes. My bladder wasn’t happy either. When we went into the room, it was all so, perfunctory. I tried to give her an inkling that this was a particularly special, yet worrying time for us. When that didn’t work I explicitly told her “I’ve had two previous miscarriages”. Hint hint: be nice to me, please. She didn’t seem to cotton on, but carried on with her checks. Fair enough – the 12 week scan is not just for the parents, it’s actually for the professionals to do their thing. She did her bit, halfheartedly pointed out a few of Summer’s organs and then said “is there anything else you want to see?” we asked “err, what else can we see, please?” – how are we supposed to know? When it came to getting our baby scan photo, we were left bemused. It was a good thing we were never going to use it in a baby reveal or put it on social media, because over the top she had typed “OF NO DIAGNOSTIC VALUE”. Have you ever seen a baby scan with that written on it? Cheers for that.
The sonographer: I’ve noted previously that Summer was a difficult pregnancy, so for peace of mind, we were having more regular scans done privately. On the evening of our appointment, the clinic was running late and I was bursting. Seeing as I was nearly 19 weeks, the receptionist said it was fine to use the loo. When we went in for the scan, the sonographer was shaken: “There’s no fluid left!” she blurted out, eyes incredibly wide. “Oh I’m sorry, I know. I emptied my bladder, the receptionist said it was ok”. “No! The baby! There’s no fluid around the baby!” The sheer terror in her eyes and the shock in her voice, it told us everything. She asked me to cough, the baby did not move. I coughed again, nothing. James and I didn’t even ask any questions, we just said we’d go to the hospital. She was shaking, utterly speechless. I understand that she was shocked, but I still can’t shake the look in her eyes and the sound of her voice. Surely that wasn’t her first bad scan? I really could have done with her working on her game face. I had no idea what had gone wrong, but I left via the back door (for our privacy) feeling ashamed.
The stupid question: On two separate occasions, I have found myself sat in the EPU, in front of two different doctors, who asked the same question really abruptly: “Why are you crying?“ One was the day I’d lost My Baby and the other was my first appointment (they asked me to come in for) after we’d lost Summer. The notes were right in front of them. I understand that they probably didn’t get time to read them, but is it ever ok to bluntly ask a mother in the EPU why they’re crying? There are ways to ask these things, caring ways. Fake it if you have to. Both times I said “why do you think? (gesticulating to the notes), because I’ve just lost my baby!”. One of the doctors replied “you seem upset, do you want to come back another time?” Err no, not really. I don’t ever want to be in the EPU, no pregnant lady does. Please try to understand that.
The use of stirrups: During my pregnancies I’ve had so many internal scans which have always been very dignified with minimal discomfort; it was simply a case of lying back on the bed. I’ve had so many (before, during and after pregnancy), that I know it’s possible to perform the scan this way. After the loss of Summer though, one consultant preferred to use stirrups, because it was easier for him. I’d have been ok for him to use stirrups while I was pregnant (although uncomfortable, I’d be doing it for my baby), but when they’re used after you’ve lost a child, because it’s simply easier for the consultant, well then it’s just degrading. To my mind, patient comfort and preference should have taken precedence.
The terminology: A week after we lost Summer, I found myself back in the EPU for a follow-up appointment to check that all tissue etc had passed during labour (incidentally this was the day which had originally been booked for my 20 week scan – incredibly bad timing). Unfortunately all wasn’t clear and so I was going to have to go in for an ERPC. I asked why this hadn’t been checked after I had Summer and the doctor said something along the lines of “when an early miscarriage takes place…” I interrupted, burst into tears and angrily said “are we still calling it that? Early miscarriage? This was neonatal death. This wasn’t early for me. This was nearly 20 weeks, nearly half way. There’s nothing early about that!” The poor doctor, he hadn’t meant to offend, but I do still think it insensitive to lump it all together as “early miscarriage”. I’ve had two early miscarriages – neither of which deserve that terminology either – and this was altogether very different.
If I’m being positive, I could say: these are only eight stories. Eight stories in the grand scheme of things is pretty good, especially given the number of medical encounters I’ve had. Though that’s true, I still can’t shift how they made me feel. How recalling these experiences winds me back to an already difficult time and rubs salt in my wounds (ha, salt of the earth NHS staff, rubbing salt in the wounds – there’s something poetic about that). None of us are perfect though, least of all me. We’re all just muddling along and trying our best. So I’ll try my best to reframe all this and remember that instead. Time to forgive and try to forget.