This week is ACOG’s Physician Wellness Week, dedicated to raising awareness and emphasizing the importance of physician wellness. This piece describes a common source of burnout for doctor moms, the illusion of “having it all.” Details of this story have been changed to protect privacy.
By Georgia Ragonetti-Zebell, MD
I receive the announcement with less than a week’s notice. It comes home with my son’s preschool paintings. “Your child’s birthday blessing will be Monday at 8:30am.”
I sigh. It always feels like a slap in the face when school events are scheduled during the day with such short notice. I know many of the other mommas stay at home, but my schedule is done months in advance to plan for surgeries and call days and office patients. I usually miss out on these special events, like class plays, Muffins with Mom, etc.
“Aren’t you off that day?” my husband says, peering over my shoulder. I check my calendar, and he’s right…sort of. I’m post-call, meaning I will work the 24 hours before, ending my shift eight hours into the day at 8am. That should give me just enough time to make it to the preschool for the birthday blessing.
“Tomorrow is…my birthday!” my little one says. “I know!” I beam back at him. “On Monday, I’ll come to your school, and we can have cupcakes, ok?” “Yay!” he yells as he runs off. He knows I’m a doctor, and that I have to work a lot. He doesn’t quite understand what I do.
“Like when you go to the doctor- except I’m a doctor for mommies. I help them get the babies out of the their tummies,” I tell him.
“So, you fix the babies? How do they break?”
Um, maybe I’ll try to explain it again when you’re older.
Sunday afternoon comes around, and I’m sitting at the nurses station when a patient walks up to the desk. “I haven’t felt my baby move in the last two hours.” She fills out the info sheet, and a nurse quickly moves her to a room. I watch the monitor in the nurse’s station, waiting for the heart rate tracing to appear. I can hear the Doppler whooshing loudly across the hall as the nurse searches for the baby.
The call light rings. “Can you come with the ultrasound?” My heart sinks, and the prayers begin running through my brain. “Please let there be a heartbeat. Please let there be a heartbeat,” I think as I wheel the machine into her room.
I ask her for more details as I spread the warm ultrasound gel on her belly. I listen to her story as I scan around, looking for movement. I try to keep her talking as I search. There is the head, low in the pelvis, as she is a couple days past her due date. The spine and ribs appear as I move the probe up along baby’s body. And, there, where there should be movement, there is none.
“Can you find his heartbeat?” she asks me. “I’m having a hard time.” I say. I keep scanning, knowing that I won’t find what I’m looking for, but not ready to let go of hope just yet. I see the stomach, liver, bladder and legs, all still, inside momma. As much as I want to keep searching, as much as I want to say “There it is!” I know I have to tell this momma the news that she is dreading.
“I’m so sorry. There is no heartbeat.”
Labor and delivery is full of sounds. There is the galloping of fetal monitors. The random beeping of IV pumps. The occasional alarm of a blood pressure cuff. The hum of computers and the chatter of patient assessments and reports. There is the incessant click-click-click of the computer mouse and the rapid tapping on the keyboard as staff document in the medical record. Papers are shuffled as birth certificates forms are filled out. Phones ring and pages sound.
A few times a day, a momma comes up to the desk, panting that she is in labor. She is put into a room, and her sounds echo down the hall as she brings her baby into the world. A cry is heard and cheers and laughter of family and friends fill the air. One of my favorite sounds is the sound of spontaneous applause when a momma has finally finished her hard work and baby is here. But the sound of a baby’s first cry will always be the best sound in the world.
However, there is a sound that no doctor forgets. The sound of a mother who has lost her child. It is a sound we hear too often, a sound we work to prevent every day. It comes from such a deep place, you can feel it in your soul, because it comes from hers. You never forget that sound. It is a sound I hear that day.
She labors through the night, and begins pushing right around 7:30am. Her perfect baby boy is born just after 8am on Monday morning. The delivery room is silent, an eerie feeling in a room usually so full of noise. There are hushed whispers and prayers. Sniffles and tears falling. There is no applause.
I check out to my partner around 8:30. I rush to the preschool, mascara smeared and hair in a greasy bun. I arrive as the birthday blessing ends. My son sees me as he is walking back to his classroom.
“You missed it, Mom!” he says with a downturned mouth and tears welling in his eyes. “I know, darling. There was a mommy that needed me. But I’m here now, and we can have cupcakes.” We share a cupcake and I head back to my car. The tears start before I unlock the door.
I’m crying for my sweet boy, who tried to hold in his tears. My mother wasn’t a doctor, but her job was unpredictable at times. I remember my own anxiety the occasional days she was late to pick me up. I would fake a stomach ache so the school would have to call her to come get me. As an adult, of course, I now understand the stress she felt on those days. But I hate that my calling affects my boy the same way.
I’m crying for myself. I feel stretched in so many directions. I want to be a good mom, a good doctor, a good wife, daughter, partner, and on and on. I don’t know how long I’ll be able to keep this pace I’ve created, but I know it isn’t sustainable. I feel guilty for missing my boy’s day, and even guiltier for leaving my patient so soon.
I’m crying because I still hear the voice of my attending, “You can’t be a mother and a doctor. Pick one.”
I’m crying because I can’t.
And most of all, I’m crying for this momma who will leave the hospital with empty arms. Over the next few weeks, I will pore over her medical records, trying to find what I missed, what I could have done differently to prevent this. My heart breaks for her and for the baby I couldn’t fix.
Georgia Ragonetti-Zebell, MD is an OB/GYN practicing in Upstate South Carolina, and is mommy to four (yes, FOUR) boys. She is a graduate of the Women’s Health Pathway at Drexel University College of Medicine in Philadelphia, Pennsylvania and completed her residency in Obstetrics and Gynecology with the Greenville Health System in Greenville, South Carolina. She has a special interest in natural childbirth, breastfeeding, and alternative methods in labor and delivery. She enjoys yoga, crochet, and reading, but spends most of her free time cleaning up poop while trying not to step on Legos.