Memories are such funny things. I could be tucking in a child, seeing a patient, speaking to a friend and some small nuance will bring back some moment in time. This happens to me quite often and I try to record these recollections whenever I can as there always seems to be a unifying theme or a lesson I thought I'd forgotten, its like stumbling upon buried treasure. Last week while clearing the ever present and sometimes overbearing pollen, which is typical of Georgia in the springtime, I happened to sweep my hand against the chilly wrought iron railing on my front porch. The cold rail against my skin was a little shocking in contrast to the balmy spring warmth of the air and I was reminded of something.
Standing on the porch lost in my thoughts, I think back days, seasons, and years before; the coldness of my hands once was a daily topic of conversation. Obstetric interns are primarily responsible for something called postpartum rounding, taking care of women who are recovering from birth and preparing for home. Given that rounds must be complete by the time the Attending physician arrives, this means all patients are seen and examined, labs checked, plans for the day developed and notes written by 7 or 8am. Often the task of rounding would fall to the first year resident- the intern who worked overnight, as this was the person guaranteed to be in the hospital at 3 or 4 am, nearing the end of a 12 or 14 hour shift. I think of how my hands were always like ice early in the morning a consequence of near constant washing and hospital air conditioning.
The joy of helping welcome a child into a family, the fulfillment of teaching a new mother something about her recovery, the thrill of being the first one to notice a problem or abnormality and the ability to take steps to correct these things were all lost on me most mornings at 3am. Patients never failed to comment on how cold my often-shaky hands were as I examined them each morning. Hands as cold as ice, they would say.
Cold hands, warm heart. This was always my reply. I had heard that phrase somewhere before, and typically this was enough to put new moms at ease. The pervasive feeling many of those long mornings for me was one of dread and anxiety. Many times the pressure to not miss anything, to give good advice, to illicit good information to inform my attending physician was overwhelming to say the least. Invariably new mothers had a multitude of questions and concerns many of which I felt wholly unprepared to answer as a newly minted first year physician. On more than one occasion I found myself saying to a harried and tired new mom with baby never neatly, but sweetly swaddled in her arms, “I don’t know”, always promising to find out the answer and feeling even more despair at the daunting thought of having to seek the answer before dawn, one more thing to do before the sun came up. Eventually, I became proficient. I recognize now that every woman I spoke with and examined helped train me over the course of a four-year residency and eventually made me an efficient clinician and counselor.
The stair rail leading to my front door is all but cleared of pollen and chill of the metal conjures new thoughts. Long nights, many days and years pass and my cool fingers bring to mind my daughter, born in January on the coldest day the city of Boston had seen in sixteen years, or so I was told. After an easy pregnancy, uncomplicated birth and postpartum course, we were being discharged home on our second hospital day. Our room was spacey and comfortable with an expansive window offering beautiful views of Cambridge just across the Charles River. That morning I shuffled about packing our things and took a moment to take in that lovely view.
It was only then that I noticed the river was completely frozen.
I checked my phone in a panic, confirming what I already knew. Zero degrees. I looked down at my perfect little new daughter, all swaddled and warm and content and instantly I had a feeling of panic and despair so biting, it is engraved in my mind to this day. There I was, a maternity expert feeling completely lost and overwhelmed at the prospect of my own new motherhood. Despite my many years of training, nothing had prepared me for such a moment. My heart began pounding, I could hear my own pulse in my ears and tears fell freely. Surely it was too cold outside for babies. The thought that my baby girl might have even a second of discomfort or injury did not seem bearable. After all, she was my long awaited daughter, tiny and perfect. I had to protect her from everything uncomfortable and unpleasant in the world, and the weather was no exception. I recognized these impulses as irrational at the time, but they were so real nonetheless. The winter morning had awakened my anxieties once again, this time not as the doctor with the answers, but from the other side as the patient and the parent.
Every day with the passage of time I hope to improve in my dual roles: physician and mother; the requirements for each are so very similar. As art imitates life, the art of medicine is linked with our human capacity to love, to bond, and to care for one another. Raising a family while practicing medicine and caring for women has been the greatest gift I could ever give or receive.
Lost in my thoughts, I find I've cleaned the whole front porch, so apparently introspection breeds efficiency. Most assuredly, the Georgia pollen will give way to another sweltering summer. Fall and then a mild winter will come and the surely coldness will return conjuring old memories reminding me of lessons learned and all that is left to do. And and the memories will continue to come.
For more narratives and perspectives on women in medicine, please see this piece, by the curator of this collection http://www.huffingtonpost.com/entry/591b2021e4b03e1c81b00918