Nurse Kim Griffaw called me to let me know that a patient was being brought in by EMS pregnant and bleeding. EMS explained that she was about 32 weeks and they described the scene on arrival as “very bloody.” No commentary was made regarding fetal heart tones, mom was tachycardia but otherwise stable. I asked Nurse Griffaw to make sure we had the ultrasound machine in the room and we waited. When the patient arrived she was clearly still bleeding having soaked her clothing and the transport drape. Nurse Griffaw and Tech Nancy Winchester moved the patient into a bed and I did a bedside ultrasound confirming the presence of a fetal heartbeat, though noting it was very bradycardic. I confirmed a placental abruption and counseled the patient that we needed to proceed with a Cesarean Section. I asked if anesthesia had been notified and Nurse Britton May confirmed they had. I left the room to scrub and be ready.

18 minutes. From EMS rolling the patient onto our ward to time of birth was only 18 minutes. Evaluation, communication, intubation and first breath… all less than 20 minutes. We are not a trauma hospital. We don’t maintain a high-risk antepartum service. Sure we get the random prolapsed cord or intrapartum fetal distress… but those are generally people that are known and have a presence before they are requiring urgent interventions. What happened Thursday was a blessing of all the right people at all the right times doing all the right things without ever being asked to do so. I scanned the patient, explained very quickly what we were going and why, and before I even make it completely out of the room to ready myself, I saw people running in the hallway to prep the OR.

I got to the operating room and count was happening, anesthesia had already made it into the room and the patient had already been given someone’s personal cell phone to call her family and quickly tell them to come. The neonatologist and his team were waiting at cut time and whisking the baby out of the room for eval within minute it took to get her out. I asked for nothing. I didn’t have to, it was just done. OB is a place we constantly welcome in life at the moment it happens. Working in that environment there is some part of all of us that acknowledge that miracle automatically without really taking the time to ingest it. We focus more on the “what ifs” because we know that there is always the potential for something to go wrong. There are thankfully rare moments in my career when less than miraculous situations have led to nearly or totally catastrophic outcomes. We take stock in those moments because we need to. We learn from them and we reevaluate our skill sets and as a team. We look to see how we function and what if any systems have failed. We ruminate on the outcome and I am sure like others, I revisit those moments in order to keep my awareness of potential recurrence from recessing into the parts of my brain that don’t want to acknowledge the heaviness that accompanies those memories.

These moments follow us and feed small doubts because they should, they are meant to keep us humble. These moments are necessary to remind us that we are small. Then something like Thursday happens. These moments are even more rare. We are seldom given the opportunity to take stock in these types of moments… the earned prideful ones. The nursing, anesthesia, tech and NICU staff performed exceptionally. There are several people involved in making it all happen the way it did. Seamlessly. Awesomely. I am very rarely without the ability to express myself, but my gratitude doesn’t fit inside any word that I can come up with. I am humbled to be part of this group, and I am uncertain as to how to tell them that I see them and am indebted to them outside of making sure that you know what amazing and worth of praise people you have in your employ. I just needed you both to know what kind of awesome is floating around on OB!