“Where is my baby?” I awoke upset that my belly, which hours before was bulging through my doctor scrubs, had surprisingly been flattened. No one had asked for my permission to deliver my baby. They told me he was delivered emergently — at 32-weeks gestation — to save both our lives.

I was a third-year pediatric resident, the senior for the pediatric ICU, on the night of my son’s birth. My overnight call had just started with an admission of a 12-year-old in pain of a sickle cell crisis. As I began writing up the admitting orders, I felt a sudden descent in my pregnant belly, and then an intense, halting stab of pain down my spine. I thought maybe, I could pass through what I conjured was a contraction, but the spikes of pain were unrelenting — and set in the sirens of an alarm. I quickly stood up. Somewhat conflicted, I began to work some courage to tell my attending faculty doctor that I needed to be seen by my OB doctor. In response to my request, she smirked and without even looking up, dismissed me. The nurse, standing behind her, insisted I take a wheelchair. “You don’t look like you can walk, doctor,” she said.

It was 2002 and residents were supposed to be superhuman. We weren’t expected to ask anything for ourselves. This time, however, heeded the nurse’s advice.

Hours later, the contractions developed a regular cadence. My blood work also began to raise the alarm — I was in an H.E.L.L.P crisis. That’s doctor talk for hemolysis, elevated liver enzymes, low platelets. But “HELLP!” was also the state of my mind. The last few months had been tough — I was working over 100 hours per week while being the present mother of a three-year-old and diligent wife to my spouse who was desperately trying to finish his PhD. Emotions were raw, especially after my recent return from Pakistan where I had left my dying father in a condition I could do nothing about. Even the recent strife with my in-laws and struggle to make all ends meet had left me a bit bitter. Yet, I had to keep my personal issues out of my head at work and struggled to keep my pregnancy healthy.

They say in our religion: “Verily, with hardship comes ease.” I had always thought that when you sacrifice the successful, harmony and peace come after. I told myself this while growing up with lots of turmoil. Just keep working hard, harder and even harder, and the strain and pain would be justified with the ends of happiness and relief. The outcome of struggles would be reward. What I have learned however after so many years, that it is not the end that is better. The verse says “with hardship comes ease.” Why “with ease?”

In the neonatal ICU, my prematurely born son, lay on his back, flaccid with tubes attached to almost all of his orifices. He was breathing harder, and my eyes and mind blurred still from all the medications after many seizures the night before. This baby needs to be intubated was my first thought.

Two weeks later at my baby’s bedside, I watched the nurses and doctors, (my colleagues and attending residents) rounding day in and out.

All I wanted was to have had just a few extra weeks of him in my womb. Inside me, he felt closer to my heart and in my control. His feet would rub inside my belly, and he would tug at me when he was hungry. Now that he was outside, all I could do was pump my milk with a lingering hope that when he is off TPN (IV nutrition), he would have enough for his first feed. I waited. I observed his every movement, his breathing, his jerks, his eyes open and close, and his soft creaseless, pink feet. Pain is most intense when we feel powerless.

Yet, it was in this very pain, this despair of lacking control, the ache of regret and heaviness of guilt, that I felt relief. I held him, for the first time, on his 13th day outside of my womb. He lay in my arms with his blanket to cover all the tubes and IV’s I knew too well. All his weight in my hands felt firm like gold. His darkly colored eyes glared back at me — he knew me, he had heard me, and he had felt the inner side of me. I drew him close, his heart beating against mine. His soft creaseless pink feet rested upon my chest.

It was the hardship that I had shared with him that bound us in that very moment. Even now, while he sleeps, I sometimes find a moment to caress the still smooth bottom of his now 16-year-old feet. I have had to learn, that it is in those most difficult, most challenging times, that there resides in us — a deep beautiful pain. It is within those moments of hardship that I found my ease.

Alya Ahmad is a pediatric hospitalist.

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