Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Participating in the greatest miracle a physician is privileged to be part of

Hans Duvefelt, MD
Physician
June 21, 2020
Share
Tweet
Share

An excerpt from A Country Doctor Writes: CONDITIONS: Diseases and Other Life Circumstances.

“Welcome back. How was your trip? Or exile … you were away for a long time.”

“Almost a year,” my nine o’clock patient answered. A woman just over forty, she looked tan and physically strong. Her short hair was peppered with gray, different from the last time I saw her. She had gone abroad on assignment for a magazine and a film production company, and before she left, she had joked that she would have to be her own doctor until she could come back to see me again.

“So, what’s going on,” I asked.

“I’m pregnant, pretty far along. I thought it was early menopause, like my mother and my sister, but that doesn’t come with morning sickness. And I can feel my uterus.”

“And you haven’t seen a doctor?”

While getting ready on my exam table, she told me about her work in small villages far away from clinics or hospitals and her decision not to seek care until she came back home.

Her uterus almost reached her navel. I took out the handheld vascular Doppler we use to measure blood pressures at the calf of people with circulation problems. I changed the probe to the one used for fetal heart tones, an attachment I had not used in a while; I stopped doing obstetrics the day I graduated from my residency thirty years ago.

“I never thought I would be pregnant again after my miscarriage when I was twenty-five,” she said with sadness in her voice as I applied the gel to her abdomen and turned on the device.

There was the loud, swoshing sound of the placenta following her own elevated pulse rate. I pressed deeper and aimed the instrument downward with all kinds of static from the movement against her skin. Then, suddenly, there it was, rapid and perfectly regular; a sound I hadn’t heard for thirty years.

“Is that the baby?”

“Sure is.” I counted. “Good, strong heartbeat, 140 and regular.”

She reached down and grabbed my hand.

“Please leave it there. I want to listen to it longer.”

ADVERTISEMENT

Her eyes moistened, and her lips began to quiver. She placed her top teeth on her lower lip as if to keep it still. I rested the probe, and we both listened in silence.

I remembered that sound, the rapid heartbeat of unborn babies, from many long nights on duty during the sleep-deprived years of residency. I remembered catching a few moments’ rest in the on-call room down the hall from two or three monitors with intertwining rhythms of babies waiting to be delivered.

Vividly, I remembered my first delivery, a precipitous double footling breech with no other doctor on the ward other than this frightened first-year resident. Just in time, as I stood there with my right hand assessing the situation, old Doc Walker appeared in his street clothes in the delivery room door.

“What’ya got, son? Nurses tell me you got two feet there.”

“Yessir,” I tried not to quiver.

Doc Walker’s slow and gentle words calmed the young mother and guided my hands as they, in turn, guided the baby, feet first, across the symphysis and onto his mother’s belly.

As the Doppler continued to tap out its rhythm, I remembered faces with smiles and tears, happy couples, and frightened, single young mothers in the delivery rooms. I remembered blue babies, me slipping in umbilical catheters, the neonatal intensivists watching and supervising.

I remembered my own son, hooked up to an apnea monitor at my own hospital. Years later, as a new grandparent, I was a visitor, strangely out of place in a different neonatal intensive care unit, watching my granddaughter through the walls of an incubator.

Thirty years since I heard that kind of heart sound, and it still touched me in inexplicable ways. I remembered, my whole body remembered, the mixed feeling of dread and excitement when my pager used to go off in the middle of the night: “Call 2350 STAT.”

Thirty years ago, I saw more births than deaths. Now I only attend departures. For a minute or two that morning, I was again participating, ever so briefly, in the greatest miracle a physician is privileged to be part of.

Hans Duvefelt is a family physician who blogs at A Country Doctor Writes: and the author of A Country Doctor Writes: CONDITIONS: Diseases and Other Life Circumstances.

Image credit: Shutterstock.com

Prev

Proactive care is the linchpin for saving America's health care system

June 21, 2020 Kevin 0
…
Next

Wisdom for child fellows and fellow children

June 21, 2020 Kevin 0
…

Tagged as: Pediatrics

Post navigation

< Previous Post
Proactive care is the linchpin for saving America's health care system
Next Post >
Wisdom for child fellows and fellow children

ADVERTISEMENT

More by Hans Duvefelt, MD

  • The art of asking where it hurts

    Hans Duvefelt, MD
  • Thinking like a plumber when adjusting medications

    Hans Duvefelt, MD
  • The American food conspiracy

    Hans Duvefelt, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD
  • Embrace the teamwork involved in becoming a physician

    Nathaniel Fleming

More in Physician

  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Why “do no harm” might be harming modern medicine

    Sabooh S. Mubbashar, MD
  • International doctors blocked by visa delays as U.S. faces physician shortage

    Arthur Lazarus, MD, MBA
  • How I redesigned my life as a physician without abandoning medicine

    Ben Reinking, MD
  • Why even the best employees are silently quitting health care

    Dr. Suhaib J. S. Ahmad
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why perinatal mental health is the top cause of maternal death in the U.S.

      Sheila Noon | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why perinatal mental health is the top cause of maternal death in the U.S.

      Sheila Noon | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...