— contributed graciously by one of the strongest, most human, practicing Emergency Medicine physicians I know
I mumbled to the nurse and to the PCT, “There is nothing wrong with the tests, that batch is fine,” but I don’t think that they heard me. That doesn’t happen to me much — I have a booming voice. But I don’t think that I wanted to be heard at that moment, although something inside me had to confess it.
“I’ll just go get a new box from pediatrics. There is definitely something wrong with these tests,” the PCT rattled off in her Staten Islandese, as she quickly rushed past me.
It wasn’t even my patient and most X-ray techs will do an X-ray without a pregnancy test in a 45-year-old woman. But the nurse dipped the urine anyway at the insistence of the tech. And it was positive. The patient insisted that she had been celibate for the past 10 years or more and she didn’t look like the lying type. She looked older than her age, like life had been unkind to her. She wasn’t a 16-year-old girl, hiding her teenage follies from her parents. At 45, you don’t hide whether or not you are sexually active from your doctor. You just don’t, unless you’re crazy, and that wasn’t the vibe I got from this patient. She was neatly dressed and her affect was quiet and concerned.
In our overcrowded and busy ER, where stretchers are stacked so deep that the heavier nurses have no space to maneuver between stretchers, you barely have time to pay attention to your own patients, let alone other people’s patients. A 45-year-old female with vague abdominal pain who was being taken care of by another physician, one of the most competent doctors in our staff nonetheless, was nothing for me to pay attention to. But I knew those pregnancy kits were just fine.
For the past 1278 days prior to that day, I had been trying to get pregnant. I did it all, except IVF — I refused to even try IVF, since if I failed that last option I didn’t know how I would go on. My husband and I had started trying to get pregnant when I was 28. We were healthy, we weren’t fat, we didn’t have bad habits. We did acupuncture and Chinese herbs; he held me upside down after coitus; we tried IUI after IUI; I used Clomid and more advanced drugs. You name it, we had tried it. I had had so many transvaginal ultrasounds that I no longer had any shame, I just plopped myself into the stirrups each time and it was game on. But never once during any of those days, had two lines appeared for me — not even a faint second line — and the blood tests were no better. I would have given anything to have the two lines that this 45-year-old patient had on that little piece of litmus paper encased in white plastic. Earlier that morning I had dipped my own urine on a test from the very same batch that the nurse had used to dip this patient’s urine, but no two lines had appeared for me. I had done it twice just to be sure, so I knew there was nothing defective with that batch.
The patient went on to not only have an Xray, but also a CT scan of her abdomen and pelvis. Metastatic ovarian cancer. Those two purple lines that would have made me ecstatic became a death sentence for her.
That night I went home and I cried for her, and for myself. Those two little lines seemed to hold both of our futures, and both seemed so bleak, but hers bleaker. I prayed for her to pass in comfort.