February 23, 2012

Jill

In 1986, Tova had a 16-year-old daughter, Jill, who had a high fever and was complaining of severe abdominal pain. Tova was the office manager at one of the hospitals where I admitted patients. Her own gynecologist was out of town. A friend told her to take her daughter to see me. I was the only female gynecologist in the area.

When I saw Jill, I realized that she had large masses in her abdomen and signs of sepsis – signs that are an indication for emergency surgical intervention. I told her mother to take her to the hospital immediately and have her admitted. I ordered a pelvic ultrasound. The ultrasound revealed multiple pelvic abscesses. The radiologist told Tova that Jill should have immediate surgery. Another gynecologist agreed with him.

According to good medical practices, Jill’s physical, radiological findings and clinical condition, surgery needed to be performed. Surgery in this case could have meant having to remove infected organs that would preclude her from ever having children.

But when I went to visit her in her hospital bed, an inner voice told me NOT TO OPERATE AND TO JUST WATCH HER CLOSELY, GIVE HER STRONG ANTIBIOTICS, AND MASSAGE HER BELLY EVERY TIME I SAW HER AND SHE SHOULD BE OKAY.

I was not only torn, I was also scared. What if she died? What if the surgery could have saved her life even though she might never have children? Against my best medical judgment, I had to TRUST that inner voice since it had not proved me wrong in the past. I decided not to operate on Jill and keep a watchful eye on her. She was placed on a regimen of three antibiotics and pain medication around the clock.

I called Tova and begged her to give me 48 hours — promising I would operate if Jill’s condition deteriorated. It took me over two hours to convince her.

For the next 48 hours Jill’s condition did not deteriorate but did not improve either, except for a slight fall on her high temperature readings. I saw her three times a day and each time would sit next to her and gently rub her belly.

By the third morning, I found Jill crying when I came into her room. She had such a pitiful look on her face, I thought the pain medication that she had been given wasn’t working. But she told me that she was crying because she had been planning to go to the prom that night and could not go since she was hospitalized.

“What is a prom?” I asked her. She had to explain what it was to the bush woman from Haiti that I was then.

I may have an idea to make her heal faster, I thought. I went to the nurses’ station to ask about Jill’s medication scheduled. She was receiving them every 8 hours, at 8 AM, 4 PM and midnight. I also found out that she could have what is called a Heplock – capping her IV line till the next dose. So she could leave the hospital to go to the prom and return before midnight, just like Cinderella.

I have never forgotten the look on the nurse’s face and on Jill’s. Tova could not believe it either. But Jill was able to go home after her 4 PM dose was over, take a shower, wear her beautiful peach dress and come back in time to get her midnight dose. Two days later, she was well enough to go home.

As the years went by, Tova, another daughter, and her mother became my patients. I never shared with Jill my fear that she could be sterile. Years later, when I no longer delivered babies, Jill stopped by my office to show me a huge 20-week belly with her first child Jacob kicking inside. It was one of the best days of my life.

As time went by and my intuitive skills became stronger, I eventually quit obstetrics in 1992 and surgery in 1999. When it was time to finally quit practicing Western medicine in 2005 it was not an easy decision to make. One morning when I had to decide whether to renew a 3-year lease contract on my office, I received an e-mail from Jill. It was a picture of her and Jacob with big smiles in their faces holding her newborn son, Harry. Seeing these two beautiful children reminded me that I was on the right track with my strong intuitive sense. We were in each other’s lives for a reason.