I didn’t know what to expect when the phone rang at the charting station today. We have a new unit secretary on labor and delivery, and while she is quite nice, she is a bit green and didn’t bother giving me a head’s up before transferring me an unannounced call from the front desk. It was an incredibly busy day for our little L&D. I had just called my program director and missed her, and since it said “private number”, I assumed it was her. I picked it up, and said “Hello?”
“Yes, hello? May I ask who you’re looking for?” It’s the charting area on labor and delivery and only two residents were in it. We’re not normally fielding telephone questions to the public. I assumed the “private number” transferred to us was a personal call for one of us.
“I asked to speak to a midwife or a nurse.”
“I am neither, I am an obstetrics resident. Is there something I can help you with?”
“I have a question. I’m pregnant, and I have a midwife I’m seeing who helped me with my first pregnancy. Well, I’m pregnant again, and she drew my progesterone, and she said it was an eight or something, and she said that was normal but I just don’t think that’s normal. Is that normal?”
“Ma’am, I’m sorry, I really can’t answer that over the phone without examining you, knowing your history and seeing all of your lab results. I’d be happy to see you at our clinic.”
“I don’t understand why you can’t just answer a simple question over the phone.”
“Ma’am, as I said, it wouldn’t be professional for me to make a judgment call without seeing the actual lab results or seeing you in person.”
“Are you telling me you expect me to PAY to see you for an actual VISIT for you to just answer this simple question for me?”
“What do you do for a living, ma’am?”
“I don’t see what that has to do with this! I just want a second opinion to know if this is normal! You just want me to PAY to see you!”
“I would be happy to give you a second opinion with all of the information if I could examine you in my office. I wouldn’t call your work and start yelling at your about how you do your job while asking you to work for free-” that was about when she hung up on me.
Sigh. Ma’am, I work for salary. I actually work for an abysmally low salary. This day that you called and yelled at me for not telling you whether your “I think it was 8” lab results were normal, I came in at 6:30 am and left at 11:00 pm. I missed dinner with my kids. Hell, I missed dinner. I delivered two babies. I rounded on nine postpartum patients and discharged six of them home with new babies. I triaged countless women with complications there for antenatal testing – chronic hypertension, intrauterine growth restriction, gestational diabetes, postdate pregnancies. I helped new moms with breastfeeding, I called a psychiatrist for a mom who showed up in labor with no family, no partner, and scars from self harm all up and down her arms. I had an immigrant tell me how she only went to two prenatal visits because her emergency medicaid only covered her for 45 days. She was a week past her due date and hadn’t been to our clinic since her second trimester. She had no job, no money, and waited to come in.
I personally talked to and examined every single triage patient. I looked over every single one of their charts. I opened up their ultrasounds and labs myself and read the results, I didn’t rely on what was documented in their chart or what was told to me. I checked every LMP, every due date, every AFI.
I felt guilty when I left and that lonely first time mom was laboring alone in her room. Her eyes looked so hopeful when she told me her boyfriend was going to come when he got off work at six. Later, she told me that he wasn’t sure he was going to show up if we couldn’t guarantee she would deliver that night. She was dilated to 7 cm. “You will deliver overnight,” I said to her. When I left at 11 pm, I am pretty sure he wasn’t there. But I have to be in at dawn tomorrow to start it all over again.
For salary, ma’am.
Good luck with your pregnancy. If it is 8, and you’re in your first trimester, especially if you’re bleeding, it’s probably not normal. I hope the practitioner you have chosen to trust with your body and your lab results cares as much as I do, and will discuss it with you.