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A Piece of My Mind
September 28, 2011

In the Still of the Night

Author Affiliations

Author Affiliations: Departments of Family Medicine and Obstetrics & Gynecology, University of Michigan, Ann Arbor (ktgold@umich.edu).

JAMA. 2011;306(12):1303-1304. doi:10.1001/jama.2011.1361

Ten years ago I sat in a sweltering, crowded auditorium with my medical school classmates waiting for the graduation ceremony to begin. I was eight months pregnant at the time and the baby was kicking my ribs under my heavy black gown. “If the dean talks too long, I’m feigning contractions,” I quipped to my friends. I was ready for graduation, ready to be a physician, ready for my child.

Three weeks later I found myself in a sparse triage room in labor and delivery. The nurse put the fetal heart monitor on my belly and hooked it up: 114 beats per minute. I put my hand up to my neck. “That's my heart rate,” I told her in a strangely calm tone. She readjusted the monitor and left the room. Soon she returned with a resident, who scanned my uterus with the ultrasound machine. He made eye contact with the nurse and she quietly slipped out. An attending physician entered and briskly repeated the ultrasound. I watched the screen blankly and knew the truth before they said a word. The resident stood at the end of my bed and put his hand gently on my leg: “I’m afraid your baby has died. We can't find a heartbeat.” Silence. I did not look at him. I remember asking him to take his hand off my leg because I thought I might throw up. The rest of the day seemed unreal, a whirlwind mix of tears, disbelief, epidural, contractions, waiting, and finally pushing. The baby emerged with the cord wrapped tightly around his legs in a figure eight and then three times around one leg. My baby, Tavi, had kicked until he tightened his own cord so much that the blood stopped flowing. After delivery I went into the bathroom and vomited.