Free Just Here Trying to Save a Few Lives: Tales of Life and Death from the ER by Pamela Grim Page A

the woman. “Just breathe.”
    “What the fuck does breathing have to do with it?” the patient screams back. “
I'm having a fucking baby!
”
    The patient is a woman half-crouched on the end of the gurney. The nurse who hates you (at some point you learn her name is Helen) is standing over the patient, helping her struggle out of her pants. The patient is thin, gaunt almost, with dirty blond hair and a pendulous belly, striated with stretch marks, and stick-like arms and legs.
    You are only two steps into the room when you smell it. Alcohol. She's drunk.
    You may not know much about delivering babies, but you are training to be an ER doctor and you know a
lot
about alcohol.
    She has half her clothes off when she pushes Helen away and screams, “Stop it, stop it! You're hurting me.” You are struggling to get a pair of gloves on when Helen is knocked back into you. You step around her and use your only available weapon, your elbow, to push the woman back onto the examining table.
    You lean over her. “You're
drunk,
” you say.
    “Yeah?” she says. More like a statement.
    You look at her and somehow you can see the rest.
    “How much crack have you smoked tonight?”
    “That's none of your fucking business,” she says in return.
    You can see her with a crack pipe in her hand. It's a picture so vivid you have to close your eyes. A crack addict, for sure. That explains why she would be stupid enough to come to this hospital. Then you think, Oh my God, the first real delivery I've ever had and it's a crack baby.
    She struggles up toward you, wailing, “I hu-ur-urt.”
    “Sit down,” you yell back. There is a note of authority in your voice that you've never heard before, but it is almost masked by an equal amount of desperation.
    “Sit down,” you shout again. “I mean
lie
down.”
    “I can't,” she wails. “I'm having a ba-aa-aa-by.”
    You shove her back down angrily. Helen is on one side and the pretty nurse, whose name is Carol, is on the other. You all struggle to get the damn pants off. Finally you get your first look at the vaginal area. The introitus, the vaginal entrance (or in this case the vaginal exit) is closed. The baby isn't exactly popping out, thank God. You at least can finish getting your gloves on.
    “Anybody try to get fetal heart tones?” you ask in a sudden moment of clarity.
    “I'll get the Doppler,” Carol says.
    You stare down at the woman's bulging abdomen. “How many babies have you had?” You are still shouting. You know you have to shout to get through to her; she is totally skanked.
    “Seven,” she wails. “Ohhhhhh, my God.”
    “
When are you due?
”
    Carol, Doppler in hand, leans over her, applying jelly from a bottle to a spot just under navel.
    “When are you due?”
    “Please, Jesus,” she says and starts panting. “Please Jesus, please Jesus, please Jesus.”
    Helen leans over her. “Do you have a doctor?” she asks. “Did you get prenatal care?”
    “Lying-in,” she moans. “I'm supposed to go there.” She begins writhing her way through another contraction.
    You've finally gotten sterile gloves on, but they are immediately contaminated when the woman tries to sit up again and you push her back down. Helen has the bottle of Betadine, an antiseptic, and begins pouring it over the woman's crotch. The patient starts shrieking again and rears up, knocking Carol out of the way. You push her back down again and put your face close to hers. “Don't move,” you tell her in a fierce whisper. She looks up at you and, for a moment, is still.
    You turn to Helen. “Do we have the stuff to resuscitate the kid? Laryngoscopes and stuff, in case this baby's in trouble?”
    “I'll get the neonatal crash cart,” she says.
    “And the Isolette?” you ask the kind-looking nurse, who now just looks very frightened. The Isolette is a warming unit in which the baby is “gently cradled after its eventful passage into a new world,” as the textbooks say.
    “Okay.”