The quiet room

“Please wait in here while I find the doctor.”

I was faced with four sterile noncommittal walls and a couch as the door closed behind me. Gone was the bustle of the busy waiting room, the TV, the well-thumbed magazines and the happy expectant couples waiting their turn for obstetrical ultrasound. After my turn, the technician had ushered me here, to the quiet room. The room we bring people to after someone has unexpectedly become gravely ill or passed away. The room we use to allow families privacy in grief. Given how vigorously the baby kicked, finding myself in the quiet room now seemed surreal. But I knew something was wrong when the cheerful demeanour of the ultrasound technician became steely and professional mid-exam. Bad news was coming, and it would come only out of the mouth of the physician. I knew better than to ask the technician any more questions.

The problem in a quiet room is that there is nothing to do except think. I was facing this alone — the price of having a military husband now deployed in a far-away land. There was no one to distract me from the deafening sound of my racing mind. At times like this, being a physician is more a curse than a blessing: the unknown is rapidly filled with a long and particularly morbid differential diagnosis. Wary of my own instinct to interpret every kick as a sign of impending placental abruption and every headache as a hypertensive crisis, I had rationalized every worry away, until now. Working full time, it was easy for me to underestimate the importance of taking care of myself: there were always people around whose needs seemed more urgent than my own. Nothing could happen to me: I was a doctor. Besides, one is now always being told to view pregnancy as a natural process. It should not cause disruption to your workplace, like that reserved for an illness.

But now, inside the quiet room, it seemed to me that these were naïve, even arrogant, notions. Segregated, isolated and in silence, I moved seamlessly and with a strange clarity through a thought process that I recognized only much later for the textbook-taught five stages of grieving.

As advertised, it was denial that found me first. Maybe I had been asked to wait in the quiet room in deference to my status as a physician, so I wouldn't have to sit with the real patients in the waiting room. But I knew this wasn't true. I had seen the pained sympathy under the icy exterior of the technician. Besides, she knew full well that I was a physician, that I would know that the quiet room meant bad news, grieving, loss.

Then anger set in. Anger at my employer and my peers for encouraging me to think I was invincible, that pregnancy wasn't a big deal. Anger at myself for having allowed things to get so out of control.

Then bargaining arrived, and with it a glimmer of hope. Now that I'd learned my lesson, now that I knew I shouldn't have explained away the little things that didn't seem right, that I should have been a better patient, that I should have given my own health care needs a higher priority than work, I would be able to do better. I would put all my energy into getting myself and my baby through this pregancy unscathed; I'd be better off for having had this little scare.

Then the reality of the despairing “what-ifs.” What if this was already a problem I couldn't fix? Despondence and a sense of looming failure kicked in. How could I have allowed myself to get into this position, almost six months pregnant and only now getting high-risk screening? Something was dreadfully wrong; it was already unlikely that all the dreams and hopes associated with this pregnancy and child would remain unscathed by the end of this day. Why had I ever thought I could juggle all the balls in my life? Why had I ever thought it important to juggle them all in the first place?

And then, a preliminary acceptance of my fate — whatever it may be. It seemed that life had already placed me onto a new and unexpected path. I needed to face reality and deal with whatever revelation today would bring. I needed to make the best of the situation that faced my unborn child and me. I had to accept that being a doctor doesn't, and shouldn't, protect me from being a patient sometimes too. Whatever tomorrow would bring, today my baby was alive and kicking. Today was not a day for grieving or quiet rooms. Significant challenges and decisions likely lay ahead. The one thing I could do now was to choose to submit to that fact, to prepare to make the best of a bad situation.

I left the quiet room and returned to sit with the other patients waiting their turn to speak to the doctor.

Karen Breeck Family Physician Ottawa, Ont.

Figure.

Photo by: Fred Sebastian