Saturday, April 15, 2017

Stories from Vacation: Bedbugs

This post conforms to the blog rules.I have encountered bedbugs before. But I have never encountered bedbugs in my next door neighbor's apartment. My next door neighbor is a retired policeman my grandfather's age. When I first moved in he gave me a new microwave oven, a re-gift he didn't need. I picked it up and as I was leaving with it, I noticed a semi-automatic rifle mounted on the back of the front door. "That's in case some guy I sent to prison comes knocking," he said.

"Ah," I replied, not sure what else to say. Was my neighbor paranoid?

"No, I mean it," my neighbor said. "There one particular guy who sent me letters and called me telling me he's coming for me now that he's out of prison."

"Sir, do you tell all your neighbors these things?"

"Well, I guess not," he mumbled. "Well anyway, I'm pretty sure it's not gonna happen but it'd be a good story if it did."

Img credit: houstondwiPhotos mp
My neighbor was full of life. He told me stories about his children, grandchildren, and one great-grandchild. "My step-son," he'd grumble, "was a disaster as a kid. He'd get drunk and get into fights and do drugs. I was always afraid that me and my wife were gonna get the call that he was dead. One time--" he started to laugh, "one time he called me, you know, once there were cell phones. He called me from the bathroom of a bar and said, 'Dad, come get me. I'm in this stall and the whole rest of the bar is out there ready to kill me.' I was in favor of him getting in trouble. His mom wanted me to go get him. She said 'He'll be arrested, and then he'll have a record.' And that gave me an idea. So I said, 'All right, son.' I got on my uniform and got my gun and a pair of handcuffs and went to the bar. Sure enough, there was a riled-up crowd shouting for him to come out and trying to bang in the door. Poor bouncers. I moved through them and banged a little myself. I shouted, 'You're under arrest!' And I put handcuffs on him, the works. We left and I took 'em off in the car. Everyone was happy."

I thought my neighbor was hilarious. I would bake bread for him occasionally and I took him to Mass once or twice. He gave me a tablecloth and an end table, and he made mechanic recommendations. We'd see each other as I went to and from work and make small talk. I knew that he helped the others, too.

Then I learned he'd been diagnosed with cancer, but couldn't be debulked because of his coronary artery disease. He had a combined triple CABG and cancer surgery. He came home in a wheelchair with an incision as long as my arm. Home health visited three times a day. I went to see him and found out that he had bedbugs. First, he told me the fact. "Thanks for comin' over," he said. "Don't mind the exterminator who'll be here in a bit."

"You're brave," commented his step-son, who dropped in to bring groceries in the middle of my visit. "When I visit him, I sit on a wood chair."

I soon learned why. I flicked away no fewer than five bugs of at least two different species (or different life cycle stages?) while I was sitting on his living room couch. It was tricky to be cordial and let him decide when the visit was over! He was clearly bored and wanted some company, and my visit lasted three hours. As I walked to my door when I finished, I vowed that I was going to wash every thread I wore with steaming water and dry it on super hot. As I was taking off my hoodie, I saw and crushed a blood-filled bug.

Img credit hiroo yamagata
Luckily, after that there were no signs of bedbugs in my apartment. Then a few days later, I noticed that the hand sanitizer at our secondary hospital really bothered my hands. I was itching like crazy. As I was driving home, I realized it wasn't the hand sanitizer. I had several discrete red bumps on my hands. "Oh good," I thought, "I can still use the sanitiz--OH NO. I HAVE BEDBUGS." I immediately called my apartment manager and he sent a home debugging bottle, complete with personal spray wand for the tough-to-reach spots.

I don't think I ever had bedbugs, though. Those were my only bites and I never saw a sign of bugs. I guess I got those bites just sitting with him. Happily, he's now bedbug free, too. Please pray for him as he recovers. Pray especially for his return to Christ and his conversion.

Thursday, March 30, 2017

Baptizing Daughters (Hope for Heather)

This post conforms to the blog rules.I waited a long time to tell this story because I didn't want to change many details. What follows is an accurate but anonymized version of my two encounters with "Heather."

The other day I was in clinic and a young teenager (think junior high or early high school) came in for her new OB visit. She was there with her "mother," but the mother was probably fifty years older than the patient, and she was of a different race. I don't know why that was--perhaps this was a grandmother or a foster-mother--but I didn't ask. This is how I met "Heather" and her mom.

Heather was in her late first trimester and pregnant with twins. When I saw her in our MFM clinic, she had just had been told from an ultrasound that she had two daughters and that they were monochorionic/diamniotic, meaning that they were at risk for twin-to-twin transfusion syndrome. They were at risk for a lot else, but TTTS is what most of our initial conversation was about. Heather had not planned this pregnancy and she had thought about abortion, but her mom talked her out of it. Heather herself really wanted the babies now. Her boyfriend was not in the picture. Heather told me in the presence of her mom that she had experimented with cocaine. But she was obviously tough. She had accepted the fact that she would be pregnant at school and finish a year late. She was clear on her new policy about drugs and sex: "One giant nope." This made me hopeful for her.

Heather's mom was suffering, but it was almost imperceptible. She was clearly not the type that engaged in drugs or sex at such a young age. Her hair was grey, she was plump, she wore grandma shoes and pastel pants, and she had perfect grammar. (In fact, she was eerily like one of my apartment neighbors, who is a nun.) I could tell that Heather's mom was working hard to accept Heather and her choices, but that those choices were very far from what she wanted for her daughter. She was never openly disappointed with Heather during our visit, and asked many helpful questions to support her daughter during the beginning of pregnancy. This made me even more hopeful for Heather.

I tried to cover basic obstetrics and adjusted it for an adolescent, mentioning by requirement that Heather was legally the one to make the decisions about her pregnancy, any birth control, and her daughters' care. I closed my visit with Heather cordially, planning ahead for six months of careful TTTS screening in addition to routine prenatal care. Our MFM clinic is not a continuity clinic (super bummer), so I did not expect to see her again.

A few weeks later, I was working labor and delivery and the upper level resident was in a C-section with the L&D intern. I was sitting at the L&D desk in her stead. The details of this next part of the story are fuzzy because there were about eight phone calls/conversations about how Heather should come to L&D and how she was asking for me by name.

The charge nurse called me over and simultaneously, my zone phone rang. On the phone was the triage intern. "The ER is sending up are seventeen-week twins, apparently super uncomfortable." The charge nurse, meanwhile, wanted to ask me whether the seventeen-week twins in the ER should come right to L&D. I said to start them in triage. Then the triage RN called the charge nurse and asked that I come to triage. The charge nurse was in the middle of asking me to go over, explaining that they knew me by name, when the intern called me again. "I'm sending this seventeen-weeker over, she's five centimeters. She's also...asking for you?"

Readers probably know that a woman in labor near term has to dilate to 10 centimeters. You might not know that tinier babies don't need 10 centimeters of dilation. Seventeen week twins would certainly and easily fall out of a five centimeter cervix.

Heather was given the room next to the statue of Mary. Mary is at the end of the L&D hall and those rooms are the quietest and frequently used for women losing children.

Heather was having a very difficult time due to pain. She also didn't know what labor at seventeen weeks meant! She had texted friends to come visit her because she was having her babies. They were all excited. She asked to get some pain medicine before they arrived.

When I heard this, I started her pain control and then explained to her that her daughters would die today after they were born, unless they had already died in her womb. She was in shock and this did not appear to faze her, but she at least registered it. Now she was on emotional overload, with confusion, mixed sadness and relief (now she would be able to finish high school without maternity leave).

I prayed that her daughters could be born alive for baptism. I delivered her first daughter alive. I asked her if she would like the baby to be baptized before she died. "I don't know," she said, "I've been thinking about that. But my mom's Catholic, and she wanted it."

I knew this little daughter had very little time on earth, but I also knew about the validity of sacramental baptism. "Heather, this is your daughter. You must ask for baptism."

After a small pause, Heather said, "all right then. Can we baptize her?"

The nurse had called the chaplain, but sometimes they take forever to come. They don't realize the urgency of the matter and come after reviewing the mother's chart. Often, I think they don't see the difference between baptism and blessing the baby's body. Frequently, they see their job as more of a crisis emotional counselor. So I called for sterile water (and yes, I did say the word "stat").

I asked Heather what the little girl's name was. She had already picked out first and middle names for both daughters. The nurse handed me a bottle of sterile water. I poured a little water into the bottle cap, mentally making sure I knew the words to say for a conditional baptism, in the case that the baby showed no signs of life by the time I turned around. I touched the baby and noticed that she recoiled, so I baptized her with the formula for living people. Shortly thereafter, the second daughter was born, and I baptized her as well. (Between baptisms, Heather's high school friends came to visit and I sent them packing to the waiting room.)

The chaplain arrived after everything was over. I pronounced Heather's daughters dead that day and filled out two birth certificates and two death certificates. But I know there were two saints praying for their young mother. I prayed to them immediately after their deaths, and I still pray to them every once in a while. I have not seen or heard from Heather since I discharged her postpartum day two. But in a tiny way, these are my spiritual daughters, so I talk with them to keep in touch with their other mother.

There are two saints praying for Heather. Strangely, I am very hopeful for her now.