One eye is open as they velcro her legs into the stirrups. I ask the anesthesiologist why that is. He says he thinks it’s because she’s exophthalmic, the medical way of saying she has bulging eyes. Her hips writhe as they insert the long, slender, metal dilators to force open her cervix. They are reflex movements, they say, she won’t remember it, she isn’t in pain. She lifts her pelvis up and off the table and fights the stirrups, trying to quiet an invisible horse she is riding into the air.
They remove the bottom half of her hospital bed, and hydraulically raise the remaining half so the doctor is positioned squarely between her legs, vagina at eye level. The medical student tucks a hanging plastic pouch under the woman’s back to catch whatever may fall. She is ten weeks along, so at this point, it will mostly be blood.
The procedure takes five minutes. Once her cervix is dilated, which is the most time-consuming part, they are able to insert a tiny, sterile vacuum that sucks out the contents of her uterus. The resident who does the procedure spins the aspirator tip around and around to make sure they have the placenta, no matter where it has chosen to lie. The contents of the aspirator are sucked along a long, clear tube into a small, clear cup that sits on top of the automated vacuum. Once the procedure is over, the doctor tips over the cup’s contents onto the table with the tools to check for anything pathological and to make sure they haven’t left anything inside her womb. The doctor finds a shimmering placental sac and a few clumps of cells — it all appears normal.
The anesthesiologist rolls the patient to the recovering unit, where a baby with EEG stickers all over him cries in the bed next door. His parents, Orthodox Jews, take turns consoling him. The wife has shaved off all of her hair and wears a perfect wig. The father is reading scripture, and his payot gently sway as he rocks and whispers under his breath.
The anesthesiologist tells her to wake up, and says her name over and over. He jostles her shoulder, but she doesn’t move. He gives up and leaves. Soon, a nurse comes by and takes up the job of saying her name over and over. The nurse shakes her leg, then her arm. She tells her to wake up, wake up so you can take your pills. But she sleeps.
Now there are two babies crying, the Jewish one in the bed to her left, and now a new one in the bed to her right.
Finally, she wakes.
The nurses come by to push their pills. I can’t swallow pills, she tells them, which sends the whole of the nursing staff into a twitter. Is there a liquid form of her antibiotic? No! They consult her again: you can’t take any size pill? She shakes her head no. Could they crush it into jello, one suggests. But it is a capsule, another cries, you can’t crush a capsule! There’s a consult with the pharmacist, who allows them to empty the capsule into food or drink, but warns it will be bitter.
A nurse feeds her a red gelatinous mess dotted with white specks on a wooden tongue depressor. When the patient leaves the first bite on her tongue too long, the nurse scolds her, tells her to be good and swallow. Another tongue depressor lies already in wait. She swallows, another spoonful follows. Then another. The nurse saves one last antibiotic-less lump of jello for her at the end.
The nurse tells her to drink the tiny plastic cup of apple juice and eat the crackers she leaves by her bed. She says she isn’t hungry. They tell her to go to sleep, close her eyes, she will feel better. But she isn’t sleepy anymore, the anesthesia has worn off. They page her cousin, who is in the waiting room a few floors down, to come get her. Her cousin will drive her home because she hasn’t told her mom.
She was supposed to begin her GED classes, but her termination had been scheduled this week. So she will start next week. I only hope she does.
The next week I get an email from the adolescent health center. They need someone to tutor a 20-year-old who is working towards her GED. The material isn’t hard at all, the email reads, very elementary math, simple science. Just a few hours for a few weeks — the student is not too far behind. And it’s her.
Columnist
Icahn School of Medicine at Mount Sinai
Katie is a Class of 2016 student at the Icahn School of Medicine at Mount Sinai, in New York City.
Pleural Space
Pleural Space looks at the experiential curriculum of medical school, the many things that are taught and learned that aren’t listed in a syllabus.