Finding the Poker face


Fifteen ultrasound scans through in the first two hours of the day, I was just signing off the report when the sister walked in.

Sister: “Doctor, there is an emergency ultrasound from the labor room”
Me: “Shift the patient in next”

The patient walked in. She seemed familiar. I put out the question I ask all the people

Me: “Did you get a scan done here before?”
Patient: “Yes, about a month back.”

When a patient usually turns up in the labor room instead of the O.P, there is always something worrisome.  (either to the patient or the treating physician)

Me: “What brings you here today?”
Patient: “I am not appreciating much movements of my baby. They sent me from the labor room to see the fetal heart.”

Once she was comfortable on the scanning bed, I went through my customary routine feeding in the patient details onto the ultrasound machine. I wasted no time and used my probe to search for the fetal heart. The heart was not flickering. I turned on other setting to see if there is blood flow in any of the vessels of the fetus. I couldn’t find anyway. The more I was exploring the fetus for any form of physical evidence of life within, the more distraught my face became.

I have been confronted with this situation before but not the very same. She was over 6 months into her pregnancy and I was put in a position to have to declare whether the baby is alive or not. She was familiar with a lub dubb lub dubb heart sounds she had previously heard of the baby. She saw me desperately searching for one. She wished.. and so did I that it would reappear.

After 15minutes of scanning, I took the probe off her abdomen. Her voice was broken as she queried1

Patient: “Doctorr… it’s not there? (Tears welling up)
Me: I nodded. (My eyes had already answered her question)

She took a deep breath and mustered courage to clean herself up and sit back onto the wheelchair. I wish I am never put in a similar situation ever again.

Breaking bad news is as it is a difficult job for doctors. But when it comes to in utero babies, we need a poker face and a strong heart as there is no relation as pure and strong as that between a mother and her child.

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