By Dr. Andrea Witlin
If I had a chance to live illness free for 72 hours, I would return to the “other side of the knife” and begin my first 24 hours as the attending high-risk obstetrician covering labor and delivery. The unit would be an imaginary conglomeration of the busy community hospital and university medical center where I used to work and considered my home away from home. Over the last 15 years, I have reinvented my lifestyle to compensate for those activities that my disease precludes, but not this one. In fact, my previously incipient disease had abruptly resurfaced with a vengeance so severe that the end of my career occurred precipitously like a pro athlete felled by a sudden career-ending injury. I was never allowed a proper and final goodbye. So, I continue to dream of and long for that last farewell.
Therefore, I would don my ill-fitting blue scrubs and unflattering cap and relish the capricious spray of blood and amniotic fluid that would likely occur. Like “old times,” I would be lucky to manage a snack on the run, but for sure, I’d throw caution to the wind and disregard my numerous dietary restrictions and medications. So, this time, my disheveled, gaunt appearance from my intervening years of chronic illness would simply blend in with the surroundings.
One more time, I would experience the palpable joy on the faces of the new parents as I placed their bundle of joy on their mother’s chest and helped the proud father cut the cord. I would pretend that we didn’t know the baby’s gender until we could see the indoor or outdoor plumbing. I would experience the exhilaration of saving a baby from fetal distress or a mom from sudden, life-threatening hemorrhage with a “crash” C-section. Lastly, I would hover over a sick mom teetering on the brink while I tweaked her IV infusions and ventilator settings in the obstetric ICU.
I would spend my next 24 hours in the high-risk obstetric clinic jam-packed with consultations for women dealing with serious medical diseases complicating their otherwise joyful pregnancies and performing ultrasounds to evaluate abnormal fetal development. Despite my onerous schedule, I would have infinite time for every question and concern. But, more importantly, I would be able to draw upon, commiserate with and share the nuances that I have learned from my intervening years of dealing with disease and its adversity. You see, I always regarded myself as an intuitive, compassionate, knowledgeable and skilled physician, but once I became ill, I realized how much more there was to understanding a patient’s life and disease than the obvious textbook descriptions. So I always felt guilty about never being able to share my newfound knowledge “from the other side” with my patients and their families.
Last, at the end of my long day in clinic, I would jet off to some major university medical center to give “Grand Rounds” the following morning, but it would not be my usual topic of preeclampsia or hypertension in pregnancy. Rather, I would speak about my peculiar combination of primary immunodeficiency and autoimmune diseases at a different, unfamiliar venue: Medical Grand Rounds. But, I would not deliver the obvious textbook presentation. I would let the attendees know how I had suffered waiting to be diagnosed, how my body had literally rotted away under their watchful eyes, and what their medications and tests did and continue to do to me, the patient. I would also describe how my diseases and their respective treatments distorted my husband’s life plans and dreams. I would explain the incredulity of how exhilarating it is to still enjoy life to its fullest. So, finally after 15 years, I would contentedly hang up my scrubs and ultrasound transducer that one last time and return to navigating the daily “minefield” of life with chronic disease and return to the “other side of the knife.”