Into the Deep

How I lost half a year of my life, even though I lived it

This newsletter has been quiet for some time, and while I have every excuse in the world — I have three toddlers, a new house, two cats, and suffered a bout of viral pinkeye which is, quite frankly, the type of disease they should use to torture information out of people — it’s mostly because I, for a while, lost the ability to write.

Not the desire, mind you. The ability.

Back in December, as many of you may know, I suffered a ruptured ectopic pregnancy, which looks really clinical when I write it — almost meaningless — but remains one of the worst experiences of my life. Except, at the time, I didn’t really experience it.

This is about to get heavy, fair warning. I’ll put a photo here of adorable children so that you’re able to cleanse and click away.

Don’t get me wrong, I remember the ordeal in great detail. I found out I was pregnant after going to the emergency room for what I thought was a ruptured ovarian cyst. The HcG numbers weren’t great — reading them having become a familiar practice during eight years of infertility and I knew better than the doctor I’d been randomly assigned to that it wasn’t progressing. — and I wasn’t surprised when the Monday before Thanksgiving, I miscarried. Or, thought I miscarried. I was surprised, however, when just two weeks later, I was floored by pain so bad, I could barely move from the bathroom floor; I laid so still, apparently, that my cat was keeping a watchful eye on me, probably so that he’d be able to eat me when I finally died. According to him. I had no plans of that nature.

I called the nurse line, who scheduled me for an ultrasound, which seemed like a difficult task for the tech, who barely spoke to me the entire appointment other than to chastise me for not getting an ultrasound sooner (I miscarried before six weeks, which is when they normally schedule you!), ask shockingly personal questions without warning or charity about what I’d just endured, and to suggest, at the end, that I “probably had a ruptured ovarian cyst” but she couldn’t know for sure because she “couldn’t see anything.”

Look, I’m no expert, but I did have dozens upon dozens of ultrasounds while undergoing fertility treatments and I’m pretty sure you can see the ovary, ovarian cysts, and other assorted reproductive ephemera pretty clearly, particularly on a top-of-the-line machine like the one she was using, but hey. I was satisfied to know the worst was behind me.

That was Friday. Sunday night, I felt suspiciously strange. Pain again. This time, though, it radiated into my chest, like heartburn. I went to bed, slept little more than an hour at a time until 2am, when I thought, I might try to use the bathroom, in case that might relieve the issue. On the way, I passed out. I woke up when I hit the floor.

And then — and this is key — I shook it off. Nothing’s wrong. Just stood up too fast. Back to bed.

That’s the beginning of six months of what I now call “a lost time.” The pain only got worse. At some point, it began radiating into my shoulder, which I knew indicated internal bleeding from all of the WebMD I’d consumed in earlier pregnancies. But I’d already had a miscarriage! At 6:30, I got up, struggled through a shower, got dressed, did a meeting in my office, then hobbled downstairs for a second meeting while my now-awake kids watched “Paw Patrol.” The entire time, I remained in pain, but convinced it would probably go away. I’d had Tex-Mex for dinner, and it was kind of a sketchy place, and I was suffering from food poisoning, probably.

The meeting ended and I stood up, and whatever pain had been radiating, exploded full force into my chest cavity, crowding my heart and lungs and making it impossible to breathe. My heart felt like it was slowing, everything began to take on a vignette sort of tinge, like an old photograph, as my eyesight narrowed to a pinpoint. I made it to the sofa and screamed for my husband. It wasn’t food poisoning; here I was, 40 years old, and about to die of a heart attack on my sofa, without my hair washed, and while the “Paw Patrol” theme music played in the background.

He had the presence of mind to call a sainted neighbor, who sent a pair of teens over immediately, while he took me to the emergency room. By the time I got there, I’d recovered enough to feel badly about missing work, and I joked in triage about bad refried beans, even though the triage nurses were confused by EKG readings. I told them about my miscarriage in passing in case it was relevant; the attending physician agreed with me that I’d had some bad food, and they sent me to the ambulatory clinic.

I stayed there for six hours. I wasn’t important, and I didn’t feel I had a reason to be. The pain never let up, but they’d get to me eventually, and they’d stationed me near the hallway in a trauma-one facility, which I knew from watching Chicago Med meant that the people I saw fly by on gurneys were near death. Car accidents. Gunshot wounds. Homeless people with frostbite and burns. Women in labor. They did some bloodwork, unhurriedly, and sent me for a CT scan, in case I’d collected a blood clot in my lungs or upper airway from the miscarriage — a concern voiced late in the day by a med student they were given the option to follow through on. I was proud of them. I’m not a med student, but I’m impressed when people speak up in class.

That’s also when it went left.

And I mean left.

All day, I’d been sitting with the mildly ill and irritated, some of whom became increasingly dramatic about their minor injuries. We were stuck together, bonding over Hallmark Christmas movies. The movies weren’t bad. One was called “Feast of the Seven Fishes,” and I remember it pretty clearly because it took all of my focus off my burning chest cavity. It wasn’t great. But it wasn’t bad. It involved Italians.

I was finally called into an exam room, but a private one. Something was wrong, the nurse said. My CT scan showed fluid in my abdomen, was I sure I’d miscarried? Yes, I said. Did I pass tissue? I wasn’t completely sure, because I’d had to travel the day everything happened, and I wasn’t paying a lot of attention to things, given that I was probably passing a baby into a public toilet at a highway rest stop, and I simply didn’t want to know about it. It felt more dignified that way, as if I was just losing the baby into the ether. But no, it wasn’t like the last time I’d miscarried. That had been an experience. I knew what was happening, I felt it, I held it. But this one was earlier, I explained, doomed from the beginning. Probably wasn’t much to pass.

Concerned, she brought in the intern, the OBGYN resident, the charge nurse in the ER, and a preceptor, which may, at that point, have clued me in that I wasn’t mildly ill. But I was excited to speak to people after six hours of silence, and I cracked jokes. I waved off apologies over how long I was made to wait. I understood, I told them. I wasn’t important. I had food poisoning.

At that point, they performed an exam that brought me, physically, to tears, and suggested that I needed more bloodwork, because my count had been going down, progressively, all day. I was t, and it wasn’t getting better. I was going to be kept overnight for observation, because the fluid was concerning and I could be bleeding — but it also could be resolving, they assured me. Maybe I had another cyst. At any rate, I was grateful for the bed and more comfortable clothes, which they’d arranged because I’d somehow selected high-waisted jeans for my trip to the ER for piercing stomach pain, along with an ultrasound, because it was suddenly clear the previous one I’d had was below standards.

I called my mom and my husband and asked for a phone charger. As far as I was concerned, now that I was completely disassociating, it was a nice break. Every time they asked if I was okay staying overnight, I pretended it was a hotel stay. A five star. My own bathroom. No kids. Totally fine.

It wasn’t fine.

Unbeknownst to me, I was starring in my very own version of Nashville Med, were it a television show scripted and filmed in Vanderbilt University’s emergency department. They were confused. I wasn’t acting sick, or like I was in debilitating pain. I wasn’t crying, pounding on the floor like the woman next to me in the ambulatory clinic who’d sprained her ankle on a curb. But the black and white photos showed a belly full of blood, and it wasn’t going away.

Fortunately for them, I was about to script my own way into their medical drama. Because it would become too hard to ignore. For everyone.

The preceptor got me dressed and was walking with me to my overnight room when my bloodwork results came back. Actually, they came back in front of me. The OBGYN resident was standing at the lab door, which was between the exam room and the overnight area, and the technician handed her the paper right as I was passing. I would have thought nothing of it, but I don’t think doctors’ faces go white all that often. She looked at me. She looked back at the paper. She looked at me.

And then everyone — and I mean everyone — turned to look at me.

A whole trauma one ER. Just staring at me.

My blood count, it turns on, had dropped. Much lower. Transfusion low. All signs pointed to a ruptured ectopic, but an ultrasound to check would take too long. I’d bleed out. Surgery. Probably. And now.

From there, it’s mostly a blur. I remember getting to the room, asking my new nurse if it was okay that she was wearing a University of Tennessee surgical cap with her Vanderbilt scrubs (it was fine, but she gets a lot of crap, she said). Four women doctors appeared at my bed-side and I am fairly sure I had a calm conversation with them, like I was just part of the team, and we decided definitively on emergency surgery together. No big deal.

They asked me to sign paperwork about fetal remains. My husband was suddenly there, and then they asked if I was religious because if I was, they could call a priest. They moved me up to med-surge and he met me there. They’d gotten him in such a hurry that he was out of uniform. No stole, but he heard my confession anyway. He had a Boston accent and called himself Fr. Tony, which reminded me of my beloved fertility doctor who’d passed just weeks before.

That was my last thought. I’m sure I was awake for some time after, but the next thing I remember is waking up and being told it was an ectopic pregnancy that had ruptured in my abdomen, on my right side. They’d taken the baby and my right fallopian tube. I was okay, but I had three IVs, and I was going to stay overnight.

I didn’t cry that night. At all. I worried about calling the nurse too often, mostly. And I put something on Twitter, but I don’t truly remember what. I had a morphine button I didn’t use. When they discharged me, the discharge nurse was extremely nice and gave me a belly binder because my jeans wouldn’t button and I would have to spend at least 30 seconds in public.

That’s where it stops. All of it. Five days later, I cooked Christmas dinner. A big one. I wrapped presents and made cookies and decorated a gingerbread Target store that I’d gotten on sale, because I thought it would make Christmas magical for my kids, even if I couldn’t process or effectively integrate myself into reality. I didn’t cry until Christmas Eve, and then only because my kids were out of control at Christmas Eve Mass and my husband had left me to care for them while he parked the car, and the task finally overwhelmed me. I shuffled everyone out but shuffled right back in when we’d all calmed down. I took photos.

I took the week off, but my immediate boss seemed unsympathetic, and I guilted myself into returning to work the week after. If I needed more time, I should talk to HR, she said. I didn’t know who to speak to or how, so I never did.

And that’s how I knew I wasn’t okay:

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