thoughts from today

I began my day at midnight last night, talking for hours with a young mother who came to our hospital by bus, in advanced labor, and cried throughout the delivery because she had decided not to keep her baby. She already had two very young kids, lived with her parents, worked at a fast food restaurant, and felt that if there was any more pressure put on her, her life would fall apart. Her husband was in jail and didn't know about the baby, though it was his. She was substantially younger than me, with little exposure outside of her small town life, but had a surprisingly solid understanding of where she was in her life. She wanted to go to school and become a medical assistant. Her own mother, who was a custodian at the local school, brought the only real income to the family, and my patient wanted to take some of that burden off of her as soon as she could. She was absolutely convinced that the best thing for her, for her two kids, and for her new baby was to give the baby up for adoption. The nurses couldn't believe that she could let such a beautiful baby go. Her parents and siblings tried to pressure her to keep it. After talking to her for several hours and trying to understand exactly what she was thinking and where she was coming from, however, I was impressed with the strength, realism and determination she had to make this decision. I don't know whether I could have done it if I were her, but then, I don't even know if I could have accomplished as much as she had with as little as she started with. It was an exhaustive conversation. I went to sleep for a few hours - surprisingly, there were no other deliveries that night - and woke up the next morning to do rounds. It was my last day at the hospital, and in my haste to leave and say goodbye to the staff, I forgot to say goodbye to her.

I got home to hear about the Virgina Tech tragedy. And then, to an email from our Dean announcing the tragic death of another medical student from our school. The second one this month. Another extraordinary person at the prime of her life who had contributed a lot to her classmates and patients, and was already becoming a great doctor. She would have graduated this June.

Some days can be remarkably sobering. Remembering that these tragedies are just falling leaves in a forest that is ablaze in other parts of the world doesn't make it any better. It just makes me wonder in amazement -and some concern- that as human beings, the best thing we can do for each other is to just keep going forward.