A Theatre not Staffed to attend 24hr a day Emergencies
About 5 weeks after Liam died my obstetrician obtained a copy of my notes and rang me to ask me to come in and discuss them with him, I told him that I knew exactly what was in my notes and that I didn’t need to come in, so unless he was going to tell me something that I didn’t know, or something that wasn’t in the notes then I already knew what was written there. I was also very angry at this stage with my obstetrician, I had trusted him to deliver Liam safely and he had failed to do that. However after putting the phone down I decided that I needed to be the bigger person and face him to see what he had to say, so I called his secretary back and told her that he had just called me to ask me to come in and I had declined however I had thought about it and was happy to meet with him, could she tell me what time to come and could she tell him that I was coming. My biggest fear about seeing him was that my anger would get the better of me, and in a situation like this one, my anger comes out in a way that I can’t talk, everything that I want to say goes over and over in my head however usually when I am so angry I find it very hard to vocalise all these things. I had a chat to a friend of mine Heidi and she offered to come along to the doctor with me, she said that if I wanted her to she would come in and be a voice for me, or if I wanted she could wait in the waiting room and look after Alethea for me, and I could call her in at any stage should I need her, which was a very gracious thing for her to offer, however I declined both of these offers and decided to go with just Alethea and I, I thought that if I took Alethea it would force me to do 2 things: firstly not to break down because she would be with me and she didn’t like seeing me upset and secondly her being with me would ease my temper because I would have to talk as I would need to tell Alethea what to do, for example sit on the seat, be a good girl etc. so it would force me out of my cocoon and make me converse with someone that I really didn’t want to.
On the way in the car, Alethea asked me where we were going and I told her and she started to fret, ‘No not there mummy, not to that Dr’ and I asked her why and she told me ‘because he made your tummy very sore and he made baby Liam have to stay in the hospital, all the other kids get to bring their baby’s home and mine had to stay at the hospital, I don’t want to see him’ I am not sure how she came to this conclusion, Ryan and I had been very careful about what we had said around her as we didn’t want her to fear any doctor or hospital, but evidently we hadn’t been as careful as we should have been and she had picked up on our dislike for him and our view that he had contributed to Liam not being here today. I told Alethea that yes the doctor had made mummy’s tummy a little sore, but it was a lot better now and that it wasn’t his fault that we had to leave baby Liam in hospital, that it had just happened and we were all very sad about it…..still she didn’t want to go.
On arrival to the practice, again there were pregnant ladies waiting to be seen. I looked at them and wanted to shake them and say ‘Don’t use this doctor, he didn’t bring my baby safely into this world’ but of course I just sat there, knowing all too well that the delivery of their baby’s would probably occur without a hitch and that to say something as callous as this a few weeks before their baby was to come would lead to undue worry on their part. When he finally called me in he told me how surprised he was to see me so soon after just talking to me on the phone and I was a little taken aback as I had asked the secretary to inform him that I was coming in.
We sat down and it was clear that he wanted me to direct where the conversation was going to go, however I didn’t want to do that, I wanted to see what he had to say. He looked at me for a long time then said ‘What would you like to talk about, do you just want to go through the notes or do you have any questions for me’ and I looked at him and said yes that I wanted to know what took so long for him to get Liam out. He turned a few pages into the notes to where he had written and said ‘I have written in the notes at 2am saying that you were to have an emergency C section, Liam was born at 244am which is not too much over the 30 mins for a category 1 C section, and while it isn’t ideal it was as fast as we could do it on that night, theatres were not even on site when we decided to do the operation and I had to call them in’ So that was news to me, this hospital which is a VERY large maternity hospital, did not have theatres on site when I needed them, I’m no Einstein but I believe that babies are born at all hours of the day not just between 7am and 8pm, why with such a large maternity unit did they not have theatres on site 24 hours a day, it had NEVER occurred to me that this would be the case. On my admission meeting all the way back in January the staff had never told me that if my baby was born at this hospital after around 8pm (I’m not entirely sure of theatres closing time but I believe it is somewhere between 7pm and 9pm) that there would be no staff in theatres should my baby need to be delivered my emergency C section and that they would have to be called in which could take up to half an hour, how could they have failed to communicate that to me? I think that is a pivotal point, when looking for a maternity hospital to have your baby at, and had I been told this back in January I certainly would have looked at having my baby at another hospital that did have 24hr theatre coverage.
After taking this new piece of information in I regathered my thoughts and redirected him to the notes stating that yes his entry was made at 2am, but this wasn’t the timeline that I had in my head and also if he turned to the next page the midwife had her own timeline and at 130am she had written that he was preparing me for theatre, so while he didn’t write in the notes till 2am the nurse had clearly showed that the decision had been made at least 30mins prior to him first writing in the notes, my baby should have been born by 2am (from the notes point of view) the time that he was first writing in the notes at. He turned the page and read the entry that I was talking about but dismissed it quickly and that was that?! Again he reiterated that he had gone as quickly as he could. I asked him why we did an epidural instead of a general and he said that that was the anaesthetist’s choice, that because theatre was not yet on site they believed that doing this would save some time. Again he told me that he had to call theatres in and that we were waiting on them to start the operation, and they were the cause of the delay.
I went home and called Ryan to discuss the new findings, he was as astonished as I was to learn that this very large maternity hospital did not staff theatres 24hrs a day. For me knowing this new piece of information was a little better, I felt like now Liam’s death was due to an institution not acting with all due care rather than my doctor or the midwife or anyone else, and that was comforting because I could now regain my faith in my obstetrician, someone that I had been with for 4 and a half years and I could blame a large organisation, I actually liked believing this story, however whenever I discussed it with family and friends their question was still ‘but where was your obstetrician during all of this, wasn’t he pulling his hair out that things weren’t going quickly, why did he not direct traffic, why did he let it take so long’ and I kept saying to them that it was because the hospital did not have a 24hr theatre that we had to wait for the people who staffed theatre to arrive and set up before he could do the operation, that his hands were tied that he went as fast as he could that the institution failed both me and him.
This was also the week that the hospital called me to tell me that they were going to conduct a ‘special’ kind of investigation known as a ‘Route Cause Analysis’ (RCA) which I was very happy with, they told me that the RCA would take around 5 weeks to complete (which I was a little shocked at because normally they take longer than that) but to please bare them as they were conducting a very intensive investigation but they would get some answers to my questions. I was happy with this suggestion because generally speaking if you don’t know what an RCA is it looks at system failures, it doesn’t look to blame anyone, rather work out where things went wrong and try to strengthen those things so that the likelihood of something like this happening to anyone else was reduced dramatically, I was happy because it meant that no individual person would be getting into trouble for Liam’s death, that the institution would be strengthened and that Liam’s death would help bring about changes so that this could never happen to someone else, and that made me very proud of Liam, no it didn’t bring him back, but I was proud that he was going to help other babies.
When looking back at how Ryan and I were ‘coping’ at this time, I think that we were doing very well, we were out and about, enjoying time with Alethea (I am forever grateful for my little girl, she has this ability to make me laugh everyday, she has the cheekiest of smiles and a great sense of humour and she really made each day bearable, she forced me to be a better mum and to have fun), we would take her scootering (which was now her favourite thing to do) take her to the beach, and the occasional movie and as a little family of 3 we were moving forward and just starting to learn what life was all about again. However what my friends and family probably didn’t realise at the time is that although it was around 5-6 weeks since Liam had passed, EVERYDAY something would happen that would bring home the reality that my baby was dead, everyday there was something right in your face, for example one day his death certificate came and then around a week or 2 later his birth certificate came, there were lots of forms to fill in for the government, we had to decide on wording to put on Liam’s plaque and after that the proof of Liam’s plaque came through and then the message came that his plaque was actually mounted. Our Twinkle Toes (hand and foot sculptures) were nearly ready and we had to choose a frame and colouring for them, our Smallprint hand and fingerprint jewellery arrived and yes some of these things were lovely mementos but lots of them weren’t, who receives a death certificate for their baby, that was a horrible day, and who receives a birth certificate after a death certificate? When a baby dies your world is turned upside down, nothing happens how it is suppose to happen, and so while we were taking 2 steps forward we were often forced back a step or 2 at the same time.
It was also at this time that I decided to start my blog. I dropped Alethea at daycare in the morning, came home to do the housework (being a Wednesday it was cleaning day, and we all know in my house rain, hail or shine it will be cleaned!) and thought about writing down what we had gone through. A friend of mine Roslyn had started a blog about a year ago, but due to having her little baby boy had not been very active for some time, until this week when she started to post again, so I emailed her and asked her how to go about starting a blog, telling her that I wanted people to know what it was like to lose a baby and I wanted to eventually, somehow, help another unfortunate couple in our situation see that there was light at the end of the tunnel, that although they were in the depths of despair that happiness could be achieved again, Ryan and I weren’t there yet, but we could see the sun rising and we were heading in the right direction, and I knew in my heart that we would be happy again, so I thought that if we wrote down our journey that people would see our progression, and know that it could be attained. I asked Roslyn whether if people ‘Googled’ my blog or baby death would they be able to find it (at this stage I really did know nothing about blogs) and she told me probably not that I would require a large amount of traffic to come up on a search engine. I was disheartened by this fact but thought that I would try writing a blog anyway, because even if only 1 or 2 people read it, that might be all it took to help someone and then it would be worth it. I sat and wrote my very first post on Microsoft Word, everything was so vivid in my mind that it only took about an 45mins to write and I quickly made a WordPress site up and then pressed post and it was done, from the time I thought about it, to the time it was up was about 3 hours, and after I had completed it I felt like a huge weight had been lifted from my shoulders. I wanted my friends to know what had happened to Liam, I had received a few comments from innocent friends trying to decipher what had gone wrong, and they had asked things like ‘Did you get to hospital on time’ or ‘were you trying for a home birth’ things like that, I wanted it out there so that everyone knew that I had done NOTHING to jeopardise my baby’s life, I had done my job by getting to the hospital, from then it was in the experts hands and I had done nothing to cause his death (Yes by this time I actually believed that I had done nothing to cause his death, it had taken a long time to realise this but know I knew it) I had so much to say that I think I wrote 3 posts in the first week, and it was then that I realised that writing this all down, although therapeutic for me was also mentally and emotionally exhausting, so I told myself that I would only post around once a week.
That Friday night the girls from my mothers group decided it was time to do a mummy’s night out at Manly Wine bar. It was lovely because I think they were trying to cheer me up, and I really enjoyed being out, I did find it quite hard to stay focussed on the conversation, and I think I probably seemed quite rude at the time because looking back I know that my mind was wondering off on its own little tangents and my train of thought wasn’t always coherent, but I enjoyed being out, in its own way it felt a little surreal to be sitting having a glass of wine and a few laughs, but it was a good step forward and it made my next experience of going out easier and then the one after that even more easier and even more enjoyable. That Friday afternoon I had posted my second ever post on my blog and while we were at Manly wine bar I checked the internet on my phone to see if anyone had read it, and to my surprise in the couple of hours that it had been posted thousands of people had read it, I sat there in disbelief, not understanding where all these people had come from and why these people would want to read about our story, it was then that I realised that I could never take my story back, it was out there for the world to see, all our raw emotions, did I want everyone to know this, I really didn’t know, were people reading our story only to feel more fortunate about their own lives or were people reading it because they wanted an understanding, I really didn’t know and I wasn’t sure whether I was doing the right thing. When I got home I discussed my fears of our blog with Ryan and he understood where I was coming from but said to me ‘Who cares why people are reading it, your purpose for writing it was to create an understanding and hopefully help someone, maybe if you keep going one day it will help one person, and then it will be worth it’ he always knows the right thing to say, he supports me in everything that I do, and again he had supported me, I had written about all his emotions as well, and being a man this is not something they usually like on public display yet he was happy for this to happen, if he was happy then so was I!
Sometimes in life people do amazing things, they don’t have to be much but they make ALL the difference in your everyday life. Ryan and I have amazing neighbours, our neighbours Ron and Kathy did, and still do so much for us everyday. When we got home from hospital, Ron had mowed our lawns for us, and had done the edges for us, and to this day he is STILL doing them for us, every week I come out and he has our garden looking beautiful, I have told him over and over that we are now capable of doing this, but he still does it saying that he doesn’t want me to exert myself and that Ryan works so hard all week he hates to see him spending his time mowing the lawns when he has his family to be with. Ron also puts out our bins for us each week, at first it was because he didn’t want me to lift anything heavy, but now he just does it to help out, I have to try to remember before him and get them out! Kathy is also fantastic she would come over to keep me company when she knew that Ryan wasn’t here, she has let me talk things over and over with her, and she has provided Ryan and I with some of the most amazing food, always down talking her cooking ability telling me that she doesn’t think it will taste any good, yet each time she cooks it is sensational. These 2 people helped Ryan and I immensely after Liam’s death, however they made themselves very scarce for the first few weeks, quietly working and doing things for us in the background not wanting to intrude and it was about now that they finally had the courage to come in and talk to us. They brought us a box of chocolates and told us that they were thinking of us all the time and it was hard for them knowing that we were inside our house grieving and they were also grieving the loss of Liam. They told us that when Ron first got our text the day that Liam had passed that he only read the first part and he excitedly told Kathy we had a baby boy, and then he read the second part and he really didn’t know how to break the news to Kathy, they were devastated for us. They were also there when my parents came over to look after Alethea the morning that Liam died, they saw how distraught my parents were, and Ron kept saying to me ‘Your poor dad, seeing him…I have never seen anyone look the way he looked that day, he was beside himself with grief’ Ron and Kathy’s first visit to our house after Liam died was very brief, they didn’t want to upset us, but wanted us to know that they were grieving with us and thinking of us all the time, we are very lucky to live next to such wonderful people who have helped out so much and lightened our load lots.
This was also the week that I met Deb De Wilde, one of the most gentle and caring person that I have come across, however as I have talked a lot above I will leave our meeting till next week!
- Posted in: The First Weeks