Progress Notes

All I could do

Chaya Murali
Chaya Murali

By Chaya Murali, MS4

They were an extremely cute couple. She had short brown hair and a sweet smile. His eyes were strikingly green, and he bore an uncanny resemblance to a certain well-known rapper.

When we walked into the room, my preceptor playfully asked, “Back so soon?” She pointed to her husband and accused with a smile, “Ask him!” As my preceptor took the history, I slowly gathered that they were parents of an eighteen-month-old, and she had received a positive home pregnancy test a month ago.

It was unexpected, and a little daunting, but they were excited. I pulled out my pregnancy wheel and dialed in the information—if the dates were correct, she was a little over 8 weeks along. We’d definitely be able to see a fetus on the ultrasound.

“Well, let’s ultrasound you and see how many babies you’ve got in there!” my preceptor joked. At that, both husband and wife widened their eyes and smiled. The father, it turned out, was a twin himself. “I’ll have to call my brother!” he said.

Of course, I knew that couples are only more likely to have twins if mom was a fraternal twin, but that didn’t matter. The energy in the room was electric and hopeful as my preceptor applied the ultrasound probe and I switched off the lights. He shifted the probe slightly, and things came into focus on the screen. We saw a sac…and nothing inside. One more shift of the probe, and another, smaller sac came into focus. It was empty, too.

The energy I felt shifted immediately, positive to negative, excited to deflated. I didn’t know what to do. Was my preceptor going to say something right then? Was he going to wait till after he had put away the ultrasound machine? What if my face betrayed what I knew already, but the couple was not yet aware of, that she had had a twin gestation, and that both fetuses were no more?

My preceptor told them. “It looks like you’ve had a miscarriage,” he said, and he went on to explain that she was pregnant before, but not anymore. Their faces fell. I expected tears, but none appeared. Both of them seemed numb. It was an unplanned and unexpected pregnancy, as my preceptor pointed out. Sometimes a miscarriage isn’t quite as painful in those situations.

Her pregnancy had miscarried before the fetuses had even developed, meaning it had happened very early. She still had the gestational tissue inside her uterus. She would eventually pass it on her own, my preceptor explained, but many women opt to have a procedure to speed the process. This conversation happened in my preceptor’s office, where he sat behind his desk, across from this cute couple. I watched from a chair off to the side.

When he finished his explanation, husband and wife looked into each other’s eyes. “Do you want to talk about it?” he asked, “Or do you know what you want to do?”

And she turned to my preceptor and, with tears in her eyes for the first time, she told him she wanted the procedure. “I think it will be easier for me,” she said, choking up.

I looked around frantically for a box of tissues, because I wanted to offer comfort, but I knew that was the only way I could do so. There wasn’t one in sight. Once we had settled on a date for the procedure, my preceptor and I walked out of the room so that the couple could talk to his secretary for scheduling. As we exited, I saw him lay his hand on her back protectively. It was the first time I saw them touch.

Back at the nurses’ station, I slipped into an empty exam room, where I finally found a box of tissues. I walked back into my preceptor’s office timidly, where I found husband and wife dry-eyed but silent. Placing the box on the desk in front of them, I said, “Just in case.” They looked at me and said, “Thank you.”

“It’s nothing,” I replied. And it was.

2 thoughts on “All I could do

    • Thanks for the link, Alex! I had just written down something I remember learning while studying for my OB/gyn shelf, but I’m sure I didn’t learn all the facts, as this article attests.


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