Emergency Room and OB Triage

OB triage

A View of the Chicago skyline from our 5th floor OB Triage room at Illinois Masonic

“Are you feeling the urge to push?”


At the time, this dialogue felt urgent – in few more hours of nothing much happening, this would feel almost comical that he had asked us.

The scared-looking Physicians’ Assistant immediately produced a wheelchair from behind the desk and made Brooke sit in it.  This was funny too, because we had spent a lot of time in our Bradley Method classes talk about the importance of standing and walking around, as a way to facilitate labor or keep it going.  Right away, it was becoming clear that at the hospital, they had other interests.  Basically, they didn’t want a baby delivered in the Emergency Room lobby, which is fair enough.  But the wheelchair also seemed like something having to do with legal liability.  They didn’t want Brooke walking, because if she did something like slip, we could sue them.  Or something to do with the assumption that Brooke would be in some sort of weakened state and would need assistance.  Or all three.  The anxious premises of a hospital often wrap up legal, emotional and corporate interests into one tightly wound, incoherent package that there’s no time to unravel.

I think a lot of people (me included, prior to this time in my life) imagine childbirth as basically you go to the hospital, they put the pregnant woman in a wheelchair, then they foist her into a bed and put her legs up in stirrups, and then a doctor tells her what to do until the baby gets there.  That’s pretty far from what happened with Brooke, mostly by design, but that’s probably part of what the wheelchair was about.  The same quasi-useless wheelchair showed up when we finally left 3 days later: they insisted that she must leave the hospital in a chair, even though she’d been on her feet probably 30 minutes after the baby was born.

[By the way – I should have said this earlier but the names of many of the hospital employees and others who aren’t close friends have been changed in all of these posts].

So the PA steered us through a maze of anti-riot-type windowless corridors.  Even the very layout of a hospital is, strangely enough, quite often anti-human.  The hallways in Illinois Masonic, fairly typical of hospitals built in the 60’s and 70’s, were like the corridors of the Death Star.  They’re so complicated that about every 50 feet, there’s a new set of signs.  Another comparison: it’s like Venice if there were no canals, you couldn’t see the sky, and everything smelled like hand sanitizer.  True, a newer, bourgier hospital like Northwestern does some work to allay this, having open spaces near all the entrances, wood-panelling and all, but once you get into the bowels of any of those buildings, you find these same confusing narrow walkways with fluorescent lighting and linoleum flooring.

He whisked us to an elevator what felt like 2 miles of hallway later, and delivered us to the 5th floor, “OB Triage.”  It was full to capacity.  When we got there, all the rooms were occupied, but we were the only people in the waiting room.  By the time we got into a room, there were 6 women, in various stages of labor, waiting to get in.  The word around the floor was that the previous night’s odd shift in weather (late-April snow) had triggered some sort of reaction in women late in their terms, or something about a full moon.  Of course, I didn’t know whether there really was a full moon, and the weather thing sounded plausible I suppose.

We were soon moved into what I think is called a “semi-private room.”  Structurally, we were in the same room as another patient, but there was an array of curtains on ceiling-mounted rails giving the illusion of separateness.  Both halves shared one bathroom, closer to our side than theirs.  When I sat down (we’d just talked to a nurse – Paz – she’s the first person who appears on my iPhone notepad list, so I must have started it around this time) I looked out the window.  It was a bit before noon on April 15.  The 5th floor window had a southern view, and the sun was shining brightly over the Chicago skyline, which I could see clearly since this was the only 5-story building in the vicinity of Wellington and Sheffield.  We were 4-5 miles from downtown, so the buildings receded a bit into the distance, but it was a striking scene nevertheless.  This is when posted the first of many, many Facebook pictures (it’s at the start of this blog).  It said something like “view from the triage room!”  It immediately got more likes than pretty much anything else I’d ever posted, any comment, or New York Times article, or blog, no matter how witty.

After at least an hour elapsed, and Paz had brought Brooke lunch (I was on my own, and had to go downstairs by an alternate route, since the elevator we had ridden up was now being service, which was quite anxiety-provoking for a bunch of reasons).  We eventually saw the midwife on call.

This turned out to be one of the more dispiriting experiences we had while there.  It wasn’t crazy new-age Missie, so that was a relief.  Instead, it was a tall, stocky older woman named Anna, with whom we hadn’t yet worked so far.  She was a bit of a grouch, but I will give her this, she certainly had the flaky-liberal detector system working pretty well.

She sized us up with one resigned but authoritative glance as if to say “oh, here we go, natural birth, blah blah blah, well that’s fine and all but now it’s time for you to face reality.”  Then she began, more or less like this:

“With a labor like this, since your contractions aren’t developing, this is how it usually goes.  You’re going to need Pitocin because we’ve got to get the labor started, your water broke almost twelve hours ago now, and you tested positive for Group B strep.  The longer we delay, the higher the risk of infection.  You’ll need Pitocin, and it’ll probably after that turn into an Epidural situation.  I know you’ve got a birth plan that doesn’t include all that, but things don’t always go the way we plan.”

She didn’t sound happy about this; there was a hint of real regret in her voice, but just a hint.  The rest of it was like a mother letting her overly eager children know that we weren’t going to Disney World after all, because as it turns out, there isn’t enough money.  We did our best to ask questions, but we were a little slow on the uptake, because this was disappointing and hard to process.

Brooke somehow had enough presence to ask “will I be able to walk around, or use a shower?”  (things we had been coached to advocate for)

“No, you’re going to be mostly lying down.  Things don’t always go the way we want them to.  The important point is to get the baby here, and keep you and the baby safe.”

We were crestfallen.  It was starting to feel like all we had learned was a complete waste of time.  There would be no calming massages, no shower used to facilitate the baby’s movement, nothing.  We’d just have to let the doctors and nurses do whatever they thought they needed to do, and we’d just be bystanders.  One of us, a bystander in pain, another just a bystander.

She left, and told us we’d have to wait a bit because they were all full downstairs in Labor and Delivery (2nd floor).  Again, the institutional demands of the hospital assumed peremptory significance.  Even though it was allegedly an urgent need for Brooke’s labor to begin because the downstairs was full, we spent another 2-3 hours in Triage.  But this being a hospital, of course, this was a question we never got to ask anybody.  Not Anna, not Paz, not whoever it is that decides who goes in which room.  Nobody.  Even though the clock was supposedly ticking.

I was getting frustrated, and I could tell Brooke was disappointed.  That said, as you’ll see, Brooke is really, really stubborn.  She had come nowhere close to accepting anything Anna had said.  She hadn’t spoken this out loud to me; I don’t think I even knew whether it was true.  I know her pretty well but we’d never been through this together.

The pause here actually gave us time to gather up strength.  Somewhere inside of me, some sort of extrovert switch was thrown.  I realized Brooke wasn’t going to be able to do one of her most common jobs in our marriage, that is, the public relations work.  Whatever the outside world was going to know about the progress of the birth, I was going to have to do it.

So I did.  I developed levels of communication, creating a texting group for immediate relatives first, then a Facebook message thread for our LUSH friends (a group of Brooke’s Seminary fellow alums), then also began Facebook status updates that seemed relevant to the whole Brooke-and-Josh community.  I’m still surprised how easily and readily I adapted to this role.

I also started texting people whose opinions I really trusted and needed to talk with.  I remember texting our friend Annie, since she had told us recently that they had been in a similar water-breaking situation.  And, most surprisingly, I started texting our Bradley Method teacher Becky.

Becky and I must have exchanged at least one hundred messages over the next 3-4 days.  As I said before, I’d come back to the subject of her phone.  In just an instant, I immediately realized: Becky was not flaky: what Becky had been doing at that first class meeting wasn’t like, checking sports scores or texting inanities with a friend.  She was coaching couples like us through birth via text.  I just hadn’t realized this until it was us.  It brings tears to my eyes now even as I write this to think just how much she did for the two of us over this stretch of time.

Annie told us she didn’t understand what the rush was about the Pitocin, that we should stall for time.  Becky did the same thing.  Thankfully the hospital ended up giving us that time accidentally.  It took another 2-3 hours.  We move down to the 2nd floor at around 4:30pm.

Next time – Labor and Delivery…

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