Yesterday was pregnancy loss day. I dedicate this story to Murphy baby #2 who I will meet someday and hold in my arms in heaven, and to all of the other tiny babies whose heartbeats were heard only by their loving mommies, but whose bodies never had the opportunity to feel their mother's touch.
It was the week before Thanksgiving when I made a calm, yet slightly anxiety-inducing call to my OB’s office to report some spotting after my early morning run. I was still quite early in my pregnancy. I knew I was well within the timeframe for a miscarriage to commonly occur. I also knew that I had never had that issue with my first, healthy pregnancy. But I already knew what the nurse would say. Don’t worry. But stop running just in case.
Fast forward four more days. I had stopped running. But now I felt cramping. Not a good kind of cramping when you are in your eighth week of pregnancy. I did the only thing I could do, I called my OB’s office again. This time, though, my OB was out of the office for the week. There was an on-call OB, whose nurse I was transferred to. She told me it was no big deal. Go drink a glass of water. I’d be fine.
An hour later, cramping intensifying, I called her again. She said, “No big deal. Drink some water. It’s probably the flu.”
More cramping, beginning to realize what was likely happening. Doesn’t my OB office care? Shouldn’t I be going in for an ultrasound? Hello? I called again. Same answer.
I began to think about other alternatives. Who could I call? Where could I go? Surely someone could help me and advise me as to what I should be doing? I knew it was not the flu. Maybe I could go to the ER? They have to help you there, right? Even if you don’t have insurance? Especially if you are in labor? Was a miscarriage the same as labor? Couldn’t I just go to my normal OB office? After all, I HAD an OB, and I HAD health insurance.
I called them again. Could I get an ultrasound to check on the health of the baby? “Our ultrasound schedule is full today,” was their response. Could I get an appointment with an OB then? Maybe they could use the little handheld device to listen for a heartbeat? “No, no appointments available today. Your OB will be back in the office next week, did you want to schedule an appointment then?” I hung up.
Later that afternoon, more spotting, more cramping. Called the OB office again. I didn’t mince words this time, “If you don’t get me in, I will just have to go to the ER and tell them that my OB office does not have time for me. I don’t know what else you want me to do.” They called back after a few minutes. “We can get an ultrasound for you down in the ER and an appointment with an OB afterward.” Great, I’d take it. “And by the way, don’t bother to schedule me with the OB whose nurse kept telling me that I had the flu all day.”
My husband and I went to the ultrasound appointment, down a dark hallway just off the busy ER. The sonographer was sadly excited to do a baby ultrasound. Apparently he hadn’t done one in years. I didn’t want to burst his bubble, but this was not going to be a happy event. He had me use the bathroom right before, and I came back to the room with tears streaming down my face.
The sonographer did his best to try to find a heartbeat. I observed his demeanor go from excited and happy, to frustrated, to sad. He had confirmed the worst. I don’t think my tears had dried from before, but not wanting to make the sonographer feel even worse, I wiped the additional tears quietly off my cheeks before heading upstairs to meet with an OB I had never met. Even my husband seemed emotional, a rare occurrence for him. But honestly, I just really felt bad for the sonographer.
We met with a female OB, who stayed late that night to see me and explain the options available, and pros and cons of each for the coming days. I made a decision that seemed logical and rational, the one that would get me back to home and work function the fastest, and we went home.
Two days later, I hosted Thanksgiving for 20. It was awkward. After all, you don’t announce a pregnancy until you hit 14 or 15 weeks just to be sure. But then when you have a miscarriage, who do you tell? How can you share the news of such a loss with people who never even knew you were pregnant? Family coming to the event you are hosting, but can barely pull off due to the pain and cramping. People who are relatives, but who you only see once a year. This is one of many challenges of miscarriage. Women (and husbands) suffering in silence. People not knowing what to say.
In the days and weeks that followed, all I could think about was how much more difficult the poor treatment I received that day from a doctor’s office in the very same hospital I worked, had made the devastation of a pregnancy loss. There was no sympathy from the nurse. No understanding. No finding a way for an appropriate add-on patient to be seen in a timely fashion. No patient-first approach. It was provider-first. Provider on-call was too busy and didn’t want to be bothered with another OB’s patient. No matter the reason, legitimate or not.
The phone calls of that day tortured me as I watched my very own hospital system’s deluge of ads on TV every day, touting the patient-centered care they provided. It bothered me so much, I wrote a letter to the head of marketing and the CEO of the hospital. I bluntly asked, "How can we advertise that we provide patient-centered care when not only do we not provide such care, you have never bothered to train your physicians and healthcare providers such as myself in HOW to provide such care." It was a hollow advertising message that tested well in the focus group. I told them they should really pull the ad, instead of raising patients’ expectations for a level of care they were ill-prepared to provide. It would only anger patients further to fall so short of the mark. I did receive some emails back that were sympathetic and kind. But they never pulled the marketing. Nor did they educate their staff on how to specifically provide patient-centered care.
Years later, it was this experience with my very own hospital system that gave me yet another reason to start my own physical therapy practice. A practice filled with Doctors of Physical Therapy who delivered truly patient-centered care, not a slick marketing slogan. We opened our doors for the first time less than two years after the miscarriage. And today, 11 years later, I am writing a blog post on this most difficult subject to share how pivotal this first-hand experience was in demonstrating to me, a healthcare provider, how much the patient experience impacts healing. How central empathy and compassion are to care. It not only shaped, rather it cemented my personal commitment to providing patient-centered care every day, every hour, to every patient. Healing begins with compassion, and without caring, health cannot be restored.
Jill Murphy is a Doctor of Physical Therapy and founder of MotionWorks Physical Therapy and an advocate for patient-centered care. A Christian mom of three, she survived a seven year journey through the broken American healthcare system in search for an answer to a heart arrhythmia that appeared during pregnancy. A stroke, open heart surgery for constrictive pericarditis, and several other surgeries later, Jill is telling her story of unfailing resilience in her upcoming book, Doctor Heal Thyself.
Having grown up on a dairy farm 40 minutes from Lambeau Field, Jill is an avid Green Bay Packers and Wisconsin Badgers fan, and is up for any activity with her three children, including walking, biking, throwing the football around, hiking in scenic locales, gardening, playing piano, singing, and coaching a middle school basketball game or two.
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