HEALTH
When Being a Doctor Risks Your Baby’s Health Residency remains grueling for expectant mothers By Dr. Suzanne Koven
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have no recollection of my husband and me deciding to have our first baby over 30 years ago, the year after I graduated medical school, when I was an intern and he a resident. We had not discussed timing the delivery with our preassigned vacations, futile as that effort might have been, or if we could afford childcare on our meager incomes. Near the end of my internship, on a rare Sunday afternoon when we both happened to be home, I looked at a calendar and counted 80 days since my last period. I went to the drugstore, bought a home pregnancy test and peed on the plastic wand. Then, like a crazed vampire slayer, I waved the dark-blue cross back and forth in front of my husband’s initially confused and then smiling face. It wasn’t unusual for me to arrive at Johns Hopkins Hospital, where I was interning, on a Monday morning, work without stopping until Tuesday evening and report again for work early on Wednesday. Some
months were even more punishing: 24 hours on, 24 hours off, week after week. The obscene fatigue that this schedule produced made me euphoric at times, depressed, irritable and nauseated at others, but always obsessed with sleep. I would stop at the grocery store on my way home from the hospital and glare at the cashier, resentful that she could go home to her own bed at night. I envied dogs I saw in the street because they could lie down when they chose. There’s no evidence that severe sleep deprivation made me a better doctor, but I could not have survived my entire residency if I had not believed it would. Attempting to stay energized when I was on call, I hit the vending machines for infusions of sugar— Snickers or stale Little Debbie cakes—on my way to the laboratory, blood bank or emergency room. I often chose the route that led through the surgical clinic, dark and deserted at night, in an unrenovated part of
JANUARY/FEBRUARY 2022
the hospital with linoleum flooring from the 1960s that reminded me of my father’s old medical office in Brooklyn. Framed black-and-white head shots of past members of the surgical staff, nearly all men, going back to the 1920s mesmerized me. So, too, did the reproductions of oil portraits of Sir William Osler, one of the founding physicians of Johns Hopkins, and his disciples, and his disciples’ disciples that hung on the walls of the wards. Sometimes, I paused by one of these portraits and listed, in my mind, the string of medical “begats” that ran from Dr. Osler through his trainees and successors to me. I never once paused to consider that my professional ancestry included few women. Once I learned I was pregnant, I started taking prenatal vitamins and complied with all the recommended obstetrical visits, blood tests and ultrasounds. Still, I drifted through my last two trimesters in a kind of oblivion. I first felt my baby move early one morning as I stole a few minutes of rest on an empty patient bed in the coronary care unit. Strange as it sounds, being pregnant as a resident made me feel more macho. My swagger had a price. I spent the last six weeks of my pregnancy confined at home with preeclampsia, my dangerously high blood pressure no doubt caused by long work hours. After months of wanting nothing more than sleep, I was forbidden to leave my bed. At 40 weeks, a monitor detected fetal distress, and I had an emergency Cesarean section, delivering a healthy 5-and-a-halfpound girl. Another female resident tacked my daughter’s newborn photo onto the bulletin board in the room where we residents entered notes in patient charts and stole naps on a ratty couch.
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