Sunday, June 15, 2014

The Barrenness of Seventeen

This all started over a month ago. She was pregnant at seventeen. Scared and unprepared, she looked for a way out. Traditional medicines were taken for a month trying to provoke an abortion. Finally, she had gone to another facility and gotten a D&C procedure to scrape out the little life. And for reasons unknown to me, a second D&C was done the next day. Unfortunately the results of those procedures included complications all too common in the developing world.

All of that happened before she came to me. She moaned and then gasped as I touched her abdomen. It wasn’t just tender along the uterus, it was tender everywhere. I knew that the prior procedure had likely caused a hole in the uterus. And I knew that there was likely infection taking hold inside. I counseled her that there was a true possibility that I could even have to take out her uterus, leaving her barren. But she was in such pain, she just nodded. I counseled the family as well.

During the operation I sent word out to the father and mother that indeed, the majority of the uterus was rotten. It had to be removed. They understood. “Clamp”, “tie”, “suture”, “cut”, again and again until the malodorous, dead organ was out. I closed her up and continued antibiotics.

The next day I sat on the edge of the bed and counseled her again. She nodded, eyes glazed over, barely listening. I told her that we would talk more specifically when she came to see me in the clinic. I counseled the family again. Each day she made progress, and finally I sent her home with follow up a few days later.

She was doing amazingly well on her return. Too well. There was no somber spirit, no sense of sadness. I needed to counsel her again. She was either in denial, or she hadn’t listened at all.

This time she started to weep. Her head bowed low. Her tears ran down her cheeks. Everything changed in that instant. She finally understood. She hadn’t before, and though her family had known, they didn’t tell her. The fact that she otherwise would have died was no consolation. Her life changed in those fleeting moments as she sat in that straight backed wooden chair. The carefree youthfulness of her seventeen years became shackled by the adult understanding of a barren life. She realized then that huge parts of her adulthood and womanhood, had been taken away. Her moans were heard in the adjacent rooms as she heaved, rocking forward and back.

Finally her breathing slowed toward normal and her tears dropped to only one by one rather than the prior river’s flow. I told her that her pain was real, and there was loss, but that her value had not changed. A conversation too often repeated with patients struggling with infertility of all types, women stuck in a culture that says they no longer have any value. It didn’t make it all okay. It didn’t make her leave with a smile. It didn’t take the pain away. She was overwhelmed by the thoughts of what her life would and would not be. New fears and insecurities were already taking hold. The depths of her tear-filled eyes laid her soul bare before me.

Mistakes made, consequences realized, naivety lost – all of it too real. Bitter truths. “Valuable, God says that you have worth and value, and none of that has changed”, it was the one truth that had the ability to resonate deep in the darkness of her soul. It is the one truth that can carry her now and through a lifetime. 

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