There is a playful saying in the hospital, “When you go to pediatrics, you want to be a mother; when you go to obstetrics, you want to be tied.”
Most people refer to obstetrics as the “birth gate”, where countless little lives are “born and seen”. But few people realize that this is the door of birth, but also the door of the ghost of many women in labor. A birth is the same as struggling at the ghost gate.
And sometimes the ghost gate does not end with the end of the birth.
1
I was pushing the treatment cart to the next ward when I heard the sudden sound of wheels rolling and chaotic footsteps on the elevator, as if stepping on a person’s heart.
“Emergency delivery of a woman in labor! Come and get it!”
As soon as the words fell, a flat cart with an infusion rack was pushed in front of the nurses’ station: “Which side is your delivery room?
“I’m the midwife in charge of the delivery room! Push it this way!” The wooden door of the delivery room was vigorously pushed open, and my intern teacher, Cheng Yu, replied loudly while putting a white coat on the outside of her dark green surgical gown.
The emergency nurse and doctor quickly turned around and pushed the flat cart with the pregnant woman lying on it toward the delivery room, giving an urgent explanation of her condition: “This pregnant woman is 39 weeks pregnant, a primiparous woman, her water had already broken when she was brought to the emergency room, and the trouble is that she is in a breech position (usually the fetus is head down, a breech fetus is breech down) ……”
“Breech position?!” Cheng Yu’s eyebrows twisted into a Sichuan character, “That won’t work! The general breech position is not down, dragging out the mother and fetus are very dangerous, must be sent directly to the operating room to do a cesarean section!”
The emergency nurse looked anxious: “But her uterus is already fully opened!”
“Then we can only deliver in breech position first.” The blood on Cheng Yu’s face faded, and she took two quick steps forward, pulling the trolley into the delivery room together with the emergency medical staff, and yelled at the nurse’s station, “Go get Dr. Zhang!” When my eyes saw me, my tone was even more impatient, “Why are you still standing there looking? Come in quickly and hand over the patient to the emergency nurse!”
“Oh, right away!” I hastily pushed the treatment cart aside and followed them into the delivery room at a run.
There were three spring-loaded wooden doors to get inside the delivery room. After everyone changed into sterile slippers at the door, Cheng Yu opened the way in front of them, followed by the rest of them pushing the flat cart. The interior was painted green, three or five figures shifted on the wall, the spring doors thumped behind them, and the sharp scraping sound of the wheels turning sharply against the ground was mixed with the painful whimpers of the pregnant woman.
Once in the delivery room, Cheng Yu immediately took off his white coat, hand and foot to the maternity bed on the sheet and nursing pads: “Hurry up!”
The crowd worked together to carefully lift the pregnant woman onto the delivery bed. The intense pain caused by contractions distorted the face of the pregnant woman, her whole face was almost screwed together, her hairline hair was moistened and knotted, beads of sweat from the forehead all the way down, sinking into the black hair.
Cheng Yu was smearing couplers on the pregnant woman’s stomach in preparation for monitoring the fetal heart when Dr. Zhang, wearing a dark green sterile surgical gown, pushed in with big strides: “Breech position? Is the uterus fully opened?”
Cheng Yu’s hands did not stop and quickly answered her, “The uterus is fully opened, so we can only assist the delivery in breech position first, fortunately the fetus is not too big.”
The two of them quickly explained the condition of the pregnant woman, while I sorted out the “informed consent form” that needed to be signed by the family, and did the patient handover with the emergency nurse: “Where is the family of the pregnant woman? Here are some documents that need to be signed. And it’s best to ask the family to prepare some hot water and chocolate ……”
“No family members.” The emergency nurse interrupted me, “She came here by herself in a taxi, no family members with her. I just asked her and she refused to give any contact information of her relatives or friends.”
“How can that be?” This is the first time I’ve seen this kind of “naked birth”, instantly a little confused, “then she did not bring anything? The child’s clothes, pants and socks, milk powder those ……”
“None of them.” The emergency nurse sighed.
Dr. Zhang was about to go with Cheng Yu to brush his hands to prepare for assisted birth, heard the conversation between me and the emergency nurse, turned to me and said in a deep voice: “The cost and the documents that need to be signed and so on after the birth, it is not possible for the pregnant woman to sign herself.” After a few seconds of pause, she turned her attention to the emergency nurse, “By the way, did you draw her blood at the emergency clinic?”
The emergency nurse quickly replied, “Blood has been drawn, but the full set of transfusion results (including HIV, syphilis, hepatitis B, etc.) will not be available until tomorrow afternoon.”
It is reasonable to say that before a health care worker performs any surgery or assists a patient in labor, he or she must obtain the full set of transfusion results. But in this case, it was clear that we could not wait for the blood results to come back before assisting in the delivery.
Time was short, and there was no other choice. Dr. Zhang took a glance at the maternal identity information on the admission file and quickly approached the delivery bed, slightly hunched over, his eyes fixed on the sweating pregnant woman: “Lai Xin, have you ever had any surgery before? Are there any allergies to any drugs?”
“No ……” the pregnant woman’s voice was light and airy.
“Are there any infectious diseases, such as AIDS syphilis?”
“No ……”
After some simple inquiries, Dr. Zhang immediately clapped his hands: “Get the delivery kit, forceps, and contractions ready! Get the intravenous channels open! Prepare for breech delivery immediately!”
2
After half an hour of chaos and bloodshed, with the baby’s loud cry, everyone’s heart finally fell to the ground after hanging for a long time.
Cheng Yu threw several nursing pads mixed with amniotic fluid, blood, feces and urine into the nearby medical trash can, and hastily swept a glance at Dr. Zhang, pointing to her feet in sterilized slippers and whispering, “Why are your shoes covered with amniotic fluid and blood? There are no wounds on your feet, right? Do you want to hurry back to wash?”
“It’s okay.” Dr. Zhang smiled indifferently, his eyes were full of joy after the relief, “there is a small wound, but the mother and no infectious diseases, do not worry.”
The child did not have clothes and pants, Dr. Zhang had to wipe him clean, with a dark green surgical sheet to wrap the baby, and then put the child on the scale, “Hey, 6 kg 8 taels!” After weighing the baby, Dr. Zhang handed the baby to me for vaccination, then took off his lab coat and went out to wash his hands and change his clothes.
After vaccinating the baby, I carried the child to the maternal bedside and smiled at the mother: “Lai Xin, take a look at your child, it’s cute.” In fact, this statement is against my heart, the newborn baby is mostly a small wrinkled mass, not really good-looking. But all mothers look at their children born in October, naturally, how to look how happy.
The company’s main business is to provide a wide range of products and services to its customers. She closed her eyes and did not speak.
I thought she was too tired or could not immediately adapt to the role of a mother, so I placed the baby gently in the crook of her arm: “You can now feed the baby, early breastfeeding is conducive to the establishment of mother-child emotions it.”
Lai Xin opened her eyes again and looked at me, her feathery eyelashes fanned out a few times and then revealed a little extremely light smile. She unbuttoned a few buttons on her front chest and slowly brought her breasts to the baby’s mouth.
I let out a soft breath.
After two hours of postpartum observation, it was time for us to take the mother and the newborn out of the delivery room.
As soon as I pushed Lai Xin and the baby into the room, the other family members of the mother immediately came up to me with great enthusiasm, surrounding the baby and examining it.
“Oh, a baby boy, fat and chubby, how lucky and young he is!”
“Earlobes are also large, is a lucky face!”
“Hey, why is the doll not wearing clothes!” An older woman pinched some hard surgical sheets and said urgently, “The skin of the newly born doll is very delicate, how can it be wrapped in a sheet!” The words just fell, she turned in their own bed locker drumming for a long time, picked up a full set of daisy-colored clothing pants socks hat, “our doll’s clothes you first take to wear, do not get the doll cold.”
I thanked her again and again and put on the clothes for the child with her.
“Thank you.” The two words slowly came out of Lai Xin’s mouth after staring at us for a while. When I looked at her again, I still couldn’t see any emotion.
Ten minutes later, Lai Xin’s bedside table was piled with household items sent by other maternity families: baby diapers, pumping papers, water cups, nursing pads ……
“The first thing you need to do is to get a good idea of what to expect. When your husband comes I will educate him!” The mother-in-law in bed 64 swept Lai Xin with a reproachful face, and poured her a cup of hot water with a kettle, “Women should be well taken care of during the month, otherwise, it will be a problem if they fall sick later ……”
The company’s main business is to provide a wide range of products and services to its customers. I thought about it, but I couldn’t resist whispering to her, “Lai Xin, you can give a family contact, you have to call a family to take care of you, your parents or whatever ……”
“No family members.”
When she said this, her eyes gradually floated a layer of water mist, sluggish eyes drowned in this watery swamp, can no longer be distinguished.
The next morning, after I finished a normal delivery, I toured the ward with Cheng Yu and gave instructions on postpartum care for the mother. Lai Xin was still lying in bed without saying a word, at odds with the lively and joyful atmosphere around her. She was as silent as a dry well, and she was unperturbed by the changes in the outside world.
When I returned to the nurse’s station, I was opening the order form and preparing to print it when a plump administrative nurse next to me took one look at me and suddenly asked, “Eh, sister, what’s wrong with bed 62?”
“What?” I didn’t react for a moment that she was talking about Lai Xin.
“That maternity is not you admitted yesterday? The family did not come, the hospital fee was not paid, and her dress was not like a person who did not get a penny.” The administrative nurse was doing the forms on the computer while rambling on, “She didn’t eat all day yesterday, but an older woman in the next bed felt sorry for her and went downstairs to buy her a box of rice and brown sugar eggs.”
“The more bizarre thing is that she went to the toilet, actually so barefoot to go, this just after the birth of a child, and the cold day, also really want to trash their own …… look really pathetic and irritating. Later an intern sister really can not look down, after work to the supermarket to buy her slippers ah what, and to her to carry to the ward.”
“I do not know if there is a problem with the spirit, but also do not like to talk, the whole person wooden, hey ……”
3
When I walked to the door of the ward again, I happened to see Lai Xin lying on the bed feeding her child.
The branches of the afternoon sun crept into the ward, and everything was warm and quiet. The child’s eyes were closed in Lai Xin’s arms, and her little mouth was slowly sucking the milk, while Lai Xin gently rubbed the child’s hand.
Although, there is no family to accompany, no supplies to prepare, not too many words, but these do not prevent her from becoming a mother.
When Cheng Yu walked into the hospital room in a hurry, the image she saw was no different from mine. She interrupted this warm and beautiful moment with a face like dust: “Lai Xin, what are you, don’t breastfeed first, hurry up and come with me to the doctor’s office!” And then turned to me and said, “You hold the baby for her, come here together!”
There were only the director and a few other doctors sitting in the office, and when they saw us come in, the other doctors looked at Lai Xin soberly, while the director gestured for Lai Xin to sit down.
As soon as he sat down, the director tilted his body to change his sitting position, his right index and middle fingers together, slowly and rhythmically tapping the corners of the wooden chair one by one, as if he was deliberating his words: “You …… haven’t had a maternity test before?”
Lai Xin slowly lifted her eyelids, wavelessly glanced at the director: “Did once.”
“Then the doctor at the maternity hospital didn’t tell you?” The director’s tone took on a somber tone, “The test department just called …… you have AIDS!”
The director’s voice just fell, my heart seemed to be clenched in a fierce way – AIDS? In that very short time, my mind raced to think of the blood-contaminated wounds on Dr. Zhang’s feet, to think of the weirdness of Lai Xin all the time, to think of this child in her arms.
If she has AIDS, what about Dr. Zhang? What about the baby?
The director waited for a long time and did not see her.
The director waited for a long time and saw that she did not say anything, so he had to repeat: “Ahem, I just said that you have AIDS ……”
Lai Xin lips opened and closed a few times, finally slowly replied: “Well.”
After saying this um word, she had no more extra words, dropping her eyelids, so that people could not see the look.
When the director saw this look on her face, he almost jumped up: “Your reaction means you know, right? Then why did you lie to us when you joined the department and tell us that there was no infectious disease? Do you know that the doctor who assisted you in labor, Dr. Zhang, was contaminated by your amniotic fluid and blood on the wound on his foot! She almost fainted when she heard that the laboratory called and said the mother had AIDS! She almost fainted when she heard that the laboratory called and said that the mother had AIDS!
My eyes were a little red. Even if I hadn’t seen Dr. Zhang’s reaction at the time, it was heartbreaking just to think about it. If Lai Xin had been honest about her HIV history before the birth, the medical staff who assisted her would have worn goggles, double gloves, and long rubber shoes according to occupational exposure standards.
The chance of a health care worker contracting HIV in case of occupational exposure is 3 in 1,000. Timely administration of blocking drugs can reduce this chance even further. However, even if it is a chance of several hundred thousand to one, it will be a devastating blow to anyone.
The first thing you need to do is to get a good idea of what you’re doing. Her tone was calm, but the words she spat out were heartbreaking: “It’s only her bad luck.”
The director was already furious, hearing her say so, almost thunderstruck: “You! Are you still a human being? What kind of words are you saying? Are you saying that it’s our fault that we helped you give birth?”
The AIDS mother who disappeared from the ward
Lai Xin snorted coldly and stopped talking. Inch by inch, the noise of the air sterilizer rattled my eardrums, and the room was dead silent.
After a few minutes, the director reluctantly took a breath, still with anger in his voice, and pointed to the baby in my arms and said to Lai Xin, “You don’t take the doctor’s life seriously, but you have to take care of your son’s life, right? You didn’t take the blocking medication when you were pregnant, you hid it from the medical staff when you gave birth, and you breastfed the baby after it was born,” the director said, getting angrier and angrier, “and because you hid your condition, you put your own child in danger too!”
HIV-positive women are not unable to have children, but without any intervention, the probability of mother-to-child transmission of HIV can be as high as 15 to 45 percent. Therefore, HIV-positive mothers must undergo strict medical treatment from the early stages of pregnancy for mother-to-child interruption, which includes taking anti-HIV drugs during pregnancy, avoiding lateral incision or the use of forceps during delivery, and prohibiting breastfeeding after delivery.
Lai Xin, on the other hand, completely avoided these three interventions.
Looking at the sleeping baby in my arms, the director slowed his tone, but his brow locked tighter: “Now this child is considered high risk for HIV exposure, he has to be tested immediately, and he has to be given HIV blocking medication immediately ……”
“No.” Lai Xin’s voice was cold and chilly.
The director didn’t react, and opened his mouth for half a day before revoicing, “What did you say? Oh …… you are worried about money are you? Don’t worry, this drug is free for the state to receive, don’t pay ……”
“Don’t want money either.”
Several of us stared at Lai Xin in disbelief, the director was even more angry forehead veins, almost broke into a cuss: “You he …… you are not a problem? The life of your own child is not cherished? I’ve made it very clear to you that he has a high risk of contracting AIDS! The newborn’s immune system is not perfect, if infected with AIDS will not live a few years! Your irresponsibility has already put him in danger, and now you want to deprive him of his last hope of survival? This is your own child, born in October!”
The baby was awakened by the sound of the heated argument, and Lai Xin took him from my arms as he cried, and before she walked out of the office, she simply dropped a sentence: “What’s the big deal, just die, I was going to abort it.”
The late autumn October chill has not reached the center before, I have fallen into the ice cellar.
4
Since then, we have taken turns to do ideological work for Lai Xin, but she only bites the bullet: no medication. If the guardian did not agree, the medical staff could not take the decision to give the child the blocking medication.
Even though we knew that the child was likely to be infected with AIDS or had already been infected, and even though we were angry at what Lai Xin had done, we finally succumbed to the absurd reality under the pressure of reason.
I saw Dr. Zhang again two days later during the night shift. At that time, I was standing in front of the disposal room with a bright yellow medical garbage bag in my hand, the wind whooshing through the hall, the lights outside the window, the sound of sirens and laughter faintly coming from the street.
In the garbage bag, containing a formed fetus. The fetus was curled up in a bean shape, the whole limbs and head swollen gray, the body still remains amniotic fluid and blood, long dead through, is a natural abortion.
The actual fact is that this is a natural selection of the best and the worst. After the output of the dead fetus, the maternal family immediately said to the hospital to deal with. Before the mother cried herself hoarse and almost fainted, Cheng Yu shoved the garbage bag containing the dead fetus into my hand and urged me to hurry and throw it into the disposal room.
I stood in the doorway, somewhat bewildered.
There were several large medical garbage cans in the disposal room, containing household garbage, infectious waste, fragile medicine bottles such as glass, and sharp objects. Any way you look at it, these trash cans should not be the home of the fetus.
“Just put him next to the trash can, someone will come to collect him later.” A figure in a white coat appeared at the door of the preparation room next door – it was Dr. Zhang. It had only been two days since I saw her, but she looked like her soul had been drained away, with sunken eyes and pale lips. The enormous psychological pressure, the intense side effects of the blocking drugs, were destroying her little by little from the inside.
The garbage bag mouth with a little amniotic fluid, the wet sticky touch from the fingers all the way up, straight to my heart.
“Someone to collect it? Where do you send it?”
“Together with the needles, infusion sets and all kinds of garbage, they are sent to the environmental protection department for disposal. There are also some private hospitals that are directly throwing these dead fetuses into the river. Or let the family pay a few dozen dollars to hire someone to bury the dead baby with the placenta under a tree as fertilizer.”
“Human life, it’s really cheap.” She sighed lowly, not knowing whether she was talking about the dead fetus or herself.
At that moment, the weight on my hand seemed to be pressing on my heart, so I could not breathe. I thought of Lai Xin’s child, and I even felt that what I was carrying in the garbage bag was the child who was probably infected with AIDS, the HIV in his body gnawing at his tiny body, his skin pierced by discarded needles and sharp instruments, and he was shipped to an unknown destination along with all kinds of medical waste.
His life and death were never his own.
5
All night shifts are difficult, especially in obstetrics.
At 10:30 p.m., when I was walking out of the dispensing room with a heavy head, another trainee nurse on the night shift came over from the ward with a strange look in her eyes and said to me, “The woman in bed 62 seems to have run away, I have been looking for her for half a day, and when I asked the family members in the same ward, they all said they didn’t notice.”
“Ran away?!” Another nurse heard what she said, her tone instantly elevated, “I X, she did not pay a penny of the hospital bill ah, we will be fined again ……”
I was so excited that I handed over the infusion bottle to another trainee nurse and hurriedly threw down the phrase “I’ll go look for it” and searched along the corridor on both sides of the safe passage without stopping.
Finally, I found Lai Xin on the fifth floor by the corridor window of the oncology department. She was holding her son, wearing a light blue striped hospital gown, standing at the windbreak. When she saw me walking quickly, a trace of surprise appeared on her face, and then she hooked the corners of her mouth, showing a little light smile: “You thought I ran away?”
I did not deny it, but asked her with a cold face: “What are you doing here? You didn’t even tell our nurse you were out for a walk.”
“It was too noisy everywhere upstairs, so I wanted to come out to get some peace and quiet. I heard that most of the people in the oncology department are dying, so I thought I’d come and take a look.”
“Do you think, am I dying too?” Lai Xin withdrew her gaze and looked at me steadily. The late autumn evening breeze came from the dark, she couldn’t help but shiver, and her arms around the baby tightened slightly.
I wanted to scold her for deserving it, for harming others and for harming herself. But looking at her at this moment, I could not curse.
“People like me deserve to go to hell, I know.” Her eyes were slightly red, “But that man, he deserves to go to hell even more.”
“Which man?”
“The man who gave me AIDS.”
She spoke slowly, “We met at a friend’s party. He was good-looking and sang well, and I was quickly smitten with him. So he confessed his love to me, and I immediately said yes ……”
“We were together for a short time, but I knew that I was in love with him. The moment the pregnancy test showed two bars, I was really happy. I thought he would be as happy as I was, I thought we would get married next, have children, and form a happy family. I didn’t tell him right away that day, but took a taxi to the hospital by myself to further confirm the pregnancy …… and ended up testing positive for HIV that very day.”
“At that moment I knew what it was like to be spinning in the sky. I cried bitterly and took the test sheet to confront him, but he laughed indifferently. He said that if I hadn’t been so good on it, he wouldn’t have had a chance to infect me ……”
“Later I stumbled upon a lot of his messages in the AIDS bar, saying that ‘women are all bitches’ and ‘it’s so fucking cool to have AIDS that you don’t have to wear a condom when you go out to call a chicken or have sex. Heh, at that time I realized that he was just treating me as a chicken in the prostitution, but also in the malicious spread of AIDS ……”
“At first I really hated it, I didn’t understand, why did he do this to me. Why was I ……”
Hearing this, I finally couldn’t help but speak out: “Then why don’t you expose this kind of rotten people? Instead, you spoil yourself like this?”
“Expose him?” Lai Xin gently laughed, eyes full of sluggish night breeze, “people like him, already counted half buried in the earth, no matter what to do to him is useless. I myself have been ruined, and do not have that leisure and public morality to remove the harm for the people.”
“Then why did you give birth to this child? And, refuse to block the mother and child?” I really have trouble understanding.
“The child …… sometimes I think, this child may be the last bit of gift from God to me, let him walk with me through the last life …… I will not live a few years, and do not want to rely on drugs to linger. If I have to leave this child alone in the world after I die, it is better to let him go with me. I live as long as we live together, mother and son.”
I was so shocked by her absurd and selfish logic that I couldn’t speak for a long time, and only after a long time did I find my voice: “What about your parents? Do they know? Talk to your family, don’t think too extreme, you’re still so young.”
“Let them think I’m dead out there.”
The next evening at 5:40, I came to the department to hand over the night shift.
The day shift nurse suddenly told me: “62 bed that woman really ran away. X, the hospital fee did not pay a penny, but also almost infected Dr. Zhang with AIDS, but actually have the face to run away like this ……”
Lai Xin is really gone. The only thing that she took away was the child, and the other household items given to her by the family, all of which she stuffed haphazardly in the bottom of the bedside table. The only proof that they ever existed was a few mottled brown stains on the hospital bed and the baby’s urine stains.
Three months and a year later, Dr. Zhang performed two separate tests, both of which came back negative for HIV. Later, she seemed to recover mentally and was still receiving pregnant women referred from the emergency room as often as before, except that she was more cautious than before when operating, and when washing her hands after surgery, she would compulsively check her exposed skin repeatedly for tiny wounds, and she would be distracted until the blood test report of the emergency pregnant woman came out.
Once the hospital filmed a promotional video on the professional exposure of medical staff, and when Dr. Zhang was approached, she turned her back to the camera and kept crying, talking about the time when she was worried about being infected with AIDS by Lai Xin’s blood, “I felt especially sorry for my husband and son, and I wanted to commit suicide.
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