My Time on the “Other” Side
Originally published Fall Newsletter 2023. Written by Becky Calabrese, MBA, MHS, PA-C.
It’s 6:00am and my alarm goes off, although I’ve been sitting awake tossing and turning for what feels like all night. Does anyone actually sleep in the 3rd trimester of pregnancy anyway? I quickly shower and get dressed, since after 6:30am, anyone could open my door and enter at anytime. People could enter at anytime anyways – there are no locks, just a nicely worded post-it on my door asking to not be disturbed until after 6:30am, and then listing out my meetings for the day. Privacy is a thing we often take for granted. That, the smell of fresh air, and the freedom to walk around barefoot. Things, along with my family and all of the other comforts of home, that I missed terribly during my 7-week admission to the Maternal Special Care Unit this summer.
I was diagnosed with vasa previa during my 18 week anatomy scan. Being in healthcare we all are aware of how many things can go wrong (or right) in pregnancy. However I never recalled learning about vasa previa. Vasa previa is a rare condition in which fetal blood vessels run through the amniotic membranes and cross over the cervix. Therefore, any contractions or rupture of the membranes can cause these fragile vessels that are unprotected by the umbilical cord or placental tissue, to rupture and lead to fetal exsanguination. My incredible OBGYN monitored me closely with serial ultrasounds, and when the vessels remained in the same position at 28 weeks, I was admitted to the hospital and my care was transferred to the High Risk Maternal Fetal Medicine team. The goal of admission was to have me in close vicinity to the OB operating rooms in case I started to bleed and required a STAT c-section, and then if all went well, perform an elective c-section between 34 to 36 weeks gestation.
Living in the hospital where I have worked for 12 years wasn’t what necessarily intimidated me. I knew I would be well-cared for, have plenty of visitors, and was familiar with all of the good places to order from when I grew tired of hospital food. I was grateful for my exceptionally supportive team who made arrangements for me to work from my hospital room so I could stay busy and pass the time. But being away from my husband and 1 year old son all summer long and not having any general feelings of freedom, ate away at me. The weeks leading up to my admission were an emotional roller coaster of trying to soak in all of the moments and cherishing the bedtime snuggles with my son knowing I wouldn’t have them for a while.
When admission day finally came, a sense of security came over me. I felt safer being monitored, I was glad that this would soon be behind me, and I was humbled by the love and support my family, friends and coworkers had already given me – stocking my room with the best Trader Joe’s treats, home cooked meals, air fresheners/diffusers, aromatherapy shower bombs, the softest slippers and blankets, beautiful plants and plenty of puzzles and coloring books to pass the time. As time went on, I had good days and bad. Days I cried all day and days I could only laugh at the irony of being admitted for so long just as the new residents had started, or the fact I needed a legit hall pass to leave the floor. Days I felt powerless and frustrated, with a total loss of control. Days I felt empowered and grateful I knew enough to advocate for myself. There is so much wrong with healthcare these days – burnout, difficult patients, devastating diagnoses, financial constraints and paralyzing politics. But there is also so much good – and I had the privilege of seeing that while admitted and on the ‘other side’. I saw the seasoned, passionate, expert nurses who cared for me teaching their newer, eager and excited staff. I cried, laughed, prayed and joked with the environmental services workers who came to clean my room everyday and the unit secretaries who greeted me every time I filled up my water. I became friends with and found great support in my next door neighbor who carried the same diagnosis I did. I felt safe in the hands of the midwife and doctors who cared for me, and was grateful for their compassion, skill, knowledge, empathy and constant reassurance. I bonded with the food and nutrition worker who delivered my 3 decaf black coffees and egg white omelette every morning at 8am as I virtually attended our Morning Safety Report. I learned the craft of tactfully advocating for yourself and sharing feedback to improve the system for others. The staff saw my one year old go from just barely walking when I was first admitted, to causing a ruckus and running down the halls, pushing every button he could get his hands on (sorry to anyone we rode the elevator with). I was able to see the privilege we have in healthcare again – the privilege to enter people’s lives and care for them at their most vulnerable times. To treat them as the humans they are and to take the opportunity we have to truly connect with them. To encourage their partnership and involvement in their own care. To document accurately and use our open notes as modes of reinforced communication and education for them. While I wouldn’t wish a long-term admission on anyone, looking back, I am grateful for the renewed perspective and profound sense of appreciation of life (and freedom) it has given me as a human, a wife, a mom, and a clinician.
Jackson Brady Calabrese made it to his elective c-section date at 35 weeks and was born in mid-August. After spending some time growing stronger in the NNICU, he joined the chaos at home. The day I was discharged I felt as though I was escaping prison and breaking all the rules. I kept the windows down the entire ride home so I could feel the warm summer breeze whip across my face. I kicked off my flipflops and have never enjoyed being barefoot more. My husband is a Godsend for ensuring everything was close to perfect for when I got home, and now appreciates why I have always wanted two washers and dryers. I have so much gratitude for our tribe who got us through this, and for the Maternal Fetal Medicine and Neonatal ICU teams for taking such incredible care of me and my family.