Stephanie Eisler, Sonographer, RDMS, shares her story of personal fears and triumphs, and how she turned them into a “fulfilling career of which (she) can say my heart is truly in it“.
“It’s a girl!”
She never cries. Briefly, I see my brand new baby girl before they whisk her away for evaluation. Laying there helpless, my uterus wide open on the operating table, I dimly see her daddy beaming with pride as he carries her out of the room and I am left waiting alone while the surgeons put me back together.
Finally, I am reunited with my baby, but solemn faces greet me. I am informed, as my daughter is gently handed to me, that “something is wrong with your baby’s heart. We won’t know exactly what until she sees a specialist.” Panic sets in. I didn’t understand, she looked fine, she acted fine, but the nurses and the doctor all had listened to her little heart and they agreed that something was wrong.
The waiting is the worst part
Friday morning, 2:01, and I am told that there is not a single pediatric cardiologist available. This was supposed to be a special time in my life, the sweet moments of welcoming my child into the world, and instead I felt helpless, as though from the start I was failing my child. Waiting was hell on earth. I was frantic. How was I just to sit there and wait for bad news? I spent Saturday and Sunday with the phone in one hand, phone book in the other, and my helpless baby in my lap, as I called every listing for a pediatric cardiologist. No one could come to evaluate her. We had an appointment set, but she would already be 5 days old, and I had to wait. Wait. Wait. And wait. Not knowing. Worrying. Preparing for the worst.
We learned that our baby had two holes in her heart. The physician patiently drew sketches on stark white paper in hopes of helping us understand. Shock. I was in complete shock. I was mad. How did this happen? I had been seen several times at a high risk OB facility and had several ultrasounds to ensure that everything was okay. How were holes in my baby’s heart missed?!?
If only we had known beforehand. If only we had been prepared for this. If only we had been able to have a specialist present at delivery. If only, if, if, if…we had known. The bottom line; had we known, we would have been prepared. We would have delivered at a hospital equipped for babies with problems and we would have consulted with a pediatric cardiologist before hand; our experience would have been completely different. Instead of feeling overwhelmed and consumed with panic, we would have found moments to enjoy, knowing we had done everything we could to take care of our baby.
Finding new strength
Twelve years later, the HEART OF IT is that my daughter’s heart, healed and whole now, aided me in discovering a career I am passionate about and to which my heart is committed. It is tough. There are days that I am not certain if I can find the strength to make it in for another day of heartache. There are days I cry and days that are filled with whispered prayers. Every day I meet new people. Every day I look into scared eyes and I feel the worry hanging heavy in the room, and so I say to them, “I understand your doctor has asked you to come here for further evaluation of your baby, because they saw something that didn’t look quite right on your previous ultrasound, right?” Usually I only get a nod of the head, since they have braced themselves for the worse, and speaking feels like admitting defeat. I sense the panic and recognize the shallow breaths and remember the feeling of not knowing during those five long days, as I held my brand new baby, feeling as though I had failed her, and fearing the worst.
Looking into their eyes I do my best to convey what I am feeling, “I know this time is scary and you have already imagined the worst. You have gone online and Googled the possibilities and now you are dreading what you will be told today.” Typically at this point the tension eases slightly, even a little laughter might escape their lips, because they are relieved to know that all parents-to-be, in this type of situation, do the very same thing. Suddenly, they no longer feel alone. Others have gone through this, and this is a ‘typical’ day for us; we are prepared for them. I sense them start to relax and put trust in me and in the practice.
I further explain what is going to happen, since the last thing they want is another “shocker,” another upsetting surprise. They need to know the process that is going to take place, so that they can prepare. “We are going to do a level II ultrasound and thoroughly evaluate everything, you will meet with Dr. (so-n-so) and he will take all the time necessary and will answer all of your questions. I will be here with you the entire time. If everything is okay, you will leave here assured of that, and if there is truly a problem, then finding out NOW is the best thing you can do for yourselves and your baby. Knowledge is vital so you can plan and make all the preparations needed for when your baby arrives.” I watch their faces change as they become aware of the bigger picture; that they have to get through this event moment by moment, but they realize that this has to happen for the sake of their unborn child. This is their responsibility. The mother who was fearful to sit on the exam table, and has been seated next to her husband in the corner, eye-balling that table, afraid of what will happen there, now willingly gets up and bravely takes her place on the ultrasound table. I encourage the father to sit, stand, be anywhere in the room he wishes. Typically he stands, holding his wife’s hand in support, and I begin my scan.
I have stood next to the bed, prepared, with a tissue box in hand, and listened with a breaking heart, as the physician informs them of the diagnosis, and explains the options, one-by-one, and then goes over them again, often times again and again, because in their state of shock, they see his mouth moving, and they are nodding, but the words are not registering. I have wrapped my arms around a patient to hold her as she weeps. On rare occasion, I have held a scared mother’s hand through an emergency amniocentesis procedure, because her husband was not able to be there on such short notice, whispering words of encouragement into her ear. I always imagine myself in her shoes; feeling scared, worried, even alone.
“Can you find a way to be there for the patient in their time of need?”
Daily, I hear the echo of my professor’s wise words challenging me. They guide me and give me strength to face these heart wrenching situations. It was my first day of clinical rotation at a maternal fetal medicine practice, and midway through the day, I was done with it all. I was ready to quit. I wanted to stop the program, drop out, and change fields. On my first exposure to high risk OB patient care, I witnessed three horrible, devastating cases. The physician allowed me to leave for a 20 minute walk outside to clear my head, and at the end of the work day, assured me that not all days were like this and the positives of seeing the babies after delivery far out-weighed the bad outcomes. Still, I ended that day deciding that I was not cut out for this.
I made an appointment to meet with my professor and inform him of my decision. He appeared very understanding. He listened patiently, then leaned back, way back in his chair, paused long enough for me to anticipate what he was going to say, looked me calmly in the eyes and slowly, ever so slowly asked, “Do you think that those horrible things do not happen if you are not there to see them?” Initially I thought that was a ridiculous question, “Of course not.” Silence filled the room as he allowed time for me to ponder his question. Once my face shifted to understanding, he asked another question, “Why did you choose this career field, for yourself or to care for others?” Now, that question hit home. This was not about me, but about the patient, of course. Patient care, in any form, in any field, was always about the patient. This question woke me up to reality. He was right. My career choice was to be of service to others. He posed more questions, “Can you find a way to be there for the patient in their time of need? Can you offer strength and support to your patient when they need it? Can you put your own feelings aside and empathize with them?”
Every day I hear his questions in my head. Before getting my patient, I read through their chart, I learn why they are being referred to us and I prepare myself, often praying for the strength and guidance needed to best serve this patient. And the cases that catch me by surprise, the unexpected findings during a scan, I struggle to keep a “poker face” and if I can, make it through the entire exam, inform the patient that the doctor is going to review the images and he will be in to speak with them. I have to make a consorted effort to calmly exit the room, I then take a brief moment to gather my emotions, either in a quiet hallway, a closest or restroom, and then I hear it, “Can you find a way to be there for the patient in their time of need?”
The “heart of it” is simple; the best patient care has to come from your own heart. We have to be sensitive and empathetic, yet strong and confident.
I find it helpful to take a moment, identify with the patient, and evaluate the situation by standing in their shoes, then care for them in the same way I would want to be cared for if I were laying there about to receive devastating information regarding my unborn child. The feeling inside of me becomes one of duty; duty to the needs of my patient.
It is the connection with my patients that keeps me strong; it is the knock on the exam door and a co-worker informing me that I have a visitor at the front, and walking down the hall to see a familiar face, this time her eyes are filled with confidence instead of fear, and then to feel the heartfelt embrace as she tells me her story of delivery and updates me on the status of her new son or new daughter. This is the occasional moment when we can share happy tears together for we both share in the feeling of relief. Other times, they have come to merely express gratitude for being there to help them prepare for the long road ahead, or to even help prepare for the loss of their child. Whatever the outcome, my responsibility is to step out of my “comfort zone” and be there for another human being, a soul in need; to connect.
Yesterday we celebrated my daughter’s 12th birthday; her spirit is amazing, her heart is genuinely kind, and she continually inspires me to be of service to others. I thank God for turning my daughter’s heart condition, and those 5 long days of panic, into a blessing; for it is because of my personal experience, that I have found a fulfilling career of which I can say “my heart is truly in it.”