Life on Abram Lake
Life as a rural physician Mama in the backwoods of Northwestern Ontario
Momma MD
It’s just after 7am on a Saturday morning and I’m standing in my scrubs outside the OR doors. My surgical mask hangs lazily from my neck as I press the doppler probe against my patient’s protruding gravid belly, anxious to capture the heartbeat of the little life inside. The scrub nurses are hastily opening the c-section equipment behind the OR doors and the anesthetist is quizzing my patient about her health in rapid fire. Against this background noise, I pick up a staticky fetal heart. 130bpm. My shoulders drop in relief.
I have been up most of the night with a labouring young primip who had been seemingly progressing well until suddenly, she had begun to bleed. Then the fetal heartbeat had begun to waver in the nausea-inducing way that only those who provide obstetrical care can understand. At only 6cm, we didn’t have time to wait for her babe to enter the world in the usual fashion. Her placenta’s hold to its attachment against the uterine wall was quickly failing and with it, her baby’s lifeline was being ripped away. A placental abruption and an obstetrical emergency.
As the anesthetist, OR nurses and c-section doctor were called in, we had prepped the patient and moved her quickly to the OR hallway. In our small hospital, everyone is called in from home creating a 20-30min nail-biting delay. This is the reality of rural medicine.
I had slept little, but the adrenaline of the situation was like a shot of espresso. My body felt tense as I focused on that tiny heartbeat while awaiting to assist our surgeon. Suddenly, my phone in my scrub pocket began to ring. I jumped, startled at the sound. Taking care to not move the doppler, I continued to auscultate while glancing at the phone. It was a number that I did not recognize.
“Hello, Dr. Sprague speaking”, I answered curtly.
“Hi, this is Brendan Sitar.”
“Yes?”, I responded impatiently. The name bore no recognition in my brain and I was quite sure that it didn’t belong to any of the locums manning the ER perhaps looking for an Obstetrical consult. I was anxious to end the conversation.
“I’m at the Forest Inn and I think I have your son here in his pyjamas.”
In a split second, my heart leapt into my throat. My mind flip floped from MD to Momma mode. Who was this man and why was my three-year old Henry almost three kilometres away from home, alone, in his pyjamas at 7am? And where was Blake? I motioned to the resident beside me to take over auscultating the fetal heartbeat and moved hastily a few steps down the hall while firing questions into the phone.
As it turned out, Brendan was the husband of a previous prenatal patient and a friend of a neighbour. He had been driving into town when he spotted a little guy, alone, in his jammies biking with determination along the road. Thinking that something was not quite right, Brendan had pulled a U-turn and stopped Henry. After a quick chat, Brendan had recognized Henry from our neighbourhood and had acquired my cell number from our neighbour.
“Would you like me to stay here until you come to get him?” Brendan finally asked.
My heart sank. I absolutely could not leave the hospital. There was nothing more that I wanted to do but to race to Henry’s side and to bring him home safely, but I had a job to do; a little life and a terrified teen Mom were depending on me to be there to do it.
I begged Brendan to just throw Henry and his bike into his truck and take him home. Henry would survive the ride home without a car seat. What could I do? Thankfully, Brendan agreed. Next, I blasted Blake’s cellphone with twenty unanswered calls. Where the hell was Blake? What if Brendan brought Henry home to an empty house?
I peeked through the OR windows. The anesthetist had swiftly placed the spinal and it was now time for me to scrub. I had no more time to try to contact Blake. In panic-mode, I called Meghan, my brother’s partner. No answer. Near tears, I then tried my brother’s cell. Thankfully, he answered, his voice laden with sleep. I blurted out the situation and begged him to get out of bed at once and race to our house to meet Brendan. He agreed and I hung up the phone, scrubbed and entered the OR, my mind flip flopping back again to the job in front of me. I could only hope that Henry would make it home safely. It was literally now out of my hands.
As a Mom to two young children, I often wonder if my struggles in balancing a full-time job with the constant desire to be home differ from any other working parent out there. Does it really matter that I am a physician? Don’t all working parents have the same challenges that I do? Don’t they all feel the same guilt that plagues me daily? Or perhaps do they wonder, as I do, how they can ever get this all right?
For so long, I truly believed that being a doctor Mama made me no different than a teacher Mama, or an accountant Dad. We were all in the same boat. Struggling in all the same ways, trying to just do the best that we could to survive.
Perhaps this is the truth, but after that heart-pumping June morning, I have come to different realization. While we all have our challenges, there are few parents out there that simply cannot be there for their kids 100% of the time, no matter how desperately they want to.
Working in remote Sioux Lookout over the past four years providing maternity care to Indigenous families has been a dream come true for me. Despite the constant challenges of working in stressful situations well above my comfort level, I truly feel privileged to do what I do. Sure, there are many days that I wish I could be home snuggling quietly on the couch with Alice or playing Playmobil with Henry, but when push comes to shove, I am so grateful to be able to work as a full-scope rural family physician – to serve those who need it most, to be challenged intellectually in ways that I never thought possible, to share in the joy and also the heartbreak of peoples’ lives, to be fulfilled.
In the end, all worked out just fine. My colleague and I delivered a screaming baby boy that morning and two lives were saved. Henry also made it home safely to a bewildered Blake who had been home all along, asleep with the ringer off and to Uncle Johnny and Auntie who both tried very hard to look stern when Henry told them the story of his adventure.
Later that morning , I too heard the whole story of how Henry had so desperately wanted to play with his friend’s crane truck that he had slipped from the house in the early hours, buckled up his helmet and biked on his own along our road, across a highway, and down a huge hill hugging Pelican Lake. He was only 500m away from his destination when Brendan had stopped him, but three kilometres away from his bedroom. Time to invest in some extra security measures for our doors!
Since that morning, I thank my lucky stars that we live in a small town, that we have friends and neighbours who look out for us and for family members who lend a hand at all hours at the drop of a hat. These are the reasons why a physician Momma can survive, by leaning on those around her. I know that our kids will always be loved and supported by Blake, our extended family, our circle of friends and their community. Regardless of where our family ends up, I hope it will always continue to be that way.
Here are some pictures of our blissful time in paradise this summer!
Life on Abram Lake 