Meanwhile, as I am trying to figure out what to do with W (they have no telephone and no reliable message drop), the OB floor is paging me frantically. J, who is now just over 30 weeks with a twin pregnancy, was admitted to Special Care with preterm labor - her first episode, a startlingly benign course as twin pregnancies go. She was hysterical and screaming and swearing and sobbing because she was on bed rest and couldn't go have a cigarette and could I please calm her down?
I told them to tell her to sit tight, and I would be there. This is the patient whom C described to me as "a bitch", but who seems to adore me. I was, after all, in clinic.
Once I got to the OB floor an hour or two later, finally - and still without a plan for what to do with W, except to make her husband promise to bring her back in three days and not to go to $other_state before the weekend - I was confronted with a hysterical girl (98 pounds of J, 60 pounds of two full-size 30-week babies) who couldn't catch her breath long enough to finish a sentence.
I'm not going to give you a cigarette. Or permission to smoke one.
She ranted at me. Most of it didn't make any sense.
You're still not getting a cigarette. But if you stop bugging me about it I'll get you a Coke.
Our OB floor, you see, has only 7-Up as a soda. I hate 7-Up. There's nothing with caffeine in it at all, and that's no good for my post-teenage junk-food junkie OB patient. She shut up. I got her a Coke. Other than nearly throwing a table at her brother, she was sweetness itself right up until I sent her home.
Yesterday, she paid me back a dollar for the Coke. I took it - I don't know what the rules are, but it was important to her.
I spent some time going over W's history with the OB proctor and ultimately established that ACOG has approved "social inductions" after 39 weeks. I called the proctor for the day after she was 39 weeks, and he said that it sounded like a very good reason to deliver a baby to him. Then came the fun part.
W and her husband have no telephone. There was no way to get hold of them. She was fourth on the induction schedule - a potential hold-off. I had to talk fast.
She made it in at eleven - hung out at McDonald's to use the pay phone to call in and check whether or not she was on the list. And now, baby is delivered, psychiatry consult called, and all seems well. J went home, no further dilation. But I'm three days behind on calling patients with lab results and discussing things like trichomonas on pap smears, and I'm tired of dealing with hysterical people, and I really wish people would stop complaining about being my box buddy because I'm my own box buddy all the time so I know what a pain my patients are...
At least, when you program, it follows its own logic. Computers don't come from dysfunctional families.