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Inside half-cover (IHC)

David Goulet

MD CCFP FPA

A different call: his wife, preeclampsia, protein on the dip, blood pressure elevated. They are admitting me to hospital. On rotation at CHEO with one more case to go, he discusses the matter with staff: You should go.

He drives to Kingston, where his wife is a teacher. She is gravid with twins, 30 weeks’ gestational age. That kind of fear: he says to her, How are you? Consumed platelets, a measure of expelled protein, primiparous. A platoon of specialists provide expertise. A resident he trained with takes him aside, explains the medical details pertinent to a decision; this resident then walks over to his wife and switches lexicons. What is the worth of a detail if it can’t be translated? The steroids in, the blood pressure stable, the platelets holding. The treating team wants to section, there being things that can go wrong, very wrong, very quickly;

and there is another decision, the negotiation between doctor and husband, doctor and father. He turns to his wife and says, What do you want to do? She answers, If you weren’t here I would just do what they told me.

The babies are born, and born alive, all the king’s horses and all the king’s men present at the delivery. He follows the second twin to the resuscitation room, watches masks being applied to their faces, tubes inserted, and someone in the room asks, What is he doing here? The resident who knows him, who had just talked to him as if he were a doctor, says, It’s ok. He’s a doctor. He says, I’m a doctor. I won’t freak out or anything. His kids are being warmed.

Three days later, it was safe for the parents to touch the twins. To touch their hands.

He went back to work at CHEO, put babies to sleep as a PGY-3. The first day back at work he says to the same staff (You should go), This is the first time as a doctor that I feel like I have something better to do. A neonate transferred from Kingston with a bowel obstruction is taken to the operating room. He speaks to the family after the operation is over, mentions that their son will be neighbours with his daughters back home.

Cover photo: Michelle Hill, Dryden, Ont Story: Shane Neilson MD CCFP, Erin, Ont

Additional photos and the French translation of the story appear on page 1470.

D’autres photos et la traduction en français du récit se trouvent à la page 1470.

T he C over P rojeCT

Canadian Family Physician has embarked on a project to assemble the portrait of family medicine in Canada. Each cover of the journal will feature a family physician chosen at random from our membership list, along with a short essay—a brief glimpse of the person and the practice. Over time, the randomness will become representative and the differences, taken together, will define what it is that all family physicians have in common.

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1470 Canadian Family Physician • Le Médecin de famille canadien | Vol 57: december • décembre 2011.. David Goulet MD