Hooray for Pis Pis!
A baby I delivered a couple of days ago was labeled “unable to pis pis” (aka pass urine, pee, piss, etc…) I immediately went to check the charts to see if the baby had a 2-vessel cord as this can be a marker for genitourinary issues. But of course, they don’t do newborn exams here in the immediate postpartum and there were no notes. I sat down and worked out a flow chart for babies who no pis pis and then took it with me to examine the baby. The cord was too dried to see good remnants of the typical A-A-V (artery, artery, vein) arrangement so I could not rule out a missing artery. I worked my way down my chart (very officially written on the little 4×5 notebook I keep in my pocket!) and I could not find anything. Cursing myself for leaving the phone number of a certain ND friend who likes to solve mysteries at my room, I redid my checklist. Still nothing. The baby was breastfeeding well and at the very least I would think we would see a distended bladder or feel fluid in the abdomen. But this perky baby was the picture of perfection. The pediatrician called in meanwhile and told us to tell the mother to wait a week and if still no pis pis then they will do a scan (ultrasound). I’d like to see anyone wait a week while we don’t pee—puhlease. Another midwife and I decided that was no good. I felt that the wrong people might be being accused of retentiveness and turned my thoughts to the pediatrician who had diagnosed the problem and decided to wait a week to investigate it. This baby was the aforementioned first boy, youngest sibling of 3 girls, whose father had clapped me on the back many, many times. I was not going to let him slide down the slippery slope over the course of a week. Having decided that either one of two things was happening, one being there was something I could neither see nor feel and that something did not bother the baby at all and two being that the diagnosis was wrong, I decided upon a course of action. I went to visit baby N every 15 minutes and I took a good look and feel in his nappy. I was posted and on the job, refusing to jump into anything else that would divert my attention. That is, until the little 2 year old sibling of an almost-born baby climbed into my lap. We laughed, we plei-pleid (played), we drew pictures in my notebook which she loovvveed. Her grandmother tried to dissuade her from my person but neither of us would have any of it. We made fishy noises as she was excited by the fish-mobile hanging in the hallway. We skipped and marched in little circles. This little activity made me very popular with the locals who were milling about taking care of their loved ones. Maybe we play differently or maybe they were just happy to see a white girl who likes children, either way I got claps and smiles aplenty. And every 15 minutes my new friend would toddle behind me down the corridor to watch me stick my hand in a baby’s nappy.
At the 2hr check, wonder of wonders, miracles of miracles, Pis Pis!!! I admit I had grown anxious and was wondering who I was going to have to corner to get this baby cared for but all such thoughts fled my mind as I did a happy pis pis dance with the toddler and baby N’s grandmother! I then strutted down the hall like the proud mamahen I was and announced to the midwives and nurses “We have Pis Pis!!” They stared at me and then I remembered to put that in the correct vernacular to be a little more clear that it wasn’t “us” that had pis pis, but the baby who belongs to M who has pis pis. “OOOOH,” they said and started laughing at me. I decided to hunt down the pediatrician so returned my little friend to her family, giving her the piece of paper she had scribbled on.
I learned today that to get to pediatrics if one takes the wrong corridor, one has to walk the length of geriatrics. As I walked through some of the old people reached out and I stopped and held their hands and talked with them. These are such a lovely, heart-led people. The first thing they share with me isn’t who they are or what they do, it’s just a warm smile and a bit of silence. I made my way slowly through geriatrics and then across to peds. I found the doctor and shared the good pis pis news then went to see if there were any kids who might want to plei plei. One of the mothers of the ortho babies who are stuck in one place because their legs are casted and suspended from a rope contraption had fallen into a deep sleep while nursing her baby. The Baby was wiggly and fussy so I quietly went and sat next to the bed and played with him…mom didn’t even stir one bit. We played peek-a-boo, pet Jodilyn’s bracelet, and we said the letter “o” in quite a few different ways until he got tired and closed his eyes for a nap with mama. I taught an older kid in a wheelchair the hand-slapping game, even though things were weighted on his side as he had an IV in one hand and I was unable to slap that one with any real intention. My hands plenty red from my big loss, I headed back up to maternity.
Medicine here is strictly clinical—very much like the 1950s in America. But it has been shown how much joy and human touch and concern improves clinical outcomes and I am unsure why this hasn’t reached this little island of joyful connected people yet. I’d like to go over to Papua New Guinea where these docs are trained and get into their minds a bit about “bed side manner”. Somebody comment and tell me the name of that Robin Williams movie where he cheers up patients? We should show it at the next staff training.
Meanwhile, I am headed back later tonight as we have 3 premature labors (mothers who are all between 26 and 28 weeks along) in the works…