As lives hang in the balance, the health care community is tackling emotional exhaustion within its ranks.
ROANOKE, VA. – A ringing telephone jarred Dr. Mark Greenawald awake at 2 a.m. The caller was a medical resident at Carilion Roanoke Memorial Hospital.
"One of your patients is going into labor," the resident said. "You might want to come in."
As he turned the key in his ignition, Greenawald remembers thinking the resident probably could handle the delivery on her own. Still, he wasted no time getting to the hospital. Within minutes of his arrival, "all hell broke loose," he says. "The fetal monitor started doing all sorts of things that didn't make sense." The mother-to-be, 20, began struggling to breathe. Greenawald's mind raced as he rushed to deliver her baby.
It soon became clear that the crisis was caused by a freak event called amniotic fluid embolism, in which fetal cells and other debris leak from the womb into the mother's bloodstream, sending her into shock. Once the leak occurs, there's little anyone can do: The maternal death rate for amniotic fluid embolism is uncertain but toward the higher end has been placed at around 60 percent. Those who survive can suffer multiple complications, including brain damage from oxygen starvation.
Greenawald's patient died soon after the delivery. Her newborn suffered massive, irreversible brain damage and died as a teenager.
Despite the odds of a tragic outcome, Greenawald blamed himself. Some of his colleagues cast blame his way as well.
"I had fingers pointed at me, questions raised about my care of this patient," he says.
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