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My Last Delivery

My last delivery



Olympia Washington has a wonderful summer tradition: Music at the Park. Just West of the first State Capital, an impressive Victorian granite building filling a city block, with cupolas and an imposing roof line is Sylvester Park. At just over an acre, it reflects the charm of the 1890’s and is as close to an old East Coast town park as we get: there is a central gazebo and a smattering of trees that provide shade. Cement walkways lead from all corners to the gazebo. In the summer, people fill the park sitting on the grass or portable chairs, have a meal, perhaps have drinks (violating a city ordinance) and listen to the bands that come to play on a weekly basis, every Wednesday evening, July and August. Despite the diversity of musical styles, the core audience remains the same, week after week and it reflects the diversity of the community. The local Air Force Band comes to play patriotic and military tunes? The oldsters with their VFW hats mingle with street people, college students, business people, State workers, the retired, and the occasional schizophrenic. The array of bands over the summer is diverse as well: Jazz, Classic Rock, Alternative Rock, Big band music, and Country.


One of my favorites was a Ska band! I even bought the CD and never heard of them again.


On a “blues” night, one August evening in 2010, I had a front row seat. The gazebo had a portable metal fence around it to prevent crowding to the stage and it gave the band some space. The fence was simple, metal uprights set in sections and linked together. The crowds segregate to a point; you land and put up your blankets and chairs, reserving space for friends. On this night, I was on the borderline between middle aged business owners and a counter-cultural group of twenty-somethings. It took me back to Santa Cruz. We were just yards from some small swings, teeter totters, and a few bike racks. Disheveled but happy toddlers ran about with abandon, occasionally disengaging from the play and throwing in some dance moves. A clutch of mothers socialized by the bike racks, long flowing print skirts and daisy-dukes, white peasant blouses showing tanned skin and long mostly unkempt hair. There were a few men who were shirtless. They smoked and took the music in. While there was dancing with adults here and there, these women danced with each other and the men stood back, tapping feet and looking impassively at the band. A blissed out colorfully dressed man with feathered wings attached to his arms swayed to the music.


I joined Kernie, my wife, after a long day’s work and we enjoyed Teriyaki chicken prior to the concert. The music was pulsing, loud, and melodic. I broke the law and had a beer. As the music picked up the young people now including some of the men danced as though it was Woodstock and their children mimicked them. I saw one young man holding hands with his child as his wife chatted it up with some girlfriends. Her attention was on her friends, and his attention was on the band when we noticed that the child had stuck his head between the metal supports of the fence, and could not get it back out. Kernie brought it to my attention and I laughed. How many comedy routines have used this, right? I was amused at the first couple efforts on the part of the child, not yet discovered by dad. The music was loud and I could not hear much else except for Kernie’s suggestion that I help the child.


By this time, the father discovered the child’s problem and he, in a panic, tried all the wrong moves which hastened a sense of crisis for father and child. I remained amused. I noticed he looked over at his wife who was clueless about this problem. He chose not to engage her.


The music played on. Another minute passed. My feet were tapping and I thought that the bass player had an especially good style of head motion as he played.


Kernie did not ask again; she made a motion and then seconded it with emphasis. I needed to go help the father. I was not so sure. I had had alcohol and was on reflection, was mostly in possession of my wits but I gave this some thought-- just what skill did I have here that the father or any other adult in the crowd did not? I felt vulnerable— while most of this crowd were strangers to me, the idea of failing this child with all the fuss and noise that would accompany that effort, made me self conscious, anxious and hesitant. The fact that I am a physician added to my anxiety: of course they have a training for this in residency or continuous medical education courses, right?


NO!—and I am not an EMT…..


I actually looked over the crowd to see if I could recognize an EMT or fireman who might have practical experience and then had to accept that the jaws of life were unlikely to be in the pocket of such an individual even if I found one.


So, I followed protocol for any emergency; I checked my pulse (slow and steady) and resolved to be a Good Samaritan. I walked over to the the young man who stood hopelesly staring down at his child. I touched his shoulder and shouted in his ear (the music was billowing loudly from a speaker ten feet in front of us), “can I try to get him out?”


My grey beard must have given him peace as he nodded with a distinct energetic movement suggesting he saw potential salvation and felt a measure of hope as he once more, looked over at mom. He moved out of the way. I stood over the child, one leg on each side of the kneeling body and suddenly, I was in the delivery room, Natividad medical center, 1981.


I was trained in a County Hospital as a Family Practice doctor. We delivered a lot of babies. I had some experience delivering breech babies. The majority of those were women who had had many children, and the job as with many deliveries was simply making sure I was there to catch the baby in time. But breech deliveries in a woman with no prior children was an altogether different problem. While book-learned and with a few examples of putting on the special forceps for such a deliver (they are called Piper forceps) my experience was limited and I had seen very difficult deliveries done this way. One stood out; I had called for the operating crew to come in before the morning shift was to start and set up for a C-section but without cell phones, there was no way to expedite this. The woman in labor needed a C-section because her baby was in a breech presentation and this was her first baby. This baby was not waiting for the operating room crew to arrive. I was delivering the baby’s legs and arms when the attending OB finally came in. We applied the forceps and with all my effort, I could not deliver the head. Dr. Lauderdale hip checked me and demonstrated: you pull down forcefully while at the same time, rotate the handle of the forceps upward, the head being the focal point of the rotation.


I did not do that delivery but the lesson and technique stayed imprinted so that 14 years after my last normal delivery in a hospital, I now stood over this little kid and appreciated how I was going to get him delivered from his trap. I put three fingers on each side of the child’s skull, mimicking the placement of Piper forceps on the head of a baby being born in this setting and while gently pulling back lifted and rotated the skull.


It was too easy. The child stood tall, free from the fence. Not a mark on him! The shirtless slightly stoned father slobbered his thanks, took the child by the hand, and wondered back to mom, smile on his face. I looked back at the crowd and not an eye was on me; no one appreciated what I had done! The band rocked on.


Kernie made eye contact with me and smiled. She really does make me a better person.


It was a great concert.




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