The Intern Blues(150)

On the other hand, Amy thought, this was her baby, her son. He had grown and developed in her womb for nine months. Knowing that a treatment was available (even though the treatment was not even close to guaranteed to work) and that that treatment might give him a life, could she deprive him of this chance simply because life would be hard for the rest of the family? She was not sure.

The cardiologist understood her concerns. He started the baby on a Prostaglandin drip, an intravenous medication that would keep the ductus arteriosus open while Amy and Larry made a decision about what to do. Later that morning, from her hospital bed, Amy began calling everyone in the world she trusted and respected, telling her terrible story and asking for advice. I was on the list of people she called. During our conversation, I mostly listened to what she had to say. It seemed clear from her words that she had already made up her mind; she was looking for approval for her decision to stop the Prostaglandin and let nature take its course. I did as she implicitly requested: I agreed with her reasoning and tried my best to offer support.

By late that afternoon, the decision was finalized. She and Larry met with the neonatologist and told her that they wanted the Prostaglandin drip turned off. After the IV was pulled, the baby was brought to Amy’s room on the maternity floor. He died in his mother’s arms early the next morning.

In the months after the death of her son, I spoke with Amy every few weeks. On October 20, the family held a private funeral. Not unexpectedly, following this, Amy went through a period of depression. But the demands on her time, caused by the need to care for Sarah, who was then three and a half years old, and Eric, who was nearly two, prevented her from becoming dysfunctional. “I have to get up every morning and get Sarah ready for nursery school,” she told me during one of these conversations. “And Eric needs everything done. The only time I get to myself is when he takes his nap. For me, that’s the worst time of the day. That’s the time I sit and think about exactly what I did.”

In early spring of 1989, Amy told me that she and Larry had decided to move to Israel. “There’s not a lot for us here,” she explained. “I don’t have a job and Larry’s not happy with his. The only family I’ve got is my father, and he’s thinking of retiring and moving away. And there are all these memories of what’s happened.”

I hadn’t spoken with her since that day. But now, here she was, picking up the phone after the third ring and saying “Shalom.”

She said she was happy to hear from me. “We live just outside of Jerusalem,” she told me, sounding exactly as she had more than ten years before. “Larry, me, and our four kids.”

“Four kids!” I repeated. “When you left New York, you only had two.”

“That’s right,” she answered. “Our last two are sabras. Aviva was born in 1990, and Seth, our baby, was born in 1992.

“And Sarah and Eric must be teenagers.”

“Right, again. Can you believe it? Sarah’s going to be sixteen in a couple of months. And Eric’s fourteen. It’s been great watching them grow up.”

“Have you been working?” I asked.

“Well, I’ve been a mother, which is a full-time job. But no, since coming to Israel, I haven’t worked as a pediatrician. That’s not the way I planned it; when we first arrived, I thought I would. I investigated how to go about getting licensed. But it was a lot of trouble. At the time, there was a glut of doctors here, and they were making it as difficult as possible for physicians who had trained outside the country to get jobs. To me it was no big deal: I had the kids to take care of, Larry had a good job, we didn’t have to worry about money. Since then, the time’s just passed, I’ve taken care of my children, and here we are in 2001.”

“Do you miss medicine?”

“No, not at all. When I started medical school, I really did want to be a pediatrician. But somewhere along the way, I just stopped wanting it so much. Residency kind of beat the desire out of me. And then when my baby died . . . well, that kind of put the icing on the cake. After living through that experience, I just didn’t care about medicine anymore. It was just a job, something to do to earn money, and since we didn’t need money, there was no need for me to do it.”

Knowing the answer in advance, I asked whether she thought her internship was worth it. “Internship was the second-worst experience of my life,” she responded. “I don’t have to tell you what the first-worst experience was, because you were around for that, too. But other than watching your baby die, I can think of nothing I’d want to do less than spending a year as an intern. It was degrading, depressing, and frightening. It brought out the worst in me, in my classmates, in those in charge of the program, in everyone. It was unhealthy, and it was just unfair—unfair to us, unfair to the patients, unfair to society. Back when I was doing it, I couldn’t see why I had to do it, and looking back on it now, I still can’t understand why I had to do it. So Bob, you can put me down for a ‘no’ vote. I don’t think it was worth it!”