Hydroponic Tomato

This last week has been extremely stressful. Miscarriage at the tenth week. 20% of pregnancies end this way. We are just a statistic. This is one of those moments when character becomes more relevant than statistics. We look at it as having been handed the “Return to go” card. I am very proud of Nicole. On top of the emotional issues that affect both of us she had to deal with medical complications. She showed courage and determination.

We are resilient. A lot of sadness of course, but we had taken good care all along to be realistic about this being an embryo. We lost an embryo, not a baby. The inevitable has slightly changed our plan, not our objective. We are back to square zero and will be back at it with renewed energy once Nicole will have recovered physically.

We take some positives out of this tragic experience.

We had exceptional support from people around us. Our gratitude goes particularly to Danny and Guylaine in Trois-Rivières, to Simon in Québec-City, to Dr. Line Blackburn and the medical staff in Québec-City and to Nicole’s parents.

We learned a lot about the local health system, we understood the deficiencies of our nearly inexistent emergency plan and we are more determined than ever to make a baby, which means that our further plans will likely be postponed by a few months because the circumstances are such that we’d rather do it in a health system that we know.

Writing is therapeutic too. I’ve been writing a lot these days and will likely do a lot of it in the near future.

La dernière semaine a été terrible. Fausse couche à la dixième semaine. 20% des grossesses se terminent ainsi. Nous ne sommes rien qu’une statistique. Ceci est un de ces moments ou le caractère est plus important des statistiques. Nous prenons cet évènement comme ayant reçu la carte de “retour à la case de départ”. Je suis très fier de Nicole. En plus du coup émotionnel elle a du aussi faire face à des complications medicales. Elle y est passé avec courage et determination.

Nous sommes resilient. Beaucoup de tristesse, c’est naturel, mais nous avons fait attention, tout le long, d’être réalistes. C’était un embryon. Nous avons perdu un embryon, pas un bébé. L’inévitable a modifié nos plan, mais il n’a pas changé notre objectif. Nous sommes de retour à la case de départ et nous attendons la récupération physique de Nicole avant de reprendre nos efforts.

Nous avons tiré des positifs de cette expérience tragique.

Nous avons eu un soutien exceptionnel par les gens autour de nous. Notre gratitude va particulièrement à Danny et Guylaine à Trois-Rivières, à Simon à Québec, à la Dr. Line Blackburn et au personnel médical à Québec et au parents de Nicole.

Nous en avons appris beaucoup sur le système de santé local, nous avons compris les déficiences de notre plan d’urgence inexistant et nous sommes plus determiné que jamais de faire un enfant, ce qui veut dire que les autres plans seront probablement retardé de quelques mois, car nous voulons le mettre au monde dans un système de santé connu.

Écrire c’est therapeutic aussi. J’ai écrit beaucoup ce jours, majoritairement en anglais, car c’est la langue commune de tous nos amis aux quatre coins de la planète.

Finally home! Nicole’s operation went well, and I could fetch her at 03:00. Unlike planned, I could not get any sleep, so we first stopped for a sleep at her parents before continuing for Trois-Rivières.

Driving back was liberating. For the first time in a week, that highway I had seen so often looked completely different. No pressure. I set my cruise-control to the exact speed limit. Almost all cars would speed me by. Despite the authorities’ declaration of the year of road safety, over 80% of highway drivers are still driving faster than the speed limit.

We had finally time to talk things through. Discuss our priorities. Make plans for the future again. Once at home, it was time to take care of Nicole properly.

I went grocery shopping to prepare her a good dinner. To pamper her after the curettage I stopped at Lush on my way home. It was my first time ever in the shop, and the sales lady was trying to be nice. Of course she could not know what we’ve just been through.

Her first suggestion was a full kit that starts with a bath… stop! Can’t take a bath after surgical intervention. “I was thinking more of something for a massage”, I told her.

The next suggestion was at the display of parfumed massage bars. They have edible ones, very sexy… stop again! “I’ll have to share with you the situation we’re in: we just had a miscarriage, I want to pamper her, not to sex her”.

Now the sales woman knew what we needed, and I got a couple of excellent, relaxing massage bars. But she kept trying to sell me shaving foam, for both my beard and my scalp which have both grown to same length since the beginning of the week.

It was a quick drive to the CHUL. We arrived around 20:00 and Nicole checked in. We went up to the ward. The personnel was very competent and professional. They apologized for the chaos although we felt we were serviced very well and noticed very little chaos.

Service was given by females and male nurses. The rooms were mixed. It did not bother Nicole so I did not investigate further, but I can imagine that this can hurt some sensitivities. My guess is that the hospital was at or beyond operating capacity so they had to accommodate Nicole in whatever bed they found. I can’t believe that a hospital that size does not have an area dedicated to women undergoing this sort of procedure. There were at least six of them scheduled before Nicole when we arrived.

What did bother me was the TV rental in-room: 11$ for the first day and 8$ each additional day, for a tiny 12″ or so! Whoever has to go to hospital is better off passing at Wal*Mart and buying quickly a portable DVD player.

The nurse gave us a whole overview of the procedure and timings. The surgery itself lasts only a few minutes and after that they would keep Nicole for about three hours under observation. Nicole wanted me to be with her throughout the procedure but hospital policy was against it. And visitor hours close at 21:00. The nurse was very forthcoming. She offered to make an exception for me to stay after visitor hours because the exact time for the procedure was not yet scheduled and most likely Nicole could quit the hospital around midnight if there were no complications.

I did not want to cause trouble. Nicole and I agreed that I’d go home to rest and come later to pick her up A.S.A.P. But I could not even think of sleeping. I was too nervous. Lucky me I could go to my friends Simon and Catherine who are living nearby. At 21:00 Nicole called that she was going in. 3-4 long hours to wait. Simon kept me company over a small scotch and introduced me to some subtleties of classical music that I was never aware of.

I expected Nicole to call, as agreed, as soon as she is next to a phone after the procedure. That was meant to be around 60 to 90 minutes later. When at 23:30 there was still no news, I took initiative and called the hospital. I could not speak with her but I was told she was OK and I could pick her up at 2:00. Relief!

Simon had to work next day and I did not want to be too much of a burden. I left around 1:00. This was a quiet moment. Humidity had fallen and it was a kind of ghostly/foggy atmosphere. It was the second time in 24 hours I regretted leaving the camera behind in Trois-Rivières. The first time was earlier in the day, when driving with Nicole on Rue des Braves after buying her pain killers. There was a park with a church there that still had beautiful autumn colors. Next year.

I drove slowly from Simon’s place to the hospital stretching it and with the car’s ventilation at the maximum to get rid of condensation. I was slightly hungry and Simon recommended a Lebanese restaurant that is open 24 hours in Place de la Cité. I discovered there was a whole night life patch there, but did not really feel social, so I made another round of the block, parked, and walked slowly into the hospital.

It was so good to see Nicole doing better. We spent about half hour at her hospital bed, waiting for the last formalities and the official release. Then I drove her to her parents home where we could finally sleep. It was over.

Things got worse in the morning. Nicole complained of increased bleeding and pain. “We’re going to the hospital, now!” she told me after hanging up the phone. She had spoken to her doctor, who was practicing at another hospital that day. Another emergency ward. Will it be like CHUL? or like CHRTR? On the road to Christ-Roy hospital.

The first thing that stroke me, was the parking lot. There are three types of parking lots: free, pay-as-you-go, pay-in-advance. This was a pay-in-advance. 1$/hour or 6$/whole day. Emergency wards are unpredictable. At the CHRTR we stayed for nine hours. At the CHUL for three. What should I do? No-brainer: I paid for the whole day. Will leave the ticket for the next patient in need.

I think it is wrong to charge hospital patients parking fees. Customers at shopping centers seldom have to pay for their parking, why should customers at the hospital do? Of all payment models pay-in-advance is the most inconvenient one, unless it was designed specifically to take advantage of patients in need that can’t really predict how much time they will need? Anyway, this is a battle to be fought another day.

The waiting room was crowded. The building was old, with some unergonomic design decisions dating back to the Seventies. Very dark, brownish, oppressing ceiling. But things were moving forward CHUL-like, not CHRTR-like. Despite system inefficiency (once again she had to register with the hospital and answer basic questions for about 15 minutes) service was excellent and Nicole could see her doctor within less than an hour. Things got worse indeed. She prescribed her pain killers and told her to fast and to be available on call for surgery at CHUL.

Waiting, again…

We did not do much for the rest of the day. The pain killers helped. Evening came and just when we started to cope with waiting another day, the phone call arrived and we were driving to the CHUL.

The next morning. Early wake up and a 90 minutes drive. OK, it was 60 minutes. The mood is still hopeful, Nicole’s bleeding has not worsened. I drop her at the CHUL hospital entrance and drive the car to the garage. The big service (whole day) was scheduled well in advance.

Rain starts. I drop by quickly at Simon’s to pick up a few things left on Panic Day. Nicole calls saying she has already been through admission, including making a hospital card. That was blazing fast compared to CHRTR.

I continue to the garage. Service there was excellent as usual. This was the first time I made use of their complimentary shuttle service. I usually try not to cause more expenses than necessary and just take my notebook with. This time was different. They immediately understood the situation and drove me A.S.A.P. to the hospital.

In the meantime, in less than one hour, Nicole has been through admission, triage and a doctor performed an initial sonography on her. A three minutes procedure. When I arrived she was waiting to be taken upstairs for further investigations, though she already had a sense that it was only to confirm the inevitable.

Compare this: Same symptoms description. Simple prescribed solution: a three minutes sonography to diagnose what causes the symptoms. Same country. Same province. Same government. Same ministry. Same money. CHRTR: nine inconclusive hours of waiting. CHUL: One hour until provisional assessment plus two hours for in depth verification and decision over the course of action. Spot the difference? The emergency admission room was smaller and more crowded at CHUL than at CHRTR, but at CHUL things were moving forward.

We overheard a nurse talking to another patient. He had severe burning all over his face. The nurse noticed he was from Bécancourt, near Trois-Rivières. “Why didn’t you go to CHRTR?” she asked. “A 90 minutes drive to CHUL is quicker than waiting 12 hours at CHRTR” he replied. We could relate to this! In the current situation, the day we lost at CHRTR did not make a difference, but what if it did? we won’t take that chance next time.

It was not yet lunch time and we were in a sonography room. The first doctor (or maybe she was just a technician) zoomed in on Nicole’s womb. Left ovary, right ovary, the embryo. “What week are you in?” 9-1/2. “This is pretty small for 9-1/2 weeks”. She called a more senior doctor. He confirmed: the size is max. 7th week. “Happens one out of five pregnancies, it’s common. You’re unlucky that it has happened on your first attempt. We don’t even analyze this unless you have a history of 3+ miscarriages.” It had not flushed naturally, it will have to be removed.

We arranged for Nicole’s parents to fetch us. Her dad even shaved for the occasion. For the past ten weeks Nicole had followed recommended pregnancy diet. The first thing we did out of the hospital was breaking that diet. Sushi.

I was shooting on assignment at the Jewish cemetery in Quebec-City that afternoon, with my friend Simon. It was a perfect Indian Summer weather, with temperatures above 20°C. Then we went to a shopping center buy him a new router. While at the checkout counter, my cell phone rang. It was Nicole. Something bad happened but the line fell. Panic! It took fifteen minutes to re-establish communication. Already the initial interaction brought to light how inadequate our emergency planning was. We had no plan!

She was bleeding. Many women have bleedings during the first three pregnancy months. Her doctor said she should schedule an emergency sonography but it was already past 15:30 and the hospital’s scheduling line was no longer attended. We decided to go to the emergency ward and wait there. Little problem: she was in Trois-Rivières, no car. I was in Quebec-City, 90 minutes away. Rush hour was just beginning!

Simon was kind enough to let me drop him at the next bus station. Then I drove toward Trois-Rivières. I was speeding. All I had in mind was to reach Nicole A.S.A.P. I was very lucky when I drove past two police cars busy enforcing speed limits. Compared to Switzerland, Germany and France, Quebec’s police use inefficient speed limit enforcement.

Later on there was a work zone. For eight long kilometers I could not pass the cars ahead of me. Speed was reduced. The slow down made time for me to actually think and tinker with the cell phone. Why had I not thought of it before? one of our local friends could drive Nicole to the emergency ward.

Danny was just back home from his work day. In ten minutes he drove Nicole to the local hospital where his girlfriend Guylaine is a nurse. She just finished her shift and helped Nicole through triage. This solved the choice of emergency ward, the options being locally in Trois-Rivières or at our hospital in Quebec-City, with a 90 minutes drive trade-off between them.

I arranged for some food for Nicole (a falafel from El Taouk) and myself. Then we waited. Almost nine hours, before going home with half of a lesson learned: we will find out in the coming days that the emergency ward at the Trois-Rivières Regional Hospital Center Sainte-Marie is different than the emergency ward at the two Québec-City hospitals (Christ Roy and CHUL) we will be dealing with.

But for now, we did not know. All we knew was that we have wasted a full nine hours. It did not have any influence on the outcome, and next time we’ll know better how not to waste time. Tomorrow is another attempt to see a doctor.