I came to work tonight with a bad attitude. I brought irritations and
squabbles from home with me and did not manage to leave them in the
dressing room where I changed into scrubs. My assignment was to a labor
room with two patients in early labor. I introduced myself in Spanish
and told the two women to let me know if they needed anything. I hoped
they didn’t ask me for much because my heart simply wasn’t in it
As the night progressed, our chronic short-staffing left all the labor
nurses confined to their rooms. Merilee, who was making a valiant effort
to get to each of us for a half-hour respite, was repeatedly called back
to cover emergency deliveries. Usually, I accept this situation with
grace. It’s the reality of working here. Now caught up in my own
personal funk, I felt like a trapped animal.
So it was no smiling angel of mercy who greeted a sixteen-year-old
brought to my labor room at about 2:00 a.m. The transporter informed me
that the ER resident had checked this young lady and found her to be
four centimeters dilated. I asked Jackie, my new patient, to move from
the stretcher onto the labor bed. Cursing furiously in Spanish-inflected
English, she inched over onto the bed. That about ended her cooperative
spirit. It seemed I had a patient with about the same temperament as her
nurse, only Jackie felt freer to express her emotions.
I tried to get the leads for the fetal monitor attached to Jackie’s
tight little abdomen. She thrashed about and could not, or would not,
cooperate. At the same moment, Vanessa Cordova arrived to see our new
patient. The beautiful Latina resident observed the trouble I was having
eliciting any cooperation from the fidgeting teenager and did not lose a
moment in getting tough.
“Now look at me, young lady. You’re going to stop that kind of
behavior. You’re going to let the nurse put those things on your belly
so we can see how your baby is doing. In a minute, an intern is going to
come and put an IV line in your arm. Right now, I’m going to examine
you to see how far along you are. If we can, we’ll give you some pain
medicine. If you’re old enough to get pregnant, you’re old enough to
behave like a grown-up.”
Accepting a glove from me, Vanessa approached the bed to do a vaginal
exam. Jackie continued to pitch and toss in the bed. She would not open
her legs to allow the slender, raven-haired resident to do the exam.
Vanessa put her free hand on Jackie’s knee to nudge the girl’s legs
apart. Jackie proceeded to smack her hand away.
That did it.
“I don’t have to put up with this, you know,” Vanessa informed her
new patient in a disgusted tone.
“I didn’t want to come to this dump anyway,” responded Jackie
contemptuously. “I’ll get my boyfriend to take me down the street to
“Fine,” commented Vanessa sarcastically. “Let ______________
Memorial have the pleasure of your company. We’ve got all the business
we can handle without you.” She then stripped off her glove and left
the labor room without a backward glance.
My former irritability had fled somehow in the midst of this little
drama. I scanned the room to exchange saddened looks with Angelique, the
midwife on duty this night. Vanessa’s behavior was not helpful or
therapeutic in this situation. I wished that she could have scraped up a
little psychological savvy in dealing with this admittedly difficult
teenage patient. We were all a lot older and a lot better educated than
this tough young woman.
I waited for a bit until a nasty contraction subsided and then, in a
calm voice, I coaxed her.
“Look, Jackie, I know you’re in a great deal of pain. You can go to
______________ Memorial if you like. But realistically, they won’t be
able to do anything different for you. You’re in hard labor now, and
if I am right, things are moving along pretty quickly. Won’t you let
us help you?”
The now teary-eyed Latina looked up at me through a tumble of dark
curls. All her former bratty attitude appeared to crumble.
“I’m just so-o-o scared,” she wailed, again gripped by a whopping
I went out to the resident desk where Vanessa was working on charts. I
told her about the turnabout in our patient’s sentiments. Vanessa had
calmed down by now too.
“OK.” She sighed. “Get an intern to do her IV. I’ll come back to
check her in a bit. If she’s far enough along, I’ll order some
Demerol. Maybe an epidural would even be better.”
Things were to proceed along distinctly different lines from that point
on. There was to be no IV, no Demerol, no epidural. Unlike most
first-time labors, Jackie was dilating almost by the minute. When I
checked her, I could feel no cervix in the way of a hard little head.
Instead of the hour-long period of pushing one might expect with a first
baby, Jackie went on to bring her baby down in three to four
contractions. Soon, a fifty-cent-sized view of baby’s dark hair was
As the intern and I were pushing Jackie’s bed out of the door to take
her back to delivery, her boyfriend arrived. Informed that only minutes
remained before he was to become a father, he complimented Jackie
“M’ija (my dear little one), you done good!”
Jackie looked at me with self-conscious eyes, and we both laughed.
“Yes,” I commented to both, “she did great!
Excerpted from "Labor Intensive" by Natalie Wyler. Copyright © 2016 by Natalie Wyler. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. Excerpts are provided solely for the personal use of visitors to this web site.