She stood just outside the room, blocking my exit so when I opened the door, hoping to have a moment to process what had happened, I almost walked into her.
My damp scrubs stuck to the small of my back. My legs ached. My hands still smarted from the hot water that had washed off the dried blood which had speckled my forearms and trickled inside my gloves to my fingernails. Fatigue and hunger were making me feel nauseous. A buzzer sounded up the corridor.
A man walked past, carrying a large silver balloon with a small bear with “Congratulations” on it. I moved aside to let him into the room I had just left.
She was tall, her dark hair drawn back, and lips pursed. Almost graceful. Her left hand rested on her left hip through her blue scrubs, whilst with her right hand she formed a wagging finger at my eye level.
Her blue eyes looked directly into mine.
“Naughty. Tut tut. That was entirely your fault,” she said. The fluorescent bulbs glared and reflected off the linoleum floor.
The senior midwife stood next to her looking on.
“Sorry” I reflexively said, feeling my eyes pricking.
I turned to the midwife.
“Sarah, please let theatre know we’ve got a case. Possible third degree tear”.
Then I had no option but to accompany her to the handover room.
“I don’t know what you were thinking pulling down for so long, no wonder she tore” she said.
I sat down behind her on one of the chairs, tucking my legs under the desk whilst feeling my lower back sag into the chair. My mouth was dry. I can’t remember what I said in response. Perhaps I said nothing.
I remember the feeling as if it was yesterday, ashamed, guilty, exposed. I was ill-equipped to deal with it.
I couldn’t formulate a response.
Feeling numb, I went back into the room to explain what had happened to the mother. The balloon bobbed cheerfully at the head of the bed. The room was warm but her new clean white sheets felt cool as I placed a hand on the bed to keep me steady.
I could see a pile of bloodied sheets in the corner of the room. The used metal instruments clinked noisily as they were tipped into the bin. The placenta made a wet slapping sound as it was placed in the shining stainless steel kidney dish before being taken to the sluice. Her baby was calm, snuffling and sucking its hand.
I can’t remember her name and barely remember her face. I do remember her bewildered look, the exhausted euphoria that comes with having a new baby. The distracted acceptance of the events as I explained them: that when I helped her deliver her baby, she had torn. She signed the consent form.
I didn’t apologise.
I didn’t apologise.
A short time later in theatre, I assisted in repairing the tear. I watched as she meticulously brought tissues together to close the mother’s wound. I helped to hold this suture here and cut that suture there. I helped mop up blood when it obscured a clear view of the skin. I wiped the blood away afterwards and counted the swabs with the scrub nurse. I gave the notes to her so she could write up the work she had done.
Later that day, as I was cycling home through the Saturday morning traffic and remnants of others’ revelry the night before, I would think about her comment as we walked away from theatres; patting me on the back, she sarcastically told me not to make the same mistake again because she didn’t want to have to clear up my mess again the coming night. Again, I apologised.
I often think about that night shift. It felt seismic in its effect. I think about that mother, who was owed the apology. I think about the apology I gave away so cheaply to someone who didn’t deserve it. And, finally, I think about why I decided to leave obstetrics.
Alice Bell is a GP in London and one of the runners-up in this year’s BMA writing competition