My baby has no arms

A prenatal patient returned to review her ultrasound results with me this week. We had barely seated ourselves in my little exam room when the she burst into tears. The interpreter listened intently to the patient's concerns, looked aghast and relayed to me, "The baby has no arms!"

I flipped through the chart for the ultrasound report, certain that I would have recalled signing off a result with such an unusual anomaly. Sure enough, it read: Single live fetus. No fetal abnormalities seen today.

"Why do you think that something is wrong with the baby?" I asked.

Like many of the prenatal patients at the refugee clinic, she had never had an obstetrical ultrasound in previous pregnancies in her home country, and was unfamiliar with the procedure. Apparently the exam had taken forty minutes, much longer than the patient had expected, and so she became suspicious that there was a medical concern.

The local radiology departments do not provide interpreters, and many patients do not have any English-speaking friend or family member to accompany them. So it's not uncommon for a patient to attend the ultrasound appointment alone, unable to ask questions or understand comments, and to follow up with me a week later to review the results with the assistance of the clinic interpreter.

The patient reached into her purse and pulled out a print-out of an ultrasound image. It was a lateral view of the fetus, with the skull, vertebrae and protuberant abdomen readily identifiable. She gestured at the picture. "No arms!" she repeated, her eyes welling up with fresh tears. I could see that to an untrained eye, the baby's upper limbs would indeed appear to be absent.

*

"The baby does have arms!" I reassured her. "They're not clear on this picture because of how the baby's holding them. Look - I can see the fingers of the right hand over here, and the left shoulder over here." I showed her the corresponding white streaks on the image.

And while I enjoyed being an instrument of reassurance, while it was a pleasure to offer her such enormous relief, it disturbed me that she had had to navigate the ultrasound experience and its aftermath alone. No mother should have to go a week convinced that her baby has no arms.

* Not the patient's ultrasound, but another baby who could have been taken for armless, but wasn't - Ariana.

Comments

[dragonfly]

Thats similar (but different) to a post I was just reading on Dr David's blog before where he got to tell someone they didnt have cancer.
Those moments are so lovely and rare (but the poor mother, thinking that her child had a significant birth defect).