LABOR PAINS (PART 2)
The second baby born thatyear at the hospital was to another couple who lived in Cherokee. They had been referred to our practice by one of the physicians who served at Cherokee Indian Hospital— where they did not deliver babies—and by Mrs. Black Fox.
Rick and I were excited about this turn of events because prior to this delivery all Cherokee deliveries had been referred to an obstetrician at C. J. Harris Hospital in Sylva.
Rick had attended the birth and then called me to join him in the nursery the next day. “Look at this,” he said as I entered our small nursery. I quickly scrubbed my hands, put on a gown, and joined Rick by the baby’s crib.
“Cute baby,” I commented.
“Sure is,” Rick responded. “I think it’s because of the doctor who delivered her!”
“But,” Rick commented, sounding suddenly serious, “look under here.”
He took off the baby’s shirt and diaper, and the problem was obvious. The baby’s diaper area and trunk were covered with tiny pustules.
“The baby’s vital signs are normal, the CBC is normal, and she’s eating like a champ. I don’t think this is a systemic infection. But what do you think?”
I thought for a moment. “Do you want to culture the baby?”
“I’ve cultured the pus from several pustules I ruptured and have done blood and urine cultures. I’m just not sure about whether to do a spinal tap.”
“Rick, I think I would. We can’t afford to be conservative with little ones like this. And I think I’d cover her with IV antibiotics for at least forty-eight hours—until we get the cultures back.”
“I was hoping you wouldn’t say that,” Rick commented.
“Well, why not call Tom Dill over in Sylva? He’s practiced pediatrics for a long time. See what he says.”
Dr. Dill concurred with my recommendation. And the baby did well. All of the cultures were negative, except for the skin cultures, which were positive for a type of bacteria called staphylococcus. After two days on intravenous antibiotics, the lesions were drying up, and Rick sent the baby home with another week of oral antibiotics.
Then, in the fourth week of January, we had two babies in the nursery with the same problem and the same clinical course.
Nancy Cunningham, Ray’s wife, was the RN at the hospital in charge of infectious disease problems. She reviewed all of our obstetrical and nursery policies, procedures, and practices and couldn’t identify a problem.
“Be careful,” Nancy warned us. “There are nurses whispering that the problem is you two.”
“How can that be?” I asked. “Just be careful,” she warned.
The next week we delivered four babies—a new record for one week at the hospital. That was the good news. The bad news was that three of the four came down with the mystery pustulosis. That put Nancy and me on the phone with an infectious disease expert at the North Carolina Department of Health and Human Services. We agreed to send the records of the six infants and their moms to him for review. Our concern was that they might shut down our birthing suites and nursery.
“Could it be our facility?” asked Nancy during the discussion.
“I doubt it,” answered the expert. “But I want to initiate a complete investigation. I’ll send a team out there. They’ll arrive tomorrow night and go over these cases and the hospital with a fine-tooth comb. So far no babies have been hurt. But staph infections can be very dangerous. Something’s going on, that’s for sure!”
When we hung up, Nancy gave me even more bad news. “It’s Dr. Mathieson.”
“What now?” I moaned. I remembered last year when he and Dr. Nordling had, I believed, led a movement to have our hospital privileges revoked.
“He says one of our nurses in the hospital is willing to testify to the medical staff that you and Rick don’t use good technique in the birthing suites. They say you all allow too many women in the suite to help the laboring woman, and these women aren’t sterile. Whoever this nurse is, she says you all don’t always scrub before you examine the babies in the nursery.”
“Nancy, that’s all a bunch of hogwash. Of course the women aren’t sterile! Neither are our nurses. And they don’t need to be. And furthermore, our practices in the birthing suites and the nursery are standard of care. This infection isn’t coming from us! But it’s got to be coming from someone. Staph doesn’t live on inanimate surfaces for very long. I bet someone’s carrying this germ and spreading it— just like Typhoid Mary. I’d call the culprit ‘Staphylococcus Sally’ or ‘Staph Sam’ and begin looking for him or her.”
“That may be, Walt, but have you considered that maybe the carrier is you? Maybe even Rick?”
“Well, I’m surely willing to be checked. But everyone else needs to be checked too. That’s only fair.”
“Let’s see what the infectious disease team says. But I’ve got to tell you, Ray is concerned. And as chief of staff, he’ll have to investigate this complaint.”
I nodded, and Nancy whispered, “Just keep a heads-up, okay?”
TO BE CONTINUED
PAST STORIES FROM BRYSON CITY SEASONS
- Dead Man Standing (Part 1), (Part 2), (Part 3)
- Eyes Wide Open (Part 1), (Part 2)
- Auspicious Accidents (Part 1), (Part 2)
- Answered Prayers (Part 1), (Part 2), (Part 3), (Part 4)
- Rotary Luncheon
- Death by Emotion (Part 1), (Part 2), (Part 3), (Part 4)
- The Invitation (Part 1), (Part 2)
- Barbecue and Bacon (Part 1), (Part 2)
- A Touchy Subject
- Family Time (Part 1), (Part 2)
- Chicken Pops(Part 1), (Part 2)
- Swain County Football (Part 1), (Part 2)
- Hospital Politics (Part 1), (Part 2), (Part 3)
- The Bobcat Attacks (Part 1), (Part 2)
- Dungeons and Apples
- A Tale of Two Surgeons (Part 1), (Part 2), (Part 3)
- Tanned Feets (Part 1), (Part 2), (Part 3)
- Wise Counsel (Part 1), (Part 2)
- An Anniversary to Remember (Part 1), (Part 2)
- Mrs. Black Fox (Part 1), (Part 2)
- The Littlest Cherokee (Part 1), (Part 2)
- Christmas Firsts (Part 1), (Part 2)
- The Silver Torpedo
- Another New Year’s Catch
- Turned Tables
- Doctor Dad (Part 1), (Part 2), (Part 3)
- The Phone Tap (Part 1), (Part 2)
- Labor Pains (Part 1), (Part 2)
PAST STORIES FROM BRYSON CITY TALES
- The Murder (Part 1); (Part 2); (Part 3)
- The Arrival (Part 1); (Part 2)
- The Hemlock Inn (Part 1); (Part 2)
- The Grand Tour (Part 1); (Part 2)
- The Interview (Part 1); (Part 2); (Part 3)
- Settling In (Part 1); (Part 2)
- First-Day Jitters (Part 1); (Part 2)
- Emergency (Part 1); (Part 2)
- The Delivery (Part 1); (Part 2)
- The “Expert” (Part 1); (Part 2)
- The Trial (Part 1); (Part 2)
- Shiitake Sam (Part 1); (Part 2)
- Wet Behind the Ears (Part 1); (Part 2); (Part 3)
- Lessons in Daily Practice (Part 1) — Anal Angina; (Part 2); (Part 3); (Part 4)
- White Lies
- The Epiphany (Part 1); (Part 2)
- Becoming Part of the Team (Part 1); (Part 2)
- Monuments (Part 1); (Part 2)
- My First Home Victory (Part 1); (Part 2)
- Fisher of Men (Part 1); (Part 2)
- Fly-Fishing (Part 1); (Part 2)
- Something Fishy (Part 1); (Part 2)
- A Good Day at the Office
- An Evening to Remember
- Another New Doc Comes to Town
- ‘Twas the Night Before Christmas (Part 1); (Part 2)
- A Surprising Gift
- The New Year (Part 1); (Part 2)
- The Home Birth (Part1); (Part 2); (Part 3)
- The Showdown (Part1); (Part 2); (Part 3)
- The Initiation (Part 1); (Part 2); (Part 3)
- Home at Last (Part 1); (Part 2); (Part 3)
© Copyright WLL, INC. 2017. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.