"They're Hiding"

Monday was pretty slow at work because of the holiday. At about 4:30pm, however, we got a frantic call from the ER telling us that there was a patient coming in by ambulance that was at full term and in active labor.

About 10 minutes later, the patient (a 350 pound black woman) came flying through the doors on a stretcher with a full entourage of ER and EMS staff (one ER doc, one ER nurse, and four EMTs). The EMTs were helping her breathe through her contractions and holding her hands. Apparently, the patient was apparently 3 days past her due date and her water had broken about 30 minutes prior to her arrival. Oh, and by the way, she was carrying triplets!! First red flag. None of our perinatologists would ever let triplets get past about 35 weeks gestation, yet this patient is apparently past 40 weeks.

All the same, we rushed her to the recovery room next to the OR, because if she was indeed in labor we would need to do a c-section. The NICU was alerted and came running over looking harried. According to the patient, she had gotten her prenatal care with Dr. P. Second reg flag. Dr. P moved her practice to another hospital about a year and a half ago.

The ER doc had done a quick cervical check in the ER just make sure there wasn't a head coming out. This check was confirmed by our OB docs. The ER staff then went back down to the ER. Since there were about 8 people in the room I went back out to the nurses station to keep an eye on all the other patients. A few minutes later the ER nurse called up and said, "You know, I was talking to one of our docs down here. He thinks he remembers that patient and said she's totally crazy. Just so you know, she may not even be pregnant. Call me back when you guys figure out what's going on with her." I promised to give her an update when I heard any news.

About five minutes later the OB resident came out with an exasperated look on her face. After doing both an abdominal and a transvaginal sono, they confirmed that there was absolutely no baby in the patient's uterus, let alone three. To this the patient had responded, "Oh they always have trouble finding them. They're hiding."

After that, the patient was sent back down to the ER, as she was clearly a psych case and not an OB case. I talked to my friend in class the next day who works in the ER. She says they get psych cases all the time claiming to be pregnant. I guess most of them just don't make it to us. Probably they just don't put on quite as much of a show as this woman did. As I said before, she was 350 pounds, with a belly that looked like she easily could have been pregnant with at least one baby. Plus, she really did act like she was having painful contractions. Maybe she was faking it or maybe due to her mental illness she really was feeling psychosomatic pain.