Tino (TD): Thanks for tuning in. You’re listening to Firsts, a podcast about first-time medical experiences. My name’s Tino, and I’m a third-year medical student.
I have a 2-part series called “First and Last.” Part 1 is about birth, and part 2 is about loss. I put these episodes next to each other to give you an idea of the range of experiences that I’ve been having this year. As a med student, I get to work with people at some of their best moments in life and some of their worst.
This episode has a few stories about birth. My grandmother will talk about how she ended up in a train crash while she was pregnant with my mom. Then, my mom will tell us about her first miscarriage and first delivery. But first, I’ll talk about the first time that I assisted in the delivery of a child. So, without further ado, here is “First and Last, part 1.”
(soft piano music)
TD: The pandemic completely changed how our lives have looked. School went online; a lot of work moved home; and many folks lost loved ones. But even in the most dire of circumstances, we made new beginnings: couples got married; students graduated; and mothers gave birth. Much of the joy and the pain, both the highs and the lows of life have persisted in 2020.
Over the summer, I worked with a patient who was pregnant. One early afternoon, she started feeling big contractions. So, a midwife and I positioned ourselves at the foot of the patient’s bed. Then the patient started to push. The midwife readied her hands. And she told me to put my hands over hers so that I could understand the motions of catching a baby.
Soon, the baby’s head began to crown. Then he rolled to his right side. And his left shoulder popped out. Then his right shoulder came. And before we knew it, the baby was out, breathing, crying, and placed on the mother’s chest.
Both the mom and the dad were crying, smiling, saying hello to their newborn, and calling them by name. Before we left, we thanked the parents for allowing us to be a part of the delivery and the beginning of their baby’s life.
Despite the physical pain and intensity of the moment, I remember that experience for the joy that I saw and felt. It was amazing to have witnessed the end of a hardworking mother’s 9-month journey. I got to be present for her baby’s first breath, first cry, and first hug with their parents. I remember looking around the room and thinking that we had all been given this gift of living.
I can only imagine what it must feel like for parents to hold their baby for the first time, if only watching childbirth made me feel this way.
(soft piano music)
TD: So I was on the labor and delivery floor last summer. And after that, I told my family about making an episode about witnessing the delivery of a baby. Delivery itself amazed me. But what I hadn’t realized was that there were even more dramatic stories about childbirth within my own family tree.
For this next segment, you’ll need to know 2 words from the Filipino language. The 2 words are Lolo, which means “grandfather,” and Lola, which means “grandmother.” My grandmother – Lola P – had a near-death experience when she was pregnant with my mom. Here she talks about waking up in a hospital. She was trying to piece together why she was there in the first place.
(sound of an approaching train)
Lola P (LP): It was a Sunday evening, I think, and of course we did not know anything about it. I woke up. We were both in a straight chair in the hospital already. I said, “What happened?”
TD: My grandparents had been driving home from a friend’s house. At one point, they intersected with train tracks. It was past 11 pm, so the guard manning the gate had gone home. The gate there would’ve stopped my grandparents from crossing those train tracks. But that night, it was left up and open.
LP: The train came, and it pulled us up to – well, it cannot stop right away, you know; the train cannot stop right away. So, when our car was off the track already, we were thrown out of the window.
TD: That night, my grandparents had friends driving behind them. When they got to the intersection, they saw the aftermath of the crash.
LP: They pick us up. We were good as dead, Lolo and I. And I was six months pregnant with your mom. So our friends who came after us pick us up and brought us to the nearest hospital, which was quite a distance.
Your Lolo was hit somewhere near his head. He was comatose. I woke up earlier. I was ahead of him. But I could not move also because of the broken arm and my big stomach. I had [hurts] all over my body. My left leg was also broken, and every time we would go to the doctor, they would bring me up to the operating room to see if I could keep my arm or not.
We stayed more than a month in the hospital. We were both suffering, but your mom was just there, quietly sleeping. (laughs)
(piano music)
TD: My grandmother was a musician. She’s playing the music that you hear now at the age of 92. She had studied at a conservatory. And she had played concert piano as her livelihood. Losing her arm might have meant losing her life’s work. Every so often, the doctors would put a feather to my grandmother’s fingertips to see if she could feel it. And if she would say, “Yes, I can feel the feather,” they would decide that she could keep her arm.
(piano music)
TD: In 1963, there were 5 other accidents at the same crossroads. That year, my grandparents and my mom were the only ones who survived. Later, it was proven that the train company had a faulty warning system.
I had a chance to review my grandparents’ medico-legal records. My Lola had fractures in her right arm, her left leg, and her jaw; she had a concussion, along with bruises, abrasions, and lacerations all over her body. But the one place where she did not have an injury was her belly – a miracle given she was 6 months pregnant. 3 months after the accident, my grandmother, in a full body cast, delivered my mom.
She gave my mom a special name because of their victory over death.
LP: That’s why her name is Victoria, meaning victorious. She was victorious.
I’ve had difficult years because of my arm, my leg, but thank God that it was your mommy. She was the angel who saved us. Could it be that she was the angel? Because those who visited us – because we had many visitors all the time – they said if one of us would survive, then we would be lucky. And yet, the three of us survived, by the grace of God. And all of those who visited us – they’re all gone! They’re all gone. And we’re still here. So, what is there for me to do yet, Lord? Why am I still here?
(concert piano music)
TD: My grandparents never stopped reminding my mom that she was basically the product of a miracle. And they felt that she was kept on Earth to fulfill a greater purpose. That purpose, to them, was to heal other people. So that’s why my mom is a physician.
Now, this train story is definitely unique. But it’s a reminder that delivery is not something we can take for granted. In fact, as many as 1 in 5 known pregnancies end in miscarriage. There’s not always a crying baby at the end of a desired pregnancy. So, when successful deliveries do happen for parents who’ve been trying to conceive, delivery, by itself, is amazing.
(concert piano music continues)
TD: These next couple stories are told by my mom. She recounts her first miscarriage and first delivery. She tells plain truths about her experiences. And those truths are often emotional.
If you know my family, you probably know that my mom’s first kid was my sister Anna. What you probably don’t know is that my mom’s first pregnancy ended in a miscarriage. She was a second-year resident in pathology when she was pregnant for the first time. The story goes that one day, at work, she started feeling nauseous. Here’s my mom.
Victoria (VC): So, I counted the days, and I thought wow I missed a period by 2 or 3 days, and just wasn’t feeling well. So when I got home, I did a pregnancy test, and lo and behold, I was pregnant. Of course, I was elated. Daddy was an attending. He was a new attending at a hospital in Staten Island, so he came to visit me, and we were very happy and all that. But since that first day, I started getting very sick, like hyperemesis gravidarum.
TD: Hyperemesis gravidarum is a type of severe and persistent nausea and vomiting that happens during pregnancy. My mom had it frequently.
VC: Classic. Couldn’t keep food down. Was in ketosis. Just could not eat. Was doing IV fluids, and that went on for a few weeks. Until all of a sudden, I started feeling better. Started eating, but at the same time, I started getting fevers, you know, and getting a temperature, and I was wondering – it must be some virus. It would come and go, and it was happening for a good 2, 3 weeks. And I realize there must be something wrong, and a few days after, I started bleeding.
(guitar music)
VC: I was working that day. I was a resident when it happened, and they sent me home. And, of course, I was in tears. I was very sad. I was actually very calm. And I do remember the ride (sound of car door closing) driving home.
(sound of a car stick shift, followed by the sound of a turning signal)
VC: And I knew I was coming to my apartment. And dad wasn’t going to be there. He was keeping another apartment in Staten Island, so I was pretty much by myself.
(sound of door opening and closing)
VC: And dad called a good friend of ours. The husband was a pediatrician, and the wife was a neonatal intensivist. She drove me to the doctor’s office, and, of course, they did an ultrasound. And they said that I had lost the baby, and probably explaining why I had this on and off fever, that it may have died, you know, weeks ago. And it coincided with me starting to feel better. The nausea went away. But I guess it was just something that wasn’t meant to be.
(guitar music continues)
VC: So, dad took the day off. It must’ve been a day or two after. And I had a dilatation and curettage.
TD: For those who don’t know, dilation and curettage is a procedure to remove tissue from the uterus of a patient.
VC: (crying) I’m surprised that even now that still moves me to crying. I do recall having tears while it was being done. It was my first pregnancy. And I think as a doctor I didn’t know what it meant, what was ahead for me, if that was a fluke or if that was the start of many.
So the doctor said to wait three months later. And 3 months later, lo and behold, I was feeling sick again, and I went to get a pregnancy test, and I was pregnant.
(basketball sounds)
And daddy was out playing basketball with friends, and I called him nonstop on his pager.
(sounds of a pager during a basketball game)
VC: And he called me back. And I shared the good news with him that I was pregnant. It was a very joyous time, and it meant so much to me more to be pregnant.
TD: My mother’s first pregnancy ended in a sad and scary way. So, when my mom gave birth to my sister Anna, you can imagine how happy my parents were when she first arrived. Here’s my mom again. This time, she talks about delivering my sister.
VC: So, I got pregnant with Anna, and of course again, I had hyperemesis, even worse. And carried to term. You know, tried to do really everything right. Took good care of myself. Ate well. And then the day came. Both my parents arrived from the Philippines. They flew all the way. And then, a few days later, my in-laws arrived. I think they arrived the day before the fourth of July because we were expecting the baby to come July 10th. So, July 3rd, both sides of grandparents were present. We were all at home. And then, I started to have my bloody show. Soon after, I started having labor pains. And, you know, it was more than 5 minutes apart. So, [we] called the doctor, went to bed. And, around 4 or 5 in the morning, I woke up my husband and said, “I think it’s time to go. It’s every 3 minutes now.” And so, it was funny: we were riding the car. My husband was driving, and I was in the front passenger seat. And 4 grandparents were in the back, squished together. And, soon after, 2-3 hours later, our first child Anna came, and everyone was there. I mean, what a great occasion! grandparents flying all the way, and, of course, dad and I just overwhelmed. And, I think, of course, it’s more meaningful after you’ve gone through a miscarriage.
Things that will also be indelibly printed in your mind and heart will be the birth of your child. Maybe it’s all the pain and the joy mixing together.
(bright piano music fades in)
(sounds of fireworks)
My sister Anna was born on the Fourth of July. My parents used to tell her that the fireworks on Independence Day were all meant for her. What I didn’t realize was that my parents could hear the fireworks outside when they first held my sister. Following a miscarriage, that day of fireworks brought relief and joy to my parents.
(bright piano music continues)
(phone rings)
VC: Hello?
TD: Hey, mom. I just got home from the hospital.
VC: How was your day?
TD: I saw my first delivery today.
VC: Oh, really? How was it?
TD: It was amazing. It was just an emotional and joyful moment to be a part of.
VC: You know my first rotation was ob-gyn too…
(bright piano music continues)
TD: Delivery is one endpoint to a journey where things could’ve gone in very different ways. If my grandmother had not survived that train crash, or if my mom kept having miscarriages, the simple fact is that I would not be here.
Sometimes I take my experiences in med school for granted. The days can be long; the exams can be hard; and the things I’ve seen can be tough to process. But having witnessed birth for the first time, now I have an understanding of the range of emotions that life can provoke – it can be painful and joyful and everything in between.
(new piano music starts)
That was First and Last, part 1. Thank you to my mom Victoria Cusi, my grandmother Pilar Cusi, and my sister Anna, for their immense help with this episode. Music is from Blue Dot Sessions and my Lola. My name is Tino Delamerced. You’ve been listening to Firsts.