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Loaded for bear

Today I'm going to see my OB/GYN for the first time since before Charlie's birth. I am not sure how to handle this meeting, since my feelings about her are deeply ambivalent. I could use some advice. How should I greet her?

  1. A warm smile, a firm handshake, and the willingness to let near-death experiences bygones be bygones;
  2. A busy but sullen silence, which will make her stare at me and ask, "What?...What?...Christ, what is your problem?" (I will of course answer, "Well, if you don't know, I'm certainly not going to tell you!" Then I'll flounce around the examination room slamming cabinet doors and rattling stirrups angrily until she throws up her hands and announces that she's going to sleep in the other room.)
  3. A sharp and dangerous bear trap cleverly concealed where only an OB/GYN dares to go
And if your vote is for option 3, do you think I should call ahead to make sure her nurse has a tourniquet handy?

I liked this doctor very much during my pregnancy. I found her competent and kind, matter-of-fact enough to reassure me that my complications were manageable, and attentive enough to make me believe they were being managed. But after the fact, I'm uneasy about the care I received.

An example. I'm embarrassed to admit it, since I take unseemly pride in being a well-informed consumer of expensive medical services, but I didn't know until after everything went haywire in November — known hereafter as The Incident — that the standard of care calls for a urine dipstick test at every late-pregnancy prenatal visit to check for protein secretion. I remember giving a urine sample once at my first visit so they could verify that I was actually pregnant, and not, I assume, just hallucinating those four early scans before being released from my RE's care. But beyond that, I don't remember ever peeing in a cup. I could have, I guess, but I don't remember it. And I am certain beyond doubt that I didn't at 28 weeks, my last appointment before...The Incident.

That's, well, that's kind of bad, right?

And I'm still unhappy about what happened on That Fateful Day — you know, the day of...The Incident. I was initially happy to learn she was the doctor on call that weekend, because she was familiar with my history and would, I felt, understand and share my concern. And at first, it seemed that she did. When I contacted her about the awful abdominal pain I was having, she told me she couldn't prescribe anything over the phone, but that I should get my blood pressure checked and go to the hospital if it was 145/90 or higher, good advice we immediately took. Paul drove me to the nearest grocery store, I wedged my vomiting bulk into the little booth, slipped my arm into the cuff, and away we went. 140/90 — close enough, I figured, and tried to notify her that we were going to the hospital, leaving a message to that effect. But That Fateful Day was to be a long and upsetting series of missed connections. The local OB never managed to get in touch with her before Charlie was delivered almost 10 hours later. I could perhaps forgive that, since I'm sure she was busy with more important things on...a...um, Saturday...night. What I am still having difficulty forgiving is that despite the messages the local OB left, despite the messages I left, she didn't call to check on me again until the following Monday. Not two-days-later Monday; the Monday after that.

I'm leaning toward bear trap myself.

I've set up this appointment for a few reasons. First, I need a Pap test and some form of contraception. (Stop laughing — I know I'm infertile, but it happens.) Aside from the possibility that I might spontaneously conceive — a possibility as remote as Pluto, which is to say far away but still visible with the Hubble space telescope — I want never to bleed again. Despite what some say about endometriosis receding after pregnancy, my periods are as crippling as ever and I would like to eradicate them entirely. Hello, continuous birth control pills.

Second, I want to get a referral to a maternal/fetal medicine specialist so I can get an opinion on just how foolhardy it would be for me to conceive again. (See above, "Stop laughing." See also "future IVF cycle," "wish, death" and "pipe, crack.") I know what Dr. Google says, and I know what the Keebler elves say, but I would like to speak with a specialist who has my medical history in mind, rather than relying on generalities.

Third, I need to know exactly what happened on That Fateful Day. Were there signals we should have noticed, harbingers of The Incident that we (and by "we" I mean "my OB," but I like to seem like a team player) ignored at our (and by "our" I mean "my") peril? Did my blood pressure, always low, steadily rise during my pregnancy as I seem to recall? How much weight did I gain? Did I really not ever pee in a cup?

Because that, well, that would be bad, right?

I don't, of course, trust this doctor any longer, though I suppose she's competent enough to reach up on in there with a speculum and an oversized Q-Tip. ("Oh, so that's where I left my bear trap! You have no idea how long I've been looking for that!") This isn't going to be a dramatic confrontation of any kind, mostly because I excel at those only after the fact in my fond imaginings, but also because The Incident is safely confined to the past and not a situation I will find myself in again (under her care during late pregnancy). I just need to know what happened, which she should be able to tell me based on her records and those of the OB who presided on That Fateful Day, and I need to know what's next.

Oh, and I need to know about the tourniquet.