“I just want to tell you that however you are, your child will be the same. If you use drugs, your child will become a drug addict.” Beside the bed where I was standing, there was a patient who, at first glance, seemed to be a normal postpartum woman.
I’m not saying she looks fat. She’s not fat (is someone feeling guilty?), but the place where she’s resting on the bed is in the postpartum ward…
On the evening of the previous Friday, I received a report that our team had admitted a pregnant woman. She was addicted to multiple drugs, had not received prenatal care, and was now experiencing very high blood pressure.
“Methamphetamine,” I said loudly to Dr. Ple. She often took care of the most severe and challenging patients since she first set foot in the hospital.
“Yes, Pae,” she replied with a slight shake of her head, as if feeling sorry for something.
Indeed, our team had previously treated a patient who used methamphetamine and developed complications during pregnancy. We were scared, cautious, and tired. And when it comes to pregnant women using meth, the image of the beautiful woman from Saba Yoi comes to mind.
…
About ten years ago, we received a referral of a pregnant woman from Saba Yoi Hospital due to uncontrollable high blood pressure. Her blood vessels were severely constricted (hence the high blood pressure), causing immediate placental abruption. The baby in the womb died before reaching the hospital. The uterus was rock hard, and of course, she was in shock despite the high blood pressure. Importantly, that night Dr. Ple was on duty. The surgery to remove the baby and placenta was swift, allowing us to control her shock and abnormal blood pressure.
During the rounds the next day, we all agreed that our patient was very beautiful. She was stunning, with a prominent nose that matched her face, and her skin was smooth and flawless. She slept peacefully on the hospital bed, unaware of anything. She slept like that, as the drug withdrawal process made her sleep deeply for about two days.
I called her “the beautiful woman.”
The beautiful woman disappeared from us for about two years, and then she was sent back to our hospital again with the same issue: pregnant, using meth, extremely high blood pressure, complete placental abruption, and the baby died. This time, our team couldn’t save her uterus because the placental abruption was so severe, and the bleeding was so intense that no medication worked. She had to stay in the ICU for a while, and after that, we never saw the beautiful woman again because she couldn’t get pregnant for us to care for anymore. But still, the beautiful woman always remained in our hearts.
Whenever a pregnant woman using meth comes in with severe preeclampsia or uncontrollable high blood pressure, we always think of her.
…
“Doctor, the patient in the delivery room who used drugs, I don’t think we can handle it. Her blood pressure is very high now. I think we need to deliver the baby. She’s 22 weeks pregnant now. What do you think?” The on-call doctor called me that evening.
The point is, if we can’t manage the blood pressure or if the liver starts to fail, or if there’s a low platelet count, it will be even harder to control the condition. If it’s very severe, it could cause placental abruption or seizures. It’s a nightmare for being on call.
“I agree,” I replied.
“Doctor, I’m not calling the pediatrician to take the baby.”
“I agree too. This is an abortion, not a delivery,” I replied, thinking beyond what I said. That is, even the patient herself couldn’t survive. If the pediatrician could save a baby weighing 400 grams at birth, I think it would be a disaster for the family.
The induction of abortion was handled immediately, starting in the early evening, and the abortion was complete by 6 a.m. the next day.
“How do you feel?” I asked the main person involved the next morning. I noticed that her body still looked strong. She wasn’t in a deep sleep like that beautiful woman.
“I’m sad,” she replied. “Actually, I only used ice, doctor, but the last time was two months ago.”
“How much does it cost? I’m curious,” I meant the ice, a drug I’ve never even seen in real life.
“Over 200, a friend got it for me.”
“And how do you use it?” I tried to mimic drug user slang, using drugs, getting high (maybe).
“I use a glass tube, put the drug in, burn it, and inhale.”
“And how does it feel?”
“It relieves stress.”
“Is that all? I thought it would feel as euphoric as a massive orgasm. If it’s just stress relief, why use it? It’s a waste.” At first, I thought it would be like a sexual climax, brain buzzing, sparkling. Oh well.
“A friend invited me.”
“Wow, you have such good friends,” I said, clearly sarcastic.
“You didn’t use meth at all?”
“No.”
“What about kratom? I heard you sell it too.”
“Yes, I sell it and use it myself, but when I found out I was pregnant, I stopped using it, doctor.”
“Do you want to quit?”
“Yes, I’m going to quit. I never knew it could cause such problems.”
“Hey, do you believe that quitting drugs is very hard? If you’re not determined, you’ll go back to using them. But what I’m worried about is your child.” Yes, she has one child. The child is growing up in an environment with a mother like this.
“I just want to tell you that however you are, your child will be the same. If you use drugs, your child will become a drug addict because if the mother can use it, the child can too. The environment is very conducive,” I concluded before we parted ways.
…
On the day of summarizing the file after the patient was discharged from the hospital, I opened it and reviewed the treatment.
“The urine test for amphetamines was positive.”
…
“You didn’t use meth at all?”
“No.”
The image of the conversation that morning came to mind.
I signed off on the treatment summary in the electronic file to bill the central fund, which should be the NHSO 30 baht for all diseases. In my mind, I wanted to check how much our hospital spent on this patient’s care. What I wanted to know more was how much we could claim back.
But what I wanted to know even more
How will she fight her fragile mind?
Thanapan Choobun has never been sparkling
May 10, 67
Thanks to: Asst. Prof. Dr. Thanapan Choobun https://facebook.com/thanapan.choobun