On April 6, 2007, at 27 6/7 weeks, Joy began having more “pelvic pressure” and the decision was made to give her corticosteroids to accelerate fetal lung maturation. Serial ultrasounds had shown that one of the babies was developing intrauterine growth restriction and was having more difficulty pushing blood through its placenta as well, so the general sense was that delivery would probably be necessary soon. On that evening she began having regular contractions.
Initially magnesium sulfate was given to try to break her labor and then indomethacin was added but she continued to contract. At that point, a second dose of corticosteroids was given and I received a call at home to end my vacation early. By the time I arrived, Joy was having considerably more discomfort with her contractions. The cervix was noted to be stretched around the cerclage and the presenting baby’s head was well-applied to the cervix. As promised, I looked her in the eye and said, “It is time” and she nodded knowingly and agreed.
A “CODE 5” was called and the five NICU teams arrived within a short period of time from all over the city. At about 4:00 AM (4:11-4:13 AM to be exact) on April 7, 2007, Abram, Adal, Ian, Noelani, and Nadia were delivered to Joy and Andres Gonzalez at 28 weeks gestation by cesarean section in Greenville, South Carolina. The response and the entire “operation” went as smoothly as was planned and could have been hoped for and, fortunately, Joy had a relatively uncomplicated post-operative course.
The babies could not have been born into a stronger or more nurturing family. As difficult and dangerous as the pregnancy was for Joy, the time since the delivery (now almost two years) has proven how important the power of faith, love, and friendship can be to overcoming all obstacles. The first-born, Abram, had problems following delivery that led to a series of medical complications and hospitalizations that have stressed the family's resources, financially, and I am sure, personally, and may well continue to do so, but there has not been one instance during that time when we were visited by Joy, Andres, and all the children that there were not smiles on their faces, optimism in their voices, and enough love in their hearts to brighten all of our spirits.
Into each of our lives come events leading to memories that we carry with us until we’re gone. That has been especially true for me in medicine. There are many patients who, unbeknownst to themselves, sometimes gave to me more than I gave to them, and I will never forget those folks. Their memories are as clear to me now as the day they happened. They are the foundation of my approach to the practice of medicine, guiding my deductive and intuitive senses, and my inspiration to awaken early every day to a new set of challenges. They have made me a better physician and a better person. Such is the case with the Gonzalez family, and I am so grateful that they have let me be a part of their lives. Dr T