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Mr. Bows:
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Hello Dr. Balis? This is Tom Bows.
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Dr. Balis:
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Hello Mr. Bows. What's wrong?
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Mr. Bows:
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You cut right to the chase Doctor.
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Dr. Balis:
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What's wrong with Sylvia?
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Mr. Bows:
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I'm sorry Doctor. It's been a long night. Okay, let me see. After you left our house last Tuesday, Sylvia started to feel worse and worse. At some point it was obvious that she was not tolerating the drugs that they gave her.
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Dr. Balis:
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Terbutaline?
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Mr. Bows:
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Yes. She was having problems breathing and was beginning to shake--her whole body was trembling violently. We took her into the emergency room late that night.
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Dr. Balis:
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I noticed during our session that she was not doing well, but...I wished I had followed my own instincts and called Doctor Malleson.
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Mr. Bows:
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You only saw her for forty minutes and she wasn't that bad yet. It's not your fault.
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Dr. Balis:
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Thank you. Were you able to track down Doctor Malleson?
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Mr. Bows:
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Unfortunately he was out of town for the holidays and we got somebody else from his office--Doctor Rush. She seemed very competent. She switched Sylvia to a different medication and they kept her overnight to check for side-effects.
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Dr. Balis:
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So you got home for Christmas night? What's wrong now?
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Mr. Bows:
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We did go home for Christmas night. Sylvia was tolerating this medication much better and we thought that we were on track again. But Saturday night Sylvia woke me up saying that she was having what she believed to be strong contractions again and she wanted me to take her back to the emergency room.
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Dr. Balis:
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Are you still in the hospital?
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Mr. Bows:
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Yes. The medication they gave her didn't work and she is now on an IV of Warfarin Sodium, I believe. She looks awful.
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Dr. Balis:
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I'm sorry.
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Mr. Bows:
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She's ashen and is hardly able to talk or lift her hand. And I think she is terrified of losing her babies. And frankly, Doctor, so am I.
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Dr. Balis:
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What do the doctors say?
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Mr. Bows:
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They said that the IV is working great. The contractions have gone away completely but the damage is done.
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Dr. Balis:
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What damage?
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Mr. Bows:
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Sylvia's cervix has developed a tear--the contractions that she was feeling pulled on the cervical stitch and tore it apart.
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Dr. Balis:
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I see.
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Mr. Bows:
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Although they are going to let her go home, Sylvia will spend the rest of the pregnancy lying on her back to prevent further damage to the cervix.
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Dr. Balis:
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I'm very sorry Tom. Is there something I can do?
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Mr. Bows:
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If you can keep Sylvia from sliding into severe depression, it would be good. It would be a disaster if she gave up right now--one of the twins is just old enough to be saved. But the consequences would be disastrous--this child would be in pain for months and months with a slim chance for life and there's even less hope for the smaller one. I really need you to help Sylvia keep it together Doctor Balis.
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Dr. Balis:
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I will do all I can.
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Mr. Bows:
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I know.
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Dr. Balis:
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Would you like me to come down to the hospital today?
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Mr. Bows:
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No. Sylvia is too out of it for it to do any good. I'll stay with her and make sure she is all right for now. I'll call you when we get back home Doctor and set something up then. Okay?
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Dr. Balis:
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Sure no problem. Just let me know.
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Mr. Bows:
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Great. So have a happy New Year Doctor. I'll be in touch soon.
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Dr. Balis:
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I hope your New Year is happy too, Tom.
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Doctor Balis' Notes on this Telephone Call
Transcripts of Sylvia Bows' Therapy Sessions
