Perspective

She was young. Oh so young. And slender, graceful, and quiet. She was uncompromisingly polite, with a soft slow smile. Her long dark hair, smooth skin, and high cheekbones spoke of her Hispanic heritage. 17 years old, 26+3 weeks.

Her equally young boyfriend was there in a show of support, although he was more like a boisterous puppy to be herded about--completely immune to the gravity of the situation. Even though it was the first truly warm day of Spring hinting at the heat of summer, he wore his chic ski cap with his bangs painstakingly crafted to carelessly sweep across his forehead.

After checking in at the desk for their genetic screening and perinatologist high resolution sonogram appointment, they sat on the hospital grade vinyl couch in the waiting area together. He laid his head on her shoulder.

The reason they were in the office to begin with had to do with an abnormally high AFP level during her Quadscreen. Really high--as in if she hadn't been pregnant, they'd be looking for a tumor.

As soon as the young couple was in the office with the genetic counselor, the next patient and her boyfriend careened into the waiting area to check in. High risk because of her morbid obesity, she was so large it was difficult to tell she was pregnant at all. It was also immediately clear that her personality was as large as she was. In fact, much of her behavior bordered on inebriated. Waves of tittering were punctuated by peals of laughter that repeatedly caused all activity in the office to come to a screeching halt in distraction. Her boyfriend was with her, and we all knew it was her boyfriend because they made the best use of their time waiting by making out on the couches in the waiting area.

After the genetic screening, the teenage couple was escorted to the ultrasound suite. The young mother clambered up on the table and shyly exposed her growing belly. Because of her small frame and slender stature the ultrasound images were simply beautiful. As the tech expertly moved the transducer around scoping out the fetus, mom smiled at the sight of her baby on the monitor. The US tech did a few quick biometric measurements, confirmed that the baby was indeed a boy, and then started to look more closely for any sign that the AFP levels were more than just worrisome. It was quickly apparent by the US tech's quietness that things were not going well. Mom could tell something wasn't right, and the look of sadness on her face was haunting. No tears, just profound sadness.

Mom's sadness was well founded. The ultrasound clearly showed a laundry list of abnormalities: Placentamegaly (it was occupying a full half of the uterus), amniotic banding, a 2 vessel cord, agenesis of the left kidney, echogenic bowel, ventriculomegaly, and a neural tube defect at the level of the cerebellum.

The US tech gave a short report to the physician who then went in to confirm the findings and to talk with the young parents.

Meanwhile, the loud couple was escorted to the other US suite. Picture quality was terribly grainy due in part to mom's obesity. Biometric measurements were completed, with baby proving to be SGA, which wasn't unanticipated. The mood was downright festive as the US tech asked mom if she wanted to find out the sex of the baby.

"It's a boy, I've already decided, but you can look if you want to," she stated matter-of-factly.

"Oh, did they tell you it was a boy at your last ultrasound?" the tech inquired.

"No, I just really, really want a boy, so..."

When the baby's peri-area came up on screen, it was very clear that she was indeed, carrying a slightly small for her age, but nevertheless healthy baby girl.

The mood in the room visibly deflated like a birthday balloon. Mom began to cry. Big wracking ugly sobs. Hysterics and histrionics enough to go around.

As we left the suite to go give report to the physician, it took everything in me not to turn and say, "You know, there's a couple next door who are having a little boy, but they'd be absolutely over the moon if they were having a baby girl instead, as long as she was healthy. So suck it up and quit your crying."

Perspective people. Perspective.