Faculty Bibliography

So that was it. They had admitted her for the pain, found she was pregnant with a simple blood test, and the ultrasound had confirmed a normal intrauterine pregnancy. So she was discharged, only the pain had continued, and then there was the bleeding. Yet all of it could be normal; for all we knew she would proceed normally to term, and I had told her so. The cervix was closed, there was no obvious discharge or tissue, the vague discomfort was not all that remarkable. I extracted further history from her in bits and pieces. She had been pregnant five times before. Two abortions. Two had made it to term, and now lived with her in a single room downtown. This past year had brought an ectopic pregnancy, the fetus implanting in the tube by mistake, causing much pain and bleeding, and needing surgical removal. A bad case of pelvic inflammatory disease had followed in early December. Now it was January, and she had come to our emergency room two weeks before with a diffuse pelvic pain, and they'd told her she was pregnant

IN A SLEEPY little town in Scotland, in the pre-AIDS era, I sat with Dr. Ted Jones, a surgeon transplanted from New York, who tended to a flock of farmers and fishermen, spotted up and down the rolling hills. It was an idyllic existence, such as it was, as tough old Jones took to the role of country doctor. 'These kids have no identity. They need role models desperately,' [Peggy McHugh] says. 'We have to learn to deal with the mothers, who may try to deny the problem as though it doesn't exist. A barrier is there between mother and daughter. Rich or poor, these latch-key kids come home to an empty house; mommy's not there. After school programs are cut, so they turn on the TV where everyone's in bed. These kids are isolated. There is nowhere for them to go. The extended family's been lost. Kids drop out of school and get pregnant. We had one who was packing her bags to leave home last week because she was six months pregnant and her mother hadn't noticed.' Many physicians, still doubting compliance with these devices and weighing the relative risks, continue to put their young female patients on the pill, potential long-term side effects notwithstanding. IUDs, meanwhile, have fallen into disfavor among physicians, because although they prevent pregnancy without on-the-spot preparation, they also complicate and promote the infections and tubal pregnancies that accompany indiscriminate sex

ON YOUR WAY into Bellevue Hospital from First Avenue, you follow a long hallway to the lobby proper before coming upon a security desk which stands between the information desk and the elevators to the inpatient floors. When I passed this checkpoint a week after the Jan. 7 murder in the hospital of the pregnant pathologist Dr. Kathryn Hinnant, the guard by the main desk was away from his station, gazing at a poster in her memory. To all the signatures on the poster he added his own, while several disheveled people limped past him on their way to the upper floors. He returned just in time to accost a gray-haired gentleman in a suit and tie - one of the hospital's head physicians. As he had been instructed to do, the guard insisted that the man show him some identification; meanwhile, several more troubled-looking characters slipped by unchallenged. Given the kind of hospital Bellevue is, could Hinnant's murder have been prevented? Rat Man, as Steven Smith was known by many on staff before his arrest in the Hinnant murder, was an inpatient in the care of the medical service twice last December. Both times he claimed he'd taken rat poison, a complaint he knew would gain him instant, unquestioned admission because, while the poison quickly leaves the bloodstream, the patient must be observed for bleeding complications which may appear later on