Suleena Kansal Kalra, M.D., M.S.C.E.
Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
I cried with a patient today. As an infertility specialist, tears are a more routine part of my profession than people may realize. The joy is brilliant. But the pain is deep.
I have the privilege to work with women who are warriors. Women who endure disappointment, injections, painful procedures, and heartbreak - over and over and over again. These women would do anything to build a family. These women make difficult decisions over their reproductive choices every day. In my office, we weigh the risks and benefits of treatment. We discuss the options available. We cling to brave and resilient hope. We have faith in the marvels of modern medicine and faith in the patients who do the real work. And, so often, as I tell my patients, perseverance pays off- there are brighter days ahead. And cautious optimism wins. But it is a depleting and lonely journey. I tell them, we will walk it together. I know they will shoulder the heavy burden and loss of control, but I will be alongside to guide, empower and educate them to make choices that align with their beliefs and goals. It is the ability to choose amidst so much they cannot control, that gives them hope and strength to overcome the, at times, overwhelming sadness.
So, I cry more frequently than you may realize. The best is when I share tears of joy with my patients. But, unfortunately, oftentimes, I also share tears of pain. Whether it be a miscarriage, another unsuccessful emotionally, physically, and financially exhausting treatment, or sometimes, just bearing witness to pure exhaustion, I feel the lump in my throat.
But, today, I cried because I saw fear in my patient's eyes. That was new. Fear has not been part of my doctor patient relationship until today. I cried with her… Not because she just came to me after her third miscarriage ... Not because she asked me if it was the run she went on that resulted in a miscarriage. Not because I could feel her heartache. But because she was afraid. She was afraid that she would not have the choice to undergo an embryo transfer.
I have had the privilege to work in reproductive endocrinology and infertility for 20 years. And I have shared private and profound moments of pain and loss. But in this case, I did not shed tears with her to share her grief, I cried because we have failed her. And we have made her load even heavier.
As a nation, we have failed to give her the faith that she will have the ability to make choices that impact her reproductive health. We have failed her because she is uncertain if she will be able to do an embryo transfer in six months or a year from now… She is worried that laws will be enacted to strip her of the autonomy to make decisions about her reproductive health with her physician.
I told her that I will fight with her, and I will fight for her. But I cried for the additional burden she is carrying. We must do better. I told her if you had asked me 20 years ago if I would I ever be having this conversation with a patient, I would’ve told you it’s unbelievable. Unthinkable. Yet here we are. The shortest distance between two people is a story. Please listen to the stories. There is great wisdom and strength in them. And let's use the stories to have the strength to relieve the warriors around us of the burdens they carry. This is no place for fear.