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The pain was so bad I bent at the waist, gripping the table. At the front of the room, I told my students, "You are excused. I'm sorry, I'm very sick. I need to leave now." The Cambodian staff of Hotel InterCon looked worried.
While I usually rode moto-taxis in Phnom Penh, the hotel got me a taxi. Once at my city apartment in Phnom Penh, I crawled up the spiral staircase. I lay on the cold tile floor and phoned Dr. Scott, my British doctor. He heard the terror in my voice. Was I dying? Something was terribly wrong.
My face was chalky white and I was cold and weak. My lower abdomen felt paralyzed with pain. No physical position was comfortable. Polly, my friend, came into the room. I lay on my back staring at the ceiling.
My husband, Ken, slept. As publishers, we kept odd hours. My work was done selling ads and writing copy, and he formatted our new magazine. Awake until 2 a.m., he needed sleep. I wasn't thinking as I was dizzy from blood loss -- at that point, I was close to 20% loss (I found that out after the fact). Time was of the essence. Looking back, I should have woken my husband.
For the last year, we tried to get our publishing company off the ground. We should have moved home to the USA instead of staying there, but Ken begged me to give our publishing company a strong effort. I missed Oregon, my home state, but I loved Ken and we were trying to get pregnant now -- finally. That was the carrot he dangled in front of my nose when he wanted to stay in Cambodia.
I lay on the floor and waited for the doctor. Dr. Scott arrived and did a short exam -- the rebound test. Funny the things I remember from nearly dying of the first ectopic pregnancy (yes, there were two) all those years ago. Strange details appear like road signs in my memories. Here's what that test entailed: Dr. Scott pushed firmly into my abdomen. When he quickly moved his hand away, the pain was excruciating.
"Get to a clinic fast," he said, "and get an ultrasound. You may have either a burst appendix or, wait, could you be pregnant? Maybe you're having an ectopic pregnancy. Get an ultrasound, then call me. Go right now."
"K'on Krau S'bone," said Polly, in Khmer (Cambodian) language, then in French, "Ectopique." She pointed to the side of her lower abdomen. I already knew what an ectopic pregnancy was, though. I was in serious medical trouble and sensed impending doom.
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When I arrived at the Clinique Aurore, a few miles down the road, the staff sat outside eating noodles at a roadside stand. Polly and I begged them to open the clinic and give me an ultrasound. Her dark eyes were wide, and she marched around as if terrified.
"She is having a problem, a big problem!" Polly said, "Maybe an ectopic pregnancy. Bleeding internally maybe." She helped me, and to this day, I'm grateful she was there. I was so out of it I wasn't going to ask her to go to the clinic with me. Again, I had lost a liter of blood at this point. That's 20% of my body's supply. Later, when I researched the symptoms of that quantity of loss, I recognized the symptoms.
Confused, yes. Cold, yes. Pounding heart. I wasn't thinking well -- and the pain didn't help. My torso was a strange wall of pain, and a sense of impending doom weighed me down. I had no doubt, in all of my being, I was in mortal danger.
Polly raced back to the house to get Ken, my husband. I stalled the surgery, explaining I needed my husband. I declined blood transfusions: they were not screening blood for HIV or Hep C, and I wanted neither. The medical staff buzzed around me like angry bees, droning"Surgery now, surgery now," but I waited calmly.
I lay on the gurney, breathing and in a catatonic position of no movement. I willed myself to live. My brother died in 1979 -- my parents could not handle my death too.
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Within fifteen minutes, Polly and Ken were by my side. Things happened very fast. Even now, I'm grateful. Not a minute was lost. A surgical team was quickly assembled. Dr. Scott came back, a Khmer surgeon, his anesthesiologist, and a nurse. I felt relieved and knew there was no more time to wait.
The internal bleeding needed to be stopped, or I would die. I wanted to stand up, to walk up the steep, nearly vertical stairs to the surgical theater upstairs.
"No," they all said, "You can not walk." I began to cry at this point. I was 37 years old, and I was at such risk of dying I couldn't walk up a steep flight of stairs. To be carried upstairs terrified me. I remember thinking, "I must not cry, I must not sob, I must not exert force."
Dr. Scott said, "I'm right here," and held my hand somehow, as they carried me up the tiled stairs. If you've ever been in Southeast Asia, you know those kind of stairs.