Doctors’ Rounds

Doctors’ Rounds

By Anna Blackmon Moore

StethoscopeAbout five months after giving birth to my son Ian, I noticed muscle pain in the front of my pelvis—tight discs of soreness just above my thighs and just below my hipbones that I could not stretch out or massage away. If I sat for long periods, the pain intensified, and I was sitting a lot, nursing Ian and then letting him nap in my lap. I watched him loosen his lips from my nipple and drift into sleep, or drift into sleep with his mouth wide open and his lips still latched, or sigh into my skin and grow still. Rather than put him down for naps in his crib, I stretched more often and started jogging again, assuming the activity would loosen my joints and strengthen my muscles.

A few weeks later, after a short, easy run through the park, Ian and I had a typical Nurse-n-Nap. He suckled for forty-five minutes and fell asleep for an hour. When he woke up, I kissed his hands until he laughed, scooped him against my side, and rose from the recliner. My hip flexors burned. I could barely straighten. Playing with Ian on the living room rug became impossible—no more Roll the Shaky Ball or Let’s Stand Up.

I went to my doctor, a GP in her fifties. She often wore flowered skirts that resembled vintage aprons; I always pictured her in a kitchen doing domestic, motherly things. During my pregnancy, when she’d treated me several times for hemorrhoids, I asked if she had children. “Oh, yes,” she said, pulling off a Latex glove and stepping away from the exam table where I lay on my side. “Two teenagers. It’s sort of tough right now.”

When I described the pain in my hips, she suggested physical therapy.

“You don’t want to take an X-ray?” I asked.

“The usual protocol is physical therapy first, then an X-ray if it doesn’t help. And until we figure out what’s wrong…”—she pulled a pad of referral slips from the pocket of her white coat—”I’d definitely stop exercising.”

“But I barely go two miles. And I love jogging.” So do my flabby thighs. So does my depression, which I additionally placate with Prozac.

“Jogging is probably making things worse.” She filled out a referral slip. “Stop for now. Go to physical therapy, see what they say.”

The physical therapist thought it might be tendonitis.

“How would I get that?”

“I’m not sure,” she said. “Hip flexors are kind of a weird place for it. Any injuries, any accidents?”

“No.” I was in my underwear, lying face up on the treatment table, my legs and torso covered by a paper sheet.

“Are you still nursing?”

“Yeah.” By then, Ian was about seven months old, eating spinach and beans and squealing for yogurt, but he still nursed. Between the writing classes I taught during the week and throughout the day on weekends, Ian and I Nurse-n-Napped once in the morning and once in the afternoon. When he twitched or cried out in his sleep, I touched his head so he knew I was there.

“Nursing can have all kinds of effects on the body,” she said. “It might get better when you stop.”

I stared into the ceiling. My hips were throbbing. “God knows when that will be.”

She laughed and started circling the ultrasound probe over the sore spots in my hips. I asked if she had children.

“A boy and a girl,” she said. “Nine and twelve.”

She clicked off the console and massaged anti-inflammatory ointment into my hips with her thumbs.

I returned three times a week for ultrasound, massage, and ice packs. I started doing the exercises she recommended. The pain worsened. On my sixth visit, she was on vacation, so I saw one of her colleagues.

“I don’t think it’s tendonitis,” the colleague said. I was on my stomach, knees bent, soles of my feet to the ceiling. She told me to raise my right knee off the table.


“That bad, huh?” She wore hiking boots and said she had an eight-year-old daughter. “Raise the other knee.”

I blew out a breath, tried to relax. “What is it?”

“I don’t know,” she said. “But you’re really weak, that’s for sure.”

I explained this new diagnosis to my therapist.

“That doesn’t make any sense.” She sat in her cushioned armchair, her legs crossed and her hands folded in her lap. I sat across from her. “You’ve exercised all your life.”

I pushed a throw pillow further down my back. Her couch was aggravating a new pain, deep in my tailbone. Sitting made it ache. Walking helped, but if I went more than half a mile my hips tightened to a burn. “I have an appointment with the acupuncturist tomorrow.”

She thought it might be bursitis. Throughout my pregnancy, the acupuncturist had treated me for hemorrhoids, anxiety, and the cavernous pressure of my son’s butt tucked beneath my right breast like an upside-down bowl. Sometimes I cupped my hand over his cheeks and patted them. Other times I pushed down on them to try and pop a few of my ribs.

“Between your bones and your tendons…”—she held up her hand as if holding a sandwich—”you have sacs of fluid called bursae. They can get inflamed. They can really hurt.”

I nodded.

“Have you had any accidents or injuries?” she asked.


“Still nursing?”

I nodded.

“That might explain it,” she said. “Nursing puts a lot of stress on the body.”

“Nursing puts a lot of stress on the body,” my dermatologist told me the next day.

I had made an appointment to treat the dandruff that had started to shower my shirts. He was examining my scalp through a lighted magnifying glass the size of an eye. He had a slim moustache and slicked black hair, a father of five. He’d told me once that he loved having kids. I wondered if his wife did. I wondered which functions she had lost with five pregnancies, five cycles of nursing.

He rubbed a patch above my temple with his index finger. “This is seborrheic dermatitis. You know how infants get cradle cap?”

“Yes.” When Ian was only a few weeks old, I had scraped scales from his scalp while he stared blankly toward his rubber duck.

“Same thing,” he said. “It could be hormonal. Pregnancy and nursing can really change the skin.”

“All the energy in your body is going to feeding your child.” I was back at the acupuncturist’s, lying face up on the massage table with my pants off and a heat lamp warming my feet.

“Other areas of your body are lacking. They aren’t getting as much energy, as much blood, as they normally would.”

I stared at a sparkly, New Age mobile.

“You’re working too, aren’t you?” she asked. She was fifty but looked thirty—tall and strong. She swam a mile three times a week and had no children.

“I teach every day this semester.”

She tapped a needle into my right hip and rotated it until I winced. “You’re putting a lot of demands on your body,” she said.

After a few weeks of acupuncture and no exercise, the hip pain improved. I could walk up to a mile. The tailbone pain, however—a ball of it right on my coccyx—was at times excruciating, and my scalp continued to shed. The shampoo the dermatologist prescribed was $106, and insurance wouldn’t cover the cost. Rather than buy it, I was rubbing vitamin E oil into my scalp three times a week and scraping off the scales with dull nail scissors.

“Your body might never be the same,” said my psychiatrist, during a check-in appointment for a Prozac refill. She, too, was a mother. Her daughter was sixteen. They had just taken a vacation together, hiking and camping in the mountains. “It’s something you have to accept and work with.”

I started putting Ian in his crib for naps, which left him wailing and sobbing before he fell asleep to the music of his mobile. I sobbed, too, for a while—I missed his flesh, his thin, wheaten hair, the curve of his nostrils, the length of his blinks when he woke. But I persisted.

The tailbone pain did not subside, and the pain in my hips kept me from sleeping through the night.

“I would see a chiropractor,” said the acupuncturist. I was on my belly with my underwear hiked up so she could stick needles into the crown of my butt.

“But the problem isn’t in my back.”

“They’ve helped me a lot in the past.” She dimmed the lights and turned on the music—ocean sounds with a harp. “That’s what I would do. Get a ton of acupuncture and see a chiropractor.”

The chiropractor asked how much Ian weighed.

“Twenty pounds,” I said. She pulled on each of my feet to stretch my hips and then walked around the table to my head. Her hands smelled like soap. “He’s about nine months.”

“It can take up to two years before the stress on your skeletal frame gets better,” she said. “First you have him stretching out your ligaments”—she cupped her hands around her belly—”putting stress on your spine, and then you’re picking him up all the time.”

She clipped my X-rays onto the viewbox. I was crooked. My right hip was higher than my left, and my coccyx was curved slightly to the right like a shortened tail. I looked like I hadn’t quite evolved.

“It’s actually not that bad,” she said, standing next to the image. “There’s no sign of arthritis at all.”

“Thank God,” I said. I’d been having visions of incapacitation.

“But your spine is out of alignment, so your hips are out of whack. You need adjustments.”

I lay on my back. She twisted my hips to the left, crossed my arms over my chest, and leaned onto me.

“Take a deep breath.”

She pushed. Nothing. She pushed again. I had been grading papers all day, sitting on my ass. My tailbone was a rock.

“You win the Tight Award,” she said, standing. Her children were grown; her daughter shared her practice.

“I sit a lot,” I said. “But I’ve always been active. I don’t understand why my body is such a mess.”

“It’s not uncommon,” said the psychiatrist. “Women recover at different rates.”

“Nursing releases hormones,” said the dermatologist. “It puts a lot of stress on the body. It can have all kinds of effects on the skin.”

“When I was getting trained,” said the acupuncturist, “my teacher had a baby. After the birth, she stopped working. Her mother moved in and did everything. It was completely understood that her only job was to nurse her baby. That was it. But in this culture, we can’t do that.”

“It will get better,” said the chiropractor. She put her hand on my shoulder. “I promise. Be patient.”

“Have you considered waiting before you have another child?” asked the psychiatrist.

“I’m thirty-six,” I said. “I don’t want to change diapers and breastfeed when I’m forty.”

“You could still wait,” said the therapist. “You have a depressive condition. It can make everything harder.”

“Ian needs a buddy,” I said. “An ally.”

“You still have some time,” said the chiropractor.

“But I want to get it over with.”

“I don’t blame you,” said the acupuncturist.

“How’s the physical therapy going?” asked the doctor.

“We can do whatever you want,” said the husband. He was lying on his back, lifting our son into the air. They were both laughing, balloons full of joy. Chris put Ian down on the living room rug and tossed his blocks into the playpen, high up into the air, one at a time. Ian watched the blocks spin and laughed again—loud roils of delight that made his belly shake while he heaved for air.

When Ian laughs, strangers laugh back. Despair retreats.

“Let’s get it over with,” I said. I was sitting on the sofa watching them, tightening and releasing my buttocks. Trying to straighten my tail.

“Having another kid is worth wrecking your body?” Chris watched as Ian reached for his tambourine, wrapped his fingers around the frame, and put a jingle to his mouth.


Chris looked at me, his hand resting on Ian’s foot. “Are you serious?”

I held out my left hand, let it droop, and shook it out. Holding Ian against my side all the time had caused some swelling; my wrist and thumb were growing rigid. I curled and straightened my fingers, tightened and released my ass, rubbed my right hip, scratched my head. Ian shook the tambourine and made a new sound.

“Yes,” I said. “Definitely.”

Author’s Note: While I have gotten treatment and relief from the tailbone problem, my hips are about the same, and Ian has been weaned for more than four months. A friend recently decided that I have Iliotibial Band Syndrome, which usually affects people in the knees. I have started lifting weights to strengthen my quads, which might help, at least until I become pregnant again.  

Anna B. Moore has essays and fiction in The American Scholar, Shenandoah, Native Peoples Magazine, and many other journals.  She lives in Northern California and is currently working on a novel.

Brain, Child (Spring 2007)

Bad Medicine and Good

By Karen Dempsey

fall2008_dempseyMy breasts ached with the need to nurse Liddy as I stood at the pharmacy counter, gripping the prescription bottle of omeprazole the pharmacist had neglected to flavor. I knew that if I gave Liddy the vile-tasting acid suppressor unsweetened she would screw up her tiny face and cry, and when the liquid hit her tender stomach it would come straight back up. I had already delayed her ten a.m. feeding to pick up the prescription; she needed to take it on an empty stomach, before she nursed. I had left her at home with my mother and my eighteen-month-old son, Brennan. She was waiting for me, crying, I imagined, from hunger, and refluxing because of the crying.

The pharmacist’s voice and expression were passive as he stared at a computer screen and clicked the keyboard. “There’s no note here about flavoring.”

I leaned onto the counter, fighting the urge to scream or throw something. This pharmacy—a huge urban pharmacy in a national chain—had already failed to refill the prescription the first time I’d called. This was my third trip here in a week, and I still didn’t have what I needed. “She has to have the flavoring,” I said. “She can’t keep it down like this. I called last night, and they said it would be ready by ten.”

“I can mix it again, but it needs to sit for twelve hours. We can have it for you tomorrow.”

The week before, Liddy had stopped breathing after a feeding. She had just been diagnosed with gastroesophageal reflux disease. At the time, I didn’t fully understand the mechanisms of reflux, and I’d thought she was choking, gagging on spit-up. I had been sitting on the couch, her warm little newborn body curled on my shoulder, when she spit up and then spit up again. Milk surged up out of her mouth and nose, and she suddenly tensed and arched away from me, her face puckered and red. “Okay okay okay,” I said, and turned her over my forearm and vigorously rubbed her back as I’d seen a nurse do at the hospital, when she’d stopped breathing after birth.

Liddy’s face was scrunched closed, and she’d turned a deep purple. John was downstairs, out of earshot. My heart raced as I searched the bassinet for a bulb syringe to suction her mouth. Suddenly she gasped, and breathed, and relaxed into my arms. The incident was over in a moment, so quickly that I had a hard time believing it had happened at all. The next morning, I learned from her doctor that these episodes occur in reflux babies when the esophagus closes off to protect itself against the burning of stomach acid. The closed esophagus prevents the child from breathing. “That scares the heck out of me,” the doctor said. “Next time, don’t hesitate to call 911.”

I thought about saying all of this to the pharmacist as he stood before me, so dispassionate, in his crisp white coat. I could feel other customers watching me, and I knew that I must look like a mad woman—my tearful, red-rimmed eyes framed by the dark hollows of sleep deprivation. Like Liddy, I’d been sleeping for only forty-five minutes or an hour at a time. When I finally spoke, my voice was low and even, though I forced the words through what felt like a knot in my own throat, a swallowed scream or sob. “She is three weeks old.”

He took the bottle from my hand and walked away.

For a moment, I thought the conversation was over, but then I saw that he was mixing something. He came back out with another bottle and said that though my insurance would only pay for the generic version of the medication he had refilled it with the brand-name, Prilosec, because it mixes faster, and had added the cherry flavoring. He said to shake the bottle, then remove the cap and let it sit for ten minutes before giving it to her, to help the medication break down.

The gastroenterologist had warned me not to expect Liddy’s condition to improve until the medication had been in her system for a couple of weeks. Omeprazole does not actually prevent reflux from occurring. It simply reduces the acid content in the spit-up, allowing the damaged esophagus to heal over time. Still, I carried the bottle home flooded with relief that we could at least begin Liddy’s treatment.

The first few days, Liddy swallowed the medication easily, but something looked off. I held the dark brown prescription bottle up to the light in the kitchen, swirling the contents and studying the bottom of the bottle, where I could see little beads floating in the liquid. John called the pharmacy again to ask about it, and he received the same advice I’d been given: Shake the bottle, remove the cap, and let it sit for ten minutes before filling the tiny oral syringe. I kept looking at the bottle, though, and at the liquid in the syringe each time I filled it. A few nights later, I called the pharmacy again.

“Oh,” said the woman who finally picked up the phone, when I described what I was seeing. “Oh, no … that doesn’t sound right.” I heard distress in her voice. She told me she needed to hang up and check something, and then she would call me back.

My phone rang again within minutes. The flavoring they had used, she said, was incompatible with the medication. The omeprazole had failed to break down. It had stayed in the bottle, in tiny, silvery beads, as I fed Liddy cherry syrup twice a day for a week. “I am so, so sorry,” she said, assuring me that she would have the prescription refilled again, this time with a compatible flavoring.

The next morning, I took the kids on a major outing by myself for the first time. We went to the Museum of Science, Brennan’s favorite place on earth, and I managed to time Liddy’s feedings right and keep her straight and still for the requisite thirty minutes afterwards while Brennan rearranged the pieces of an enormous Lite-Brite and built a fragile wall with spongy, yellow blocks. The outing exhausted but also energized me because I had made it through the morning alone, in public, with two very young children.

When Brennan fell asleep in his car seat on the drive home, I took advantage of the relative quiet to call the pharmacy again. Yet another pharmacist answered the phone. At first, he could find no record of another refill. Stunned that anyone in the store could be unaware of the terrible mistake they had made, I retold the story, no longer feeling the need to hide my fury. He put me on hold and came back on to say that the medication had been prepared overnight, and the store had identified the correct flavoring, but they didn’t carry it, and they had not yet been able to arrange for a delivery.

“This is the eighth phone call I have made to your store about this prescription,” I told him. “I have been in to talk to a pharmacist three times. Someone has to take responsibility here. My daughter needs this medication, and you need to get it for me. Someone has to figure this out, right now, and that someone cannot be me.”

He promised to call me back.

I drove home, slipped Liddy out of her car seat and into the special sling-like seat that held her body straight and upright, then carried a sleeping Brennan to his crib. I sat at the kitchen table and dialed John at work; the moment I heard his voice I knew that my reserves of strength had dissolved. I wept as I described my latest, fruitless phone call. I had remembered another pharmacy, one that specialized in compounds, and I wanted to know if they could take the omeprazole already prepared by CVS and flavor it into a form Liddy could tolerate. I just couldn’t pull myself together to make that final phone call. I spelled “Skendarian” out for John, and he hung up to look for the listing.

Skenderian Apothecary is an independent, family-run store about a fifteen-minute drive from our house. I had been there only once, after Brennan’s birth, when, in the process of sterilizing the tubes for my breast pump, I had somehow melted them into a rubbery lump. I’d spent that desperate afternoon calling around for replacement tubes and posting a message to my local new mom support group listserv. Another mom had e-mailed to recommend Skenderian. I called the pharmacy, and the woman who answered told me to come right over. She kept the store open for me past closing time and showed me how to cut the ends of the tubes so they would fit my machine.

John called me back just minutes after we talked to say that Skenderian, which specialized in compounds, could take the omeprazole we already had and flavor it on a form Liddy could tolerate.

I called the big-chain pharmacy for the last time, and the young guy I’d spoken with on the drive home from the museum told me they had located the flavoring and he would spend his own time, after his shift ended, driving to the other store to pick it up so that they could have it ready for me that evening. He also suggested that, after this refill, I transfer my prescription elsewhere. His pharmacy—with one of the highest volumes of prescriptions in the area—was not equipped to do it.

I let him finish and then told him I would be in to pick up the prescription, unflavored, and that I would be transferring everything over to Skenderian. And then I hung up, and waited for my new babysitter to come and care for Brennan so that he could run his toy trucks through the back yard instead of accompanying me on the frantic drive to two separate pharmacies.

After fetching the bottle from the original pharmacy (along with the address for the complaint department of its national headquarters), I drove over to Skenderian and carried Liddy inside. A man who I would come to know as Robert, the pharmacy manager, met my glance from behind the counter.

“My husband called—”

Robert nodded and reached out to take the brown plastic prescription bottle I held in my hand. “I talked to him,” he said. “Let’s see what we’ve got.” He examined the label, then held the bottle up to the light just as I had a few minutes before. “Bubblegum or grape?” he asked.

I paced Skenderian’s immaculate waiting area. We deliver for any reason, read a sign posted over the registers. I looked around and saw, tucked into the corner, a basket of brightly colored toys and books. Several therapeutic chairs rested nearby, including one that bore a sign beckoning, Try this seat.

Robert came out with the uncapped bottle of omeprazole, and held it out for me to taste. “Sweet enough?” he asked.

Skenderian became a regular outing for the three of us, as Liddy’s dosages changed frequently and her medication regimen soon expanded to three separate prescriptions. On my second or third trip there, I parked outside and entered into a long negotiation with Brennan over how many matchbox cars he could bring in with him. When I finally got both kids into the store, Robert’s younger brother Joe was waiting behind the counter, holding a pen out to me. He had already located Liddy’s prescription, set it on the counter and flipped to the page in his notebook where I needed to sign for it.  My face must have given away my astonishment. He laughed and said, “I saw you getting out of the car. I know from experience that it takes a while with two.”

Most of the staff, in fact, knew me by sight once I had been in a couple of times. “How is Liddy today?” they would ask, reaching up to the shelf or into the refrigerator for whatever prescription I had called in.

We visited the store once or twice a week, and it soon began to rival the Museum of Science for Brennan’s favorite place on earth. He ran straight to the toy basket each time we walked in, digging for the red plastic van and the tiny dinosaur that had quickly become his favorites

I began to think of Joe as my personal pharmacist. He conducted a great deal of research after the shelf-life of omeprazole compounds came into question, and helped me determine when the time was right to switch Liddy from the liquid compound to solutabs, little tablets that break down instantly in water, which were easier to store and dispense. Joe would compliment me on a new haircut, and say things like, “You’re a good mother,” unsolicited, with utter sincerity. He told me anecdotes about his own two children, and said Saturdays were his favorite day to work because it is a slower day and he can chat with people.

The sense of ease and familiarity I felt with the staff took on new meaning as summer approached, when I finally admitted—to John, to my doctor, and to myself—that I was sliding into the depths of post-partum depression. When I spoke to my doctor about anti-depressants, I had a fleeting but intense desire to have her call the prescription in to some other pharmacy where I could remain anonymous. My cheeks burned when I went into Skenderian, alone this time, to pick up the medication. But Robert saw me walk in and sailed right over, asking gently, “We haven’t done these for you, before, have we?” And then he spent ten minutes advising me on easing into the medication. My eyes welled as he spoke, but he never looked away as he talked about beginning with half-doses the first few days and trying different times of day if the drowsiness was too intense. He cautioned me against taking cold medications, which would keep me awake when we both knew that I couldn’t afford a sleepless night. And he smiled when he said that a glass of wine, once in a while, would be okay.

Liddy suffered through eight or nine ear infections in her first eighteen months.  The pain increased her refluxing and fussiness and marked the periods of our most sleepless nights. With each new round of antibiotics, her pediatrician prescribed numbing ear drops to soothe the pain while we waited for the infection to subside. On New Year’s Eve, I checked our supply to see that we were nearly out, and desperately dialed Skenderian, hoping they had some on the shelf so that I could get it before the holiday.

The answering machine picked up and a prerecorded message told me the store was not only closed for the holiday but would close early for New Year’s Eve, at two p.m. I stared at my bedroom clock, which told me it was after three, as I listened to the message and the beep that followed.

“Oh, we’re fucked,” I said—into the pharmacy answering machine.

When I had confessed to John my reluctance, months before, to fill the antidepressant prescription with Skenderian, he had made me laugh by assuring me they already thought I was crazy.

So when I told him now about the message I had inadvertently left, he burst out laughing, then quickly composed himself. “I’m sure it happens all the time,” he said. Though I was sure I’d feel sheepish the next time I went into the store, I knew that they knew me and that they’d be laughing, too.

Author’s Note: The bad bottle of omeprazole sat on a shelf in my refrigerator for months. I kept it as a reminder of what we had gone through, Liddy and I, a reminder that I had held the pieces of the puzzle and that I had to fit them together, even when it was hard and I was tired. John took the bottle out one day when he was cleaning the fridge. “Why are we keeping this?” he asked. The stubborn silvery beads that had not broken down after all those months. I knew what it held and represented, and I didn’t need it anymore. I told him he could toss it, and I heard it disappear into the trash.

Brain, Child (Fall 2008)

About the Author: Karen Dempsey’s writing has appeared in The New York Times, Babble and other publications. She lives in Massachusetts with her family. Follow her on Twitter @KarenEDempsey or read more of her work at

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