At midday on Christmas Eve, 2009, Dr Stephanie Martin was conferring with a patient in her office at Memorial Hospital in Colorado Springs. Lithe, with fine bones and long limbs, Martin, 42, looked more like a ballerina in scrubs than the head of high-risk obstetrics at a major metropolitan hospital. She was, in fact, a competitive ballroom dancer with the kind of energy and precision of movement that served her well during medical crises.
Martin was expecting a busy but not unusual day when, during the conference, an urgent message sounded over the intercom: “Code blue, East Tower, labour and delivery rooms.” In hospital terminology, code blue signals the most dire of emergencies: a patient is in cardiac arrest and needs immediate resuscitation. To a layperson, it means someone is dying; in the labour and delivery rooms, it means both mother and baby are in peril.
Martin ran down the hall to the labour and delivery rooms. Not on Christmas Eve, she told herself.I can’t lose anyone on Christmas Eve.
Tracy Hermanstorfer, 34, had entered the labour room with her husband, Mike, a long-haul truck driver, early that day. She was in good health and was expecting a delivery as normal as her previous two. A routine amniocentesis had revealed their baby would be a boy, and they had already picked a name. She and Mike, 38, were excited by the prospect of a Christmas baby.
By 12.30 that afternoon, after several hours of contractions, Tracy was growing tired. She had been given an epidural injection to ease the pain of labour and delivery, and her attending nurse was watching her closely. The baby’s heart rate was a little slow, and a foetal monitor had been attached to his head, but there were no major problems. “Rest, close your eyes,” Mike told his wife. “It looks like you’re going to have a long day.”
Racing down the hall, Martin felt the familiar rush of adrenaline in her veins. With it came a memory that continued to haunt her whenever a code-blue alert sounded. Her thoughts flew back to July 4, 1997, her first time as attending doctor on a maternity ward. Only a week before, she had been just another resident on the ward. Seven days later, as the doctor in charge of emergencies, Martin encountered a normal birth – involving a healthy 21-year-old woman – that had gone suddenly, horribly wrong.
Amniotic fluid had escaped the placenta and entered the mother’s bloodstream, causing what looked like a massive allergic reaction. She began to bleed internally – a classic sign of an amniotic embolism. In minutes, the mother’s heart and lungs failed, and the baby’s heart rate plummeted. Despite performing an emergency C-section, Martin lost both mother and child.
The two deaths sent the young doctor into an emotional tailspin. Martin took to her bed and stayed there for days. What good am I? she wondered. No-one could talk her out of her depression; not even her neonatologist husband, Jeff. Healing had been Martin’s primary passion since she had decided as a child growing up in Texas that she wanted to become a doctor. Now doubt had crippled her just as she had achieved her goal.
Martin’s recovery took weeks. Only her grit and determination to know more about the causes of foetal and maternal deaths gave her the strength to return to the delivery room. “I can’t give up,” she decided. “I have to find a solution.”
Every code blue in the labour and delivery unit became another challenge for her – and an invitation to do further research. Through her experiences over the 12 years that followed the July 4 incident, Martin became an expert in the field of maternal cardiac arrest.
Tracy closed her eyes and appeared to doze. Mike felt her hand and thought it seemed too cold. He looked into her face and saw that her lips were turning blue and her skin was a translucent white. Something was wrong.
“What’s going on?” he called out frantically to the attending nurses as they leapt to Tracy’s side. One began trying to revive her, while the other pulled the cord that triggers the code-blue alert. Mike recalls being hustled into the hall as people converged on the room. A minute or so later, two chaplains came to meet him.
Only a minute had passed since the alert sounded. Martin burst through the door of the labour and delivery room to find Tracy inert in her bed. All signs of life were rapidly fading. She had no blood pressure and wasn’t breathing. A nurse began administering rigorous chest compressions.