Christmas Bonus Episode: "The Tiny Foot"

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Ever grappled with an ethical dilemma that gnawed at your soul? Picture a doctor faced with a haunting moral decision during childbirth. This episode unravels the profound emotional toll of his choice, one that would ripple through both his life and the family he touched. We uncover the intricate dilemmas healthcare professionals face and the weighty silence they often bear, through a gripping tale that challenges us to reflect on our own moral compass and the humanity we owe one another.

Let's pivot to a narrative that warms the heart. We journey alongside a resilient young girl, born with only one good leg, who refuses to be fettered by what life throws at her. Through tenacity and sheer willpower, she emerges as an extraordinary harpist, her music touching souls and providing solace. The doctor who delivered her finds an unexpected redemption in her melody, revealing the profound impact we can wield on each other's lives. A story that celebrates the human spirit, the power of resilience, and the beauty of life’s serendipities, this episode is a testament to the influence we can unknowingly have on the trajectory of others' lives.

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Episode Transcript

Speaker 1 (00:18):
I have another short story for you, and this one is a
true story about a doctor and aburden he carried until one
particular Christmas season.
I hope you'll enjoy it with me.
Stay tuned to hear the storythe Tiny Foot by Dr Frederick

(00:46):
Loomis.
Doctor, just a moment please,before you go into the delivery
room.
The man was about 35,well-dressed and intelligent, an
executive of a large oilcompany.
His first baby was to arrivewithin the hour.
He had spent the precedinghours by his wife's bedside,
miserable, with the feeling ofhelplessness and anxiety common

(01:09):
to all prospective fathers atsuch a time, but nevertheless
standing by to comfort her byhis presence.
I must tell you one thingbefore the baby gets here,
doctor, he said I want that baby, and so does Irene, more than
we ever wanted anything else, Ithink, but not if it isn't all
right.
I want you to promise me rightnow that if it is defective and

(01:34):
I know you can usually tell youwill not let it live.
No one need ever know it, butit must not live.
I'm depending on you.
Few doctors have escaped thatproblem.
I had not been in Californialong before I encountered it
there, just as I had encounteredit elsewhere.
Fortunately, it is a problemthat usually solves itself.

(01:56):
Babies that are defectiveeither mentally or physically,
after all, are infrequent, yetthe possibility of having one
hounds almost every waitingmother.
Her first question, on openingher eyes after a baby is born,
is always either what is it oris it all right?
Whichever question comes first,the other invariably follows,

(02:20):
and the one as to its conditionis always the more important,
however they may feel about itin individual instances.
Doctors rightly resent andresist the rather persistent
effort to make them the judgesof life and death.
Our load of responsibility isenough without that.
Treatment is difficult, asHippocrates said, when the

(02:43):
preservation of life is the onlyquestion.
If the added burden of decidingwhether or not life should be
preserved were placed upon us,it would be entirely too much.
Moreover, the entire morale ofmedicine would be immediately
threatened or destroyed.
Two years after I came toCalifornia, there came to my

(03:04):
office one day a fragile youngwoman expecting her first baby.
Her history was not good froman emotional standpoint, though
she came from a fine family.
I built her up as well as Icould and found her increasingly
wholesome and interesting astime went on, partly because of
the effort she was making to becalm and patient and to keep her

(03:24):
emotional and nervous reactionsunder control.
One month before her baby wasdue, her routine examination
showed that the baby was in abreech position.
As a rule, the baby's head isin the lower part of the uterus
for months before delivery, notbecause it is heavier and sinks
in the surrounding fluid, butsimply because it fits more

(03:46):
comfortably in that position.
There is no routine spontaneousturning of all babies at the
seventh or eighth month, as isso generally supposed, but the
occasional baby found in abreech position in the last
month not infrequently changesto the normal vertex position
with the head down by the timeit is ready to be born, so that

(04:07):
only about one baby in 25 isborn in the breech position.
This is fortunate, as the deathrate of breech babies is
comparatively high because ofthe difficulty in delivering the
aftercoming head and theimperative need of delivering it
rather quickly after the bodyis born.
At that moment the cord becomescompressed between the baby's

(04:28):
hard little head and themother's bony pelvis.
When no oxygen reaches thebaby's bloodstream, it
inevitably dies in a few shortminutes.
Everyone in the delivery roomis tense, except the mother
herself in a breech delivery,especially if it is a first baby
.
When the difficulty is greater,the mother is usually quietly

(04:48):
asleep, or almost so.
The case I was speaking of wasa complete breech, the baby's
legs and feet being folded underit, tailor-fashioned in
contrast to the frank breech inwhich the thighs and legs are
folded back on a baby's bodylike a jackknife, the little
rear end backing its way intothe world.
First of all, the hardest thingfor the attending doctor to do

(05:11):
with any breech delivery is tokeep his hands away from it
until the natural forces ofexpulsion have thoroughly
dilated the firm maternalstructures which delay its
progress.
I waited as patiently as I could, sending frequent messages to
the excited family in thecorridor outside.
At last the time had come and Igently drew down one little

(05:33):
foot.
I grasped the other For somereason I could not understand,
it would not come down besidethe first one.
I pulled again, gently enough,but with a little force, with
light pressure on the abdomenfrom above by my assisting nurse
, and the baby's body moved down, just enough for me to see that
it was a little girl.

(05:53):
And then, to my consternation,I saw that the other foot would
never be beside the first one,the entire thigh, from the hip
to the knee, was missing andthat one foot never could reach
below the opposite knee.
And a baby girl was to sufferthis, a curious defect that I
had never seen before, nor haveI since.

(06:15):
There followed the hardeststruggle I have ever had with
myself.
I knew what a dreadful effectit would have upon the unstable
nervous system of the mother.
I felt sure that the familywould almost certainly
impoverish itself in taking thechild to every famous
orthopedist in the world whoseachievements might offer a ray
of hope.
Most of all, I saw this littlegirl sitting sadly by herself

(06:39):
while other girls laughed anddanced and ran and played.
And then I suddenly realizedthat there was something that
would save every pang but one,and that one thing was in my
power.
One breech baby in ten dies indelivery because it has not
delivered rapidly enough.
And now, if only I did nothurry, if I could slow my hand,

(07:01):
if I could make myself delaythose few short moments.
It would not be an easydelivery anyway.
No one in all this world wouldever know.
The mother after the firstshock of grief would probably be
glad she had lost a child sosadly handicapped.
In a year or two, she would tryagain and this tragic fate
would never be repeated.

(07:21):
Don't bring this suffering uponthem.
The small voice within me saidthis baby has never taken a
breath.
Don't let her ever take one.
You probably can't get it outon time anyway.
Don't hurry.
Don't be a fool and bring thisterrible thing upon them.
Suppose your consciousness doeshurt a little.
Can't you stand it better thanthey can?
Maybe your consciousness willhurt worse if you do get it out

(07:44):
in time.
I motion to the nurse for thewarm, sterile towel which is
always ready for me in a breechdelivery, to wrap around the
baby's body so that thestimulation of the cold air of
the outside world may not inducea sudden expansion of the
baby's chest, causing theaspiration of fluid or mucus
which might bring death.
But this time the towel wasonly to conceal from the

(08:06):
attending nurses that which myeyes alone had seen.
With the touch of that pitifullittle foot in my hand, a pang
of sorrow for the baby's futureswept through me and my decision
was made.
I glanced at the clock.
Three of the allotted seven oreight minutes had already gone.
Every eye in the room was uponme and I could feel the tension

(08:27):
in their eagerness to doinstantly what I asked, totally
unaware of what I was feeling.
I hoped they could not possiblydetect the tension of my own
struggle at that moment.
These nurses had seen medeliver dozens of breech babies,
successfully, yes, and they hadseen me fail too.
Now they were going to see mefail again.

(08:48):
For the first time in my medicallife, I was deliberately
discarding what I had beentaught was right for something
that I felt sure was better.
I slipped my hand beneath thetowel to feel the pulsations of
a baby's cord, a certain indexof its condition.
Two or three minutes more wouldbe enough, so that I might seem

(09:08):
to be doing something.
I drew the baby down a littlelower to split out the arms the
next usual step and as I did so,the little pink foot on the
good side bobbed out from itsprotecting towel and pressed
firmly against my slowly movinghand, the hand into whose
keeping the safety of the motherand the baby had been entrusted
.
There was a sudden convulsivemovement of the baby's body, an

(09:32):
actual feeling of strength andlife and vigor.
It was too much, I couldn't doit.
I delivered the baby with herpitiful little leg.
I told the family and the nextday, with a catch in my voice, I
told the mother.
Every foreboding came true.
The mother was in a hospital forseveral months.
I saw her once or twice and shelooked like a wraith of her

(09:55):
former self.
I heard of them indirectly fromtime to time.
They had been to Rochester,minnesota.
They had been to Chicago and toBoston.
Finally, I lost track of themall together.
As the years went on, I blamedmyself bitterly for not having
had the strength to yield to mytemptation.
Through the many years that Ihave been there, there has

(10:17):
developed in our hospital apretty custom of staging an
elaborate Christmas party eachyear for the employees, the
nurses and the doctors of thestaff.
There is always a beautifullydecorated tree on the stage of
our little auditorium.
The girls spend weeks inpreparation.
We have so many difficultthings to do during the year, so
much discipline and so many ofthe stern realities of life that

(10:41):
we have set aside this one dayto touch upon the emotional and
spiritual side.
It is almost like going to animpressive church service, as
each year we dedicate ourselvesanew to the year ahead.
This past year the arrangementwas somewhat changed.
The tree on one side of thestage had been sprayed with
silver paint and was hung withscores of gleaming silver and

(11:03):
tinsel ornaments, without atrace of color anywhere and with
no lights hung upon the treeitself.
It shone, but faintly.
In the dimly-litted auditorium,every doctor of the staff who
could possibly be there was inhis seat.
The first rows were reservedfor the nurses and in a moment
the procession entered.
Each girl in uniform, each onecrowned by her nurse's cap, her

(11:26):
badge of office.
Down their shoulders were theirblue-red cross capes, one end
tossed back to show the deep redlining.
We rose as one man to do themhonor and as the last one
reached her seat and we settledin our places again, the organ
began the opening notes of oneof the oldest of our carols.
Slowly, down the middle aisle,marching from the back of the

(11:49):
auditorium, came twenty othergirls singing softly.
Our own nurses in full uniform,each holding high a lighted
candle, while through theauditorium floated the familiar
strains of silent night.
We were on our feet againinstantly.
I could have killed anyone whospoke to me then because I
couldn't have answered and bythe time they reached their

(12:10):
seats I couldn't see.
And then a great bluefloodlight at the back was
turned on very slowly, graduallycovering the tree with
increasing splendor, brighterand brighter, until every
ornament was almost aflame.
On the opposite side of thestage, a curtain was slowly
drawn and we saw three lovelyyoung musicians, all in

(12:31):
shimmering white evening gowns.
They played very softly inunison with the organ a harp, a
cello and a violin.
I am quite sure I was not theonly old sissy there whose eyes
were filled with tears.
I've always liked the harp andI love to watch the grace of a
skillful player.
I was especially fascinated bythis young harpist.

(12:53):
She played extraordinarily well, as if she loved it.
Her slender fingers flickeredacross the strings and as the
nurses sang, her face, madebeautiful by a mass of auburn
hair, was upturned, as if theworld, that moment, were a
wonderful and holy place.
I waited when the short programwas over to congratulate the

(13:15):
chief nurse on the unusualeffects she had arranged.
As I sat alone, there came downthe aisle a woman I did not
know.
She came to me with armsoutstretched.
Oh, you saw her.
She cried.
You must have recognized yourbaby.
That was my daughter who playedthe harp, and I saw you

(13:36):
watching her.
We remember the little girl whowas born with only one good leg
17 years ago.
We tried everything else first,but now she has a whole
artificial leg on that side.
But you would never know it,would you?
She can walk, she can swim andshe can almost dance.
But best of all, through allthose years when she couldn't do

(14:00):
those things, she learned touse her hands so wonderfully.
She is going to be one of theworld's great harpists.
She enters the university thisyear, at 17.
She is my whole life and nowshe is happy.
And here she is.
As we spoke, this sweet younggirl had quietly approached us,

(14:20):
her eyes glowing, and now shestood beside me.
This is your first doctor, mydear Our doctor, her mother said
.
Her voice trembled.
I could see her literally sweptback as I was through all the
years of heartache to the daywhen I told her what she had to
face.
He was the first one to tell meabout you.

(14:41):
He brought you to meImpulsively.
I took the child in my arms,across her warm young shoulder.
I saw the creeping clock of thedelivery room of 17 years
before I lived again those awfulmoments when her life was in my
hand, when I had decided ondeliberate infanticide.
I held her away from me andlooked at her.

(15:04):
You will never know, my dear Isaid you will never know, nor
will anyone else in all theworld, just what tonight has
meant to me.
Go back to your harp for amoment, please, and play Silent
Night for me alone.
I have a load on my shouldersthat no one has ever seen, a

(15:26):
load that only you can take away.
Her mother sat beside me andquietly took my hand as her
daughter played.
Perhaps she knew what was in mymind.
And as the last strains ofSilent Night, holy Night, faded
again, I think I found theanswer and the comfort I had

(15:49):
waited on for so long the End.