It was just supposed to be a long lunch -- step out of the office, make the 10-minute drive to the hospital's ob/gyn department, sit through the ultrasound of our 20-week-old baby, and bring back a black-and-white photostrip to pin to the wall.
Maybe grab lunch somewhere on the way back.
The appointment, as they do, began innocently enough. Heartbeat? Check. Kidneys? Strong and healthy. "And see that? The baby's waving to you!" With that, the pleasant ultrasound tech explained that the radiologist would be in shortly, and have a nice day.
"When we perform an ultrasound scan, we're looking at the development of the fetus and for anything that may or may not be associated with a health issue," the radiologist explained, moving the wand over my wife's midsection. Understood. This was our third child. We knew the drill by now.
"I'm noticing something."
What was that you said?
"See this? The baby's intestine looks abnormally bright." As he squinted at the monitor, the physician went on to explain that this finding -- medical term, echogenic bowel -- is a "soft marker" for certain health conditions. While not diagnostic in itself, it's been correlated with conditions such as cystic fibrosis and Down Syndrome. Given our advanced ages (40 and 41), the anomaly placed us squarely in the high-risk group.
As he continued his monotone delivery of statistics and tests and probabilities, I felt my blood turn to ice. It seemed as if someone had placed the room on a spindle and spun it like a top. I felt my mouth asking questions that I didn't even care about the answers to. More than anything, I wanted to get out of that cramped room. I was suffocating. I needed air.
The debate over medical overtesting is nothing revolutionary -- it's been part of the national conversation surrounding cancer and heart disease for decades now. It seems to touch all the third rails -- Financial. Political. Religious.
Earlier this year the debate resurfaced when San Francisco cardiologist Dr. Rita Redberg argued in an opinion piece in the Archives of Internal Medicine that a slew of medical tests performed on President Obama were unnecessary, expensive, and perhaps dangerous. A summer of opinion-volleying followed, with media pundits on all sides chiming in.
Separate from the financial and health-risk controversies surrounding AFP, CVS, amniocentesis and other prenatal procedures is the ethical concern of what to do with all this information. In our case, if further testing had revealed that our child did in fact have a chromosomal abnormality or cystic fibrosis, there's nothing we could have done. Many parents forego testing altogether for this reason, of the mind that nothing the doctors tell them will make a difference.
Add to this the profound dilemma posed by false positives. Tests aren't perfect. A female colleague nearly terminated her pregnancy over prenatal testing that suggested a particularly dire health condition. She did not, and her baby daughter was born perfectly healthy.
As an opinion spectrum, of course, nobody is more "right" than anyone else -- it comes down to personal preference, comfort levels, and what you're emotionally prepared to accept.
Count me among the group who like to know as much as they can about what they're facing. Yes, it was a whirlwind summer of sleepless nights, Internet research and pointless speculation. Ultimately, our son was born with no issues. We have no clue what could have led to the finding on the scan. We're thankful.
But while it was a distressing journey, I'm still glad we took it.