November Update

I am a self-professed science nerd. I not only love using modern technology but investigating its origins and uses. As the Nurse Manager at CHOICES, I have the privilege of using a very sophisticated ultrasound machine. Ultrasound has been used clinically in obstetrical practice since the late 1950s. It quickly went through a rapid number of changes. The first came in 1966 when Dennis Watkins, John Reid and Don Baker created pulse Doppler ultrasound technology. This new technology allowed for imaging of blood flow throughout many layers of the human heart. An ultrasound of the heart is now referred to as an echocardiogram. Using standard ultrasound or doppler ultrasound, a visual image forms. This cardiac echocardiogram can then be used to measure, diagnose and provide a treatment evaluation. We can measure blood flow and diagnose maladies such as congestive heart failure, murmurs, or various diseases. After diagnosis, an effective treatment is prescribed, or surgery is recommended.

A reality struck me the other day while in the ultrasound room. I was performing a limited OB ultrasound on the young woman lying on the table. On the screen, I looked at her uterus, visualized her bladder, and scanned across her pelvis. At some point I moved from scanning the young woman on the table and switched patients, now using ultrasound to scan a separate individual, someone completely different from the person I had started with and whose name was on the screen.

As the probe settled over the patient’s uterus, we could plainly see a thriving baby nestled in her uterus. The tiny little one was fully visible, crown to rump, and there was a beautiful, fluttering heart, capturing our attention. As I zoomed in on the baby’s heart I could see the contraction of the cardiac chambers, ejection of the blood, relaxation of the cardiac chambers, and the refilling of the chambers again with new blood. There was a distinct and perfect rhythmic sinusoidal wave form produced that was generating these live images. I was able to record a video clip of the heart beating, as well as capture the motion of the systole diastole cycles that were produced using M mode on the ultrasound machine. This was no longer an ultrasound on the woman, this was an echocardiogram on the baby! 

My background in nursing is rooted in emergency room medicine where patients with acute chest pain and myocardial infarction were placed on cardiac monitors and 12 lead EKGs were obtained to diagnose and differentiate what was happening electrically in the heart. We’d use EKG and sometimes order echocardiograms to look for problems in myocardial tissue, electrical conductivity, or to diagnose various cardiac diseases.

The sinusoidal waveform on the echo cardiogram of this seven-week fetus gave me the SAME type of imagery that we use to view adults. The only difference was that the baby is much smaller.

I remember thinking – It is actually the baby, inside the mother’s womb, who was getting an ultrasound. Yes, I did have to view him/her through the mother’s uterus, but this little human had its own separate body, complete with its own heart. I was seeing a tiny image-bearer with its own separate brain, its own organs, its own hands, and its own feet, etc.

While working in the emergency room over many years, I saw my fair share of dying and death. Cardiac monitors show activity, while life is still hanging in the balance, even as death approaches. But a person is definitively dead when the electrical signals have stopped, and the heart is no longer beating. Alternatively, all creatures that possess a heart that is beating are by any and all definitions, alive.

Here this baby was floating inside the amniotic fluid, nestled safely in his/her mother’s womb, fully alive, demonstrating sinusoidal waves, systolic and diastolic cycling of the cardiac chambers, with an audible heartbeat at 138 bpm. This was my second patient that day.