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What We Have Here...
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You or Your Baby?
By Noah Evslin, Medical Researcher
If you watch our show closely, you know it's not the medical treatments that make Private Practice different than other shows on television; rather, it's the ethical debates our doctors have over any of the myriad decisions they need to make each week.
In this week's Episode 419, "What We've Got Here...," a pregnant patient, VAL, gets diagnosed with an aggressive form of Burkitt's Lymphoma. This causes Sam and Addison to be on opposites sides of the following dilemma:
Do you convince a pregnant woman to undergo a life-saving procedure that will most-likely cause the demise of her 24-week-old still-unborn child?
After Val comes into the practice complaining of swollen glands, Sam has to break the news to her that she has Burkitt's Lyphoma, which is a particularly malignant and fast-growing cancer of the lymphatic system.
Normally, when a patient has this type of cancer, a doctor would want to start chemotherapy immediately. In this case, however, chemotherapy could fatally harm Val's twenty-four-week-old fetus.
Thus, Val is faced with the following set of choices: does she deliver the baby at twenty-four-weeks even though her child is barely on the cusp of viability? Or, does she wait a few more weeks, as her child's survival rate increases every single day the baby is allowed to stay and develop in the womb? The problem, of course, is the longer she waits to treat the cancer, the lower her chance of survival becomes, as every day counts with a fast-growing cancer like Burkitt's Lymphoma.
Addison wants to deliver the baby immediately, so they can start treating the cancer. Sam prefers to wait, as he knows there's a good possibility the child won't survive outside the womb. Val also wants to wait. In fact, she'd rather die than risk the life of her unborn child. Val's husband, Gary, desperately wants Val to give up the baby and start the chemo, as he knows if they wait too long, he will lose his wife.
After the stakes are raised due to a complication called SVC Syndrome, Addison convinces Val to undergo an emergency C-section and deliver the baby.
In the end, although both the baby and Val survive the procedure, it's left unclear whether or not they will survive what comes next: namely, Val's ongoing fight with cancer, and the baby's ongoing fight for survival as a premature baby.
Did Addison make the right decision in convincing Val to have the C-section?
What would YOU do?