Unbearable, p.18
Unbearable, page 18
Grant had pointed out to me that the city doesn’t release death data by hospital. “Statistically, the last death Woodhull had before that was twelve years before,” she said, which put Woodhull in line with Denmark despite the population not being as healthy as Denmark’s. (She apparently didn’t count Shamony Gibson, an artist who had a cesarean at Woodhull in September 2019 and died of a pulmonary embolism at a different hospital less than two weeks later.)
Two months after those conversations, Christine Fields was dead.
* * *
THE NIGHT before Jose and I met for the first time, I sat at my desk re-reading what had just been reported about Christine’s death. The New York Times’ Joe Goldstein had obtained a confidential state report linking Fields’s death to a too-long incision on her uterus during her C-section. The doctor apparently tried to repair it on the spot, but not well enough. Despite that, the doctor’s report claimed “no intraoperative surgical complications,” so no one caring for Christine in the hospital afterward knew to pay close attention. She had bled to death internally.
Goldstein also reported that two weeks before Christine died, the same doctor had been linked to an infant death after a woman attempting a VBAC suffered a uterine rupture. This doctor, seventy-two-year-old Ronald Daniel, had been recently fired. His colleagues anonymously described him as “caring and competent,” and “several” said they didn’t think there was any pattern besides the two deaths.
The nature of Christine’s injury was chillingly familiar. So was a name in the story. I riffled through a pile of papers and opened a folder Maggie and Matt had given me containing Maggie’s medical records. What I saw in black-and-white made me dizzy, and then nauseous. Right there on the first page, the medical notes were signed Ronald Daniel. The same doctor had operated on Maggie and Christine, about four years apart, each time committing a strikingly similar mistake. Each time with witnesses, but without immediate accountability. Each time with a partner screaming for help. But Maggie had lived to raise her child. Christine had not.
I hadn’t expected to come into my first meeting with Jose bearing news of another way Christine’s death might have been prevented, but I had no choice. He took it stoically.
“I would just love to tell ’em,” he said slowly, of Matt and Maggie, “that if it’s the same doctor not to feel no type of way. It’s not their fault.” After all, only the hospital could have known this happened more than once. And if anyone understood not wanting to fight the hospital after it took from you someone you loved, it was Jose. He had told me that medical error at another Brooklyn hospital had led to his partner Teresa’s death, but he had been too wracked with grief to report it. Later, after Christine died, he wondered if maybe it was the universe punishing him for not fighting harder back then.
It was rare to have two situations be so parallel, to be able to compare two tragedies so directly: the same doctor, a similar error that took far too long to detect. I couldn’t get past where they diverged, which was what happened when their partners screamed for help. And did that make the difference between the fact that Maggie came home and Christine didn’t?
I wondered what Jose thought about it. “He’s screaming for help,” I explained. “But they don’t call security on him.”
He winced. “I hate to even think that that happens,” Jose muttered. “I hate to even put a color to this thing.”
I told him I regretted even having to bring it up.
“It could be the truth,” said Jose, now becoming distraught. “It’s just that I hate to think that that happens in 2024.”
“And I don’t want to put anything in your head,” I said, “if that’s not what you feel happened. Because you were there and I was not there.”
He shook his head again and again. “Christine and I teach our kids not to be like that,” he said. Not for the first time, he was speaking as if she was still alive, out of habit or fidelity. “I’ve never been like that. I always got along with any color,” he said, as if someone had accused him of doing something wrong.
“I would love to think that that’s over in 2024,” repeated Jose. “We shouldn’t even be treating each other like that. You feel me? But you’re right. It does happen.”
That’s when he told me something he hadn’t spelled out before. That other woman who got seen before them, upsetting Christine, the woman who later got to have her family in the operating room? She was white, or at least light-skinned.
Later, I sat down again with the documents surrounding the two women’s experiences, trying to make sense of what they shared and how they diverged. Strictly speaking, their partners’ cries for help came at different times. Matt had been allowed to be present for the surgery, and hadn’t had to choose between attending to the newborn and to his partner. He had happened to be at Maggie’s side when she began to falter. Jose had been at the NICU with his baby and only later learned that Christine, rather than resting as her mom had said, had been agitated and asking for him. Nobody had told him. By the time Jose found Christine, she had likely been in critical condition for thirty minutes. But there had been so many moments leading up to that point where things could have been different. If Christine’s preferred midwife had happened to still be there, or if Christine had been seen with greater attention earlier, would someone have noticed something was amiss? Could more support have prevented a surgical birth, or if it were indeed necessary, could that have been identified earlier without descending into screaming emergency? And would a white woman have been left alone in a room that way to bleed out internally?
* * *
IT TOOK a few months for Jose to tell me about yet another factor that had compounded his pain at losing Christine. In the summer of 2021, when Nova was only about six months old, Christine started throwing up, and Jose told Christine that he was sure she was pregnant. She insisted she couldn’t be. But she was. At the time, they were mainly staying at her mom’s apartment, as many as four to a room with Liam and Nova. Christine was overwhelmed. She said she couldn’t be pregnant again, not yet.
Jose told me he was against abortion. “I’m not going to lie, I never did that in my life,” he said. “I believe if I get someone pregnant, we should have the child. It’s just who I am. I take care of my children.” But he also understood the precarity of their still-new relationship, and of Christine’s own stability. She was still in school. They were tentatively trying to build a life.
Reluctantly, Christine went to Woodhull to be seen. She told them she couldn’t be pregnant again. She returned with a pill they told her she had to take by the end of the night. Even the following day would be too late. Christine returned home in a panic that she had to make her decision that night. Though it’s not entirely clear, it’s likely Christine had been administered mifepristone, the first pill to end a pregnancy, and had returned with the second one, misoprostol, which the FDA says can be taken up to forty-eight hours after mifepristone. If so, the abortion was already underway. In any event, she returned home tortured by the decision before her.
They wept together, and then Christine took the pill and went into the bathroom in her mother’s apartment to let the induced miscarriage take its course. Then she went into her bedroom and didn’t want to come out. Jose, wracked by his own guilt and disapproval, didn’t try to comfort her, and he put up a stolid front. They sobbed in separate rooms.
The next morning, Jose told her he couldn’t do it anymore. She stared at him, wondering if he was leaving her. But what he couldn’t do anymore was be in that apartment where it all had happened, living with her mother, staying where it felt they would never have the life they wanted. She was welcome to come with him back to Bushwick. “Because if we are going to have a family,” he said, “we have to have a family.” And they would find the space to have more kids if they wanted to. Christine started packing. Soon after, they moved in together, and then to the lottery apartment.
Paradoxically, the abortion—or at least the crisis point around it—had brought them closer together. That didn’t make his feelings of guilt disappear. When Christine died, Jose wondered if it was God’s punishment for the abortion. Although there was no way to know for sure, Jose told me he had always accurately predicted his babies’ genders, and he believed that she had been pregnant with a boy that time. “That was a baby boy and we have a baby boy now,” he told me. “And because we chose not to have that baby boy, she chose to have Anuel, now she’s not here? I was basically blaming myself. The choices we made.”
Still another choice they’d made at Woodhull haunted Jose. In advocating for her care when they’d come in, and then fighting the C-section and Jose’s presence in the operating room, had they given themselves a reputation of being difficult? He could tell himself a plausible story of how this would have turned the medical staff against them: “Like, ‘Oh, these are parents that want things,’ ” Jose said. “Since we know she don’t want this, she don’t want that, let’s just throw her in a room and leave her there.”
Maybe. One national study looked at women who declined procedures while giving birth in American hospitals and found that they were likelier to report mistreatment in the aftermath, especially if they were Black. “In the context of childbirth care,” the researchers wrote, “women pay a penalty for exhibiting behavior that may be perceived as uncooperative, and this penalty may be greater for Black women.” But it’s also possible that being meek and compliant could have had the same outcome for Christine—being ignored—when they were up against forces so much bigger than the two of them.
A growing body of research was suggesting that the hospitals where many Black women tended to give birth could account for some of the hideous disparity in both mortality and morbidity, or severe complications. The national data showed that in 2010 and 2011, 74 percent of Black women delivered at hospitals where patients were disproportionately Black, and that the ones who delivered at the hospitals that served the most Black patients were the likeliest to have poor outcomes.
When the same researchers drilled down to New York City, they estimated that choice of hospital could account for as much as 47.7 percent of the racial gap in severe mortality. In 2017, ProPublica looked at New York State data for serious complications from postpartum hemorrhage—an indicator chosen because women of all races suffer from it at roughly similar rates—and found that “high black-serving hospitals had complication rates 21 percent higher than low black-serving hospitals.” Both Maggie and Christine, of course, had hemorrhaged. Left unexplained was what made “black-serving” hospitals have such different outcomes.
* * *
IT WAS tempting to blame everything that had happened on Dr. Daniel. Why hadn’t he noticed that he’d left Maggie to bleed out internally? Why hadn’t he told anyone to take special care with Christine after his mistake—one we now knew he had made before—while still finding the time to amble over to Jose and make unsolicited small talk?
There was someone I thought could help me understand what happened. P. Mimi Bhatt is an assistant professor at New York University’s nursing school. She’s also a licensed midwife who spent fourteen years working labor and birth at Woodhull, until resigning in March 2024.
The public hospital system, she pointed out, pays less than the private. “When you have lower salaries, you attract a different kind of clinician,” she said. “I don’t know any better way to say that.” That meant people who were like her, “who are working at a financial loss because I want to be in service to that community,” and people who couldn’t get a job anywhere else. It came at a cost for all the clinicians. “You don’t have the latest technology. You don’t have all the latest equipment. You don’t have twenty-four-seven emergency dental or endocrine coverage or psychiatric coverage in your hospital.”
And it meant that doctors were so hard to recruit, she argued, that the leadership at Health and Hospitals was unwilling to let even bad doctors go. But even when doctors were fired, as Dmitri Shelchkov and Ronald Daniel finally were after Sha-Asia’s and Christine’s deaths, it wasn’t enough. “If you stick to the bad actor narrative, you get rid of the bad actor,” Bhatt said. “And it makes people think maybe the problem is solved, but it’s not solved because the problem has always been in the system.”
In January 2025, a midwife at Woodhull, Nicole DeNuccio, testified before the New York City Council and was even more explicit. She said that in March 2023, OB/GYNs at Woodhull had “issued a collective plea for help,” demanding more doctors who were paid better. “Physicians were also forced to work shifts that they did not feel were safe for them to work,” she added. “One key example being an OB physician in his seventies who faced health complications who requested not to be scheduled on the night shift.” Nonetheless, she said, that doctor was handed a night shift by another doctor who had been working sick, and that night in October 2023, a woman under his care lost her baby and her uterus ruptured. “Two weeks later,” DeNuccio continued, “he remained scheduled for a night shift, and that night he made a fatal surgical error and postsurgical management decisions that resulted in the death of Black mother Christine Fields.”
And maybe it wasn’t just the doctors. Katy Cecen is a trained midwife and former public hospital NICU nurse turned activist. Since Christine’s death, she had been helping Jose and Denene organize the weekly protests outside Woodhull, while providing support to the family. She told me that even without a surgical error, any patient who just had a cesarean is at risk for excessive bleeding and is supposed to be watched closely for at least two hours. It would have been hard to miss that something was wrong with Christine if someone had been regularly checking on her, including her vital signs. If they had, they could have easily seen that she had ripped out her heart monitors and her IV, indications that she was unusually disoriented and confused, a red flag.
“If the nurses had been doing their job,” I asked, “would Christine be alive?”
“If the nurses had been given the resources to do their jobs, yes, absolutely,” Cecen replied. “I mean, if the other woman”—Maggie—“is alive, why not Christine?”
But on this, too, Cecen wanted to make clear she didn’t blame the nurses personally. For years, she had been taking to social media to criticize the coverage of the maternal deaths at Woodhull as focusing too much on individual doctors, instead of systemic problems at the hospitals. To me, she spoke wearily of reporters who only wanted to talk about interpersonal racism and not the structural kind. “It’s not because the nurses are terrible people who hate pregnant women and don’t care about them,” she said. “It’s because that is a one-on-one patient and they have no ability to double their nursing staff in a shift.”
The pandemic had compounded a nationwide nursing staffing crisis. About a quarter of nurses told researchers they were experiencing unsafe staffing levels, and more than half said their workload had increased because of the pandemic. Indeed, data from the New York State comptroller showed that Woodhull had lost almost a quarter of its full-time registered nurses between 2020 and 2023, the biggest drop among the city’s public hospitals. Temporary nurses had only partially filled the gap, and each one represented a need to be integrated into the existing team in a perennially chaotic environment. And full-time nurses at Woodhull were likely to be paid less than their travel counterparts, or their full-time colleagues at private hospitals in the city.
Bhatt told me she’d resigned from Woodhull in March 2024 because of the consecutive departures of Grant, the chair of obstetrics, and the chief medical officer. Contrary to the impression I’d gotten in my conversation with Grant, Bhatt maintained it had been Grant who had insisted on trying to do something more, and not to accept less from any other provider. “Helena was the first one to say, you need to document this, document this, and submit it to leadership,” she said. “She wasn’t trying to protect people. And she would say this to me all the time, if you wouldn’t bring your daughter here, then there’s a problem.” Bhatt felt like that was no longer true of the leadership that succeeded her. “I’m old enough now to know when leadership is not in alignment with my values,” she said. That included the head of OB, she said, who had forced Dr. Daniel, recovering from being hospitalized from Covid, to work nights. That’s what happened on the night Christine died.
The story of Woodhull was also one of a wealthy, purportedly liberal city that tolerates gaping inequality. “That’s what really disturbs me about New York City,” she said. “We have, what, thirty-eight maternity care hospitals in the city, but it is a deeply segregated system.”
I had told Bhatt that I had strongly considered switching to Woodhull in 2020, where she had long worked, but stuck to NYU, where she taught. “So even for you, when you’re saying, I was going to go to Woodhull, you are not the typical client that we see at Woodhull,” she said, matter-of-factly. “You’re not. You get to come to Woodhull because you’ve made a very educated decision from a privileged place. And I’m saying this as a privileged Indian woman.”
Bhatt continued, “Most of the women who are coming to Woodhull are not making that kind of deliberate choice. This is their community hospital. This is their neighborhood hospital. Maybe this is where their auntie delivered or their friend delivered or their sister delivered.”
In Christine’s case, it was where she had been born. In New York City, it was relatively easy to get on a subway or bus and go somewhere with more resources, but that was no guarantee these patients would be treated well in exchange for the time and hassle they might not be able to afford either. Woodhull was also a place where just about everyone was on Medicaid as a matter of course, without particular shame.
Bhatt thought that individual racism could have played a role in what had happened, but argued that it was also too simple an explanation. “A lot of the providers within the system are Black and brown,” she said. “If anyone’s white, it’s the midwives, to be honest.” And sure, she said, race played a role in calling security on Jose, but on the other hand plenty of providers at Woodhull had stories about being attacked by patients or the people with them.
