Uncanny X-Men #512: A Medical Review
Uncanny X-Men #512
Matt Fraction, writer
Yanick Paquette, penciler
Beast and his team of scientists have traveled back in time to the San Francisco of 1906 looking for Nicola and Catherine Bradley. They find Catherine just in time to rescue her from an attack by goons from the Hellfire Club — immediately afterward, Catherine Bradley suffers some significant vaginal bleeding. The doctor who examines her diagnoses her with placenta previa and places her on bedrest.
Placenta previa occurs when the placenta, instead of its normal location along the side or top of the uterus, implants along the bottom of the uterus, covering up the opening to the birth canal. It is a fairly common cause of vaginal bleeding during later pregnancy, but is very, very rare in the first trimester (the first three months of pregnancy).
More common causes of first trimester bleeding include implantation bleeding, miscarriage or threatened miscarriage, or an ectopic pregnancy. Trauma can play a role as well, as can non-uterine causes of vaginal bleeding.
There is nothing a physician or mother can do to cure placenta previa. Minimizing the recurrence of bleeding from the previa is wise, so that is why bed rest is recommended. Luckily, most placenta previa resolve by themselves — as the uterus grows during pregnancy, it pulls the placenta up higher. For a placenta previa discovered during the second trimester, there is a 90% chance it will resolve by the delivery date.
Currently, a cesarean (c-section) is the preferred method in the United States for delivering the baby when there is placenta previa. If c-section is not an option — for instance, in certain more remote parts of the world, or at the turn of the 20th century — the baby can be delivered vaginally, but it is a bloody mess. While there is a risk the mother may die due to placenta previa, it is the baby who faces the greatest risk of death. Currently in the United States, the maternal mortality rate from placenta previa is 0.03% (I don’t have the data, but I suspect the risk was several orders of magnitude larger in 1906).
Taking as given the standard ethical warning about a physician treating a member of their own family, this scenario opens up a couple of intriguing questions, questions that were for some reason not covered in my Medical Ethics class in medical school.
1. Since James Bradley already knows that Catherine dies in childbirth, is he — consciously or sunconsciously — not going to try as hard to save her life as he should?
2. If the situation comes down to the life of the mother versus the life of the child (not uncommon when dealing with placenta previa), and since he himself is the child, wouldn’t his medical decision making be severely compromised?
(I guess part of the ethics depends on your opinion on time paradoxes and whether or not the past is immutable)
June 29th, 2009 at 8:08 am
In this case at least, it seems that the Temporal Prime Directive(disrupt as little as possible when travelling in and interacting with your subjective past) either trumps or reinforces the Hippocratic Oath(do no harm), depending on your point of view.
June 29th, 2009 at 9:21 am
I would love to be in a medical ethics class that did try and cover these questions.
June 29th, 2009 at 11:46 am
Are we playing by Timecop rules? Because that means if he touches the baby, he’s gonna blow up like Ron Silver
June 30th, 2009 at 7:20 am
Why is Elijah Snow impersonating an MD in this comic?
July 2nd, 2009 at 7:48 pm
It seems that if the past is genuinely mutable, and not in the canonical “creates an alternate timeline” way then ethics demands that he favour saving the baby over the mother, assuming another physician couldn’t attend instead. If he allows himself to die as an infant and the past is mutable, than she dies anyways, because he never existed, therefore never went back in time, therefore events play out as they would without him and she dies. This would seem to suggest that he would be ethically obliged to have someone else perform the delivery, since the patient being under the care of a physician who could cease to exist due to possible complications is pretty obviously undesirable. Of course if any change caused by time travel intrinsically creates an alternate timeline, as is the official (though poorly observed) rule in the Marvel Multiverse, then as soon as they appear in the past the X-Club are in an alternate timeline and he isn’t actually delivering James Bradley-616. You could argue in that case that he’d be quite driven to save the mother, even at the cost of the baby’s life just to know that SOMEWHERE she was alive, since he can’t save his actual mother.
July 3rd, 2009 at 6:56 am
“and means that she is experiencing morning sickness a little earlier than expected — classically it begins around the 12th week…”
Are you sure about that? The resources I have say that morning sickness usually ends by the 12th week.
July 4th, 2009 at 6:36 am
I agree with Bill, morning sickness is said to end by the 12th week. Personally I was sick as a dog – both times – at seven weeks. I was told that it should go away by 12 weeks. It did not. It’s one symptom that I’ve rarely seen follow the “rules” in anyone.
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