It's 2013, and I have just pushed two little girls out of my body and into the world. Then everything changes. I remember intense pain, placentas, a hole in my uterus, and countless white coats swarming around me. My body is tilted backward, and somewhere in the distance I hear someone say, "There's a lot of blood." One of the white coats sits down beside me and asks me every two minutes: "Can you hear me? Can you open your eyes?" 

Am I going to die now, I think. Were we only meant to have this brief encounter with each other?

The pain becomes less intense, the noise from all the white coats fades, and I'm wheeled into the maternity ward with a little over two litres of blood less in my veins. It's wonderful to see the tiny creatures again. Less wonderful is the realisation that my swollen, fluid-filled feet from the preeclampsia are still there. Everyone assures me that all the retained fluid will soon flush out of my system. I look forward to it immensely. The babies weigh surprisingly much for such tiny creatures. It feels as though I have two bricks resting on my chest. The fact that I feel like the worst mother on the planet remains unspoken. My legs are filled with fluid, and the skin feels tight. "Did you sleep well?" a white coat asks every morning. "No," is my answer every single time. I explain that I can't lie flat. I must keep the bed fully upright, surrounded by every spare pillow the white coats have managed to track down, and still, there's an unsettling sensation in my throat. Maybe it's reflux. I honestly don't know. The white coat says I'm probably just anxious. The swelling in my legs keeps getting worse. I press into the skin and watch the marks linger. I joke with the white coats about everything I'd let them do if they could just get rid of the fluid. "Can't you just poke tiny holes in my legs? Throw me at the consultant like a water balloon?" They tell me it's perfectly normal to retain even more fluid after giving birth.

A Family-Friendly Hospital

The white coats take great pride in being a mother-and-baby-friendly hospital. What I long for, though, is a family-friendly one. The children's father is hardly allowed to be there, only two hours a day. Of course, I can visit him in the corridor downstairs. But I'm exhausted, in pain, struggling to breathe, and my legs are swollen with an absurd amount of fluid. I struggle just to walk and fetch milk for the babies or food for myself. By the time I manage to get hold of a slice of bread, mealtime is over and the food has been cleared away. After several days of barely eating, I finally dare tell a white coat that I simply must eat now, while there's still food available, and that I can feed the babies afterward.

"You can eat later. Babies first!"

The message is drilled into me from day one. I understand the logic, but honestly, what the hell? Aren't adults supposed to put on their own oxygen mask first? Too exhausted to argue, I let it go and try again the next day. This time I make it to the kitchen and come back triumphant with half a bread roll, ham and cheese. I manage one bite before the babies wake and need feeding, and by the time they're settled and asleep in my arms, the roll is just out of reach on the tray. Ahhh. Hunger turns into indifference. 

My older sister and my close friend and colleague come to visit. A white coat urges them to leave. "Mother is tired. She has a slight fever. She can't handle any more visitors. She needs rest. "They're told visiting hours are over. I try to explain that I want visitors for as long as possible and that, since I'm alone in the room, it should be fine. The white coat says mothers aren't very good at setting boundaries or expressing what they need, and that I need rest. I don't say it out loud, not the way I truly feel it: You have no idea what I need. I need to be with the people I love. I need to get away from here if I'm going to survive. I need food, and I need someone to get this damned water out of my body. The evening and the next day are consumed by tears, loneliness, and the relentless swelling in my legs. I don't have the energy to be properly furious, but I am. At night my heart races. It sounds like a herd of wild horses. A white coat comes to check my blood pressure.

"You're probably just a little anxious," she says.

The delivery-room coat drops by. She asks if I'm doing okay and expects me to say yes. I tell her I'm not sleeping. There's a bubbling sensation in my throat. I'm short of breath, my pulse is high at times, and my legs are full of water. I ask whether all that fluid isn't supposed to disappear. She asks me to roll up my trouser legs. She looks at my swollen, log-like feet for two seconds and says, "They do look a little big, but I don't actually know what your legs normally look like." I pull my trousers back down with a sigh and think quietly to myself: There's nothing you can do to help me. I want to go home.

A new white coat tells me I can go home if I manage to care for the babies alone through the night. They need feeding and changing every three hours. I explain that I'm so exhausted and in so much pain that I can't manage it. Somehow I seem to get sicker at night, though I don't understand why. But my wonderful husband, the children's father, will be home for the first two and a half months to help me. I'm ready to go home. In my mind, everything will get better once I get there. "No," says the white coat. "You have to make it through the night alone, without help." I fight through that night with everything I have.

Something's Wrong

Early the next morning I roll the babies with me into the bathroom, to take a shower. A white coat bursts in, hysterical. "Did you bring the babies into the bathroom? The steam!" Are you kidding me? I'm thinking. My children can tolerate steam. But the words never come out. I feel vulnerable standing there in the shower. I can feel the blood running, I've hardly eaten or slept for six days, and I doubt my own abilities as a mother. The babies disappear from me. It feels as though they belong to the white coats.

Before we leave I ask the discharging coat if I can take diuretics. She says absolutely not, because I could become dehydrated. I don't understand the logic, considering I've never felt more waterlogged in my life. I ask again: "Are you sure it's not a good idea to get rid of all this fluid? It's not going away. There's more and more of it. I have fluid all the way up my thighs." The answer remains the same.

We go home. What a feeling of freedom. I delight in being with my husband and children and in the fact that we can do exactly as we want. We settle down in front of season two of Game of Thrones. The babies sleep in each of our arms. Life in the living room is wonderful for about thirty minutes. Then everything starts falling apart. The room spins. I feel nauseous and impossibly weak. During the night I feel unable to hold the babies. I don't trust my arms. They're so weak. I feel strange in ways I can't explain.

My husband and the babies sleep downstairs on the sofa while I stay upstairs. I gather every pillow in the house and stack them up. I try to sleep sitting upright. I drift off here and there. My sense of reality begins to fray. At one point I say out loud to myself: "You have nothing to do with Game of Thrones. It doesn't matter which house you support. You're sitting in your bed, in your room, and now you need to pull yourself together."

Another night comes. I'm alone in my own Westeros world while my beautiful family is downstairs. They feel impossibly far away, as though they belong to another realm. The living room downstairs might as well lie beyond the Wall. I call the maternity unit and speak to a white coat. I explain that I'm very ill and worried about my health. I'm told to call back if I get worse. I search my symptoms online, together with the word "childbirth." It says that if you have these symptoms after giving birth, you should seek treatment immediately. You shouldn't wait to see your GP the next day.

I get worse, more worried, and call the unit again. I explain all my symptoms to a new white coat: that I've barely slept in a week, that I'm unable to care for my babies, that the coats at the hospital said it was anxiety, but that I'm afraid I'm seriously ill. The white coat agrees. Probably anxiety. I say I can accept that the hyperventilation and the high pulse might be, but the bubbling in my throat can't be. For some stupid reason, I don't mention that I'm a psychologist.

He hears my dry cough over the phone and says it could be pneumonia. Suddenly, I feel hopeful. Maybe I can just take antibiotics and make this go away. "But are you absolutely sure it isn't something more serious?" "No, I don't think so. You can't come in tonight. Call your GP tomorrow." I don't mention what I found online. I simply say goodbye and wonder whether I'll survive until morning. I think about calling emergency services, but after being turned away once already, the threshold feels impossibly high. What if it really is just anxiety? I hold on to the faint hope that it's pneumonia.

I try to relax by leaning my head against the wall while sitting on the edge of the bed. I try to convince myself it's anxiety and breathe calmly, but I can't. A nagging doubt remains about whether I belong to House Stark or the Targaryens. It's all so complicated and difficult to decide. I plan for the next morning. There are ninety minutes left until I can get up. I just have to endure. I dream about antibiotics, sleeping pills, long sweet sleep, and Jon Snow.

It's the Heart

I tell my husband, who's standing bent over the crib, that I'm going to the doctor. The taxi driver keeps glancing at me in the mirror and says there must be something wrong with my lungs. I arrive at my GP's surgery wearing tracksuit bottoms and Crocs and walk straight to reception. "I need to see my doctor," I say. "I'm really quite seriously unwell." The receptionist tells me he hasn't arrived yet, but that I can wait outside his office. Four of us are sitting there when he finally appears. I practically leap out of my chair and explain, desperately, that I don't have an appointment but that I have to see him. Inside his office, I burst into tears. Between waves of hyperventilation, I explain that I haven't slept for eight nights, that I'm seriously ill, unable to care for my babies, and that the maternity unit thinks it's either anxiety or pneumonia. My GP quickly rules out pneumonia. He listens to my lungs while I lean forward, but hears nothing abnormal. He asks me to breathe normally. I try. "Breathe properly," he says sharply. He's never spoken to me like that before. I've never cried in his office before. He tells me to go for imaging. There may well be an element of anxiety involved, he says, but he wants to investigate further. Then he hands me a prescription for sleeping pills, which I accept like an addict in withdrawal.

On the way to imaging, the taxi driver won't stop looking at me and says he doesn't like the sound of my breathing, insisting on driving me right to the entrance. I lean heavily over the reception counter, but every time someone speaks to me, I straighten my back. It's strange how deeply shame governs us: I want them to understand that I'm sick, yet I keep trying so hard to pull myself together. The radiographer is kind and gently guides me through the MRI scan. On the lift ride down afterward, an elderly man asks if I'm alright and whether I need help as I hang over the railing. I tell him I'm fine.

On the way to the pharmacy, a third taxi driver glances back at me again and again, then says, quietly, that I really don't look well at all. Just as the taxi pulls over, my GP calls. "You have fluid on your lungs. You need to go to A&E." He calls again while I'm crawling up the stairs toward my front door. I remain lying there on the steps while he speaks. "You're going to the hospital." I ask whether it's serious and whether I need to hurry. "Pack your toothbrush and go." Outside, the sun is shining. Part of me wants to stay there forever. It takes me more than an hour to pack a toothbrush and get myself into another taxi bound for A&E.

"We've been expecting you. You're going to lie down whether you want to or not," they tell me in the emergency department. Two white coats rush toward me with a hospital bed. I refuse to lie down and am allowed to sit on the edge instead. Wires attached to my body, my pulse taken, oxygen tubing beneath my nose. Then another room: more wires, more questions, more hands. I pull myself together. A strange burst of energy arrives now that I know I'm finally about to receive help. Before long, they tell me it could still be my lungs, but they think it's my heart. I ask whether I can send a text message to my husband, and they hand me my phone.

They think it's my heart, though it could be my lungs. I don't know when I'll be home. I think I may have to stay here for a while.

A few minutes pass before I ask for my phone again. If I die, the last message I send to the man I planned to grow old with can't be clinical in tone. I love you becomes my final text. Immediately, I feel guilty. What if I frighten him? One of the white coats calls cardiology, and suddenly we're rushing through corridors. My consciousness begins to slip. I register that everyone is moving quickly, but calmly. They politely ask another patient to wait for the next lift. We need to be prioritised.

Your Own Mask First

They place an oxygen mask over my face. It feels like being gagged. Speaking becomes difficult. I feel nauseous. One of the white coats explains that he needs to ask me several questions and asks me only to nod or shake my head. "Have you gained weight recently?" Dear God. Has nobody remembered to mention that I gave birth to twins eight days ago? My weight has gone dramatically up and down. I start miming a large belly and childbirth. He asks again. I wave my hand vaguely, so-so, to indicate that there are no straightforward answers. Finally, another white coat mentions the birth, and we're able to move on.

The white coat tells me they need to insert lines into my main arteries. If there's one thing I truly can't stand, it's needles. Panic starts creeping in. The white coat warns me that it's going to hurt. Suddenly, I start to gag, and they hand me a bowl. I rip the oxygen mask off my face. Apparently that's not acceptable. The mask has to stay on, no matter what. They place it back over my face while simultaneously trying to insert lines into the arteries in my wrists. Then panic fully takes over. I tear the mask off again, gasp for air, kick wildly, and lash out around me. One of the junior white coats looks terrified. That frightened expression burns itself into my memory. I want to die. I can't endure any more pain. My body has had enough. Then, immediately, another thought crashes in: Of course you don't want to die. You have two tiny babies. They can't grow up without a mother. Calm down. Breathe slowly. Stop kicking. Be still. You're a psychologist, for God's sake. You know how to do this. Far away, I hear a firm but gentle voice: "You need to keep the oxygen mask on." I let her place it back over my face. They insert the lines into my arteries, but by then I can no longer distinguish the pain. I only know it existed.

I don't know how long I've been asleep, but when I wake up, I'm connected to what feels like a sea of machines. The oxygen mask becomes my companion for days. All the white coats are serious. They're trying to understand what happened. "It's a good thing you came in when you did. We were talking minutes. It was crucial that you calmed down and that we managed to get the oxygen mask on. You went from full panic to completely calm. That was decisive. The situation is still serious." I gather my courage and ask: "What's the worst-case scenario?" The white coat looks grave. Reluctantly, she answers: "In the worst case, a heart transplant." My profession is to read between the lines. I know a heart transplant isn't really the worst-case scenario. I also know enough about the body to understand that oxygen saturation around seventy percent, blood pressure of 260/160, and a dangerously elevated pulse sustained over time pose a serious threat not only to the heart, but to the brain as well.

That first night in the hospital, one of the white coats tells me that she can monitor me from the observation room and that I'm completely safe, but that if I want, she can stay in my room instead. I nod. She sits quietly working through the night, and the soft sound of her keyboard is strangely comforting, almost lulling me to sleep. What an extraordinarily warm and gentle human being. I don't think she has any idea how much it means to me that she stays. I never tell her.

Eight Days of Heart Failure

Over the following days, my heart's pumping capacity gradually climbs to around twenty percent. That counts as good progress. One of the ventricles is still leaking. My heart has enlarged after eight days of heart failure.

On my second day in the hospital, I receive the less frightening diagnosis: postpartum cardiomyopathy, heart failure related to childbirth. Two or three mothers in Norway develop it each year. It's been five years since the last case at this hospital. A well-known but rare condition. Everyone who develops it is heart-healthy beforehand, and almost everyone makes a full recovery afterward. The most wonderful senior consultant in the world explains this proudly and with visible relief, relieved that they've finally landed on a diagnosis. The treatment consists of heart medication and diuretics. Seven litres of fluid later, my legs are finally recognisable again. Seeing my children again is indescribable. It hurts that they can only visit briefly, but I sleep most of the time, and I know they're well cared for. My children are absolutely worth dying for, and living for.

It feels safe in the cardiology ward. But after about a week, they do the unforgivable: they send me back to the maternity ward. Back to the white coats who refused to admit me when I called in desperation, two nights after being discharged. They're going to monitor my heart now. My heart, in their hands. The white coats I have absolutely no trust in.

I feel unsafe again lying in their bed. Tears roll down my face. A young white coat asks too gently: "Have you heard of the baby blues?" I want to scream: I'll show you baby blues. But I don't have the energy. I settle for an icy stare. Once again, all I want is to go home.

Eventually, after two weeks, I finally do. I do have to return a couple of times, among other things because of suspected blood clots, but after four weeks, I'm officially discharged and free. After leaving the hospital, I replay everything that happened, over and over, in my mind. For months, tears come whenever I think about how close it all was. So many coincidences. Even during follow-up appointments long after the critical admission, the white coats comment that I didn't seem to understand how ill I really was; I, who only wanted to go home. Little did they know that I'd felt death holding a cold, clammy hand around my ankle almost from the moment I gave birth, and throughout the entire hospital stay.

In the end, I'm lucky. After six months, my heart is healthy again. After a year, I no longer need medication. Today, I'm completely healthy. The girls turned thirteen this year. I even did it again and gave birth to a baby boy five years. Maybe not the smartest decision in the world, but without any doubt, the most joyful one.

What We Don't Say Out Loud

I've told this story many times since, as a patient, sometimes; more often now, as a psychologist thinking about what it takes to actually help someone. The more I turn it over, the less it feels like a story about a missed diagnosis. It's a story about a feeling that had nowhere to go. I wasn't short of things to say. I said, quite plainly, that something was wrong with my throat, my legs, my sleep. What I couldn't say, what I didn't have the words or the standing to say, was underneath all of it: I am terrified, and I need someone to take that seriously before they take my temperature.

That's the part I think about most now: how much energy I spent managing my fear so it wouldn't be mistaken for hysteria. Straightening my back at reception. Not mentioning that I was a psychologist. Trading my own alarm for a calmer, more acceptable word, anxious, because that was the word being handed to me, again and again, by people who were tired, stretched thin, and doing their best inside a system with no time to spare.

This is where emotion-focused work has something to offer medicine, and not only therapy rooms. Fear that isn't received doesn't go away, it goes underground, and it takes the person's voice with it. Long before anyone can be helped to regulate a feeling, they need the far more basic experience of being felt in it, someone slowing down long enough to let the fear be fear, without renaming it something smaller and easier to manage on a ward round.

I still wonder, sometimes, whether things would have gone differently if just one of those early conversations had left space for what I was feeling, rather than moving quickly to reassure it away. Not more tests, necessarily. Just someone willing to sit with I think I might be dying for a moment, before answering it. That, to me, is the work: helping people find the words for what's happening beneath the symptom, and helping the people around them, clinicians included, develop the patience to hear it. It doesn't take much time to meet someone without judgement, or with a little curiosity and warmth. It takes intention, and a system that protects room for it.

If we want humane hospitals, we need humane systems around the people working in them, and perhaps a few more emotion focused therapists in the room, reminding everyone, patients and professionals alike, that a feeling heard is very often the first and most important step toward being helped.

Anne Hilde Vassbø Hagen is a psychologist and managing director at the Institute for Psychological Counselling (IPR) in Bergen, Norway, and at the Norwegian Institute of Emotion Focused Therapy. She is the author of several books on emotions and therapy, including Angry Kids, Angry Parents and the textbook Emotion Focused Skills Training for Parents. She has also created the animated film series Alfred & Shadow, and the educational film Angry Kids, Angry Parents.

This is a translated and edited version of a Norwegian text first published on www.psykologisk.no.

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