But addicts aren’t all homeless people or mentally ill. They’re adults with jobs and children. They’re teachers, lawyers, doctors, and even nurses. One group of patients became the victims of one nurse’s addiction, and their story is both disturbing and heartbreaking. But it’s also relevant, given the way people, and women especially, are treated by the healthcare system in this country.
This group of patients wanted nothing more than to be mothers, so much so that they turned to one of the most prestigious medical schools in the country to undergo in-vitro fertilization. But the pain medication they were supposed to receive during their egg retrieval procedure was stolen by a nurse at their clinic, and they were forced to undergo the procedure without proper pain management. This horrific story is documented in the podcast The Retrievals, from The New York Times and Serial Productions. It’s about addiction, pain, and trying to assess a punishment that should fit this crime. But the Yale fertility clinic scandal teaches us so much more, including what our nation’s leading experts really think about women and their health.
One Nurse’s Drug Addiction
We like to think of nurses as caring, compassionate individuals. We only see them in our time of greatest need, and we would hope that the demands of their profession would ensure that only the most serious, dedicated people are accepted into that membership. But nurses are average individuals like any other, and though they’re subject to a code of ethics and behavior similar to other healthcare professionals, they’re also susceptible to the faults and vices that the rest of us are.
One source estimates that 1 in 5 registered nurses is a substance abuser. Addiction and substance abuse in any form should be tackled as a serious issue that impacts communities, not just the addict, but it’s even more disturbing when you consider the heavy weight of responsibilities that nurses bear. They’re responsible for caring for people at their most vulnerable, and it shouldn’t need to be said that they’re in no capacity to meet that duty if they’re under the influence of alcohol or drugs.
But that didn’t stop Donna Monticone, a fentanyl-addicted nurse caring for women at the Yale Reproductive Endocrinology and Infertility Clinic. She was responsible for caring for women as they underwent the procedures related to in-vitro fertilization, mainly egg retrievals.
An egg retrieval happens at an extremely delicate time in a woman’s menstrual cycle. Having had her ovaries hyperstimulated by artificial hormones to over-produce, the eggs have to be captured no later than 36 hours after the hormone injection, so that all the eggs aren’t lost when the woman ovulates. These eggs are retrieved by a needle inserted through the vaginal wall and up into the ovary. The eggs are then fertilized by separately captured sperm, and an embryo is created and later implanted in the patient, which ideally will implant in her uterus and result in a successful pregnancy. At Yale and likely other clinics throughout the country, patients undergoing these time-sensitive and expensive procedures are given a low-level sedative and fentanyl for pain management.
Except, as The Retrievals podcast reveals in detail, Donna Monticone was stealing fentanyl from syringes and replacing it with saline, then giving it to patients. While she stole the opioid for her own use, women undergoing egg retrievals were essentially given saltwater as a painkiller. The ensuing consequence for the women, described in detail in the podcast, is nothing short of every woman’s nightmare.
The Painful Consequences
“It felt like someone was ripping something from the inside of your body,” says Katie, one patient who worked at Yale as a neuroscientist and who turned to their fertility clinic to undergo the IVF process. Other patients taken advantage of by Nurse Monticone’s addiction describe writhing in agony during the procedure and later in the recovery room.
Another woman said, “They started the procedure. And, you know, I was just sort of taken by surprise, not expecting the excruciating pain. My blood pressure started going up. I was sweating profusely and telling them I was just in too much pain, that they had to stop. At that point, I remember them giving me more, more of the pain medication, and me saying, it’s not making a difference.”
A patient named Laura said she told the doctor during her egg retrieval that she could feel everything. “They didn’t believe me,” she told The Retrievals host, Susan Burton.
Monticone supplied her fentanyl addiction through her job at the fertility clinic from June to October of 2020, and in that four-month period, federal prosecutors deduced that she stole 75% of the clinic’s supply, affecting around 200 patients. But as the podcast reveals, this estimation could be slightly off because Yale was less than forthcoming about their former employee – it took a notice from the Department of Justice informing patients they’d been taken advantage of and that their former nurse was now under investigation. A follow-up letter from Yale told women that there was “no reason to believe this event had any negative effect on your health or the outcome of the care that you received.”
But that isn’t true. As the fourth and final episode of the podcast explains, the trauma former patients endured during their egg retrievals followed them for years after their experiences. Those who eventually became pregnant said their egg retrieval experience followed them to the delivery room, where they had even more increased anxiety and hesitancy over what should have been a safe, calm, birthing process. Those who didn’t become pregnant wondered how many eggs the doctor might have been able to retrieve if they’d been properly medicated and in a relaxed state, a possibility that haunts them.
In the end, Monticone’s theft was discovered by an anesthesiologist who noticed the cap on a vial of fentanyl came off too easily, which spurred an internal investigation. Monticone was questioned, drug tested, and eventually confessed to stealing it to satisfy an addiction that her attorney says began after a stressful divorce.
Monticone could have faced up to five years in prison for the theft and cover-up, but her sentence – largely due to the fact that she was the sole caregiver of her three children – was reduced to a handful of weekends. What’s even more baffling is that many of her patients had sympathy and compassion for her – until it was revealed in court that she, too, was once an IVF patient. But it was her own addiction and her duplicity that separated her patients’ care from the care she received as an IVF patient.
Medical Professionals Often Don’t Trust Women To Know Their Own Bodies
What should be even more infuriating about this scandal is that these women repeatedly brought their concerns to the doctors and nurses on staff, and were told across the board that the egg retrieval process was just painful – implying that if they couldn’t handle the pain, maybe they should question their commitment and how far they were willing to go to become mothers. If you can’t handle what it takes, then how are you going to handle being a mom?
Why didn’t anyone on the medical staff pick up on the sudden uptick in women experiencing severe pain during the egg retrieval procedure? Did they just assume they had a wave of sensitive, dramatic patients? Or had they, perhaps unconsciously, bought into the mindset that lay women, without any official medical training, didn’t and couldn’t actually know anything accurate about their own bodies and experiences? It’s certainly one explanation for why so many patients’ pain was brushed aside.
The theft, the abuse, the pain, and Monticone’s sentencing only serve to add salt to the wound. Now, 70 former patients have brought a lawsuit against the clinic for failing to stop Monticone earlier, and at heart, for not truly listening to them when they spoke up about their experiences. As a bastion of Ivy League higher education, Yale has an endowment in the billions. We can only hope that the outcome will in some small way mitigate the pain, anguish, humiliation, and suffering that these women experienced during their most vulnerable period.
As with any scandal and abuse of vulnerable individuals, there’s a lesson to be learned. It isn’t to discourage wanting what we want or to forgo motherhood. It’s to listen to women who have horrible experiences in this imperfect system that doesn’t really seem to care about any of us and to believe them.
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