184. Ivan the Terrible

I meet 40 year old Mariya for the first time just a week before her scheduled repeat cesarean (she's has three prior cesarean deliveries, a number that puts her at risk for significant intraoperative complications).  

I note that there have been previous discussions regarding a tubal ligation, but as I try to confirm that, it is clear that Mariya wants a tubal ligation but her husband Anatoly does not. We've doing okay up to now he says, a generous use of "we." I suggest that a final decision can be made the day of surgery.

Delivery date arrives, no tubal ligation he says.  She's silent.  Surgery went well but post-op there's another difference of opinion.  He wants to name the newborn Peter, but Mariya and her 17 year old daughter prefer Luke.   

When I see her the next morning, Anatoly tells me, I think we'll end up with Peter.