My Toughest Case: A Malnourished Pregnant Teenager

Pamela Markiewicz Wiseman, MD / Family Medicine at Louisiana State University Health Sciences Center

One of the most important – and most challenging – parts of Dr. Pamela Wiseman’s job as a family physician is to help patients adopt healthier behaviors. For 20 years, she delivered babies; now she works doing prenatal and pediatric care with her family medicine partners and sees patients of all ages.

During a particularly tough case, two lives were at stake: that of a teenage girl and her unborn child.

Wiseman first met the teen early on in her pregnancy. Despite an iron deficiency, she was “generally healthy and very motivated to do all the right things to ensure that her baby had a good start in life.”

The teenager decided to become vegetarian, thinking it would be a healthier option for pregnancy. But instead of gravitating toward alternative protein sources, along with fruits and vegetables that are recommended for a well-rounded diet, the expectant mother began to solely consume carbohydrates and fats – especially because there was a lack of resources and access to healthy food in her neighborhood.

Her anemia continued to worsen and she soon developed Kwashiorkor, a serious nutritional disorder most often seen in developing countries and places experiencing famine.

“I tried contacting her to ask her to come to the hospital for evaluation, but her phone had been disconnected,” recalled Wiseman.

Wiseman always makes an effort to get to know her patients. “It is so much easier to take care of patients when you really know them and their families,” she said. In this case, she and her nurse chose to make an unexpected house call. “[The family] was very surprised to see us, but she grabbed her bag and left for the hospital right away.” She was then given blood transfusions and after a few days was well enough to return home to carry out her pregnancy. “She continued to learn about healthy food and changed her diet to better nourish herself and the baby.”

The fortunate outcome? Wiseman eventually delivered the young woman’s healthy, full-term infant.


Undergraduate: Loyola University New Orleans

Medical School: University of Virginia Medical School

Year Graduated: 1992

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