The world's first glimpse of Dr. Paula Mahone came last year on the afternoon of Nov. 19, just hours after she delivered seven babies in six minutes and helped make medical history.
She sat at a table in an auditorium at Iowa Methodist Medical Center in Des Moines. Hundreds of reporters -- there must have been 30 television cameras -- demanded an answer:
How did this happen?
"I would have to consider it a miracle," Mahone told them.
A woman gives birth to septuplets, and for the first time in history they survive, and the doctor who delivered them explains it as ... a miracle?
You could see the eyes rolling. Well, yes, sure, but the mother was taking a fertility drug, wasn't she? And then there was all that reproductive technology involved, wasn't there? And really now, how can a doctor, a child of facts, chalk all this up to -- what, exactly?
God. Paula Mahone believes in God. She talks about her faith every chance she gets. This week, she returned to Goucher College in Towson -- she is a 1980 graduate -- and, calmly, without a trace of self-consciousness, discussed the marriage of medicine and miracles.
"I'll tell you," she says, "I don't understand everything, but God certainly does."
There is much more to 39-year-old Paula Mahone than what we glimpsed that November day after the McCaughey septuplets entered the world.
She is a woman of faith and a student of medicine. She is a born-again Christian and a pro-choice feminist. She is a black doctor thriving in the middle of a state that is as white as bond paper.
Miracles, you want miracles? How about a single mother raising three girls in Youngstown, Ohio? The oldest child, the girl who wanted to be a doctor, was sent to a suburban elementary school. She was the only black student.
"It was a blessing in disguise," Mahone says. "All my life I'm usually one of only a few."
She was 9 when her father, William, a captain in the Air Force, was killed in Vietnam. Her mother, Norma, returned to college, taking classes part-time. It took her eight years to finish; she graduated from college the same year her daughter Paula graduated from high school.
Only two girls in Youngstown took every college-prep course offered. Paula Mahone ignored the physics teacher who encouraged her to drop the course. Nurses don't need physics, he told her.
A college classmate of her mother's recommended Goucher. It was a women's school then; Mahone loved the place. She felt safe, unintimidated, excited by the variety of students there.
"I was a feminist before I knew the word feminist," she says, laughing.
She wasn't a straight-A student. "She didn't test very well, but when it came time to do laboratory work, she aced it all the time," recalls Helen Habermann, a retired biology teacher. "I think she holds herself to very high standards."
Mahone says she always expected excellence from herself; that's the way she was raised. After medical school, she worked at Emory University Hospitals in Atlanta, where she met her future husband, Ron, on a blind date. She then worked at the University of Rochester.
There were setbacks. It happened rarely, but there were patients that refused to allow her to treat them. What was it -- her gender? her race? She didn't know.
"I get angry, but to spend a lot of time concentrating my anger on that would just be paralyzing," she says. Of the four black men she went to medical school with, none finished. "Not because they weren't bright, but because they were angry."
She says Iowans have accepted her; at least no one has refused her care. She has worked as medical director of perinatal services -- high-risk pregnancies -- at the Des Moines hospital since 1993.
The minority population of Carlisle, Iowa, home to 3,600 people and the McCaughey family, is less than 100, but Bobbi McCaughey and Mahone hit it off immediately. They had one thing in common: their faith.
"I would tell her if this had to be, God chose the right person in her," Mahone says.
But Mahone wasn't excited that first time that Bobbi and Kenny McCaughey -- and their parents -- entered her office. Far from it. There was no talk of miracles or God's great works or the power of prayer. There was talk of statistics and failed pregnancies and the health risks to premature babies.
"We did not disregard medicine because we believe in God," Mahone says.
And everything she read in the medical literature pointed to one outcome: "This was going to end badly."
Women just don't give birth to seven babies.
"There was no protocol," she says. "There was nothing in the literature that told you about seven babies."
Now, of course, there is. Today, the McCaughey septuplets are nearly 4 months old. Earlier this month, the last two children left the hospital and arrived in their cramped home in Carlisle, where a team of 60 volunteers helps feed, clean and comfort them. If you want to talk to the parents, please send a fax to their agent.
Life has changed for Mahone as well. After delivering the septuplets, she and her partner have experienced an increase in business. She has been swamped with speaking engagements. She smiles, wryly, at the notion that her opinion is so valued now, when people "couldn't have given two cents for it the day before."
She remembers her first meeting with Bobbi McCaughey, the quiet seamstress, who was 16 weeks pregnant with seven fetuses. When the reproductive doctor told Mahone's office, this was the reaction: "You're kidding."
There were no assurances then. Mahone assumed the pregnancy could not possibly last long enough for the fetuses to survive. She gave the McCaugheys all the information she had.
That included the prospect of selective reduction, or abortion. "I'm born-again," Mahone says. "However, I'm pro-choice and think that women have to have all the options. Sometimes I have resolution about this and other times I question it."
The McCaugheys rejected the idea. As long as patients understand their options, as long as they have all the information, Mahone says she can accept whatever decision they make. You can debate the ethics of having seven babies, she says. You can't debate whether the McCaugheys acted according to their beliefs.
"I believe that this family sees it as a success, and as a physician that's all that's important," she says.
Unlike some other specialists, Mahone does not fault the doctor who gave Bobbi McCaughey the fertility drug.
"Anybody who's in science or medicine has to understand that there's nothing exact about what we do," she says. "You can do everything right and have a terrible outcome. Physicians who are horrible and don't do anything right still have patients who live and survive."
Amazingly, Bobbi McCaughey remained pregnant -- 20 weeks, 22 weeks, 25 weeks. Mahone thought she might make it. "She was emotionally powerful, the babies were growing well."
The delivery, by Caesarean section, came at 30 1/2 weeks. While premature, the babies were relatively healthy; doctors remain cautiously encouraged about their development.
An 'easy' delivery
The truth is, Bobbi McCaughey's pregnancy and the delivery presented far fewer problems for Mahone than most of her patients.
To Mahone, that's where the miracle comes in. Why did the McCaughey septuplets make it when other babies don't?
"This is not because she prayed harder than anyone else. It is a question I will be looking forward to having answered when I see God face-to-face," she says.
"I attribute the success of the pregnancy to God blessing Bobbi McCaughey. We would have trusted him if every baby had died. We trusted him no matter what happened."
On Sunday night, in the chapel at Goucher College, Mahone described her faith. She quoted from Psalm 92 -- How great are your works, O Lord!
Afterward, students surrounded Mahone. One sought her out.
"I'm getting ready to graduate and have to choose a graduate school," said Latisha Jackson, 21, a senior in sociology. "Listening to her encourages me to put God first. It's great hearing her, especially since she's a black female who has succeeded and is doing well. I know the Lord will direct me."
Jackson shared her thoughts with Mahone. The two women hugged. Miracles are where you find them.
Pub Date: 3/11/98