Thursday, March 5, 2015

Joy, relief and optimism

I knew that I was going to have a long day at the hospital. I am to have a 12-hour duty, where I am to see several patients, listen to their complaints, write them prescriptions and erase their pain and suffering. Though my words and touch are comforting to my patients, I am to follow the same cycle of listening, talking and prescribing every day.

Nobody in the right sense of mind would want to associate themselves with pain, illness and suffering. Yet, doctors do it, hoping that they can wipe off all these maladies in whole or part. Sometimes they emerge successful, sometimes they succumb to  disease.

It was raining heavily. The car stopped outside of the hospital building with a strange noise. I knew from the urgency of the driver and the whispering from within the vehicle that something was terribly wrong. In a few moments, I came to know that my assumption was right. Much more was wrong than I had initially imagined.

A young woman, who looks like being in her twenties was brought out of the car on a trolley to the hospital emergency wing. It looked as if she was dehydrated, tired and spent. In a quick look, I could say that it was an obstetric emergency. This would mean that I should act up. Soon.

Now, it is not quite possible to deal with any obstetric emergency single-handedly. One needs to have a healthcare team to support them. The first step, therefore, is to call for help. I called in the top of my voice and nurses and doctors from everywhere arrived to the scene. I did a quick examination of the patient. Her pulse rate was shooting up and the blood pressure was falling down. I realized that it is a sign of shock. She might have lost a lot of blood, and might still be bleeding.

One of the nurses pushed a large bore cannula into her vein. I ordered another nurse to draw up some blood for investigations. Yes, I needed to know what I was dealing with to be able to treat her condition. I looked at her past ultrasound scans and figured out that all her scans had been normal. Her expected date of delivery was just one month away. I noticed that the uterine size was more than the expected size for her gestational age. Suddenly it hit me. I was looking at a case of abruption of placenta. If I am not going to do anything in a few hours, I am going to screw up my patient's life.

I ordered for blood and auscultated the abdomen. I could hear the foetal heart beating. The tone was not quite good, so I should anticipate danger anytime. By that time, the ultrasound machine was brought and I found from the scanned images that a huge clot of blood is present inside the uterus. The clot is likely to grow in size and might even kill the baby. The solution was to do an emergency Caesarean section to save the baby and the mother.

I called up the obstetrician on duty and prepared the patient for surgery. I wrote her case sheet, interpreted her investigation reports and got the consent form signed by her relatives. The blood transfusion was started. By that time, she had started to look better. Pinkish hue was spreading on her cheeks. I was relieved, but I knew that nothing but a termination of pregnancy and delivery of the baby safely will not solve the issue.

The obstetrician and the anaesthetist examined the patient in less than five minutes. They hurriedly prepared for the surgery. They looked up my examination details and found that the patient needs to be operated upon immediately. She was taken to the operation theatre in another ten minutes. I had been working under stress for the patient for a long time, so I sat down to rest a bit. I knew that I can't rest for longer : because I have to alertly wait for the next emergency.

The surgery went well. The bleeding was controlled. She gave birth to a lovely baby girl. In three days, she recovered really well. I heard from the obstetrician that she is responding well to her medication. I couldn't be more happier.

One day, the staff assistant approached me, asking me to visit Room 406. It was strange, because I never used to do room visits. My job was always at the casualty wing and the operation theatre complex. The assistant did not know why I was called there. I decided to visit the room anyway.

Room 406 was where my patient was admitted. It was the day she was leaving the hospital and she had insisted that she wanted to meet the doctor at the emergency wing before she left the hospital. She had brought flowers for me. When she handed over the flowers to me, she cried a bit. She thanked me a lot for saving her life. She told me that, during her brief times of consciousness in the emergency room, she could see me working besides her, examining her and ordering people around her to do things. She told me that I am her hero.

Optimism came flowing into me. Everyday, I go to hospital with a heavy heart - not wanting to see any further casualties, not having to deal with another emergency. But I invariably end up with a lot of emergencies and work overtime. I have often been very tired and spent. But that one patient who calls you a hero, that one patient who thanks you for the work you did, that smile of the baby you helped to be born, that joy on the face of her relatives when she recovers - all these fill me up with optimism and makes me want to work hard for my patients again.

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