Wednesday, July 31, 2013

It's Not A Perfect World

Head first and with a quick thrust, he made it. Being slippery wet, he wiggled away as I tried to get hold of him. In a perfect reflex, I grabbed his ankle, supported his back and lifted him up. Slimy wet and stark naked, he swayed his hands towards her. Then I glanced at her. She let out the most beautiful smile I've ever seen on a woman's face. A smile that heralded the inner outburst of exceeding joy that seemed to have completely effaced the moments of excruciating pain. I smiled back and turned him towards me and saw his rosy red cheeks. He gave out a low cry. I cut the umbilical cord and held him closer to me. That was when he peed on my labour gown.

It makes a doctor glee when a new-born passes the first stools or shoots his first pee. Because it's a sign of normal development of the gastrointestinal tract and the urinary tract. It allays the fear of any major congenital anomalies associated with these systems. I was happy too. "Your little pumpkin peed on me", I grinned. She giggled. Being the only doctor present in the septic labour room at that moment, I left her allowing the placenta to separate. I took the baby to the incubator. The nurse did the essentials for the baby like wiping the amniotic fluid dry, sucking the mouth for fluids that might obstruct the breath and made the baby feel warm. He was in good apgar and seemed very active. I watched him briefly as he poked all his four limbs into the air. It seemed he was too impatient and wanted to explore the new world he was into. I requested the nurse to notify the paediatrician and went to the mother's side. I removed the placenta and completed the other stuff like suturing and recording her vitals before she could leave the labour room to the ward nearby along with her baby where she could nurse him. 

It seemed like a perfect ending to all that anguish, all those lamentations and fear that gripped her.

A painting by Cynthia Angeles titled Grief

Earlier that day, when I entered the SLR (Septic Labour Room), I was nervous. I was told that a junior resident was on leave and they were managing a hectic department with lesser man strength. So I had to stay in the SLR with the nurses and take care of the patients there until they find a spare resident. How a final year medical student can replace a resident, I thought. However, there was only one patient in labour in the SLR and I felt relieved.

I went by her side as she lay on the cold metal board, occasionally screaming with pain whenever she had contractions. I took her pulse and blood pressure. As I was leaving to record my findings on her case notes, she looked at me asked, "How long would it take for my baby to come out?”. I had no idea. I had just come in and I really had no idea of her labour progress. However, I didn't want to showcase my ignorance. "When your baby is ready", I smiled feeling smart. "Will he be alive?" she pestered. 

I went by her side, bent near her and heard her story. I came to know that the present pregnancy was her second. This first one ended in a spontaneous abortion. Naturally, she was so scared of the outcome of the present pregnancy. And this time, to make matters worse for her, she was admitted in the SLR with premature rupture of the membranes. Her womb refused to open up in the normal speed and so was given medication to hasten it. And the doctors had told her that her baby was in distress and was in danger until delivered. I could understand her pitiable state of mind.

But I was so determined. Something told me that everything would be alright. I stayed with her and did my best to encourage her and allay her fears. And when the right moment came, I conducted the delivery and out came a baby that looked healthy and was doing fine. It indeed was a perfect ending, I thought. 

As she sat on a wheelchair with her baby close to her bosom and both wrapped in a blanket and about to be wheeled out to the ward, she thanked me. She asked me for baby name suggestions. I beamed a broad smile and humbly refused as nothing hit my mind. Before leaving, she asked me for my mobile number. Normally I’d never given it to any patient before, but as I wrote it down on a piece of paper and handed it over to her, she received it with great honour and heart full of gratitude.

Three days later, I received a call and on the other end, I heard a wailing voice that reminded me of the mother I’d meet three days ago except that it seemed a lot more coarser after repeated episodes crying. “My baby died doctor” is what I heard at the other end interspersed between sore weeps.

I hate to leave you with such pessimism. But let this be a gentle reminder that sometimes it's not a perfect world. And life has to move on. Make the best of it when it's still not too late.

- Do leave a comment below or contact me if you wish to communicate your feelings. Thank you for patient reading.