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.

Tuesday, July 23, 2013

Hypertrophied Mouths & Atrophied Brains

Disclaimer: The following is based on true life experience. Though it would seem like a rant, it isn't.  It is just a capture of how workplace stress can influence people and how people responding to it might in turn affect the workplace. I am too young to be writing this. Constructive criticism is always welcome.

A lady, of dark complexion and in her late forties, was afoot with arms folded on her protruding abdomen. She wore a white gown and a plastic white cap to her crown. While she spoke, her voice was loud and discordant and the cacophony she created seemed to fit her figure. It was my first day and as I entered ward G, her shrill piercing voice perturbed the peaceful room filled with pregnant women. My first impression on seeing her was to try my best to avoid any kind of conversation with her. But as I entered the ward, the screams stopped momentarily and then it started again. This time it was at me that she was screaming, only a bit louder.

“Who are you, doctor?” she almost yelled.

“Intern. OG – 2, Sister” I replied and managed to pull a smile.

There was discernibly no pause after I’d finished my humble introduction. She went on to tell me what the junior residents of OG – 2 had left incomplete, urging me to finish them or remind them about it. She didn't notice my gesture of reassurance. Her attention shifted to the orderlies who were on their morning routine of cleaning the wards. Relieved (temporarily), I slipped into the ward and found jobs already waiting for me.

I was in that particular ward for around 8 weeks. I tried my best not to be mindful of the people around me but went on with my business. But I couldn't help but notice the conspicuous difference when she was not on her shift. I learned that the other interns working in the ward were also pissed off with her. They even had their own version of abusive names for her. No wonder she was the most disliked person in the entire floor. I did not bother to carry any hatred or grudge against her, until one fine evening.

I was finishing my shift and was about to leave home. I was tired. I had to do an ECG for a patient. There was no ECG machine in ward so I rolled the ECG machine from the nearby ward, just some 20 meters away. As I was finished with the ECG, the ward attendant, a lady clad in pink, offered to roll the ECG machine back to ward. I had not demanded her but probably out of some compassion to a tiring soul or perhaps remembering my previous gestures of good will to her, she offered me help. Though I politely refused, she was already rolling the ECG machine back. Only to be stopped by the stout, arrogant creature sitting on a cracking old chair. “You don’t have to do what this intern orders. You are here to do this ward work and you’ll do what I say”, she yelled. I could say she was flushing with rage, but her coal dark countenance was too incompetent to reveal any signs of it.  The ward attendant was trying her best to explain. But I wasted no time. I rolled the ECG machine to the adjoining ward on my own and I left home. I was too pissed off. I did not talk back because I knew that behind her big mouth there were no brains backing her up. Any argument would be pointless. I was cursing her on my way back. But soon it slipped off my mind and I was back to my peaceful routine.

I would not say all nursing sisters were of this kind. No. While I was in the nearby OR (operating room), after the surgeries of the day were over, I came out and sat in distress in the nursing station. I was having an attack of migraine. The nurse there took out a kettle and some milk she had brought for herself. She prepared a strong cup of coffee and offered me. More than the caffeine, her care and compassion had a considerable soothing effect on my nerves.

I often wondered what made the arrogant sister of ward G so arrogant. Was it because of the increasing work place stress? Of-course, ward G was one of the busiest and hectic wards in the whole of the hospital. But there were other wards more hectic than this and not all nurses breed such air of arrogance. Maybe she was more susceptible to such stress? Maybe she had other problems which contributed to this? Whatever, she required professional help. And there’s nothing in that to be ashamed of. I sincerely feel that in such places where the work load tends to be more and work flow become hectic, the institution should provide some sort of help/assessment for their staff to keep increasing stress levels at bay. Workplace stress can bring out varied untoward behaviour of people and this only tends to affect the workplace even more adversely for the others. Though the title of this post resonates the residual amount of anger I have on her, I do feel bad at the same time. Trying to act a little more maturely, I keep thinking of changes that can be brought to the system processes at work that will help make the workplace more conducive to the health care force as well as for the patients.


Sunday, July 21, 2013

Love letters to the wind - Always By My Side

The problem with reading a Nicholas Sparks novel is that it can create a romantic spark in you. And so here, I've have written a love letter (quite in formal language :-p) expressing some aspect of love which might be of some trouble between couples. I hope to write a series like this occasionally as and when it sparks since I have no lover to mail it to. But when I finally meet her, she can read this and ....

My dearest 2B Y-If,

Let me spill out my heart to you, the entirety of it, holding nothing to hide. It is my real desire that you always stay at home, never go out for work, and take care of the household and our kids. And the reason for this is no male chauvinism. I have better reasons to exact such sacrifice from you. 

Do not consider the job of the homemaker to be menial or trivial, I've always regarded it a noble profession, often paid too less and deprived due recognition. The fact that you'll put your entire heart here, will sure make our home like heaven. Our children will grow up with the loving and tender care that I often felt I was deprived of. As important as this is, I also feel you'll be free from the pressures of work. The less strain on your body and mind will preserve your angelic beauty from time. I'll always have you with me when I am back home from work, to relieve me from the tiring day's work with your gentle strokes of tender love.

But look at you! Though I've known you only for a little time now, I feel a deeper connection with you. I feel I've known you since your birth. I can see how you grew up with so many dreams and desires. I can imagine of the answers you'd have come up with when teachers would have enquired you of  future ambitions. I can see how much of untiring effort you've put into turning those dreams into reality. Every morning, you had put the sun to shame, toiling hard & harder, slowly rising up to fame. I do not wish to trample on your hopes and flush them down the drain. 

Go into the world and show them what a strong and resolute woman can do. Soar high like a refreshing fountain that never runs dry. Be successful; I want to see all smiles and happiness on your face. I shall be of support in everything you wish to do. I do wish you the best for a successful career. I promise to be of extreme help and I never shall hinder.

But here's my request to you: Reach for the stars and soar high, but do so with one hand. Yes, with one hand only! With the other hand, hold on to mine. Always. Don't regard me as a weight pulling you down! Never! But wherever you soar, let me follow. I'll be proud of you and help you in every endeavour.
All I want is you always so close.

Yours in love,

Wednesday, July 17, 2013

Books: Constant Friends

I put some of my books together soon, lit the candle and took a quick shot !

“Books are the quietest and most constant of friends; they are the most accessible and wisest of counselors, and the most patient of teachers.” 
― Charles William Eliot