TROLLEYYYYYYYY …CHECHEEEEE… TROLLEYYYYYYYY (CHRONICLES OF LABOUR ROOM PART-1)

PART-1

It has been 4 years since I joined my course…

Finally amma asked me today as I was brushing my sparkling teeth…”eda kochu…1.5 years of study left …Ready to handle a patient yourself???”
I scan myself for a second and replies…

“SuRE MA…provided the patient is PREGNANT”

The month long Labour room posting has changed my outlook….honestly…I have a new perspective of everything…not just gals…360 degrees of life…kudos to all mother who have had normal vaginal deliveries (not de caesareans !!!)

There’s too much to write in…so I split my post into parts…so as not to tire my lovely readers…
This is the first instalment. No MASALA has been added…neither have I edited or proof read…what u r readin right now is what is pourin out as I sit in front of my dying monitor tappin my rusty keyboard.


“The number you’ve dialled is currently busy. Please try after sometime”-call WAITING

“One thali-meal please”…..and this is followed by a long WAIT…and curses begin to pour out of the hungry food bag of yours…as if the WAITER is responsible.

Yeah…to ’wait’ is something I hate just like anyone else (hmmm…yeah I hate too much ‘weight’ too)

Ladies n gentlemen, here I introduce to you a typical yet different, tiring yet thrilling ‘WAIT’.

She’s not mad…but anyone around might ask why someone isn’t tying her up to the bed. She twists…jumps…shouts…screams…yells…’Allah…Krishna…Eeesho…Ammaaa...etc’. What pushes a layman into curiosity is the environment surrounding her bed that remains serene in spite of all hues and cries.


8 heads peep into her perinium(ooo…no vulgarity meant…). All well –learnt, smart, trained heads. All wearing the ‘theatre’ chappals (ordinarily wearing a chappal after getting into a Parx trouser and tucking in an Excalibur shirt is weird…but inside a ‘sterile’ room, where everyone is supposed to be STERILE, no gals scoff at you…there is no choice).
Yeah that’s us…the Interns…!!! And this is ‘day one’ of our ‘labour room’ postings.
With every second the intensity of her cry rises…and we are the only ones who are tensed and sweating (freshers!!!)

‘Thar she blows’

A hairline appears…recedes…appear again…

‘No…it’s not going back…heyyyyyyy…it’s fullllllll…House surgeons…Interns…get ready…’

‘CHECHEEEEEEEE TROLLEYYYYYYYYYYY’

Now is the ‘run’…

’the run for a new life’

…attendant pants in with a trolley…the mother is asked (in reality shouted) to jump into the trolley…she will have snatched off all the cannulas (and that mean the giant needles that we laboriously instil into veins for needy supplementation of fluids…drugs etc.)…creating a ‘bloody’ field in the bed. The trolley reaches the ‘labour cot’ within seconds.


I ‘run’ towards the ‘dressing room’ (you don’t have face creams…body sprays…talc…combs waiting for you) put on the gown (‘sterility’ is the golden requirement…not a spot of contamination is allowed…in reality…this is a more self defensive technique…who’ll want to spoil his dress with meconium…blood and amniotic fluid?).

Now is the ‘tough’ part…wearing ‘gloves’… !!! I’ve not yet learnt to put my fingers into the sterile pair of gloves within split seconds as the seniors do.

“C’moonnnnnnnn what the hell are you waiting for”…yells the senior PG student-another female

(Fortunately or unfortunately Gynaecology is a female dominated area. Trust me, if males ruled here…half the labour related complications and unwanted fuzzes could’ve been history).
Still trying to adjust the gloves I rush to the labour cot…


“SUPPPPORTTTTTTTTTTT”


Rest is automated…I push the perineal towel so hard that I start to think if my force is what is blocking the baby from his journey into this world.

Two elephant sized PGs literally jump over the mother’s tummy(medically- fundal ‘push’)
The entire labour room shakes in her ‘thunderous’ cry.

HAAAA….ATLAST…HERE HE COMES…


A tiny head pops out…before I can say ‘hi doooooooo’ the HS pulls him out…and there is a spurt of all nasty fluids…you’ve got to be really lucky to save your mouth and attire.

No it’s not over…the baby is still clinging on to her womb…


I cut the final physical attachment between them (technically-‘clamping’ the cord and cutting it)(fortunately none can cut off the psychological tie)
Everyone sympathises at cries…but now is one special moment when a cry is the most vital and auspicious symbol of life.

The new kiddy has to cryyyyyy…(technically we record it as BABY CRIED SOON AFTER BIRTH…CSAB). Else you’ll witness another scene of terror…when a Paediatrician will be kicked out of sleep and driven in…you’ll see nurses running in search of suction tubes etc.


Well folks the first phase of ‘delivery’ is the hard yet fascinating part…it took me almost the experience of assisting 3 deliveries, to understand what exactly happens.
Rest of the action is passive…and boring and tiring…I don’t wish to scroll into the tale… (it involves suturing)

KEEP GLUED…TRUE ACTION IS JUST COMIN UP…
”HOW GOVERNMENT SAVED DE DAY n a WOMB”….
(2 B CONTD.)

Triage: Prioritising Lives

(0% fiction,100%realty)

“Life was created…or perhaps it sprouted up from nowhere all of a sudden. I was born. I needed air to live. I breathe in and out at least 16 times in a minute. I never care if what I expire can choke my neighbour. I have power. I can create life but not at the same pace at which I take it. “

The stethoscope that adorns my neck was once an ornament that made me ‘look’ a doctor. It set me apart from a nursing student who too wore a white coat. With the passage of time, it let me hear the non-stop machine that panted ‘lubb dupp’ and now I was using it to detect life.

“The heart still beats”, shouted Neha. We were rushing to the SICU (Surgical I.C.U). I was holding the Ambu bag. I felt thrilled. I was pumping life into him…oxygen.

I knew he was breathing. I didn’t care if it were the last puffs that he got to gasp. A multitude of thoughts flashed through my mind. I didn’t exactly know why the M.O (Medical Officer) chose us to accompany the patient; did he overestimate the fourth year students who were posted at the emergency room?
(The patient was brought 15 minutes back, drenched in blood; an old man in his sixties; a case of road traffic accident. He had sustained severe head injury)

I could see his abdomen rise and fall…rise and fall…yes he was alive. I kept on pumping, a puff every 5 seconds.

I wished the elevator would ascent faster.

Neha once again checked if the tiny organ was still panting. Yes, it was.

Lubb dupp…lubb dupp

The attendant who pulled the trolley seemed to carry a ‘mask like face’…the kind of face that one gives when suffering Parkinsonism. He was sweating just like us.

The poor old man who lay in the trolley knew nothing; he was helpless and not even his pupils could move in response to light, the energy that keeps life alive.

People who flooded the corridor gave way for the sprinting trolley.

Someone else was panting too…running at the same pace as we were. It could been his son or brother or a relative. I was damn sure the guy was not a stranger filled with compassion.

Finally we reached the SICU (Surgical Intensive Care Unit). Our job was over, the patient was ‘delivered’. Now all that I cared was to get the Ambu-bag back (the surgery casualty was short of supply and SICU had its own Ambu-bags).

“Hey do a CPCR!” yelled a house surgeon.

Why me? I have never done this before. I checked if Neha was puzzled just like me…no…she was about to jump over the patient to break his ribs and give the lifesaving resuscitation.

Well in that case why should I miss my chance?

“Sir…errr…I need a demonstration…or in plain terms…I am short of confidence”, I spoke, and waited for the house surgeon to shout.

But he was cool and calm and taught me how to do it.

‘1-2-3-4-NOW…’I said and Neha pumped the bag.

After a couple of tries, I turned to Neha, “Want to try?”

It was Neha’s ‘chance’ now and I took the Ambu-bag from her.

‘Okay, that will do’. The house surgeon checked for a carotid pulse. With his fingers still on the patient’s neck, he turned to the fellow resident and asked if the patient ‘really’ required to be put into a ventilator.

I didn’t understand why these guys were damn so cool. What the hell where they waiting for? This was why ‘we’ soaked our coats…drenched ourselves in sweat?

It took me a couple of seconds to get a grip on what was going on. The poor old man was almost dead…perhaps the brain was already off when we rushed him out of the emergency room.
The Medical Officer had done all that he could do within the four walls of the room. So he sent us with this patient. He was correct. By this time at least five new emergency cases would’ve got attended by the senior residents, who were back at the casualty, seeing to patients who had better chance to ‘survive’.

The stethoscope was not fabricating sounds. The beats were kept alive by the injected Adrenaline. They receded once the action of the drug exhausted. The abdomen did not move once I stopped pumping oxygen. A ventilator…the ultimate and the last hope to rejuvenate life…must be reserved for a ‘better’ case…someone who had a 0.1% better chance to survive and not a ‘dead’ patient.

We had ‘lost’ him on the way to the SICU.

Neha and I walked out of the SICU. The guy who was running with us was waiting there…I didn’t know what to say.

‘Sir, please…I can stand anything…please say…is there a hope?’

“Well…we are trying all that we can do…” before I could complete, Neha interrupted, “The chances are too low”.

I felt a bit frustrated…felt offended.

Who cares…? It was 8.00pm and our shift was over.

I returned home…having learnt something new.

‘TRIAGE’… Prioritising ‘Lives’.

Someone was dead and tomorrow his body will go through the post-mortem examination…torn open, and then sutured back…samples will be sent to various laboratories…final reports will be written.
Someone will shed tears; some others might smile; weeks or perhaps months may pass and all will be back normal.

(Triage means the assessment of the seriousness of wounds or illnesses to decide the order in which a large number of patients should be treated. CPCR stands for Cardio Pulmonary Resuscitation. A ventilator is an equipment that maintain a flow of air into and out of the lungs of a patient who is unable to breathe normally)

(Thanks 2 diva nawale, de title sprouted up during a chat session, and Amooma...i broke her sleep just 2 read out de entire post !!! and Azgar)

(entrant for ‘Get your story published in The Chicken Soup for the Indian Soul – Indian Doctors at BlogAdda‘)