And, lest you think, 12 C-sections...those are nice, easy, happy, short cases. Ya, sometimes. But here, more often than not, they are difficult, sad, and, occasionally, long cases. Let me illustrate with a series I'll call:
"True (Disturbing) Stories from 2am in the OR"
WARNING: Graphic medical descriptions.
2am Friday- Emergency C-section for a baby with hydrocephalus (enlarged head from a congenital abnormality). The head was too big for the mom to deliver. We got the baby out, barely alive and obviously deformed with a very large, misshapen head. Per standard procedure, I handed the baby to the midwife. She took one look, gasped, shrieked, and quickly tried to hand him back to me. I'm not sure why...Did she want me to put him back?! Sadly, there is not much we can do for children with hydrocephalus here because we don't have the resources/surgical equipment and most of the patients cannot afford to travel to the capital city for treatment. Sad.
2 am Saturday- I'm elbow deep in one of the most horrendous "C-sections" ever. Its not really a C-section. She needed a C-section several days ago...now she needs a miracle. The teenage mother had been in labor for days. I was called to do a C-section because she hadn't delivered yet. As soon as I opened the abdomen foul-smelling, purulent, bloody fluid gushed out. At first I couldn't find the uterus because it was all the way up by her spleen and had shrunk to the size of a grapefruit. There was no baby in the uterus...just a gaping hole. I turned my attention back to the pelvis...her bladder was stretched up to her belly button and part of it was dead. Behind the bladder I found the tiny, blue hand of a decomposing infant who had clearly died several days prior. Extracting that baby was the most gruesome, disturbing thing I have done. Ever. I can't imagine being that mother. Why didn't she come to the hospital sooner? Maybe it took her several days to travel. Or she didn't understand. Or they didn't have money. It was probably a combination of factors...all of which are much too common here. Now, she can never have children of her own and will need major reconstructive surgery...both huge challenges for her to overcome in this society. Unfortunately, this is an all too common scenario here.
2 am Sunday- As I was
falling asleep at midnight after returning home from a C-section,
I heard an ambulance and thought “there comes another C-section…but I
sure hope not.” Sure enough, just after
I had fallen into a deep sleep I was awakened by the phone call… “C-section, rupture utérine" (at least I could understand that much of the midwife's French). So I trudged back in. Opened the abdomen. First thing: blood.
Second thing: a little hand. An infant, floating free in the abdomen. Not alive. Then,
placenta, also free floating…and a ruptured uterus. I closed it as best as I could and did a tubal ligation. 3 am. Time to go home...after fixing this:
2am orthopedics
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| that doesn't look right |
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| "There is a fracture" "Where?" "In the ER" (if that doesn't make you laugh...check out the link for some doctor humor) |
3 comments:
oh Tabetha! How sad for those poor women. I cannot imagine how sad it is to be a part of those tragic moments in their lives. Something we surely never got any training for either (you know, since you are not an obstetrician!!)
ps. The fracture patient has a condition I've never heard of, called a-systole.
Oh Tab, that made me cry. You are doing such incredible work. I can see where prayers for strength, peace, and surrender are so greatly needed--you and Luke are on such an emotional ride. So thankful that you've been able to save the mamas...will pray for them, too, at the tragic loss of their babies. International hug to you.
I've been on a rollercoaster reading your blog. Near tears as I read about women in situations that should never happen in this day and age (thank you for serving them as you do). And then laughing till my stomach hurts as I followed your link "there is a fracture in the ER".
thank you
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