Wardrounds

All in A Night

Someone must have told God I was getting off far too easy on my call days.

The days were not fewer than other resident doctors’ calls, they were just lighter. Call it coincidence or whatever you will, but since I had been on labour ward call, I had caught up on my reading and I had been enjoying long nights of poring over textbooks in the reading room. But something or someone must have told on me because the series of events that happened that night made all other nights pale in comparative busyness.

The first patient came at about 7:40 pm; she was our patient, fully booked, and had had 5 previous deliveries all in the hospital. She was not a first timer, and so would not need much orientation on labour ward rules. By the time she came, she was already 8cm dilated. I opened a partograph for her as the rules in the centre demanded, and she was progressing very well. After setting up an IV line and monitoring her contractions, I took her vitals, saw that they were normal and handed her over to the capable hands of the midwife. It was no use hanging around. The next time they would need me, if at all they would, was in two hours, and until then the nurses were more than able to take care of her.

As I walked back from the labour ward to the reading room, I heard some commotion in the distance. It was a very quiet night so any sound that went above speech decibel was easily heard. I could not make out what the commotion was about because the hospital gate was some 300 metres away, but the unmistakable sound of people disagreeing with each other could be heard. I hoped with all my heart that if they were patients, then they were heading for the A&E rather than the labour ward. I had topics to cover and I was determined to get to them.

It could not have been more than 5 minutes after I sat down that my phone rang. I rolled my eyes at the ceiling and proceeded to pick the call. The things I heard next were a torrent of jumbled words, heavy breathing and a lot of movement in the background.

“Matron, please calm down and repeat what you said again.”

“Baby…” – jumbled words – “body…” – more jumbled words – “…not out” – heavy breathing – “… its head.”

“Honestly matron, I don’t know what you are saying, but I am on my way now.”

I hurried out of the reading room, not sure if I locked it, and I sprinted those 50 metres to the labour ward. As I rushed into the narrow hallway that led to the ward, I met a glut of nervous humans. There must have been about 10 of them; fearful, panicking relatives in various degrees of melodramatic display. I paused for a few seconds to find my bearing and figure out how to best navigate this human maze to the one room I needed to be in.

In that pause, those six words from the phone conversation had the opportunity to assault my frontal lobes – Baby! Body! Not out! Its head! Then it clicked. In one unified moment of near panic and realisation of what the nurse must have meant, I said as loud as I could to the mob of relatives.

 “Please, you have to go outside.”

Not even one person acknowledged that I had spoken. I repeated myself, but everyone continued whatever preoccupied them – three people were huddled together as they prayed audibly, two men consulted as they talked in low tones, two elderly women paced the small space and from their demeanour, one had to be the patient’s mother and the other a mother-in-law. The remaining four were just teenagers, probably cousins or siblings, who looked both confused and afraid. I tapped one of the men on the shoulder to nicely ask them to step outside so I could get through to the labour ward. He merely turned looked at me and continued his conversation without missing a beat.

My panic at the precious time I was losing made something snap inside me and I said in a voice I didn’t know I possessed, “Out! Everybody out of this corridor, now!”

There was pin-drop silence.

Even the praying stopped. I regretted that tone the moment I used it but I rationalised that it was only necessary because I had to get to that baby before it became too late. The mob was quiet now, no one moved. They were not sure how to respond to me because they did not know who I was. ‘Young’ and ‘female’ did not always translate to ‘Doctor’ in people’s minds.

 

I was going to say something further when the matron opened the swinging doors and shouted in a voice laden with relief, “Doctor, thank God you are here!”

The crowd of ten suddenly transformed from the cynical group who did not know what to make of me to people willing to cooperate with whatever I told them to do. The man I tapped earlier said, “Ahh doctor, we will go awsai for you nah.”

He turned to the others and said, “Oya make we go awsai, make we gee doctor room. Oya, oya.”

He herded his people outside and as I pushed the sliding doors into the labour-room changing room, I heard one of the praying trio start a new prayer point: “Lord, please help this young doctor to help our sistah.”

I echoed that prayer as I kicked off my flats and dove into the theatre boots propped up in the corner.

“Matron, what is going on?” My breathing was fast from sprinting, my heartbeat even faster and louder from too much adrenaline, and my manner brisk from the sense of emergency. I looked around and tried to take in the scene before me. It was a very uncommon sight.

A young woman, early to mid-twenties was lying in the dorsal position; legs apart, hips slightly flexed and knees almost fully flexed. Two tiny lower limbs, two buttocks, even tinier upper limbs, and a back protruded from her. There was no head in sight! The words the matron said over the phone suddenly made sense – baby, body, not out, its head – it must have come out all wrong. The nurse, I imagined, wanted to say that the baby’s body was out except the head. This was definitely a case of Head Entrapment in a poorly managed breech delivery.

I had only one very explosive thought: Where on earth is the senior registrar when you need him?!

 

TO BE CONTINUED

Written by Aida Scribbler

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Dr. Aida Scribbler
Aida is a Medical Doctor who is constantly torn between her love for creative writing and her dedication to medicine. Not to worry, however, she has learnt to combine the two just fine and is enjoying the beautiful outcome. She is always expecting your emails at aidascribbler@yahoo.com

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