I was in the canteen today having a cup of coffee when I got the call
that I was needed in the labour room (on a emergency callover) for an eclampsia patient -that’s the condition when a woman in labour ends up having
convulsions(fits) and starts bleeding from excessively high blood pressure and can die of bleeding.
Well, I rushed over there and took over the case and started
the necessary treatment. Meanwhile I couldn’t help glancing over (occasionally)
to the next bed where a delivery of a child was going on. The person doing the delivery was a postgraduate student of the gynecology&obstetrics department and she soon pulled out the baby (naturally) and then without bothering to check whether the baby was breathing or not- she handed
it over to the two house-surgeons who were assisting the birth (trying
to learn hands-on) and she went away.
The two house-surgeons, both of them just passed out graduates with only theory knowledge and no practical experience -were trying to make the baby breathe for the first time- and this has to happen withing the first 5-6 mins after birth to prevent any brain damage due to lack of oxygen
Unfortunately this baby was not responding even after 7-8 mins, at which point normally the doctors usually give up their efforts and declare that the baby was born dead. Meanwhile I was also so busy with the patient i was treating-that I only had time to glance over occasionally. By now 8-9mins had passed and both the house-surgeons (and me) knew that the baby was gone by now- almost ten minutes without oxygen to the brain? What chance had the kid?…the house-surgeons as per procedure should have called for expert help- if they realized that a case had gone beyond their capacity to treat. But stubbornly they kept trying the same old thing without asking for help- which is the highest crime you can do according to me.
Unfortunately this baby was not responding even after 7-8 mins, at which point normally the doctors usually give up their efforts and declare that the baby was born dead. Meanwhile I was also so busy with the patient i was treating-that I only had time to glance over occasionally. By now 8-9mins had passed and both the house-surgeons (and me) knew that the baby was gone by now- almost ten minutes without oxygen to the brain? What chance had the kid?…the house-surgeons as per procedure should have called for expert help- if they realized that a case had gone beyond their capacity to treat. But stubbornly they kept trying the same old thing without asking for help- which is the highest crime you can do according to me.
Till finally, the staff nurse in the ward (prompted by me) went and called
the on-duty pediatrician who came up and spent a few more minutes trying the
same things already tried unsuccessfully by the two house-surgeons. He then as
one final effort inserted a suction tube up the baby’s throat and vacuumed out
the thick mucus plug which was obstructing the lungs. Suddenly, the baby took
her first breathe and started crying . The
pediatrician handed over the baby to the two house-surgeons to complete the
formalities and went away to wash. The two students consulted between themselves and
decided to put the time of birth on the case sheet - as just a few minutes ago as
they didn’t want to get into any trouble in the future..they were giggling that
this was the time they would even use for drafting the horoscope for the kid. They
then placed the crying baby beside the unconscious mother and went away.
As no one told the mother that her baby had been without
oxygen for almost 12-14mins and had died first and then come back- she would be
very happy if she learnt the news. But will she be as happy if she learnt that
because of the oxygen deprivation during the crucial period- her kid would be
most probably a retard…oops a special-needs kid in the future? Will she be
happy then- being saddled with a child who will never be normal her life-long
but be a burden? Was this good news or bad news? that their kid had first died and then miraculously come back to life (getti-ayasu, as they call it)...or that because the kid was late in breathing the parents would have to suffer with the kid all their lives (especially financially) and it would have even been better to let the child die after the first 10mins when it didnt breathe ? who can decide that? thank god it wasnt my case and i didnt have to make that decision..
And this episode proves the entirely stupid idea of posting
untrained doctors to rural areas as compulsory rural service- it would be an
utter disaster for the rural people if that happens. Till junior doctors get
enough experience they should never be allowed to treat patients by themselves-
there are so many things which can go wrong and peoples health is not the place
to gain political points. Those politicians who support this idea should be
hanged.
Thats very heart rendering tale. There needs to be more accountability from medical professionals. very sad indeed. Don't they have any standard procedures?
ReplyDeleteI think this should be taken as a cautionary tale and spur us on to prevent such things in the future... as i said earlier, compulsory medical service in rural areas for untrained juniors is a sure-shot recipe for disaster...rather the govt.should increase incentives and facilities for more experienced people to voluntarily go and serve the rural areas.
ReplyDeletethis is horrible
ReplyDeletehorrible
horrible
i agree sujatha and thats why i am so surprised that people with absolutely no knowledge of what really happens are the one's who decide policy. this might happen in more frequency if certain hare-brained schemes of ignorant health ministers come to pass...
ReplyDeleteTotally agree . In fact its only after I started working in a private hospital that I realized the poor way in which we treat patients in India. As junior doctors we never used to even explain to the patient what was happening.
ReplyDeleteAbsolutely Kripa and thank God for the Housey's that day that RK sir wasnt around....i think it was Meena mam's duty that day(not sure)..anyhow they escaped with their nonchalant attitude but unless they make more of an effort to improve they will definitely get caught in some more difficult case somewhere else. and to send them to villages compulsorily just to teduce the cost to govt of posting new doctors is such a obviously stupid idea that i wonder that people are not going on strike. we all know that PHC's are often involved in violence by patients, who will guarantee the safety of students (girl students) in such cases?
ReplyDeletethis is ruthless cruel.. irresponsible.. !!!! still cant belive this!!!
ReplyDeleteTrue Jeny...and thats what we are working on to prevent in the future
ReplyDeleteDoctors are considered to be God. They better not play with someone's life. Thanks for creating awareness.
ReplyDeleteThis is really shocking. This can happen only here, in India. No wonder one in four dead babies are here, in India. UNICEF says so.
ReplyDeleteCame here via Sujatha Sathya. Will read more post of yours.
I came here from Sujatha Sathya's blog...
ReplyDeleteOh my god... This is horrible.. Really!!! I cant believe that Doctors actually kid about such things... When we trust our everythin with them... :(
Doctors are supposed to be Gods. We trust them with our lives. And this is what they do? Painful.
ReplyDeletenot everyone do that....and the few who do will not last long in the profession
ReplyDeleteand people..just to give some perspective....i am also a doctor and i and lots of other doctors do our best in often impossible situations...but there are blackmarks in every profession arent there? not just in medicine...
ReplyDeleteI agree.. Not all... But we cannot really compare a doctor who doesnt do his job to a software developer who doesnt do his, now can we!!! Eventhough they are few in number, what gives them the right to play with another life!!! Pathetic! Thank u for this post!!!
ReplyDeleteCame through Sujatha's blog...What the hell!! is all I could manage after reading this...good u prompted the nurse.. just wondering if you complained about this to the higher authorities of the hospital or did you inform about all this to that mother later..since u witnessed all this..i really wish you did..
ReplyDeleteSuku, I did bring it to the notice of the relevant personnel of the hospital..but in a informal way-i wish you would take care that these things dont happen in the future way...because of two issues
ReplyDelete1) the house-surgeon posting is usually bi-weekly between departments and by the time appropriate enquiry is done and action is instituted- they would have rotated back to a different hosp/different speciality for training
2) being from a different speciality i wasn't supposed to have noticed that- and any mention in a public forum like the monthly death audit meeting - would have ignited an internecine warfare between departments and the gyn dept would perforce have to defend their actions in public (whatever they thought privately)- because it was amtter of prestige for the department.
and finally the very point of this post- was the angst behind letting lose half-trained doctors on people...remember these were just students and as per the govt. new plans- they were to be sent out into the villages to replicate this on a large scale. And one last point....i know this doesn't excuse me- but i am too junior in the hierarchy to make a difference or get my voice heard- that's why my letting off steam in the anonymity of the internet- offline they would have massacred me and my career. but lets hope the future is better when more of us youngsters get a voice and demand to be heard.
Ganesh
I wish the child leades a normal life.
ReplyDeleteOh dear God... A small negligence can cost an entire life??!!!!
ReplyDeleteBut I feel this happens because they treat it as a 'case'and not as a 'life'. Its just another case number in their file, but if you read it properly, you have a life in the file...
I pray such negligence dont happen for people! Nicely written Ganesh.. You've enlightened me!
Regards,
Anand
Life's like that
These things happen Ganesh. So many things could/should have been done right.
ReplyDelete- the O&G PG could've waited to see if everything was right before leaving
- the house-surgeons could have alerted the senior immediately after 3-4 minutes
- the nurses / paramedics could have alerted the senior (pediatrician) on their own
- clear-cut emergency procedures, which state without ambiguity, what should be done in emergencies, should be laid out.
It's a pity, but these things happen. I'm sure that the house-surgeons would be carrying this incident (and guilt) to their graves, despite their outward seemingly jocular veneer.
I don't know if posting experienced would have prevented this incident from happening.
In my opinion the issue of safety of doctors in rural areas is being blown out of proportion. For the most part, patients, especially rural folk, respect doctors. This is evident from your post "Gypsy Doctor". The Dr Sethulakshmi case is a one off case and cannot be taken as the norm.
-V
PS: Doctor, you come off as a genuinely concerned person; I hope you keep that humanity with you throughout your career.
i hope so too Anon, although its quite hard not to turn cynical when you are exposed to a lot of depressing stuff on a daily basis..i do love the few times when the real meaning of service filters through our minds and uplifts our spirits..i wait for those times
DeleteJust read this and I am appalled at their callousness... whatever happened to the Hippocratic oath you guys take, isn't it supposed to mean something!!! Insensitive jerks those two morons are, I hope they lose their license...
ReplyDelete