The 'Labour' 'Theater'

Today is the last day of my posting in the Dept. of Obstetrics and Gynecology at the TMA Pai Hospital at Karkala 40km away from my home in Manipal. Today is therefore, also the last day I would get to spend in the best place in Karkala (the air conditioned theater, labor theater that is) considering the heat currents of the current year. I’m not sad. I’m just introspecting. A little pensive, perhaps. I haven’t got to sleep much in the last 3 days- ½ hour once, 25 minutes onetime, 2 hours another time and a lil’ longer last night. I can’t remember what day each of these naps belong to. You would be nodding your head with me, if you ever had a chance to skip sleep for a couple of consecutive nights. Like me, you would fail to differentiate those sleepy days with those sleep-deprived nights and slumber is essentially the one thing that differentiates one day from another. Well, it wasn’t always work that had the privilege of keeping me awake. One night, it was an idea of a crazy nighttime adventure. A few late night games of ‘Taboo’ and ‘Charades’ during the jobless night shift. And one night, I just didn’t feel like going to sleep and spent the night with the lame excuse that it has been months since I’ve watched a movie!

Today is my last day and I’m ‘on call’ again for the 5^th time in the last 10 days owing to the 5 day leave for my glamorous 2000$ winning Mumbai trip this month (yes, correct. You can learn a few tips about modesty from me) and all alone in the labor theatre (hereby, referred to as ‘LT’). Being on call essentially means what it stands for- people can call you anytime in those 12 hours and you better respond in the first 3 calls, from the LT phone ringing to fetching teas and files, being treated like shit and just playing ‘freeze’ as the sleep deprived frustrated post graduates relieve their stress on you as they play in their ‘pool of estrogen’. Remember that the interns are at the bottom of the ‘doctor food chain’.

My friends say that I exaggerate. I wouldn’t disagree but a wee bit of exaggeration in a narration adds spice and might occasionally make few events sound dramatic but gets everybody all ears and drives the message home. I may exaggerate a little but facts will remain facts no matter what I say or write.

Like I always love to say; ‘anything that happens in your life can be either enjoyed or at least will remain as a good experience’. This episode as I would call it is another experience because I can’t remember that I’ve learnt in the last 2 weeks. Zilch. But for one face I would never ever forget in my life and the tangible agony it carried. I was the same face that kept me distracted that day, even in the operation theater (another theater wherein man makes holes this time to pull out babies after losing his patience) wherein I was called to be the 2^nd assistant (the guy who gets to hold the retractor till his hand goes numb) and I was just lost in the blood till the crying baby just brought me back from that labyrinthine abyss! Most of my ‘on call’ days were very busy days. This, one day, like any other day, I was moving from one bed to another among the 4 beds, monitoring contractions and taking blood pressures allotting a generous 15 minutes for each ‘gonna-be- mother’ woman, as they moaned and groaned in pain with each contraction. My job was to carefully keep a record of these episodes of intense ‘grade- 10‘ pain and document them as ‘howmany’ for ‘howlong’ in ‘howmuch’ time until I get a satisfactory 3-4/ 35-45’’/10’ to write; ‘the patient progressed well into the second stage of labor with good uterine contractions’. You have to be professional to do that, meaning to turn into an emotion-less stone and a few jokes behind the scene even when people are dying does help. If you want the logistics of how it works, here it is. There are 4 beds in the LT here. The monitoring of BP and contractions should happen once every half hour for each patient and you give about 15 minutes to do all that stuff. Now, if you have added 2+2 along with me, you would have realized that by the time I finish with the last patient on bed 4, I’m already lagging by half hour in writing progress for the first patient! It only gets worse when suddenly one of the 4 women decide to deliver and you need to scrub in to be an assistant even for the simple SVD with RMLE (Spontaneous Vaginal Delivery with Right Medio-lateral Episiotomy) after which you realize that you’ve fallen behind in writing progress for the last 2 hours. Not only laborious but also exhaustive.

Among all this screaming, the bloodshed, the perpetual procreation of mankind, affectionate scenes of handholding and tears of joy, this particular woman entered the scene and handed over her file to me, which said ‘missed abortion’. There is a dead baby in her womb and she didn’t know it, until now. She will be induced for labor and will have to undergo the labor like any other expectant mother though she now knows that the end result of all of this is a dead piece of her flesh, blood and soul that shall enter the world with ‘no life’ but ironically with a face so calm and at peace that every being on this planet starting with the first moments of crying would strive for all his/her life. She had to stay in the LT even after expelling the dead fetus to be under observation and to her misfortune, the busier the day was getting they were just more and more deliveries happening the whole day. She was there on her bed watching all those crying babies, new mothers and so much life all around. To everybody’s surprise, she neither cried nor wept.

We, as doctors, knew that it was another misfortunate incident in the imperfect field of medical science. Some of us even went to examine the corpse out of curiosity to answer our questions and measured the infant like we measure any other with normal vitals. When we mention that a disease has just 1% mortality, do we realize that for that one person affected out of the 100, it is 100% mortality?! I requested the seniors to shift her to another room but they showed no concern. They said it happens and she’ll have to accept the fact one day, anyway. I don’t have anything against them; I have no sides to take for sides are only taken when you see the insufficient halves of the story but isn’t that so easy for us to say. I went up to her at the end of the long day and said to her not to over think about it and it’ll all be okay. She blankly looked at me and said ‘nothing’. I remember that face from before. It was the same look when my roommate who unfortunately failed in his final year MBBS university exams for no apparent reason known. For me, knowing the genius and the hard worker he is was worse news than hearing the news of my own passing. 

It was the same look that said, Why me? They haunt me- questions with no answers.