THIS CAN HAPPEN: VOLUME V
Dr. Gangadhar Sahoo
It was an incidence of early 1980s. I was posted as specialist of Obstetrics and Gynecology (O&G) in the Sub-divisional Headquarters Hospital, Deogarh in the district of Sambalpur.
My friend Dr. Sudarshan Dash was the 2nd specialist of the same fraternity. My wife was the lady assistant surgeon. Besides we three , a dozen of new doctors were posted at a time following a mass transfer of doctors. The mass transfer was following a tussle between the Sub-divisional Medical Officer (SDMO) on one side and other doctors in the other side lead by the O&G specialist. The subordinate staffs were also divided into two groups. Public, especially the local political leaders and goons also took advantage of the situation by fanning the flame.
After all the young new doctors joined, the situation came under control. Calm prevailed after the storm. Since there were two gynecologists there was every possibility of creating a difference and misunderstanding between me and my friend Sudarshan. The hospital staff and those so called public leaders were eager to exploit the situation. Both of us decided not to entertain the external interference into our professional matter. One understanding was made between us that in my patient I would be the consultant, he would be the assistant and vice versa. In no circumstances we would reveal the professional matter/secrecy to others. That understanding actually did wonders for us.
We were doing all emergency cases under open ether anesthesia. One of our assistant surgeons was trained by our surgery specialist to do that. Very complicated cases like ruptured uterus, ruptured ectopic pregnancy, PPH etc were operated / treated successfully by us. Gradually our team became famous. Patient load increased. Then we planned for routine gynecological and obstetric cases to be operated. One of the batch mates of Sudarshan, Dr. Prasanna Kumar Mishra was posted in VSS Medical College Burla as anesthesiologist. We contacted him to visit our hospital once in a fortnight on holidays to administer anesthesia. He gladly agreed. He was an efficient anesthesiologist. We kept routine cases for operation. One day we had kept two cases. The second case was a previous caesarian section case. I was the consultant surgeon, my friend Sudarshan was my assistant, Dr. Chintamani Panda was the consultant pediatrician. Under spinal anesthesia the caesarian operation was started at around 4 pm. A full term matured male baby was delivered. We congratulated the mother for giving birth a son after a daughter in her first pregnancy. Sweets were poured into the labor room. All the family members with our hospital staff enjoyed the party. But in the operation theater a sense of undue calm prevailed. The placenta could not be delivered. All tricks failed. It was a morbid adherent placenta. It's only treating is hysterectomy, hysterectomy and hysterectomy. But many problems stood in front of us. We were not prepared for that, nor had I faced such a situation in my short experience of clinical practice . However the only sister who was assisting us went for preparing the trolley for hysterectomy. The spinal anesthesia time was limited and there was no facility for administration of general anesthesia. Patient was bleeding but there was no facility for blood bank in a radius of 100 km. With all adversities surrounding us, my team was in a point of no return. All the staff in OT encouraged me to accept the challenge and go ahead. "Do what's right. God's there", was their motivational words.
About one hour had passed before we started the hysterectomy. Spinal anesthesia effect was there. We finished the hysterectomy as quickly as possible, fortunately within the regional anesthesia effect. Since there was considerable blood loss without replacement of blood, the volume was only maintained by IV fluid. The only oxygen cylinder available in the OT got exhausted. The anesthesiologist cautioned us to be prepared for a stormy postoperative period and left for Burla in the evening. Patient was stable in the immediate postoperative period. Her vitals were within normal limit. Urination was adequate. There was no abnormal bleeding per vaginum. Baby was active. Mother had started breast feeding. I and my friend stayed in the hospital up to 9pm to do the ward round and to examine the two labor cases admitted in the labor room. Before departing from hospital I once again examined the patient . Her postoperative findings were satisfactory. I returned to my quarters relaxed and satisfied.
Next day morning I went to the Obstetric ward first before going to the labor room and ward round. What I saw was a heart breaking scene. One bed was kept on the veranda and in the ward the previous evening operated patient was not found. I smelt a rat. Immediately the staff sister in charge came running with her bed head ticket. In that surprisingly I found a note hand written by the father of the deceased. “Knowing your name and fame I had brought my daughter to be delivered by you. You did your job. It was a rare complication which you faced during operation of my daughter. But you and your team managed successfully with much skill and care. We are blessed with a grandson with your touch. At the mid of the night my daughter had a severe chest pain and collapsed. The emergency doctor and staff tried hard but in vain. My daughter didn't give us time to call you. I am satisfied that in spite of all your efforts she died with an unusual and rare complication. She is blessed in the way that she died in your hand. I am sorry I couldn't meet you before taking her body. Her horoscope was very much right. It was the will of God. Before leaving us she handed over to me the responsibility of her son. Sir! Never feel guilty for her death. You are our living God. I will definitely come and meet you with the most valuable gift you have given us. Namaskar ." Gobardhan
I had nothing to ask to the staff sister. The note of the father was self explanatory. While reading the note drops of tear were rolling down my cheeks.
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