THIS CAN HAPPEN: VOLUME XXI & XXII
Dr. Gangadhar Sahoo
This can happen vol XXI
This is an incidence of 1976-77. I was a first year PG student in the Department of ObGy, VSS Medical College, Burla, Sambalpur. After finishing my internship in SCB Medical College Cuttack, I had just joined in the postgraduate course. In VSS Medical College our contemporary batch were doing their internship. It was because of a sine die of the college for nine months following a violent clash between the medical students and engineering students which left one engineering student dead and several injured. Many of that batch were my friends. It was a happy moment for me spending time with my friends in a relatively new place. Gradually I had become acclimatized to the place, people, environment, language, traditions etc . At that time there was also a regional feeling between eastern Odisha and western Odisha people. This feeling had infected the student mass. Sometimes it was taking violent shape resulting in clashes between groups in medical college. We the medical students from eastern Odisha were the most vulnerable group. Otherwise the medical college was the best at that time for teaching, training and learning.
One of my classmates Dr. Ranjan was posted in labor room as an intern when I was the labor room officer. He requested me to allow him to conduct a vaginal delivery under my guidance. At that time number of deliveries in our labor room was very few. So once in a blue moon an intern was getting a chance to conduct a delivery. It was not uncommon for the unfortunate interns to complete a month long labor room duty without even observing a vaginal delivery. Fortunately in one afternoon shift a grand multigravida (G5P4,all four pregnancies had uneventful vaginal birth) was admitted into the labor room in active labor. Everything was favorable for an uneventful vaginal birth . It was expected that she would deliver within approximately two hours. My friend was very happy to get a case of his choice. After all rituals an intravenous fluid was started as a routine procedure. Labor room sister was ready with the trolley. Within one hour cervix was fully dilated and membranes ruptured spontaneously with discharge of clear amniotic fluid. Uterine contractions were adequate. Vertex was at zero station . We were all ready to welcome the baby at any moment. My friend was very much excited. All the labor room staff were encouraging the mother to bear down (to push down). During each contraction every one was looking at the perineum to see the crowning. One hour passed. But no progress.
With adequate uterine contraction, full dilatation of cervix there was no descent of the vertex for one hour. Grande multi with these findings, labor arrested for more than one hour arouse apprehension of rupture of uterus. Apprehending some problem the Senior Resident Dr. Rath was consulted .As per his advice patient was shifted to OT. The findings were same. What might be the cause of protracted labor? Nothing came to our mind. It was decided that a trial of forceps should be done before going for CS . Dr. Rath asked the OT sister to be prepared for CS . He attempted a trial of forceps but it failed.
Protracted labor with failed trial of forceps in a grande multi was rather an absolute indication of LSCS. The senior resident was the surgeon, the senior PG was the first assistant and I, being the junior most was satisfied to be Mr. Doyen (the 2nd assistant in abdominal surgery). My friend Dr.Ranjan was the observer.
After opening the abdomen it was found that there was a CONSTRICTION RING ( a hypertonic abnormal behavior of the circular muscle fibers of the uterus) around the fetal neck, obstructing the descent of the fetal head. That was the first occasion I saw such a case. Constriction ring is a very rare condition. I was fortunate to be a part of that operative delivery on that eventful day. In my 46 years of experience that was my first and last case.
The lesson learnt from this anecdote is that Obstetrics is predictably unpredictable.
No laboring mother can be taken lightly. Every mother in labor is problematic unless otherwise proved. In the best of best hands and in the best institution problem can arise. Three important things in Obstetrics can save three or more lives:
1. Apprehending the problem.
2. Preparation to face the problem if at all arises.
3. Timely intervention.
For that,the Obstetrician should possess three things:
1. Knowledge
2. Skill
3. Patience
Because God can't be everywhere, He made mothers. He also made the Obstetricians to take care of His creation .
My friend thanked me to witness such a rare case.
MAN PROPOSES GOD DISPOSES.
This Happens Vol XXIII
Dr. Gangadhar Sahoo
It was the golden jubilee celebration of our 1970 SCB MBBS batch at Pramod Hotel, Cuttack. Our batch had 177 friends. Out of 177 around 17 had left us forever. The attendance was very good. Friends from inside and outside India had come. Some faces appeared as if unknown and some totally forgotten. The atmosphere inside the hall was electrifying. In one part it was as silent as the Biochemistry class taken by Prof Panda. Here , “Silence is not empty , it's full of answers.” In other part of the hall it was like a pre class TAMASHA and in some other part like orchestra of different musics, sounds, clapping and posturing. Everyone had forgotten one's age, status, position and personality. As if all were back to their young 1970s.
The inauguration meeting started in the evening with felicitation of two of our teachers Prof. Rajguru of Ophthalmology and Pof. Das of Cardiology, release of three books authored by our friends and felicitation of each member of our batch.
In the morning session was the assembly and general body meeting. The hall charge was given to Prasanna. He is a professional manager. In every monthly get-together he had proved his professional skill as manager.
That day in his original style as anchor he started the program. He usually projects the stage as an OPERA PARTY stage and comes prepared with traditional musical instruments and plays those with high professional skill. Really it's worth seeing and enjoying.
All members of the 1970 batch were invited one by one to the stage and asked to speak out their hearts. It was really full of emotions, surprises, ecstasy and sorrows. Audience in the hall was spellbound.
Came the turn of Prasanna, the opera master. He had a brilliant career. From a rural background of village Bari, struggling in each step, crossing the hurdles of education, he was marching forward to achieve his goal of life. He had the distinction of standing in the best 10 positions in matriculation, passing MBBS in the first chance with flying colors from SCB Medical College, when passing meant, fortunately snatching the degree from the jaws of failure. He had mastered the art and science of passing MD PAEDIATRICS examination under Professor Gopal Das, where passing in first chance was absolutely an exception. In his service carrier he had proved his exemplary efficiency in clinical practice, academics, administration, organization and what not. God is kind enough to bless him with everything. He is unique in the sense, "Here is a guy who has climbed each step of the ladder to reach the top by virtue of his will power, perseverance and hard work. I am proud to get a friend like him."
In his speech "MY LAST WISHES" he declared something startling which made everyone dumbfounded. He said," At present we are 68 years old. We are capable of doing everything for ourselves, for the family and for the society. So everybody is quite cordial and supportive towards us. Time will come when me and my wife become incapacitated. Who will come to our rescue? By chance if one of us passes away, imagine what will be the condition of the other who is left behind? "
Therefore I pray Lord Jagannath to fulfill my ultimate wish of life, "Take both of us at a time. If not , take her first. I can manage alone. Don't do the reverse. I know she will lead a wretched life without me in this complicated and self centered society. "
The audience found no time to react. The tears of joy/sorrow rolled down the cheeks, no tissue paper could wipe it out.
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