The History of a Medical School Sophomore - For Crying Out Loud

You know you're in trouble when you'd rather be operated on than watch a surgery live. Atleast that was my state the first 2 or 3 times I was pulled in to the OT, pale and woozy. Diligently, I convinced myself that each incision, every stitch, was just the doctor's duty of alleviating a patient's suffering than some absurd conspiracy to inflict visual torture on me.

Taught by the best Professors in the Department, I did the unthinkable – I fell in love with Surgery, or at least the unit we had been assigned. Having done a 360 in the branch I was most apprehensive about, I mistook my newfound confidence for a power to take on anything MBBS has to offer.
Till I learnt where we'd be posted next – OBG, or Obstetrics & Gynecology – a fortnight of dealing with women's health, expecting mothers and related surgeries.

The thought of screaming women and their wailing babies didn't sound very appealing.

I trailed my unit-mates in locating the "Out-Patient block" of our Women & Children's hospital. On reaching there, I discovered more than just the place – it dawned on me how literal its name was, seeing innumerable women scattered on the pavement in front of the entrance, while the designated waiting area inside lay barren as the Sahara. 

Careful not to step on anyone's feet, the seven 'doctors' parted the sea of patients to get in. Contrary to the cacophony outside, the clinic was dead quiet. A half hour later, Professors, PGs and interns filed in, ready to tackle the herd of expectant ladies.

Day one passed with instructions on determining the age of the fetus by merely feeling the protruded belly, in addition to declaring the unborn child's position in utero.  Basic concepts aside, we were asked to measure the blood pressures of several subjects before being let off.

Two days later saw us all scrubbed in to watch surgeries in action. Three operating tables stood parallel to each other, with two different cases for us young guns to witness – a fibroid removal and a hysterectomy. Just as the uterus was being separated in the latter, my unit-mate Laxmi prodded me and Kriti to check out the case of a 'huge abdomen' in the adjacent chamber. Little interested in seeing insides stitched up, we abandoned our station to observe the new arrival.

The patient had already been given the spinal tap required to shut out all sensation from waist down. A scalpel came out of nowhere and promptly cut the stomach with a clean, horizontal incision. Droplets of blood spurted out the layer of fat and muscle, as gloved hands grabbed the opening to tear it up wider. Before we could comprehend what was happening, something was pulled out by a nurse, just as it broke into a shrill cry.

 We had just witnessed the birth of a beautiful baby boy. A Cesarean.

The blue preemie was rushed to the incubator where a pediatrician ensured its stability while checking its sex, weight and general health, oblivious to the three awe-struck second-year students. On finding our voice, we started thinking of hypothetical names for him, settling on Kriti's suggestion of 'Pratham', Sanskrit for 'the First'. After efforts of cooing and whistling bore no outcome, I moved on to singing everything from Guns 'n' Roses' "Don't Cry" to "Happy Birthday" till the clock forced us to proceed to class.

The fourth day saw us summoned by our Head of Department, who was ticked off by our failure to report to him hitherto. After a warning, he handed us over to our Ma'am, whose first assignment for us was to figure out the layout of the entire hospital. That exploration had us charting everything from the labor wards to the neonatal ICUs onto our notebooks, with no idea why we'd suddenly turned cartographers. Only later were we informed of the gravity of admitting people to the wrong ward by ill-informed doctors, often proving fatal.

Curiosity got the better of us during the subsequent visit; we decided to hit the NICU instead of taking the routine history in the ward. We tip-toed into the sterile, air-conditioned confines of the unit, immediately meeting a dozen incubators housing the tiniest babies ever seen.  I hovered over the heated containers, experiencing both the joy of survival and the misery of suffering the pre-term neonates symbolized. At one point, the nurse who came to check on them, handed over a newborn for us to hold – each of us girls fully utilized the opportunity to cuddle the bundle of joy as long as allowed. Bidding it farewell by letting its minute digits curl over my little finger, I halfheartedly made my way out with the others.

Rounds were the least attractive part of the week. Shadowing Professors who completely ignored us to teach Post-graduate students, we were confined to asking the same old questions to women admitted into the hospital with complications like high blood pressure, Anemia and Diabetes. Announcements from the NICU wafted in now and then, beckoning the respective mother. "Lakshmi Vaibhav Kumar" came the first one. "Geeta Vaibhav Chandra" came another. One after the other, each amusingly with the same middle name, aroused our interest. It took "Noor Vaibhav Ahmed" for us brainy group of 7 to realize the nurses had an odd way of pronouncing 'wife of'. So much for our implausible theories of pre-term births connected to a particular maternal name.

As medicos, the most-expected and the least-awaited event of the department was labor. Days before we were to wrap up with OBG, we ventured off to the Labor Ward, the site for natural births. We went to the second labor ward, with cases prone to complications, where the soon-to-be-mom was lying in the typical delivery position.

I had anticipated the rush of emotions this particular experience would draw, but revulsion wasn't one of them. Being a poorly-funded government facility, it got away with filling the wards with numbers way beyond its capacity – in the 6-8 beds crammed into the tiny space, on the floor, underneath cots, the scene was pathetic. None of those admitted were provided the luxury of drapes or sheets to obscure them from the public. The state of the beds and instruments used was further appalling, but there was hardly anything we could do.

The lady lay writhing in agony, having been in labor for over a day, subject to the added annoyance of nurses screaming, "Push!", "Don't you want your baby?" and other remarks that didn't seem quite fruitful. Seeing her exhausted, the obstetricians decided to resort to an episotomy – a procedure to surgically widen the outlet of the birth canal. Jelly-like blood emerged in copious amounts, making us dread the mother's condition. Further difficulty in the process forced the doctors to seek the aid of a vacuum pump which used negative pressure to quicken the delivery. On pulling the infant out, its umbilical cord was seen dangerously wound around its delicate neck, leading to all the complications that ensued. As the baby was carried away, the medics remained for stage three of delivery (after-birth) and to stabilize the bleeding and pain.

While the specialists got busy with ensuring the mother's well-being, we went to see the baby boy, a celebrity in his own right, being photographed and recorded by the staff. Kriti suggested "Prateeksh", Sanskrit for 'the next', as other baby names got trumped in the discussion.

Strange enough, by the end of the week, I was a tad poignant about leaving OBG, its social relevance and medical importance a new chunk of awakening for me. Though I still don't see myself pursuing this particular stem of medicine, I have a newfound respect and awe for everyone who does.

More importantly, I've been cured of my wish to swap places with the patient, now totally content at playing the spectator. 
Announcing the rebirth of my passion for medicine,
Until next time.