Wednesday, June 8, 2011

LNMs and beyond....

Another very interesting fact about this place - the lack/ absence of trained personnel both clinical and paraclinical. Take for example our theatre assistant... NS... A cobbler by profession who used to sit at the gates of the hospital taken in by my senior and trained as the jack of all trades. Driver, chowkidhar, lab technician, nurse, pharmacist, compounder, doctor.... wait a minute.... DOCTOR?!!!! Yup. He became so empowered by his new found abilities that he decided to get a local practitioner/quack degree (secretly of course) and now has a flourishing practice (not so much of a secret). But they say a little knowledge is a dangerous thing... which brings us to my dilemna...
Wednesday, June 8, 1:00pm... Unbooked third time pregnant woman in labour with two previous home deliveries... On examination - Breech with fetal bradycardia.... Treatment plan - Emergency ceasarean.... Operating surgeon - Me!!! At which point I have to seat myself to take few deep breaths while weighing the pros and cons... Pros - The only chance for the baby to live, the cheapest and closest, the other option being the govt hospital where she's as good as dead... Cons - Me never having delivered a breech via caesar, limited facilities for neonatal resuscitation, absence of a more experienced surgeon around (my senior consultant is currently on leave), and did i mention... ME!!!
With the scales tipping heavily in the favour of the baby's last hope for survival I decided to operate.
Thats when NS announced, "I'm not doing this operation. I can't take this risk, I'm not going to be responsible." And so he proceeds to dissuade me and the relatives for treatment here. But as luck would have it the relatives want to take a chance on me!! :) So I proceed to prepare the theatre... As soon as I'm out of earshot.... "She is just a girl. She doesn't know anything. I'm telling you take your bai to the govt hospital...."
I return to find the patient and relatives gone.... 


  1. Lydia, humility a rare and precious commodity especially in professionals. Asking for a second opinion, referring a patient to someone more experienced is not a sign of weakness but a sign of wisdom

    Don't take NS's comments personally. Others in your position would have got the same.

    NS doesn't need to be revered by you but perhaps you can consider his views which come from experience. One day he WILL SAVE YOUR BACON!!!! betcha!

    PS: Can Linzi join in with this blog. She is fascinated like I am.

  2. I have absolutely no qualms in referring patients, I do it every day. After assessing sick patients and giving them emergency first aid, we usually send them to Bhilai thats another 2 hours away. But when it comes to surgical or obstetric patients it gets complicated as we are the only operating unit in the city. It gets even more complicated when patients refuse to leave and beg us to do whatever we can like in this case.
    And this issue with NS is only the tip of the iceberg. I respect him for his age, experience and knowledge and like you said he is a valuable asset which is why I do not want to antagonize him. But this is not the first time he has over-ruled my decision or undermined my abilities. Also issues of malpractice, wrong treatment and the like... Not only with me, but also other doctors here. The admin is helpless however there being no suitable replacement. The most crippling factor in mission hospital is politics. If your own staff work against you, you cannot last long.... And neither can your patients...
    PS - I sent an invite to chachi but to her sky id. Will send on this id.