The maternity ward at Palghar rural health centre was far from a pretty picture.In December 2004 it consisted of an old steel cupboard,an antiquated teakwood table and a creaky chair valiantly trying to bear the weight of a well-nourished bespectacled individual.This individual is of late liked or hated(whatever may be the case)as superashdoc and dedicates quality time to a site named RxPG - you must have no doubt heard of it.
However my memory takes me back to the 31st of December 2004 - my last day in maternity.
It was close to 7.30pm in the evening and I was taking my evening round of the 10 bedded ward and putting the last of my notes for the patients.The sister on duty was Mrs More and she looked almost on the verge of crying.Not that she had any special affection for me,just that she would have to now conduct the deliveries on her own.(I used to do them myself unlike others who just came in at their own convenience only to perform episiotomy suturing.)
I glanced at my wrist and cursed-I had lost my wrist watch in the train.I then took out my mobile.The time showed 7.35 pm."Only 25 minutes now and my duty would be over",I thought.It wasn't a very happy feeling.I had enjoyed my stay and my work and would miss it sorely.My eyes then drifted to the number on the mobile handset-1100.I vaguely recalled some advertisement about 'desh ka mobile' and Rajpal Yadav using it as a truck headlight saying "Raat mein bhi chalta hain' .My thoughts were interrupted by the advent of Dr.Umesh ,Medical officer in-charge of the maternity.
"Hi champ,"he said.I merely smiled."Looks like you won't be able to go home tonight",he continued.
"Why not ?"I asked surprised.
"Well,there has been some derailment at vaitarna station and so no trains stopping here till morning."he said coolly.
"Also a patient is going to arrive at about 8pm.She called me.Full term primi .Just take care of her buddy as I won't be here.New year party you see!"
At that moment I felt like throttling him but didn't.I just nodded and went back to my chair.I then sent the boy to the hostel to summon Vishal who had gone to pack his bags.
The patient and my co-intern Vishal arrived at the stroke of eight.I did a PV exam and took a detailed history.The cervix was 3 cm loose,bag of membranes intact,vertex presentation.The FHS were normal and there were minor labour pains.I judged that the lady would be troubling us sometime close to dawn.
After dinner I did one PV exam at about 11pm .4 cm loose.I yawned and decided to call it a day.We interns had to sleep in the MO's office and lay our own bed.I had specially remembered to buy Mortein mosquito coil having advanced action MMR or some such thing.Without the coil ,the IMR(read intern mortality rate )due to mosquito bite would have the WHO and maybe the Ministry of Health interested.
We slept fitfully till about 2 am when Vishal leaped out of the room dancing like Prabhudeva.Within seconds I joined him.The cot had caught fire due to the embers of Mortein coil.The ward mama then emptied 3 buckets of water before the conflagaration was doused.
After a longish lecture about the safety parameters in mortein coil usage mama let us go and sleep on the chairs in maternity ward.I entered the ward and saw the expecting mother Leela in pain.I shifted her to the labour room and examined her.The membranes had ruptured and cervix was 6 cm loose 50% effaced.I advised her to sleep in the labour room.
At around 5am we were woken up by More sister."I think she is fully dilated "she screamed shrilly.I jumped into action.I entered the room,wore the apron and donned gloves.Vishal followed suit.Putting her in lithotomy position I examined and could see the head .
Shouting at the patient to push hard I tried to create space for the descent of the head.After 15 min of effort and alternately screaming at the woman and pleading with her,I inferred that an episiotomy would be needed.At the peak of the labour pains ,sister More gave the episiotomy;Vishal gave fundal presure and I deftly delivered the head.Rotating the head clockwise into left occipito transverse I laterally flexed the baby to deliver the anterior shoulder.The next instant the room was plunged into darkness.....................
Pandemonium ensued as I shouted for mama ,Vishal shouted for light and sister shouted for me."Light the candles",I roared.
"No candles Sir,"mama said."They got over last week".
At that very moment ,I got a brainwave.
"Vishal ,take out my mobile ,"I said calmly.The normally lazy Vishal was quick to understand.He took it out of my pocket and snapped it on.As the bright light focussed on the baby I delivered it out.Milking the cord proximally I clamped and cut it .Suctioning the mouth and slapping the baby on the back ,sister More elicited the first cry of the baby which had become slightly blue.
"Now for the placenta ,"I thought.
The placenta was out within minutes.But my difficulties were only beginning!
I just looked at the vaginal mucosa in the light of the phone torch(It was seeming dimmer now)There was not one but 4 apices.I looked at sister More who had given the episiotomy but she looked away.Leela was crying continously and bleeding too due to the vaginal mucosal lacerations.I thought of calling Dr.Umesh but realised that he might not be in his senses due to hangover of the late night party.
Summoning every ounce of my confidence I turned to Vishal.He simply nodded and focussed the mobile as best as he could.He had implicit faith in my abilities and his belief gave me strength.
I took all 4 apices in my first suture and fixed them .Then I used continuous interlocking sutures taking multiple bites in a curved fashion so as not to leave a single bleeding point.Then came the muscles and lastly SKIN .As I finished ,the bleeding had also narrowed to a trickle.I double checked to ensure there was no other tear and removed the gauze swab from the cervix.
As I removed my apron,I felt a hand on my shoulder.I turned to look into the smiling face of Dr.Umesh."Sir.when did you come?"I asked in surprise.
"Just as you were about to start your suturing",he replied.
"But why didn't you take over?"I queried.
"O ,I didn't have to son,"he said,"I knew you are the best .Even I couldn't have done it better!"
With tears in my eyes,I touched his feet.He embraced me and then feigning mock sternness he said,"Your job doesn't end here doc.Have you examined the baby?"
I turned to the small tray which held the baby-little, chubby and cute. As I touched her cheek (it was a girl), she gave me the sweetest of smiles.
"You have a way with girls,I see," said Dr. Umesh. "This is your NEW YEAR gift. Happy new year!"