Thursday, May 16, 2013

Not Dead Yet

Second case of the day. Spun around to tie myself in my damp green cotton OR gown. I looked at the two scrub techs getting the instruments ready. I thought, “Why two?” So I asked, “Which of you is learning?” They laughed, “We both are”. So I asked again, “Ha, ha, no, one of you has to be in charge in order to teach the other one, who’s in charge?” One said that he was “in charge”. Incision time. I cut. No one else did anything. Hmmm. “Dab”, I said. A few minutes later I looked up at them and said, “You weren’t joking when you told me that both of you were learning, were you?” No was of course the answer. “How many C-sections have you scrubbed on” was my following question. One had never been near a C-section, the other had seen a few. It was a long operation, full of “dab”, “hold”, “do this”, etc.

When it is time to get the baby out, the assistant usually has to help push on top of the mom’s belly. Well, nothing was moving and I felt like I was struggling all alone. Then I realized that I actually was struggling all alone. I had told the primary assistant where to put his hands (on the area of baby’s bottom on the outside of the mothers big belly), but in disregard of my instruction, his hands were fully pushing on mom’s chest. “Wait a minute there fella, we aren’t trying to learn CPR here” is what I wanted to say. But alas I held back. I repositioned his hands and we tried again. Things weren’t going well. I asked for the forceps (big spoons that are usually used in vaginal deliveries, but sometimes I use them in difficult C-sections too). Unfortunately, all I got was a blank stare from everyone in the room. I directly looked at the midwife and forcefully told her to get me the forceps. She knows forceps, right? I mean, she watches me use them, so she should, right? She must have been scared because she ran off for a moment, only to bring back a little hand held hemostat type instrument. Again I held back from the sarcasm that was tickling the tip of my tongue. It wasn’t time for talking, I had to get the baby out. So I kept working and said that those instruments didn’t seem to have any way to help me get the baby out, and that I was asking for the delivery forceps. Maybe louder would help, “DELIVERY FORCEPS!” I could tell that we weren’t getting anywhere. So, I took the scalpel and cut a bigger incision, leaned my whole weight on the abdomen, and brought the baby out. Whew! Then came more of the same “hold this, dab here, help me see over here”… Finally we were done. Throughout I joked with my two “learners”, but also told them seriously that they had to scrub with someone who was a bit more experienced than each other in any of my future cases. As I finished up, I popped off my blood covered gloves into the trash bucket, looked at them both, and had a good laugh as I said “Ha! You guys tried to kill me, but you have failed!”

They might not have killed me, but I surely did feel a bit beaten up. I would say it was the biggest comedy of errors of any case here, but unfortunately similar cases are all too familiar. Thankfully this one I could see with some humor, sometimes I feel the weight of frustration without the fringe of a laugh. Oh mercy, I think I getting old and tired from the stress. Bless the Lord, at 3:30pm it is finally lunchtime! I do love lunchtime. 

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