About birth and death…
Being a medico I have seen both at close quarters. I have felt the elation of helping bring a life to the world, desperately trying to pull people away from the clutches of death and at times resigning to the inevitability of it all.
If you think that birth is a celebratory event, for most of us maybe but is not always the case in many parts of rural India. I did my internship from a similar setup. Although a well known medical college, the biggest in the district catering to over a thousand patients, we often encountered a few who opened our eyes to the stark reality of rural India.
Sometimes it would be the woman’s third or fourth pregnancy. She would be in poor health, severely anemic in most cases. Unable to afford timely meals, often unaccompanied by the spouse, barely pushing through her pregnancy, when to top it all would be met with disappointing glances if she gave birth to a girl child and even more disapproving if it was a 3rd in a row of previous female siblings. Somehow her reproductive health seldom mattered.
From spending all night taking episiotomy sutures to catching a baby in the nick of time because there were multiple deliveries going on at the same time, I have pretty much seen it all. I have seen patients not even wince when an episiotomy was taken to screaming their lungs out during delivery making me wonder if I should simply leave the scene and flee. Epidurals weren’t commonly given for normal deliveries back then. I know I sound ancient but that is how it was. There were plenty of limitations you had to work with.
I was once tutored by the mother in law as to how fast the baby was going to pop out irrespective of the woman being only 2 fingers dilated and then being given those ‘I told you so’ glances when the baby hurried out well before time proving my scientific judgement wrong.
The obstetric ward would be a whirlwind of emotions. Having taken deliveries in the hospital corridor because the family didn’t get the mother on time to buying food for a new mother with my pocket money because she was starving and didn’t have a family to go back to(may have been a sex worker), the grim reality of birth in rural India is less celebratory and more ghastly.
Cut to surgery postings during my internship, my first experience with death. I remember this man clearly. An aged gentleman who walked into the surgical OPD, a tad late perhaps and was diagnosed with strangulated hernia. He was admitted immediately and operated upon. By then he was already in full blown sepsis. He was shifted to the ICU post operatively and I was asked to monitor him. To my utter dismay, he arrested during my shift . Long story short , we lost him and I remember being utterly shell shocked as I walked out of the critical care unit. My colleague asked me ‘You look upset, is this your first time losing a patient?’ I said “Yes” and walked away.
I have seen a few pass away post that. It is never easy. The latest I suppose was in the covid ward when a patient with D-Dimer of >40,000 had a cardiac event. If I had heard of ‘angor animi’ only in books, I know what it looks like now. I could see it on his face( the fear of impending death as it is literally translated). That ,I suppose is the saddest thing ever. When you know you will lose a patient and there isn’t much you can do to help.
The worst part is conveying the news to the near and dear ones. It gets to me every time. One of the reasons I do not enjoy critical care. As puristic and impossible as it sounds, I want people who walk up to me to get better and as idiotic as it sounds, if not I take it as a personal defeat. Just the way I am when it comes to dealing with birth and death.
