Here's to Monday

Monday was quite the day. In the course of 8-2 I saw quite a lot of obgyn!

We had moved into the Thackers on Sunday, and Mr. and Mrs. Thacker were still in Calcutta. Vishal had welcomed us into his house with open arms and we had feasted all day and night. Ale and I went to bed with visions of fairies and sugarplums, and the best was only yet to come (Mr. And Mrs. Thacker).

(Don't read the next paragraph if you don't like blood and guts and female organs. And if you don't find medical talk interesting probably ignore a lot of this post.)

Monday morning started off with a rickshaw to the hospital. Within several minutes of my arrival to the obstetrics floor, a woman rolled in in labor. What then happened was horrific. In the next 20 minutes, I heard she was "6-7" followed by her being rolled into the delivery room. With her legs wide open, some local anesthetic was being drawn up in a syringe. I was confused as to why local was being used (they don't get epidurals in this hospital and I had never heard of local being the anesthetic of choice in childbirth) and then I saw a scalpel come out. I have only gotten nauseous and almost passed one time in a medical setting. In third year during my Obgyn clerkship, I started feeling cold sweats and nausea when I saw a woman's perineum tear during childbirth. Well the second time came then. I could feel my stomach turn upside down and the sweat heading on my forehead as I saw a scapel slice through her perineum and hear this woman's screams. I could not even watch the repair, I was so faint.

It's interesting to me that I can easily slice through the skin and fascia of a human being in an operating room, I can watch IV's be placed, I can dissect a cadaver-- a person that has died, and yet to watch the perineum tear in an un-anesthetized woman is what gets me. I better learn to get used to it given my career choice of obstetrics and gynecology. Episiotomies used to be very common in the US, but as far as I know, they found that the damage was worse when a cut is placed versus a natural tear. I have never seen one done in the US (and I've seen a good 50 plus vaginal deliveries) but I'd suspect vacuums and forceps would be used before an episiotomy nowadays. I can not be more thankful that whenever I choose to have babies, I will be doing so in a country with so many resources.

(Queasiness over.)
After that morning shocker, I went on rounds. I still only understand 5 percent of what everyone is saying, so I've come to glancing at the charts after we go over each patient so I can at least get a concept of what is going on. At the end of rounds I found myself following one of the doctors into a semi-OR (like an outpatient procedure type of facility) and I saw a d&c done for what I presume to have been a miscarriage (St. johns doesn't do elective terminations as it is a catholic hospital.) The procedure was done, but with one dilator and I'm not sure how the curettage fit in because it was bigger than the dilator.

Next up, I knew there was an elective cesarean that should be going to the Real OR (called Operating Theatre in India) so I decided that it was as good a day as any to figure out how to go into the OR. I asked a lot of people where and what to do until I somehow got changed into scrubs, put on some OR flip flops (my sneakers just would not suffice but luckily I kept my socks on) and was directed to obstetrics OR. The room I was told to go into turned out to be a laparoscopic cystectomy and not the cesarean, but it was still so interesting to see this done in an Indian OR. Although the room was unairconditioned and everyone was in flip flops, the surgery was completed done like any other I have seen.

After this operation, I decided it was time for lunch so I found Ale and we ventured out for a little break. On my return to the hospital, before I even got into the obstetrics ward, I spotted the team heading into the elevator with an emergent cesarean for a breech delivery. I ended up in the right cesarean OR this time and got to see my first Indian cesarean. I am so in awe of watching every little move and comparing it to the US. I wonder how much we must waste and yet how much we must gain from our wealth and resources.

The baby was pulled from its mothers womb and was such a beautiful little munchkin. If you think babies in America are cute, you must see a freshly born Indian baby! Cuteness.

As the cesarean wrapped up, I had to excuse myself to go meet Ale so we could get our visas registered at a foreign office in another part of town. Which is a whole 'nother adventure I will talk about in the next post.

We got home around 3pm and waited for Mr. and Mrs. Thacker to get home (aka we were glued to our iPads and had delicious chai the maid prepared for us.) Once the Thackers came home, we were captivated by the saris she had boughten in Calcutta and the stories they were telling. And soon it was time for dinner. The cook had prepared a meal for everyone (Mrs. Thacker usually makes all the meals but has help for when she is out of town or needs a sous chef) but Mrs. Thacker was busy making the delicious bread right of the stove so it would be hot for us (we are spoiled) as we devoured the goodness. We had daal and a carrot coconut dish and pickled mangos and lots more. If you see Ale and I in the States in 2-3 months, please ignore the additional 50 pounds we each have gained.