Debbie-downer

Today was kind of yucky. My belly didn't like dinner last night, but on waking up this AM I knew I had to suck it up and go to work. There are only 2 days left of work and we need to get our ducks in a row. Aka I need to get my evaluation so I can get credit for this craziness. And since things in India seem to happen really quickly, I should have done that last Friday. But since I didn't, I had to go in today.

I decided I'd drop off the paper with the department head since she was in charge of me, although she really hasn't worked with me at all. I had tried to go to her OPD (outpatient clinic) but she had sent me to other rooms, so no one-on-one contact, this will make for an interesting eval. Well I handed it to her and she told me to meet me in the labour room at 10 to get the eval back. So I went to OPD (I figured sitting was the only way to learn) and then returned at 955. And then waited until 1120. In the midst of this hour , I got to listen to one woman howling in pain during her labour.

The women labour without pain meds, without their husbands or mommies (well occasionally the moms are there but I don't think they are allowed to stay for long.) Then they just get whisked away to the delivery room next door when they are about to push out the baby. All alone, in an old room, in agony, without their family (never seen a mom or husband in there) as an episiotomy is done and being told to "shhhh shhh" or "relax" and getting on and off a bed. I don't think I would become an OBG in India. Heck, I don't even know if I would become a doctor in India. Besides the obvious intelligence factor (aka these people are smmmaarrt), medicine just isn't the same here. At least for me. I know it is a different culture. But I want to help people by taking care of them. I want to make them feel as good as they can in a yucky situation. I'm talking rainbows and pansies. And here it feels like doctors know they are gods and this is their right (obviously a generalization on my part!) There is no asking permission to examine, there is no gentle words and soft touches. The women in labor are told to be quiet, eyes are rolled when they scream and yell. Pickups with teeth are used on unanesthesized perineum. Yes the doctors here know dosing by heart and can list off the differential for anything by memory, but I don't see the same the same connection to the patient. There is no talk about communication with patients. They don't put the patient on a pedestal like we do. And I'm acting like doctors in the US are all rainbows and pansies. Far from the truth. But that's what I strive for at least.

So as this poor woman screams in agony in a room of 7 other laboring women, is "shhhh"-ed and is all alone, my belly is rumbling, I'm sweating like a pig and am so nauseous, just listening to all this for an hour. And then all the sudden the doctors decide she is to deliver, she has reached the 2nd stage and we don't have time to roll her the 20 feet to the room next door this delivery is so imminent. So they break down the bed (the first time I've seen this in India, but what we do for every laboring patient in their private room when the baby is ready to be pushed out in the states.) And so she gets to deliver her baby in a room of 7 other laboring women, some with visitors, all these doctors and nurses and people she doesn't know. They give her the episiotomy and she screams in agony and then out comes the little baby. Not my idea of giving birth. I wish I could capture this moment and play it to every laboring woman in the US. Their complaints about needing more ice chips, when are they getting their epidural, about their birth plans. The documentaries about too many cesareans in the US. Enough. I'm not sure if I'll be more compassionate or less compassionate when I go back to the hospitals in the US. When the pregnant women hand you their detailed birth plan about what is to happen, that no pitocin is to be used and no cesarean done, that only Enya can be played, and that the temperature has to be 82.4 degrees. I mean I know that's what I'm going to do when I have a kid (in 500 years.) Lets hope I'll be more appreciative of the luxuries afforded to women in the US which will make me more compassionate.

So I obviously had a mini-melt down (no pun intended) as I waited in that room. A whole another point, why would she tell me to wait for her if she wasn't coming? I kept asking the secretary and different doctors if they had seen her and then I finally found her on the gyn side still doing rounds an hour and 20 minutes later. Now I completely understand rounds are important, way more important than me. But if she knew she was doing rounds why would she tell me meet her in the labour room? She didn't even mention anything about my waiting and told me to pick it up from her secretary later. I was so thrilled.

And since this has been a tiny bit debbie-downer. Here is a funny story:

When we first got to India, Ale used to be really shy when she went to the bathroom and would make me wear headphones. Then a couple weeks ago I noticed she had stopped even closing the door. Girls are confusing.