I Will Need to Break Your Other Leg by Prasanna Gautam

Author:Prasanna Gautam [Prasanna Gautam]
Language: eng
Format: epub
ISBN: 9781781610541
Publisher: Hammersmith Books Limited
Published: 2013-01-15T00:00:00+00:00

I had been called in to help only a little while before because Indramaya, a girl of barely sixteen, had not been able to deliver her baby spontaneously. It was her first pregnancy. She had arrived at the hospital about an hour earlier after over two days spent in labour. The village midwife could not cope and in desperation had set her on a bullock cart to journey twenty-five miles to our hospital. The agonising screams of each contraction had heralded her arrival.

Nirmala had examined the poor girl and started an intravenous infusion of dextrose solution to help with blood pressure and general well-being. Once the contractions had slowed down, exhaustion consumed her and her sobs of pain diminished. Her blood pressure was low but the heart rate of her unborn baby was satisfactory. Its head had crowned nicely so we could see it in the birth canal but the mother just could not push. Nirmala therefore decided that outlet forceps would be necessary to assist the birth.

I was busy in the out-patient clinic when Nirmala came to explain the situation. Both Leela and Pushpa, the other two doctors at the hospital, were away from Dharan that day. Leela usually looked after the obstetrics and gynaecology patients. I would assist her when she needed help. I did all the routine medical work. Pushpa, being the senior doctor, a chest specialist with a huge private practice, saw mostly chest patients and dealt with hospital administration. On this occasion I was on my own.

Nirmala was a highly trained and experienced midwife. If it had not been for her, Leela would never have been able to cope with the workload. So I had no reason to doubt her assessment. The trouble was that I had never conducted a delivery with forceps.

En route to the labour room, my mind was rapidly delving into the deep recesses of my brain trying to recall all the information I had memorised about forceps delivery. It was sheer coincidence that this had been the subject of my final-year obstetric viva exam five years before. First, the examiner had asked me what the indications were for deciding to use forceps. When I had blurted out all the relevant conditions, she had asked me to identify the correct instrument from among several gadgets laid out in front of her on her huge desk. I had picked up the forceps and held each half in either hand.

‘Go on, apply the blades,’ she had instructed, pushing a latex pelvis towards me. I did as requested and locked the blades.

‘Now pull out the baby,’ she had said.

The textbook procedure was to use both hands, first down, then towards you, and then up towards your chest in a smooth half elliptical arc. I did just that, to the smiles of the examiner. I later discovered that she had given me the highest marks for that viva voce examination. Now, five years later, I needed to be certain that I had retained these textbook skills.

‘Can you do this in real life?’ asked a frightened, untrained young doctor of himself.

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