Disclaimer: The following semi-coherent notes are based on my very short term experience in Gynae Emergency OT. I do not wish to offend anyone. Basically what I want to say is “Iss post ke sabhi Doctor aur Paramedics kaalpanik hain. Iska kisi bhi sachchi ghatna se mel hona sirf ek sanyog and/or exaggeration hai“.*
*For humor purpose only. Not for medico-legal purposes.
Harrison Ford discovered the assembly line system to streamline and divide work systematically so that everyone has a specific role and hence minimum confusion will ensure best output. You take such a system, hang it upside down, beat it to a pulp, and then laugh at it just to hurt its feelings. Whatever is left of that system is basically how a Gynae Emergency OT works. To make you realise the sorry state of affairs, let me tell you that amidst all that confusion, the actual sufferer is a lady and her husband who, more often than not, are expecting their 5th or 6th child, mostly because the husband has a progressive mentality, and wants his wife to have a great career as a human-vending machine.
The usual way that any emergency OT works is that a patient is wheeled in, assessed pre-operatively, operated upon, and finally the red zero-watt bulb will be switched off and the surgeon gets to say “dawa ke sath dua ki bhi bohot zarurat hai“, while the anaesthetist burns with jealousy. I’m just kidding about that. Anaesthetist is never jealous, because he is too busy playing subway surfer. Anyways, Gynae is not any usual emergency OT. Hence, the modus operandi is a little different here:
1. Written shifting orders will be obtained for patient A. Suddenly, a patient B with more serious condition will be reported, and verbally agreed upon to be shifted asap. 45 minutes and 8 calls later, patient C will be shifted to pre-op, because patient A had delivered normally, and no one has any idea about patient B now.
2. Patient C will be asked to be shifted to the operating table, and ‘Sherlock Holmes and the curious case of missing Nursing-Orderly‘ will be enacted out. Half hour later, the N.O. will come back with tea and biscuits for everyone, and hence all his sins are forgiven.
3. Patient C is shifted on the table. And preparation for spinal anaesthesia is begun. The technician is working his ass off and running around at inhumane speed of 3.5 km/hr, and the anaesthetist is very close to bursting a vein inside his own head.
4. Then you prick the patient and with every prick she withdraws herself away from you, and 5-6 consecutive pricks later, the patient is almost finished doing the Madhuri Dixit step from the song “Dhak Dhak karne laga“, and you are finally done injecting the drug.
5. Patient B is back from exile. The Gynae team is playing Lok Sabha- Lok Sabha over that patient. Patient C is hoping the child about to come out better be worth going through all this.
The noise level in the said OT can get quite high, and contrary to expectations, Gynae vs Anaesthesia is the least entertaining argument because only a few lucky ones get to see the real showdown, the Pearl Harbour, the Panipat-Kurukshetra: Nurses vs Gynaecologists. Now that is a high-decibel, entertaining fight which is settled in a very grown-up, mature way using the words “Shut up”, and “YOU shut up”. Then both the sides cool their heads by a novel technique of meditation known as ‘Scream at the Intern doctor’.
I have been taught and/or learnt through experience a few tricks that have made life easier here.
1. Never shout back. Not only are there high chances of her pitch being drilling-through-brain-level shrill, she has more labour room experience, hence you’ll be dead before you can even construct the sentence in your mind that you want to shout.
2. Is that uterus contracted or flabby, who am I to say? I am a mere mortal, and I shall help her, as long as I have breath in my lungs, and oxytocin in my syringe.
3. No matter how laid-back you are, they will always like you more than the paediatrician who arrives at the scene like the police in Bollywood movie. Be proud of yourself.
Also, hang in there. 9AM the next day, you’ll be able to hear your thoughts, look at the birds, appreciate the blue of the sky once again.