Phobia in Obstetrics & Gynecology

One would think phobias were in people and were described in Psychiatry. There could not be any specifically in Obstetrics & Gynecology. Well, it is there in all branches of Medicine, especially in the surgical lines, in all people in all wakes of life. I am writing about Obstetrics & Gynecology because that is my specialty. It is phobia for HIV. There is reason enough for the phobia. There is no guaranteed cure for the disease, and it can spread to the doctor on contact with the body fluids of the patient. But we have to do what we have to do – treat patients. There should be no place for a phobia. But it there all right. We had this fourth year resident, who had this phobia, but would not admit it. It was our Gynecology operation day, and it was her turn to operate. The patient was HIV positive and was scheduled for an abdominal hysterectomy. She said she would rather not do the case, because she was not very confident of performing an abdominal hysterectomy. So my Associate Professor said it was all the more reason she should operate and get more experience. We always assist residents, even if they are qualified. There was no way out, so she finally did operate. But she kept asking the Associate Professor to do whatever she thought was tricky. At one stage they told me the posterior pouch was obliterated by dense adhesions and it would best to perform a subtotal hysterectomy. I offered to help separate the adhesions, but they said no. They finally performed a subtotal hysterectomy. We had this Lecturer who was quite senior. There was a HIV seropositive patient who needed a cesarean section. He did not want to operate on her. I always do whatever my juniors cannot do or will not do. But he would not say why he did not want to operate. Since he could not get anyone else junior to him to operate, and since he dared not tell me to operate without any reason for his reluctance, he started the operation. But he sent for me soon. I reached the OT. The baby had been delivered. He said there was a tear in the lower segment close to the bladder, and he did not know what to do. It was a small tear, and I was sure he must have dealt with far worse cases. I washed up, dissected the bladder away and stitched up the tear. I asked him if he would be able to deal with such a situation in future, since I had shown him how. He could not say no. Then I asked him if he could do the remaining operation as usual. He could not say no. SO I left him and he completed the operation. Luckily for us or him, he got a transfer to another institute soon after. Then we had that Associate Professor in another unit, who came to the OT with band aids on both the hands for cuts, he said. There was a HIV seropositive patient scheduled to undergo hysterectomy that day, and in the opinion of the unit Professor, that was the reason for the band-aids, not any cuts on the hands. There was that same Professor who had another HIV seropositive patient who required a hysterectomy. She tried to send the patient to a laparoscopic surgery workshop, but they did not want a seropositive patient. Medical treatment could not be given because the patients had large leiomyomas which would not respond to medical treatment. So the patient was finally scheduled for an abdominal hysterectomy, and another Professor heading a junior unit was called to operate on the patient. He consented for the sake of old friendship, performed the hysterectomy while our professor observed, pricked himself accidentally, and then took the prescribed course of chemoprophylaxis.