Attitudes 12

The old woman had undergone a hysterectomy in another hospital. They realized she was bleeding inside late evening. They transferred her to our hospital in the night. Our people found she had a severe hemorrhage inside. She required urgent treatment to stop that bleeding. They contacted the Associate Professor at 2:30 A.M. There was no one experienced enough to open her abdomen in campus. The lecturer had completed her 3 months of maternity leave and was absent without sanctioned leave despite reminders to join duty. Out of six posts of lecturers, only one was filled. The others were kept vacant because the machinery could not fill up two of them for reasons unknown and three because they felt they were forced to keep them vacant since they were due to ad hoc promotions of concerned lecturers. The fourth year residents did not feel confident of handling the emergency. The AP advised embolization of the bleeding vessel by interventional radiology. It was done. When I reached the hospital in the morning, I learned about all this. The patient was in the OT and so was the AP. I asked them what was being done. “I have asked them to explore her: the AP said. “But she underwent embolization of the bleeding vessel successfully” I said. “Why explore her now?” “She had a large amount of blood inside. It has to be removed. If not, it may get infected.” “But she had all that blood inside her when you got the embolization done” I said. “If you were going to explore her abdomen anyway, why did you get an embolization done? That was undue intervention, will all the attendant risks and expense.” “That is correct” said the AP. “But it was 2:30 A.M. I could not come down that time from my home in the suburbs. So I advised embolization in the meantime.” I was appalled. “But I would have come down if you could not” I said. I stay nearer to the hospital than you do.” The AP did not say anything to that. I remembered coming down like this a number of times in the past because another AP could not come down. I hope they remember what I said and act accordingly in future.