Being Back To Work

A thirteen days' break rejuvenated half of us who joined duty today, while the other half went away to get rejuvenated. At least that is the way it is supposed to work. Here is how it went today. "Sir, we have a patient of Tetralogy of Fallot for MTP." one Registrar reported. "Is she cyanotic?" I asked. "They have not written that on her paper" she answered. "Is she looking cyanotic" I asked patiently. I had indeed been rejuvenated. A fortnight ago I would have got exasperated. "Umm... no Sir." "We will give a low spinal to this Tetralogy of Fallot" said the senior anesthetist. "We don't want to give her general anesthesia." "If she is unfit for anesthesia, we will do it under local anesthesia." I offered. "She can get further pulmonary artery spasm if she gets pain. I prefer low spinal anesthesia" she said. "We did a second trimester MTP in another unit that day like this." "How?" I asked. "We gave her an epidural block. Then they put extraovular something." "And then?" "Then we kept her in the OT under observation" she said. "She aborted at 8:00 P.M." I was stunned. "They abort 24 to 48 hours after extraovular instillation of any agent" I said patiently. "You cannot occupy an OT table to observe a patient until she aborts." My nerves seemed to be taking the usual shocks well. Then there was a case of postmenopausal bleeding undergoing a hysteroscopy and fractional curettage. I looked into the hysteroscope and found her to have a flat polyp arising from near the left tubal ostium. The endoscopic system was nonfunctional, because of viruses in the system, they said. So I held the endoscope focused on the polyp and let all of the lecturers and resident doctors peep in to see what it looked like. The last one was a first year resident. She came along, held the eyepiece with her bare hands and looked it. "Hey!" shouted the others. Then I realized what she had done. I discarded the endoscope which was contaminated. Then I just smiled when she went away sheepishly. She actually had no business adjusting the eyepiece because then the focus would have moved away from the polyp, and she did not have adequate training and experience to focus it properly. She should also know about surgical asepsis and antisepsis. Before vacation I would have scolded her thoroughly. But today I took it in my stride. There were a few more episodes today that elicited a reaction from me quite different from my usual reactions. Either the break had done me good, or I had matured unbelievably in those 13 days.