The patient had been in the ward for quite some time. She had a bit of bad luck. On second thought I thin she had a lot of bad luck. She underwent an abdominal hysterectomy for a posterior wall leiomyoma which had grown into the broad ligament on the right side. It went off fine. But the second day she developed profuse melena. We treated her for stress induced gastritis and she responded. From the fifth postoperative day she started getting high grade fever. With her history of having received blood transfusions and the hospital area being endemic for malaria, we treated her for suspected malaria and also changed her antibiotic. Her report for malaria came negative, but her fever went away. Her wound healed well, but she started getting high grade fever from the 12th postoperative day. We performed a pelvic ultrasonography and discovered a small collection in the pelvis.
“Can the sonographers tap it?” I asked.
“No. They said the bowel is in between.”
We removed two sutures in the vault of vagina, hoping the collection would drain out from below. I did not. She responded to the third antibiotic, this one quite high up in the potency and cost scale, and her fever came down. So we waited. She started getting fever again.
“Ask a senior sonologist if the collection can be tapped” I advised. The senior sonologist said it could be, provided the patient purchased a special needle. But the patient had no money. Her husband somehow arranged for the money and bought the needle.
“Sir, the collection cannot be tapped” my Registrar informed me “because they do not have an ultrasonography machine. Tomorrow is Sunday. Now it can be done only on Monday.” That was too much. I called the ultrasonography department.
“Our one machine has started hanging” the Lecturer said. “If we start tapping and it hangs, there will be problems.”
“I understand” I said. “Do you have no other machine? Surely such an institute does not function on one machine.”
“Our other machine is taken for an imaging workshop.”
“By whose order?” I asked. This was sounding horrible.
"By higher order.”
Higher order? As in from heaven?” So now they were having hallucinations and were hearing God?
“No. higher means from surgery department.” She was scared of specifying names, but I knew. They all were scared of only one person there, who they thought had higher connections.
“See, I am asking you to request your boss and get the machine back for this tapping. This poor woman has received the highest possible antibiotics. She needs treatment urgently. We cannot postpone it to Monday, like an elective procedure. It is not like a girl getting her hair permed or straightened which can be put off by a couple of days.”
“How can I get the machine back from the workshop?”
“Now it is lunch time. All the grand people who attend workshops love to eat fancy food at this time. While they do so, the patient can get treated. If she is not treated, it will be a shame on all of us. I am not asking this for myself. I am asking it for a poor patient who cannot afford to go some place where they take money and give her her money’s worth.”
I put the phone down. I could do no more. My Registrar informed me later that they finally tapped her. The patient became afebrile and went home fine.
I wonder how many such higher orders are passed that I do not come to know about, and who requests, pleads, reasons, threatens to get something done for patients at such times.
“Can the sonographers tap it?” I asked.
“No. They said the bowel is in between.”
We removed two sutures in the vault of vagina, hoping the collection would drain out from below. I did not. She responded to the third antibiotic, this one quite high up in the potency and cost scale, and her fever came down. So we waited. She started getting fever again.
“Ask a senior sonologist if the collection can be tapped” I advised. The senior sonologist said it could be, provided the patient purchased a special needle. But the patient had no money. Her husband somehow arranged for the money and bought the needle.
“Sir, the collection cannot be tapped” my Registrar informed me “because they do not have an ultrasonography machine. Tomorrow is Sunday. Now it can be done only on Monday.” That was too much. I called the ultrasonography department.
“Our one machine has started hanging” the Lecturer said. “If we start tapping and it hangs, there will be problems.”
“I understand” I said. “Do you have no other machine? Surely such an institute does not function on one machine.”
“Our other machine is taken for an imaging workshop.”
“By whose order?” I asked. This was sounding horrible.
"By higher order.”
Higher order? As in from heaven?” So now they were having hallucinations and were hearing God?
“No. higher means from surgery department.” She was scared of specifying names, but I knew. They all were scared of only one person there, who they thought had higher connections.
“See, I am asking you to request your boss and get the machine back for this tapping. This poor woman has received the highest possible antibiotics. She needs treatment urgently. We cannot postpone it to Monday, like an elective procedure. It is not like a girl getting her hair permed or straightened which can be put off by a couple of days.”
“How can I get the machine back from the workshop?”
“Now it is lunch time. All the grand people who attend workshops love to eat fancy food at this time. While they do so, the patient can get treated. If she is not treated, it will be a shame on all of us. I am not asking this for myself. I am asking it for a poor patient who cannot afford to go some place where they take money and give her her money’s worth.”
I put the phone down. I could do no more. My Registrar informed me later that they finally tapped her. The patient became afebrile and went home fine.
I wonder how many such higher orders are passed that I do not come to know about, and who requests, pleads, reasons, threatens to get something done for patients at such times.
