I was teaching my postgraduate students 'Dystocia' when I remembered this story. For those who don't know what 'Dystocia' means - 'Dystocia' is difficult labor. It can be caused by many factors in the mother and the baby. For those who don't know what 'Iatrogenic' means - 'Iatrogenic' is some problem for the patient caused by the treatment of a doctor.
Some of the students were half sleepy - poor souls who work day and night without sleep at times. I decided to tell them this story partly to educate them and partly to wake the sleepy ones up.
'This happened when I was a resident doctor. There was an honorary Professor in the department. This one had a lot of rich patients in private practice. Some of the patients were foreigners. It seems they expected the Professor to deliver them personally, for which they paid well. If the Professor was busy elsewhere and an assistant delivered them, the payment would be less. A resident doctor from my batch was working with this honorary doctor. That day they were in the OT. There was a call for this honorary doctor. I can put down only the honorary doctor's part of the conversation as heard this resident doctor, who recounted it to us later.
"Oh, she has gone in labor, huh?"
"............"
"How much is the dilatation?"
"............"
"Full?"
"..........."
"Of course she will deliver if you let her bear down."
".........."
"Ask her to breathe in and out, in and out, deeply." (That prevented the patient from bearing down or pushing the baby out, we knew). "And ask her to cross her lower limbs and hold them tightly together." (That would keep the lower end of the birth passage tightly closed and the baby would not be able to come out, no matter how much the poor woman pushed). "I am on my way to the hospital."
With that, the honorary doctor jumped into the car waiting outside and rushed off to deliver the patient.
"What must have happened to that baby?" someone asked.
"Its head must have been compressed by the patient's thighs preventing exit" I said. "That could have caused injury to the head and its contents."
"Oh!"
"Yes, oh!" I said. "Nothing bad might have happened to the baby too. I call this 'iatrogenic dystocia'. When you practice after you qualify, I advise you never to do this."
They shook their heads.
Some of the students were half sleepy - poor souls who work day and night without sleep at times. I decided to tell them this story partly to educate them and partly to wake the sleepy ones up.
'This happened when I was a resident doctor. There was an honorary Professor in the department. This one had a lot of rich patients in private practice. Some of the patients were foreigners. It seems they expected the Professor to deliver them personally, for which they paid well. If the Professor was busy elsewhere and an assistant delivered them, the payment would be less. A resident doctor from my batch was working with this honorary doctor. That day they were in the OT. There was a call for this honorary doctor. I can put down only the honorary doctor's part of the conversation as heard this resident doctor, who recounted it to us later.
"Oh, she has gone in labor, huh?"
"............"
"How much is the dilatation?"
"............"
"Full?"
"..........."
"Of course she will deliver if you let her bear down."
".........."
"Ask her to breathe in and out, in and out, deeply." (That prevented the patient from bearing down or pushing the baby out, we knew). "And ask her to cross her lower limbs and hold them tightly together." (That would keep the lower end of the birth passage tightly closed and the baby would not be able to come out, no matter how much the poor woman pushed). "I am on my way to the hospital."
With that, the honorary doctor jumped into the car waiting outside and rushed off to deliver the patient.
"What must have happened to that baby?" someone asked.
"Its head must have been compressed by the patient's thighs preventing exit" I said. "That could have caused injury to the head and its contents."
"Oh!"
"Yes, oh!" I said. "Nothing bad might have happened to the baby too. I call this 'iatrogenic dystocia'. When you practice after you qualify, I advise you never to do this."
They shook their heads.
