The poor woman had a bladder mass and a 10 weeks' intrauterine pregnancy. She was passing blood in urine and needed urgent treatment of the bladder mass. I diagnosed the condition and referred her to the concerned superspecialists. She went there at 11:00 A.M. Their resident passed a Foley's catheter into her bladder, kept her without admission and sent her to our emergency room at about midnight for admission in our ward.
:But she has a serious urological problem" my Registrar protested. "You should have admitted and treated her."
"But she is pregnant" said the concerned superspecialty resident. "So admit her in your ward."
My Registrar stood her ground and finally she got admitted in the superspecialty ward. More than a month passed. We were in the obstetric OT that morning. My Registrar came to tell me that the superspecialists were planning to operate on that woman and wanted one of our doctors as a standby."
"What do they expect will happen to a woman's pregnancy at 14 weeks, that our doctor will manage while they operate on the bladder mass?" I asked incredulously. My Registrar did not know what the superspecialists thought. So I called them.
"I appreciate that you are operating on the woman with the bladder mass" I said. "But I don't understand what you expect of us as standby. If you will explain it to me, I will brief my resident and send him/her."
"You know, she might deliver" the superspecialist said.
"No woman delivers a baby at 14 weeks" I said patiently. "If at all she may abort."
"Whatever" the superspecialist said.
"They do not abort with the speed of a flash in the pan" I said. "If she starts bleeding, call us. Even that has no active treatment. Prophylactic administration of progesterone has already been done to avoid an abortion. I don't have people to spare from my OT when there is no need. If there is true need, I will come myself, leaving all my patients."
"We are also busy in our OT when you people call us for bladder injuries and such" he/she complained.
"Yes" I said, "I thank you for that. But note the difference between our calls and your call. You are calling us because the woman is pregnant. We call you only if there is a bladder or ureteral injury. We do not call you for every patient because each of our patient has a bladder and two ureters."
He had no further argument to offer. They operated without having to call us. Now she is in her third trimester, being treated in our antenatal clinic.
:But she has a serious urological problem" my Registrar protested. "You should have admitted and treated her."
"But she is pregnant" said the concerned superspecialty resident. "So admit her in your ward."
My Registrar stood her ground and finally she got admitted in the superspecialty ward. More than a month passed. We were in the obstetric OT that morning. My Registrar came to tell me that the superspecialists were planning to operate on that woman and wanted one of our doctors as a standby."
"What do they expect will happen to a woman's pregnancy at 14 weeks, that our doctor will manage while they operate on the bladder mass?" I asked incredulously. My Registrar did not know what the superspecialists thought. So I called them.
"I appreciate that you are operating on the woman with the bladder mass" I said. "But I don't understand what you expect of us as standby. If you will explain it to me, I will brief my resident and send him/her."
"You know, she might deliver" the superspecialist said.
"No woman delivers a baby at 14 weeks" I said patiently. "If at all she may abort."
"Whatever" the superspecialist said.
"They do not abort with the speed of a flash in the pan" I said. "If she starts bleeding, call us. Even that has no active treatment. Prophylactic administration of progesterone has already been done to avoid an abortion. I don't have people to spare from my OT when there is no need. If there is true need, I will come myself, leaving all my patients."
"We are also busy in our OT when you people call us for bladder injuries and such" he/she complained.
"Yes" I said, "I thank you for that. But note the difference between our calls and your call. You are calling us because the woman is pregnant. We call you only if there is a bladder or ureteral injury. We do not call you for every patient because each of our patient has a bladder and two ureters."
He had no further argument to offer. They operated without having to call us. Now she is in her third trimester, being treated in our antenatal clinic.
