She came to us in a bad shape. The family resided in the city, but had gone to their native place in North India. She was carrying her third child then. She had a fall, and they found out that the baby was dead in her womb. They got a D & C done there, and came to us after 15 days. She was literally pouring out pus from her uterus, and was having high fever too. We gave her high antibiotics, then switched to higher antibiotics, but there was no improvement. Her sonography did not reveal any abnormality. But I had a feeling that there was a major problem on the left side of her uterus, where a lot of pus must have collected. So I asked for a CT scan, and it showed a huge collection of pus inside her. In the meantime, she kept lying down in her bed looking very sick, and her husband kept meeting me, asking me to do something to cure her. I got the surgeons to drain out the pus, and she started improving. The next day she was sitting up, all smiles.
"Now you will be OK" I told her. "But I would advise you not to have another baby. There is a hole in your uterus, through which the pus was entering the uterus. It will most probably remain unhealed. Your uterus may rupture at that site during the next pregnancy, and it may even prove fatal. I will speak to your husband about it too."
Her husband came to see me when he heard of this. I explained everything to him.
"How did that happen?" he asked me.
"Her uterus was probably perforated during the D & C" I said, "which caused a lot of bleeding inside, and it got infected."
"I know why that happened" he said. "I had sent her to a good hospital 65 km away from our place. It was expensive but good. She came back without getting treated there. She wanted it done by a woman near our house. This woman used to work as an assistant in a nursing home. Now she thinks she is a doctor, has set up a nursing home, and does these things herself. She has messed up a number of patients. She has no medical degree. Even the nursing home she runs is not licensed."
"Oh!" I said.
"Doctor, you saved her. Two days ago, she probably realized she was slipping away. So she said,'call my children. I want to see them once...'."
"....." I just looked at his tearful eyes, unable to say anything.
"Even I thought she would not make it. That was why I kept meeting you and asking you do something more."
"She was fortunate she came to this hospital" I said. "That saved her."
"I will stop that evil woman who did this to my wife and many other women" he said with passion. "I will complain to police. Is there any other body I can complain to?"
"Perhaps the state medical council can help" I said. "But it regulates doctors. This woman is not a doctor, you said."
"I will do something" he promised.
"Be careful" I said. "From what I read in the newspapers about your native place, that person may pay some hooligans to beat you up if you make any trouble. If they do away with you, your wife will have no husband, and your children will become orphans."
"I will do it from here" he said, thanked me profusely again and went away.
It has been a few days since, but I still think of the mother who somehow knew she would not make it and wanted to see her children once before the inevitable happened. I was glad her husband had not told me this while I was working on the management decisions for getting her well, because perhaps the pressure would have made the detached analytical process difficult.
"Now you will be OK" I told her. "But I would advise you not to have another baby. There is a hole in your uterus, through which the pus was entering the uterus. It will most probably remain unhealed. Your uterus may rupture at that site during the next pregnancy, and it may even prove fatal. I will speak to your husband about it too."
Her husband came to see me when he heard of this. I explained everything to him.
"How did that happen?" he asked me.
"Her uterus was probably perforated during the D & C" I said, "which caused a lot of bleeding inside, and it got infected."
"I know why that happened" he said. "I had sent her to a good hospital 65 km away from our place. It was expensive but good. She came back without getting treated there. She wanted it done by a woman near our house. This woman used to work as an assistant in a nursing home. Now she thinks she is a doctor, has set up a nursing home, and does these things herself. She has messed up a number of patients. She has no medical degree. Even the nursing home she runs is not licensed."
"Oh!" I said.
"Doctor, you saved her. Two days ago, she probably realized she was slipping away. So she said,'call my children. I want to see them once...'."
"....." I just looked at his tearful eyes, unable to say anything.
"Even I thought she would not make it. That was why I kept meeting you and asking you do something more."
"She was fortunate she came to this hospital" I said. "That saved her."
"I will stop that evil woman who did this to my wife and many other women" he said with passion. "I will complain to police. Is there any other body I can complain to?"
"Perhaps the state medical council can help" I said. "But it regulates doctors. This woman is not a doctor, you said."
"I will do something" he promised.
"Be careful" I said. "From what I read in the newspapers about your native place, that person may pay some hooligans to beat you up if you make any trouble. If they do away with you, your wife will have no husband, and your children will become orphans."
"I will do it from here" he said, thanked me profusely again and went away.
It has been a few days since, but I still think of the mother who somehow knew she would not make it and wanted to see her children once before the inevitable happened. I was glad her husband had not told me this while I was working on the management decisions for getting her well, because perhaps the pressure would have made the detached analytical process difficult.
