I don't know which of the following three stories told in a story telling competition that was held during my residency is the best.
Story 1
This one happened when I was doing my residency in Obstetrics and Gynecology many years ago.
There was a 23 year old woman with acute abdominal pain. The surgeons had decided she had a lump in the abdomen that was excruciatingly painful. She was admitted and put on the operation table. It was the middle of the night and they were waiting for an anesthetist. She was screaming with pain so much, that they left her in the operation room and sat at the table outside. Suddenly her screams stopped.
"Go see if she has died or something" the Registrar said.
The houseman went in to check and came out on the double.
"She ...ah..."
"What?" the Registrar asked, suddenly worried.
"She is OK. The painful abdominal lump is gone, and there is a baby between her legs. I don't know what to do about the umbilical cord that seems to be going inside her."
The woman was spared a laparotomy by a busy or tardy anesthetist. The surgeons had not realized she was pregnant and in labor.
Story 2
The woman was 8 months pregnant. She had a valvular heart disease and was in early cardiac failure. We sent a call to the cardiologists. The cardiology Registrar saw her and advised some cardiological tests. He also advised an ultrasonography of the abdomen.
"A cardiologist wants an ultrasonography of the abdomen?" I asked, surprised. "This is the first time I have seen this happen. Please ask him why he wants one."
My Registrar asked and informed me about it.
"He wanted it to see if there was any large mass or fluid in the abdomen, that would compromise her breathing and cause breathlessness."
Of course she had both a large mass (the fetus) and fluid (amniotic fluid) in her abdomen, just like all pregnant women have.
Story 3
The woman was admitted in the medical ward with severe anemia. Her hemoglobin was 4 g/dL (normal range is 12.5 to 14 g/dL). We received a call from the medicine residents. My Registrar saw her and reported back to me.
"The patient is 35 weeks pregnant and has severe anemia."
"OK. What did they want from us?" I asked.
"Actually their professor asked them to do an ultrasonography and send us a call at the same time. The professor thought she had a uterine fibroid, which was causing the anemia."
"Fibroid causes heavy menstrual bleed loss, while a pregnancy causes amenorrhea (absence of menses)" I said. "You can actually feel the baby at such an advanced stage of pregnancy."
"The professor felt it was a fibroid" my Registrar said.
If we could diagnose a heart disease, anemia, pneumonia, and cirrhosis, the medicine guys should be able to diagnose an advanced pregnancy, I thought. Well, the 'should's may be very well justified, but that does not make them real.
P.S. (29-11-2014)
There was another patient who was single, admitted in the medical ward. She was there for investigations of hepatosplenomegaly. The got an ultrasonography done on her as a part of the diagnostic work up. It showed she was 8.5 months pregnant and had no hepatosplenomegaly. It goes to show that they do not read my blog, or read it just to get angry if there is anything that they think is criticism rather than praise. Well, I praise them for managing so many patients so well despite being understaffed. The purpose of writing such posts is not to criticize, but to try and avoid such happenings in future.
Story 1
This one happened when I was doing my residency in Obstetrics and Gynecology many years ago.
There was a 23 year old woman with acute abdominal pain. The surgeons had decided she had a lump in the abdomen that was excruciatingly painful. She was admitted and put on the operation table. It was the middle of the night and they were waiting for an anesthetist. She was screaming with pain so much, that they left her in the operation room and sat at the table outside. Suddenly her screams stopped.
"Go see if she has died or something" the Registrar said.
The houseman went in to check and came out on the double.
"She ...ah..."
"What?" the Registrar asked, suddenly worried.
"She is OK. The painful abdominal lump is gone, and there is a baby between her legs. I don't know what to do about the umbilical cord that seems to be going inside her."
The woman was spared a laparotomy by a busy or tardy anesthetist. The surgeons had not realized she was pregnant and in labor.
Story 2
The woman was 8 months pregnant. She had a valvular heart disease and was in early cardiac failure. We sent a call to the cardiologists. The cardiology Registrar saw her and advised some cardiological tests. He also advised an ultrasonography of the abdomen.
"A cardiologist wants an ultrasonography of the abdomen?" I asked, surprised. "This is the first time I have seen this happen. Please ask him why he wants one."
My Registrar asked and informed me about it.
"He wanted it to see if there was any large mass or fluid in the abdomen, that would compromise her breathing and cause breathlessness."
Of course she had both a large mass (the fetus) and fluid (amniotic fluid) in her abdomen, just like all pregnant women have.
Story 3
The woman was admitted in the medical ward with severe anemia. Her hemoglobin was 4 g/dL (normal range is 12.5 to 14 g/dL). We received a call from the medicine residents. My Registrar saw her and reported back to me.
"The patient is 35 weeks pregnant and has severe anemia."
"OK. What did they want from us?" I asked.
"Actually their professor asked them to do an ultrasonography and send us a call at the same time. The professor thought she had a uterine fibroid, which was causing the anemia."
"Fibroid causes heavy menstrual bleed loss, while a pregnancy causes amenorrhea (absence of menses)" I said. "You can actually feel the baby at such an advanced stage of pregnancy."
"The professor felt it was a fibroid" my Registrar said.
If we could diagnose a heart disease, anemia, pneumonia, and cirrhosis, the medicine guys should be able to diagnose an advanced pregnancy, I thought. Well, the 'should's may be very well justified, but that does not make them real.
P.S. (29-11-2014)
There was another patient who was single, admitted in the medical ward. She was there for investigations of hepatosplenomegaly. The got an ultrasonography done on her as a part of the diagnostic work up. It showed she was 8.5 months pregnant and had no hepatosplenomegaly. It goes to show that they do not read my blog, or read it just to get angry if there is anything that they think is criticism rather than praise. Well, I praise them for managing so many patients so well despite being understaffed. The purpose of writing such posts is not to criticize, but to try and avoid such happenings in future.
