A Silent Prayer

This one is a guest post by Dr Angeline Zachariah, my better half. Trained as a Clinical Pathologist (DCP, 2008 Batch, Christian Medical College, Vellore), she is a big help in outpatient department and the Laboratory. Angel, as she is popularly  known, belongs to the MBBS Batch of 2000, of Medical College, Trivandrum. 

It has been quite some time since I've been praying for MD. She has been coming regularly for ante-natal care since the last 2 months. 

Today she came about 1 week past her expected date of delivery. And we have induced her. 

The reason for my prayers . . . 

MD has been married for about 7 years. She has 2 children . . . both girls. 

When MD first visited us for ANC, she told her story. It was with much difficulty that her in-laws agreed to let her visit a hospital for antenatal care. Her husband was also not interested. The obvious reasons . . . her 2 pregnancies have resulted in 2 girls. 

She narrated how her husband had refused to see the first born when he came to know that the baby was a girl. It was when one of our nurses told him to leave the baby in the hospital that he took a peek at the baby. 

In fact, it was her brothers who forcibly brought her for antenatal care and now, for the hospital delivery. When they went to bring her to her mother's home, she was bluntly told by her husband to not return to him if the third baby was also a girl. 

However, there was something that encouraged me. She told me that she was determined to educate her daughters now that she has seen me . . . a lady doctor. 

As I talked to her every time she came for antenatal care, I realised that this lady is in the danger of being abandoned by her husband. It is not uncommon that we see wives being abandoned just because they could not deliver a male progeny. I could not help but pray that she has a boy baby. 

When I returned home, I wondered if it was right for me to pray that she has a baby boy . . . or should I fervently pray for a change in heart of the husband and the in-laws? And of course a change of heart of the communities/societies we are in. 

Sex selection . . . A slap on the face for the doctors

When I was in Medical School, I remember one of my professors telling me that the greatest bane of the modern Indian society was the fact that healthcare, education and religion had become commercialised and profit oriented. Few years later, I had a very senior doctor commenting that after politicians, doctors are the most corrupt lot.

Today morning, I happened across this article, which if true, shows doctors in very poor light. 

Gender determination in the unborn and their selective abortion is an evil which has taken the imagination of the average Indian. Sex ratios are going from bad to worse in most of our states.

And we see this quite often in our part of the country. 

Couple of days back, we had a lady in the Labour Room in her third pregnancy. The anxious look on her face was enough to help our doctor to diagnose that her first two children were girls. When she delivered the baby, it was unnerving to see her groping the perineal area of the baby as soon as he was delivered. I could have imagined her grief if the baby was a girl.

Recently, I had a request to copy a very grotesque snap which accompanied a previous post.  

Now, to find a research article which shows a lower sex ratio in doctor families is terrible. All said, I've not seen the original research article which prevents me from coming to any conclusion. One can argue that the study covered only one medical college. 

However, that's quite a matter to have some amount of introspection among the healthcare fraternity . . . 

Do we care ? ? ?

Babies . . . All God's creations . . .

Today (Friday, 3rd February) morning has been very taxing. I had decided quite beforehand that we needed to take a firm decision on continuing PD on the ventilator. The previous day, she went into status epilepsy and we had to really drug her and she was slowly slipping into multiorgan failure. The relatives tried their best to get an ambulance with a ventilator to transfer her to Ranchi but to no avail. 

As I arrived in acute care, PD's brother had made up his mind to take her by manually ventilating her all the way to Ranchi. I could not convince him that nothing more may happen considering the long time she has been in ventilator and the signs of multiorgan failure which was becoming very obvious. As I started writing the referral letter, I noticed that PD's heart rate had suddenly started to dip. I rushed in just to realise that she was going into a cardiac arrest. We started cardiac resuscitation. 

After about 10 minutes of resuscitation, her heartbeat was back - but she had a very high blood pressure. And she started to have seizures. I looked at the pupils to notice anisocoria. It was not there in the morning when I had reassessed her. We realised that we were losing PD. Within the next 15 minutes, she suffered one more cardiac arrest and she did not respond to any more resuscitation. PD was declared dead. It was heart-wrenching to realise that 4 girls aging 10 years and below would not have a mother in their lives anymore. 

The total bill had come to about Rs. 70,000. The family paid about 30,000. And that was our first maternal death of the year . . . 

Later, as I sat in my office, I enquired about one of the babies that was born last week by emergency cesarian section who had multiple deformities. I was given the impression that the baby would be taken by the parents to a higher centre in Ranchi for further evaluation. From our side, we had realised that the baby had an imperforate anus - rather a rectourethral fistula, talipes valgus, a tracheo-oesophagal fistula with a blind esophagus among few more minor problems. 

The father came to me  in no time and explained that the family was trying to get finances to take the baby to Ranchi. I explained that we cannot keep the baby longer. As I discussed, my thoughts turned to the fact that maybe they were not interested in the baby. So, I suggested adoption. Encouraged by the response of one of my colleagues and dear friend, I started to dream that maybe, we could find someone similar who could care for this little boy. . . 




However, the family has all along maintained that they would take the baby sometime. . . 




Well, before I sign off . . . I need to tell about the delivery I had today morning. . . PD, a 3rd gravida with no live issues - both of the previous babies dying during childbirth. To complicate matters, PD had been quite regular on her antenatal check ups - and there were enough problems - TORCH test positive for Cytomegalovirus and Herpes Simplex, Intrauterine growth retardation and a breech presentation. . . . 




We had begged the relatives to take her to a tertiary centre at Ranchi. They did not relent. PD turned up with quite good contractions and bleeding per vagina. I took her in for Cesarian section and I had a tough time. She was blessed with a 2 kg boy baby . . . The relatives were delighted. . . And within no time, the relatives had decided to take the baby for a second opinion in Ranchi . . . I wondered if they would have done the same if the baby was a girl. . .