Maybe this is just what happens when one practically lives in a hospital, or maybe it has to do with medicine in rural India in particular—but I’m encountering unbelievable things all the time. Here are some memories that still boggle my mind at the end of the day.
Anecdote 1: As a lab tech shadow, I peered into the medical record of a 20-year-old woman being checked for sickle-cell anemia—she had a hemoglobin level of 1.8 mg/dl! I was in disbelief that she had arrived alive; generally, in the States, anything under 7 could be cause for blood transfusion. Dr. S explained that she is from one of the tribes that has very poor access to healthcare, and that she had put off coming to the hospital for as long as possible. As I scanned the list of other patients getting tests, I saw that the whole patient population is really different from what I’m used to seeing in the States (no surprise), with Hgb readings commonly under 10 mg/dl and often around 5 mg/dl.
Anecdote 2: Last week we were ushered into the patient rooms at Kenchanahalli with the words, “Come! There was an abortion! Come see the fetus!” We braced ourselves for a major scene, but on arrival everything was surprisingly calm. The patient had had a miscarriage of her 6-month-old fetus; she lay recovering behind the curtain, and the fetus was brought out for us to see. It was small and wet, curled up in a kidney-shaped metal tray. Its many congenital abnormalities were presented to us simply and without ceremony—under-formed limbs here; brain growing outside of the skull there. I realized then that a potentially traumatizing medical moment for me was underway, and yet, it was not traumatizing. On this side of the curtain, things are only as big of a deal as you make them. The tragedy of a miscarriage was made to be, this time, just a strange and surprising medical moment when I didn’t know quite what to feel.
Anecdote 3: Yesterday evening I scrubbed into an emergency surgery for a ruptured ectopic pregnancy. My first reaction was one of surprise—they scrub in with “surgery sandals”! Surprise turned to fear—they don’t sedate the patient! they only have one unit of blood! there is only one trained nurse! Fear turned to admiration—the surgery was smooth and quick, without complications, and was an incredible demonstration of how much can be done with limited resources. Two sutures tied up a fallopian tube, several points on a uterus, and two layers of abdominal wall. The team was focused and cooperative. The surgeon taught about the procedure at her every step and decision point. And, thanks to a 90% subsidy for tribal patients, the whole operation will cost the family only 600 Rs, or about 15 USD.
No comments:
Post a Comment