During my stint in Tororo, I had to handle one of the most difficult cases in my first few years as a doctor. One night during my emergency duty I was called upon to see a lady. She had gone into labour for some hours and then suddenly her contractions stopped. When I examined her, I found her to be full term pregnant, but my heart sank when I realized that her contractions/labour pains were absent. On palpation, her abdomen was quite tender and to make things worse, The foetal heart was not audible.
I had never seen a case like this before. Being raw and very much inexperienced, I was baffled and couldn't make out what the problem was. I had to consult Dr. Gosavi, who in some ways was like my mentor there. I told him everything I could deduce about the patient and related all my findings to him on phone. After a few more queries, he deduced the uterus had ruptured and asked me to get the theater ready and shift the patient.
On opening the abdomen, we found that the uterus had ruptured transversely (horizontally), in the lower segment. Luckily for the patient, it was just at the site where we make an incision for the lower segment ceasarean section. Through that gaping wound, we removed the dead foetus, and then sutured the uterus in a way that it would not complicate matters when the lady had children in future. After that, I watched in amazement as the lady made a steady and uneventful recovery. It was a great solace for me especially to see her recover so well.
No amount of classroom teaching can prepare you enough for a real life situation. When faced with a patient in a grave situation, you need to keep your wits around you and do the best you possibly can. For me there was a lot to learn through my seniors such as Dr Gosavi there. I realized that I had to take big strides in terms of learning on the job and gaining experience so that I could be useful to the ailing community.
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