A tale of two cases

Just as I was finishing dinner, I was called by Mida, the nurse in neonatology. She was panicked and said she needed help.

Lisa and I jumped up from the dinner table and ran to the hospital. (I think I forgot to say goodbye to our friends.)

When we arrived, I was told a mother had started having vaginal bleeding hours earlier but did not come to the hospital due to financial concerns. Finally, after four hours and no stoppage of the blood, she sought care.

I immediately rushed to the operating room and prepared for the delivery. Minutes later, I was handed a floppy, blue baby. I sprinted to the neonatology room and we began the resuscitation. The resident doctor, nurse and medical student checked for pulses, did chest compressions and got medications. I placed a breathing tube and gave oxygen. Unfortunately, the patient had no pulse for greater than 10 minutes. As we gave our last dose of adrenalin, a spontaneous heart rate appeared but we knew the outcome was going to be bad.

No less than 5 minutes later, Dr. Ellie, the over-qualified surgery resident, opened the door and said we have another. A pregnant woman arrived who started bleeding just minutes ago. We quickly stabilized the patient from the first case and I left to find the new mother.

It was not difficult to locate her. I just followed the trail of blood. When I arrived in the obstetric room, I was absolutely shocked. Blood was everywhere. On the floors, smeared on the walls and pouring like a faucet over the exam table. She had lost at minimum two liters just in the room. At one point, I lost my footing in the pool beneath me.

Dr. Ellie and I placed multiple IVs in the patient, pumped her full of fluids and blood, and then quickly transferred her to the operating room. Within minutes, he handed me a pink, crying infant. I carried him back to neonatology for observation.

For the next 10 hours, we worked aggressively on the first child. At 8AM, his heart began to give out and he began dying. I spoke with the family and they wanted to hold him as he took his last breaths.

At 8:15, I handed the mother her dying child. She cradled him, cried and shook her head. She then looked up at me a said “don’t be sad, you did the best you could.”

Soon after, I returned to the nursery. The second mother was just recovering from her surgery and wanted to see her child. We handed her the child and she grinned ear to ear.

It was an odd juxtaposition; Two pregnant women, both with profuse vaginal bleeding and yet two completely different outcomes. As is often the case, the financially limited patient suffered.

Advertisements

One Response to “A tale of two cases”

  1. Francisco Acosta Says:

    Wow!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: