My Christmas PresentS

Having to work on a public holiday is something that I never look forward to. The thought of being in the hospital, working like a mad dog, and earning only RM170, while others are relaxing at home, spending valuable time with their family and friends.

I probably woke up on the wrong side of the bed that day. It started off badly when I got a 'lecture' from dad for the smallest thing ever, and later only reached the hospital at 0820H. I was doing my morning rounds when my collegue, who was on-call the previous day called me up to see a patient before he headed home.

It was 38 year old lady, 30 weeks pregnant, having difficulty in breathing. She was known to have Bronchial Asthma for the past 2 years, and my friend had treated her as having an asthma attack. Despite the medical therapy given, her condition didn't improve much and he has informed the specialist about it. He was asked to observe the patient and inform her again if the patient's condition worsened.

I reassessed the patient soon after that and she deteriorated rapidly. She became drowsy; clearly because she was tired from breathing to fast and the accumulation of CO2 in her body. 3 of my other collegues joined to actively resuscitate the patient-by intubating the patient, performing CPR and all. To cut a long story short, her heart stopped beating at 1015H and I pronounced her dead at 1115H.

There were so many things running in my mind at that time. How could she die so suddenly? Was it even an asthma attack? Could it be another diagnosis which was missed earlier? How I am I going to inform my specialist? the Pengarah? And the worse part-How to do I break the bad news to her husband?

You see, maternal mortality is something really HUGE. It is something UNEXCEPTABLE in the field of medicine. Pregnant ladies are not supposed to die..When something like this occurs, the news will go up to the ministry and the all health personnel involved, right from the time she booked her pregnancy up to the last one that saw her, will be investigated thoroughly. It will be a must for us to attend meetings at hospital , district, state and maybe even national level.

To make matters worse, later that evening, I had to attend to a 4 year old child, known case of complex congenital heart disease, who was gasping in the paediatric ward. After performing massive resuscitation, I could not revive the patient and the child succumbed to death.Cause of death: most likely from severe cyanotic spell.

Conclusion:

Two mortalities in one day. One from O&G, one from Paeds. In a district hospital. With no specialist around. One hell of an experience that I shall never forget. Ever.