Saving a life
It was around lunchtime on a rather slow day at the hospital. Some of the roads leading to the hospital had become impassable, due to the frequent mudslides that plague this area during the monsoon season. But the slow day was about to give way to a very challenging afternoon.
“Have you heard the news?” Dr Sadichhya, one of our junior doctors, asked. “There’s a woman with an ectopic pregnancy (a pregnancy which has implanted outside of the uterus) and a hemoglobin level of 6.5 who is bleeding and needs surgery.”
No, I hadn’t heard the news. But clearly, she did need surgery. Now, this is not the sort of patient on whom in the West a family doctor and two junior doctors would operate on. While this was certainly not a routine case for us, we all knew that we needed to do what we could to save this woman’s life. We went about getting blood arranged to give to her from our small blood bank and prepared for the surgery.
Normally, we do surgery under spinal anesthesia, but this patient was too unstable for that. Our anesthesia assistant gave her general anesthesia, and then gave her manual ventilation throughout the next three hours of surgery. Squeeze the bag, wait a few seconds, squeeze again.
We began, as we do before every surgery, with a prayer for the operation and the patient’s safety. Even more than usual, each of us in that room realized our need for God’s help in successfully carrying out the operation. As soon as we opened her abdomen we were met with a torrent of blood. It took several minutes of sucking and sponging to clear the field enough to locate the ectopic pregnancy. To our surprise, it was not in the fallopian tube, the most common site for ectopics, but was attached to the outside of the uterus. This is very unusual, and makes surgical treatment much more difficult and more risky. The baby was about 3 months old, and over 2 inches long. The tragedy of this baby not living was not lost on us, but without the operation the mother would have no chance of survival.
After 3 hours, the patient had received 3 units of blood and several bottles of IV fluid. We had removed the ectopic pregnancy along with her appendix, and had tied her fallopian tubes to prevent any further pregnancies. The bleeding had finally been controlled, and she was brought back to the ward in stable condition.
While the initial credit for this sort of “save” might go to the docs doing the surgery, I made sure to remind our staff the next morning in our devotion time/staff meeting that this surgery wasn’t possible without a complete team effort. Everyone from our cleaners to lab staff to nursing to security was necessary in order for this operation to be possible. And without God’s guiding hand orchestrating the whole process, the outcome could not have been successful. It was a proud moment for each of us looking around the room and recognizing that all of our contributions helped this woman survive.
Pictured here is the patient with her husband a few days after surgery. She has since been discharged from the hospital and is back with her husband and four children at home. We rejoice that her life was saved, and that we have the privilege of making a difference here in Far Western Nepal.