The Bloody Truth

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BLOODY TRUTH

While the Medicine and Paediatric departments hold investigations as the

Holy Grail, for us Gynaecologists, it was just another obstacle to be

surmounted by any means possible. Thus, the physicians would gather round a

gaunt and frail looking patient, who would feebly ask all these exalted

beings, gathered around him, " Please sir, when will you start my treatment? "

They would wrinkle their collective noses and deign to reply, " Baba, you

have been admitted for investigations. Let the results come first, then we

will see. " The retort, " If I die before that? " remained unasked.

I have seen Physicians (or Internists, as they like to call themselves) jump

with joy when the diagnosis of their colleague of

Rutherford-Courtingham-* syndrome has been disproved by the

investigations and their own suspicion of Smeeter-Krebs* triad confirmed.

The ultimate outcome for the patient, however, remains the same, as both the

conditions are incurable. (*Or some such equally impossible names.)

For us Gynaecologists, the going was fairly easy. If on the anaesthetist's

round a remark was written that Haemoglobin of 10.1 gm /dl made the patient

unfit for surgery, the registrar immediately called the intern or house

officer and gave him a dressing down on how he felt about nincompoops who

wrote any Hb below the 11 mark. Immediately, after a suitable period of

mourning over the low HB, it would miraculously rise to 12.3, and the

patient would be operated without a fuss, and with splendid results.

The poor, neglected Haemoglobinometer, which is a thin glass tube, was kept

gathering dust, in the dark recesses of the ward cupboard. The term 'Store

in a cool dark place' acquired a new meaning. Our real Haemoglobinometer

was, of course, the lower eyelid of the patient. We used to just pull it a

bit, peer wisely at it and write a suitable number on the paper. For

operative patients, we took the precaution to prick the patient's finger

just a wee little bit. This was for the benefit of the extra smart

anaesthetists who would occasionally ask the patient whether they had

received a prick to their finger. Thus, our department was chugging merrily

along....

....until one day, the unthinkable happened. Gynaecology was blessed by a

member of the nearly extinct species; The Sincere Intern! Satyendra was

actually not an irritating guy, if at least 25 feet and preferably a glass

wall in between separated you from him. Anything less, and the goose bumps

would be out. He had an adenoid, pinched facies with a nasal twang. He had

this cute habit of picking his nose while talking to you, well, cute

according to his mother, maybe. But the worst thing about him was his

sincerity.

No one minds a sincere fellow, if he does it inconspicuously without harming

any soul. But Satyendra's sincerity usually consisted of showing the

Professor how idiotic the others were. On his third day, he dropped the atom

bomb in our midst.

We were posted in our HOD's unit, I was the registrar, along with 2 house

officers and 3 interns. On the rounds, our HOD remarked that she had ordered

a repeat HB to be done yesterday for an anaemic patient, which seemed

strangely absent from the case paper. I turned towards the house officers,

who in turn gazed scowling at the interns. The HOD had just remarked that it

had better be done today and was nearly off to the next patient, when

Satyendra stepped self importantly forward and said in a loud voice, " But

the Haemoglobinometer is broken! "

There was a moment of stunned silence. The HOD, who had taken a step towards

the next patient, paused in mid air. My jaw dropped by a clear 5 cms. Both

my house officers clenched their fists. The other 2 interns gave just a

frightened look. If thoughts could kill, all of us would have been in jail,

except Satyendra, who would have been cremated.

" What? " asked the HOD, who was the first to recover from this silent

tableau. Sayendra self importantly cleared his throat and exclaimed, " Madam,

yesterday when I went to do the Hb of this patient, the ward sister told me

that she did not know where the Haemoglobinometer was. Then I searched for

it and found it under some old dusty files. It was in two pieces. "

" What? " exclaimed the HOD again. She seemed to have difficulty in

understanding anything today. Satyendra again cleared his throat and began,

" Madam, when I went to... "

" I know that! But under some dusty files....? Since when has this been

broken? "

My heart sank to my umbilical level. When I was an intern, about 1 1/2 years

ago, we had not been so lucky as to have a 'darshan' of this fantastic

device. Maybe in some past prehistoric days, some lucky person must have had

the blessed opportunity to put his lips to suck up the sliver of blood up

the intact tube. However, I don't think that anyone had been so fortunate in

the recent history.

Before anyone could so much as lick his lips in order to answer Madam's

question, Satyendra grasped the opportunity with alacrity. " Madam, the ward

sister does not know, but when she joined about two years ago, it was

broken. "

The human body sometimes acts so stupidly. I mean, at times of stress, why

does it think that it is necessary to dry out certain portion like the

tongue and oral cavity, and to wet others. Now before you get any ideas, I

meant the palms. All our bodies were wetting and drying at the above spots,

but meanwhile our brains were clicking frantically, groping for a plausible

answer to the next inevitable question. My brain, I must confess, had thrown

in the towel. It groaned inaudibly and threw up both its hands saying,

" Another fine mess you have got us in. " before shriveling up into its

favourite occipital corner.

Madam was dumb struck for a moment, as the perfidy of the situation struck

her. Then she fixed all of us with her piercing eyes and in her best

sarcastic tone, asked us, " And pray, how have all of you been doing the Hb

for so many days? "

I nudged my brain, but it just groaned and curled up in its corner. My jaw

remained in its unhitched position, and my tongue remained as dry as a

desert. Just then, my house officer, Anita, perked up, and in an

inspirational moment said, " Madam, Kishore Sir told us that we could use the

Paediatric Haemoglobinometer until ours was replaced. So we always used to

borrow their instrument for Hb. "

I prodded my brain and stammered, " Er... Yes! Because we didn't want the

patients to suffer, Madam. "

Madam then turned to Satyendra and said, " If you couldn't do the Hb, you

should have at least asked any of these people how to do it! " We then

continued the round, with a crest fallen Satyendra dragging behind.

~~~~~~~~~~~~~

That evening, all of us sat enjoying cold coffee at the Canteen. All of us

were laughing at our near escape. We all thanked Anita for her brilliant

brain wave. Just then, Arvind, my counterpart from Paediatrics was passing

by. I called him over and told him, " Today your department saved all of us

from a great disaster. "

He pulled a chair while we recollected all the juicy details. At the end of

it all Arvind clasped his forehead and remarked, " But our own

Haemoglobinometer was broken 6 months ago, and we told our HOD that we use

the Gynaecology intrument! "

~~~~~~~~~~~~~

Kishore Shah 1974