The year was 2018. I was a brand-spanking new community service doctor, just released from the clutches of internship. Man, was I proud of myself.
Not only did I survive being an intern doctor for 2 whole years, I didn’t have to be institutionalized, not even once.
I was as sane as sane could be, ready to tackle the new year and face any challenges head-on. I wore my best nikey takkie and my brand new scrub top and headed off to the rural clinic I was placed at. I was confident, ready and energetic. Id go as far as saying I was a little bit excited.
As I walked in, I bypassed an ambulance which I didn’t think much of. Afterall there were probably numerous patients being moved to-and-fro the clinic. I smiled at the paramedic and gave him a small wave. He looked pissed off. I was about to find out why. (bad sign number 1).
I walked in and greeted everyone, trying to introduce myself. The nurses were obviously busy and involved in some sort of dilemma. I followed a nurse who seemed to be running. (the 2nd bad sign).I walked into a small room the width of 7 tiles. I saw multiple nurses and paramedics hovering around a lady who was obviously pregnant.
Through the absolute mayhem which I observed for 10 full seconds, I didn’t hear the lady complain once (3rd bad sign). I cleared my throat, ‘hi guys im doctor moosa-the new community service doctor), I said in my most professional voice.
“SISI, LINDA’NGIPHANDLE, NDI BUSY!!!” one of the nurses screamed without hearing my sqeaky introduction. i ignored the command and stepped closer to the patient. I tried again.“what happened?” I asked forcefully now. “im the new doctor” I said a bit louder.“WENA?Lo ngane? EPI’LO STETOSCOPE HEH?”
I whipped my stetoscope out my bag, waiting for approval. I scanned the room and the patient.I found the following:
1. Absolute chaos.
2. A pregnant female with a very high blood pressure and decreasing oxygenation with no face mask oxygen. A GCS of about 9 (very worrying). Eclamptic preganant female with pulmonary edema ?
3. people trying to secure an IV access.
4. One paramedic drinking an eno (stress gastritis)
5. No team leader in an apparent resuscitation.I reasoned with myself, if I didn’t step up, this lady and her baby could die and me being the doctor, id be responsible.I felt my bladder distend.
I screamed as loud as I could.”STOP!”
Everyone stopped.I assumed my position at the head of the lady in silence. I did a quick examination.‘PREPARE FOR INTUBATION please’
I called out loudly.
Everyone looked surprised.‘NOW, PLEASE. NOW NOW NOW’ I tried to raise my voice higher.
I was scared shitless. My very first day of community service. My very first hour of being a community service doctor. My own resuscitation. Why is this happening today? I thought back of the past 2 years when every senior medical officer would use the community service talk as ammunition, and I cursed them because they were right.
“ya moosa when you’re in comm serve we will see what will happen..”
“in comm serve theres no one but you.. we will see who will give you advice”
“handle the emergencies on your own now, you’re alone in community service”’
“you failing at a simple IV line, who is going to help you during comm serve?”
Truthfully, I was scared out of my mind. The art of intubation was a frightening one. What if I failed? What if i cant find the cords? What if the patient dies? What if I cant get the tube in? What will the nurses think of me? A failure? A bad doctor? A useless doctor?
All of these doubts creeped into my mind. Without any other doctor beside me, I had no choice but to succeeed. No one would help me. No one would try for me. No one would save me. Im responsible for this life and the life she carries.
I almost fainted. Lucky my adrenals pumped more than enough adrenaline to keep me standing. My stomach churned. My armpits were on fire.
I checked my equipment as confidently as I could. I could feel the sweat dripping into my ears deafening the outside noise. I could feel the pressure around me and within me. My heart throbbed.
Lub-dub lub-dub lub-dub..
I positioned the patients head and neck and slipped the metal blade of the laryngoscope into the throat and began my quest to find the cords. I saw the epiglottis and did some maneuvering. Nothing. No cords in sight.
SH*T.I looked again. And again. And again.
Hello vocal cords.I pushed the tube in, and BOOM. A flood erupted into my face.
Hello pulmonary edema.
I was so relieved. I didn’t care that my glasses had mucous and water on it.I did the needful and secured the tube. The paramedic offered me an eno. I politely accepted.I watched them exit the gate, and I felt a wave of relief.
This is the first time I had really felt like a doctor, and it showed.