all in a day’s work

April 22, 2008

i scrubbed into theatre today for a total abdominal hysterectomy that i wanted to watch. it was 2 hours long! i got a little bored halfway through because i couldn’t really see what was going on from where i was standing, just bits of bowel and fatty tissue here and there and of course the resected uterus, fallopian tubes and ovaries. we cut open the resected uterus to look at its cross-section, and there was a white mass growing into the uterine wall (this lady had endometrial cancer).

+ as you can it’s not really grey’s anatomy-esque… save for the green surgical drapes, and scrubs that we all have to don. there is no drama in a hysterectomy, at least. although at one point the anaesthetist instructed the nurse to take the patient’s temperature during surgery and the nurse said “there isn’t a reading”, to which the anaesthetist jokingly said “nothing? she must be dead then!” and i sort of laughed – not at the remark per se but at the way he said it so mockingly (which, in that situation, was extremely inappropriate of course- i need to stop laughing at the slightest things.)

also i went for ant3natal clinic this AM, and the doctor was absolutely beyond himself- i was not impressed. it’s a long story but if anyone is interested, here goes:

so we normally screen for D0wn’s syndrome (DS) at 12-14 weeks into the pregnancy in the form of an ultrasound test where the thickness of the baby’s neck (ie. nuchal translucency) can be measured… this helps us to give a risk estimate of the couple having a baby with DS. if the risk is found to be more than 1 in 300, a more invasive but definitive diagnostic test is offered- it is called amniocentesis and it carries a 1 in 200 risk of miscarriage or damage to the foetus

what really irked me was that this particular doctor not only spoke in riddles, but also tried to dissuade his patients from having the DS screening test. this is exactly what he said:

“would you have the test so that you will terminate the pregnancy in case of a bad outcome, or would you rather NOT have the test, so that you won’t have to terminate the pregnancy because you don’t know the outcome?”

i had to listen to that spiel 5 times over and it was not funny! if a woman insisted on having the test, he would retort with “so are you saying that if your baby was found to have D0wn’s, you would terminate the pregnancy? because it’s no good screening for DS if you’re not going to terminate it, you know.”

i was horrified that he seemed to keep harping on abortion, as though it was the sole option he could offer the parents…whatever happened to being objective and showing empathy? so what if the parents know that their child may have D0wn’s- it doesn’t mean that they will love it any less and it certainly doesn’t mean that foetuses who have D0wn’s should not be given a chance at life. i don’t think he was being fair to parents who have kids with D0wn’s…in fact he was being so rude and overbearing at one point in time that i felt like punching him at the back of his head (of course i couldn’t since i don’t reckon my indemnity insurance will cover me for that) .

having a baby IS and should be a lovely thing but he was totally killing the joyous mood and frightening patients unnecessarily with that cloud of DS and termination (emotional blackmail i might add). it is true that DS screening is contentious but i feel that couples should be given the choice and doctors need to be non-judgemental, irrespective of the parents’ wishes. my take is that all children are a gift from God and are precious and special, no matter what. well, thankfully clinic ended ridiculously early (he had to attend a meeting), and i desperately wanted to high-five someone out of sheer relief.

ps.sorry for the long medical discourse, i got carried away by frustration. usually i very much enjoy clinics, but this one was a nightmare! arGH

pps. kairui also wrote a post on Down’s Syndrome and one of the comments was from a mother with a kid who has Down’s, you might like to read it

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