Pregnant? The patient's guide to parenting.

How did it come to be that every time I mention I'm not feeling well, the knee-jerk reaction from friends and colleagues is that I MUST be "with child"?

Is it not a perfectly normal reaction to throw up a little bit in my mouth after I've witnessed runny mustard poo leaking down my patient's leg?

Is it not a perfectly normal physiological response to want to up-chuck the contents of my intestines after examining a most foul-smelling macerated cess-pool of pus that used to be a scrotum before Fournier's Gangrene got hold of it? (Scrot-rot - in layman's terms)

Apparently, according to the four ovary-less-hairy-testicled type of doctors I worked with yesterday morning, it is a clear indication of impending mommy-hood.

Yesterday, the day of constant nausea, I also had my blood drawn for HIV testing as I've now finished my course of ARV's. Happy to report, the test was negative.

YAY!

No more condoms necessary during sex with my long-suffering husband!

Yet, my aforementioned male colleagues were more interested in my obvious pregnancy.
Mastermind MB, of course, used my HIV testing as an opportunity to phone the lab and request a quantitative beta-HCG (formal pregnancy test) on my blood...just to make sure...soooooo funny.

But it got me thinking...

What if I WAS pregnant? I don't know anything about being a parent!

But then I rememembered...

Just take lessons from your patients Dr S!

Over the last two shifts these are the parenting lessons I've picked up:

1: When your twelve year old son gets thrown over a fence by some bigger boys, and tears open his scrotum on the barbed wire, bring him in to the hospital at night, and then leave him there all alone.
Let him open up a folder by himself.
Let him suffer the pain of having his ballsack sewn closed by himself.
Do not leave your cellphone number for the doctors to call you when he is repaired. Tell him to walk home, in the dark, through the most notorious ganglands in Cape Town, by himself.
He is a whole twelve years old after all.

(We ultimately called the police to take him home)



2:When your seventeen year old son's eighteenth birthday rolls around,just before matric final exams, do not remember it.
When he reminds you that it is his birthday, tell him you don't care.
When he asks you if he is not important to you, agree that he isn't.
When he tells you that he might as well then kill himself, encourage him to do it.
When he overdoses on 50mg of benzodiazepines in a desperate attempt for your love and is rushed in to the casualty unit by the paramedics, show him he is indeed not worthy of your love by not visiting him.

(He survived,thank heavens)


3: Drive like an asshole and hit a twelve year old child. Don't bother stopping, even though the kid has flown halfway across the street and is lying on the road motionless. Oh no, what one does in this situation is put your foot on the accelerator and drive away as fast as possible, leaving the helpless child for dead.

(The paramedics who brought him in to be intubated on his way to the children's hospital told us that in a fantastic intervention by karma - the car's licence plate had been left on scene!)

I'm writing all of these lessons in my little book of things to do when I get pregnant.

(Which I'm not. Test turned out to be negative.)

Fact: An abortion is not the same as a pregnancy

The last twenty minutes of the trauma shift are nerve-wracking for me.

I've usually managed to sort out most of the emergencies by then , and am just waiting for the next doctor to arrive. I'm on edge in those last twenty minutes because without fail, always, always, always, some crazy emergency comes rolling through the door. This ensures that I will be tied up dealing with it way past gong-home time.


Like this morning. At 06h40...


Uncle of patient comes into trauma unit, says that Niece had an abortion in January, and now is complaining of tummy pains. "Did the patient have the abortion in our clinic?" we ask. Uncle says yes, and that she just has some tummy cramps that have been going on for a month.

Clearly not an acute emergency.

Niece gets sent to the line to wait for the doctors in the consulting rooms.

Uncle comes back to unit 5 minutes later, saying that the patient is now having a baby.

Confusion reigns.

We insist that Uncle brings Niece into the unit for examination.

Niece is clinically 8 months pregnant, in fully fledged labour with a fetal head crowning between her legs.

Niece is adamant that the tablets she was given for the abortion in January have only started working now in June.

*this is what's known as - "a lie"*


Doctor S and nurses rush the patient on a stretcher through the hospital to the Midwives Obstetric Unit next door, as we do not have the correct instruments for delivering babies in the trauma unit.

Niece "aborts" a full term healthy baby girl. Congratulations Niece!

The whole truth is that Niece wanted a second trimester abortion in January and was referred to a secondary hospital for the procedure. Our hospital only does first trimester abortions.
Niece never went, but still believed that the abortion would happen, somehow.
Niece was in denial for 9 months. Niece thought she could "believe" the baby away.

Niece did not know the difference between an abortion and a pregnancy.

This was not Niece's first pregnancy.

Niece had already been through two pregancies.

The power of denial is mind-blowing.

Doctor S only left her trauma shift at 07h40.