Fresh Stillbirth

Everytime I start work after a long break, I know there will always be something eventful awaiting for me. And today was not exceptional.

While, like usual, as I was busy managing my Empires and Allies clinic, my nurse called for me saying there was a patient who came in complaining of lower abdominal pain and some funny sensation of things coming out from her vagina. Reluctantly I had to leave my serious business and attend to the patient.

So, there was this obese lady lying on the bed, groaning in pain, while my nurses stood around her awaiting further instructions from me. 

Me: Puan, kenapa ni?

Patient: Saya perut sakit sudah 1 hari... Sekarang rasa macam ada benda nak keluar dari bawah.

Me: Hmm... Ya ke? Berapa lama tak datang kotor?

Patient: 2 bulan lebih.

Me: Betul ke? (Presses tummy) Perut sakit kuat ke?

Patient: Tak kuat sangat... tapi macam rasa ada benda nak keluar daripada bawah.

Me: (turn around to my nurses) Staff Nurse tolong sediakan trolley ngan VE set. Nak buat speculum dan vaginal examination.

Well, after 5 minutes of buzzing around in the clinic like headless chickens, my nurses managed to get me what I wanted. And when the nurses stripped the patient's pants off, the imminent sight just confirmed what I suspected. There were blood stains all over this perineum and inner thighs.

Me: (turning towards the nurses) Pergi ambik itu Doppler dan check fetal heart rate. Tolak US scan mesin ke sini juga.

Nurses 1, 2 and 3: Aye. (Screeching away efficiently)

Me: (turning towards the patient) Cakap betul-betul. Berapa bulan dah tak datang kotor? Ini bukan 2 bulan. Saya rasa sekurang-kurangnya 4 bulan. You ada tak cuba nak gugurkan anak?

Patient: (Still in shock) Doktor saya betul-betul tak tau saya mengandung.

Me: Ok tak apa. Dapatke fetal heart?

Nurse 1: Takde lah boss.

Nurse 2: US machine dah sedia boss.

Me: (Holding the US probe and scans up and down): I nampak baby tapi jantung baby macam tak ada. Tak apa, kita buat VE sekarang.

As I gloved up my hands and start digging, I felt something... soft... and bulging... And I summoned my midwife nurse.

Me: I rasa os dia dah full... dan rasa benda... macam kepala macam membran... dah lama tak buat benda ni dah...

Nurse 3: Tak apa... saya check... (And she stuck her gloved up fingers in) Betul-lah, itu membrane!

Me: Ok. Prepare transport patient ke Hospital Kuala Pilah. Set line bagi IV drip.

So as I was busy discussing the case outside the room with Hospital Kuala Pilah's O&G team, I heard a commotion from the room itself.

Nurse 1: Doktor, cepat!

Me: (gasping in my heart) Ok... Apa jadi?

Nurse 1: Doktor mari tengok!

And the entire gestational sac splurted out onto the bed, with no fetal signs of life. It was a fresh stillbirth.

Me: Puan, baby dah keluar tapi tak dapat diselamatkan dah...

(And she burst into tears and wept)

Me: Staff nurse... treat as post delivery... dan hantar ke Kuala Pilah once ambulans dah sampai.

Nurses 1, 2 and 3: Ok Boss. Doktor ni jonah lah... setiap kali mula kerja mesti ada kes pelik.

Me: -.-" 

I guess I had better start visiting door-to-door to check for any unbooked pregnancies then.