I was rounding with a doctor when we were diverted to an emergency. A woman had delivered and was hemorrhaging. Her baby was not breathing and did not respond to resuscitation. The woman was my age but her dark skin concealed any signs of aging. She was experiencing a lot of pain for which no medication was given. It took all my strength to hold her during a torturous examination by the obstetrician to find the source of the bleed. Thankfully her uterus was contracting, however the doctor was forcefully palpating it to further stimulate the contraction which was causing her to lose more blood. She was shivering and her eyes grew white. The doctor left another student and I to massage her uterus. The woman fought us due to the pain. I kept holding her, trying to explain why we were doing what we were doing.
We felt abandoned. The doctor had to round on another eighty patients that morning and was not coming back. The interns in the room were not being very proactive. I kept talking to the woman, cleaning her and trying to keep her warm. It was the least I could do for a woman who was bleeding to death who had just lost her baby. We checked her blood pressure, started her on fluids, and most importantly politely asked the interns about her treatment plan. One intern went to find blood but returned from the blood bank empty handed. “Blood will not be available for another 10 hours” the intern casually said.
This did not seem to faze anyone else but the other student and I. The patient did not have ten hours to wait. Her complete blood count results came back with a platelet count almost ten times less than normal. This woman needed platelets quickly. She was continuing to lose a lot of blood. The urgency and fear in our faces grabbed a doctor’s attention to which we highlighted her thrombocytopenia. The doctor then told an intern to find platelets and not to return without them. He returned with two bags of frozen platelets. It took another half an hour to get warm water to defrost them until the woman was finally transfused platelets. After two bags she was still bleeding heavily. Another two bags of platelets were found, defrosted and given to her.
I could not decipher this woman’s full story- when her labor started or why her baby died. The last I saw of her baby, it was wrapped in a blanket being taken to the mortuary. Her file had been temporarily misplaced. She was in and out of consciousness. At times she would murmur that she did not want us to help and would not care if she would die. Her mouth was dry. I could not find anything in her belongings to drink so I broke the golden rule and bought her food and drink with my own money. If I was going to break the rule, this woman was surely worth it. I put the straw to the mango juice in her mouth and she drank. She opened her eyes and said thank you.
The trouble is that so many patients are hungry, thirsty and in need of something. Women in labor ask for something to drink all the time and unless they have something with them they cannot get anything. Four hours from the onset of her bleeding, the woman finally started to clot. It would take another eight hours for her to become stable. By the next day she was talking and eating the food prepared by her husband. I left her curled up on the bed under the small blankets that she intended for her baby. Instead she’ll take them home, blood soaked and empty.