Within just the past week of observing at Santhiram, not only have I seen outpatient (OP) of general medicine but I have also seen a C-section delivery of twins (the ~lame~ reason why the title says “lively”).
The general medicine department in Santhiram is set up so that patients register and sit in the waiting room that’s right outside of the office. Each patient is then called into the office one by one. Inside the office, there are one or two doctors along with up to four PG students and a few interns. Each of the doctors and PG students sees a patient so there are often five patients in the room at a given time. There are so many patients who come in to see a doctor that over seventy patients were seen every day during my time in general medicine.
This is the general medicine OP room, where patients’ histories are taken and relevant diagnoses and referrals are given.
Patients are taken back into this more private area to conduct further tests for diagnoses.
These patients are often very ill. One patient was sitting next to me with her head on the table and her hand against her stomach because she was barely even able to get herself to see the doctor. And, some patients wait a day or two until they feel a little better before visiting the doctor. Although consultations for general medicine are free in Santhiram, patients still have to pay for investigations, such as blood tests and X-rays. Some patients opt not to do the tests because they either don’t have the money or don’t want to spend their money on tests so determining the exact cause of illnesses can be difficult.
Most patients have symptoms that are consequences of very poorly managed diabetes and hypertension. And, many patients come in with a headache or fever because they have viral or bacterial infections, such as Typhoid or Dengue fever. I even saw a patient who was stung by a scorpion on her finger while she was working in the fields. She was injected with lidocaine on both sides of her finger to relieve her pain, and she was kept in casualty for observation to see if she develops any concerning symptoms that would require further treatment.
“Do you want to watch a cesarean section of twins?” the doctor asked.
“What? Really? Yes.” I said instantly but also slightly confused because I was not observing in the OB/GYN department that day.
She took me to the operating theater that’s on the second floor of the hospital and told me to wear a gown, face mask, hair mask, and slippers. As I entered the operation theater, I began hearing some well-selected Indian movie music, and instantly, I was excited for this surgery to begin. Fifteen minutes later, I was watching tensely as the doctor was making incisions on the patient’s abdominal wall and uterus, and she started pulling the babies out one by one — both were boys. The newborns were then shown to and felt by the mother for a few seconds, and they were taken to a different room by nurses. I have never seen the birth of children before so it was so striking that there were now two babies who just entered this world. I almost felt protective of them. Now, I clearly understood why the doctor was saying that she loved her job despite night shifts and emergency cases.
After the operation, I immediately went back to the general medicine department to continue observing, but I kept thinking for a few minutes about the surgery that I had just watched.
While observing at Santhiram, I have also been working on writing a small book on how a support center for women and children in Hyderabad was established. I will write another blog on just this topic because there is so much I want to share with you about this center and the stories that led to its establishment. Be on the look out for another blog next week!