Friday, March 22, 2013

Obgyn Banjarnegara

Tomorrow will be my last day here in Banjarnegara. Been having my clinical rotation here often, and this last one—obgyn is the most satisfying one. The reason being, the midwives are friendly and selfless, the specialist are humble and willing to teach, the akbid (student who studying to be midwives) won’t fight with you. One thing about studying here, you are given plenty of chances, to do anything you are capable of doing. Except IUD insertion (which became very rare), I did almost everything that is of my competency or beyond my competency. And for that, I am satisfied, and thank God I am given such opportunities.

The first time I see a woman giving birth, it was so shockingly scary. The whole perineum is like going to burst in a second. And then this head popped out, followed by the shoulder and the body. Amazing to see that satisfied wrote all over the mothers faces. All the crying and shouting, pain and suffering suddenly seems like nothing to them. I can even suture their perineum without pain killer because they are too concentrating in looking at their babies. (okay, without lidocaine only for the minor tears). I certainly can’t imagine how my mother looks like when I was born, especially when I am my mother’s first child, which means more pain and suffering.

Everything seems so difficult at first. To diagnose, to know which is normal which is not, to know what are the next steps to do, to help in delivering a newborn. Obgyn is like separate territory that I fear to step in, especially with the mothers yell and cry. They are like female tigers to me. After four weeks here and with the guidance of my beloved residents and midwives, I finally manage to help in a delivery confidently. More, i even did curettage, vacuum (only helping to pull actually), episiotomy etc etc. And i am not even asked to mop the floor or clean the gloves. We are considered like one of their colleague, actually a member of this maternal ward.

Thanks to the people here. Xie xie! I am glad.

Pigeon Holes, literally.

Sometimes i just don't understand why they must use a small wok to cook fried rice, when they have super a lot of customers.

ByeBye RSUD Banjarnegara

Wednesday, March 20, 2013

The Newborn

I carefully unfold the sterile linen and spread half across my shoulder, another half covered my arms, waiting for the baby. This is the first time I was asked to carry a newborn. During cesarean section, I was always the one assisting, doing suction and the lame job, but this time, since the perinatal staffs were on their way, I took over their job. The next thing I know, the doctor passed the baby right into my arms, and I carried it across the sterile room into another room for resuscitation. And he was moving, like really moving. God. But there was something wrong with the baby.

Atresia Ani, with various malformations in the extremities, the newborn did not cry at all. The anesthesia staff inserted endotracheal tube into his throat, trying to clear the airway, and did bagging, trying to make the baby continue breathing. I stood at one side, hoping the baby made it. The family members were called in to see their baby, and the grandmother cried instantly. Oh my… I almost lose my tears. The cry was so…. Sad.

The intubation did not succeed. It formed emphysema subcutis around the neck, and the baby neck grow bigger and bigger. There is no other way to help the baby except resuscitation, and even resuscitation made damage. I put on a glove, and took over the CPR. Such a small newborn, I don’t think he had a name yet. And I don’t even know whether I should called him a he, because his genital organ was ambiguous. Before long, he lossed his pulse, and his pupil enlarged. He was pronounced death.

Half an hour ago, he was still moving, in my arms.