Chapter 132 Shadows and scalpel
Chapter 132: Shadows and Scalpel
Linda Miller came out of the shadows with a complicated look on her face. She looked at the videos and pictures on her phone and then she put the phone in her bag and walked away.
She had been invited for Trey's party by one of his friends. Initially, she didn't think she would attend the party but after what she witnessed today, she decided to attend.
Northbridge...
Golden was on rotation in the obstetrics and gynecology unit. She had been in this unit for the last two weeks and was ending the rotation today.
Unlike in her first year where students observed surgeries from the observation gallery, they were allowed in the operating room.
Golden and other students stood behind the observation line in the theater so as not to obstruct the sugery going on.
They were far enough to give a respectable distance, but close enough to see what was happening on the operating table.
The operating theatre hummed quietly with activity. A nurse adjusted the IV line while another arranged surgical clamps on a steel tray.
The heart monitor echoed steadily across the room.
Beep… beep… beep…
Golden folded her hands tightly behind her back, forcing herself to remain calm. They were all dressed in theatre gowns, gloves, and nose masks to remain sterile.
This was no longer a classroom lecture. This was someone’s life on the table.
The patient lay on the operating table, draped in sterile sheets as the obstetric team carefully began the Caesarean section.
Professor Harding, the supervising consultant, glanced briefly at the students watching.
“Alright, future doctors,” he said calmly. “Since you are observing your first complicated Caesarean section, let’s see how much you’ve been paying attention.”
The students straightened immediately, their masks hiding their nervousness.
“At how many weeks is a pregnancy considered full term?” Professor Harding asked.
One of the students answered quickly.
“Thirty-seven to forty weeks, Professor.”
“Correct,” Professor Harding nodded. “And our patient today?”
Golden spoke this time. “She is thirty weeks pregnant, Professor. That makes this a preterm delivery.”
“Exactly.” He gestured toward the surgical field where the obstetrician carefully maneuvered around the uterus.
“Now, can anyone tell me why a Caesarean section might be necessary in a patient with uterine fibroids?”
A tall student beside Golden raised his hand. “Fibroids can obstruct the birth canal or distort the uterus, which can make vaginal delivery dangerous.”
“Very good,” the professor replied. He was impressed with the students. They had been paying attention during their lectures and it was now evident in the theatre.
Another student added thoughtfully,
“they can also cause complications like severe bleeding during labour.”
Professor Harding nodded approvingly.
“Yes. Fibroids can increase the risk of hemorrhage and may interfere with uterine contractions. In cases like this, a Caesarean section is often the safer option.”
The professor turned slightly so the students could see better.
“Now observe carefully,” he said. “What layer of tissue is being incised right now?”
Golden leaned forward slightly.
“The uterine wall, Professor.”
“And before that?” he asked.
A student near the back answered.
“The abdominal wall and the uterus after opening the peritoneal cavity.”
“Good. A Caesarean section involves several layers: skin, subcutaneous tissue, fascia, peritoneum, and then the uterus.”
At that moment the surgeon gently lifted the baby from the uterus.
A small cry filled the operating room.
Several students instinctively leaned forward.
Professor Harding smiled faintly behind his mask. “And that, ladies and gentlemen,” he said, “is why we do what we do.”
Golden felt a warm current in her heart as she watched the little baby scream from her lungs.
The newborn was quickly handed to the pediatric team. The professor turned back to the students.
“Next question. Why must babies delivered at thirty weeks receive immediate neonatal assessment?”
“Because they are premature, Professor. Their lungs and other organs may not be fully developed.” Golden answered.
“Precisely. Preterm infants are at risk of respiratory distress, temperature instability, and infection.
Which is why obstetrics never works alone. It works with neonatology, pediatrics, and many other specialties.” Professor Harding said, folding his arms calmly.
Golden watched the pediatric team carefully examine the baby. She wondered at the amazement of the process of bringing a child into the world.
While the pediatrics team worked on the baby, the atmosphere in the theater suddenly changed.
The heart rate monitor began to blare. The blood pressure of the patient had begun to drop hence the triggering of the alarm.
Professor Harding frowned slightly. “Hmm… suction.” The assisting nurse immediately responded.
Professor Harding looked toward the students again. Every situation in the theater was a teachable moment.
“Alright class, quick question. Why might fibroids increase the risk of bleeding during a Caesarean section?”
A student answered nervously.“Because fibroids are highly vascular, Professor.”
“Correct,” Professor Harding said.
Another student added, “and they can prevent the uterus from contracting properly after delivery.”
“Good. And what do we call that condition?”
There was a brief pause. Everyone tried to remember what they had studied.
Golden spoke calmly.“Uterine atony, Professor.”
Professor Harding nodded.“Exactly.”
At that exact moment, the suction machine grew louder as dark blood pooled into the canister.
The professor's voice became sharper.
“We’re bleeding more than expected.”
The students stiffened behind the observation line. So many thoughts running through their minds. Would the patient be okay? Would she make it?
“Uterine tone is poor,” Professor Harding glanced at the students again.
“Alright. Let’s think clinically.”
He pointed toward the surgical field.
“If the uterus fails to contract after delivery, what is our immediate concern?”
Several students answered at once. “Postpartum hemorrhage.”
“Correct.”
Golden’s eyes remained fixed on the surgical field. Something didn't feel right and she was trying hard to place a finger on it.
The surgeon was working carefully around a large fibroid embedded near the uterine wall.
Professor Harding continued.
“What medications are typically administered to stimulate uterine contraction?”
A student answered, “Oxytocin, Professor.”
“Good.” Professor Harding nodded as he continued what he was doing.
“Sometimes misoprostol or ergometrine.” Another student added.
“Excellent. You lot are really impressive today.”
Suddenly one of the surgeons spoke again. “Blood pressure is dropping slightly.”
The anesthetist adjusted the IV line, trying to stabilize the patient.
Golden who had been studying the surgical area carefully finally had a eureka moment. She raised her voice slightly.
“Professor?”
Professor Harding turned to her.“Yes, Miss…?”
“Golden Nixon.”
“Yes, Miss Nixon.”
Golden pointed toward the monitor showing the surgical view. “The fibroid appears to be interfering with the uterine muscle contraction around that section.”