One of our family’s finest Christmas experiences was in 1976, celebrated in Glasgow, Scotland.
I was finishing three months as a resident at the Queen Mother’s Hospital, an obstetrical, teaching hospital. On Christmas morning, all the families of patients came in as did all the residents and professors. With the families came portions of their favorite grog – protection against bitter winters?
It was a brief respite from days and nights in labor and delivery, the operating rooms and the flying squads responding to the homes of women in distress. A very small number of pregnancies are ticking time-bombs. The centuries-old question has always been: which ones?
A few years later, my Glasgow experience proved of value in a small, remote town (winter, 1,400 souls) in Alaska – a summer job working for a solo practitioner. Stan had a 38-foot gill-netter and a commercial fishing license. When he fished, I tended the clinic.
Several nights after arriving, Stan phoned to invite me to observe a “routine” delivery to see how things were done. The setting was over 100 air-miles from the nearest hospital, no road, frequent overcasts, 6,000-foot mountains dropping abruptly to salt water, no navigation aids and sufficiently northern for compasses to be useless.
After an easy delivery, we awaited the third stage of labor, delivery of the placenta. With no progress, Stan re-examined. His brow began to furrow and beads of sweat appeared. At his request, I gowned up and quickly recognized no discernible plane between placenta and uterine wall – a retained placenta. In severe cases, a hysterectomy may be necessary. We decided to await daylight to fly her out.
An hour later, heavy bleeding began. While Stan awoke the local flying service’s owner, I added two more IVs. Stan saw the woman straight to the operating room in Juneau. There, she was transfused (eight units), and, next morning, flown to Anchorage. A week later, she reappeared at the clinic, pink, smiling with happiness, holding her babe.
Because a veterinarian flew in only once a month on a weekend, we kept most of the biologicals (shots) for pets. Also, folks occasionally brought us sick animals, but for me examining a Great Dane with a facial swelling was an unfamiliar role. I couldn’t ignore the dog’s owner; she was pregnant and big. Encountering her a week later, I learned that the dog, on antibiotics, was better. Still, I was perplexed. She was near or at term, and I had not seen her at the clinic.
She had had no prenatal care and was in labor a week later. The fetal head was well down (engaged) in the pelvis and fetal heart sounds were somewhat high. Hmm? The result was a healthy 5-pounder. There remained an irregular form in the abdomen – a twin! Delivery ensued as did heavy bleeding. The twin was pale with shallow breathing. Uh, oh, double trouble.
In walked Stan in knee-high rubber boots, just off the boat. After a half-dozen mouth-to-mouth breaths, the babe pinked up and got right while I attended the bleeding. All did well, except Stan – in 17 years, he’d never had twins.
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.