I slowly inject the anaesthetic through the needle I have just placed into the lower part of the woman’s spine. She is sitting on the edge of the operating table leaning forward into the arms of the large operating theatre sister who embraces her, holding her in a slightly hunched position to ease the insertion of the spinal needle. Did I say ease? It still took 10 minutes of sweating and stabbing on my part. I am the third person asked and I confess to succeeding not so much by skill as necessity – everyone else is stuck in Monday morning’s outpatients. The drugs flow easily and I remove the syringe and long spinal needle. We give her a couple of minutes and then the surgeon tells her to lie down. Dr Kekana has been on call all weekend and only had a couple of hours sleep last night. I even inadvertantly overheard her bed calling her.
I busy myself at the “head end” of table. I am, for want of a better term, the “anaesthetist”. I was called in at the last minute I forgot my book of drug doses. I hope nothing goes wrong. All the Caesarians here are done under spinal anaesthetic – none of us really know how to do safe general anaesthetics. But we have read the right chapter in the book. I try to look busy. Prepare a couple of drugs, copy a few blood pressures from the monitor screen to the chart in front of me.
Dr Kekana starts the operation. Sister says something to the mother-to-be who is staring at the ceiling, her view of her own lower half mercifully obscured by green drapes. She begins singing, lifting her voice in improbably gusty and melodic song. It is Zulu, but “Jesu” features prominently. She stops after one verse. A theatre nurse takes up the tune and after a breath mother joins in once again, this time in harmony. A male theatre assistant walks in with a box of swabs. As he walks across the theatre he adds a resonant deep bass line, filling in the beats after each line the women sing. Sister finally joins in, four voices echoing around the small theatre to the beat of the heat rate monitor’s beep and Dr Kekana’s softly muttered requests to her assistant. I have not been concentrating. The mother’s blood pressure has dropped, a side effect of the spinal anaesthetic. I give her some intravenous fluid and a small shot of a drug to help push it up again.
A new song has begun, this time in English. “I worship you Jesu,” the four voices sing. It appears almost to the beat of the music that the child is born from the mother’s belly, his mouth opening in a cry even before his body is fully out. The cord is cut. The child gives two more half-hearted cries and promptly falls asleep, covered in fluid and blood. The theatre nurse plucks the baby up, dries and swaddles him and brings him to the mother who breaks into a broad grin. She kisses him, a single tear trickling from one eye. The baby is taken to the heated cot as Dr Kekana starts to close the uterus and abdomen. It is a stark and welcome contrast to the Caesarian last week, in which the mother greeted her baby with a bleak look and a request for a tubal ligation.
Dr Kekana has finished and the mother is wheeled to recovery. She wearily writes her notes but, we both say, whether finishing an knackering weekend on call, or starting a Monday morning can there be many better ways than this?
I mean apart from still being in bed. Obviously.
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