On Call All Saints Day

According to history - Halloween began as All-Hallows-Eve, the night before All Saints Day. November 1st was reserved to celebrate the Saints of the church, followed by All Souls Day on November 2nd which celebrated all departed souls.

As such, previously unknown to me, the day with the powerful spiritual Mojo is actually not Halloween, but rather the day after, when all the spirits are said to rejoin the living world. If I had known this fact previously, I would have switched my on call day. The spirits were out, and they were urging people to go to the hospital. Here was the day:

NOVEMBER 1st
6:30AM - We receive call from the overnight team - 2 deliveries, but otherwise quiet during the night of Halloween.

6:30AM-7:30AM - Tranquil - able to check email, have a bit of breakfast. We check on the post-partum patients, go over notes from last night. Being a holiday, we are looking forward to an easy day - Whoops!

7:30AM - a few follow up patients, a 6 year old boy who has pain when swallowing, but, oddly, no fever. His physical exam revealed enlarged tonsils with pus, large lymph nodes, and still no fever - after more questioning, we found out that he was given only 1 injection of Penicillin 4 days prior by a private doctor - we decided it was best to continue treatment for strep throat.

Next a 12month old who 3 days ago, fell while walking and ended up with swelling around the right eye. The parents decided to spend the 150 Quetzals - 18$ to get an X-Ray of the head / face. Here, one must pay for imaging - if they didn't have the money, they would either forgo imaging or be forced to travel 1 hour to the public hospital in the city. As it turned out, the X-Rays did not show a fracture, and the 12 month old looked great - Pretty easy so far.

8:00AM - Our first challenge - a woman in labor - 5 centimeters dilated. We palpated the stomach, did an internal exam to determine stage of labor, if the babies head was correctly positioned down. These maneuvers are not always easy - but, without access to an Ultrasound, you do the best you can.

8:30AM-10:00AM - Other patients are steadily coming in - not overwhelming, but not the easy day I had envisioned

10:30AM - Somehow, in only 2.5 hours, our pregnant ladies cervix dilated to the full 10 cm - she was ready to have her baby.

11:00AM - A 6lb baby boy enters the world - with hand over his face while coming out, as if saying "NO, put me back in". Luckily I performed my primary responsibility well - I did not drop the baby.

11:30AM - We finish with mom and baby - they are wheeled to our post partum ward. However, we look over at our waiting bench - and it is full

11:30AM - 3:00PM - A flurry of patients, emergencies. A boy with the largest leg infection I have ever seen (he received a cut from a bike pedal 20 days prior, was not given the correct antibiotic by a local doctor), another man whose hand was so swollen by infection he could not use it. A woman wit severe dehydration who needed IV fluid, a boy with developmental delays who had fallen, another woman in Labor whose baby was actually positioned the wrong way - transverse in her belly. All this along with other, more typical cases of cold, flu, prenatal care.

3:30PM - A lul - this could be it - Just need to check on the 4 people in our post partum ward, then we can sit

5:00PM - Lunch

5:15PM - Almost simultaneously, two more women in labor - for one it is her 7th baby (she is 32) and the other - her 11th baby (she is 38). They are both dilated to 5 cm - meaning that they could both give birth at the same time.

6:00PM-11:00PM - more patients - a finger fracture, more kids with colds. Our dehydrated lady finally looks better after 2 liters of IV fluid (after about 10 tries to find a usable vein). But, our labor ladies are now 7 and 8 centimeters.

12:30AM- I fall asleep on one of the observation beds - close enough so I can hear when they wheel our ladies to the delivery room

1:30AM - Our lady gives birth to her 11th child

2:00AM - Our other lady is not progressing through labor - she is still dilated to only 8cm. We check on our 4 post partum ladies again - every 6 hours. They are not happy for the 2AM wake up call.

3:30AM - I once again pass out on the observation beds.

5:00AM - Our lady continues to not be ready to give birth, still under 10 cm. Now we are thinking of sending her to the city hospital.

5:30AM - we need to check on our 4 post partum ladies one more time, before transferring to the next team

6:30AM - THE NEXT DAY - We hand off - and I promptly go to be for 4 hours before afternoon class.

What a day.