It was another long night duty in the Department of Gynaecology and Obstetrics. I have an abundance of enthusiasm for this subject. But, it was brought down considerably, when I was asked to take Ms.R for a Pre-anaesthetic Consultation(PAC). A PAC is done to evaluate if a patient is fit for administering anesthesia for his/her subsequent surgery. So, why did Ms.R need a PAC?
Ms.R is 22 years old. The same age as I am(rather was, a month ago). She is this polite girl who has a nice smile. She is petite and pretty, yet has none of the fears of a patient who has to undergo surgery. Why surgery?
I had her case-sheet in my hand. I was not there when she got admitted so, I had no clue what she needed surgery for. One look at her, I thought it must be a simple D&C that they do for miscarriages. I learnt that she was unmarried only as I began reading her history. This irked me. What can an unmarried, 22 year old woman suffer from that would need a PAC?
The diagnosis shook me. It was not supposed to. It removed the smile off my face I usually have when I talk to patients(entusiastic about Ob-Gyn, remember?). She has a large fibromyoma in her uterus which is causing her a lot of pain and bleeding during menstruation. This is not really an earth-shattering diagnosis. So, why this surgery?
The fibromyoma, commonly called as a fibroid is a fibromuscular growth in the walls of a uterus. It is almost always benign, but can grow to monstrous sizes as Ms.R’s has. The thing that is even more disturbing is that, the growth is so big that if the surgery that is needed for its removal may not achieve the goal and she may have to have her uterus removed with it, as well. This is the surgery. A Myomectomy(removal of the fibromyoma) which can potentially turn into a TAH(Trans-Abdominal Hysterectomy – removal of the uterus).
I look at Ms.R again. She has already been explained the procedure that can probably rob her of the chance of having children. This really disturbs me. Imagine a girl, at the verge of turning into a woman, not being able to become a mother because something which is usually benign has turned malicious. Deep down, every woman longs to be a mother. Especially, where according to the Indian culture, no woman is considered “complete” without bearing children. The chains and shackles we build for ourselves! I can almost feel Ms.R’s fear when her gaze keeps darting to the Operation Theatre where the Anesthetist’s Office is.
Ms.R smiles at me. Something about that smile that shows a lot of courage, yet a hint of disappointment. I smile back at her and I hope I have enough strength in me that I can pass on to her, that will sustain her through the surgery. I hope that I pass on enough positivity to her, so that the surgery she is supposed to undergo just remains a Myomectomy.
