Hitting the Curve

Just the other night I got a page to run and do a crash section. A special 4 digit number comes up on the pager and you don't call it, you just run or at least walk briskly to L&D. I called anyway, since the rookie secretary might not have known what she was doing.

Her response to my, What's Up was, "I don't know what's goin' on back there, but everybody is in room 11!" This was a little different than the quick and concise message I am used to hearing from a more experienced secretary, so I quickly made my way to L&D.

When I came on the unit, a bed was coming out of room 11. This means the patient was being "wheeled back for a section". Sections cannot be done in delivery rooms, they must be done in an operating room, so when the expectant mother starts to crash, the bed rails are put up, the lines are taken off the wall and away you go. And these beds are large. Getting one disconnected and put into motion always reminds me of a ship casting off a dock, since it involves teamwork, and planning ahead. At least two people are needed to maneuver a bed quickly through a hospital, with another running ahead for doors, obstacles or clearing and holding an elevator if needed.

The bed coming through the door and into the hallway had a nurse pulling it by the foot and two nurses pushing it from the head. There was also a nurse in bed with the patient. She was on all fours between the patient's legs with one hand all the way in the patient's vagina, practically up to her elbow. There were also people running ahead to prepare the OR, and an entourage trailing, consisting mainly of worried family members and a couple of MD's trying to explain things to them. The patient was moaning with her head back, wide eyed and probably scared from the sudden burst of activity and purpose she witnessed in the staff.

The reason Karie was in bed with the patient, with her hand deep in the patient's vagina, was because of a prolapsed cord. This means the umbilical cord, which is supposed to come out behind the baby, decides to comed out first. A loop of it slips past the baby's head and into the vagina. The moment this happens a C-section is needed. The cord will always be occluded between the baby's head and the cervix, resulting in a dead baby. Karie's job, until the baby was out, was to push the head of the baby back up into the uterus just enough to take the pressure off the cord. If she let go, the head will descend enough to cut off the blood supply from the placenta, killing the baby.

Having quickly assessed the situation, I replaced the nurse at the foot of the bed. This is the steering position when it comes to hospital bed navigation, since the bed will generally go where the front of it is pointed. There were two nurses in the back, and their job is mainly to push. They are like the engines of the bedship. It's actually harder to pull and steer than it is to just push the bed, which is why I usually take that spot from one of the nurses. One also must sort of "block", or push various wheeled items to the side when going down the hall. In this case, the entire unit (about 8 nurses) had left their patients in their respective rooms to help, so the hallway opened up before me like the Red Sea. Flush with adrenaline, and seeing the open hall, we really started to move.

Near the end of the hall on the left, there are large automatic doors that open into the surgical suite. A nurse had already hit the wall-button, and they swung open. We were getting closer to the left turn with a full head of steam. We were sort of at a trot, with 350 pounds of human on a 400 pound bed. Seeing the door approaching, I began to get a little concerned about our speed versus negotiating the curve. I was right - we were simply going too fast for the curve, and I yelled, "STOP!!". The two pushers very effectively reversed their thrust and locked into a pulling posture, feet sliding across linoleum tiles. I also began pushing on the front of the bed to slow it down, while turning into the doorway. We were going to make it.

The problem arouse with my concern for Karie, who up to this point had been diligent in her job of riding on the bed backwards with her ass in the oncoming breeze, her hand deep inside the patient's vagina. In the confusion and adrenaline rush to save the baby, the rails had not been put up on the sides. This means that my decision to avoid the walls and rapidly turn the bed on deceleration could prove costly should Karie roll off the edge. Because I was closest, I made a move to steady her.

My free hand flung to hold her steady while I yelled, "HOLD ON, KIDDO!" Being that her backside was the only part of Karie available for me to grab, I suddenly felt a fleeting moment of social reservation and stopped my hand. Alas, it was too late. No sooner had I made contact with her left cheek, when I quickly withdrew. It amounted to a very sudden and forceful slap on Karie's defenseless ass.

I noticed she jumped. Her buried hand must have moved, since the patient also jumped and let out a yelp. I also noticed the two pushers, who had looked forward to see if we were going to hit anything, stare wide-eyed at me. Without missing a beat, Karie yelled back, "I HEARD YOU!"

I must have looked like a cowboy. First yelling hold on, kiddo , followed by a robust slap, the patient's family probably thought the hospital recruited their PA's from the state of Texas. One of the pushers, having resumed forward momentum, asked me if I had actually just slapped Karie's ass. There was no denying it. I said nothing and just kept pulling. I should have grinned and screamed, "YEEEEEHAW, THAT'S RIGHT, FOLKS!!"

Ultimately, nothing came of it. The section was done quickly and efficiently and the baby was fine, and Karie, being as comical as your average L&D nurse, thought the slap was hilarious regardless of the reason.

I was actually able to quickly laugh with her about it during the surgery, since she was also on the operating table, between the patient's legs, under the sterile drapes, still keeping the baby alive until we got to it.

She kept her ass down, though.