Fortunately that situation ended well with the cesarean birth of my sister.
So it was not altogether unfamiliar 47 years later and a world away in Venice when my wife called me to announce that she was hemorrhaging heavily. The situation was somewhat different - I was an adult, a physician; we were in a foreign country with a foreign language and medical system. Despite these differences, the emotions this situation evoked were all too familiar - an overwhelming fear bordering on panic. A part of my mind was objectively commenting on my reaction making note of the fact that I was trained in dealing with medical emergencies so why was I so discombobulated? The difference of course was not only the unfamiliarity of the landscape but also the familiarity of the "patient". The stakes were definitely higher.
When Marguerite passed out and took what seemed like forever to regain consciousness, going white as a sheet and emitting short sonorous noises from her foaming mouth it heightened my concern. The bleeding was moderate and didn't seem life-threatening but accessing medical care was going to be a challenge. If she fainted lying down, the likelihood of walking 10 minutes to the vaparetto and enduring a 30 minute boat ride to the hospital in the upright position was small. Should we wait and see if it would stop? Should we call 911 (or in this case 118) and get an ambulance? How would I explain where we were? What was the cost of an ambulance? How long would it take for them to get here?
Finally I took the proverbial bull by the horns and
called 118, and after a bit of back and forth between myself and the operator,
communicated (I thought) within reason what the situation was. After
asking if she had any medical problems and if she was conscious the operator
said she would dispatch an ambulance and it would be there "soon".
Ambulances in Venice are large motor boats. We had
laughed as we passed them parked in front of the hospital on our way into
Venice never thinking that we would be the recipients of the grand canal tour
in one 2 short days later.
I was torn between staying with Marguerite and going
down to the "street" to await our saviours. The distance between the
two involved 3-4 flights of narrow 18th
century marble stairs, a jaunt across a courtyard and through 3 doors, all of
which closed locked. I made the trip back and forth 4-5 times before finally,
after 20-30 minutes of these round trips, I saw 3 guys wandering somewhat
aimlessly toward me. This vision was not what I had anticipated. I had in mind
bells and whistles, lights and sirens, high speed approach, and
controlled recklessness in landing directly in front of our apartment the
resultant wake flowing up and over the canal wall onto the sidewalk, lightly
soaking my waiting feet. These fellows' approach was more subtle and reserved
having parked 1 block away with no fanfare. They seemed neither in a
hurry nor equipped for an emergency. They were wearing orange rubber fireman
like pants and white polo shirts. They were pushing an object which appeared to be a cross between a
wheelbarrow and a rickshaw. No first aid bag, no oxygen ..... nothing. It made
me wonder if I had somehow undersold the situation to the 118 operator.
After we established with my non-existent Italian and
their marginally better English that they were indeed the help I awaited, I
directed them into our apartment and up the stairs. En route 1 of them
(presumably the designate English speaker though that was questionable) took a cursory history and asked whether
my wife could walk down the stairs. I replied that I thought not given that she
had already fainted once and was wired to faint at the drop of a hat at the
best of times.
After a brief assessment and, I suppose not being overly
impressed with our blood offering, they attempted to get her up. No half
measures here (let's sit her up and see how she does with that and then get her
standing). No, they took her by the hand and in 1 fell swoop jerked her into
the standing position. Simultaneous with this maneuver the faint residue of colour in my wife's complexion
vanished and approximately a liter of clot and blood plopped on the floor and
splattered outside the bathroom into the hallway.
There was a brief moment of awkward silence following
fast on the heels of the splashing plopping sound created by the blood/floor
interface.
It was at this moment that plan B went into effect. One
of the keystone cops was dispatched presumably to return to the boat for some
equipment, and the patient was placed in the modified wheelbarrow and taken
down a short flight of stairs to a narrow hallway/landing. I was instructed to
get some clothing for her. When I returned she was sitting partially reclined with an attendant slapping
her ashen obviously unresponsive face having entered her second faint of the
evening. I assisted them in getting her more horizontal and when she came to
under the therapeutic administration of more slapping she promptly vomited -
spinach and ricotta cheese ravioli which, through the effects of gravity wound
it's way down between the space between her neck and shoulder ridge, seeping
down into her upper shoulder blade region. This display coupled with the
impressive faint seemed to in some way trigger plan C - incomprehensible urgent
words were exchanged between the remaining 2 attendants and 1 ran down the
stairs and presumably out to the ambulance. I was left in the narrow hallway
attempting to clean up the vomit, and administer a cool cloth to her forehead while the remaining orange pant clad Italian
maneuvered the wheelbarrow either up or down depending on his patient's
apparent alternating likelihood of fainting or puking again.
After a seemingly interminable time with increasing
concern and impatience I grabbed the front of the transport device and
indicated that I would assist in getting her down the stairs. 1 short flight
was all the attendant would agree to and shortly later his cohorts arrived back
on the scene with a bag of equipment and quite handily went to work starting an iv and covering her with sheets.
I was designated to hold the iv bag and we commenced
down the remaining 2 flights of stairs, through the courtyard and down the
street to where the ambulance was docked.
We took off and sped through the canals with blue lights
flashing. The only disappointing thing was the lack of a siren the presence of
which would have completed the scene. Apparently we created a bit of a
stir as tourists on bridges and passing water taxis took video and still
footage of the event as we flew by.
Arriving at the hospital canal-side the stretcher
carrying Marguerite was expertly whisked through the loading bay area into the
emergency room. I followed close on their heels feeling quite ignored by the
medical personnel during the trip and disembarkment. The team entered the
assessment room and one attempted to close the door on me. After much
discussion they decided to let me stay the announcement that I was a doctor
having finally seemingly convinced them (being a husband apparently was not
adequate qualification to stay.
She was assessed and quickly transported through an open
courtyard featuring crumbling facades and ancient marble and brick floors to an
elevator which served to deliver my wife to the gyne ward and myself back to
the 21st century.
The gyne team demonstrated their efficiency by accepting
her in transfer, hurrying her into an assessment room and slamming the door in
the face of the quickly pursuing, objection raising husband/doctor. This time neither credential was sufficient
for my admittance to the inner sanctum.
The outcome ultimately was that they were going to try
to control her bleeding with medication overnight and reassess the situation in
the morning. By this time it was midnight and I was unceremoniously advised to
leave. I felt quite unprepared for the task of returning the 3-4 k trip to our
apartment - a somewhat dazed brain and a iPhone gps running at 10% power where
my tools. I felt a bit like I was setting off on the amazing race with no map
or sense of direction with which to arrive at my intended destination.
After floundering around somewhat aimlessly for 30
minutes hoping to see a familiar landmark and sparingly doling out short
glimpses at my failing gps, I asked for help from an American couple studying a
map. They pointed me in the right direction and, a vaparetto ride and multiple
dark narrow streets later, I arrived "home". After saying a short desperate prayer and taking stock of
the unusual feeling in my stomach (like I had just free-fallen 10 stories in an
elevator), I fell into a dreamless sleep.
To be continued.......
