From the Bedside to the HMO

A few weeks after I arrived, our first real emergency occurred. A patient,Donna, who had been receiving her obstretical care in Billings, Montana, up to that point presented to the hospital with major hemorrhaging. She was pale, going into shock, and we had to act quickly if we were to save her life. She had what is known as placenta abruptio, and it occurs when the placenta separates prematurely from the uterus. Small separations can be treated conservatively with bed rest and fluids, but a major bleed like she had required immediate transfusion and a C-section. Well, we had no blood stored in the lab refrigerator, no anesthetist, no pediatrician, and no second doctor to assist. "She looked at me and said, "Doctor, am I going to die?" "No I said, but we will have to act fast." We did have a walking blood bank, and within a few minutes we had two donors lying on the table, donating blood. While one of the nurses was preparing the surgery room, I found the spinal anesthetic tray and gave her a spinal. With the hospital administrator as my assistant, I began the operation. The surgery was fast but successful and soon Hardin had witnessed it's first C-Section since the hospital had opened. "Is this the was things are going to be in the future?", I thought to myself.