News Review
8 NOVEMBER 2024 ausdoc . com . au
My most memorable day as a doctor ?
Only connect : My t
August 2001
Dr Geoffrey Mullins
Perth , WA
“ I VONT to do an emergency caesar , quick !” the Dutch doctor ’ s voice crackled from the heavy handheld emergency phone I had been issued but had not yet mastered .
Andre was a tall , good-natured GP who had been working at Dili Hospital for over a year and did much of the obstetrics as it lacked a permanent specialist obstetrician . These were the days of UN peacekeeping troops in East Timor after the long occupation by
Indonesia had finally ended . I had warmed to Andre immediately as he was one of the very few people who spoke some English and he had an air of confidence that was reassuring .
He told me the operating room was already preparing for the procedure ; he would be there in 30 minutes and hoped I could have the patient anaesthetised and ready by that time .
This was my second day as the only anaesthetist and I was already finding my job challenging .
The hospital lacked many things and was greatly in need of specialty medical staff , technical assistance , equipment , drugs .
Miscommunication
By far the greatest difficulty I faced however was the language barrier .
The languages spoken in East Timor are Indonesian , Tetum and Portuguese . Apart from a few expatriate medical practitioners , very few of the 300 plus East Timorese staff spoke English . It was also rare to find a patient with any understanding of English .
When it came to the operating room , my initial approach was that commonly used by English speakers when faced with the non-English speaker .
I would speak very slowly , opening my mouth wide and carefully enunciate the words .
Next , I would raise my voice in the hope that the loud English words would penetrate further into the brain of the listener — perhaps to a part of the brain that somehow understood English .
Finally , if my listener still had that gentle bemused look that I was becoming very familiar with , I would reach into my pocket for my Indonesian – English dictionary .
I would then find the appropriate word and point at it repeatedly while staring at my listener hoping for some indication that all was now clear and they understood what in the hell I was talking about .
So , on my first day , when confronted by a patient who developed a very fast heart rate , I decided this was an excellent opportunity to begin my teaching sessions with the nurse anaesthetists .
I soon had the attention of the entire operating theatre staff .
With a raised voice I slowly and loudly enunciated the words “ too fast ”.
I then pointed at the rapid ECG trace on the patient monitor and repeatedly said the words “ too fast ”.
Unconvinced that I was being fully understood , I took out my Indonesian – English dictionary , found the word “ fast ” and pointed at the word and then the monitor .
To my delight the two nurse anaesthetists suddenly both smiled knowingly but then strangely began to make blowing noises through their pursed lips much to the amusement of all the operating room staff .
Somewhat bemused I finally looked down at the dictionary and found my finger had inadvertently been pointing at the word “ fart ” immediately above the intended word “ fast ”.
This incident thankfully helped me establish a casual rapport with the staff which lasted for my stay at the hospital .
The delivery
But I digress . In response to Andre ’ s request for help with the emergency caesarean , I hurried to the maternity ward to see my first obstetrical patient in Dili .
It was obvious she was severely distressed being in strong labour with dangerously high blood pressure and signs the fetus was being starved of oxygen .
I hurried back to the operating room closely followed by the patient on a trolley . Two operating nurses were busily preparing instruments as I moved the patient onto the operating table and positioned her on her side in preparation for a spinal anaesthetic .
I was about to start when she suddenly had a strong painful contraction . I stopped my preparation and began to massage her back while murmuring soft