Blood Relatives…WHO?

“Sir there is a rupture uterus. She is looking very pale. We are arranging for blood. The anesthetists have been called” – it was a typical call from one of the junior doctor on duty from the labor room in the middle of the night. Such calls instantly awaken and put the consultant-on-duty in alert mode.  As I accelerated my car on the nearly deserted roads in the middle of the night, I did a mental rehearsal of what all complications and challenges I was likely to face and what all should be done. No wonder rupture uterus is called “electric emergency in obstetrics”. It is a potentially catastrophic event during childbirth by which the integrity of the uterus is breached. It is a life-threatening event for mother and baby.

Rupture uterus: Baby dead, mother endangered

As I was racing up the stairs to the labor room operation theater, I passed a junior doctor. He was obviously breathless hurrying back from the blood-bank carrying two units of blood in his hands. It must be for that patient in shock. I asked him “Why did you go personally?” The reply as expected: “Sir, all relatives have disappeared as soon as we told them to replace blood. The helping staff in the operation theater is very busy helping the doctors as this patient is critically bad. So I went personally. She may die, sir!” (We had a system in the hospital for patients requiring blood transfusion wherein relatives were encouraged to replace blood.)

Blood bag

Once in surgery, I quickly did what was to be done and the patient stabilized. As I looked up from the surgical field, I saw two units of blood running fast into her veins. I could also see two more units of blood ready to be transfused once these got over. I inquired “Who amongst you gave blood for this since the relatives have disappeared?” As expected two were donated by the junior doctors who were actually assisting the surgery and two others were from undergraduate M.B.B.S students who were watching the surgery. Such a routine scenario! We all had a knowing smile on our faces.

Blood donor's smile

Surgery successfully over, I came out of the operation theater and while I was descrubbing I requested the nursing staff to call the relatives of the patient. I wanted to brief them about the condition of the patient. The nurse meekly said: “Sir she has no relatives”. I could guess that she must have seen the picture of no one coming forward as a relative of the patient when blood replacement must have been asked for surgery. I smiled cryptically. I went to the area where relatives of patients wait and just announced: “Who all are the relatives of Mrs. X (Name hidden)? She is out of danger now!” and like a miracle 15 to 20 apparently healthy and young people sprung up: “Sir we all”! I briefed them. Then I said “She will require two more units of blood. She has lost blood considerably”. Immediately most in the group stepped back. From the corner of my eyes I could see some of them actually leaving. Only two remained who immediately blurted in chorus: “Sir we are not her blood-relatives. We are just neighbors”. “Who is her blood relative then?” An absolutely frail looking old woman was forwarded by them “She sir, only she”. “No other blood relatives?” I smilingly asked. Their eyes went blank and as if aimlessly they started looking at the junior doctors who were standing with me!

Ironical smile

As I started my car to go back home I couldn't help wondering: who were her relatives – her husband? her brothers? sisters? uncles? aunts? parents? or the doctors who rushed to save her life with their own blood - donated blood for her, came and assisted in surgery and will now take care of her all throughout till she goes home?  This idea just looped in my mind again and again that night “Blood relatives who?”