Deplorable consequences

The chief danger lies in the possibility of a spontaneous rupture of the uterus…

Spon-tan-e-ous…

If in introducing his hand into the uterus the obstetrician encounters any hindrances to penetrating to the foot, whether from lack of space or as a result of a contraction of the uterine wall, he should refrain from further attempts to carry out the version…

Good. Provided I am able, by some miracle, to recognise these ‘hindrances’ and I refrain from ‘further attempts’, what, might I ask, am I then supposed to do with an anaesthetised woman from the village of Dultsevo?

Further: It is absolutely impermissible to attempt to reach the feet by penetrating behind the back of the foetus…

Noted.

It must be regarded as erroneous to grasp the upper leg, as doing so may easily result in the foetus being revolved too far; this can cause the foetus to suffer a severe blow, which can have the most deplorable consequences…

‘Deplorable consequences.’ Rather a vague phrase, but how sinister. What if the husband of the woman from Dultsevo is left a widower? I wiped the sweat from the brow, rallied my strength and disregarded all the terrible things that could go wrong, trying only to remember the absolute essentials: what I had to do, where and how to to put my hands. But as I ran my eye over the lines of black print, I kept encountering new horrors. They leaped out at me from the page.

Extracts from the short story Baptism by Rotation by Mikhail Bulgakov (1891-1940).

Commentary

Awoken by a nurse in the middle of the night, a recently qualified young doctor has to perform a delivery of a baby in transverse lie without much experience in obstetrics. Like several other stories set in the countryside (written by Clement Gunn, John Berger), the short story carries a sense of adventurousness and urgency to act swiftly as the skilled professional in an understaffed and remote area. There’s no such thing as “not on-call” when you’re a country doctor in the 1900s.

Mikhail Bulgakov (1891 – 1940) was a Russian physician-writer. He had a wide-range of interests – theatre, opera, Medicine, Russian and European literature. He worked as a surgeon, a physician, a journalist and a writer. He eventually chose writing over practising Medicine. His satirical sense of humour and the realism that’s ever-present in his writings, brings his characters back to life.

More info

  • Mikhail Bulgakov – Britannica link for more information about the author.
  • Baptism by rotation – The short story in Doctors and Patients, An Anthology edited by Cecil Helman
  • Transverse lie – UpToDate information used under commentary and for more info.
  • Albert Döderlein – Döderlein’s operative obstetrics is the book that’s being consulted by the young doctor in the story. Professor Albert Döderlein was a German obstetrician and gynecologist.
  • Featured image: A birth scene (circa 1800s). Oil painting by a French painter (unknown), Åbo, Sweden (later Turku, Finland), 1800. Iconographic Collections.

Contributed by

Lekaashree Rambabu

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