Scrubs

"Here," Dr. Roberts said, after he opened a cabinet and withdrew a package, which he handed Martin. "If you're coming into the delivery room, put these on."

Martin stared at the slick plastic wrap. The label read, 'Surgical Wear – Trousers and Shirt – Quantity: 1, Size: Large.'

"I assume that a large is the proper size."

"Yes," Martin answered in a daze.

"The loo is just there. No need for you to scrub but slip on booties before you enter the theater." Roberts stared at the infamous Dr. Ellingham. They man seemed to be frozen. "And don't touch anything in theater you ought not. You can touch your wife. Hand holding is good."

"I know about sterile procedure in theater!" Martin snarled.

A female yelp echoed from down the way and Martin clearly recognized Louisa's voice. "She's in pain."

"Might be too late for an epidural."

Martin winced; the thought of a needle penetrating Louisa's spine was painful. "That would slow delivery."

Roberts sighed. "But if we think the baby's heartrate is slowing…"

Martin's eyes went wide. "Then no anesthesia." He pushed open the loo door, quickly stripped off, and opened the scrub pack. The feel of the material under his fingers suddenly made the gorge rise in his throat. Coughing, he managed to force the acid-laced bolus back down. He stopped moving for a movement as surgery memories flooded his mind. But as he recalled key moments in his professional life, he heard Louisa screaming from nearby – her voice as distinctive to him as his own. He pulled on the shirt and trousers, and somehow the feel of the cotton blend material calmed him. As he opened the door he heard Louisa again, but this time she was weakly calling out his name.

The room was moderately lit but cold, and with only a sheet and flimsy gown over her, and her legs bare, Louisa shivered as another contraction started – but this one went on and on – but managing to get a breath she had to scream. In the back of her mind the primal scream seemed to say that she had power; the power to get this baby out. As her uterus stopped it's rhythmic squeezing, she got another breath. "Martin! God, Martin, where are you?" she managed to say.

Then the door of the room opened and framed by a bright background Martin hurried in.

Dr. Roberts followed, with a frown, as Martin went to her and took her left hand. "I heard…"

"Yeah…" she said weekly. "Martin, it hurts so much! I…" Then it started all over. She was able to not scream, but just. After another two minutes or so, her head fell back on the pillow. "God. It hurts… a lot." She bit her lip.

Martin winced as she said it. He turned towards Roberts. "She needs an epidural."

Roberts nodded. "Precipitous deliveries… uhm…"

"The bones of the pelvis are much compressed. Yes." He faced his wife. "Louisa, we can give you anesthesia."

"No, no. I want to be awake!"

"Yes. But we'll inject numbing agent into your spine, in the lumbar region, to give you relief. You'll still ne able to push, when needed." He gulped. "And wide awake to see the birth of our child."

Her fingers clutched his. "Okay…" she said, "And here comes another one…"

Roberts stepped forward. "I'll apply an electrode in a moment." A nurse prepared the instrument, which would be attached to the scalp of the child. When Louisa had stopped writhing, and he saw she was paying attention, addressed her. "Mrs. Ellingham, I'll insert this instrument," he held it up so she could see it. "We need to monitor the baby's heart."

"Okay," Louisa said in a distracted way. "Anesthesia… I WANT it," she barked out. "And BLOODY NOW!"

Roberts nodded. "Right. Get an anesthetist in here. Now." He was calm, but seeing his patient in such pain unnerved him. He had seen all sorts of births: but in this case he had concerns. His patient was in a lot of pain, reducing the frequency of contractions by using anesthesia would help both mother and baby, and last he wanted to look good for Ellingham. He'd not want to get on this fellow's bad side. Martin Ellingham had a way of not only barking, but also biting. Roberts knew of at least four doctors or nurses who no longer worked in this hospital after Ellingham's verbal attack had ravaged them.

He applied the instrument to the baby's scalp and verified there was good placement and the monitor was working. "Good. A hundred fifty BPM." He considered that normal.

A nurse came back into the room. "Dr. Roberts, the anesthetist left for a coffee and is not now answering his page."

"Well try again!" Roberts spat. "Who is it?"

"Fellowes." She replied weakly, "Yes, Doctor." Then she left.

"Bloody man. Fellowes," Roberts told Martin quietly. "Coffee likely means he's mooning over a buxom waitress somewhere. Man's a tomcat, if you know what I mean."

Martin's attention was drawn back to his wife, who was now crushing his hand in a vise-like grip. Squirming under the force on his fingers, he said, "I can do it."

"Uhm?" Roberts said.

"I am doing it," Martin told him then he turned to a nurse. "Bring that equipment over here." He got his hand away from his wife after she stopped contracting and was now moaning in a soft way. "Louisa, I need you to sit up. Can you swing your legs over the side of the bed?" He helped as she did as he asked. "Good girl." He rolled a high table to her, placed in front of her, locking the brakes on the wheels. "Now in a moment, I'll have you lean forward, heads on arms. You!" He beckoned to another OB nurse. "You'll help my wife, maintain her position."

The woman nodded assent. "Yes Dr. Ellingham."

Martin said, "Be right back." He ran to the scrub room, performed a quick disinfection, then returned, hands held high. "Gloves. Mask."

A third nurse was at his side, she held out gloves which he donned. "Right. Tray?" he asked.

"Ready," that nurse answered, indicating the instruments ready behind the laboring woman, who was contracting painfully once more. The nurse got a mask onto him and now prepared, at least medically, he was ready.

Martin went behind Louisa and reached across the labor table. "Louisa, I'll be disinfecting your lower back. You'll feel the cold fluid."

Louisa, engaged in trying to push what felt like a very large and firm football out her pelvis heard him. "Do it," she grunted.

Martin swabbed her bare back, after counting the lumbar vertebral bodies, to find the proper spot. Just there between L3 and L4. He found the spot, picked up the syringe with the attached large bore needle. When he realized that Louia had stopped straining, he was ready. "Louisa first a local injection. You'll feel a little prick. Louisa, I'm inserting the needle now. Don't move."

"Yes," Louisa moaned. "Hurry up. Another one is coming one!"

Martin waited thirty seconds for the local to start working. "Bigger stick, Louisa." He pushed the epidural needle into her skin (her lovely skin – oh my god – Martin don't foul this up!), advanced it a centimeter through the fat and muscles of the back (not her back – he could not bear that thought) another few millimeters, and felt the characteristic 'pop' as the needle penetrated the dura.

Breathing through his open mouth, he announced. "I'm though the dura." He slightly withdrew the plunger, and when he saw clear fluid extracted, he was in the proper spot. "And into the epidural space," he announced, then he disconnected the syringe and then attached the catheter. A bit of tape and all was ready.

Martin realized that Roberts was right next to him. "Good technique," he said into Martin's ear. "Good hands." Roberts gave Martin the next syringe, filled with the anesthetic. "Steady."

"This might feel cold to you, or warm," Martin told her.

"Just do it, Martin," Louisa answered, gritting her teeth.

The anesthetic went it. "Now, just sit there for a minute, please," Martin told her.

Louisa muttered with half a laugh, "I feel like a car being serviced for MOT."

Martin been breathing through his mouth, and then with his heart thundering in his ears, he forced himself away from the table, hot bile rising. "Sorry," he said as he ran into the scrub area, tore off his mask and vomited into a bin.

Through the closing swinging door, he heard Louisa tell everyone, "Sorry about that. He does that sometimes."

Martin threw up some more.

Author's note: I know someone (an anesthetist) who gave his wife an epidural during her third delivery. The nurse anesthetist on call was on the way by car, but had to drive to the hospital.