Ob-gyn ERs are useless without enough staff

2008/10/25

As the term "ob-gyn" suggests, obstetrics and gynecology usually get lumped together. But while women consulting obstetricians are usually expectant mothers, those who come to see gynecologists are battling illnesses that affect women.

Naturally, the two groups of patients are hardly in the same frame of mind when they visit their doctor. Yet, some hospitals treat these two groups as one and the same.

Sokun Tsushimoto, a Zen Buddhist monk-turned-physician, recounts his internship in his book "Soi toshite Ikiru" (Living as a monk-doctor) from Shunjusha Publishing Co.

"Life, old age, sickness and death are all there (in the ob-gyn department). As an outside observer, I cannot help thinking that the patients in both groups must have uncomfortably mixed feelings at times," he writes.

Childbirth is a painful but exhilarating process. Yet, it is deeply disturbing to realize that even today in central Tokyo, a mother puts her life on the line during labor.

Earlier this month, a 36-year-old pregnant woman who was near her due date and suffered a cerebral hemorrhage was turned away by eight hospitals before she finally was admitted. She later died.

The first hospital to refuse her was a Tokyo metropolitan facility that is designated as an emergency prenatal and neonatal center.

Yet, the hospital's obstetrics department did not have the required number of doctors, and there was only one doctor on duty during the weekend when the pregnant mother needed help.

Other hospitals that refused to treat her were also well-known institutions. Some gave the excuse that all their beds were filled. I picture in my mind a cluster of deluxe, central Tokyo hospitals with their doors shut tight at night, despite the fact that they are supposed to provide refuge to any woman in need.

What is the point in having such facilities if they are desperately understaffed? I've heard that medical students now avoid specializing in obstetrics because of the grueling workload and the high risk of litigation.

With obstetricians so stressed from overwork, I suppose they can hardly afford to celebrate the births of babies.

Tsushimoto says: "Buddhist monks preach 'life' in general, and doctors try to save individual lives. Every life is a part of the eternal, infinite 'network of life' in the broadest sense of the term."

Yet, this network of life is in danger of unraveling.

In the above case, the young mother's baby was delivered safely. Years down the road, I wonder what this child will think about its mother, who sacrificed her own life for it.

A new life in exchange for an older one. Both make us stop and question the meaning of existence and the purpose of this nation's emergency medical system.

--The Asahi Shimbun, Oct. 24(IHT/Asahi: October 25,2008)