Fate, is that you?

So, this is the story from my emergency duty, which is every Friday, and after an year at KEM Hospital, each Friday switches on my flight on fight response for the whole day; even the eight Fridays where I was posted elsewhere, I was so jittery and I realised I had been programmed now to take on every Friday with the same spirit.

Anyways so it was evening 7pm, me having missed my lunch, was surviving on the tea from the themos we had asked Sundar chaiwala to spare till we could finish drinking. I am the only one in RR and have 4 patients lined up. I tried triaging them, but I realised it was pointless as all of them needed an immediate assessment. So I started with history, examination and taking senior opinion to admit them to labour ward and some directly to be prepared for surgery. 

So the last patient had come with fever at full term gestation. She has been referred from a peripheral hospital and her referral sheet (to be noted) mentioned patient with fever, not in labour, (query) ? leaking per vaginum; and was referred to emergency medicine (to be noted) in the morning. There patient spent time waiting in line and when it was her turn, the medicine resident elicited history (to be noted) of leaking per vaginum since 2 days! And she was sent to RR, it was nearly 7 pm when she finally reached us. I took her to the examination table, simultaneously eliciting history. She was running a high fever, her vagina was warm, her counts were high and she was already in active labour. My senior came to RR and relieved me to have lunch. I handed over the case to her after writing down my findings. In my mind it was clear that her labour would be short and so we could let her progress, it was a matter of couple of hours, however my senior told me that even those few hours would be critical and we need to expedite the process as much as possible and so we will have to operate her. I went to have some food, and returned, by then the decision of emergency caesarean section was given and patient was prepared for surgery. We still had to wait for her blood to be cross matched and in the meanwhile I had noted scar tenderness (previous 3 lscs) in a waiting ward patient and had asked to get her shifted to OT, that being more of an urgency was prioritised. I went to assist that case in the OT and as soon as the OT table was available for the other patient, we called to shift her but we were informed that she was just about to deliver normally and there was no point in shifting her to OT. So she delivered, but the liquor and baby were stinking of the very typical foul odour clearly pointing out that chorioamnionitis had set in. Meanwhile the relatives were all happy and celebrating the birth oblivious to the medical details. The neonatologist informed us of multiple neural tube defects in the baby, and that the baby was shifted to NICU on double inotropes and second line antibiotics. At this point I wonder if it was wrong on the part of fate for the whole episode from right from scans missing birth defects, patient reporting late to hospital, peripheral hospital missing PROM, her having to wait in medicine department so long, then OT being busy for 1hour and her having to go through normal labour or, was it right in the part of fate that she was spared of having to undergo a caesarean section for a baby that doesn't have a good prognosis?