La silla!

This word was a huge part of my everyday life at work in the DR. “La silla!” refers to the wheelchairs in the hospital that have seen their better days. These wheelchairs, probably thrown out every day at some hospitals back home, are the lifeline of the hospital that I’m working at. If you are riding “la silla” that means you are too sick to walk. For these tough physicians at this busy hospital you have to be REALLY sick to merit a push on the wheelchair. For example, a woman who is septic and semi-conscious will probably get a ride on “la silla”. I say “probably” because despite the selective use of wheelchairs in this hospital, they are still hard to find.

In my time in labor and delivery, “la silla!” was in high demand. Don’t get the wrong idea, women who are 10 cm dilated and ready to start pushing their baby out are still not considered in dire need for a wheelchair and so they usually walk down the hallway across the hall to the delivery room. Can you imagine convincing a woman in the US to walk anywhere when they are completely dilated without any pain killers whatsoever?! Before my experience here, I thought it just wasn’t possible but women do amazing things here.

We do use the wheelchair often here in labor and delivery. Women who are crowning (medical word for head is almost ready to deliver) get to ride “la silla!” Of course, la silla is not exactly an awesome thing to ride. Actually it’s pretty horrifying at times. The wheelchair turnaround is fast and many times women are told to sit in the wheelchair even though the wheelchair is covered in the last patient’s (or the one before that, too) stool or blood. Sometimes, we put a plastic garbage bag or paper bag down out of courtesy for the patient before they sit down but sometimes there just wasn’t enough time.

For me, it never got easier when I had to shout at the patients to get on the wheelchair. It just felt so wrong to yell at a woman in so much pain, a woman who is about to deliver, and forcibly make stand up, put her legs together, and sit down in the nasty “silla.” I know that it’s done here this way because of the volume of patients and the different culture of medicine care here. I remind myself that they have the patient’s best interest in mind- it’s better to deliver in the delivery room than on the nasty dirty plastic mattress or “la silla” and sometimes you have to be forceful to get the patient to understand they have to hurry. But man, I sure won’t look at a wheelchair the same way ever again.