This is now, that was then

Two nights ago we were woken up and rushed out to the hospital to assist an emergency c-section.

The story was arrest of labor, bordering on 8 hours with no progression.

Now there´s no anesthesiologist in Requena (there aren´t even surgeons, the general practicioners do six months of training to be able to perform emergency appendectomies and c-sections) so all surgeries take place with only an epidural.

After about 4 hours of frantically trying to round up the necessary surgical equipment and an IV catheter (which took close to three hours to find on its own) we were ready to go, only to discover. . .
No lidocaine.

Without lidocaine the insertion of the epidural needle is too painful to be realistic, so there was no way to procceed with the surgery.

We were now approaching 12 hours of stalled labor. The only option was to put the woman on a "fast boat" to Iquitos, the nearest large city. This involves a 4 1/2 hour boat ride, a two hour ambulance ride, and then the inevitable delays in the hospital itself to gather the surgical equipment (which the family has to buy for themselves) and round up a surgical team.

Luckily at this point the baby was like "screw this" and decided to poke his head out and be born the normal way.

All ended well, but for the want of one vial of a medicine that abounds in emergency departments throughout America (the laceration cart at both ERs I spent time at has at minimum 4-5 half used vials in it all the time, we routinely throw away 2-3 vials per shift if they´ve been opened too long), this woman and child were nearly lost.