Saw a young woman with intellectual disability who had uncontrollable epilepsy associated with areas of cerebral atrophy. She has been free of seizures since excision of a temporal lobe and hippocampus three years ago.They are hoping I can help with her constant slight urinary incontinence. It is probably a cerebral problem, but all possibilities are being investigated.
Asked if she had ever had sex she said, "He tried but he couldn't do it."
Although twenty three years old she attended with her guardian who asked her why he couldn't do it. She said, "Because I didn't let him." This was all news to her guardian - I think they might have more discussion on the way home.
Too busy for lunch then ran to the labour ward for a GP having a difficult delivery. The head was nearly on the perineum but the vacuum cup kept detaching while the baby's heartbeat was difficult to detect. The patient had an epidural so couldn't push very well. The head had rotated enough to apply forceps which still required some effort as the shoulders were stuck. After some manoeuvres the large baby was delivered in good condition with the perineum intact. No tear but a lot of tears.
After the birth,the patient's mother said that she had watched me deliver her other daughter with forceps only two weeks ago. I thought she looked familiar.
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