 What is the inspiration for the simulator's name?
I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. By slipping a hand round and below it they can easily guide the baby out. As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place.
 Its use of literary device
 Its emotional connotations  Tydeman's mother  Tydeman's wife  Its use of literary device